Using a Multisensory Approach in the Treatment of Dyslexic Children
The aim of this assignment is to discuss the methods of helping dyslexic children which employ a multisensory approach, it will cover reflection on the current approaches to helping dyslexic children, reflection on research into current approaches to helping dyslexic children, reflections on research into a multisensory approach for dyslexia, reflections on the application of a multisensory approach to dyslexia and evaluation of dyslexia management using a multisensory approach, using reflective practice, case histories and research statistics.
The International Dyslexia Association describes dyslexia as:
"a neurologically based, often familial disorder which interferes with the acquisition and processing of language. Varying in degrees of severity, it is manifested by difficulties in receptive and expressive language - including phonological processing - in reading, writing, spelling, handwriting, and sometimes in arithmetic. Dyslexia is not a result of lack of motivation, sensory impairment, inadequate instructional or environmental opportunities, or other limiting conditions, but may occur together with these conditions. Although dyslexia is lifelong, individuals with dyslexia frequently respond successfully to timely and appropriate intervention."
The problems that those with dyslexia often encounter come under the following categories
- Phonemic Awareness - identification of sounds
- Auditory Discrimination - hearing the small differences between sounds
- Handwriting - due to immaturity of eye-hand coordination
- Expository and Creative Writing
- Visual-Motor Perception
- Gross Motor Coordination
- ADD and ADHD
- Speech and Language
- Rote Memory Tasks
- Social, Behavioural and Emotional Issues
Generally, of course, difficulties can lead to problems learning other work and emotional and other issues. In the longer term there is dissatisfaction with life and a vast proportion of prison inmates are dyslexic. On the positive side a proportionally large number of millionaires are also dyslexic.
Plenty of research has taken and is taking place on the cause of dyslexia and it seems that the brain of those with dyslexia functions differently to those without. However, the topic of this essay is treatment rather than cause, so I shall concentrate on this aspect.
Multisensory teaching is the use of all senses when teaching so that the different channels will support each other in learning. Gillingham and Stillman (1956) said that the multi-sensory teaching is based upon the constant use of all the following: how a letter or word looks, how it sounds, how the speech organs or the hand writing feels when producing it. The pupil uses the visual channel (eyes), the auditory channel (ears) and kinesthetic (motor memory) and tactile (hands) to learn.
Phonology is the study of sounds and a phoneme is the smallest unit of sound in a language.
REFLECTION ON CURRENT APPROACHES TO HELPING DYSLEXIC CHILDREN
There has been much debate in the past about the best method of teaching those with dyslexia and the most popular of these is phonics. This involves teaching the child which sound each individual letter makes and then they learn to put these into appropriate combinations to spell words. Whilst this is not as straightforward at it could be with the English language since there are many inconsistencies, it is a good foundation to work from.
Whereas many children just pick up phonic awareness without much effort, those with dyslexia often have to learn it specifically and research by Vellutino and Scanlon (1987) and Wagner and Torgeson (1978) show that the lack of phonemic awareness is often the major obstacle for children learning to read and once this is overcome, reading becomes much easier. However, for many children phonic awareness is not enough, the children also need specific tuition in common letter-sound correspondences as Adams (1988), and Byrne and Fielding-Barnsley (1989) found.
Whilst phonics is now taught in most schools it is done by either sight or hearing and does not incorporate all the senses and so does not use a multisensory approach. The following tasks have been shown to have the most positive effect on reading acquisition and spelling, and these are provided through phonics instruction.
auditorily discriminating sounds that are different
blending spoken sounds into words
word to word matching
isolating sounds in words
segmenting spoken words into sounds
deleting sounds from words
Another big improvement in general teaching for dyslexia these days is the use of material that is of interest to the child. Previously the Janet and John type books that were given to four and five years where used for much older children because they had a similar reading age. However, obviously the older children were less inclined to read it since it was not very interesting to them. There are now plenty of books available to suit different combinations of abilities.
