Proof of School Speech Pathology Over-identification?

One of our SLP visitors posed a critical science question for all of us to consider.  Here is the comment:

“I wonder where you get your data. SLP’s have to substantiate eligibility with standardized tests and data of progress. With our caseloads, there is no way we would take on a child that didn’t need it! That said, new regulations require language services that formerly were not covered if it could be shown that a child had a concommittent intellectual disorder. The result of that regulation is that practically any intellectually disabled child also receives language services.”

Kids stuff for school.

Our quick answer was designed to touch on some “evidence” on the matter:

“Take a look at “About Us” for the premise, and consider the many posts covering disproportionality, over-identification, least restrictive environment and failure to dismiss. Consider actual clinical examples and the use of aggregate data. For IDEA 2004 renewal, consider how the law was changed to reduce LD over-placement because of issues of construct validity for test interpretation. We argue for improved skill development. Consider the content of “Themes of Interest II.’ Look at, “SLPs Can Lead Over-identification Preschool Prevention Programs.”

Yes, the question posed is excellent and the right one.  It goes to the question of what constitutes proof.

Dr. Jay Greene and his colleagues demonstrated the influence of a macro variable on the over-identification of at-risk children for special education placement and retention, financial incentives for local superintendents  to increase the population:  “There is a statistically significant positive relationship between bounty funding systems and growth in special education enrollment. Bounty funding results in an additional enrollment increase of 1.24 percentage points over ten years.”  2002  (Congress did address the problem.)

School SLPs are instrumental in placing children nationwide, and therefore we can say they have made decisions influenced by financial patterns in their districts.  Likewise, they are influenced by state policies: “An analysis of U.S. Department of Education data shows that the percentage of students in special education varies widely among states. While Rhode Island tops the country at 18 percent, Texas, at 9 percent, is at the bottom. The average percentage across all states is 13 percent, and two-thirds of states are above that number, according to the data.”  Thus in Rhode Island  SLPs are part of a pattern making them more likely to recommend children than SLPs in Texas, and so forth.

We infer working school SLPs are not aware of the patterns of over-identification in their caseloads, while the known problem is older than the SLPs:

“Concerns about the overidentification of ethnic and culturally diverse students in special education first gained national attention in the 1960s as civil rights advocates, educators, administrators, and policy makers began raising questions about the overrepresentation of minority students in classes for the mentally retarded. To a great extent, disproportionate placement still remains today. Although the problems varies from state to state and region to region, it is seen as an ongoing national problem which may result in students who are unserved, misclassified or inappropriately labeled, or receive services that do not meet their needs. Disproportionate placement of these students into special education classes may be seen as a form of discrimination.”   Amy Zirkelbach, 2002

Recommended is the following post  for the practical implications of managing identification:

How One SLP Manages Caseload and Eligibility

SLPs need to take heed of the  conditions around them:  “

“While African Americans make up approximately 17 percent of public school enrollment, they account for 31 percent of students identified as having mental retardation or intellectual disabilities, 28 percent of students labeled as having an emotional disturbance, and 21 percent of students who have learning disabilities. Some of these categories aren’t pure medical diagnoses, calling judgment, and perhaps bias, into play.”

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