Episode 18 - Early Identification & Intervention of Reading Disabilities with Hugh Catts

HUGH CATTS, PhD is Professor and Director of the School of Communication Science and Disorders at Florida State University. His research interests include the early identification and prevention of reading disabilities. He is a past board member of the International Dyslexia Association and past board member and President of the Society for the Scientific Study of Reading. He has received the Samuel T. Orton Award from the International Dyslexia Association and the Honors of the Association from the American Speech-Language-Hearing Association for his career contributions in each of these disciplines. His current research concerns the early identification of reading and language disabilities and the nature and assessment of reading comprehension problems.

Episode Transcript

Danielle Scorrano: Hello, Dr. Catts, how are you today?

Dr. Hugh Catts: I'm doing well. How about you?

DS: I’m doing great. Wait, I'm actually better that we're talking and thank you so much for being on the podcast. I mean, I have to start by saying how lucky I feel to be here with you prior to you delivering the 2021 Robert J. Schwartz Memorial lecture at Windward. I have a sneak peek into your research, and I have so many questions for you. So thank you.

HC: Thank you very much. Nice to speak with you.

DS: So how are you, speaking of the world that we're in right now, we're talking over zoom. How have you been personally, professionally over the past year?

HC: During COVID… it's been a real different year. Personally, I've been pretty good. I just got my second dose of the vaccine, so I'm feeling better and ready to go out a bit more. Professionally, it has been a bit of a challenge. I'm the department chair here at FSU and trying to run a department virtually has been an interesting thing to do. I'm also involved in a large longitudinal study looking at early identification. We're developing a screening tool for dyslexia and the pandemic kind of put a halt to our longitudinal part, but we've also done some data collection using virtual assessments. So we're assessing kids over the internet, which is been an interesting process.

DS: Yes. we can actually relate to that at Windward because at the Winward Institute, we're running the “Predicting Literacy Outcomes of the Windward School with Haskins. The internet distance portion has been interesting with students. I definitely agree with that. And I hear that you're also teaching students as well. At FSU, are you teaching virtually, are you teaching in person?

HC: Yeah, we're teaching virtually. Our big challenge has been the clinic. In the department of speech, language and hearing, we're training speech language pathologists, so providing them with a clinical experiences has been a challenge. We've been fortunate enough to have some placements and we're using telepractice and simulations to do some of the clinical training. But for the faculty, it has been difficult trying to carry on research with a pandemic.

DS: You did mention a screening tool, and I know when you deliver the Schwartz lecture in April, you'll be talking a lot about early identification. Prior to the recording, you were talking about your dream team of mentees and former doctoral students, and you know, Dr. Hogan was one of them who was a recent guest on the podcast. So I want to hear all about your background as a researcher, a scholar, someone who presents regularly to educators who mentors researchers. I mean, there's nothing that Dr. Hugh cats can't do. So tell us more about your background.

HC:  I was actually trained as a speech scientist at the university of Florida and did studies on the acoustics of children's speech, but early on in my career, I came across research showing a language basis to dyslexia including the phonological difficulties that many children with dyslexia have. It stood out to me because those problems ran in my family. I have a brother who's has dyslexia and, uh, I also had some problems early on learning to read and had all those phonological difficulties. I was fascinated by that and went on to learning as much as I could about dyslexia and language basis of it. I ended up changing university so I could teach in that area. I've had some wonderful students over the years, some who've worked with me on projects, mostly longitudinal studies following kids that are at risk for dyslexia and looking for early predictors of dyslexia. I’ve also done a bit of work with comprehension. I was at University of Kansas for many years and moved to Florida state seven years ago where I'm department chair here.

I have several large grants in which we're looking at early identification. As you said, I I've had the great fortune to be able to travel all over the world and all over the U S as well, to speak to different groups about dyslexia. I've really enjoyed that learned a lot from hem as well. I really enjoy doing those types of workshops.

DS: I know I can speak for a lot of educators where we learn so much from you. And as a research practitioner, myself, there's been a lot of your work that I've been recently reading. One of the recent articles I read was your insights about the simple view of reading and particularly how we look at dyslexia. As we conceptualize dyslexia, I know that you have recently, or it's in press now, your article with Dr. Petscher, when you developed a model, the multifactorial model for dyslexia, the cumulative risk and resilience model for dyslexia. As we conceptualize dyslexia, where does it fit in this overall framework of reading disabilities of language language-based learning disabilities, or even just developmental language disabilities?

