841352ANN
research-article2019
THE ANNALS OF THE AMERICAN ACADEMYUSEFUL ASSESSMENT FOR SPECIAL EDUCATION
Assessment for
Special
Education:
Diagnosis and
Placement
Over the last 40 years, federal legislation has led to
improved access to public education for students with
disabilities. Today, more than six million students
receive special education and related services through
American public schools; however, evaluation practices
for eligibility determination largely have remained
unchanged. Assessment approaches used for identification, program planning, and evaluation of progress,
arguably, have been insensitive to cultural differences,
contributing to disproportional representation of children from different backgrounds in specific special
education disability categories, and inefficient because
they are too broad to immediately inform instructional
planning for both students within and across disability
categories. This article critiques current practices for
identifying children for special education services and
offers considerations, grounded in developmental and
cognitive neuroscience, that could lead to more useful
assessment approaches that optimize all students’
learning.
Keywords: disabilities; comprehensive evaluation; eligibility determination; precision education
By
Jennifer R. Frey
A
s recently as the late nineteenth and early
twentieth centuries, students with disabilities were denied access to public school education and had no educational protections under
the law. Rights of students with disabilities
evolved within the larger context of civil rights
legislation (e.g., Section 504 of the Rehabilitation Act of 1973) and landmark judicial
Jennifer R. Frey is an associate professor of special
education and disability studies in the Graduate School
of Education and Human Development at The George
Washington University. Her work has been published
in leading journals and handbooks in the fields of special education, speech-language pathology, pediatrics,
and school psychology.
NOTE: The author thanks the issue editors and Dr.
Kevin Pelphrey for their helpful contributions and
reviews of this article.
Correspondence: [email protected]
DOI: 10.1177/0002716219841352
ANNALS, AAPSS, 683, May 2019
149
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THE ANNALS OF THE AMERICAN ACADEMY
decisions (e.g., Brown v. Board of Education 1954; PARC v. Commonwealth of
Pennsylvania 1971; Mills v. Board of Education of District of Columbia 1972)
that ensured access to and protected opportunities for all people, regardless of
race or ability. With the passage of the Education for All Handicapped Children
Act (PL 94-142) in 1975, children with disabilities, for the first time, were legally
entitled to a free and appropriate public education (FAPE) in the least restrictive
environment (LRE), meaning, to the extent possible, students with disabilities
were to be educated in public schools, within general education classrooms, with
additional supports, and with peers without disabilities and only placed in more
restrictive environments if they could not make adequate progress within a general education context. At that time, the educational emphasis was on protecting
access and preventing exclusion.
Since the initial passage of PL 94-142 in 1975, continued federal legislation
designed to support equal opportunities and access (e.g., Americans with
Disabilities Act 1990; Individuals with Disabilities Education Act 1990, 1997;
Individuals with Disabilities Education Improvement Act [IDEA] 2004) and
continued support from the U.S. Supreme Court (e.g., Board of Education of
Hendrick Hudson Central School District v. Rowley 1982; Endrew F. v. Douglas
County School District 2017) led to improved educational opportunities and
programming. By law, it is insufficient to merely provide students with access to
public education. Students who qualify for special education services are entitled
to Individualized Education Programs (IEP; IDEA 2004) that meet their unique,
identified needs and support their learning (i.e., allow them to make progress) in
the least restrictive educational setting (i.e., general education with supplemental
services must be considered before alternative special education instructional
programming or more restrictive educational settings outside of the general education classroom are applied [IDEA 2004]). Today, more than 6 million students
(13 percent of all public school students) between the ages of 3 and 21 years old
receive special education and related services (National Center for Education
Statistics [NCES] 2018; see Figure 1), and students with disabilities have demonstrated growth in both academic and social learning (Frey and Gillispie 2018).
Despite this progress, our communities and educational systems continue to
struggle to meaningfully include and meet the learning and developmental needs
of all children, particularly those with high-intensity needs (U.S. Department of
Education 2016).
Traditionally, assessment has played a critical role in screening children to
identify those who may have a disability and need a comprehensive evaluation
and determining, of those students who are evaluated, who qualifies for additional services and protections (i.e., classification and eligibility determination).
The process from referral to eligibility determination to educational placement,
however, remains a bumpy road for many students and their families. Currently,
assessment practices can be useful for supporting educators and related specialists in making eligibility decisions. Yet a reliance on standardized norm-­referenced
tests, the traditional “wait to fail” approach, and imprecise and variable guidelines
for eligibility decision-making challenge our current use of testing for selection
and placement in special education.
