Flanagan Webinar For Wiley 3 22 10

A Theory- and Research-based Approach to SLD Identification: Integrating RTI with Cognitive Assessment Data
Dawn P. Flanagan, Ph.D.
St. John’s University
Yale Child Study Center, School of Medicine

Presentation Outline
The Field of School Psychology is Polarized on What Constitutes “Comprehensive” Assessment for SLD Identification
The Crux of the Debate is the Utility of Cognitive and Neuropsychological Tests for SLD Identification and for Guiding Intervention Selection and Development
RTI and Cognitive Assessment are Complimentary
Contemporary Cognitive Assessment Differs from Traditional Cognitive Assessment
Tier II Interventions Work for Many, But Not All Students
Tier II Nonresponders Should Receive a Comprehensive Evaluation That Includes Cognitive Assessment – Necessary to identify a disorder in one or more basic psychological processes and necessary for Differential Diagnosis
Rather than using the traditional ability-achievement discrepancy method or an RTI-only approach to SLD identification, a “Third Method” Approach should be used
Relevance of a “Pattern of Strengths and Weaknesses” for SLD Identification
“Third Method” Approaches Integrate data from RTI with Other Data Sources
Assessment for Intervention – Linking Cognitive Assessment Data to Intervention
Conclusions and Questions

Cognitive Assessment for SLD Identification:
The Field of School Psychology is Polarized
Communiqué (2008)
Why Is This The Question?

Cognitive Assessment
Traditional
Atheoretical assessment and interpretive approaches (e.g., some subtest analysis approaches)
Limited to no attention paid to neuropsychology literature
Ability-Achievement Discrepancy
g
Wechsler V-P Dichotomy
VIQ
PIQ

Traditional Cognitive Assessment
Verbal
Ability
FSIQ
Nonverbal
Ability
1930s to the late 1990s

Cognitive Assessment
Contemporary
Cattell-Horn-Carroll (CHC) Theory
Flexible Battery Approaches
School Neuropsychology
Alternative research-based methods for identifying patterns of cognitive strengths and deficits
g
Gf
Gc
Ga
Gv
Gsm
Glr
Gs

Cattell-Horn Gf-Gc Theory
Gf
Gq
Gsm
Gv
Ga
Gs
CDS
Grw
Gc
Glr
Broad
(Stratum II)
Fluid
Intelligence
Quantitative
Knowledge
Crystallized
Intelligence
Short-Term
Memory
Long-Term
Retrieval
Visual
Processing
Auditory
Processing
Processing
Speed
Reading/
Writing
Correct
Decision Speed
Narrow
(Stratum I)
69 narrow abilities found in data sets analyzed by Carroll (1993)
Figure by McGrew; originally printed in McGrew & Flanagan (1998)

A Landmark Event in Understanding the Structure of Intelligence
Carroll, J. B. (1993). Human cognitive abilities: A survey of factor-analytic studies. New York: Cambridge University Press

Carroll’s (1993) Three-Stratum Theory of Cognitive Abilities
G
General
Intelligence
General
(Stratum III)
Gf
Gc
Gy
Gv
Gu
Gr
Gs
Gt
Processing
Speed
(RT
Decision
Speed)
General
Memory &
Learning
Broad
Visual
Perception
Broad
Auditory
Perception
Broad
Cognitive
Speediness
Broad
Retrieval
Ability
Broad
(Stratum II)
Fluid
Intelligence
Crystallized
Intelligence
Narrow
(Stratum I)
69 narrow abilities found in data sets analyzed by Carroll
Figure by McGrew; originally printed in McGrew & Flanagan (1998)

Carroll’s Research-based Conclusions About the
Cattell-Horn Model
“The Cattell-Horn model...is a true hierarchical model covering all major domains of intellectual functioning...among available models it appears to offer the most well-founded and reasonable approach to an acceptable theory of the structure of cognitive abilities”
Carroll (1993)

An Integration of the Gf-Gc and
Three-Stratum Theories of
Cognitive Abilities
Based largely on McGrew’s analyses in 1997-1999

Contemporary Cognitive Assessment Based on CHC Theory
10 Broad Abilities and Over 70 Narrow Abilities
Integrated Model First Published in Flanagan, McGrew, & Ortiz (2000)

The WJ III(Woodcock, McGrew, & Mather, 2001)
The first in a flurry of test revisions that represented advances unprecedented in assessment fields

