Sample Case: Gifted/Learning Disabled
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edconsult@eudoramail.com |
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EXCERPTS FROM BACKGROUND: Concerns about behavior as well as phonologically based functions surface in X’s history at age 3, simultaneous with his preschool entry. Prior to that, there were no developmental concerns. Upon school entry, concerns about self-control prompted psychological as well as language evaluations. X’s exceptional intelligence has also been well documented from an early age. Phonological difficulties were indicated in word discrimination errors (the following perceived as the same: wash/watch, vest/vexed, defection/deflection, falls/false), in function word (words high in syntactic, low in semantic value) errors during sentence imitation and in misperceptions during oral vocabulary probes (the meaning of brown given as “a brownie snack”) as well as word finding difficulties and therefore circumlocutions (the meaning of forest given as “where dinosaurs live, a branch in it”). X has also received speech therapy for frontal lisping of sibilant and palatal sounds (grade 3). Vying for control has been a theme throughout the record. The psychological evaluation at age 3 reported that X would take control by intentionally changing some detail of the directions while saying that he knew what he had been asked to do, although this interpretation fails to consider X’s phonological deficits . A kindergarten psychological described competitive/control behavior in X’s verbalizations indicating that either he or the test item had “won”. He is described also as dominating group activities (grade 4). There are vivid examples of X’s refusal to be dominated in the record. In grade 4, while X was out of the room, his teacher moved his desk without giving him notice. When he returned, he was upset and simply moved it back to its original position. In another example X managed a consequence free violation of the rules by failing to go to the rest room during the allowed time, refusing to lose points by going at an unallowed time, then wetting his pants and getting to leave the room with no reported penalty. X has had an extended year program and a one-to-one aide, self-contained placement and now home bound tutoring for one hour a day (parent report), all due to behavioral issues. IEP objectives address behavioral concerns: complete class assignments, follow rules of the classroom and games, cooperate with peers, decrease argumentativeness, respect authority. Most recently (02-03), IEP objectives suggest issues of lying and failing to accept responsibility. Dealing with frustration and awareness of others are the basis for objectives as well. X is to sustain attention during seat work and manage stress when it is a source of attentional breakdowns. He is to make transitions between tasks and classrooms more adaptively. Also in the record is a theme of difficulty with shallow tasks requiring high levels of mental effort, i.e., working memory and attention. His lowest scores have been on tests of working memory (age 3 - sentence imitation 8, age 5 - animal pegs 8, grade 1 - digit span 10, concerns regarding multistep directions, learning math facts, maintaining focus for the purpose of organization). Despite X’s ability and his achievement in some areas, there are IEP objectives for low level skills that have been mastered already. Furthermore, these same objectives are very much the same from grade 3 through grade 5. EXCERPTS FROM ANALYSIS Reading/Writing Despite X’s above average scores for reading skill (word attack, word identification) and his solid phonological competence, spelling and some reading (Gallistel-Ellis and other tests of multisyllable words) errors reveal that his actual knowledge base does not live up to the high expectations set by his scores. Spelling and reading errors suggest a failure to achieve a precise awareness of the regularities of English orthography (reading droped as dropped, spelling writing as writeing). It is most likely that low oral motor tone makes the largest contribution to X’s orthographic confusions. His articulation errors, whether reading or not (incomplete words, nonword repetition), come in longer words and often at the end of them. The actual form of the errors (mafreastum vs mafreatsun, debetain/debutante, dissolby for dissolubly) has the effect of reducing the need for transitions between motor patterns, i.e., suggest mild diadochokinetic problems. X’s comprehension is limited primarily by the fact that he does not have the experience he would need to support in depth understanding of more sophisticated passages. Some of his lack of experience is due simply to his youth. However, a good portion of it has to do with his highly restricted school and therefore social contexts which excludes him from exposure to the typical feelings and concerns of other people. His school experience has also restricted him in a more purely cognitive sense in that he has been asked to limit his thinking to formulaic instruction (formula banks for an extreme example), take it at face value even when its validating reference is completely unclear to him (see especially math findings) and to resign himself to his lack of access to what it means (see content of his writing sample). The restrictiveness of this kind of thinking is not a problem that can be addressed through