From Assessment to Intervention Part I: Who Do We Assess?



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From Assessment to Intervention Part I: Who Do We Assess?

  • By
  • Mike McCall, M.A. School Psychology
  • School Psychologist/Learning Specialist
  • &
  • Sheara Fernando, M.A. School Psychology
  • School Psychologist/Learning Specialist

Presentation Outline

  • Background on Psychological and Academic Screening
  • Deciding Who Needs Screening
  • Types of Screening Tools
  • Use of Screening Data
  • Case examples of Screening Data
  • Questions and Discussion

Purpose of Psychological/Academic Screening

  • The goal of psychological and academic screening is to quickly and cost effectively identify students who may have deficiencies or impairments that warrant intervention
  • Part of the goal is to sort students, but that is not enough
  • Effective screening can guide intervention and assessment decisions

Facts of Psychoeducational Assessment

  • Cost
    • $100 to $250 dollars per hour
    • Full assessments take 6-8 hours with the client if done correctly
    • Reports are going to take 2-4 hours of work
    • 1 hour of review of the report
    • Total $1,000 to over $2,000 for a full psychoeducational assessment
    • ADHD screenings cost $300 to $600 dollars

Determining Who Needs Screening

  • Some schools with lots of resources may screen all student-athletes when they enter the university
  • Others may want to target high risk populations such as special/contract admits or other high risk populations
  • Still other schools may choose to screen only after the student is referred/self-referred for the problems

What are we looking for in a screening?

  • Specific Learning Disability – if student has average cognitive ability but below average reading, writing, math, or communication skills
  • Behavioral/Neurological Disability – screening for maladaptive behavior and disorders such as ADHD
  • Social/Emotional Disability – student has anxiety, depression, bi-polar, schizophrenia, or any other disorder that negatively impacts academic functioning

Types of Screening Tools

  • Norm-referenced tools (e.g. Nelson Denny Reading Test, OWLS, or any other standardized test that can be given by a non-psychologist)
    • Assess intelligence, achievement, behavior, and social-emotional functioning
    • Goal – assign a numerical value to client’s functioning
    • See strengths and weaknesses within the client and compared to peers

Interpretation of Discrepancy and Disability

Popular Norm Referenced Screening Tools

  • Nelson Denny Reading Tests – standardized scores with percentiles and grade equivalents for vocabulary, comprehension, reading rate, and total reading
    • Protocols are expensive ($112 per 50 response booklets)
    • Takes about 40 minutes to administer
    • Scoring can be time consuming
    • Provides cutoff scores for students in college that are predicted to have reading difficulties
    • Reading fluency may lack accuracy

Popular Norm Referenced Screening Tools

  • Woodcock Johnson – III tests of Achievement (WJ-III) – Nationally standardized tests that relate directly to assessment for learning disabilities
    • Covers seven areas of learning disabilities
    • Most tests have to be individually administered
    • Writing samples, fluency tests, spelling, and calculation can be group administered
    • Protocols are expensive
    • Scoring can be tedious for the writing
    • May not help provide intervention information but allows for comparison to a college population

Popular Norm Referenced Screening Tools

  • Behavior Assessment Scale for Children – 2nd edition (BASC-2)
    • Screens for social, emotional, behavioral, and psychological strengths and deficits
    • Good for evaluating possible problems with attitudes towards school, attention, test anxiety, alcohol problems, and psychological problems
    • Protocols are expensive
    • Must be given by a psychologists with training
    • Time consuming

Popular Norm Referenced Screening Tools

  • Intelligence tests – CogAT, Stanford Binet V, WASI
    • CogAT can be group administered
    • Standford Binet V and WASI need to be individually administered
    • Tests will have to be interpreted by a psychologists
    • They are time consuming and expensive
    • Scores can be derived from SAT scores (see next slide)

Standard Scores from High School

  • SAT/ACT scores – can be used to estimate IQ
    • http://www.davidpbrown.co.uk/psychology/iq-conversion.html
    • http://www.iqcomparisonsite.com/GREIQ.aspx
  • COGAT scores