Another method of learning to read is called whole-word instruction or the look-say method, where children learn words by frequent viewing of the words. Also there is the whole-language approach which is similar to the whole-word method except that the children are encouraged to guess words they don't know from the context. These two methods became more popular in the 1990s but there was a return to phonics when the research proved this was the better method.
REFLECTION ON RESEARCH INTO CURRENT APPROACHES TO HELPING DYSLEXIC CHILDREN
There is a wealth of information on current approaches to dyslexia. Chall (1967, 1983) looked at the range of research into helping dyslexic children and found that the focusing on the teaching of phonics was by far the most effective method. Later, Jeffrey (1976) and Polloway (1986) et al, found that phonics teaching methods had much better results than other methods.
Haskell et al (1982), took this further and found that when explicit training was given in letter-sound correspondence, the students were more accurate on word recognition tests involving both regular and irregular words, than those who received whole word training or no training at all. Burminster (1975) found that the high frequency letter-sound relationships particularly should be taught early. Coleman (1970), Skailand (1971) and Silberman (1964) found that sound blending should be taught explicitly.
Early treatment is highly recommended, obviously this minimises the learning delay and the emotional issues that are part of a dyslexic child's life. Generally, the individual steps in learning to read and write have to be taught rather than expecting the child just to pick them up, like most other children to.
REFLECTION ON RESEARCH INTO A MULTISENSORY APPROACH FOR DYSLEXIA
Whilst most multisensory methods for dyslexia follow the guidelines above, that is use phonics and teach the child explicitly, they take this one step further and teach it in a multisensory method. There is various research which supports this method, although this is limited, but I have not found any research which is negative about the multisensory approach. This method just enhances the child's natural learning skills. As Guyer and Sabatino (1989) said that "because all the pathways to the brain are being used, the strong senses help the weak ones".
Research by both Roberts and Coleman (1958) and Hulme (1981) found that children who were finding it difficult to read and write found improvement by the tracing on their memory for letter sequences. This same improvement was not found in those who were of average or better ability with their reading and writing. Tracing involves going through the motions of writing the letters, this can be done in the air, in sand or in many other ways.
Research by Wake Forest University Baptist Medical Center in America indicates that dyslexia is a multisensory disorder and that it is caused by a delay in the combining of information from different senses. During learning a non-dyslexic child will match the written word with the spoken word when read to, however, because this process is not so synchronised with a dyslexic child, this connection does not always occur. In this case the use of a multisensory approach will enhance the learning.
REFLECTION ON THE APPLICATION OF A MULTISENSORY APPROACH TO DYSLEXIA TO DYSLEXIA
Multisensory techniques were first used for dyslexia by Dr Samuel Torrey Orton in the mid 1920s. He then got together with Anna Gillingham and produced the Orton-Gillingham method which is probably the best known multisensory method for treatment of dyslexia. There are now plenty of slightly different multisensory methods available, mostly based on this method.
There is now plenty of research available supporting the use of multisensory techniques with dyslexia. Whilst the basic method of phonics is still usually used in the multisensory approach, it can be taught in a different way, encouraging the use of a range of different methods of teaching and using all the senses.
According to McIntyre and Pickering, in their article entitled Multisensory Structured Language Programs: Content & Principles of Instruction they say that there are six aspects of multisensory education, these are phonology and phonological awareness, sound symbol association, syllable instruction, morphology, syntax and semantics.
The use of multisensory methods when teaching children with dyslexic type problems not only ensures that the learning is processed by a range of sensory channels, it also makes the learning more interesting and more like playing and therefore less stressful. For instance, one way could be to make letters out of plasticine, for young children this can be great fun, especially if they can choose different colours to do so.
Philomena Ott (1997) says that the multisensory method of teaching reading should be as follows:
1. The pupil looks at the word using his eyes
2. The pupils says the word aloud using his lips
3. The pupil writes the word using his hands while at the same time he says the letter names
4. Then he reads the word he has written.
and this should be done repeatedly until it is habit.
