1 00:00:00,000 --> 00:00:06,240 Hello and welcome to the What in the World is Dyscalculia podcast. 2 00:00:06,240 --> 00:00:12,800 This podcast is presented by Educalclearning hosted by me, Dr. Honora Wall. 3 00:00:12,800 --> 00:00:18,380 If you have questions about what this is or how to help your child or student who has 4 00:00:18,380 --> 00:00:27,040 this or if you are an adult with this, please visit our website, educalclearning.com or 5 00:00:27,040 --> 00:00:35,080 email me, Honora at educalclearning.com and I'd be happy to talk with you directly about 6 00:00:35,080 --> 00:00:37,440 your specific questions. 7 00:00:37,440 --> 00:00:44,840 In today's podcast episode, I want to talk about the deficit model of diagnosing any 8 00:00:44,840 --> 00:00:49,040 learning disability or any learning disorder, including dyscalculia. 9 00:00:49,040 --> 00:00:54,760 And there's a lot of thoughts about the deficit model and whether or not we should continue 10 00:00:54,760 --> 00:00:58,720 using it. 11 00:00:58,720 --> 00:01:04,440 I think we should change the terminology, but I think we should follow the model. 12 00:01:04,440 --> 00:01:07,640 So let's talk about what all of this means. 13 00:01:07,640 --> 00:01:14,720 Using a deficit model is the common term to talk about how we use testing to identify 14 00:01:14,720 --> 00:01:21,520 learning challenges that are not temporary, something that has to do with atypical neurodevelopment 15 00:01:21,520 --> 00:01:29,600 such as dyslexia, dyscalculia, dysgraphia, high functioning autism versus something that 16 00:01:29,600 --> 00:01:31,720 is a temporary condition. 17 00:01:31,720 --> 00:01:38,800 Low numeracy, having a weak math foundation, a lot of times students in low socioeconomic 18 00:01:38,800 --> 00:01:46,280 communities are not considered to have a learning disability because having a low SES environment 19 00:01:46,280 --> 00:01:50,900 is something that can be overcome through interventions. 20 00:01:50,900 --> 00:01:57,560 So we use this model to identify when we have a specific type of concern that needs to be 21 00:01:57,560 --> 00:02:01,440 addressed differently. 22 00:02:01,440 --> 00:02:07,240 A lot of people don't like using the term deficit model because they think it focuses 23 00:02:07,240 --> 00:02:11,720 on weaknesses rather than strengths. 24 00:02:11,720 --> 00:02:17,920 And certainly as educators and as math coaches and interventionists and as parents, we want 25 00:02:17,920 --> 00:02:22,240 to focus on student strengths because they all have strengths and that's where we begin 26 00:02:22,240 --> 00:02:27,120 building future success from that base of the strength. 27 00:02:27,120 --> 00:02:34,120 But we also want to know where we have problem areas, concerns, issues that need to be addressed 28 00:02:34,120 --> 00:02:37,320 and supported in a certain way. 29 00:02:37,320 --> 00:02:44,600 So the deficit model came about historically by giving a battery of test, IQ test, working 30 00:02:44,600 --> 00:02:51,720 memory test, processing speed test, reading and computational ability test, etc., etc., 31 00:02:51,720 --> 00:02:58,320 administered by trained licensed psychologists or neurologists who are trained in administering 32 00:02:58,320 --> 00:03:04,600 and interpreting the scores from these tests. 33 00:03:04,600 --> 00:03:13,680 And within those results, we look to see is there a difference between a person's performance 34 00:03:13,680 --> 00:03:21,240 and what we assume their performance should be based on the rest of their scores. 35 00:03:21,240 --> 00:03:28,680 So when we find a student who has higher scores in most areas of the different battery of test 36 00:03:28,680 --> 00:03:36,040 and yet there's a significantly lower score in reading or in math or in writing, then 37 00:03:36,040 --> 00:03:43,640 we know that we're looking at a potential atypical neurodevelopment, some sort of specific learning 38 00:03:43,640 --> 00:03:45,440 disorder. 39 00:03:45,440 --> 00:03:47,680 So that's where the term came from. 40 00:03:47,680 --> 00:03:51,720 We're looking to see where's the difference, where are the low points that we are surprised 41 00:03:51,720 --> 00:03:57,800 by because the rest of the scores have higher points. 42 00:03:57,800 --> 00:04:02,520 So there's nothing negative in that system. 