Contemporary Cognitive Assessment
SB5 (2003) – Based on CHC theory
KABC-II (2004) – Based on CHC theory and Luria
DAS-II (2007) – Based on CHC theory
g
Gf
Gc
Ga
Gv
Gsm
Glr
Gs

Contemporary Cognitive Assessment
WISC-IV (2003) – CHC terminology (e.g., Fluid Reasoning, Working Memory) and CHC approach to interpretation (Flanagan & Kaufman, 2004, 2009)
WAIS-IV (2008) – CHC terminology and interpretive approach (Kaufman & Lichtenberger, 2009)
Keith et al. (2006)

Summary of Relations between CHC Abilities and Specific Areas of Academic Achievement (Flanagan, Ortiz, Alfonso, & Mascolo, 2006)
See McGrew and Wendling (in press) for an extension of this work

Comparison tables may be found in:
Flanagan & Alfonso (in press). Essentials of Specific Learning Disability Identification. Hoboken, NJ: Wiley.

Subtypes of Reading Disability (Fiefer, in press)
(1) Dysphonetic Dyslexia – difficulty sounding out words in a phonological manner (Ga-Phonetic Coding; Gsm-Memory Span, Working Memory)
(2) Surface Dyslexia – difficulty with the rapid and automatic recognition of words in print (Glr-Naming Facility; Gv-Orthographic Processing; Gs-Perceptual Speed; Gc-Vocabulary Knowledge)
(3) Mixed Dyslexia – multiple reading deficits characterized by impaired phonological and orthographic processing skills. It is probably the most severe form of dyslexia. (Multiple CHC abilities or processes involved; attention and executive functioning)
(4) Comprehension Deficits – the mechanical side of reading is fine but difficulty persists deriving meaning from print (Gf-Induction, General Sequential Reasoning; Gc- Language Development; attention and executive functioning)

Correspondence Between Diagnosis and Treatment
as syndromes/disorders become more discretely defined, there may be a greater correspondence between diagnoses and treatment
Kratochwill and McGivern's (1996; p. 351)

Individual Differences ARE Important
Why do some children fail to respond?
Perhaps because interventions are being applied “blindly” as a one size fits all method without understanding whether or not specific cognitive deficits exist

Individual Differences ARE Important
“A neuropsychological process that is important to reading skills development is working memory – it is a crucial process for early reading recognition and later reading comprehension. One must assess it if one is to develop the most appropriate method of intervention (Teeter et al., 1997).”
“Given the findings from the neuroimaging and neruopsychological fields of deficient performance on measures of working memory, processing speed, auditory processing ability, and executive functions, evaluation of these skills is necessary to determine the most appropriate program to fit the individual child’s need.”
Semrud-Clikeman
(2005)

Individual Difference ARE Important
“The danger with not paying attention to individualdifferences is that we will repeat the current practice of simple assessments in curricular materials to evaluate a complex learning process and to plan for interventions with children and adolescents with markedly different needs and learning profiles.” (Semrud-Clikeman, 2005)
“Nonresponders” provide sound evidence that
one size DOES NOT fit all.

Comprehensive Evaluations (That Include Assessment of Cognitive Functions) Are Necessary for Nonresponders
Cost – Benefit
Do Tier III interventions work?
Would it make sense to gather more information about Tier II nonresponders prior to implementing Tier III interventions?

For a copy of this White Paper, contact James (Brad) Hale, Ph.D. at: jamesha@pcom.edu

Expert Panel Consensus For Using Intensive RTI to Meet the Needs of Children with SLD
Item #8 Increasing intervention intensity in a multi-tier response to intervention model will meet the academic and psychosocial needs of all children with SLD
Hale et al. 2010 Expert Panel White Paper (N = 58)

NAPSA Practitioner Survey
Increasing intervention intensity in a multi-tier response to intervention model will meet the academic and psychosocial needs of all children with SLD
McHale-Small NAPSA Survey (N=680; Administrators; Practitioners; Specialists)

Response at Tier II?
Responder?
YES, Return to Tier 1
Regular Education and
Progress Monitoring
NO, Tier III Intervention
OR
NO, Comprehensive
Evaluation and Problem-solving
to Redirect Intervention
Flanagan, Fiorello, & Ortiz (in press); Flanagan, Ortiz, Alfonso, & Dynda (2008); Hale & Fiorello (2004)

