Monthly Archives: October 2009

Public Policy and Over-identification

Special education “best practices” are partly directed by federal mandates, i.e., IDEA 2004.

Professional organizations can advocate for service roles adding to statutory requirements but they should support the law. These organizations should advocate for reducing misidentification: “The American Speech-Language-Hearing Association (ASHA), Council of Administrators of Special Education (CASE), Council for Exceptional Children (CEC) Council for Learning Disabilities (CLD), Division for Learning Disabilities (DLD), International Dyslexia Association (IDA), International Reading Association (IRA), Learning Disabilities Association of America (LDA), National Association of State Directors of Special Education (NASDSE), National Association of School Psychologists (NASP), National Center for Learning Disabilities (NCLD), National Education Association (NEA), School Social Work Association of America (SSWAA).”

Every school district’s (LEA) special education department monitored by a state agency (SEA) must work to reduce and avoid the misidentication of at-risk school children to protect against FAPE violations. Every employee must do the same.

IDEA-2004 promotes the use of scientific foundations for special education practices. Science provides an ethical foundation for “best practices.” Debate before reauthorization of IDEA 1997 brought forth scientific information to suggest that over-identification was contributing to increases in special education enrollments, and therefore to increases in systematic FAPE violations. At the core is a child’s civil rights, and for some this is an ethical matter.

It is not best practice for special educators and related services personnel to misidentify non-disabled children. It is up to the individual to consider the ethics, improve and lead others.

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School SLP Contracts and Compliance

School SLPs receive employment contracts.  Contracts require compliance with IDEA regulations.  If the employer is out of compliance with federal regulations, what is the SLP responsibility?  To be an acceptable employee, one might have to follow illegal practices, such as the placement of non-disabled minority children.  If SLPs speak up, directors can say they are “non-compliant”  for job performance.  Ambiguity is embedded in employment contracts.

School Speech Pathology and Birth to 21

Birth to 21

Where do at-risk children get into special education? And who puts them there? And how do they stay?

There are growing numbers of early intervention children (Part C):

1991: 1.77% population
2001: 1.78% population
2008: 2.52% population

“For example, for fiscal year 1991, 194,363 children were reported to be receiving services as of December 1, 1990. The number represents U.S. and outlying areas” (U. S. Department of Education). Physicians, speech-language pathologists, social workers and psychologists make clinical and eligibility determinations.

Prior to Part C, under-identification of infants and toddlers was the fact, and there was good reason for the U. S. Congress to bring them into the system. “Some argue that alternative early identification (perhaps by kindergarten) and early intensive intervention could prevent a learning disability from developing into a condition requiring special education” (Congress Report).

SLPs increasingly are key decision-makers.

At grade 1, the highest number of special education pupils are classified SLI pupils — 50%. Around grade 7, SLPs start disqualifying SLI pupils, and the numbers go down from there. At grade 1, the learning disability, mental retardation and emotional disturbance categories are relatively small.

By grade 3, learning disability determinations shoot up, passing SLI and rising from there. SLI enrollments drop, returning to baseline. Emotional disturbance increases slightly throughout the grades. Some emotionally disturbed children are misplaced as LD pupils. Mental retardation enrollment remains constant.

LD children are placed late, and do not benefit from early intervention. Early on many are misidentified as SLI pupils. Once LD students are identified, and mixed in with minority and difficult-to-teach children, there is a rush to place. A kind of panic sets in, and this state of flux invites misidentification. Teachers are under pressure to show good scores for No Child Left Behind testing. This is a perfect storm for misplacement.

Along with mental retardation, those disabilities having a biological basis have more stable rates of identification. “This is particularly true considering the category of “other health impairment” including students with visual, hearing, orthopedic, and other physical impairments. These students account for about 4% of the service population at all ages until the last few years of school.”