43 00:04:02,520 --> 00:04:09,240 But in that wording, saying that we're using a deficit model, that's where we run into 44 00:04:09,240 --> 00:04:13,680 trouble and people really have a problem with that wording. 45 00:04:13,680 --> 00:04:16,600 Sounds like we're focusing on the wrong thing. 46 00:04:16,600 --> 00:04:18,400 And I can agree with that. 47 00:04:18,400 --> 00:04:24,120 I would say let's try calling it a discrepancy model instead. 48 00:04:24,120 --> 00:04:27,440 A discrepancy is a more neutral term. 49 00:04:27,440 --> 00:04:31,960 We're seeing a difference that we don't expect to see. 50 00:04:31,960 --> 00:04:36,160 And it shows us that we need to look further into a certain area. 51 00:04:36,160 --> 00:04:42,360 So we're not focusing on weaknesses and we're not saying that a person has something wrong 52 00:04:42,360 --> 00:04:43,360 with them. 53 00:04:43,360 --> 00:04:48,040 We're saying we didn't expect to see this score. 54 00:04:48,040 --> 00:04:50,400 This person should be scoring higher. 55 00:04:50,400 --> 00:04:55,200 Let's take a further look and see what we can do to support them in this area. 56 00:04:55,200 --> 00:05:02,400 But that kind of model is very important and very useful for identifying student needs, 57 00:05:02,400 --> 00:05:08,560 which is the point of going through testing. 58 00:05:08,560 --> 00:05:16,240 It's very important that we look at neuropsychological evaluations for students before we decide whether 59 00:05:16,240 --> 00:05:21,920 or not they have a specific learning disorder like dyscalculia. 60 00:05:21,920 --> 00:05:28,400 And the discrepancy is really a key feature of what we're looking for in that battery 61 00:05:28,400 --> 00:05:30,600 of tests. 62 00:05:30,600 --> 00:05:35,240 So first I'm going to focus on the tests and why that discrepancy is important. 63 00:05:35,240 --> 00:05:40,760 And then I'm going to look at some other methods that people sometimes use and why I don't 64 00:05:40,760 --> 00:05:45,680 think they are as comprehensive as neuropsych evals. 65 00:05:45,680 --> 00:05:52,120 So first of all, if we have a neuropsychological evaluation, we get a complete picture of the 66 00:05:52,120 --> 00:05:54,920 student. 67 00:05:54,920 --> 00:06:01,640 This gives us a lot of information and having very low scores in math, which would identify 68 00:06:01,640 --> 00:06:11,240 dyscalculia, reading, which would identify dyslexia, or writing skills, which would identify dysgraphia. 69 00:06:11,240 --> 00:06:16,160 That's really key because some of our students have very fast processing speed or they have 70 00:06:16,160 --> 00:06:24,360 great working memory skills or they have superb executive function skills. 71 00:06:24,360 --> 00:06:30,360 And those skills cause them to have higher performance in the majority of the tests that 72 00:06:30,360 --> 00:06:31,560 we give them. 73 00:06:31,560 --> 00:06:38,360 And yet we can see a discrepancy in those key content areas, math, reading, or writing. 74 00:06:38,360 --> 00:06:44,440 I had a student a few years ago, and this was such an interesting case to me. 75 00:06:44,440 --> 00:06:50,360 The student was very, very driven and had extremely fast processing speed and very high 76 00:06:50,360 --> 00:06:53,960 working memory scores. 77 00:06:53,960 --> 00:07:00,520 She also very clearly had ADHD and dyscalculia. 78 00:07:00,520 --> 00:07:06,560 She was able to support herself through elementary, middle, and high school, got really strong 79 00:07:06,560 --> 00:07:13,400 grades in everything except for math, had really strong test scores in every area except 80 00:07:13,400 --> 00:07:20,200 for math, and was able to be accepted into an Ivy League university. 81 00:07:20,200 --> 00:07:21,200 This was great. 82 00:07:21,200 --> 00:07:22,560 She was very excited. 83 00:07:22,560 --> 00:07:29,760 She was also struggling through her math classes at this Ivy League school because she did 84 00:07:29,760 --> 00:07:32,600 not have any accommodations of any kind. 85 00:07:32,600 --> 00:07:40,880 And it was very difficult for her to get accommodations that were useful for her dyscalculia. 86 00:07:40,880 --> 00:07:47,000 So in an effort to explain more of her needs to the school and to help her get the support 87 00:07:47,000 --> 00:07:54,600 she needed, her parents got her an updated neuropsych evaluation. 