Cotterall (1970) summarised the Fernald multisensory method as follows
1. The word should be written on a piece of A4 by the teacher using a cursive script
2. The teacher pronounces the word very slowly and clearly. The pupil repeats it
3. The pupil examines the word carefully, noting any particular difficulty or tricky letters
4. He then traces over the letters with his fingers, saying the letter names aloud as he traces them
5. He then folds the paper over
6. He writes the word from memory
7. He then turns over the piece of paper and checks that he has written it correctly
8. He then uses the word in a sentence or a story
Research at the National Institutes of Child Health and Human Development in America have show that a multisensory teaching method is the most effective way of teaching those with difficulties in reading. Research indicates that the use of a multisensory method is much more effective in improving reading abilities than using phonics on its own.
It is particularly effective when the sensory input is particularly strong, for instance bright colours or interesting sensations such as sandpaper letters.
The Hickey Multisensory Language Course involves the use of games such as clapping games and What's the Time Mr Wolf to develop rhymic movement and phoneme awareness. The alphabet is then taught and this is followed by a series of picture cards with a letter and a picture of the word beginning with that letter on it and then a series of worksheets covering a whole range of different word patterns.
Margaret Combley (2001) says the following "Naidoo (1972) states that learning to read and spell depends upon the ability of a child to form automatic and permanent associations between what he sees, hears, says and writes, and that failure lies in the inability to do this. If we analyse the complexity of the task a learner faces when using the language skills, we shall see that what is required is, in fact, a multisensory activity."
EVALUATION OF DYSLEXIA MANAGEMENT USING A MULTISENSORY APPROACH, USING REFLECTIVE ANALYSIS, CASE HISTORIES AND RESEARCH STATISTICS.
There are many studies, personal anecdotes and some statistics available for the different methods of multisensory treatment of dyslexia. However, there is very little information available on multisensory treatments as a whole. Research by Lindamood-Bell indicates that with their treatment there is a dramatic improvement in reading and other relevant abilities after just 6 weeks of their treatment. Their figures are as follows
Word Recognition 19 37
Spelling 19 27
Word Attack 34 55
Paragraph Reading Rate 16 16
Paragraph Reading Accuracy 16 37
Paragraph Reading Fluency 9 16
Paragraph Reading Comprehension 39 63
Overall Paragraph Reading 16 34
Vocabulary 66 73
Oral Directions 37 50
Word Opposites 37 50
Problem Solving 19 39
All of these skills except the paragraph reading rate have improved into the normal range and some of the improvements have been quite dramatic. This figures are quite indicative of the other figures given by different people [www.lblp.com].
The Dynamic Phonics website quotes the following research, although it doesn't state the total number of children involved:
One experimental group was matched to two control groups by using school free lunch percentages and the school's 3rd and 5th grade reading scores on state mandated testing.
The experimental group: This was the first year the teacher was using the program. She attended a one hour talk by the author at the beginning of the year. She had a 3rd-5th self contained SPED classroom. Because of scheduling problems, she was only able to use Dynamic Phonics for about 30 minutes per day. The children spent another 30 minutes doing other reading activities that mostly involved independent reading activities. Even with this small amount of reading time, her children attained over one year's reading growth according to the Woodcock Reading Mastery Test.
1st control group: This class was also an 3rd-5th self contained SPED classroom. This teacher used a literature based reading program with the Houghton-Mifflin reading series. The teacher taught sight words and the children had phonics workbooks for extra practice. These children had about an hour of reading instruction per day. The children in this class attained 0.326 year's reading growth according to the Woodcock Reading Mastery Test.
2nd control group: This class was a 3rd-5th self contained SPED classroom. This teacher used the Focus reading series, the Modern Curriculum Press phonics books, and had the children read for 15 minutes at home every night. The reading time in this class was at least 2 hours per day. The children in this class attained 0.833 year's reading growth according to the Woodcock Reading Mastery Test.