reading comprehension activities per se and must instead be accomplished through changing his general approach to learning (see recommendations). Math X has the capacity for deep appreciation of math concepts. However, he has fallen short of fulfilling this potential in a number of ways. In the first place, X has tried to imitate the formulas given to him instructionally (provided with a formula bank to do his computations, approach to CVLT-C). This consigns him to an endless tautological loop that has no validation point outside of itself. He is left with a total reliance on memory since there is no base in meaning from which he could reinvent the algorithms for himself. This is a far more effortful and less sustaining way to learn than true understanding. X sees that this is so and is frustrated by the fact that he must work very hard to commit to memory something which he does not understand and therefore can conceptualize no use for and in the end even cannot manage to memorize. He is too intelligent to be satisfied with this. Further, the effort to squeeze himself into empty formula/algorithm usage has contributed to a now more pervasive problem where he feels that he cannot help himself to figure things out (broken Halloween decoration he felt neither he nor anyone else could fix, drawing to halt with computations until given some guidance for basing his moves in meaning, piecemeal rendering of the ROCF with the open admission that he doesn’t know where it is all leading, content of his writing). This leaves X in the untenable position of being totally dependent and therefore totally under the control of others for the sole purpose of pleasing them by performing steps that for him have little meaning. Control issues are unavoidable under these circumstances. The fact that math instruction has been divorced from those experiences that yield meaning (draw a picture of a fraction; recognize the relationship between place value, the laws of distributivity and the long division algorithm) has left X without an opportunity to develop those intuitions that come from meaningful experience; those intuitions that provide the basis for appreciating when a concept or algorithm applies. Without this foundation, X cannot use current learning to build to further learning or use previous learning to provide grounding for current learning. He is again in the untenable position of giving up control to adults on whom he must now rely for magical information, information whose grounding alludes him. Cognition In the context of a history of increasing insistence on behavioral (behavior management programs and classrooms) and academic compliance (repetition of skill work especially in math), supported in part by various medications, X has failed to learn the degree to which he can and should assert himself. He is too compliant academically (math computations, CVLT-C, ROCF willingness to copy the model without a grasp of the underlying structure), trying to do things the way he’s been shown rather than use his own very ample intelligence to find what is meaningful. Ironically, X is most “compliant” behaviorally (this testing) when he is allowed to assert his intelligence in a way that allows him to find what is meaningful to him. This often means making errors, experimenting and revising. X does have patience for this. Where he lacks patience is in the mechanical exercise of formalisms that are empty for him because he does not see what they mean. He lacks a similar balance in intelligence and the experience which allows for intuition to guide his thinking. Given his highly restricted curriculum, first in a self-contained class with narrow objectives repeated from year to year and his exclusion from the social experiences of school while on homebound instruction, X has not been able to have enough experience to perceive the patterns and regularities in social situations as well as in other information fields for which his intelligence is especially well geared (Raven). Inadequate involvement with those direct experience (the result of an overly restrictive, repetitive, narrow set of objectives) that would lead to perceptually based insights and intuitions is reflected pervasively in X’s academic performance. He has not intuited what the long division algorithm is all about. Nor has he understood the nature of fractions well enough to draw them easily or to use the concept in problem solving (applied problems, length/weight problem). It is also seen in his failure to pick up orthographic regularities when they are less obvious, i.e., multisyllable words. It is suggested in the record and in X’s own statement about preferring to play with children either younger or older than he, i.e., he does not have the understanding of more subtle, same-plane interactions between those who are peers. In the end he seems to have over simplified personal interactions into those in which one person controls or dominates and the other complies, very much the model to which he’s been exposed in school. This pattern seems to be a result of highly biased experiences resulting from ever increasing control battles with adults. It is not an essential part of his cognitive or behavioral profile. In fact, at this testing he was easily brought to a more open, receptive, exploratory frame of mind. Once there, he is not only happy and socially engaging, he is able to use his very ample intelligence to learn at the