88 00:07:54,600 --> 00:08:01,600 Well the interpretation came back as saying that she did not have dyscalculia because 89 00:08:01,600 --> 00:08:10,560 her math scores were in the high 30s, maybe low 40th percentile, which is outside our 90 00:08:10,560 --> 00:08:16,720 typical range of looking at that tail end of the bell curve and saying, oh, 25th percentile, 91 00:08:16,720 --> 00:08:19,080 that's where we're going to have an issue. 92 00:08:19,080 --> 00:08:25,400 However, every other score in every other part of this very comprehensive battery of 93 00:08:25,400 --> 00:08:30,200 tests, the student scored in the 99th percentile. 94 00:08:30,200 --> 00:08:37,120 The only place where she scored less than the 99th percentile was in math. 95 00:08:37,120 --> 00:08:44,840 So she did not show a deficit in math abilities, but she showed a huge discrepancy between 96 00:08:44,840 --> 00:08:51,960 her math performance and the expected performance based on all of her other testing. 97 00:08:51,960 --> 00:08:57,120 So if we had used a discrepancy model, if the psychologist who administered the test 98 00:08:57,120 --> 00:09:00,480 had looked through that lens, this would have been clear. 99 00:09:00,480 --> 00:09:09,760 And instead, it wasn't, and those results did not help the student get any accommodations. 100 00:09:09,760 --> 00:09:15,680 So moving away from just having that deficit idea in our head, but acknowledging discrepancies 101 00:09:15,680 --> 00:09:17,760 is really important. 102 00:09:17,760 --> 00:09:23,360 I also like the discrepancy model for students who have gone through a period of time where 103 00:09:23,360 --> 00:09:32,000 they've worked with a trained dyscalculia specialist because my students, after a year or two, 104 00:09:32,000 --> 00:09:38,040 sometimes only one year of tutoring work, going through the program and using the accommodations 105 00:09:38,040 --> 00:09:45,920 that Educate Learning recommends, they end up scoring in the 36th percentile on Iowa 106 00:09:45,920 --> 00:09:54,960 Test of Basic Skills, on most of their neuropsychological evaluations, on their state mandated testing. 107 00:09:54,960 --> 00:10:02,040 They're hitting a high level two, low level three, and this shows that they have growth. 108 00:10:02,040 --> 00:10:07,080 It can be interpreted to look like they've moved on away from having dyscalculia, and 109 00:10:07,080 --> 00:10:08,800 that's not true. 110 00:10:08,800 --> 00:10:16,360 Just because they've moved away from a deficit standard, they still have a discrepancy standard 111 00:10:16,360 --> 00:10:22,240 where their math performance is lower than performance in other key areas. 112 00:10:22,240 --> 00:10:27,200 These students still need their accommodations, and they still need to have the right support, 113 00:10:27,200 --> 00:10:32,040 where those scores are going to go right back down to where they were before we did some 114 00:10:32,040 --> 00:10:35,000 interventions. 115 00:10:35,000 --> 00:10:39,200 The classroom grades, however, are not likely to go back down. 116 00:10:39,200 --> 00:10:44,680 I have not seen that with my students looking at longer term results. 117 00:10:44,680 --> 00:10:51,560 I have not done a full longitudinal study, so this is anecdotal information, but our 118 00:10:51,560 --> 00:10:59,120 students maintain their ability to perform very well in class, engage in math, think 119 00:10:59,120 --> 00:11:04,560 of themselves as mathematical thinkers, and do very well until they get to a standardized 120 00:11:04,560 --> 00:11:08,280 test that does not allow for accommodations. 121 00:11:08,280 --> 00:11:14,960 Then they kind of hit a ceiling of about that 35th-ish percentile. 122 00:11:14,960 --> 00:11:22,400 We see that discrepancy, and I highly encourage educators to focus on those discrepancy areas. 123 00:11:22,400 --> 00:11:27,080 If you're a psychologist or a neurologist listening, think about this when you're interpreting 124 00:11:27,080 --> 00:11:28,080 results. 125 00:11:28,080 --> 00:11:41,880 There's a discrepancy that is significant, not only a deficit as compared to a dry percentile. 