There is no single test to diagnose dyslexia

Sumber https://www.facebook.com/suri.scharles.1/posts/508206563293274

Dyslexia in Malaysia.

From 2015 to 2016, there has been a sharp increase number of students diagnosed with Dyslexia; 3082 to 8937. In 2018, it was reported there are 11,148 students (data ending June 2018) diagnosed with Dyslexia and attending schools under the Ministry of Education (KPM).

Allow me to explain what is needed to assess and diagnose Dyslexia or any other Specific Learning Disorders.

Assessing and Diagnosing Dyslexia

Dyslexia is a Specific Learning Disorder (SLD) that is not so straightforward and easy to diagnose. There is no single test/tools that can be used to assess and diagnose dyslexia.

A number of factors to be considered:

Child's development,
educational and behavioral issues, and
medical history.
Home life includes Spoken Language at home
Early School Year experience background.
Vision/Visual Processing and Audio Processing Functioning
Neurological tests.
Psychological testing
Speech and Language Development Test
Executive Functioning Tests
Testing reading and other academic skills

- Oral Language
- Word Recognition
- Decoding
- Spelling
- Phonological Processing
- Automaticity/Fluency Skills
- Reading Speed and Comprehension
- Vocabulary Knowledge

No two children with dyslexia will experience the same set or degree of symptoms. Therefore, the task of assessing, relating and interpreting the information collected should be the responsibility of a professional who is thoroughly familiar with the important characteristics of dyslexia at different stages in the development of literacy skills, and he/she should also be knowledgeable of the influence of language development and behavior on literacy learning.

He/She should be an expert diagnostician:

- The nature of the dyslexic learner

* Strengths
* Weaknesses
* Learning Style
* Underlying Issues
* Co-Occurrances
* Language Background

- The Neuro-Biology of reading

*Reading and the Cognitive Functioning of the Brain
*Understanding of reading development
*The Single Word Processing and Beyond Text Comprehension
*Understand both linguistic and non-linguistic processing

Understand the inter-connectivity of the cognitive and emotional networks
- Reading and the Limbic System: Emotion and Memory

My question is, how, where and who are the experts diagnostician assessing and diagnosing these 11,418 students? General Practitioners? Family Doctors? Pediatricians? Occupational Therapists? Speech Therapists? Teachers? Educational Psychologists? Psychiatrists?

Let's think about this:

A
1. Could it be possible there has been a misdiagnosis?
2. If yes, what are the implications of it?
3. How would it affect those children that has been misdiagnosed?
4. Are we willing to admit our mistakes and correct them?
5. Are we willing to reassess those children and "unlable" them?
6. Provide them with the right tools, support and intervention?

B
1. It was a fit diagnosis
2. What are the findings to justify the diagnosis?
3. What is the plan of action?
4. How do you draw out the intervention?
5. Who would be the best key person to draw them out?
6. Who would be the best person to deliver the intervention?
7. How do we provide support to both students and "interventionist"?
8. How do we ensure these children are getting the quality support and right "treatment"?

#Nopunintended.
#Donttakeitpersonal.
#Learnandteachoneanother.
#Sharingiscaring.
#DrSuriSCharles

IT'S LUNCH TIME!

Pusat pekhidmatan Pendidikan Khas

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Pihak sekolah bole membuat temujanji secara berkumpulan untuk murid2 yang disyaki ada masalah pembelajaran untuk berjumpa dengan pegawai pendidikan khas di 3PK yang berdekatan.

Pihak sekolah boleh hubungi 3PK berhampiran untuk perbincangan. Selepas itu, pihak sekolah perlu menghantar surat permohonan kepada Pengarah Bhgn Pendidikan Khas.

Sila hubungi 3PK Putrajaya di 03-88849246, atau emel 3pkputrajaya@gmail.com

Consultation with Clinical Psychologist

Jika suspek anak ada permasalahan pembelajaran, Jumpala Clinical Psychologist sebagai permulaan

Consultation with Clinical Psychologist can help to confirm any suspicions that there might be a learning or cognitive disability.

