Robert F. Newby

Use of the Restricted Academic Task in ADHD Dose-Response Relationships

Behavioral assessment techniques have been shown to make a significant contribution in the evaluation of stimulant medication response in children with attention-deficit/hyperactivity disorder. This article examines the role of a behavioral measure consisting of standardized observation of a child while he or she performs an academic-like task (Restricted Academic Task). This technique is reliable and valid for repeated administrations across medication dosages and placebo. It can assist in optimizing medication dosage for individual children, given its sensitivity to dosage effects. It also allows the capture of medication-related changes in an area of functioning that is not directly assessed by parent and teacher judgments and ratings. In this way the Restricted Academic Task may have greater ecological validity than the results of other, more traditional in-clinic measures. Finally, given the idiosyncratic nature of stimulant medication effects on individual children, it contributes to the explication of a specific childs behavioral dose-response relationship.

Improving the Reading Comprehension of Children with Dysphonetic and Dyseidetic Dyslexia Using Story Grammar

Five 8- to 10-year-old children with dysphonetic and dyseidetic dyslexia were given instruction in reading comprehension using a story grammar strategy in which story instruction was differentially designed to match the simultaneous or sequential mental processing strengths of each dyslexia subtype. A multiple baseline, single subject experimental design and statistical analyses indicated that the experimental treatments yielded statistically and clinically significant improvements in the proportion of qualitatively important story elements recalled by the subjects, when compared to baseline traditional remedial instruction. The results suggested that students with dyslexia can increase their reading comprehension with training in metacognitive strategies. The question of whether the results were attributable to the subtype-matched methods per se or to strategy training in general, as well as a number of methodological issues, is being explored in subsequent research.

Academic Attainment Findings in Children with Sickle Cell Disease.

BACKGROUND Children with sickle cell disease (SCD) demonstrate deficits in cognitive and academic functioning. This study compared the academic attainment of children with SCD relative to national, state, and local school district rates for African American students. METHODS A retrospective chart review of children with SCD was completed and academic information was collected from caregiver report and school records. One-sample tests of proportions were calculated to compare academic attainment rates in children with SCD relative to national, state, and local school district normative data of African American students. RESULTS Overall, 197 patient records were reviewed. A higher proportion of children with SCD were retained a grade relative to national, state, and local school district rates for African American students. In addition, a higher proportion of children with SCD received special education services relative to the national, state, and local school district rates for African American students. CONCLUSION Children with SCD demonstrate higher rates of special education services and grade retention relative to African American peers. Overall, children with SCD demonstrate poorer academic attainment relative to healthy, African American peers highlighting the need for increased focus on special education services to address school performance issues within this population.

Results of an Early Intervention Program for First Grade Children at Risk for Reading Disability.

Abstract Thirty‐eight first grade children with low emergent literacy skills who were at risk for difficulty in learning to read were tutored for a median of 58 half‐hour sessions in addition to their regular classroom instruction. The tutoring (Early Intervention Program, EIP) focused on word recognition, phonetic application and comprehension in context. The EIP childrens word recognition in isolation and in context, reading speed, and comprehension were superior to well‐matched controls at completion of tutoring, at the end of first grade, and at third grade. At grade three, the EIP group was equivalent to a group of average‐reading classmates on word recognition in context, acceptable accuracy and answering comprehension questions, but not on word recognition in isolation or on reading speed.

Empirically Tested Interventions for Subtypes of Reading Disabilities

Research in child neuropsychology has contributed significantly to the differentiation of subtypes of learning disabilities over the past two decades. Recent research reviews have outlined a multitude of different subtype systems (Rourke, 1985; Lyon, 1985a). Although a consensus has not yet been reached on the most valid subtype classifications, several common themes are emerging. For instance, some mathematics disabilities are clearly attributable to an underlying, nonverbal learning disability (Rourke, 1989), and many reading disability subtypes can be related to underlying deficits in the dimensions of phonological or orthographic processing (Newby & Lyon, 1991). One of the most important assumptions behind the effort to specify different subtypes of learning disabilities involves the notion that different subtypes need different kinds of intervention. The term “educational validation” refers to research that examines this assumption (Fletcher, 1985; Lyon, 1985b; Newby & Lyon, 1991). Reading disability or developmental dyslexia represents the most common and most extensively studied class of learning disabilities. The main aim of this chapter is to examine several research programs that have attempted educational validation of subtypes of reading disabilities.