126 00:11:41,880 --> 00:11:47,760 That's what happens when we look at the full battery of diagnostic testing, which I always 127 00:11:47,760 --> 00:11:48,760 prefer. 128 00:11:48,760 --> 00:11:53,640 I'm always very happy when I get a neuropsych evaluation on a student because I have a lot 129 00:11:53,640 --> 00:11:58,920 of information to work with, and I know exactly where to jump in with the work. 130 00:11:58,920 --> 00:12:04,200 A student who has fast processing speed needs a different approach than a student who has 131 00:12:04,200 --> 00:12:06,560 slower processing speed. 132 00:12:06,560 --> 00:12:09,320 We need different types of support. 133 00:12:09,320 --> 00:12:13,840 Same is true for working memory skills and for visual spatial skills. 134 00:12:13,840 --> 00:12:18,560 We just don't get that kind of information if we look at a response to intervention program 135 00:12:18,560 --> 00:12:24,440 or if we're simply looking at report card grades or standardized test scores on those 136 00:12:24,440 --> 00:12:27,000 state mandated tests. 137 00:12:27,000 --> 00:12:36,160 The issue I have with using an RTI or just classroom-based performance as a way to screen 138 00:12:36,160 --> 00:12:44,240 for dyscalculia is that we have no idea whether or not the student has a learning disorder, 139 00:12:44,240 --> 00:12:49,040 the math learning disability that we're talking about, they might just have low numeracy or 140 00:12:49,040 --> 00:12:53,480 weak foundation. 141 00:12:53,480 --> 00:12:55,880 They might just have severe test anxiety. 142 00:12:55,880 --> 00:12:57,800 Maybe they freeze. 143 00:12:57,800 --> 00:13:04,480 We're not going to know that until we see more information from a more complete battery 144 00:13:04,480 --> 00:13:05,480 of testing. 145 00:13:05,480 --> 00:13:12,560 If we're just looking at whether or not a student responded to Tier 2 or Tier 3 interventions, 146 00:13:12,560 --> 00:13:18,280 we don't know why and we don't know if we've done the right intervention work to support 147 00:13:18,280 --> 00:13:19,680 their needs. 148 00:13:19,680 --> 00:13:24,960 So we could very well have been giving the wrong prescription glasses and wonder why the 149 00:13:24,960 --> 00:13:29,920 student still can't see to use one of my favorite analogies. 150 00:13:29,920 --> 00:13:36,160 So we need to know about the discrepancies between a student's performance in a specific 151 00:13:36,160 --> 00:13:43,480 area, math reading or writing, as compared to what we expect based on the rest of their 152 00:13:43,480 --> 00:13:45,120 battery of tests. 153 00:13:45,120 --> 00:13:51,480 So there is a lot of talk about moving away from a deficit model and that conversation 154 00:13:51,480 --> 00:13:58,080 turns into throwing out neuropsychological evaluations and saying, oh, we're going to focus 155 00:13:58,080 --> 00:14:05,240 on student's strengths, put them into an RTI or some other intervention-based program, 156 00:14:05,240 --> 00:14:11,520 and we're going to just use these tiers of support to move them into strength. 157 00:14:11,520 --> 00:14:15,880 The problem is we have no idea what's causing the problem for the student, so we have no 158 00:14:15,880 --> 00:14:19,080 idea if we're using the right interventions or not. 159 00:14:19,080 --> 00:14:25,160 All we know is that things aren't working and we can't figure out why. 160 00:14:25,160 --> 00:14:32,800 So if you have the choice, and a lot of times we don't, these evaluations are costly and 161 00:14:32,800 --> 00:14:37,920 not all schools are in a position to administer them. 162 00:14:37,920 --> 00:14:40,880 They may or may not have a school psychologist on staff. 163 00:14:40,880 --> 00:14:45,040 They may or may not have the funding for this kind of testing, or they may or may not understand 164 00:14:45,040 --> 00:14:51,200 the importance of this kind of testing and the difference between a full battery of test 165 00:14:51,200 --> 00:14:55,120 versus the intervention programs they're doing. 166 00:14:55,120 --> 00:14:56,520 And this can be hard for parents. 167 00:14:56,520 --> 00:15:01,200 Yes, you can go get your own evaluation done, but not all insurance is covered. 168 00:15:01,200 --> 00:15:02,920 They can be very expensive. 