HC: The simple view of reading was introduced over 30 years ago now by Gough and Tunmer to try to capture what's involved in reading. They were particularly interested in decoding, and they wanted to indicate how decoding was separate from other parts of reading.

Their model argues that decoding plus language comprehension or linguistic comprehension is equal to comprehension. So, one not only does one have to be able to read the words but needs to understand those words in order to understand what they read. Individuals can have problems with different parts of the reading process.

The decoding aspect of reading is particularly problematic for children with dyslexia. The primary characteristic of dyslexia is a severe and prolonged problem with word reading. It’s differentiated from other types of reading problems, such as a poor comprehension or specific reading disability, which is not due to word reading problems, but other difficulties in language and knowledge and cognitive processing that would allow somebody to understand what they're reading.

DS: That's interesting.

HC: Now you said, how is that different from other types of language problems? The other language problem that I've been interested in for much of my career is specific language impairments, which is now moved to a different name. It's slightly different than a specific language impairment, but I say developmental language disorder.

Children with developmental language disorders have problems in spoken language, either in producing or/and in understanding spoken language. There is an overlap between children with dyslexia and children with a developmental language disorder in that about 50% of clinical cases that have either one of those problems will also have the other.

That tends to be the case because kids that come to the attention of clinicians usually have either a more severe problem or have more secondary issues. We see a higher co-occurrence of dyslexia and DLD in the clinical groups. But if we go out and measure, reading ability and language abilities, we see that they overlap about 30%.

So about 30% of the kids who have dyslexia will have a severe enough language, problem problems in vocabulary and grammar to be identified as having DLD and about 30% of the kids who have spoken language difficulties will have a word reading problems that are severe enough to be referred to as dyslexia.

DS: Hmm. That's interesting. I know when Dr. Hogan was on the podcast in June, she talked about developmental language disorders as a spectrum. And you've conceptualized this model of dyslexia with Dr. Petscher as more of a spectrum. Yes. I want to clarify what this model is and the purpose of the framework of the multifactorial model. Can you give us a summary of what this multi-factorial model is?

HC: It’s easier with the visual image to show you what the model's about but let me give you a little background on the model. For many years in trying to understand dyslexia, we've approached it kind of from a single deficit notion. That is that there's a primary underlying cause for children that have severe and prolonged difficulties learning to read. Initially, it was vision. The early, early views about why children had problems reading was it had something to do with the visual system. But we came to recognize that that most kids who had dyslexia seemed to have problems in language, particularly in the phonological aspects of language, being aware of storing, retrieving phonological, or sound based aspects of language. And the reason that seems to be important is because that they were mapping the letters of written language onto the sounds of speech. And if you have phonological difficulties, it makes it more difficult for you to learn to how the orthography of language works.

But we had kind of blinders on if you will. And once we got ahold of that theory, we kind of went with it and focused primarily on the phonological basis. But as we began to look at individual differences in in kids, we found that not all kids who had dyslexia had a phonological difficulty and not all kids who had phonological difficult ended up with dyslexia.

So if we were going to explain word reading problems fully, what we had to do was look for some other potential causes, other factors related to word reading that could account for those difficulties beyond phonological difficulties. We still think about phonological problems as being a major factor in many cases of dyslexia, but sometimes the problems aren't as severe as they are in other cases.

What our model does is an extension of what other people have proposed in the past as a notion that multiple factors interact to create the probability that you're going to have difficulty with learning to read. It's not an “either or” type of thing. So with these things, the genetic neurological biological factors that I'm talking about, don't combine to absolutely determine that you're going to have dyslexia. They just increase the probability that you're going to have it. And so what we've begun to add to our notion are other factors that might affect the kind of the trajectory of reading development are things like problems, outside language problems that are outside the area of phonology like problems in vocabulary, grammar, so forth. And when we look there, we find that that most kids with dyslexia have some degree of difficulties with spoken language. It may not be severe enough to say that they have a developmental language disability, but they have enough of it to increase their probability of having a reading problem when you combine that with other factors, primarily the phonological difficulties. So looking at early language development is going to be an important thing to do if we're going to identify kids that have a higher risk for reading problems.