LD pupils tend to drop out of school later at a higher rate than non-disabled pupils. Some critics say LD children “get lost in the system” and receive less challenging instruction. As LD children grow older, the stigma of special education impairs motivation and social development just at the point where demanding life transitions must be planned. Here is an example of the negative consequences of misplacement.

Once again, we see that SLPs and school psychologists are key to special education misidentifications when they occur. Also they are key to continuing misidentifications.

SLPs are central to placing special education children from birth to age 21. They are potential leaders in reducing misidentifications. Disqualified clients will receive better FAPE protection. Smaller caseloads will result, and remaining clients will receive better treatment and better FAPE protection.

Over-identification Muddle: Who Minds the Store?

Who is minding the store?

Who is watching for misidentification?

In the typical school the answer is no one! No one fully understands and manages the range of programs and decisions IDEA 2004 covers from birth to 21 years. Regrettably, special education viewed historically and on the grand scale of American schools is in its infancy. So is IDEA. “A camel is a horse built by a committee,” the saying goes.

The medical models of early intervention (Part C) give way to the developmental models of early childhood education. The developmental models give way to models of academic learning (Part B). The categories of evaluation and placement shift, change and overlap with little or no linkage among them. Specialists, teachers and administrators maintain a pigeon-hole system and can’t see relationships, nor talk about them.

Special education directors are pinned down by compliance issues set up by state auditors. This can impair the ability to conceptualize the broad issues and related areas of reform. Upward leadership to change state and federal requirements is a super challenge and doesn’t increase salary.

Downward changes such as those of 2004 are filtered and reworked at the state level. For example, RTI in special education grew out of the need to cut down on over-identification, especially of SLD placements. Now RTI is being rolled out programmatically as only an opportunity to improve services to children and an opportunity for specialists to “get involved.” It is being disassociated from its IDEA roots as Senators Rudd and Kennedy addressed it in 2003, to reduce the numbers of children improperly placed in special education at the expense of their school rights (ConnSense).

The potential solutions to over-identification are cheap, simple and largely conceptual. Exotic RTI-like programs are not needed. Labels must be defined accurately and placement criteria applied consistently. Staff realignments to support early intervention can take place without new funding. Internal reviews of all school cases can monitor for occasional placement errors. IEP meetings need to focus on the big picture: “How is this child doing and where is his or her educational program heading?” States should cut down on the use of paperwork checklists to define and dictate indirectly what it means to be a competent special educator. Special education directors need to inspire growth and reform. States in the role of translators of IDEA initiatives should communicate clearly, accurately and often, using their web sites to coordinate improvements rather than to document compliance.

LD Mystery

We are pulling apart the LD over-identification mystery.

One piece of the puzzle has been how pupils are evaluated for learning problems: ” a predominant approach to determining whether a child has a learning disability is comparing an IQ test score (as a measure of “ability”) with an achievement test score for reading or math…..Some researchers point out that these kinds of comparisons cannot be made much before 4 th grade when “meaningful” scores can be compared. Thus a child might be learning disabled or be at risk of developing a specific learning disability but not be identified and receive special education and related services until he or she is well into elementary school” (Congress Report).

We see the origin of the “wait to fail” approach (Ed evolve). The psychologist must “get good numbers” before diagnosing LD.

But where are the LD children waiting? Here is the answer: They are buried in the SLP caseload in the speech and language impairment (SLI) category. A significant portion of SLI pupils morph into LD children. The underlying pathology for the two categories is the same, a genetically-based cognitive-linguistic processing disorder (Speech genes).

Surveying criteria across states, the processing perspective is not applied often to SLD placements. “The presence of a processing disorder, while prominent in the federal definition of SLD, was relatively absent from most states’ classification criteria. Only 13 states required determination of a processing disorder” (Greatschools).

