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Case Study Interventions Monique Janssen Interventions for Bruce Wayne Bruce Wayne participated in a psycho-educational evaluation that

involved administration of the Wechsler Individual Achievement Test- Second Edition (WIAT-II), the Clinical Evaluation of Language Fundamentals- Fourth Edition (CELF-4), and the Keymath. Results from these three standardized tests indicate that Bruce is struggling with reading and math and likely has some sequential processing problems. What follows are some suggested interventions to strengthen Bruces academic performance. Interventions in the Classroom Teachers have described Bruce as a strong-willed child who is resistant to engage in activities that do not interest him. This is common in children who struggle with sequential processing as it is required in every class. Problems with sequential processing will make mathematics and reading difficult. In math Bruce will struggle to determine the steps necessary for solving the problem, while in reading he will have difficulty comprehending text. Finding ways to make the activities interesting and rewarding to Bruce will be important for future school success and this may require rewards based programming. Bruces homework load should be reduced to avoid overwhelming him, as it will take him longer than his peers to complete assignments. The possibility of giving Bruce extra time for in class assignments and tests should be explored if Bruce is using some assistive tools such as flow charts reminding him of the steps for math, or computer aids for reading. This is important because using these tools will take time. Additionally, making sure Bruce is given instructions through multiple modalities (particularly using

charts, pictures, symbols, and gestures) and asking him to repeat directions will help him to retain the information. The teacher should make a point of making eye contact with Bruce immediately before giving instructions to ensure he is attending and directions should be as simple as possible, repeated often, and presented in a meaningful context. Teacher personality should be carefully considered during classroom placements as Bruce performs better when he likes the teacher. Furthermore, the teacher needs to be able to institute firm and consistent discipline combined with frequent positive reinforcement to maintain Bruces motivation. To promote consistency across home and school, a communication book could be used for the teacher and Bruces parents to keep in touch. The parents may also want to reinforce the importance of school and reward Bruce for completing his homework and meeting mutually agreed upon goals. Bruce will benefit from one on one time with a tutor to help him catch up on missed worked in math and reading and to aid him in developing studying strategies. Some study strategies to try include chunking, highlighting important information and repeating it often, and understanding how to elicit help when confused. Moreover, Bruces parents might consider counseling to help Bruce adjust to his new living arrangements, build self-esteem, and understand that he is a smart person who happens to have a learning problem. Interventions for Language Bruces scores on the WIAT-II reading and writing subtests indicate the Bruce is struggling quite a bit with reading and somewhat with spelling. Additionally, his performance on the CELF-4 receptive subtests show that he is performing below his peers.

In order to improve Bruces receptive language I recommend a referral from his doctor for a hearing test to ensure that there is no hearing damage resulting from the history of ear infections. I also recommend giving Bruce preferential seating in the classroom so that he can be close to the teacher which may aid him in paying attention and make certain he can hear. Another possibility would be to refer Bruce to a Speech and Language Therapist for further examination and possible treatment, which would probably involve using a meta-cognitive orientation. The meta-cognitive orientation focuses on teaching students to use strategies for thinking and using their language rather than focusing on acquiring the language skills (Law, Campbell, Roulstone, Adams, & Boyle, 2008). Lastly, I suggest that at home Bruces parents encourage receptive language such as rewarding Bruce for following directions; asking him to give summaries of what has happened in favorite stories, shows, movies, or video games; and playing games that require listening to opponents for success. The reading and spelling subtests both indicate that Bruces phonemic knowledge is weak, which may be related to difficulties with hearing. All suggestions regarding hearing mentioned above are relevant, but I would add to this list some interventions designed to strengthen his reading. Working with a volunteer or tutor on a language program that included instruction on phonics and comprehension will help. If no such person is available the school or parents may want to invest in some computer programs for Bruce. The CASTLE program is a computer-based program that teaches students to use reading strategies in understanding text. Another computer program that can be tried is Kurzwheil, which will allow Bruce to scan the text into the computer and then have it read to him while the words appear on the screen. Kurzwheil is a complicated program to

operate and may need to be used in a quiet room. Meta-cognitive strategies can be used to improve Bruces reading whereby the focus is on strategies Bruce can use when he is struggling rather than merely reviewing the basics. For this reason a program like CASTLE may help him perform at his age level without necessarily having all the basics usually required for reading (Wexler, Vaugh, Edmonds, & Klein Reutebuch, 2008). When educational information is really important the possibility of supplying it to Bruce through video should be explored. I would encourage the tutor and the parents at home to read with Bruce as often as possible; perhaps taking turns reading pages if the book is difficult and then reflecting on what was read. Additionally, verbal games such as rhyming words or giving him three or four words and asking him which does not belong may help improve vocabulary and his understanding of phonics. Practicing reading and playing language games should improve Bruces spelling as he will be more familiar with words and have a greater understanding of phonics. Playing games that involve spelling such as Scrabble or crosswords may be fun ways to encourage Bruce to improve his spelling. Interventions for Math Scores on the WIAT-II indicated problems with numerical operations and a low average performance on math reasoning. The KeyMath was administered and indicated that Bruce struggles with numeration, subtraction, multiplication, mental computation and time and money calculations. It appears that many of Bruces problems with mathematics are in dealing with the basics and missing class while in the hospital may have exacerbated this. Bruce needs extra practice to catch up to his peers. This practice may involve a peer tutor to aid with in-class work and reviewing the basics at home or

with an adult. If possible this extra work should be focused on improving Bruces understanding of numeration and time and money. Mental computation will come with practice but a lack of interest may be interfering so using performance based rewards might help. At home, Bruces parents may want to reinforce his math skills through work sheets or flash cards, particularly those dealing with subtraction and multiplication. Practicing time and money should be included in the environment; perhaps by having Bruce set an alarm clock, time the amount of time he spends doing fun activities, or encouraging him to do time calculations in other ways. For example, a parent could say Bruce we need to leave for your friends house in fifteen minutes, what time will it be when we leave? Allowing Bruce to manage some money, save up for specific items, and then make the purchases himself could improve his understanding of money. Taking him to the bank and having him open a savings account will offer Bruce a more sophisticated experience with money in a concrete manner.

