Hold on: this book may shake your foundations and test your beliefs about learning disabilities. The field now benefits from a body of scientific research providing valid and reliable evidence on the efficacy of instructional interventions. Four distinguished authors, university-based, research-trained specialists in learning disabilities and psychology, have assembled a ground-breaking reference providing us with sound tools for assessment and instruction to improve outcomes for students at-risk or identified with learning disabilities.

Yet the research findings may disturb you.  How many of us use the term “visual learner” or define a student by “learning style”? How often have students with general reading problems been described as “dyslexic”? What about suggesting that an “auditory” or “visual processing disorder” forms the basis for dyslexia or that a “multi-sensory integration” component is necessary for remediation? You may be surprised to learn that little in the way of evidence exists for the accuracy or effectiveness of these popular ideas and notions.

Fletcher, Lyon, Fuchs and Barnes open with an overview of the history of the field, federal legislation, and how current educational policies have developed. Resulting classification schema and assessment models are cogently explained. Eschewing the oft-employed cognitive/achievement battery to build a diagnosis, they propose a hybrid model of assessment combining measures of response to instruction (RTI), low achievement, and intra-individual differences to provide a treatment-centered assessment strategy.

Organized around core academic domains and the evidence-based interventions respective to each, the science of cognitive process, neurobiological factors, and efficacy of methods and practices in reading, math, and written language is thoughtfully examined. Our distinguished authors fearlessly provide scientific proof that supports and, at times, refutes many of the well-known and widely marketed instructional programs.

The final chapter addresses the gap between research and practice. Although considerable progress has been made in designing assessment and instruction for students, outcome studies reveal that a majority continue to suffer dramatic deficits in reading, writing, and math. Why haven’t research findings been effectively translated into classroom practice? The authors cite poor implementation, inattention to prevention, a lack of consistent screening/progress monitoring, and a reliance of clinical craft over scientific evidence.  They conclude with overall findings and “top ten principles for instruction” including:

• Early intervention programs can be preventive: studies found that the percentage of those at risk can be reduced from 10-25% to approximately 2-6%.
• Direct instruction coupled with strategy instruction was found most effective with word letter reading disability (dyslexia). Phonemic awareness training is most effective when it includes a letter component.
• Time “on task” should be increased. Interventions should supplement, not supplant, instructional opportunities.
• The nature of a program is less important than its comprehensiveness and intensity. Training in motor, visual, neural, and cognitive processes without the academic content will not lead to better academic outcomes.
• Instructional programs need to be integrated: it is not enough to simply provide “skills” instruction.
• It is possible to produce impressive growth in higher-order processes even when students’ foundational skills are weak.

These findings will resonate with educational therapists, especially the importance of linking skills instruction to academic content. Familiar with using an academic task as a “hook” to build executive functioning skills and pinpoint secondary and tertiary gaps, educational therapists understand how academic content becomes the context for uncovering students’ needs and gifts. The authors’ research affirms the a priori foundation for educational therapy’s methods and practices, providing deserved evidence for how our work is germane to students’ academic survival.

In contrast, the authors are pointed in their criticism for unproven, ineffective methodology and instruction. They note “…basing interventions on processing deficits, theories of brain function, vision, acoustic processing, perceptual skills, and so forth, with no attention to specific academic skills and content, leads to a morass of pseudoscientific interventions that do not result in improved outcomes” and “…are often simply deceptive in their appeal to parents and teachers.” The authors vigorously assert that assessment be linked to intervention with frequent progress monitoring stating “…the field of LD has matured to a point where testing for the sake of diagnosis is outmoded and potentially iatrogenic. People with LDs need to move into treatment quickly and efficiently.” (Fletcher et al., 2007, p. 273.)

By integrating science, practice, and policy, this work is an invaluable and accessible resource for professionals whether they are designing school programs, implementing instructional programs, or advising students and families. The authors’ contribution is a worthy one, for they have provided scientific proof on the state of the field today and approaches that work and those that, sadly, do not.

Patricia Holden M.A., M.F.T., is a learning disabilities specialist and family therapist in San Francisco and Marin County (LMFT 13146). Trained as an educational therapist, she partners with professionals and works with students and families. Patricia has been an associate member of AET since 2000 and can be reached at www.edlightenment.com.