most essential and meaningful level in almost no time at all. In these situations he does best with THE LEAST POSSIBLE AMOUNT OF DIRECT INSTRUCTION and the greatest opportunity to be helped while putting things together for himself. Lack of these kinds of experiences has led to the secondary handicapping condition of believing that problems cannot be solved without direct, formulaic instruction (long division, fractions, theme of writing, broken Halloween decoration). Oddly, despite the concerns about X’s noncompliance, he does attempt, to a fault, to comply with the exact form of instruction (CVLT-C, ROCF, effort to execute math algorithms correctly). When he is “successful” in this empty imitative process, he loses the deeper structure of the information field (CVLT-C, ROCF). For the most part, his attempts are ineffective any way since it is nearly impossible to memorize large amounts of discrete information without any consolidating framework (ROCF especially, loss of information on the CVLT-C, failure to commit math algorithms to memory). RECOMMENDATIONS 1. Above all else, X needs a rich curriculum with the opportunity to explore and use his resources to understand. In that curriculum, X will need to begin the long road back to realizing that learning requires one to take the initiative to uncover meaning rather than copy instruction. 2. In conjunction with the above recommendation, indeed implied in it, is the need to have a total an immediate ceasing of the control battle since each assertion of control only escalates the counter response to it. Clearly the adults will need to be the first to let go. The following would be necessary in order to both help X resolve his control issues as well as create a productive learning environment for him: Create or find an educational context that X finds engaging. This means enriched content with opportunities to explore information directly and deeply. Possibilities for existing programs might be in Montessori schools or magnet schools dealing with art, music and/or computer animation. Bypass the need to be micromanaged by adults and instead establish the opportunity to learn as a result of direct interaction with the information field. Adult assistance should be given to help X make the most of his own initiatives (as in the prompts during math testing at this evaluation) and never to provide a prescription that is meant to be followed. When there must be consequences of his actions, they must be natural consequences. They must NOT be contrived (points, free time penalties, time outs...). For example, if X damages something, he must fix it or work to earn the money to repair it. This is one more way to eliminate the presence of adults as arbitrary control agents. Avoid the use of drill and practice as a way of learning with X. When he does comply with it (CVLT, ROCF, math computations), it causes him to have shallow, narrow and virtually unusable information. When he does not comply, he is in trouble. This is a completely no-win situation for X and cannot be allowed to continue. Most of X’s resistance seems to come from a feeling of being forced to do things that have no meaning for him (algorithms for fractions and long division for which he has been given no explanation). When he responds with resistance, teachers will need to take that as a signal that they have provided inadequate instruction; inadequate in allowing X to use the provided context to find meaning. In no case should X be “helped” by giving him formulas to follow, most especially formula banks. 3. As a crucial part of an appropriate curriculum for X there will need to be intentionally planned opportunities for him to develop his interests. This is essential to X’s regaining enough trust in his school environment to be willing to trust that compliance with it will not be a source of personal compromise or defeat for him. At the least the following will need to be included: support from an informed computer programming consultant or field expert who can show X how to use the computer to work with color and graphics as well as animation in a way that supports advanced computer applications and offers an alternative to his current interest in violent games (see below as well). support from a teacher who can guide X in using his interest in music, visual and film arts to complete assignments and enhance learning activities. support in helping X use his intuition for performance art (especially of the confrontational kind) as a way to transform his objections into a constructive form of self expression. 3. Math instruction will need to follow from the above. All operations need to be taught in their essential meaning. For example, adding fractions with unlike denominators can be done with a series of drawings or trading of manipulatives, likewise for equivalent fractions. X needs to know that all of these procedures gain their validity because they are based on the principle that multiplying by 1 maintains the identity of the original number. Explanations should be based on X’s own attempts to find meaning. In the long division example, his approach (subtracting by groups of 25) should be written out as a computation for him and then translated, step by step back to the traditional algorithm. 