I recently started having headaches almost daily. When these headaches began to impact my quality of life and productivity, I decided it was time to go see my doctor. After listening to me, the doctor wrote me a prescription for a medication he gives all his patients with headaches. Seemed to make sense, until I stopped to think! Does one medication work for every patient with headaches? What is causing my headaches? Wouldn’t it make more sense to treat the cause of the headaches? The doctor should have looked more deeply and diagnostically when he met with me.
Just as we sometimes see the “one size fits all” approach in health care, it happens with reading intervention as well.
In 1967, two early authors on learning disabilities, Johnson and Myklebust wrote, “The single most important factor in planning for a child with a learning disability is an intensive diagnostic study. Without a comprehensive evaluation of his deficits and assets, the educational program may be too general, or even inappropriate.”
WOW! Two things are remarkable, in my mind, about this quote. First, it was written 50 years ago and still holds true today. Second, when we choose reading interventions for students, we are often choosing educational programming that is too general, inappropriate or a waste of time. When it comes to a student with reading challenges, we have no time to waste.
Johnson and Myklebust clearly wanted us to understand, even back then, that assessment must drive intervention. This starts with screening for all students multiple times per year. Examples of common screening tools include: Dynamic Indicators of Basic Early Literacy Skills (DIBELS), FAST Bridge, NWEA Measures of Academic Progress. Screenings tell us who is in danger of not meeting standards. From those results, we must also look at other pieces of data, observation and information from teachers and parents to determine if further diagnostic assessment is needed. If it is determined that the screening data was likely accurate, diagnostic assessment should be used to pinpoint the lowest level of skill deficit.
Let’s take Johnny for example. Johnny was screened just like all his peers. He scored quite low on the reading fluency measure, and this score typically indicates that Johnny will not achieve proficiency on the spring high stakes testing. It would be easy to assume that Johnny needs an intervention in reading fluency, right? Wrong!
First, we need to vet out other reasons for the low test score. Did Johnny sleep well the night before? Has he ever scored low on other reading fluency measures? Is his teacher concerned about this?
Maybe the answer to these questions is yes, and there are legitimate concerns!
Even then, we don’t know WHY Johnny is struggling with fluency. Diagnostic assessment needs to be done to determine if he lacks phonemic awareness skills, decoding skills or word recognition skills. Examples of diagnostic reading assessments include: Diagnostic Reading Assessment (DRA), Qualitative Reading Inventory-6, Woodcock Reading Mastery-III. It is best practice to “test backwards and teach forward.” This means, if Johnny is struggling with all areas, we need to go back to the lowest level skill and intervene from there.
Once a research based intervention has been chosen to target the lowest skill deficit, it is imperative that teachers are doing two things. First, they must implement the intervention with fidelity as prescribed in the research or program guidelines. This means following the procedures of the intervention including how often the intervention takes place and how long each intervention session lasts. (Imagine if I took my blood pressure medication only when I felt like it. How effective would that intervention be?) Second, teachers must keep data specific to the area of skill deficit using progress monitoring tools such as: AIMSWEB, easyCBM, FAST Bridge. Check out this chart for more information on progress monitoring tools. Your progress monitoring data will help you know when to continue the intervention, change the intervention or stop the intervention.
Remember, when deciding on reading interventions, you must screen students, narrow down concern areas using diagnostic assessment and progress monitor. As confusing as this may seem, we must use what we know to intervene effectively and improve reading outcomes for our learners. The bottom line? Just as the doctor should have looked at the cause of my headaches to choose an appropriate treatment, assessment is key to reading interventions and improving achievement in your readers.