## International Dyslexia Association ## Grapevine, Texas ## October 30, 2015 # Nickola Wolf Nelson, Ph.D., CCC-SLP Michele A. Anderson, Ph.D., CCC-SLP # Western Michigan University --- - **Nickola Nelson is a co-author of the Test of Integrated Language and Literacy Skills (TILLS). References to this measurement tool will be made during this session. Nonfinancial: No relevant nonfinancial relationships exist.** - Many graduate students, colleagues, test administrators. - Nelson, N. W., Plante, E., Helm-Estabrooks, N., & Hotz, G., (2016). Test of Integrated Language and Literacy Skills (TILLS). Baltimore, MD: Paul H. Brookes Publishing, Inc. (with potential royalties). Paul H. Brookes Publishing Co. also contributed financially and nonfinancially to the development of the TILLS. - U.S. Department of Education, Office of Special Education Programs, and Institute of Education Sciences, National Center for Special Education Research, Grant R324A100354 to Western Michigan University funded the standardization research on the TILLS. However, the opinions in this presentation are those of the authors and not the U.S. government. - Nelson, N. W. (2010). Language and Literacy Disorders: Infancy *through Adolescence. Boston, MA: Allyn & Bacon.* --- "Simple View of Reading" • Reading decoding/ word recognition Sound/word level knowledge • Sound/word level knowledge • Phonological (and orthographic) aspects of language Focus on form • Focus on form Reading comprehension • Reading comprehension Sentence/discourse level knowledge • Relies on accurate decoding Focus on making sense • Nonphonological aspects of language Relies on accurate decoding Word recognition (D) X Oral language comprehension (C) = Reading comprehension (R) --- Vocabulary Part of C ## D C R Word Oral Language Reading ## Recognition Comprehension Comprehension Simple View of Reading (SVR; Gough & Tunmer, 1986) Simple View of Reading Redux (Tunmer & Chapman, 2012) --- *“Dyslexia is a specific learning disability that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.”* - Adopted by the IDA Board of Directors, Nov. 12, 2002. This Definition is also used by the National Institute of Child Health and Human Development (NICHD). Many state education codes, including New Jersey, Ohio and Utah, have adopted this definition. Learn more about how consensus was reached on this definition: Definition Consensus Project. --- Vocabulary Part of C ## D C R Word Oral Language Reading ## Recognition Comprehension Comprehension # Listening comprehension > Reading comprehension (Badian, 1999; Stanovich, 1994) --- How simple are the pieces? DECODING/WORD RECOGNITION • Phonemic awareness • Orthographic • Orthographic awareness • Morphological awareness • Vocabulary • Vocabulary knowledge ▪ Structure ▪ Structure ▪ Semantic • Real word reading with or without syntactic context • Etc. • Etc. ▪ Semantic Nonword reading • Nonword reading and spelling • Real word reading LANGUAGE COMPREHENSION • Word recognition ▪ Speech perception ▪ Speech perception ▪ Reading decoding ▪ Reading decoding Vocabulary • Vocabulary • Complex syntax • Complex syntax • Cohesive devices ▪ Morphology ▪ Phonology • Etc. ▪ Phonology ▪ Orthography Concrete word ▪ Anaphoric reference ▪ Catephoric reference ▪ Catephoric reference Discourse structure • Goal to measure language, not world knowledge • Etc. • Concrete word referents • Figurative meanings • Discourse structure • Inference • Figurative meanings • Multiple meanings • Inference • Logical reasoning ▪ Categorical/contrastive ▪ Part-whole • Logical reasoning • Memory • Attention • Goal to measure ▪ Part-whole ▪ Synonym/antonym • Memory • Attention ▪ Temporal ▪ Logical ▪ Logical ▪ Emotional ▪ Emotional Etc. • Etc. --- Figure 8.1. Illustration of the many strands that are woven together in skilled reading. (p. 98) --- - Two dimensions may explain dyslexia and specific language impairment (SLI) - Phonological skills (sound/word level) - Nonphonological skills (sentence/discourse level) (Bishop & Snowling, 2004; Catts, Adlof, Hogan, & Weismer, 2005) --- ## Sentence/Discourse Ability Dyslexia Good