Tim Conway, Ph.D.

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A Transdisciplinary Model for Assessment and
Treatment of Learning Difficulties in Children
and Adults

• Tim Conway, Ph.D.
• The Morris Center, Inc.
• www.TheMorrisCenter.com

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Transdisciplinary

• two or more disciplines pool their
  approaches/knowledge and modify them, so that by
  working together they are better able to
  improve/treat the problem or weak skills.

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Transdisciplinary Assessment Treatment Program
for Learning Disabilities

• Overview of Services
• Intake/Screening Appointment
• Phase I Assessment
• Phase II Assessment
• Treatment
• Post-treatment Assessment
• Follow-up/Generalization

1933
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Learning Disabilities - Reading

• Dys difficulty Lexia words
• Poor skills in Reading
• Neurological in origin
• Lifelong, but environment may alter course
• Core deficit in Phonological Component of
  Language
• Accompanying Challenges (50)
• ADHD
• Sensorimotor
• Behavior problems

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Transdisciplinary Team

• Disciplines on the team
• Pediatrician/Psychiatrist
• Nursing/Nurse Practitioner
• Psychology/Neuropsychology
• Occupational Therapy
• Speech-Language Pathology
• Teacher/Special Education

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Transdisciplinary Assessment

• Intake/Screening Appointment with Director
• Collection of records
• Identify presenting concern(s)
• Provide scope and sequence of assessment and
  treatment program, timeline of program,
  associated costs,
• Provide research/educational data, identify
  additional community resources, etc
• Determine fit for The Morris Centers services
  and clients needs

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Transdisciplinary Team Assessment

• Two Phase Assessment
• Phase I Broad Neurodevelopmental Evaluation
  Medical History
• Phase II Assessment of Specific Abilities to
  Identify an Individual Profile of Strengths
  Weaknesses (for diagnostic and treatment planning
  purposes)

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Transdisciplinary Team Assessment

• Phase I Evaluation (broad screening)
• Neurodevelopmental evaluation
• Medical and Developmental History Exam
• Screening of all brain systems including
  neuromotor, perception, learning, attention,
  speech, language, memory, motor planning and
  cognition.
• Nutrition, sleep, behavior, allergies, medical
• Psychological evaluation
• Diagnostic interview psychosocial, educational,
  behavior, family history.

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Transdisciplinary Team Assessment

• Phase I Assessment Team members
• Nurse Practitioner or Developmental-Behavioral
  Pediatrician
• Clinical Psychologist or Pediatric Psychiatrist
• Director of The Morris Center

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Transdisciplinary Team Assessment

• Phase II in-depth assessment to identify an
  individuals specific areas of strength and
  weakness that may contribute to presenting
  concerns or difficulties
• Attention/Intention
• Intelligence/Cognition
• Oral Language
• Memory
• Sensorimotor
• Written Language
• Mathematics
• Behavioral Observations

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Transdisciplinary Team Assessment

• Phase II Team Members
• Clinical Psychology
• Neuropsychology
• Occupational Therapy
• Speech Language Pathology
• Educational Specialist
• Nursing
• Psychometrist

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Transdisciplinary Treatment Program

• Key treatment features are based on neuroscience
  and behavioral treatment research findings
• Intensity ( of hours per day)
• Frequency ( of days per week)
• Specificity (clarity of treatment program)
• Ongoing data collection of program effects for
  program self-evaluation
• Selective post-treatment assessment with
  standardized tests to document treatment gains

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Transdisciplinary Treatment Program

• Treatment targets within an Transdisciplinary
  model
• Speech-Language Therapy
• Targets improving foundational language skills
  that may cause the learning difficulty, e.g.
  phonological processing/decoding
• Occupational Therapy
• Targets sensory and motor skills that may
  contribute to learning difficulties, e.g. sensory
  defensiveness, visual processing/perception, etc.
• Psychiatric/Medical
• Medication and behavioral management of
  attention, mood or behavior disorders.
• Psychological Treatment
• Client
• e.g. developing adaptive coping skills for
  academic and life stressors
• Parent
• e.g. better behavior management, conflict
  resolution training, etc
• Client Parent/Spouse (separately or combined)
• Developing adaptive family or marital
  functioning, relative to learning difficulties.

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Treatment - Case Study

• High school student
• History of dyslexia
• Years of school-based academic intervention
• Years of reading tutoring
• commercial centers, by private 11 tutors
• a family member was an ESE Reading Specialist
• A first-team athlete
• Weak skills in
• reading (gt5 years below grade), writing
  spelling
• comprehension
• auditory and visual memory
• visual-spatial
• attention

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Treatment - Case study

• Transdisciplinary Phase I II assessments
  identified weaknesses in
• Language
• poor phonological processing, reading, spelling
  and comprehension
• Occupational Therapy
• sensory integration deficits including poor
  praxis, vestibular, visual vigilance, visual
  tracking, and visual processing
• Medical
• poor attention, as exhibited by difficulty
  maintaining attention to relevant visual and
  auditory stimuli

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Transdisciplinary Treatment Program

• Individualized, Transdisciplinary treatment
• Speech-Language Therapy
• Occupational Therapy
• Clinical Psychology/Counseling
• Intensive, Frequent and Explicit Treatment
• 22-25 hours of language treatment per week
• 5 days/week for 4-5 hours/day
• 1 hour of counseling per week
• 1 hour of parent education per week
• 5 hours of occupational therapy per week
• 12 weeks of 11 Transdisciplinary treatment
• (duration of treatment is client dependent)

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Documented Treatment Results

• Selective re-administration of pre-treatment
  standardized, nationally normed-tests for
  measurement of post-treatment gains.
• Graphical representation shows pre-treatment
  scores as blue stars and post-treatment
  scores as green stars
• Green arrows indicating areas of significant gain
  or improvement.

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pre-treatment skills post-treatment skills
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Transdisciplinary Assessment and Treatment Goals

• Identify and then improve weak skills to develop
  new strengths in
• Language
• Sensorimotor
• Cognition/attention
• Behavior
• Develop independent functioning in language,
  sensory-motor, behavior achievement, relative
  to an individuals true potential.
• Provide essential tools for success in
  academic, occupational and interpersonal domains
  of life.

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Thank Youwww.TheMorrisCenter.com