IDEA 2004 does correctly sketch the symptoms of LD which include oral language processing:

“Oral expression
Listening comprehension
Written expression
Basic reading skill
Reading fluency skills
Reading comprehension
Mathematics calculation
Mathematics problem solving (Great schools)”

The SLI category is a holding area for later psychometric evaluation. In grades 1 and 2 SLPs carry approximately 50% of all special education pupils, whereas by age 14 the percentage drops to 4%. Congress reported: “This pattern results because most speech and language impairments are mild and tend to diminish, or disappear, as these children mature and receive speech/language therapy.” A significant number “disappear” because their symptoms move to literacy performance.

A sequence of misidentification errors is happening:

First, LD is misidentified as SLI — “Under-identification.”

Second, LD is identified but late — “Late identification.”

Third, SLI drops out of the eligibility picture — “Under-identification.”

According to the Congressional Report (1998-1999) all other disability categories remain relatively stable across age groups. The trading relationship exists between SLI and LD.

The definition of LD, however, does not explain placement of non-disabled children. They come in LATE. adding to total numbers — “Over-identification.”

Five to Eight

We need to understand where and how at-risk children are admitted into special education. We need to know who decides and by what criteria. What are the danger spots. With this sort of information we can begin to control misidentifications through school leadership.

The transition between five and eight years is the “wait to fail” period.
Developmentally disabled children move onto the solid ground of non-clinical educational instruction. Gradually learning begins to break down. Some children are retained in the current grade. Boys lag behind. It is hard to tell much in the first grade so heavy concern is not voiced until grade 2. The fairly exotic labels used in preschool begin to be less useful. “Progress in the general curriculum” (IDEA 2004) is the litmus test for how many disabled children actually learn.

Typically deficits of literacy development begin to replace speech problems. The school psychologist is called in for formal testing, if the child can perform on standardized tests. If not, further delay occurs.

When the psychometric data come in, they point to learning problems. IEP teams include a regular classroom teacher, a special education teacher, and other specialists. The focus is on poor learning rather than on disability categories. The medical diagnosis has faded away. The learning disability category fits what is really happening to the child.

Unfortunately, it fits many types of non-disabled children who are breaking down in learning. Migrant children, for example, simply do not get enough time in one school. Bilingual children are trying to learn using faulty English. Children with behavioral problems do not pay attention. Boys are just a little slower linguistically. Defiant children are hard to teach. Culturally different children speak dialects of English and are hard to understand. This is the “difficult to teach” population of children who tend to be placed in special education (Jim Wright).

The case for RTI has some merit. Intervene prior to special education and let the children sort themselves out as to learning aptitude. (“RtI was developed starting in the late 1970s by numerous researchers seeking a method of identifying learning disabilities that avoids the problems of the discrepancy model. Unlike the discrepancy model, RtI allows for early and intensive interventions in the regular education setting based on a student’s learning characteristics before any referral to special education. The benefit of RtI, according to the Council for Exceptional Children, is that children do not have to “wait to fail” before they receive help” (OLR).

The period between five and eight years is where misidentification can run amok. All three types of misidentification are on display:

“Under-identification — that is, failing to identify children who have disabilities and need special education to succeed in school;

Over-identification — that is, classifying students with disabilities they do not have; and

Late identification — that is, delaying identification of students with disabilities until later in their schooling when special education services may be less effective” (Congress Report).

Birth to Three

We need to understand where and how at-risk children are admitted into special education. We need to know who decides and by what criteria. With this sort of information we can begin to control misidentifications through school leadership.

A starting point is state-to-state early intervention programs. Infants and toddlers from 0 to 3 years can receive early intervention services under Part C of IDEA 2004. For example, in Arizona, services are rendered under the Arizona Department of Economic Security, Arizona Early Intervention Program, or AzEIP (Arizona 0-3). A child can be referred to AzEIP by interested parties, and referrals can be made online. U. S. states use different agencies under the law, and procedures vary quite a bit.

“Developmental delay” in Arizona means…”a child has not reached fifty percent of the developmental milestones expected at his/her chronological age in one or more of the following areas of childhood development:  physical, cognitive, language/communication, social/emotional, and adaptive self-help” (Arizona 0-3). Early signs necessitate flexible and inconclusive diagnoses because of the plasticity of early development. Categories are broad. Indefiniteness opens the door to all kinds of early diagnostic errors shaping subsequent educational decisions.

