Educational strategies

Connecting the ws cognitive profile to educational strategies

by: Nancy Grejtak

In April of 1988, an article was published in the WSA newsletter entitled Optimal Teaching Techniques for Williams Syndrome Children. Then came Information For Teachers, first published in the newsletter in the Fall of 1993, then made into a booklet available for purchase. In 1996 the WSA published Testing And Evaluation Strategies in order to provide information for parents, teachers and school psychologists.

Much of the success our young children are experiencing today is due to the hard work of the authors and contributors to the above articles and handbooks: Debbie Cooper, Ella Tharp, Dr. Eleanor Semel, Dr. Jeff Crisco, and Dr. Karen Levine.

In reviewing the 1988 article and the two handbooks by Dr. Levine, pieces of the WS cognitive profile emerge. With school age children we see:

Strengths

Sociable nature, expressive vocabulary, long term memory for information, short term and long term auditory memory, hyperacusis (both positives and negatives - helps with phonics, hurts when child becomes excessively worried about noises).

Areas of Concern:

Attending difficulties (often distractible & impulsive but not necessarily hyperactive), visual-spatial & visual-motor integration difficulties, visual memory deficits, difficulty with abstract concepts and abstract reasoning, perseveration on "favorite" topics.

Children with Williams syndrome have more difficulty processing nonverbal information than verbal information. When administered the WISC-III (or the earlier edition WISC-R) they score significantly lower on the nonverbal (performance) subtests than the verbal subtests.

The scatter of scores across all of the WISC subtests is quite varied, which tends to negate the predictive value of any sort of an average IQ score. Hence the WSA does not recommend the use of the WISC as an indicator of IQ (in fact the Kaufman-ABC or DAS are the preferred IQ measures for WS). It does, however, show the discrepancy between nonverbal ability and verbal ability in the WS cognitive profile.

There is a generic field of study known as nonverbal learning disorders. Within that arena, educators and clinical psychologists see many different subtypes, which present overlapping characteristics. There is general agreement that in order to have a nonverbal learning disorder, there should be a significant discrepancy between verbal and performance subtests on the WISC.

Children with WS share several key characteristics with children who have been diagnosed as having a nonverbal learning disorder. They both exhibit spatial relationship difficulties resulting, in the classroom, in handwriting problems. They share difficulty with math, which also has spatial roots, as well as being associated with the abstract reasoning deficit. They do best at reading in general, which is linked to their verbal strengths. They do better at the lower level reading sub-skills such as word identification and phonics than they do at comprehension, which requires more abstract reasoning and, in general, the ability to go from parts to a whole. Comprehension also requires the reader to be able to understand implicit semantic relationships among words and be able to make inferences.

An area of difference appears to be in personalities. WS children, as we well know, are very sociable and outgoing. Children with nonverbal learning disorders tend to be shy and withdrawn, although they too are reported to be very verbal and friendly as very young children. Both, however, have some difficulty making and sustaining friendships. The common factor seems to be that both have difficulty reading nonverbal cues, and therefore are often inappropriate in their social interactions.

Nonverbal function, in a cognitive sense, involves visual processing and the harder to describe idea of perception. The affected individual does not form visual images easily and does not revisualize well (i.e. from memory). He or she also perceives the world differently than someone whose perceptual ability is seen to be intact. In a way, perception is the more spatial aspect of cognition, e.g. going from parts to whole, understanding cause and effect, etc. So a child with a deficit in this area would tend to focus on the details (and even perseverate on them) but fail to grasp the complete picture.

In her 1988 article, Debbie Cooper commented throughout the article on how Laura had difficulty with visual input, did better with curriculums emphasizing auditory processing and how she needed a very sequential approach. If one thinks simply of what nonverbal learning disorder implies with its name alone, Laura's preferred learning style for her cognitive profile makes perfect sense. The auditory/oral input would leverage on her verbal strengths and a highly sequenced curriculum would help her organize the information, improving her ability to ultimately generalize the skill, because it would take her slowly and steadily from the parts to the whole.

A methodology which promotes learning in this way is direct instruction. As the name implies, it involves directly teaching each aspect of a skill. It also engages the student orally, to ensure that they become an active part of the process. Direct instruction programs are very sequential in nature, progressing in a building block way until the target skills are acquired and mastered.

The most common element of all of the remedial interventions described in the literature on nonverbal learning disorders is the use of verbal mediation and verbal self-direction, both for analyzing information and for organizing to perform a task. This means the child must be taught, through direct instruction, how to talk himself/herself through various steps, to successful completion of the process or task.

This concept can be used to improve verbal reasoning, vocabulary development, reading comprehension, and social skills. Because writing involves cognitively difficult processes requiring idea development, organization, and the ability to go from parts to a whole, it lends itself well to a verbal mediation approach. Handwriting can also be taught this way to young children.

Following are some specific strategies which have been recommended for teaching children with nonverbal learning disorders. Because individuals with Williams syndrome exhibit characteristic overlap, these approaches should be considered in the IEP planning process:

Reading Comprehension:

• Ensure that decoding skills have been mastered first (the student must be able to read words accurately before he/she can understand meaning). Typically a phonics based reading curriculum is most effective.
• Teach reading comprehension skills directly, e.g. making inferences, deductions, understanding cause and effect, etc.
• Develop self-questioning techniques to monitor comprehension.
• Teach students that they must interact with the text.
• Encourage verbalization of strategies to enable students to internalize comprehension strategies (who, what, why, where, when, etc.).
• Teach the organization and structure of paragraphs.
• Teach signal words indicating transitions.

Vocabulary Development:

• Make concrete associations for unknown words whenever possible.
• Be "child centered", i.e. use words they encounter in their own reading, define words they want to know, work from known associations and understandings.
• Encourage students to verbalize and paraphrase their understandings.
• Work toward a depth in understanding - don't let them slide by with surface understandings.
• Connect words into meaningful semantic categories.
• Teach multiple meanings.
• Build semantic maps or webs.
• Highlight morphological rules and patterns, directly teach prefixes, roots, suffixes.

Writing:

• Provide brief daily practice to improve handwriting rate and legibility.
• Teach student to use verbal self-directions to guide those practices.
• Address posture, position of hand and paper, grasp of pencil, directions for forming individual letters.
• Teach keyboarding and word processing skills to the student at a young age.
• Focus on only one aspect of writing at a time (e.g. pre-writing, writing, editing).
• Hold expectations for rate and volume of written products based on the student's demonstrated abilities.
• Teach transitional words.
• Teach organizational patterns for writing paragraphs, then for longer works such as essays.
• Provide a purpose and structure for writing

By following these principals, we are utilizing the student's verbal strengths to remediate difficulty they have processing nonverbal information. Ultimately, the goal is to have the student internalize the process and become totally self-directed in his/her evaluation and self-correction if so required.

The Education Committee would like to hear from parents and professionals regarding the effectiveness of these or any other educational approaches for children with Williams syndrome.