There's also some evidence that problems in vision could contribute to the likelihood of, of having a reading difficulty. We see problems with motion, sensitivity problems with attention span, something what's known as “crowding,” where some individuals will have a crowding phenomenon of the words or letters that are in the periphery will seem closer together and blur each other out which make it harder to read. We don't understand that completely, but it looks to be something that's associated with dyslexia, attentional problems. Kids that have attention deficit disorder, if they also have some other difficulties or other risk factors, can go on to have reading problems. We've also considered the possibility of that.

Risk factors might also involve other environmental situations or factors that typically we haven't thought about. We previously thought primarily about the biological basis of dyslexia. But if you have that biological basis and you also have environmental factors that are severe enough, they can increase your risk for reading problems.

My colleague Yaacov Petscher has become particularly interested in trauma and in looking at kids that have had adverse childhood experiences and how those experiences can result in trauma, which affects their academic performance and in doing so can interact with other risk factors to lead to having a higher probability of having a reading disability.

DS: Before you go into the protective factors, I have a couple of follow-up questions for you, so on the risk factors basis. You’re looking at a multiple number of factors that increase the probability. I like to conceptualize it as a “yes, and.” As you're talking from an educator's perspective, if I'm looking at a child, I want to clarify and ask some more questions related to the phonological basis and the word level reading.

Do you still consider factors like verbal working memory, rapid automatized, naming and phonological awareness, phonemic awareness as major factors or how does that all fit into the framework?

HC: I would still consider them to be major factors, but one of the things that we've learned, if we're only going to look at the funnel object or aspects of language, we're going to miss quite a few kids that end up with dyslexia because their phonological problems may not be severe enough to indicate a risk if you're only looking at the phonological difficulties. There was a study done a couple of years ago by Bruce Pennington, where he had two very large samples of children and found that if you looked at the beginning of kindergarten kids who ended up with reading difficulties by the end of second grade, they often didn't have severe enough phonological problems to have identified them.

If we only look at phonology, we might miss kids who end up with reading problems. Now, as I said before, most of the kids who end up with dyslexia or severe reading problems later on, will have some problems in phonology. It's whether they're severe enough for them to stand out. So that's why I, myself, Bruce, other people talk about looking at multiple factors to give you a better indication of risk. And that's where we would look at something like rapid naming, language development, the vocabulary syntax, visual abilities, attention, trauma, or family history. We want to look beyond just phonological difficulties, if we're going to identify kids that are at risk for a later reading problem.

DS: That's an interesting point. I read 40 to 60% is the likelihood of family history for dyslexia.

HC: Yeah. Anywhere from 40 to 60%. If you've got a parent or a sibling with dyslexia, you've got a 45-50% chance of having reading problems. Now, remember that’s of having severe enough of difficulty to have reading problems, but again, that's on a continuum as well. So you might have a 60-70% chance of having some problems in word reading, but it’s on a continuum. Family risk doesn’t necessarily lead to either having a problem or not having a problem. The whole reading distribution, if you will, for kids and family risk is shifted down. So the risk is shifted up but their abilities are shifted down.

DS: My other question for you… I just loved diving into this and digging into this. And just a side note. I did write about this model for our upcoming Beacon, which is our biannual journal. So I'm eager to learn more and just ask some more questions for you. But the last question I have about the risk factors. Oh, actually I have another question, but one other question I have about the risk factors is the vision you talked about. Talking about vision as contributing to the problem, I just want to clarify and ask is you're still not saying that dyslexia is a vision problem. You're just saying that some visual impairments may also contribute to this problem. I've heard a myth in the popular world is that dyslexia is a vision problem, and I want to clarify that that's still a myth.