Arizona children can receive services where there is an Established Condition: “Diagnosis of a physical or mental condition which has a high probability of resulting in a developmental delay.” Suggested conditions include: “chromosomal abnormalities, significant auditory impairment, intraventricular hemorrhage, cerebral palsy, significant visual impairment, metabolic disorders, neural tube defects, periventricular leukomalacia, hydrocephalus, severe attachment disorder, or failure to thrive.”

Medical opinion carries weight, and it too can condition later educational decisions. Medical diagnosis does not predict educational disability, particularly, learning disability. An elegibility translation must be carried out by IEP teams.

Eligibility can be based on “Informed Clinical Opinion: A review of records, evaluations, and observations to help make assessment and eligibility decisions.”

At the level of early intervention we can expect all three kinds of misidentification to result from eligibility decisions:

“Under-identification — that is, failing to identify children who have disabilities and need special education to succeed in school;

Over-identification — that is, classifying students with disabilities they do not have; and

Late identification — that is, delaying identification of students with disabilities until later in their schooling when special education services may be less effective” (Congress).

IDEA Misidentification

IDEA reauthorization negotiations in the U. S. Senate, the HELP Committee, Chaired by Judd Gregg (R-New Hampshire), set forth changes in the substitute bill (ConnSense). The Committee “received hundreds of e-mails and held over 80 joint meetings with interested parties to receive feedback on the introduced version of the bill. The bill passed today reflects the changes and suggestions brought forth from those discussions.” Revisions and improvements included changes to monitor special education misidentification:

“Reducing Misidentification of Non-Disabled Children

Allows for the development of new approaches [RTI] to determine whether students have specific learning disabilities by clarifying that schools are not limited to using the IQ-achievement discrepancy model.

Provides funds for training school personnel in effective teaching strategies and interventions to prevent over-identification and misidentification of children.”

A cross section of organizations were aware of changes in IDEA 97 to cut down on misidentification of at-risk school children.

“Groups Supporting The Individuals with Disabilities Education Improvement Act of 2003:

American Association of School Administrators (AASA)

American Federation of Teachers (AFT)

American Therapeutic Recreation Association (ATRA)

Arc of the United States

Association for Career and Technical Education (ACTE)

Association of University Centers on Disabilities (AUCD)

Autism Society of America (ASA)

Children’s Defense Fund (CDF)

Consortium for Citizens with Disabilities (CCD)

Council for Exceptional Children (CEC)

Council of Chief State School Officers (CCSO)

Council of the Great City Schools (CGCS)

Learning Disabilities Association of America (LDA)

National Association of Social Workers (NASW)

National Association of State Directors of Career Technical Education Consortium (NASDCTEC)

National Association of State Directors of Special Education (NASDSE)

National Center for Leaning Disabilities (NCLD)

National Education Association (NEA)

National School Boards Associations (NSBA)

Tourette Syndrome Association, Inc. (TSA)

United Cerebral Palsy (UCP)

Eligibility, RTI

“The International Reading Association (IRA) convened a group from the special education and regular education associations to craft a set of fact sheets on the roles of the various professionals and parents who are involved in implementing response-to-intervention (RTI) procedures” (2006, RTI Roles). Nine policy statements were published.

Collaborating groups were: “The American Speech-Language-Hearing Association (ASHA), Council of Administrators of Special Education (CASE), Council for Exceptional Children (CEC) Council for Learning Disabilities (CLD), Division for Learning Disabilities (DLD), International Dyslexia Association (IDA), International Reading Association (IRA), Learning Disabilities Association of America (LDA), National Association of State Directors of Special Education (NASDSE), National Association of School Psychologists (NASP), National Center for Learning Disabilities (NCLD), National Education Association (NEA), School Social Work Association of America (SSWAA).”