Standardized Test of Study Skills

  • www.hhpublishing.com/_assessments/LASSI/scales.html
  • Learning and Study Skills Assessment (LASSI)
  • 10 scales
    • Attitude – Information Processing
    • Motivation – Selecting Main Ideas
    • Time Management – Study Aids
    • Anxiety – Self-testing
    • Concentration – Test Strategies
  • Factors that significantly contribute to success in college
  • Can be modified through interventions

Screening with University Tools

  • University required placement tests
    • Foreign Language
    • Math
    • SAT-II tests
  • These tests can give information about strengths and weaknesses in classes that may be required for graduation
  • Foreign language difficulties could be related to language deficits
  • Math placement scores, which are often required, can be a cheap way to evaluate math skills

Curriculum Based Measurement

  • Curriculum Based Measurement (CBM) – assesses student skills in terms of fluency
    • Fluency is a combination of speed and accuracy when performing a skill
    • Students who lack academic fluency will likely struggle in school
    • Visit www.interventioncentral.com for more information
    • Shinn, Mark R. (Ed.) (1989). Curriculum-based measurement: Assessing special children. New York: Guilford Press.

CBM continued…

  • Oral reading fluency – measured using 1- minute reading probes
    • Measure total words attempted
    • Measure errors
    • Subtract errors from total words to get words read correctly per minute (WRCM)
    • Oral reading fluency (Below 150 words per minute is slow
    • Accuracy is measured by dividing words read correctly by words attempted and multiplied by 100
    • Accuracy below 90% means the material to too difficult

CBM continued…

  • Writing Fluency – measures words written for a prompt in a 3 minute time span after thinking for 1 minute
    • Measure total words, total letters, words spelled correctly, or grammatically correct word units
    • Helps see how students write with regards to legibility, spelling, grammar, and speed
    • A drawback is that there are no norms for college students

CBM continued…

  • Math fluency – measures the number of digits correctly calculated per minute
    • Gives an indication of specific areas students may lack skills
    • Doesn’t assess applied math reasoning
    • No norms exist for college students
    • Low accuracy and fluency may make it difficult for students in college if they cannot use calculators

Curriculum Based Assessment (CBA)

  • CBA directly observes a student performance in local curriculum to make decisions about future instruction and intervention
    • Test what is taught
    • Make assessment from student’s class material
    • Not formalized
    • Helps make decisions within specific material
    • Helps psychologists see actual work
    • Very cheap and often very quick to administer

Other Inexpensive Assessments

  • Informal writing samples – poor organization, weak vocabulary, poor spelling, grammatical errors, lacks elaboration
  • Observation of behavior (look for off-task, frustration, fatigue)
  • Poor grades (but not enough on its own)

Use of Screening Data for Referral

  • Goal is to not refer students who are unlikely to meet a diagnosis or be helped by an assessment
  • Assessment is expensive, time consuming, and emotionally draining
  • Likely, you will refer more for ADHD for medication than other disorders

Using Screening Data For LD Referrals

  • IQ/Cognitive functioning
  • To make a diagnosis of LD, a student must have academic achievement scores that are significantly lower than an IQ score
    • Generally IQ needs to be above 80, and achievement at a minimum needs to be 1 standard deviation lower (e.g. Full Scale IQ of 80 needs achievement scores of 65)
  • Ask student if they have ever been tested for disabilities
  • For IQ, use the SAT/IQ estimator
  • If you can afford/have access to a psychologist, have them give a brief IQ measure such as the SBV or WASI
  • Have the student request CogAT scores from their high school

Using Screening Data For LD Referrals

  • Reading
  • Standardized reading measures – NDRT, WJ-III reading subtests, WIAT-II, WRAT, GORT-4
    • NDRT- can easily be group administered
    • Total scores below 35 percentile are likely to have difficulty with reading
    • Individual achievement tests – compare to college peers (should have norms for this) Scores below 85 will likely have trouble, and below 70 need further referral