Mathes and Colleagues (2005)
Provided Tier I and Tier II intervention to struggling first-grade readers in six schools
Severe difficulties in phonological awareness, letter-sound correspondence, and word reading
Three conditions
Tier I classroom instruction only (n = 92)
Tier I plus Tier II intervention (consisting of Proactive Beginning Reading Instruction; Mathes et al., 1999; n = 83)
Tier I plus Tier II intervention (Responsive Reading Instruction; Denton & Hocker, 2006; n = 80)
Reported in Denton, Fletcher, Simos, Papanicolaou, and Anthony, 2007

Tier II Intervention
Tier I instruction plus daily 40-minute, small group interventions for about 30 weeks in the first grade (groups of 3 students to one teacher)
Six certified teachers who received about 42 hours of professional development delivered by the developers of the programs they used
Responsive Reading Instruction
Proactive Beginning Reading Instruction
High levels of fidelity were achieved by intervention teachers

Results of Tier I and Tier II Intervention
Of the 255 students who received Tier I and II interventions, only 22 were reading below average(below benchmark) at the end of the intervention period
Below 30th percentile on WJ III Basic Reading Skills
87 students did not reach a common oral reading fluency benchmark
40 WCPM by end of 1st Grade
14 students were identified for Tier III intervention based on primarily on availability (Denton, Fletcher, Anthony, & Francis, 2006; Mathes and colleagues, 2005).

Tier III Intervention
16-week intervention provided daily in groups of two students to one teacher
First 8 weeks students received the Phono-Graphix program (McGuiness et al., 1996) two hours daily
Followed by 8 weeks of the Read Naturally program (Ihnot et al., 2001) one hour daily
Six teachers were well trained in intervention programs
Students response to Tier III intervention was highly variable

Results of a Tier 3 Intervention Phase
Benchmark
30th Percentile
Key: PG = Phono-Graphic Phase; RN = Read Naturally Phase (From An evaluation of intensive intervention for students with persistent reading difficulties. Journal of Learning Disabilities, 39, 447-466. In D. Haager, J. Klingner, & S. Vaughn. [2007]. Evidence-based reading practices for response to intervention. MD: Paul H. Brookes Publishing Co., Inc.)

Important Consideration
The education community must ask whether it is important and reasonable to expectthat even students with severe reading difficulties can be taught to read competently, closing the gap with their peers (Denton, Fletcher, Simos, Papanicolaou, & Anthony (2007).
Can we help more children if we understand them better via a comprehensive evaluation?

Response to Intervention
Responder?
NO, Comprehensive
Evaluation and Problem-solving
for Differential Diagnosis and Intervention
Selection or Modification
YES, Regular Education
Instruction and
Progress Monitoring
Criteria for SLD met?
YES, Eligible for
Special Education Services?
Implement Modified
Intervention and Progress Monitoring
In LRE
NO, Continued Problem Solving;
Implement Modified
Intervention and Progress Monitoring
Flanagan, Fiorello, & Ortiz (in press); Flanagan, Ortiz, Alfonso, & Dynda (2008); Hale & Fiorello (2004)

A Comprehensive Evaluation , that Includes Cognitive Assessment, is Necessary for Tier II Nonresponders

Common Components of Third Method Approaches to SLD Identification
COGNITIVE STRENGTH
Average or higher abilities and processes; May also include strengths in academic skills
Statistically significant difference between cognitive integrities and circumscribed cognitive ability or processing deficit(s)
Cognitive deficit(s) is specific, not general or pervasive, because overall cognitive ability is at least average
Statistically significant difference between cognitive integrities and academic skill deficit(s)
Academic deficit(s) is unexpected, not expected, because overall cognitive ability is at least average
Discrepant/Discordant
Discrepant/Discordant
ACADEMIC WEAKNESS/FAILURE
Academic Skills/Knowledge Deficits
COGNITIVE WEAKNESS/DEFICIT
Cognitive Ability or Processing Disorder
Consistent/Concordant
No Statistically significant Performance Difference (constructs are related empirically )
Flanagan, Fiorello, and Ortiz (in press); Hale, Flanagan, and Naglieri (2008)

