Reading -
What is specific reading disability and how is it assessed?
Some children are more able than others, irrespective of whether
they are singleborn or multiples. Some children will be less
able to read because they are generally less able at most if
not all school activities. Specific Reading Disability is not
about such children. Rather it is the name given to children
who are of at least reasonable ability in all other areas but
who have a specific deficit in reading. This is not the place
to recognise the ongoing debate in Education and Psychology
about this distinction, which goes well beyond multiple births.
This distinction raises one issue about diagnosis, in that
one needs to know whether the child really has the intellectual
capacity to read well. Such assessment may involve an educational
psychologist or someone with similar expertise who can use
very specific tests to focus in on what this particular child
may need. When the child also has attention problems such
as ADHD, the question
of assessing ability becomes even more complex, since there
needs to be some recognition that some specific skills such
as Arithmetic (that is one part of many standard intelligence
tests) does rely on good attention. You need to be able to
measure ability, uncontaminated by attention and other problems.
For example, ADHD children may also be more impulsive and
guess at an answer without thinking the problem through.
The mere fact of such an assessment raises many new issues.
It cannot just be done by observation in the classroom but
means the child or children must be singled out. Drawing attention
in this way to the fact that one child may be less able to
read than their twin or higher multiple may be very traumatic
in itself and has to be handled carefully both in the class
with the other children and at home. Some children can be
unwittingly very insensitive and find it great to emphasise
just how much better their reading is than that of their other
multiple. Sometimes it works in reverse:
" The difficulty we had was with the one who did
NOT have the problems. He was upset his brother was being
taken out of class and singled out for special attention.
What had he done wrong that he was not getting the same? After
all, everyone knew he was doing much better at school…."
Assessment may be arranged through the school but sometimes
the waiting list can be very long. While parents may be tempted
to "jump the queue" and to seek some private assessment,
it is worth checking with the school about this. It may not
be much good having someone come up with a whole list of what
should be done, if there are practical reasons why these ideas
cannot be implemented in the particular classroom situation.
At the same time, it is worth checking with the person doing
the assessment, that they have adequate experience of multiples
and of the most common comorbid conditions in multiples that
can complicate the evaluation.
What does comorbidity mean?
Many children have not just one problem but several, and
good assessment needs a full evaluation and an intervention
strategy that takes all into account. We give two examples
here as the topic is covered more in the ADHD section:
(i) children with reading problems often have poor
self-esteem and feel they are going to fail at everything.
This may be more common in multiples, because of the very
direct comparisons with their multiple brothers or sisters.
If you know you are the "dumb" one (and children
use crueler words than this), then you may not try your best
in any assessment and your potential may be underestimated
(ii) some multiples are slower in developing fine
motor co-ordination and this may impede their performance
on some of the tasks that are often used in assessment.
How old are the multiples?
This may seem an odd question, but is actually important
in gauging the reading and intellectual skills of multiples.
Most formal assessments work by comparing the child's performance
with norms for children aged almost exactly the same e.g five
years, five years:three months etc. We lack good guidelines
on what to do with very preterm children, as many of the multiples
are. It may matter less by the time children are well into
primary school, but the younger the multiples the more it
may matter. In the 1970's, one of the very large US programs,
the Louisville Twin Study actually developed separate norms
for twins on some of the standard measures used with infants
and preschool children. This has not been pursued further,
even though there are many more
extremely preterm multiples.
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