4. X would be encouraged to develop his writing primarily by asking him substantive questions that help him develop his ideas more completely and more intricately. Additional detail should come as a result of asking X to connect ideas and pursue their implications not as a goal in itself. He enjoys these kinds of probes and willing responds to them. 5. It would help X to develop a more effective awareness of orthographic patterns, particularly as they appear in multisyllable words. This involves both orthographic and morphological awareness. Direct instruction in rules should be avoided (see recommendation #2). Instead, X will need to have systematic exposure to patterns in a way that will allow him to intuit them. Some suggestions follow: X might be asked to screen his reading materials before beginning to select words of which he is unsure. These could be subjected to orthographic and morphological analysis and extended to words of similar construction. For example, if he selects the word constitution, X would be asked to identify the syllable breaks and helped to find and define the root word and affixes. Suffixes can be varied to demonstrate the integrity of the root and the role of an affix in indicating part of speech: constitute, constituency. The same can be done for prefixes: destitution, restitution, institution. Even this one example has obvious benefits in its capacity for generalization to other unknown words. He might enjoy putting together a graphic demonstration highlighting different syllables and affixes. This could be left to his invention but the goal would be to make it clear to himself and other students where the morphological and orthographic subdivisions occur. This could be done with different fonts or kinds of lettering, color, size even possibly cartoon letters or eventually computer animation for those parts of the word that change, i.e., affixes. It is best, however, to keep suggestions to a minimum and let X explore this on his own. He might be asked to share his product with other children learning the same principles. Ask X to read material of such high interest to him that he will want to confront and understand most of the words. 6. The test consideration that seems important as a modification is an exemption from multiple choice testing since it forces X into stereotypical responses that his atypical experiences don’t support. Instead of choosing from among the given options, X might be allowed to write in his own answer. The current modification calling for quizzes covering a shorter time duration should not be necessary and in fact would encourage exactly the fragmentation and disassociated information gathering that is part of X’s problem. Once his program is changed so that learning is contextualized in meaningful experiences, X should no longer have difficulty with larger amounts of information. Information will no longer be discrete (as with the ROCF). It will be integrated in a way that consolidates and allows reference to be made to related ideas. 7. X’s oversimplification of control/dominance issues is a serious point of vulnerability for him that can afford very little exacerbation. One possible exacerbation is the kind of video and computer games he plays. X says that he is drawn to them by the color and graphics. There may be alternative games for him to play that also appeal to his interest in these qualities. In fact, given X’s competence and clear aesthetic preferences, he might be a candidate for learning computer animation and experimenting with creating his own games. 8. Occupational therapy support will need to address the issue of handwriting and especially keyboarding, i.e., discomfort that X feels when he holds his hands in keyboard position and failure to effect rotation movements when writing. OT goals and objectives will need to be part of the IEP and available to teachers so that they know how to handle X’s OT needs. 9. There should be a speech evaluation with the goal of determining if mild oral motor weakness contributes to the kind of slurring, sound transpositions and omissions that occur in lengthy words when X reads and spells. These findings will need to be submitted to the team to determine how they should affect instruction in reading and spelling. 10. Every effort should be made to provide X with positive peer interactions. Following are some suggestions that might be supported by a psychotherapist: Orchestrate group assignments where each student is given a specific role to perform, i.e., produce a dramatization or make a movie of a period in history or section of an assigned reading; create a graphic display to show the relationship between multiplying by 1 and finding the common denominator.... The projects should be selected so that X will have a role at which he is competent but so will the other students. Group interactions may need to be monitored and redirected toward a good product vs in-group dissension. Have X work as one of a dyad. Each of the two students would identify a project they want to complete. When it is his turn to be in charge of his own project, X would tell the other student how s/he could help. When it is the other student’s turn, X would take direction as the helper. 11. Whatever is decided about medication, it is clear that X can find the stimulation and pleasure he needs within an appropriately individualized learning situation (i.e., this testing). This should be the first line of intervention and medication needs assessed from that point forward. Miriam Cherkes-Julkowski, Ph.D. |
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