CHC Abilities and Processes Related to Basic Reading Skills and Reading Comprehension in Children Ages 6-8 Years
(Cross-Battery Assessment or other Flexible Battery Approaches May be Necessary to Measure All Important Abilities and Processes)
Gc
Ga
Gs
Gsm
Glr
Important Broad
CHC Cognitive
Constructs
Important Narrow
CHC Cognitive
Constructs
LD
VL
PC
US
P
MW
MA
NA
Co-normed
KABC-II
Non. Wrd Dcd
Timed NWD
Verbal Know.
Timed Wrd Rec
Phon. Aware.
Word Order
Fluency
KTEA-II
Atlantis
Riddles
Rebus
RAN
WJ III WM Cluster
WJ III Aud. Attent.
Supplemental
WJ III Gs Cluster
CTOPP
= Consistent significant relation
= Strongest and most consistent significant relation

Flanagan et al. Operational Definition of SLD A “Third Method” Approach
Continued on Next Slide
Flanagan, Alfonso, and Mascolo (in press). In Flanagan & Alfonso (Eds.), Essentials of Specific Learning Disability Identification. Wiley

Flanagan et al. Operational Definition of SLD A “Third Method” Approach
Flanagan, Alfonso, and Mascolo (in press). In Flanagan & Alfonso (Eds.), Essentials of Specific Learning Disability Identification. Wiley

Name:_____________________ Age: ____ Grade: ____
Examiner:____________________ Date: ___________
KABC-II and KTEA-II Data
Pattern of generally average cognitive abilities and processes establishes basis for satisfying criterion of “an otherwise normal ability profile”
Pattern of empirically or logically related cognitive and academic deficits establishes basis for satisfying criterion of “below average aptitude-achievement consistency”
40 50 60 70 80 90 100 110 120 130 140 150 160
Grw Broad/Narrow Cluster
Reading Composite( )
Sound Symbol ( )
Reading Fluency__(_ _)
Domain-Specific
Ga Broad/Narrow Cluster
Nonsense Wd Decod( )
Phonol. Awareness_( )
________________(___)
Glr/Gs Broad/Narrow Cluster
Assoc. Fluency_____(___)
Naming Facility____(___)
WJ III Gs Cluster__ (___)
Historical Concept of Intra-Individual Discrepancies
Glr-MA Broad/Narrow Cluster
Rebus_____________(___)
Atlantis_ __________(___)
__________________(___)
Gsm Broad/Narrow Cluster
Word Order__ ( )
Number Recall_ ( )
WJ III Working Mem. (__)
Unexpected Underachievement
Gf Broad/Narrow Cluster
Story Comp.__ ( )
Pattern Reasoning ( _)
_______________ ( )
Gv Broad/Narrow Cluster
Rover_ __( )
Triangles_______ ( )
_______________( )
Gc Broad/Narrow Cluster
Expressive Vocab. ( )
Verbal Knowledge ( )
_______________( )
40 50 60 70 80 90 100 110 120 130 140 150 160

Name:_____________________ Age: ____ Grade: ____
Examiner:____________________ Date: ___________
KABC-II and KTEA-II Data
GENERAL Learning Difficulty
DOMAIN-GENERAL
EXPECTED Underachievement
(aka “Slow Learner”)
40 50 60 70 80 90 100 110 120 130 140 150 160
Grw Broad/Narrow Cluster
Reading Composite( )
Sound Symbol ( )
Reading Fluency__(_ _)
Ga Broad/Narrow Cluster
Nonsense Wd Decod( )
Phonol. Awareness_( )
________________(___)
Glr/Gs Broad/Narrow Cluster
Assoc. Fluency_____(___)
Naming Facility____(___)
_________________(___)
Glr-MA Broad/Narrow Cluster
Rebus_____________(___)
Atlantis_ __________(___)
__________________(___)
Gsm Broad/Narrow Cluster
Word Order__ ( )
Number Recall_ ( )
_______________(___)
Gf Broad/Narrow Cluster
Story Comp.__ ( )
Pattern Reasoning ( _)
_______________ ( )
Gv Broad/Narrow Cluster
Rover_ __( )
Triangles_______ ( )
_______________( )
Gc Broad/Narrow Cluster
Expressive Vocab. ( )
Verbal Knowledge ( )
_______________( )
40 50 60 70 80 90 100 110 120 130 140 150 160

On the Flanagan et al. and Kavale and Forness Operational Definitions of SLD…
These operational definitions provide an inherently practical method for SLD identification that carries the potential for increased agreement about the validity of SLD classification
Kavale, Holdnack, & Mostert (2005, p. 12)

The Importance of Assessing Cognitive Abilities and Processes and Academic Skills…
By identifying specific targets for remediation, the possibilities for truly individualized intervention are increased significantly.