Interventions for James Howlett James Howlett recently participated in a psychological assessment that involved the administration of the Woodcock-Johnson III Tests of Achievement (WJ-III) and the Comprehensive Test of Phonological Processing (CTOPP) because of concerns with his academic achievement in math, reading and writing. Results from these standardized tests indicated that James struggles with math, but that his reading and writing are average. However, fluency is an issue for James as he struggled most with math fluency and decision speed. Intervention suggestions follow. Interventions for Fluency Fluency is clearly an issue for James; however, the cyclical nature of James academic challenges as presented by his father suggest that some other factor outside of learning may be interfering with his academic performance. I recommend that James have a physical so the doctor can rule out ADHD, seasonal affective disorder, and sleeping problems. Regardless of whether there are medical explanations for James cyclical academic performance the following interventions should improve his academic performance. James knows what he needs to do but it takes him longer than his peers to complete the work. With fluency issues practice is key, as his speed will improve over time and with experience. The importance of practice is shown as James improves from the fall to the spring when working with his Dad but appears to lose this knowledge over the summer. I recommend ensuring that James practices his math, reading, and writing over the summer to prevent him from losing the information he worked so hard to obtain during the school year (Gortmaker, Daly, McCurdy, Persampieri, & Hergenrader, 2007). In school James should be taught to organize his notes and structure his

assignments so that he is able to pick out the important information. Paraphrasing, repetition, and making real world connections to the work are study strategies that will likely help James. In order to ensure James is processing as much information as possible during class time the information should be presented to him in a multi-modal fashion that makes use of verbal, written, and pictorial cues. Additionally, James should be given extra time when completing assignments and tests as it will take him longer than his peers to complete the work. Interventions for Language James performed well on the subtests for reading and writing; however, reading fluency was somewhat difficult for him. Since parent and teacher reports suggest that James has difficulty with reading and writing I will make some suggestions for improving literacy skills. The school should provide James with some extra instruction in phonics and James should practice his reading frequently. Encouraging him to read rewarding and stimulating text will be important at home. Perhaps James can be taken to the bookstore or library in order to get new books, comic books, or magazines of his choosing regularly. James reading should be done with someone else, an audiocassette that reads a passage first and then allows time for James to read it back, or the Kurzwheil program as these strategies will improve fluency (Roberts, Torgesen, Doardman, & Scammacca, 2008). Additionally, some choice in class reading assignments may increase James motivation. Writing can be practiced in similar ways to reading such as encouraging James to send emails or write letters to friends and write lists before shopping.

Interventions for Mathematics The results of the WJ-III indicate that James struggles with math fluency. James knows what he needs to do but it takes him longer than his peers to complete the work, so practice is key. Until James speed improves, he should be given extra time to complete tests to ensure his marks assess his ability and not what he had time to complete. To keep things interesting and make up for processing deficits teaching should be done using multi-modal methods of instruction such as visual information being presented with oral information. The visual information will be particularly helpful because James can refer back to it as needed. To improve the efficiency of his mathematics practice James should be taught to self monitor his performance. A self-monitoring performance program will involve James working on a worksheet for a couple of minutes and then checking his work (Brady & McDougall, 1998). The work sheet should focus on mathematical basics such as numeration, subtraction, and multiplication. The time period will be singled with an audio cue telling James it is now time to check his work. After he checks his work he records how many questions he completed and how many were right. James can later put this information into graph form to track his progress. Self-monitoring has been found to be successful both during and after the intervention period if the student continues to use it. Many students like self-monitoring because it is quick and provides a visual indication of what has been accomplished (Brady & McDougall, 1998).

References Brady, M.P., & McDougall, D. (1998). Initiating and fading self-management interventions to increase math fluency in general educational classes. Exceptional Children, 64(2), 151-166. Gortmaker, V.J., Daly, E.J., McCurdy, M., Persampieri, M.J., & Hergenrader, M. (2007). Improving reading outcomes for children with learning disabilities: Using brief experimental analysis to develop parent-tutoring interventions. Journal of Applied Behavior Analysis, 40(2), 203-221. Law, J., Campbell, C., Roulstone, S., Adams, C., & Boyle, J. (2008). Mapping practice onto theory: The speech and language practitioners construction of receptive language impairment. International Journals of Languages & Communication Disorders, 43(3), 245-263. Roberts, G., Torgesen, J.K., Doardman, A., & Scammacca, N. (2008). Evidence-based strategies for reading instruction of older students with learning disabilities. Learning disabilities Research & Practice, 23(2), 63-69. Wexler, J., Vaugh, S., Edmonds, M., & Klein Reutebuch, C. (2008). A synthesis of fluency interventions for secondary struggling readers. Reading and Writing, 21(4), 317-347.

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