Conclusions: The difference between the experimental group and the first control group are substantial and demonstrate the power of this reading program.
Obviously this method did not use the most time, but had the greatest increase in reading ability
The Slingerland Multisensory Method website quotes the following research, and this also doesn't give any more information:
The Royal Study on Achievement (1999)
Conducted by Nancy Royal, Ed.D. at the Prentice School.
On a test of Word Attack, 10 months of instruction resulted in 15.2 months of progress.
On a test of Word Identification,10 months of instruction resulted in 20.1 months of progress.
On a test of Reading Comprehension, 10 months of instruction resulted in 16.9 months of progress.
On a test of Spelling, 10 months of instruction resulted in 8.7 months of progress.
Thus, there were significant gains in acquisition of phonetic skills, word identification, and reading comprehension.
The Toe by Toe website quotes the following:
My son has been working on Toe by Toe for the last two terms...He now has a reading accuracy of 10.02 (it was 7.08) and a reading comprehension of 12.06 (previously it was 8.00). I would just like to pass on my thanks to you and everyone concerned in the production of this book that has given my son the chance to access the normal school curriculum and increase his self confidence to an amazing degree
The following comes from the Lexia Learning website:
"At the end of second grade, his teachers suggested a tutor for the summer. This was an unusual step for them. Of course, I was anxious. We debated over what to do. He worked so hard all year, and we wanted him to go to day camp, but we saw that he wasn't learning. I don't even remember when how we stumbled on Lexia's Touch and Learn software. We debated about the decision. First, there was the expense. We would have to buy the program which was manageable, but also, we didn't have a computer. It was a major decision for us," says Judith, "but we did it!"
Allen loved the program. He enjoyed working independently on a computer, and began to feel successful. According to his mother, he wanted to spend every free minute after camp with the software. Still, she remained worried. "I saw him playing lots of games on the computer. He especially loved the basketball game (an exercise to develop awareness of long vowel sounds and to practice applying a silent-e to appropriate words). In fact, he still loves basketball," she laughs. "But we didn't know if he was learning."
In September, Allen went back to Gateway. His teachers were astounded and delighted by the progress he made over the summer months. They said he was like a different child. By the end of the fourth grade, he was testing in the 99th percentile in reading. He continued at Gateway through the fifth grade, but the real breakthrough came because of that summer he spent with the Lexia program. Previously, nothing came automatically for him. Allen needed the drills and additional practice. He also liked being able to monitor his own progress with the software. That's what did it."
Emily was about two years behind with her spelling age despite being above her age on most of her other abilities, including her reading. This was made worse by the fact that her twin brother's spelling age was nearly three years ahead of his actual age.
Because she was so frustrated with her difficulty in spelling the thought of it made her cross and therefore it was hard to progress. It caused arguments and upsets at home and insecurity at school. It was affecting every area of her life and also the rest of the family. She has always been a volatile child and this has made it much worse
Evaluation and Analysis
The school tested her and she was found to be slightly dyslexic. They didn't consider that she needed further help saying that it would sort itself out, but the family disagreed being concerned about the emotions involved, rather than the spelling problems. Various methods were considered. Part of the problem was a difficulty with spelling, but part of it was caused by the emotional upset that went along with it.
It was essential to help her spellings without making it feel like she was doing extra work it needed to be something that was both enjoyable and educational.
However, the use of different multisensory methods, such as using plasticine and playing games distracted her from the fact the was actually and doing spellings and it relaxed her which also helped her to learn. These methods were also fun, and the sort of thing that she would have done for pleasure anyway.
Whilst much is done today to try to help the child with dyslexia, and the body of research is steadily increasing, a greater emphasis needs to be put on using multisensory methods to assist with the learning. Not only are multisensory methods very effective, but they can also be very enjoyable, involving a range of activities so that the child forgets that he is actually learning.
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