Diagnostic evaluation of reading disabilities in JoAnn Kelley

Diagnosis of Reading Disabilities

Diagnostic Evaluation

Child's Name: JoAnn Kelley

Grade

Native Language: English

Age

Family Background

JoAnn was adopted by her foster mother while JoAnn was in third grade. JoAnn was removed from the custody of her biological parents after repeated reports of domestic violence in which the biological father inflicted physical harm on JoAnn and her Mother. The biological mother refused to file formal charges on the father and JoAnn was removed to foster care. Remediation and counseling attempts failed and the foster mother adopted JoAnn during the summer between second and third grade. JoAnn lives with her adopted father, mother, stepsister and stepbrother. The situation is nurturing and stable.

School History

JoAnn has been reported to be attentive in all of her classes and has participated in class. She excels in many subjects but shows extreme deficiencies in some. Her math and reading skills have been a source of difficulty in the past. Math skills are in approximately the second grade level. She does read, however, reads slowly, especially when reading aloud in class.

Medical History

JoAnn has been healthy and has had no significant medical problems. Not much is known of her earlier medical history when she lived with her biological parents.

Previous Referrals and/or Consultations

The foster parents have been to several conferences with the school regarding fidgety episodes and the inability to sit still for long times. The parents report that they do not see this behavior at home. It was determined that the behavior only occurs some of the time and is especially prevalent when JoAnn is asked to read aloud or do math in front of the class.

Writing Tests

JoAnn shown excellent writing skills and produces a hand typical of her grade level and functioning skill. She has no noticeable deficiencies in this area.

Initial Impressions

Appearance/Behaviors

JoAnn always appears well groomed and polite.

Attitude Child Presents

Child presents a confident attitude when interacting with adults and children alike.

Speech Problems (if Apparent)

JoAnn occasionally exhibits slurred speech, particularly when pronouncing certain sounds such as b, d, f, the, ga, and other sounds on occasion.

Other Information

JoAnn is confident in most cases, but exhibits nervousness when asked to read aloud in class. Sometime she turns her head when spoken to. She slurs speech at times.

Diagnostic Analysis - major Reading Problems

Decoding

JoAnn exhibits decoding problems and occasionally confuses sounds. Two days ago I noticed that she inadvertently read the word dog as bog. These types of sound reversals are common, especially when reading in class.

Vocabulary

JoAnn has exceptional vocabulary for her age and reading level.

Comprehension/Recall

JoAnn has satisfactory recall and comprehension. However, on occasion will exhibit restlessness during comprehension exercises. She hesitates when asked to answer.

Writing/Handwriting

JoAnn exhibits excellent handwriting skills.

Attitude

JoAnn has a pleasant and eager attitude. She has true desire to learn and tries very hard to please.

Recommendations for Remediation

The primary concern for JoAnn occurs particularly in the oral reading portion of the reading program. She frequently slurs her speech and turns her head to the side. Her family history indicates that she has never been screened for hearing difficulty. However, considering that JoAnn excels in most areas, except those that involve listening and speech. The first recommendation would be to schedule JoAnn for a hearing evaluation from a physician. Pending those results, appropriate devices such as hearing aids or other treatments as necessary may be the first course of action.

If a hearing evaluation indicates a hearing loss, corrective measures should be the first course of action taken. After that, evaluations need to be scheduled for speech therapy for evaluation and recommendation. Occasionally JoAnn will reverse certain letters such as b and d on spelling tests. This may not indicate dyslexia and may be related to a hearing loss. Correction of the hearing loss in addition to appropriate speech therapy may be the needed to correct this situation.

Pending the clinical results, a meeting should be scheduled with the adoptive parents to attempt to develop a comprehensive program that includes an integration of home activities and school activities geared at helping to reinforce the principles learned in therapy. JoAnn is happy and well-adjusted girl, particularly considering her previous background. She does exhibit some fidgeting when asked to read aloud or work on the board. This may be due to self-consciousness about her slurred speech and oral reading problems. She is very nervous when asked to perform an activity in front of the class. In time, this should improve as the hearing is corrected and the speech difficulties diagnosed and corrected. The parents indicate that she does not exhibit any of these characteristics or behaviors at home. However, the parents did indicate that sometimes she tilts her head in a peculiar way when listening to you.

JoAnn displays several single word reading problems, however, in general is ahead of many her age. Her vocabulary is excellent and she has a language knowledge that is exceptional. She loves to read and to be read to in return. She is helpful to other students when placed in a one-on-one situation. It is recommended that JoAnn receive instruction in phonics with an emphasis on fluency. This approach should integrate decoding, fluency, and comprehension.

It is recommended that after Joan's hearing is checked and measures taken to correct any deficiencies, that JoAnn undergoes intensive individualized instruction, concentrating on her exhibited deficiencies. JoAnn exhibits some tendencies that may point to dyslexia, such as reading and writing b and d backwards. However, this will have to be reevaluated at a later time due to the fact that it may not be true dyslexia, but may be due to a hearing problem. JoAnn often is seen playing with her ears and tugging on them. Some of the other students tease her about this and she seems to be self-conscious about it.

It is recommended that JoAnn undergo 40 minutes of private speech and reading instruction five days a week for the entire school year. The areas of concentration should be in decoding and distinguishing similar sounds such as b and d or m an n. It is expected that any comprehension problems are related to this factor as well. The proposed program will involve JoAnn's adoptive parents as well. They will be encouraged to read to JoAnn and pronounce words as clearly as possible and to assist in her instruction in a participatory manner.

JoAnn seems to lack self-confidence when asked to read in front of the class. She becomes nervous and starts to stutter at times. She noticeably slurs her speech. It is expected that as JoAnn's hearing problem comes under control, she will be able to master reading in class with little difficulty. Encouragement will be needed to improve this area. If it becomes bothersome or does not respond to positive reinforcement, evaluation by a psychologist may be warranted.

A lack of knowledge about JoAnn's home life prior to her adoption is a hindrance in determining the best course of action for JoAnn. It is not known if these problems existed in the past, or if they are recent onset. JoAnn has shown an incredible ability to adjust to new situations and has shown incredible resilience in adverse situations. This will undoubtedly be to her advantage in the ability to overcome this new challenge.

In the event that a hearing loss is not found, the same interventions as previously described would still be appropriate, such as intensive on-on-one instruction and speech therapy. However, if a hearing loss exists, these interventions would be ineffective without treatment of the hearing loss. It may be necessary to probe deeper in her past in this case to determine a cause for her behavior. It is believed that the root cause of JoAnn's reading difficulties stem from an organic cause, rather than a learned behavior. However, if no hearing loss is detected, it may be helpful to determine if these problems are perhaps from her previous home environment, perhaps learned from the mother or father.

JoAnn's problems mimic dyslexia in some ways. However, it is believed from this evaluation that they may all be related to a hearing impairment. These conditions are expected to respond favorably to a comprehensive program concentrated in speech therapy and intensive individualized instruction.