HC: It’s not the type of vision problems that we have been brought up in the popular press about the, you know, having problems such that colored lenses will improve your reading performance or sometimes people talk about visuals, visual stress related to color lenses, or problems with ocular motor control so forth. Those don't seem to account for the severe cases of reading disabilities, but there is a possibility that there are other problems that are, as I said, related to other aspects of visual attention, visual crowding that could be major contributing problems in some individuals. Whether that problem alone could lead to reading difficulties, we don't know. There is some evidence suggesting that visual problems do count for independent variants in reading ability over and above the phonological difficulty. So I don't want to rule it out. We just don't know as much about it. One things that thing we don't know is we don't have really good screening tools to identify those problems. I talk about them from a research perspective, but I'm not sure at this point we can actually measure those well enough to include them in screenings for dyslexia. There's some people that think we can, I'm just not convinced yet. But I'm certainly not going to rule it out.

DS: Okay. Interesting. What about the role of oral language development and reading disabilities? You've talked a little bit about that throughout, and I know that you you and colleagues have worked a lot with oral language. So what is that role of oral language development and reading disabilities?

HC: Print is just spoken language written down. It differs a bit in the sense that we write and talk about different things. But written language is still a transcription of what was initially oral language. So one's language skills is going to impact multiple aspects of reading development. I talked about the phonological aspects influencing learning early decoding skills. Also, one’s vocabulary influences your ability to learn, to read words. If you know what the word is and that word is part of your vocabulary and you're attempting to decode that word, you have a target to go for when you're sounding it out. We know that kids with better vocabularies will learn better word reading. Vocabulary and other aspects of our language are important for comprehension because we're making sense of language once we've turned it in the language. So the decoding part of it turns it into words and the knowledge of sentences and spoken language abilities can be used to begin to understand.

DS: I have to tell you that oftentimes when I learn, at the end of the day, I just sit and either daydream or will just dream about the brains inner working. So I know over the next few days, I'm going to be dreaming about dyslexia and all the multifaceted areas of it. But I think you bring up a really good point about screening, I do want to get to that. I also know that you started talking about protective factors. What do you mean by protective factors and what are some examples of protective factors that are part of the model?

HC: Yeah. So for kids that seem to have the same degree of risk, we look at their their difficulties in phonology or language or background of traumatic experiences and so forth, we would view those two kids the same or equally at risk. And we find out later on that one of them is a lot better reader than the other. People have been interested in it and trying to explain that, and we can’t always explain it on the basis of severity. It's not the case that one individually has more severe risk factors than in the other.

People in other fields like psychological fields have looked to other factors that might explain the positive factors in the environment that might reduce the probability that one would have a reading problem. The general category of those are sometimes noted as protective factors. But there's really two different classes of factors that could act to reduce your probability of you have reading difficulties. The first is what's called a promotive factor and a promotive factor is just the other end of a risk factor.

So let's say you have a phonological difficulty. And on top of that, you, you were late to develop oral language. You have a limited vocabulary. We would think about language as being a risk factor for you. But on the other hand, let's say your language is quite good. You have a very good vocabulary and good understanding of spoken language, but you have phonological difficulties. What the good language would do was it would promote better reading outcomes because you'd have a better vocabulary. You could use your vocabulary to help you learn words and so forth.

Promotive factors work both for the good and both for the bad. Protective factors, on the other hand, work, primarily in the case, in situations where there is a risk already occur occurring. Examples of those include perseverance and passion, which some people call grit, other people have studied things such as a mindset, the notion that if you try harder, the belief that if you try harder and work at it, you'll get better. But we've been interested in, in not how it works for all kids, but how it interacts with other risk factors. My colleague Yaacov Petscher has a bit of evidence that suggests that our kids that are at risk because of other factors and have limited mindset, we actually have more negative outcomes in those with a more positive mindset.

The place where I look more for protective factors have to do with kids is having family and teacher support. We know that a child that has a teacher that understands what dyslexia is and the problems that the child might have and takes that child kind of, if you will, under their wing will protect some from the negative consequences like other kids teasing them. A teacher who doesn't put the child that is in a spot that is going to cause anxiety for the child will help the negative reactions to reading so forth. I consider that a protective factor- a parent who does the same.

Those types of supports can reduce the probability that the child's going to have significant difficulties learning to read. We don't know as much about protective factors. We have to study them as much, but we're interested in what those might be and how we can put those into play both in screening and an intervention.

DS: Would you say that an evidence-based reading instructional program would be considered a protective factor or is that part of the model?

HC: That's a good point. So the best protective factor is really good instruction. If we have really good instruction and a child is at risk, the probability of having a reading problem is going to go down significantly.

