Clinical case study of reading difficulty in a fourth-grade student

Reading Education

Special needs and special education students have traditionally had more immediate needs in cooperative learning settings when compared to typical students. To be an effective teacher is not always as easy as telling the students to just sit-down and read. Teachers have to understand that there can be less obvious problems at hand like dyslexia, AD/HD, or English as a second language to name a few. When there are underlying issues, both the teacher and the student have to work more closely together in order to reach some desired outcome. "Teaching effectiveness is inferred from the product that was created; it is the product that is the indicator of scholarship." (Cranton, 2000)

This report aims to provide the general background information about a recently completed clinical case study. The underlying object of this case study was to assess a student with some sort of reading difficulty, set up a program to help assess and correct the problem if possible, and then to record the findings in order to evaluate either success or failure. This type of work provides many opportunities to assess personal rewards and also to evaluate intrinsic rewards one expects of him or herself. The ups and downs of teaching an individual with a specific problem or learning disability can bring to light many personal phobias and justifications in the teacher just as easily as it can demonstrate the student's or his or her parent's fears and expectations. Teaching in this kind of one on one setting can make everyone travel the full spectrum of emotions.

Risk Reward

The bottom line is that this process provided a fulfilling and serious intellectual reward for all involved. This project entailed a thorough knowledge of the reading process, the ability to demonstrate pedagogical content knowledge and utilizing specialized knowledge of the student's personal learning ability. This scenario also provided an excellent opportunity to utilize various teaching assessment tools in order to diagnosis the reading problems.

To complete the underlying work, a six step lesson plan approach was used because of the simplicity of documentation while still offering efficient implementation skills. "The six standards they propose are that the work should have clear goals, require adequate preparation, make use of appropriate methods, produce significant results, demonstrate effective presentation, and involve reflective critique." (Cranton, 2000) The case study followed this lesson plan approach:

1. Student Data, (i.e. Title, grade, functional level, etc.)

2. Materials needed

3. Objectives

4. Procedure

5. Evaluation

6. Enrichment Activities

Student Information & Interview background

The case study centered on an 8-year-old 4th grade student named Eric. M. Eric has followed a normal path from preschool through his current elementary school. According to his parents, Eric has a history of not being able to follow basic instructions and at times being labeled by teachers as too self absorbed or even selfish. This assessment seems to have been based on the fact that play times often entailed him not being able to follow social setting rules. In other words, play time meant he would take toys from other children, he was socially outcast by the other students and therefore he did not engage in reciprocal play. His self-confidence must have taken some serious mental beatings over the course of his educational life because during the initial meeting, he made little to no eye contact, his body language and verbal communication skills seemed distant.

Eric's parents provided a psycho-educational testing result that they had requested when he was 3 because they felt, historically, that his language skills were developing 'only minimally' by that age. The results of this test showed that in several areas, Eric was developmentally delayed by over a full year across the board. He clearly demonstrated that he was a great deal more interested and skilled at visual-motor tasks such as finishing puzzles or building with Lego blocks. The doctors at the clinic that completed the psycho-educational testing felt that at the time, Eric was probably too young to be labeled as autistic but he seemed to be demonstrating autistic like behavior. Later tests revealed that Eric's real reading association problem was that he had Dyslexia.

To summarize, Eric M. exhibits behavior that can be considered to be younger than his actual chronological age; he has difficulty following instructions or simple rules; he does not participate well in social groups settings; he has demonstrated temper tantrums and frustration during these abnormal social peer interactions; he has been diagnosed with Dyslexia.

General problems and materials needed

Eric M. needed to learn how to read. "Of all the things that children have to learn when they get to school, reading and writing are the most basic, the most central and the most essential." (Bryant & Bradley, 1) Reading and writing are not just academic skills, they are the foundation and means of shaping the way a child learns to think and how he or she learns to interact with society as a whole. There is an obvious connection between exposure to the written word and the ability to formulate and to learn new words. Eric's dyslexia was going to affect all aspects of his life if this particular problem was not properly diagnosed, addressed and eventually corrected to the fullest extent possible.

By allowing Eric to read several early readers in a controlled environment and with no other external distractions, it was clear that he had several weaknesses. By listening closely to his reading, it was obvious that he was having trouble with some simple two syllable words. "By second grade his basic tools for reading should be in place. In particular, second grade should see the emergence of a child's ability to read easy multisyllabic words such as rabbit, butter and sleepy." (Shaywitz, 113)

Other shortcomings ranged from his trouble with sounding out unknown words, he made many common reading mistakes in the areas of both phonics as well as assumptive reading, he needed to greatly increase his vocabulary, he would need help with basic sentence context and understanding and he also needed to learn new study skills so that he could apply any new reading or learning techniques into future educational ambitions.

Objectives: Sources and testing information

The objectives of the case study were only a part of the overall assistance that Eric M. will need over the next few years. That is because reading is a process that takes many years to master and although most individuals do not want to admit it, reading is a very complex process. The goal for this progression was to first try to build report with Eric. Next, introducing him to phonics and some basic alphabet sounding skills he may have missed in earlier grades, then incrementally build on those skills with higher and higher levels of reading.

