Cognitive constraints on learning to read in children with an intellectual disability who are deaf and hard of hearing

Item does not contain fulltextLearning to read is challenging for children who have hearing impairments and concurrent intellectual disabilities because they face barriers due to both conditions. In many developmental domains, including executive functioning and language development, auditory and intellectual disabilities mutually influence each other; a deficit in one domain hinders coping mechanisms to compensate for distortions in the other. The resulting impact is more than the sum of the parts. It affects the way students learn to read and the way they process written text in many ways. Little is known about the key factors in literacy development for children with both hearing impairments and intellectual disabilities. This chapter integrates recent findings on reading development in children with both of these conditions to define a research base for two exploratory studies on literacy attainment in these learners. Recommendations for literacy education are based on these studies

Modeling individual variation in early literacy skills in kindergarten children with intellectual disabilities

In the present study, we investigated (i) to what extent the early literacy skills (phonological awareness, letter knowledge, and word decoding) along with cognitive (nonverbal reasoning, attention, phonological short-term memory, sequential memory, executive functioning) and linguistic (auditory discrimination, rapid naming, articulation, vocabulary) precursor measures of 53 six-year old children with intellectual disabilities (ID) differ from a group of 74 peers with normal language acquisition (NLA) and (ii) whether the individual variation of early literacy skills in the two groups to the same extent can be explained from the precursor measures. Results showed that children with ID scored below the NLA group on all literacy and precursor measures. Structural equation modeling evidenced that in the children with NLA early literacy was directly predicted by phonological awareness, PSTM and vocabulary, with nonverbal reasoning and auditory discrimination also predicting phonological awareness. In children with ID however, the variation in word decoding was predicted by letter knowledge and nonverbal reasoning, whereas letter knowledge was predicted by rapid naming, which on its turn was predicted by attentional skills. It can be concluded phonological awareness plays a differential role in the early literacy skills of children with and without ID. As a consequence, the arrears in phonological awareness in children with ID might put them on hold in gaining proper access to literacy acquisition. What this paper adds: This paper adds to the theoretical knowledge base on literacy acquisition in a special population, namely children with intellectual disabilities (ID). It addresses factors that influence early literacy learning, which have not been investigated thoroughly in this special and specific group. Furthermore, the children are not tested solely on literacy, but also on cognitive measures that may influence literacy acquisition. Whereas most research in ID focuses on groups with specific syndromes/etiologies, this paper takes a varied group of children with ID into account. The paper also adds to educational insights, since the findings imply that children with ID are able to use phonological pathways in learning to read. Educators could teach these children phonics-based literacy skills tailored to their individual learning needs

Cognitive constraints on learning to read in children with an intellectual disability who are deaf and hard of hearing

Learning to read is challenging for children who have hearing impairments and concurrent intellectual disabilities because they face barriers due to both conditions. In many developmental domains, including executive functioning and language development, auditory and intellectual disabilities mutually influence each other; a deficit in one domain hinders coping mechanisms to compensate for distortions in the other. The resulting impact is more than the sum of the parts. It affects the way students learn to read and the way they process written text in many ways. Little is known about the key factors in literacy development for children with both hearing impairments and intellectual disabilities. This chapter integrates recent findings on reading development in children with both of these conditions to define a research base for two exploratory studies on literacy attainment in these learners. Recommendations for literacy education are based on these studies

Screening high-risk patients and assisting in diagnosing anxiety in primary care: The patient health questionnaire evaluated

Background Questionnaires may help in detecting and diagnosing anxiety disorders in primary care. However, since utility of these questionnaires in target populations is rarely studied, the Patient Health Questionnaire anxiety modules (PHQ) were evaluated for use as: a) a screener in high-risk patients, and/or b) a case finder for general practitioners (GPs) to assist in diagnosing anxiety disorders. Methods A cross-sectional analysis was performed in 43 primary care practices in the Netherlands. The added value of the PHQ was assessed in two samples: 1) 170 patients at risk of anxiety disorders (or developing them) according to their electronic medical records (high-risk sample); 2) 141 patients identified as a possible ‘anxiety case’ by a GP (GP-identified sample). All patients completed the PHQ and were interviewed using the Mini International Neuropsychiatric interview to classify DSM-IV anxiety disorders. Psychometric properties were calculated, and a logistic regression analysis was performed to assess the diagnostic value of the PHQ. Results Using only the screening questions of the PHQ, the area under the curve was 83% in the high-risk sample. In GP-identified patients the official algorithm showed the best characteristics with an area under the curve of 77%. Positive screening questions significantly increased the odds of an anxiety disorder diagnosis in high-risk patients (odds ratio = 23.4; 95% confidence interval 6.9 to 78.8) as did a positive algorithm in GP-identified patients (odds ratio = 13.9; 95% confidence interval 3.8 to 50.6). Conclusions The PHQ screening questions can be used to screen for anxiety disorders in high-risk primary care patients. In GP-identified patients, the benefit of the PHQ is less evident. Keywords: Anxiety disorder, Patient health questionnaire, Primary care, ScreeningCase finding, Criterion validit