If you're at risk and you not only have good tier one instruction, or you go into a into small group or even a one-to-one instruction with a skilled interventionist, I mean, that would be the best form of a protective factor.

DS: I think that's a really good point. As I'm sitting here as an educator, I was teaching at Windward up until last year, so I always think about this through the educator's perspective. As you are talking about this model and looking at all these different factors, I'm thinking about the implications for educators. As we look at this model in terms of screening, what are those implications? If I were to turn to my colleague, another teacher at school or another teacher at a different school, what is the model saying for screening and intervention? Should we be broadening our look at students or overview at students, or that we should be looking at more nuanced deficits? What would you say to educators and about how they apply your research and practice?

HC: Yeah. I mean, that's the first thing to point out is just my research. What has come together with this this model is I borrowed a lot of these ideas from colleagues that have also been interested in multiple factors in dyslexia. Other people have talked about protective factors as well. It's a model that Yaacov and I put together to help us on our thinking. Buy it's not just us that have begun to think in this way. And I do think it has implications for early identification.

I think it takes us a place we haven't been in the past. We've kind of had a pretty good idea of factors in terms of early screening for the last 20-30 years. I’ve been doing this for a long time now. If I look back to papers that I did in the nineties, I was looking at some of the same factors that are part of screening instruments that are being used today.

We have our usual suspects for screening like phonological awareness, letter naming, RAN, language ability are the ones that different measures looking at. But what kind of a multifactorial model suggests is we might want to broaden that a bit.

What I had my attention drawn to by Yaacov is the notion that we probably should pay more attention to what are called bio-psychosocial indicators, things in the child's environment, changes in the child's psyche, change in the child's biology that we might not have picked up by looking at the usual suspects. We've been trying to look at this through parent and teacher questionnaires to look at, what are the factors that parents or teachers indicate to us that we could put into our models that would help us differentiate between kids that are at risk and not at risk.

Early identification is a really difficult thing to do. We've got to remember that what we're trying to identify are not a discrete group of kids. These are kids that are further down on a normal distribution of reading ability. Reading’s distributed more and more than bell curve. What we refer to as children with dyslexia are kids at the very lower end of that distribution. Because we have to differentiate between kids that don't meet that criteria, there's a lot of gray area. Having a bit more information might be able to help provide us with information about which kids are more or less at risk and give us some idea of which ones we might want to follow up on and provide with some additional intervention.

DS: When I conceptualize explicit evidence-based reading instruction, for example, we know that it's necessary for kids with dyslexia. It's important for many kids and it benefits all students. So when you're talking about early screening and early identification, to me, it shouldn’t be a question, right? When we screen kids early, all kids are going to benefit and you're going to catch those students that do have those bio-psycho-social markers showing a reading difficulty, or even a reading disability.

HC: Well, I mean, actually we might have to ask the right question to get at some of those things that I mentioned that might not be part of our typical battery. I know you said all kids can benefit from screening. The one caution I have in screening is the way that we do it. It only seems to be maximally effective if it's done within an environment where kids have had good instruction to begin with because some of the better indicators of risk are early literacy ability. Letter naming and how quickly kids are learning their letter names and learning letter sound correspondence is going to give us a pretty good indicator, an indication of how easy it's going to be for them to learn and read words.

Without early instruction, we're not going to see kids differentiate themselves in letter naming letter sound abilities. If we were to give one of these screening instruments in a school, let's say a high poverty school with kids that come to school with less experience with literacy, differences in their language, or abilities, we might find 80% of the kids failed the screen. So that wouldn't be inappropriate use of the screen. We want to make sure that we have high quality reading instruction in place to get the most optimum use out of a screening tool, particularly if we do it at kindergarten. It would be better if it was done say in October of the school year after the kids have had some experience with early literacy because letter naming is one of our better indicators of, of risk for later reading difficulties. Now we can screen earlier. I mean, there are some screening tools that are being used in preschool. Nadine Gaab has an instrument that works down as far down as preschoolers and it's a good screener. But we're going to have more accuracy as we move into kindergarten, particularly if the kids have had some literacy and language experiences that will will start to differentiate them. But if kids come to school with limited literacy and limited language, we're not going to see the individual differences that might be indicative of later problems.