Ini adalah diantara nama test penilaian yang akan dibuat bersama Clinical Psychologist

Cognitive Performance
- Weschler Intelliigence Scales for Children- Fourth Edition ( WISC-IV)
- Raven's Progressive matrice & Vocabulary Scale

Adaptive behaviour
- Conners Early Childhood ( Conners EC)
- Conners 3rd Edition

- Adaptive Behaviour Assestment Systems - 2nd Edition (ABAS-II)

- Childhood Autism rating Scale - 2nd Edition (CARS-2)

- Dyslexia Screening Test Junior - (DST-J)

- ASEBA School-Age Form & Profiles : Child Behaviour Checklist (CBCL)
- ASEBA School-Age Form & Profiles ; Teachers' rating Form (TRF)
- Autism Diagnostic ObservationSchedule, 2nd Edition (ADOS-2)

But all this test have it own limitation. Its in English and dont use local data .

Sebarang pengesahan masalah pembelajaran bukan dengan hanya sekali jumpa pakar dan dapat pengesahan. The valuation, assesment, observation and test should be done for a period of time.

Setelah mendapat assesment report from Clinical Psychologist, ia akan menjadi lebih mudah untuk merancang the next course of action.

Its wrong to say ' Anak saya tak tahu membaca dan menulis, dia ada disleksia' atau 'Anak saya disleksia sebab tu dia tak tau membaca dan menulis'

'There must be a cause and reason why the kid is having difficulty in learning to read despite conventional instruction and having adequate intelligence,,,'

'Dyslexia' is just a term to describe the multiple cause that lead to difficulty in reading.

- ini belum masuk bab menulis as copying, writing as written expression, writing as comprehension...... , belum masuk bab emotional and behaviour, Dan kebanyakan mereka juga adalah borderline High Functioning ASD, showing autistic trait but not diagnose as one..... anxiety..... low self esteem....
Dulu saya selalu cakap to myself, As long as Qaisya know how to read and write, I am good already.... how wrong can I be....

Ujian saringan disleksia

Ada ramai parent yang merasakan anak mereka dyslexic, hanya melalui andaian sendiri atau hanya selepas membuat 'dyslexia screening' atau ujian saringan disleksia. Ujian saringan/screening hanyalah peperiksaan awal.

Untuk kepastian , buatlah pemeriksaan lanjut dan dapatkan pengesahan dari pakar pakar berikut

1. Development Paedtracian
( Bukan Paedtracian/ DrKanak Kanak akan hanya memeriksa kesihatan , masalah pembelajaran bukan kepakaran mereka )

2. Educational Psychologist
3. Klinical Psychologist
4. Occupational Therapist
5. Psychologist
6. Special Need Teacher/ Guru Pendidikan Khas
7. Speech- Language Pathologist/ Therapist

Setiap mereka ada bidang pengkhususan mereka. Diagnose dan assestment yang betul adalah sangat penting untuk merancang intervension yang sesuai. Tujuan assestment / penilaian bukanla untuk pengesahan disleksia sahaja, tetapi adalah untuk mengetahui apakah permesalahan / kondisi seseorang itu. Apabila buat assestment , beritahu kenapa buat assetment, dan biarlah mereka yang menilai dan buat pemeriksaan yang sepatutnya berdasarkan permasalahan yang dimaklumkan. mana tahu ia bukan hanya disleksia atau ada permasalahan lain? Tidak perlu cakap nak buat pengesahan disleksia, nanti yang lain 2 tak diperiksa pula, sebab Doktor dan pakar akan ingat kita nak buat pengesahan disleksia sahaja. Assesment ialah untuk mengetahui dimana kekurangan/defisit/delay. Untuk mengenal pasti the strengh and ciri ciri / personaliti. Follow up mesti dibuat kerana mereka dalam proses pembesaran... apa yang didiagnose hari ini mungkin akan berubah pada tahun depan. What kind of progress sepanjang tahun... jika tiada , perlu ditahu kenapa? kena buat perubahan. Cara pembelajaran tak sesuai? salah diagnose ke?

We are racing against time. Jika salah diagnose, salah buat intervension, selepas setahun dua , anak masih tiada perubahan...