The underlying theme is to adjust these training skills to take into consideration the dyslexia that has made Eric's ability to learn so difficult. "A unanimously acceptable definition for dyslexia has not yet been formulated. In fact, there has been probably been as much controversy over how to define this disorder as over how to treat it." (Clark, 17) In order to teach with dyslexia in the forefront of thought, the following process was used to address reading skills:

1. Step 1 was to recognize words on sight.

2. Step 2 was for Eric to sound out familiar words

3. Step 3 was to analyze the parts of words

4. Step 4 was to concentrate on comprehension

Evaluation -- remediation program

This process did help Eric improve his reading, vocabulary and comprehension. However, there was no evaluative reporting or data gathering. There were simply a few 'early readers' that he should have been able to read, but because of his dyslexia, he was unable to. After several sessions of this intensive 4 step process, Eric had no problem reading any of the early readers that were an issue at the beginning of the process.

In that sense the case study could be considered a real success. Also, a side effect of the newly acquired skills came in the sense of increased self-confidence, self-awareness and self-esteem. He seemed to look forward to the sessions as they progressed which implied that he was not bored or overwhelmed in any way. His parents said that he was more social with the neighbors and he was having fewer problems in school in regard to antisocial attitudes.

Because of the techniques utilized in this case study, it was possible to see into Eric's world. A major part of getting a student interested in some new or enhancing an existing skill entails seeing from the student's point-of-view. By allowing Eric to write his book, it became more apparent what types of interests and thoughts he had about the process. This insight provided new approaches to teaching what he needed in a way that he could actually comprehend. An example of this finding can be seen by his love of animals. This discovery was made several sessions in, but once discovered changed the sessions in a positive way. The application of a dog running, horses and zebras, birds instead of bats all helped drive home consonants that always stay the same.

There were other outcomes that point to a positive result for the overall case study. The concept of left and right was beyond Eric prior to the reading sessions. Without directly covering the concepts, he found a way on his own to grasp the idea. His parents said that he was more curious on drives and he wanted to talk more about what he saw outside and even on the news. In other words, he became more of a learner completely on his own once he felt as though learning was not as difficult as it was prior to these new tools and skills being acquired.

Enrichment: Post testing

The main post case study objective is that Eric M. continues to learn new skills as well as implementing the ones he has just learned. If the skill set cannot be used outside of the one-on-one sessions, then further individual work would be recommended. It would be a tragedy if Eric only applied the ideas when he was in the case study setting. His current and future teachers all have to be made aware of the progress he has made with the intention of spurring further growth and development. One solution for this dilemma is for Eric to be taught how to chart his own progress. If possible, this self-evaluative process should add family, friends and other teachers in order to reinforce the progress already made. Even though bringing others into the process, it actually would promote greater independence and self-esteem.

Eric was taught to think aloud when reading to himself. This concept promotes asking questions of what is being read which in turn promotes asking for help when it is needed. One of the major concerns for anyone suffering from an undiagnosed dyslexic situation is that they are far less likely to ask for help because they are embarrassed by the fact that they cannot read normally. By reading and thinking aloud while alone, pertinent questions about a passage arise to surface of the mind.

Follow up testing and practice can be accomplished in the same way this case study was applied and conducted. Several books were chosen and read aloud in a controlled setting. Notes were taken in regard to what was known and what was unknown from the books. From there, specific exercises were practiced in regard to the books read. When the exercises were completed, the reader went back to attempt to read the original content again to see if positive progress was made.

Recommendations

Recommendations for dyslexic readers can be summed up in a few points. The main issues that need to be addressed are that the amount of energy that is spent decoding the meaning of unknown words or phrases is very high. This problem escalates into the reader then not wanting to read because of the energy expended. The diminished decoding skills also lead to a smaller vocabulary and eventually the vicious cycle demoralizes the reader into completely avoiding books.

It is very important therefore to increase both the phonic ability to decode words while at the same time increasing vocabulary and word meaning. The resulting language comprehension will reduce the fear associated with reading. Having a strategy and a good foundation of family support can also improve the will and desire of a reader.

There was no external technological input in this particular case study process. In other words, the only techniques used were writing and reading and the hooked on phonics tape series. There is no reason why future studies of this kind would not also include and implement computers, I-pods or any other relevant technology in order to enhance the learning process.

Conclusion before & after

In conclusion, special education students have a much more difficult time when compared to typical students, so different techniques need to be applied to the teaching methods. This report provided background information about this case study and assessed a specific student with dyslexia as a reading difficulty. In order to teach the student new skills, a four step process was followed to address the existing reading skills issues. The end results of the case study process seemed to have made adequate levels of improvement for the student based on the fact that the books that he was not able to read before the study were easily read and understood after the sessions were complete. However, there is always plenty of room for more and greater future skills improvement because learning how to read is a lifelong event.