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151
Figure 1
Percentage of Students Ages 3 to 21 Receiving Services under IDEA by Disability
Category
SOURCE: Data obtained from https://nces.ed.gov/programs/coe /indicator_cgg.asp.
NOTE: Disability categories with less than 1 percent of students are not displayed.
Furthermore, perhaps the issue we, as educators, should be emphasizing is not
necessarily who qualifies for special education in what category but, rather, what
supports children need to be successful in their educational environments. While
the majority of students enrolled in public schools do not qualify for special education services under the IDEA (2004), we all learn differently. Addressing individual learning differences within and across instructional settings would enhance
all students’ learning. There is an opportunity for assessment to play an important
role in improving the efficiency and precision with which we identify and monitor
the learning and behavioral supports all students need to successfully navigate
their learning environments—leading to more useful assessment data for educators, specialists, and parents. Ultimately, we must strive to develop an approach
that allows all children—with and without disabilities—to fully access and benefit
from learning opportunities designed to optimize their development and success
within and outside the classroom.
Emerging theories and methods from multiple fields of science and practice
can help us to leverage our own expertise within educational assessment to
improve our techniques and approaches to support all learners. This article critically evaluates current practices for identifying children for special education and
considerations for the use of assessment for educational placement and planning,
including limitations and challenges associated with current practices, and offers
considerations that could lead to more useful assessment approaches designed to
maximize children’s developmental and educational outcomes.
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Status Quo: Assessment in Special Education Today
The purposes of psychological and educational assessment include (1) identifying
children for whom we may need additional information about their learning or
development or who may be at high risk for academic challenges (screening); (2)
diagnosing differences and determining whether a child is eligible for additional
educational services (classification and eligibility determination); (3) planning for
instruction or intervention; (4) monitoring progress; (5) informing the development and refinement of educational approaches, and (6) providing accountability
of learning and instruction to school districts, states, and even the U.S. Department
of Education (e.g., Adequate Yearly Progress [AYP]). The tools and methods we
use to gather information, or “assess” a child, must be designed for and aligned
with the intended assessment purpose (American Educational Research
Association [AERA], American Psychological Association [APA], and National
Council on Measurement in Education [NCME] 2014). These conceptually distinct, yet practically connected, functions of assessment support educators and
related specialists in identifying children who need and qualify for additional
educational supports and designing supportive learning environments for all
students.
Children are identified for special education services through a “comprehensive and individual evaluation” (IDEA 2004) process, and eligibility determination is based on state-level eligibility criteria and documentation of educational
need. That is, federal legislation (i.e., IDEA 2004) offers opportunities for
children to receive special education services when a disability within one of
the following thirteen categories results in a need for educational supports and
services: autism, deafness, deaf-blindness, developmental delay, emotional disturbance, hearing impairment, intellectual disability, multiple disabilities,
orthopedic impairment, other health impairment, specific learning disability,
speech or language impairment, traumatic brain injury, or visual impairment,
including blindness. Figure 1 illustrates the total percentage of students in
public school receiving services under IDEA, at 13 percent, and, of those, the
distribution of students receiving services under IDEA within each of the disability categories.
While definitions of each disability category are provided within IDEA, there
are no federal eligibility criteria within each disability category or mandates about
which tests or what practices to use to determine eligibility; these decisions are
made at the state and district levels, leading to great variability in what constitutes a “comprehensive and individual evaluation process.” The general referral
and evaluation process, however, is similar across states. To be eligible for special
education services, a child must be classified within one of the thirteen disability
categories delineated in IDEA (2004). First, children can be referred for further
evaluation. Next, a more comprehensive assessment process, gathering information about a child to inform decision-making, is completed to classify children
and determine eligibility to receive special education services. Once eligible for
special education services, it is imperative that the assessment process continues
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and that data are collected to inform and evaluate instructional programming and
to monitor students’ progress toward their educational goals.
Referrals
A parent, teacher, or other professional can refer a child for special education.