Attention Deficit Hyperactivity Disorder in Children With Sickle Cell Disease Referred for an Evaluation

Neuropsychological deficits, including difficulties with attention, are well described in children with sickle cell disease (SCD). Very little is known about attention deficit hyperactivity disorder (ADHD) in children with SCD. The objective of this study was to determine the proportion of ADHD in children with SCD referred for neuropsychological evaluation. This prospective, cross-sectional study included patients (age, 4 to 18 y) with SCD and completion of a neuropsychological evaluation between December 2013 and March 2016. Patients were referred for neuropsychological evaluation because of concern regarding school performance, development, and/or behavior. The diagnosis of ADHD was made by a neuropsychologist on the basis of the diagnostic criteria in the Diagnostic Statistical Manual—Fourth or Fifth Editions. ADHD medication usage rate was obtained by medical record review. Of the 89 patients with SCD referred for neuropsychological evaluation, 25% (95% confidence interval, 16%-35%) met diagnostic criteria for ADHD. Only 21% of the patients with SCD and ADHD were prescribed an ADHD medication. Our study supports routine ADHD screening in children with SCD who have poor school performance or behavioral concerns. Despite the benefits of pharmacologic treatment, the majority of patients with SCD and ADHD did not receive a medication for management of their ADHD.

Well Compensated But Never Quite Solved: Lingering Dyslexia

Tim, whose family owned a bookstore, first came for evaluation in third grade to explain and provide recommendations for his academic struggles, particularly in reading, spelling, written language, and memorization of math facts. He then came for two separate evaluations during middle and high school. The longitudinal information thus available about the progression of his reading problems illustrates a common case of partially remediated word reading disability.

A Mystery of Perplexing Symptoms: Neuropsychological Assessment in a Case of Dysautonomia

Poor misunderstood Laura! Preschool staff filled out referral forms about her struggle with “physical and verbal control when with others” and “swaying attention.” Her kindergarten teacher felt that she actually enjoyed disturbing others, although Lauras parents suspected that this teachers status as the oldest and most dominant in the traditional culture at her small rural school might have been coloring her view of students who did not sit and do their work quietly. Were her periods of apparent fatigue really signs of becoming less interested in the work? Elementary grade staff debated if she might be a “tactile/visual learner” rather than an “auditory learner.” Things became particularly perplexing when she started showing quirky medical features, such as rapid weight shifts, losing her sense of smell at age 6, and being diagnosed with asthma and then unexpectedly never having asthma symptoms again after a 10-day course of steroids.

Sense and Sensibility: Relating Behavior Control Issues with Self-Regulation of Sensory Input

Jennifer was referred for a neuropsychological evaluation as a supplement to a psychological evaluation for behavior problems and a previous history of academic difficulties. Her prenatal development, birth, and early infancy were normal. Early developmental milestones were attained at the normal rate for both motor and language functions. There were no significant head injuries and no other neurological insults. Since 5 years of age, during times of stress, she has gone through episodes lasting up to a month of often closing her eyes and shaking her head. Her primary care physician had ruled out Tourettes disorder, but she had not had a neurological evaluation. Jennifers parents reported in interview that she has always shown very high sensitivity to sound, touch, and smell. Vision and hearing screening tests were normal.

Sorting Sounds: Reading Disability with Phonological Awareness Deficit

As Angies father was reading to her one evening near the end of junior kindergarten, he paused in the story to play a game with her of matching letters to their sounds. Angie had been slow in learning to recognize printed letters earlier that year, and he thought it would be good to practice some more advanced alphabet skills now. He was dismayed to discover during the game that she was bafflingly inconsistent at recognizing even the/a/sound that began her own name. Had Angies teacher not commented recently that the class was working on this for the past several weeks?