What do the the groups say about controlling special education eligibility?

The Introduction does say: “To support these efforts, the Individuals with Disabilities Education Improvement Act of 2004 (IDEA 2004) gives more financial flexibility to local education agencies (LEAs). Under the Early Intervening Services (EIS) provisions in the law, to help minimize over identification and unnecessary referrals, LEAs can use up to 15 % of their federal IDEA funds to provide academic and behavioral services to support prevention and early identification for struggling learners.”

But a quick tally of eligibility reduction statements in the nine papers showed that only 11 statements were written. Three papers made no mention of over-subscription. Three mentioned RTI as a means of reducing misidentification of minority children. In tone and content, none argued forcefully for minimizing misidentification.

RTI is viewed as a means of improving professional services to children cooperatively rather than protecting their eligibility rights.

Three to Six

We need to understand where and how at-risk children are admitted into special education. We need to know who decides and by what criteria. What are the danger spots? With this sort of information we can begin to control misidentifications through school leadership.

Children are referred for special education from age three to six years. There are different routes to eligibility: early intervention transfer, parents and child-find. Yes, this is a point where misidentification errors can be freshly made, or compounded.

Developmentally delayed children from early intervention carry with them medical and developmental assessments leading to continuing eligibility. Inter-agency teams help them transition into the local public school special education department. At the transition point eligibility criteria change, and team members must sort out how to translate.

Children who are developmentally delayed in Arizona are evaluated for “physical, cognitive, language/communication, social/emotional, and adaptive self-help” delays. With transference to a public school, they must qualify for special education services “…based on the results of tests and information gathered in seven areas: vision, hearing, cognitive development, physical development, communication development, adaptive development, and social and emotional development. A child must meet criteria for one of the following special education classifications, described in ARS §15-761: Preschool Moderate Delay, Preschool Severe Delay, Preschool Speech/Language Delay, Hearing Impaired, or Visually Impaired” (Ed.Com)”

Parents are warned to be alert to the changes at hand, ones that confuse the practical side of proper special education identification:
“1) of the change in types of services from the medical model to the educational model; 2) that services will need to be based on an educational need rather than a therapeutic need; and 3) that the use of classifications or labels for the child will be common place. Parents may need to learn new special education terms.”

Part C is relatively new and still evolving, therefore, so are the standards. On July 31, Cirrrveau and Andrews, of the Arizona Department of Education, announced:

“The DD (Developmental Delay) category has the same definition as the former Preschool Moderate Delay (PMD) category, but extends up to age ten. Preschool funding for DD is the same as the former PMD category and funding for school-aged DD students is the same as Emotionally Disabled (ED), Mild Moderate Retardation (MIMR), Specific Learning Disabilities (SLD), Speech-Language Impairment (SLI) and Other Health Impaired (OHI). Preschool Speech-Language Impairment (PSL) was absorbed and is defined in the (SLI) Category. Preschool Severe Delay (PSD), Visual Impairment (VI) and Hearing Impairment (HI) retain the same definition and funding.

A DD category in Arizona allows districts to identify preschool children with moderate delays as developmentally delayed and this educational category may stay with the child as they transition to kindergarten. IEP teams are able to focus on the child’s ongoing progress monitoring assessments and other data to determine present levels and needed goals and services as the child transitions to kindergarten rather than reevaluating every child to determine a school-age category. Children identified as SLI will also more easily transition to kindergarten without the need for re-determining eligibility from PSL to SLI.”

We see in the Arizona system no preschool label for “learning disabilty” or any discussion of how under-identification might be addressed: “Under-identification — that is, failing to identify children who have disabilities and need special education to succeed in school” (Congress). This is the danger point where states must anticipate learning disabilities and intervene properly to reduce the number of children placed in special education. This is a critical topic for further discussion. One can argue easily that the early use of the SLI category is absorbing LD pupils until they fail academically, termed the “wait to fail” problem.