Setiap program intervension dan terapi , terutama di tempat swasta akan melibatkan kos dan masa.

Dapatkanlah assestment dari Dr. dan Hospital. dan berbincang selalu dengan Guru dan Sekolah.

Our Journey#2
============
A very detail and comprehensive report . By Kidzgrow. This is the same report given to PPUKM, when applying the OKU Card. Eventhough I have the report, I don’t understand it at that time , looking back, All the ‘red flag’ have already been stated in the report. I don't do what is required ... The missing opportunity.... 

Prosedur temujanji di Hospital Kuala Lumpur

Prosedur temujanji di Hospital Kuala Lumpur

UNIT PSIKITRI KANAK KANAK DAN REMAJA

Institute Pediatrik

Hospital Kuala Lumpur

50586 Kuala Lumpur

Tel : 03 2615 5555 Samb. 6908 ( Kanak-kanak )

Unit Pemulihan Cara Kerja

Institut Pediatrik

Hospital Kuala Lumpur

Tel : 03-2615 5652

Tel : 03-2590 6909

CDC – Child Development Center

Prosedur untuk buat appointment

1.      Dapatkan reference letter dari pihak sekolah dan klinik kesihatan.

2.      Dapatkan temujanji bersama Dr. Kanak-kanak ( Paedtracian ). Sila bawa hasil kerja anak, report PDM jika ada, atau surat dari guru sekolah.

3.      Paedtracian akan membuat penilaian awal sebelum diberi appointment ke Klinik Psikitri, CDC – Child development Center dan Unit pemulihan Cara kerja.

Prosedur temujanji di Klinik Kesihatan & Fakulti Sains Kesihatan , UKM

Kepada sesiapa yang ingin membuat temujanji di UKM

Prosedur berikut yang perlu puan ambil tindakan.

1. Dapatkan surat Rujukan daripada Hospital/klinik/sekolah/ majikan mengenai pemasalahan yang dihadapi.

2. Faxkan ke talian 03-26878192 atau email kpk_fsk@ukm.edu.my untuk rujukan & tindakan pihak KPK-FSK selanjutnya. (list dalam senarai menunggu )

3.Sila maklumkan kepada kami 2 no. telefeon yang masih aktif untuk menghubungi pihak puan bg tujuan pemberitahuan tarikh temujanji. tarikh akan dimaklumkan setelah berbincang bersama pakar. makluman tarikh temujanji melalui telefon & SMS dan selewat-lewatnya 2 minggu sebelum tarikh yang dicadangkan.

4. Dokumen yang diperlukan: (a) Surat Rujukan (b) sijil Kelahiran & MyKid (c). Surat Akuan Pelajar (Sek. Bantuan Kerajaan) (d) Surat Akuan Majikan/ Kad Pesara ( Kakitangan Awam) (e). Laporan Akademik/Perubatan (Jika Ada) (f). Kad Pemilik OKU

5. Bayaran yang dikenakan oleh KPK-FSK.
a.Pendaftaran pertama=RM30
b. Pendaftaran ulangan=RM5
c. Penilaian Psikologi=RM10- RM200/Penilaian
d. Rundingan Psikologi=RM25/Jam

Garis Panduan untuk buat pengesahan masalah pembelajaran ( part 1 )

Garis Panduan untuk buat pengesahan masalah pembelajaran ( part 1 )

============================================

Jika parent mengesyaki anak mungkin ada permasalahan pembelajaran,sediakan satu senarai checklist mengapa parent mengesyaki anak ada permasalahan. Cheklist ini beserta Birth dan Growth Development History ini juga akan digunakan sebagai rujukan ketika berjumpa pakar sama ada Development Paedtracian, Clinical Psychologist atau Paedtracian Occupational Therapist ( Doktor kanak kanak tiada kepakaran untuk pengesahan permasalahan pembelajaran) LD is not a medical condition.
Jika di Hospital kerajaan akan dirujuk ke Jabatan Psikitri kanak2( tak tahu la kenapa rujukan pertama biasanya jumpa Psychologist, mungkin untuk menilai emosi ?)
Ada sebahagian Hospital ada Child Development Center (CDC)

https://disleksiadad.blogspot.com/2018/11/prosedur-temujanji-di-klinik-kesihatan.html

https://disleksiadad.blogspot.com/2018/11/prosedur-temujanji-di-hospital-kuala.html