DS: As you're talking, it sounds like this, that yes, we need screening and we need effective reading instruction so that we can ensure that all students are getting exposed to language, rich, effective reading instruction and identifying the students that are still having difficulty with that type of reading instruction.

As we think about screening in general, a couple more questions about that. If you have school leaders or teachers that come to you and ask you about screening, what are those key insights that you are providing for them to apply in their school contexts. I mean, where do educators even start when they think about conceptualizing early screening in their schools?

HC: Yeah, quite a few things. So first, as I mentioned before, having good quality reading instruction to begin with, right? So if that's in place, then we can begin thinking about doing the screen. Before we do think about doing this screening, the important thing to have in place is what you're going to do if a child fails the screen. So what, what's the result of the screening? We need to have in place a program that will allow educators to address the kids that seem to be having trouble or have risk for later reading problems. I I primarily argue for MTSS type model to where we have different levels of of instruction, depending upon the needs of the of the child.

I really need to have that in place. I see a lot of emphasis being placed on screening and States wanting to implement screening for our kids, but we need to have plans for what they're going to do with that screening before we choose particular screeners to be used for that purpose. Early identification is there to provide early intervention.

We want to have an intervention program in place and have trained personnel to be able to carry it out and have it differentiated so that it can respond to the needs of kids with different probabilities of having a reading difficulty. The other thing is, is to recognize that screening is not a perfect “either or” thing.

It’s an assessment of the risk that the child is going to be some error associated with it. Our instruments aren't perfect in their identification so we have to recognize that we could screen a child one time and find out that later on that there is not at risk or we could screen a child and find out later on they were at risk, but our instrument didn't tell us the risk is and missed them.

How we might identify that child is by using an instrument a second time or a couple, three times a year. A screen might then pick up on a child that might've missed them initially. I suggest to people not to use an absolute cut score. If you've got a screening tool and you get a particular score and you're one point below that score or that you are one point above that score doesn't mean necessarily you're not at risk. You'd have some idea about a confidence interval, right? That's preferable around scores. It gives you an idea of what the probability is that the child's true score is somewhere within that interval and use something like that to do your identification, as opposed to the exact score. And then I think we know the measures that we should be looking for at different ages.

Beginning of kindergarten, we want measures that have subtests that measure phonological awareness and phonological memory, letter naming, letters sounds, rapid automatized naming, and oral language ability output seems to be a better than a receptive language measures. Naming pictures or repeating sentences tends to be a good instrument and getting information about family history should be part of the intake. When kids come into school, find out what the family history is. It's not as if we're going to predetermine that a child is dyslexic. We'll just use it as an indicator of potential risk and the same thing with language development. We want to know whether a child is late to talk or whether the child had had spoken language problems early on or was identified as having a developmental language disability. Those are the types of things that we can look for.

DS:  It seems to me that as you're talking, the implications for educators is to have that more comprehensive model and overview and examination of a child. And I like what you said, too, that it's not a determinant, but it's a probability. And I think, you know, in, in thinking back to the research on mindset, for example. Just because a child may be showing these deficits doesn't mean they're never going to be able to read. But what are those protective factors that we can also instill like great instruction delivered by a trained professional, with supportive environments, with a language rich home environment. These are all the things that seem to be the necessities for our child as to stimulate their language development, especially when they are at risk of having a reading disability.

 

HC: Yeah, that that's right, Danielle. I mean, kids who are at risk for dyslexia, because of a range of biological genetic and environmental factors, is combined in a way that it makes it difficult for them to learn to read it. It doesn't mean they can't learn to read. It just means that it's not going to be as easy for them. So high quality instruction initially will show us that we probably need to do something different. That's where their response to instruction or intervention comes in. Right. Because these kids are unlikely to respond to high quality classroom instruction. For the ones with the most significant problem, they're going to need more, specialized instruction, small group instruction.

DS: Greater dosage, right? Repetition of skill learning.

HC: Yeah. Yeah. And I think it's important for teachers to understand that notion of dyslexia, as opposed to this hysterical medical diagnosis that that's been promoted. That makes it seem like it's something that is difficult to change. It is a challenge to change, but high quality instruction can change as we're talking.