169 00:15:02,920 --> 00:15:10,720 But if you have the opportunity, getting an evaluation from a licensed psychologist or 170 00:15:10,720 --> 00:15:15,320 neurologist definitely gives us the most information. 171 00:15:15,320 --> 00:15:21,000 Ask the test administrator if they work from a discrepancy model. 172 00:15:21,000 --> 00:15:22,080 Talk to them about that. 173 00:15:22,080 --> 00:15:27,160 How do they interpret those scores and what are they looking for when they look for learning 174 00:15:27,160 --> 00:15:33,920 disorders or other disabilities, and have that conversation. 175 00:15:33,920 --> 00:15:39,000 When you get those scores back, take a look at the percentile ranks in many different 176 00:15:39,000 --> 00:15:43,040 areas and see where there are discrepancies. 177 00:15:43,040 --> 00:15:48,800 Not deficits, but discrepancies, a difference in what we expect then in how the student 178 00:15:48,800 --> 00:15:50,120 performed. 179 00:15:50,120 --> 00:15:57,880 That's our key bit of information for determining the best support for students. 180 00:15:57,880 --> 00:16:03,480 If you have a neuropsych evaluation and you're not sure what all of this means, please reach 181 00:16:03,480 --> 00:16:10,200 out to me at Hanora H-O-N-O-R-A at educaalclearning.com. 182 00:16:10,200 --> 00:16:14,720 And I'll be happy to talk with you about the results and what that might mean for your 183 00:16:14,720 --> 00:16:17,240 student or for your child. 184 00:16:17,240 --> 00:16:22,000 If you are a school or a school district wanting to do more training for your teachers in how 185 00:16:22,000 --> 00:16:30,360 to interpret these evaluations and what kind of support should be put into place based on 186 00:16:30,360 --> 00:16:35,680 discrepancies that come up in these evaluations, please reach out. 187 00:16:35,680 --> 00:16:41,560 I've done a lot of reviewing and analyzing and making recommendations for schools in 188 00:16:41,560 --> 00:16:46,960 different parts of the country and for parents who want to know more about their student 189 00:16:46,960 --> 00:16:49,960 and how their brain works. 190 00:16:49,960 --> 00:16:53,640 And I'm happy to help you out with that as well. 191 00:16:53,640 --> 00:16:59,040 You can also go to the website, educaalclearning.com, go through our blog post, go through some 192 00:16:59,040 --> 00:17:06,160 of our information where we touch on different areas of the diagnosis process and what that 193 00:17:06,160 --> 00:17:13,120 means and how you can use those results to put a great plan into place. 194 00:17:13,120 --> 00:17:19,400 This is how the students who use the educaalclearning model find their path to success. 195 00:17:19,400 --> 00:17:25,120 We use all the data we can find to create the best path forward and we let that drive 196 00:17:25,120 --> 00:17:29,320 our initial interventions and accommodations. 197 00:17:29,320 --> 00:17:33,080 And then we tweak when we find out what works best for the student. 198 00:17:33,080 --> 00:17:38,880 We get rid of things that aren't working as well and we try to move them away from being 199 00:17:38,880 --> 00:17:45,640 pulled out of their classroom, away from being pulled out of a brick and mortar school, trying 200 00:17:45,640 --> 00:17:50,960 to give them as many options as they can with their local public school if that's the family's 201 00:17:50,960 --> 00:17:58,080 choice and really just give that information, make it useful for the student and for the 202 00:17:58,080 --> 00:18:01,400 school. 203 00:18:01,400 --> 00:18:06,360 So to sum up, if you hear someone talking about a deficit model, they're really just 204 00:18:06,360 --> 00:18:12,000 talking about what kind of evaluations are we using and how do we interpret them. 205 00:18:12,000 --> 00:18:13,880 Don't think of it as deficits. 206 00:18:13,880 --> 00:18:20,520 Think of that as looking for discrepancies, looking for areas that catch our attention 207 00:18:20,520 --> 00:18:25,200 because we expected a different level of performance based on the other test. 208 00:18:25,200 --> 00:18:31,960 Let those discrepancies guide you towards the best path for supporting students. 209 00:18:31,960 --> 00:18:37,640 Thank you for listening to What in the World is Dyscalculia and I will speak with you again 210 00:18:37,640 --> 00:18:38,640 soon. 211 00:18:38,640 --> 00:19:06,200 I'm Dr. Honora Wall signing off.