The Value of Assessing Cognitive Abilities and Processes…
Even if a student never enters the special education system, the general education teacher, the student’s parents, and the student him- or herself would receive valuable information regarding why there was such a struggle in acquiring academic content, to the point of possibly needing special education

What is a Specific Learning Disability?
IDEA Definitions and Practices
Determining Specific Learning Disability
Discrepancy between “ability” and “achievement” (typically using cut-off points and global IQ)
Failure to respond to scientific research-based intervention
May permit the use of other alternative research-based procedures for determining whether a child has a specific learning disability, as defined in §300.8(c)(10) (OSERS Final Regulations-8/06)
Flanagan and colleagues
Hale and Fiorello
McCloskey
Naglieri
Feifer and Della Tafano
Berninger
Geary
All value RTI approach; All consider RTI data in the diagnostic process

On Third Method Approaches
Della Tofallo(2010; pp. 180-181) – RTRI or Response to the Right Intervention
Make no mistake…integrated models [third method approaches] of identifying (and serving) students with LDs do not arrive prepackaged along with dozens of studies touting their “scientific validation.” However, they are evidence-based because they emanate from the marriage of a collective body of knowledge that has been acquired through research in the fields of neuroscience, pedagogy, assessment, and intervention.

“At the current state of scientific knowledge, it is only through a comprehensive evaluation of a student’s cognitive and psychological abilities and processes that insights into the underlying proximal and varied root causes of [academic] difficulties can be ascertained and then specific interventions be provided targeted to each student’s individual needs, a process long advocated”
From Reynolds and Shaywitz (2009)

Diagnostic Impressions Following a Comprehensive Evaluation/Third Method Approach
Bob’s academic difficulties in reading and writing have persisted despite being exposed to quality instruction and intervention over a prolonged period of time. These difficulties could not be explained by global cognitive impairment, social-emotional problems, cultural and linguistic differences, sensory-motor difficulties, lack of motivation, environmental disadvantage, or a health-related impairment. Rather, Bob exhibited specific and circumscribed weaknesses in cognitive areas that are known to be related to difficulties in reading and writing, namely short-term memory, retrieval ability, phonological processing, and possibly associative memory. Thus, while Bob has the ability to think and reason like most children his age, as demonstrated by his performance in the cognitive areas of Fluid Reasoning, Comprehension-Knowledge, and Visual-Spatial Thinking, he possesses specific and related cognitive and academic deficits that are consistent with a diagnosis of Specific Learning Disability (SLD).
Failure To Respond to quality instruction and intervention
Global Ability at least Average; Low Achievement Unexpected
Exclusionary Factors ruled out as primary reason for underachievement
Domain-specific weaknesses/deficits in cognitive areas that are related empirically to achievement weaknesses
Meets third method criteria; “pattern of strengths and weaknesses”
Flanagan, D. P., & Alfonso, V. C. (in press). RTI Data and Cognitive Assessment are Both Useful for SLD Identification and Intervention Planning. In N. Mather & L. E. Jaffe (Eds.), Expert Psychological Report Writing. New York, NY: John Wiley & Sons.

Learning Disability Quarterly, Volume 31, Summer 2008

Linking Assessment to Intervention

RTI at Tiers I and II
Tier I Screening
At-risk in Reading
Decoding
Fluency
Comprehension
Tier II Treatment Protocol
Reading Recovery
Students
Amy
Belinda
Carl
Mascolo and Flanagan (2008)

Reading Recovery Results
Amy, Belinda, and Carl are making some gains in Reading Recovery
No appreciable change in reading performance
Tier II “nonresponders”
Need for a comprehensive evaluation that includes cognitive assessment

Individual Differences Are Important
One Size Does Not Fit All

Instructional Planning is Complex and Requires a Team of Experts
Home and Community
School Environment
Diagnostician
Regular Ed Teacher
CHILD
Multiple Data Sources
Knowledge of and Access to Appropriate Resources
Parents and
Other School Personnel
Special Ed Teacher