However, “the current teacher referral process that initiates special education
classification and placement is idiosyncratic and fraught with inaccuracy” (Raines
et al. 2012, 285). Teacher training in behavior management and disability studies,
access to appropriate resources, use of evidence-based instructional and behavioral strategies, and school climate influence teacher referral practices (Skiba
et al. 1993). In addition, often there are fewer and more delayed teacher referrals
for emotional and behavioral challenges than what are identified using standardized screening procedures (Eklund et al. 2009), suggesting a level of subjectivity
in teacher referral practices and a need for methods beyond teacher referral to
accurately and efficiently identify students with disabilities, especially those with
emotional and behavioral challenges (Eklund et al. 2009; Raines et al. 2012).
In the reauthorization of the IDEA (2004), Congress noted that educational
outcomes for children with disabilities could be improved through prereferral
interventions, or early intervening services, to reduce the need to identify and
categorize students as having a disability before providing necessary educational
supports. Following the reauthorization of the IDEA (2004), schools began to
more systematically adopt evidence-based instructional strategies for all students
(high-quality universal instructional practices designed to prevent academic failure and behavioral challenges for the majority of students and thus reduce the
number of special education referrals), identify children who truly are at risk for
learning and/or social behavioral difficulties, and provide more targeted support
for these students at risk. This model is the Response to Intervention (RtI)
framework, which now often is referred to as a multitiered system of support
(MTSS). According to the Council for Exceptional Children (CEC), “The RtI
process is designed to identify struggling learners early, to provide access to
needed interventions, and to help identify children with disabilities” (CEC 2008,
74). In schools that have adopted an RtI or MTSS framework, implementation of
evidence-based instructional practices, universal screening, and data-based
decision-making have reduced the rate of special education referrals (Marston
2005), reduced special education placements in kindergarten through third grade
(Bender and Shores 2007), potentially addressed inconsistent and biased referrals, and theoretically provided a system for determining which students may
require special education services (Barnett et al. 2004). Thus, “when properly
implemented, response to intervention is integral to making effective special
education referral and eligibility decisions” (Hoover 2010, 290), and the emphasis on implementation of evidence-based practices, frequent data collection, and
data-based decision-making can move us beyond thinking about diagnosis and
identification in special education to thinking about how to support all learners
so that they can fully access their educational environments and opportunities.
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Comprehensive evaluation for eligibility determination
Once an official referral for special education services is made, the school
must follow up. Every student identified as possibly needing special education
services is entitled to a timely (within 60 days from the date the parent or legal
guardian signs the consent form) and appropriate evaluation (IDEA 2004), and
comprehensive evaluations have been the traditional method for determining
special education eligibility since the passage of PL 94-142 in 1975.
Based on the referral information, school personnel will determine the types
of assessment data that need to be collected and who will be responsible for collecting these data (Lerner and Johns 2012). Evaluations may include direct
observations of the student; administration of standardized norm-referenced
tests; completion of criterion-referenced tests; parent- and/or teacher-completed
rating scales and checklists; parent, teacher, and/or student interviews; and educationally relevant medical information.
While federal legislation does not dictate the methods or specific tests to use
in an evaluation, the IDEA (2004) does provide guidelines for how to collect
evaluation data. More specifically, the evaluation team must represent multiple
disciplines (e.g., psychology, speech-language pathology, health, education) and
include at least one teacher or specialist in the area of the potential disability. In
addition, the tests used must be designed to assess the area(s) of concern, administered in the student’s native language, validated for the purpose in which they
will be used, and free from cultural or racial bias, and eligibility for services must
be determined using multiple measures (IDEA 2004; Lerner and Johns 2012;
Overton 2016). The Standards for Educational and Psychological Testing also
state: “Test scores alone should never be used as the sole basis for including any
student in special education programming, or excluding any student from such
programming. … Test results may provide an important basis for determining
whether a student has a disability and what the student’s educational needs are”
(AERA, APA, and NCME 2014, 187).
Federal legislation also provides guidelines and regulations designed to promote equitable assessment practices during the comprehensive evaluation and
eligibility determination process (see IDEA 2004). However, despite these
efforts, children from culturally, linguistically, ethnically, and economically
diverse backgrounds continue to be disproportionately (both under- and over-)
represented in several of the disability categories (e.g., Ferri and Connor 2005;
Raines et al. 2012; Samuels 2005), and disproportionality has been linked to categories that rely more on clinical judgment for making a classification decision
(Harry and Anderson 1995; Overton 2016).
