12. Special Education Overidentification 2011: OHI

The special education category “other health impairment” (OHI) has grown significantly in recent years. The IDEA definition:  “Other health impairment means having limited strength, vitality or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, and sickle cell anemia; and adversely affects a child’s educational performance” (Nasat).


OHI ” began to increase in 1991 when the federal definition was expanded to include ADD and attention deficit hyperactivity disorder (ADHD)” (ED Sector).

Attention Deficit Hyperactivity Disorders require behavioral judgments for special education placements.  It is controversial for accurate eligibility determinations.

OHI often involves independent medical diagnosis which carries weight in IEP meetings for placement. Translating to curriculum impact is a qualitatively different task. The condition of  rheumatic fever does not predict reading ability.

ADHD children are “hard-to-teach,” bothersome, and routinely referred for special education evaluation.

“Attention Deficit Hyperactivity Disorder (ADHD) is one of the most talked about yet misunderstood disabilities in the schools. …There are several reasons that a student may be labeled ADHD, but do not actually have this disorder. It is often the first response a teacher might have to a student who misbehaves. A lack of discipline can exasperate behaviors that look like ADHD. A slow learner might not be paying attention due to content over his or her head. A gifted student may be inattentive, because the material is too easy and the student may already understand a concept and not want to listen to the teacher explain it again. It is difficult to differentiate these other factors between ADHD. Several things should be ruled out before a diagnosis is made” (School Psychologist).

“Frequently, bright children have been referred to psychologists or pediatricians because they exhibited certain behaviors (e.g., restlessness, inattention, impulsivity, high activity level, daydreaming) commonly associated with a diagnosis of ADHD…Almost all of these behaviors, however, might be found in bright, talented, creative, gifted children. Until now, little attention has been given to the similarities and differences between the two groups, thus raising the potential for misidentification in both areas – giftedness and ADHD” (Teacher Vision).

“Identification of speech and language impairments is further complicated by the fact that they often masquerade as other diagnostic conditions. For example, children with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) may in fact have an underlying language disorder” (Medscape).

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