listening comp & sentence formulation Average in both Low reading decoding & fluency & spelling Sound/Word Ability High sound/word skills and surface Low Reading + reading? Low Language Good Reading Decoding + Poor Comprehension --- Language Levels X Modalities Model TEST OF INTEGRATED LANGUAGE & LITERACY SKILLS Language Level | Modality | Language Level | | | --- | --- | --- | | Sound/Word Level | Sentence/Discourse Level | | | Listening | 1. Vocabulary Awareness(VA) 2. Phonemic Awareness(PA) | 6. Listening Comprehension(LC) 8. Following directions(FD) | | Speaking | 4. Nonword Repetition(NWRep) | 3. Story retelling(Comp Qs)(SRcomp) 13. Social communication(SC) | | Reading | 10. Nonword Reading(NWRd) 11. Reading Fluency(RF) | 7. Reading comprehension(RC) | | Writing | 5. Nonword Spelling(NWSp) 12c. Written Exp-word score(WEwd) | 12a.Written Exp discourse score(Wedisc) 12b.Written Exp sentence combining score(WEscs) | | Memory | 14.Digit Span Forward(DSF) 15.Digit Span Backward(DSB) | 9. Delayed story retelling(DSR) | Nelson, N. W., Plante, E., Helm-Estabrooks, N., & Hotz, G. (2015). Test of Integrated Language and Literacy Skills (TILLS™). Brookes Publishing Co., Inc. --- # 15 Subtests ## 17 scores (3 scores for Written Expression) --- # 1. Vocabulary Awareness ## “Here are three words. Let’s read them together.” ## “dog–cat–bone” Say, “Tell me two words that go together.” Then ask, “Why?” --- # 2. Phonemic Awareness ***“If the word is bip, and we take away the first sound, the word becomes[hesitate]… ip.”*** ***“If the word is stig, and we take away the first sound, the word becomes… tig.”*** --- # 3. Story Retelling Select the age-appropriate story and say, “I’m going to ***read you a story. Listen carefully. Your job is to tell the story back to me just like I tell it to you.”*** --- # 4. Nonword Repetition ## Say, “I am going to play a voice recording for you. The person on the recording will say a pretend word that is not a real word. You will only hear the word once. Listen carefully so you can say the word just like the person you hear.” Start the recording. --- # 5. Nonword Spelling ## Administer immediately after Nonword Repetition. ## Say, “I am going to play another voice recording of pretend words. These are the same words you said before. This time your job is to spell the words.” ## “Remember, these are not real words, but they are like real words…” --- # 6. Listening Comprehension ## Say, “I’m going to read some very short stories. Your job is to listen and pay careful attention. Then I’ll ask you some questions about the story. Tell me ‘yes’ if you are sure the answer is ‘yes.’ Tell me ‘no’ if you are sure the answer is ‘no.’ If the story doesn’t clearly tell you the answer, tell me ‘maybe.’ --- # 7. Reading Comprehension Administer immediately following Listening Comprehension: ***“Now, it’s your turn to read some short stories and answer the questions in your Student Book. Circle yes if you are sure the answer is yes. Circle no if you are sure the answer is no. If the story doesn’t clearly tell you the answer, circle maybe.”*** --- # 8. Following Directions ## “I’m going to give you some directions to follow with your pencil in your Student Book. Listen carefully because I can only say them once. When I say ‘Go,’ move the card and use your pencil to follow the directions.” --- # 9. Delayed Story Retelling Turn to the age-appropriate story and say, “Remember the story ***[Tommy the Trickster/The Rubber Raft]? Tell me the story again. Try to remember as much as you can. Start now.”*** --- # 10. Nonword Reading ## Say, “These are pretend words that are not real words, but they are like real words. Your job is to read these words out loud.” --- # 11. Reading Fluency ## Say, “Here are some facts that tell a story. First, read the title out loud.” ***“Now read the facts.” If the student is an emergent reader, you may say, “Just read the words you know.”*** --- # 12. Written Expression – Discourse, Sentence, and Word Scores - ***“Here’s another story. It has facts about a little dog. It’s okay, but it sounds choppy. Here is an example of how you could put the facts together to make it sound less choppy and more interesting.”