Linking Assessment to Intervention
Requires good instruments
Well trained clinicians
Well trained teachers and special educators
A mechanism in place for bringing data together to problem-solve in an attempt to offer the most effective instruction and interventions to children

Intervention Types
Need to differentiate between
Direct Interventions (remediation)
Accommodations
Compensation
Instructional/Curricular Modifications
Intervention: any technique, product, or approach that intends to address directly an identified area of weakness through remediation
Accommodations: any technique or support that intends to alleviate the symptomatology associated with an identified area of weakness (e.g., circumventing the impact of a processing speed weakness via extended time - - the symptom is not “Gs deficit” – that’s the problem; the symptom is “unfinished assignments” - - when you extend time you alleviate the symptom and assignments are completed.
Compensation: strategies taught to a student that he or she is expected to apply independently to by pass weaknesses

Different Cognitive Ability Profiles Suggest Different Interventions

Different Cognitive Profiles Suggest Different Interventions
Amy’s cognitive testing shows a significant deficit in phonetic coding – she doesn’t know how to translate symbols into sounds
Ga deficit impacts her fluency – labored reading
Lack of decoding and fluency impacts comprehension
Intervention should focus on Phonemic Awareness – Remediate Ga

Gc deficit – language deficit
Comprehension is poor b/c of low Gc
Poor vocabulary – needs to re-read to gain meaning, which impacts fluency
Intervention should focus on vocabulary development – Remediate Gc-VL, KO
Accommodation of extended time due to a global Gs deficit

Gsm deficit
Decoding is poor – he cannot hold the complete phonemic string in mind long enough to say the word
Comprehension is poor because he needs to allocate all memory space decoding words and therefore cannot focus on meaning
Fluency is impaired because he must re-read the text to gain meaning
Intervention should focus on developing a sight word vocabulary
Carl needs to be taught compensatory strategiesto assist with poor Gsm (text previews; guided notes; one comprehension question at a time)

Different Cognitive Ability Profiles Suggest Different Interventions
All had same academic deficits (decoding, comprehension, fluency)
All made slow gains with Reading Recovery
All had different patterns of cognitive strengths and weaknesses
Reading Recovery – allocating time to areas that do not need to be trained
Not enough explicit instruction in main problem area because the intervention was not tailored

Amy’s Intervention
No need to focus on comprehension and fluency
Amy needs phonemic awareness training

Belinda’s Intervention
No need to focus on decoding
Belinda needs to focus on building her vocabulary
She will also benefit from strategies/adaptations to build fluency

Carl’s Intervention
No need to focus on comprehension or fluency
Carl needs sight word reading and memory strategies

http://www.multilit.com.au/

RTI-Only Camp
No evidence that your method is effective and leads to positive outcomes for children
Lack of documented effectiveness is not the same as documented ineffectiveness
Failure to Prove is not Proof of Failure (Braden et al., 2009)
We are just beginning to do the research – using current instruments, current theory, current methods
Look for upcoming special issue of JLD, Cognitive and Neuropsychological Assessment Data That Inform Educational Intervention (Guest Edited by Hale & Fuchs)

School Psychologists are Scientist-Practitioners
Third method approaches then arrive to you “with a call to duty – the duty of the scientist- practitioner to engage simultaneously in both practice and research calculated to evaluate current practice in order to guide future practice.”
Della Tofallo(2010; p. 180) – RTRI or
Response to the Right Intervention

Conclusions

“To Test or Not To Test” is the Wrong Question
Rather than Abandoning our Best Tools, Practitioners Need to Learn How to Integrate Assessment for Intervention
into their Practice and Evaluate the Effectiveness of their Recommendations for Children with SLD

“In an ever-changing world, psychological testing remains the flagship of applied psychology”
Embretson, S. E. (1996). The new rules of measurement. Psychological Assessment, 8 (4), 341-349.

http://www.slideshare.net	27
http://blackboard.stthom.edu	9
https://blackboard.stthom.edu	2
http://www.google.com	2
http://keene.blackboard.com	1

Flanagan Webinar For Wiley 3 22 10

by Kevin McGrew on Mar 31, 2010

Accessibility

Tags

Upload Details

Usage Rights

5 Embeds 41

Statistics

Flanagan Webinar For Wiley 3 22 10 — Presentation Transcript