Using Screening Data For LD Referrals

  • Reading
  • CBM – create 3 reading probes from an introductory course textbook, administer all 3 and look at range/median scores
  • Oral reading rates below 150 words per minute could be referred for reading problems
  • Accuracy scores below 90% may indicate trouble with phonemic awareness and phonic skills

Using Screening Data For LD Referrals

  • Reading
  • Informal measures – have students read aloud to you
    • Look for hesitations, decoding of unknown words, rereading/backtracking
    • Ask questions about reading to measure comprehension
    • Have students highlight what is important
    • Ask them to define difficult words to check for understanding
    • Compare their understanding to when you read with them

Using Screening Data For LD Referrals

  • Writing
  • Standardized tests - WJ-III writing subtests, WIAT-II, WRAT, OWLS
    • Individual achievement tests – compare to college peers (should have norms for this) Scores below 85 will likely have trouble, and below 70 need further referral
  • Look at SAT writing scores – may not be used for admitting students, but scores should be reported

Using Screening Data For LD Referrals

  • Writing
  • W-CBM/Informal measures – Goal is to assess quality of writing
    • Look for spelling errors, grammatical difficulties, handwriting quality, organization, ability to type, fluency
    • Students with low scores may have trouble in classes with a heavy focus on papers or in-class writing
    • Have students read their writing aloud to see if they self correct
    • Organization and elaboration problems should be identified as well

Using Screening Data For LD Referrals

  • Math
  • Standardized tests - WJ-III math subtests, WIAT-II, WRAT, Key Math
    • Individual achievement tests – compare to college peers (should have norms for this) Scores below 85 will likely have trouble, and below 70 need further referral
  • University required math tests – SAT-II, or math placement scores
    • Talk with the math placement coordinator obtaining and understanding the results
    • Are the problems conceptual, calculation based, or both?

Using Screening Data For LD Referrals

  • Math
  • M-CBM/Informal measures – Goal is to assess problems in math
    • Many students struggle with math
    • Math takes a great deal of time to learn, so many students don’t spend the time trying to grasp the skills
    • Use M-CBM to assess fluency and accuracy for calculations
    • Use an introductory math text to assess how they try to solve math problems (e.g. skip steps, disorganized approach, messy writing, lack of skills, ability to use a calculator)
    • Refer students who seem to have conceptual problems understanding math for further testing (a calculator may be enough for those who understand how to calculate)

Using Screening Data For Psychological Referrals

  • ADHD, Social/Emotional/Behavioral
  • If a behavior screening reveals at least 1 standard deviation from average, it may be worth a referral to a psychologist
  • Scores that are 2 standard deviations above normal should be referred as soon as possible
  • Measures include – BASC-2, CBCL, CAARS, Brown ADD scales

Using Screening Data for Intervention

  • IQ – not particularly helpful because it is a stable construct, but consult a psychologist on how to make sense of the scores
    • Working memory skills can tell you what to expect when students are learning new information
    • Perceptual reasoning can help you see if they have difficulty deconstructing and reconstructing information (can they put the puzzle together)
    • Verbal scores indicate can help you see how well they can solve problems with language

Using Screening Data for Intervention

  • Reading – Standard scores and percentiles may help with LD referral, but the tests may not indicate the quality of the problems
    • NDRT – Low vocabulary could indicate students need to work on learning definitions while reading; low comprehension – use prereading strategies and self-questioning; fluency – repeated reading and listening passage preview, Kurzweil/audio books
    • WJ-III – nonsense words can reveal decoding skills
    • CBM – indicate fluency difficulties, so use repeated reading, listening passage preview, , Kurzweil/audio books
    • Informal reading – for comprehension, teach highlighting, Q-system, self questioning, organization of paragraphs, prereading, , Kurzweil/audio books

Using Screening Data for Intervention

  • Writing – writing problems can be varied, so intervention should target problems
    • Low spelling – have students practice important words for classes (key terms) using cover, copy, compare; have students practice phonemic awareness; have students reread their writing
    • Grammar – teach basic sentence structures to use, subject verb agreement, consistent tenses, advanced punctuation
    • Organization – Analyze well written paragraphs, teach students how to outline (e.g. Inspiration)
    • Elaboration – pick simple objects/ideas and have students create lists of descriptors, Inspiration
    • Fluency – practice writing short answer and essays for tests