*** - ***“Now it’s your turn to put the facts for your story together in a way that sounds better.”*** --- ## Discourse Score: 18/20 - content units = 90% **Sentence Score: 18** content/7 T-units =2.57 **Word Score: 74/88 wds** without error = 84% --- # 13. Social Communication ***“This activity is about acting a scene, like from a show on TV or a movie. Your job is to be an actor.”*** Say, “I’ll give you a really short scene. Then I’ll ask you to tell me what one of the people would say. This is important—you should say it how the person would say it in the scene. Remember, you’re the actor! Let’s try one. I’ll do the first one to show you.”*** “It is red. It is my favorite color, and I will kiss you if you buy it.” --- # 14. Digit Span Forward 15. Digit Span Backward ## 14. Say, “I am going to say some numbers. Listen to the numbers, and when I finish, you say them back to me exactly the same way.” ## 15. “This time, when I read the numbers to you, I want you to listen carefully and say them back to me in backward order.” --- Factor analysis support for the SVR | | Factor Reference Structure (Semipartial Correlations) | | Final Communality Estimate | | --- | --- | --- | --- | | | Factor 1 | Factor 2 | | | Phonemic Awareness | 0.547 | 0.074 | 0.550 | | Non-word Spelling | 0.600 | 0.067 | 0.642 | | Non-word Reading | 0.734 | -0.058 | 0.786 | | Reading Fluency | 0.406 | 0.077 | 0.325 | | Written Expression Word Score | 0.409 | 0.009 | 0.267 | | Story Retelling | -0.052 | 0.500 | 0.345 | | Vocabulary Awareness | 0.229 | 0.472 | 0.629 | | Listening Comprehension | 0.009 | 0.548 | 0.476 | | Reading Comprehension | 0.264 | 0.420 | 0.589 | | Following Directions | 0.153 | 0.409 | 0.412 | | Social Communications | 0.075 | 0.476 | 0.428 | --- Regression Analysis Support for the SVR Tunmer & Chapman, 2012 Age 7;0-7;11 (N = 122) TILLS, 2015 Ages 6;0-18;11 (N = 1887) | Model | R2 | ΔR2 | β | Model | R2 | ΔR2 | β | | --- | --- | --- | --- | --- | --- | --- | --- | | 1 Age | .001 | .001 | .045 | 1 Age | .007 | .007 | .047* | | 2+List Comp | .460 | .459 | .260* | 2+List Comp | .356 | .349 | .303* | | 3+Wd Rec | .773 | .313 | .525* | 3+Wd Rec | .533 | .177 | .051* | | 4+Vocab | .797 | .022 | .210* | 4+Vocab | .571 | .038 | .294* | * Statistically significant p < .05 --- Identification Core Subtests, Cut Scores, and Sensitivity/Specificity 6-7 YEAR OLDS • Core subtests • Vocab Aware • NW Rep Sensitivity • Phoneme Aw • Sensitivity 84% Specificity • Specificity 84% • Core subtests • Vocab Aware • NW Read • Sensitivity 88% • Specificity 12-18 YEAR OLDS • Core subtests • Phoneme Aw • NW Spell Rdg Comp • Reading Fluency WE-Word • WE-Word Sensitivity 86% • Sensitivity 86% Specificity 90% • Specificity 90% --- ## Corroborating Information Multiple sources Co-norming Student Rating Scale --- - History of difficulty learning to read and write - Tested for Special Ed in Grade 3 (not with the TILLS), but did not qualify - Test of Early Written Language (TEWL-3) SS 106 - Wechsler Indiv Achievement Test (WIAT-III) th th ▪ Word Reading 12 %ile; Word Reading Speed 25 %ile th th ▪ Pseudoword Decoding 12 %ile; Pseudoword Decoding Speed 50 %ile th ▪ Early Reading Skills 12 %ile th ▪ Reading Comprehension 16 %ile st th ▪ Oral Reading Fluency 21 %ile; Oral Reading Accuracy 7 %ile; Oral th Reading Rate 27 %ile ▪ Spelling 23th %ile (fist/fix, could/cold, tal/tall, nite/night) th rd th ▪ Math problem solving 23 %ile, Numerical operations 39 %ile - Classroom teacher reports relative strength in math “particularly if story problems are read aloud” rd rd Gen Ed. Teacher SLS in 3 Grade Parent SLS in 3 Grade --- 9 year old girl TILLS TM | | Oral Language | | | | | | | | | Written Language | | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Sound/Word Level | | | | Sentence/Discourse Level | | | | | | Sound/Word Level | | | | Sent/Disc Level | | | | | | PA | NW Rep | DSF | DSB | VA | LC | FD | SR | DSR | SC | NW Read | RF | NW Spell | WE- Word | RC | WE- Disc | WE- Sent | | | | Standard Score | 3 | 9 | 7 | 6 | 5 | 