- Bila mula merangkak, berjalan, cara berjalan dan duduk ( w sitting atau tip toeing )
- Bila mula bercakap ( Bahasa yang digunakan ) Jika ada kelewatan mula bercakap dan pelat perlu dirujuk kepada Speech Therapist
Jika anak masih berumur 6 tahun kebawah ( belum memasuki persekolahan Tahun 1), Gunakan ‘Growth Development Chart’ sebagai panduan. Rujuk kepada Jurupulih kerja/ Occupational Therapist untuk kepastian.
- Dominant side dah establish ke belum ( penggunaan tangan kanan atau kiri, midline crossing, kebolehan mengayuh basikal membuat pusingan penuh semasa mengayuh, lompat satu kaki, kaki mana yang digunakan, baling bola untuk melihat kekuatan tangan dan kebolehan membuat anggaran balingan) Cognitive skill, gross dan fine motor.
- Anak bole terima arahan? anak faham arahan, berapa lama anak bole focus untuk membuat sesuatu aktiviti?
Pendidikan Awal
Sejak bila mula bersekolah / playschool
- Bila mula belajar membaca dan menulis? ( sekurangnya mestila 6 bulan ),
- siapa yang mengajar, teknik apa yang diguna, adakah belajar jawi dan alquran pada masa yang sama,
- Jika dibanding dengan rakan sekelas yang bersama2 belajar adakah terdapat perbezaan ketara terutama skil membaca dan menulis.
Bagaimana perangai anak disekolah? Suka menyendiri atau bole bersosial ?
- adakah anak sudah bersedia untuk belajar secara formal, ( school readiness)
- Bahasa pengantar/ perbualan utama yang dugunakan anak ( Melayui atau English )
- Mata dan telinga juga perlu diperiksa untuk kepastian. Cek mata dengan ophthalmologist, bukan cek mata dikedai cermin mata biasa.
TRO, to rule out jika mata dan telinga adalah penyebab .

- To be continue.

Screening & Assestment

What is a learning disability assessment ?
===================================
An LD assessment is a gathering of relevant information about an individual’s areas of strengths and challenges to determine whether or not he or she may have a learning disability. The components of the assessment process may vary depending on which individual, clinic, or agency is conducting the assessment, but most assessments include the following:
- Screening (informal interview, brief test, and/or review of growth development, family, education and environment histories)
- Evaluation (formal testing for achievement, intelligence, and processing)
Diagnosis (a statement specifying the results of the assessment, including the type of LD identified)
- Recommendations (for school, and/or daily living)

Screening vs Assestment
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Ujian Saringan = Screening test
---------------------------------------------
The purpose of screening is to determine whether an individual needs assessment. The purpose of assessment is to gather the detailed information needed for an intervension program that meets the individual needs . ... Screening is a process for evaluating the possible presence of a particular problem
Diantara screening tool yang biasa digunakan ialah -
Dyslexia Screening Test Junior - (DST-J))

Assestment = Penilaian.
-----------------------------------
Ujian penilaian assestment dilakukan oleh certified professional.

Cognitive Performance
- Weschler Intelliigence Scales for Children- Fourth Edition ( WISC-IV)
- Raven's Progressive matrice & Vocabulary Scale
Adaptive behaviour
- Conners Early Childhood ( Conners EC)
- Conners 3rd Edition
- Adaptive Behaviour Assestment Systems - 2nd Edition (ABAS-II)
- Childhood Autism rating Scale - 2nd Edition (CARS-2)
- ASEBA School-Age Form & Profiles : Child Behaviour Checklist (CBCL)
- ASEBA School-Age Form & Profiles ; Teachers' rating Form (TRF)
- Autism Diagnostic ObservationSchedule, 2nd Edition (ADOS-2)