Using Screening Data for Intervention

  • Math – these problems can be either conceptual, fluency based, or calculation based
    • Fluency – flashcards, calculators (if allowed), worksheets, practice problems
    • Calculation – same as fluency (but check to see if it is don’t know how to perform the operation or carelessness), Touch Math
    • Conceptual – connect abstract concepts to real world applications, often students need to spend more time thinking about the math problems, practice problem solving steps

Using Screening Data for Intervention

  • ADHD – Consult with a psychologist, but these interventions can be useful
    • Study in distraction free settings (1 person rooms)
    • Give frequent breaks (15 minutes of work, 1-2 minutes of relaxation)
    • Break studying up over the course of the day
    • Foster use of a planning system
    • Add structure to daily routine
    • Intermix stimulating activities with mundane activities
    • Teach organization

Using Screening Data for Intervention

  • Study skills – some students may have descent academic skills but do not know how to study
    • LASSI – pick competencies that are low and try to improve one to two at a time
    • Create small peer mentoring groups
    • Create a summer bridge program that emphasizes studying
    • How to Study in College by Pauk and Owens
    • Have counseling center/psychologist run test anxiety groups

Case Examples

  • Student 1
  • 18 years old
  • NDRT (Total – 1, Vocabulary – 3, Comprehension – 1, Rate – 6)
  • WJ-III writing samples subtest (SS – 86, 18th percentile)
  • SAT – 630 ACT Composite - 13 HSGPA – 3.16
  • IQ conversion – 70
  • What would you do?

Case Examples

  • Student 2
  • 18 years old
  • NDRT (Total – 4, Vocabulary – 3, Comprehension – 7, Rate – 10)
  • WJ-III writing samples subtest (SS – 94, 36th percentile)
  • ACT Composite - 15 HSGPA – 2.113
  • IQ conversion – 81
  • What would you do?

Case Examples

  • Student 3
  • 18 years old
  • NDRT (Total – 44, Vocabulary – 42, Comprehension – 47, Rate – 14)
  • WJ-III writing samples subtest (SS – 101, 53rd percentile)
  • BASC-2 – attention problems in at-risk range
  • SAT – 910 HSGPA – 3.4
  • IQ conversion – 97
  • What would you do?

Process of Referral

  • Use one or a few psychologists who are trusted by disability services
  • Using the same people consistently can help build a working relationship so assessments happen in a timely fashion and are useful
  • Ideally, programs may need to hire services of a licensed professional at least on a part time basis

Process of Referral

  • Expect full assessments to take 4-8 hours of face time
  • ADHD assessments may take 1-2 hours of face time
  • Students will get better results early in the day when they are not exhausted
  • May need to find psychologist who can assess on weekends
  • Reports take several hours to write, so there may be a week to a month delay from testing to when the report is ready

Process of Referral

  • Send a packet of screening data to the psychologist
  • Write a description of the student’s behaviors that you are concerned about
  • Give a copy of the university’s disability criteria to the psychologist
  • Make sure the student agrees to complete the testing

Questions and Discussion

  • What do your schools do for screening?
  • How many students are being referred for psychoeducational assessments?
  • Are you structuring interventions around screening data?
  • Others?

References

  • Sattler, J. (2001). Assessment of children: Cognitive applications (4th ed.). La Mesa, CA US: Jerome M Sattler Publisher.
  • www.interventioncentral.com
    • Shinn, Mark R. (Ed.) (1989). Curriculum-based measurement: Assessing special children. New York: Guilford Press.

Presenter Contact Information

  • Mike McCall , School Psychologist/Learning Specialist
  • mccallmw@sc.edu
  • 803 – 777 - 3581
  • Sheara Fernando, School Psychologist/Learning Specialist
  • fernando@mailbox.sc.edu
  • 803 – 777 - 3581


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