8 | 7 | 6 | 5 | 10 | 2 | 0 | 4 | 7 | 5 | 11 | 7 | | | 16-19 | | | | | | | | | | | | | | | | | | | | 15 | | | | | | | | | | | | | | | | | | | | 14 | | | | | | | | | | | | | | | | | | | | 13 | | | | | | | | | | | | | | | | | | | | 12 | | | | | | | | | | | | | | | | | | | | 11 | | | | | | | | | | | | | | | | | | | | 10 | | | | | | | | | | | | | | | | | | | | 9 | | | | | | | | | | | | | | | | | | | | 8 | | | | | | | | | | | | | | | | | | | | 7 | | | | | | | | | | | | | | | | | | | | 6 | | | | | | | | | | | | | | | | | | | | 5 | | | | | | | | | | | | | | | | | | | | 4 | | | | | | | | | | | | | | | | | | | | 3 | | | | | | | | | | | | | | | | | | | | 2 | | | | | | | | | | | | | | | | | | | | 1 | | | | | | | | | | | | | | | | | | | | 0 | | | | | | | | | | | | | | | | | | | --- TILLS scores for 9 year old girl | Age Band | Identification Composite Standard Score | Cut Score | Sensitivity | Specificity | Decision: Is the identification composite less than the cut score? Yes | | --- | --- | --- | --- | --- | --- | | 6-7 years | | 24 | 84 | 84 | This score is consistent with the presence of language and literacy disorders. No This score does not meet the criterion for identifying language and literacy disorders. | | 8-11 years | 22 | 34 | 88 | 85 | | | 12-18 years | | 42 | 86 | 90 | | • Core subtests • WE-Discourse • Vocab Aware • NW Read | Sd/Word Comp | Sent/Disc Comp | | --- | --- | | 50 | 75 | --- rd rd Gen Ed. Teacher SLS in 3 Grade Parent SLS in 3 Grade --- - Hx of prematurity; born at 26 weeks, in hospital for 5 months - Primary eligibility speech/language impairment on basis of language - Goals in multiple areas of language and math - Verbal expression - Language content - Reading comprehension - Math calculation - Math reasoning --- 10 year old boy TILLS TM | | | Oral Language | | | | | | | | | Written Language | | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Sound/Word Level | | | | Sentence/Discourse Level | | | | | | Sound/Word Level | | | | Sent/Disc Level | | | | | | PA | NW Rep | DSF | DSB | VA | LC | FD | SR | DSR | SC | NW Read | RF | NW Spell | WE-Word | RC | WE-Disc | WE-Sent | | | | Standard Score | 10 | 12 | 7 | 10 | 4 | 3 | 5 | 3 | 6 | 0 | 4 | 11 | 7 | 10 | 3 | 12 | 5 | | | +2 SD | 16-19 | | | | | | | | | | | | | | | | | | | 15 | | | | | | | | | | | | | | | | | | | | 14 | | | | | | | | | | | | | | | | | | | | 13 | | | | | | | | | | | | | | | | | | | | 12 | | | | | | | | | | | | | | | | | | | | 11 | | | | | | | | | | | | | | | | | | | | 10 | | | | | | | | | | | | | | | | | | | | 9 | | | | | | | | | | | | | | | | | | | | 8 | | | | | | | | | | | | | | | | | | | | 7 | | | | | | | | | | | | | | | | | | | | 6 | | | | | | | | | | | | | | | | | | | | 5 | | | | | | | | | | | | | | | | | | | | 4 | | | | | | | | | | | | | | | | | | | | 3 | | | | | | | | | | | | | | | | | | | | 2 | | | | | | | | | | | | | | | | | | | | -3 SD | 0 | | | | | | | | | | | | | | | | | --- TILLS scores for 10 year old boy | Age Band | Identification Composite Standard Score | Cut Score | Sensitivity | Specificity | Decision: Is the identification composite less than the cut score? Yes | | --- | --- | --- | --- | --- | --- | | 6-7 years | | 24 | 84 | 84 | This score is consistent with the presence of language and literacy disorders. No This score does not meet the criterion for identifying language and literacy disorders. | | 8-11 years | 27 | 34 | 88 | 85 | | | 12-18 years | | 42 | 86 | 90 | | • Core subtests • WE-Discourse • Vocab Aware • NW Spell • NW Read | Sd/Word Comp | Sent/Disc Comp | | --- | --- | | 92 | 57 | --- 360122 --- - Hispanic; not an English language learner - History of speech/language impairment on basis of language - Syntax goals • Morphology goals - SLI primary and SLD secondary on IEP --- 14 year old boy TILLS TM | | Oral Language | | | | | | | | | Written Language | | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Sound/Word Level | | | | Sentence/Discourse Level | | | | | | Sound/Word Level | | | | Sent/Discourse Level | | | | | PA | NW Rep | DSF | DSB | VA | LC | FD | SR | DSR | SC | NW Read | RF | NW Spell | WE-Word | RC | WE-Disc | WE-Sent | | | Standard Score | 0 | 0 | 4 | 8 | 4 | 5 | 2 | 7 | 8 | 4 | 0 | 0 | 0 | 2 | 0 | 9 | 6 | | 16-19 | | | | | | | | | | | | | | | | | | | 15 | | | | | | | | | | | | | | | | | | | 14 | | | | | | | | | | | | | | | | | | | 13 | | | | | | | | | | | | | | | | | | | 12 | | | | | | | | | | | | | | | | | | | 11 | | | | | | | | | | | | | | | | | | | 10 | | | | | | | | | | | | | | | | | | | 9 | | | | | | | | | | | | | | | | | | | 8 | | | | | | | | | | | | | | | | | | | 7 | | | | | | | | | | | | | | | | | | | 6 | | | | | | | | | | | | | | | | | | | 5 | | | | | | | | | | | | | | | | | | | 4 | | | | | | | | | | | | | | | | | | | 3 | | | | | | | | | | | | | | | | | | | 2 | | | | | | | | | | | | | | | | | | | 1 | | | | | | | | | | | | | | | | | | | -3 SD | | | | | | | | | | | | | | | | | | --- TILLS scores | Age Band | Identification Composite Standard Score | Cut Score | Sensitivity | Specificity | Decision: Is the identification composite less than the cut score? Yes | | --- | --- | --- | --- | --- | --- | | 6-7 years | | 24 | 84 | 84 | This score is consistent with the presence of language and literacy disorders. No This score does not meet the criterion for identifying language and literacy disorders. | | 8-11 years | | 34 | 88 | 85 | | | 12-18 years | 2 | 42 | 86 | 90 | | • WE-Word • Core subtests • Phoneme Aw • Reading Comp | Sd/Word Comp | Sent/Disc Comp | | --- | --- | | 8 | 58 | --- Support for the SVR Factor analysis: 2 factors To Infinity and Beyond To Infinity and Beyond Beyond Regression models: SVR (including vocab) explains variance in RC Clinically meaningful • Individual differences rule • Student may be good at word recognition or • Student may be good at word recognition or reading fluency but still struggle with word structure knowledge • Comprehension may vary across types of discourse: • Listening Comprehension • Story Telling • Following Directions • Parent, teacher, and student input are critical • Take advantage of strengths; target • Following Directions • Social Communication • Social Communication Memory and attention may play varied roles --- # Comments Questions --- Badian, N. A. (1999). Reading disability defined as a discrepancy between listening and reading comprehension: A longitudinal study of stability, gender differences, and prevalence. Journal of Learning Disabilities, 32, 138-148. Bishop, D. V. M., & Snowling, M. J. (2004). Developmental dyslexia and specific language impairment: Same or different? *Psychological Bulletin, 130(6), 858-886.* Catts, H. W., Adlof, S. M., Hogan, T. P., & Ellis Weismer, S. (2005). Are specific language impairment and dyslexia distinct disorders? Journal of Speech, Language, and Hearing Research, 48(6), 1378-1396. Gough, P. B., & Tunmer, W. E. (1986). Decoding and reading disability. Remedial and Special Education, 7, 6-10. Hoover, W. A. & Gough, P. B. (1990). The simple view of reading. Reading and Writing, 2, 127-160. Nation, K., Clarke, P., Marshall, C. M., & Durand, M. (2004). Hidden language impairments in children: Parallels between poor reading comprehension and specific language impairment? Journal of Speech, Language, and Hearing Research, 47(1), 199-211. Nelson, N. W., Plante, E., Helm-Estabrooks, N., & Hotz, G., (2016). Test of Integrated Language and Literacy Skills (TILLS). Baltimore, MD: Paul H. Brookes Publishing Co. Scarborough, H. (2001). Connecting early language and literacy to later reading (dis)abilities: Evidence, theory, and practice. In S.B. Newman & D.D. Dickinson (Eds.), Handbook of early literacy research (pp. 97–110). New York: Guilford Press. Stanovich, K. E. (1994). Annotation: Does dyslexia exist? The Journal of Child Psychology and Psychiatry and Allied Disciplines, *35(4), 579-595.* Tunmer, W. E., & Chapman, J. W. (2007). Language-related differences between discrepancy-defined and non-discrepancy-defined poor readers: A longitudinal study of dyslexia in New Zealand. Dyslexia, 13(1), 42-66. Tunmer, W. E., & Chapman, J. W. (2012). The simple view of reading redux: Vocabulary knowledge and the independent components hypothesis. Journal of Learning Disabilities, 45, 453-466.