DS: I really want to just become one of your students and listen to one of you your courses, but as you talk about your research, working with colleagues, what are some areas of research that you're interested in the future?

HC: Yeah. I mean, I started working with early identification 30 years ago, and I'm still as interested about it today like I said in how we can make that more accurate, how we can connect it with intervention better, how we can add other factors that typically haven't been involved with it and particularly how we can do it faster, how we can do it with less burden on teachers. We're trying to use voice verification or speech verification to help score assessments so that children might be able to take the assessments independent of the teacher. We're also doing computerized adaptive testing so that we can very quickly signal the child's ability level. We're using both speed and accuracy of response to try to do that more efficiently.

We're putting screening in a gamified context so that they can be more interesting to children. I’m also interested in expanding the multifactorial models of reading and talking about other factors that might contribute to explaining individual differences or helping us understand what we might do in intervention and assessments. We know that standard treatment protocols for dyslexia work quite well. We don't know how we might augment those given a range of risk factors. So the child has traumatic experiences on the top of having a reading problem that child might benefit from additional supplemental intervention on top of the standard treatment protocol. We don't know kids that have attention deficits. How does that get combined?

People are beginning to do some research on combinations of interventions. But the evidence is pretty clear that standard treatment protocols that work on phonological based interventions that teach kids how the code represents the sound structures of language and allows them to practice that and get fluent with that is the most effective approach to working with all kids with dyslexia. Some kids it's going to be more successful with. And what we'd like to know is what we do with the kids that it's not as successful with. Or what might we do to make it more effective for kids in general?

DS: I wish you were here actually in New York like we were talking before we recorded, because we would have loved to show you around a Windward classroom. Just to see the students, when you said standard academic, you know, standard intervention protocol, that explicit instruction in reading that incorporates a lot of different skills. It's really quite a scene to see. I know that you've seen it in your history of research and really analyzing student response to intervention, but it really is such a joy to see when a child can learn to read, especially when they've had difficulty in the past. First of all, before I ask my last question, thank you for doing this. I've learned so much from you. And I know that when this is episode is released that so many people are going to have questions for you. You are presenting to us in April via live stream for the 2021 Schwartz lecture. Can you give a short preview of what participants should anticipate learn from you during the lecture?

HC: I'm looking forward to doing that. The one thing about giving a lecture is that it's in a more prepared, structured context. It will be one in which I can kind of tell a story from the beginning and go through to the end. These kinds of spontaneous interviews are interesting to do, but as a researcher in and somebody who's particular about being accurate and informative, I always like having the lecture format to do that. I probably will spend more time talking about actual screening and what instruments are available. I’ll talk about where one can get more information about dyslexia. There's some really good websites to help with identifying screening tools to use. I'll talk a little bit about some of the work that we're doing with the Chan Zuckerberg Initiative on developing a screening instrument, as well as other colleagues that have screening tools.

I hope will be informative for people that are dealing with the issues. I don't have all the answers. I’m still really active in research and in reading, trying to learn more about dyslexia and how we best address it. So, you know, in the next month and a half, I'm going to know more.

I'm always excited to share what I've just learned. That's the professor in me is sharing the knowledge with other people, and like I said, learning from people as well. I'm looking forward to a month and a half as well.

DS: I love that you're also a lifelong learner. Thank you so much, Dr. Catts, for sharing your expertise with us. And we look forward to seeing you live on April 20th at 7:30 PM for the 2021 Schwartz lecture. You'll be probably, what, be in your back deck from, from Florida?

HC: Yeah, I don't know. I mean, I may be in my back deck. By then, hopefully it'll be nice and warm and I'll be outside and do the lecture. If not, we'll find another spot for it, but I do look forward to it. I enjoy giving talks. I much prefer interacting with an audience, but maybe I'll be able to see a few people on the screen. It’s so nice to see people you're talking to. I did a talk earlier in the year with I don't know, about 300 people on zoom and the people were from all over the world. There were people from, from Singapore and South America. Some of the people I've met before were in on it, and it was good to see them and talk to them.

DS:  The joys of presenting virtually at least during COVID has taught us a lot about that, but we're so happy that we can learn from you virtually and as well on the podcast and look forward to reading more of your research. Thank you so much, Dr. Catts!