Implementation of RtI or MTSS frameworks has not reduced disproportionality within special education categories (Raines et al. 2012). For example, specific
learning disability continues to be the category under which the most children
with disabilities were served (34 percent of all students with disabilities were
classified as having a specific learning disability; NCES 2018; see Figure 1).
However, students with disabilities who were Pacific Islander, Hispanic,
American Indian/Alaska Native, or black were classified with specific learning
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disability at higher rates (ranging from 38–42 percent) than students with disabilities who were white, Asian, or two or more races (which ranged from 22–31
percent within this category; NCES 2017). Only 9 percent of all students with
disabilities received services under the category of autism; however, the percentage of students receiving services for autism was more than double that for Asian
students with disabilities (19 percent of Asian students with disabilities were classified as having autism). In addition, the overall percentage of students with disabilities who received services for an intellectual disability was 6 percent;
however, 10 percent of black students with disabilities received services for intellectual disability (a higher rate than for students of other races/ethnicities).
Across all disability categories, the percentage of students receiving special education services under the IDEA was highest for American Indian/Alaska Native
(17 percent) and black (15 percent) students (NCES 2017).
The concerns related to test bias, fairness in testing, bias in the referral process, and overreliance on traditional standardized norm-referenced tests are not
new struggles for our field. In the 2004 reauthorization of the IDEA, additional
emphasis was placed on racial, ethnic, and linguistic diversity and the need to
prevent inaccurate identification of students (Lerner and Johns 2012) and cease
practices that resulted in identifying students for special education due to cultural factors or denying special education services to students because of cultural
or linguistic differences (Overton 2016). While we have explored psychometric
test bias and revised measures to reduce risk of cultural and racial bias, other
factors (e.g., poverty, lack of opportunity, adverse childhood experiences) influence a child’s development and learning and thereby her or his performance on
the measures used for selection and placement. The environmental factors that
often disproportionately affect minority students in the United States have been
found to contribute to poor cognitive and behavioral outcomes and possible
increased risk for disabilities and school failure (Skiba et al. 2008). These factors
are not always systematically considered or assessed. Furthermore, students with
disabilities rarely are evaluated within the context of their previous experiences,
interactions with others, what they have learned, how they learn, or how they
communicate what they have learned (see Mislevy, this volume, for a sociocognitive perspective on assessment), which leads to less useable inferences, interpretations, and applications of assessment data.
Determining eligibility
The multidisciplinary team of professionals completing the evaluation compares the assessment data to the state and federal standards for the suspected
disability (e.g., autism or specific learning disability) to make an eligibility
determination. First, the team decides if the assessment data provide evidence
that the child meets the definition of one of the thirteen disability categories.
While there are federal guidance and state-level definitions for each of the
disability categories, some disability standards and definitions are vague. “The
imprecision of federal regulations creates variability in standards among
states, and the imprecision of state regulations creates variability in standards
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among districts within states” (Salvia, Ysseldyke, and Bolt 2007, 626). One
example is in the evaluation of specific learning disability, which is defined by
the IDEA 2004 as
a disorder in one or more of the basic psychological processes involved in understanding
or in using language, spoken or written, that may manifest itself in the imperfect ability
to listen, think, speak, read, write, spell, or to do mathematical calculations, including
conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. … Specific learning disability does not include learning problems that are primarily the result of visual, hearing, or motor disabilities, of
intellectual disability, of emotional disturbance, or of environmental, cultural, or economic disadvantage. (IDEA 2004, Sec. 300.8 (c)(10))
Differences in state-level eligibility standards and methods to meet the federal
definition of a specific learning disability exist. For example, one state may use
an aptitude achievement gap to classify a specific learning disability, but the
calculation of such a discrepancy and the tests used to evaluate a discrepancy
between intellectual ability and academic achievement may vary. Thus, in states
and districts using a discrepancy measure as an indicator of specific learning
disability, some students may be identified in some states and not in others
based on how the discrepancy is calculated and the tests that are used (Salvia,
Ysseldyke, and Bolt 2007). For states that classify a child as having a specific
learning disability based on failure to respond to instruction or targeted intervention, the definitions and conditions for a “lack of response” to intervention
are rarely operationally defined (Salvia, Ysseldyke, and Bolt 2007). While it has
been posited that the traditional methods for classifying specific learning disability (e.g., aptitude-achievement discrepancy) have insufficient theoretical and
psychometric evidence supporting their use, progress-monitoring data within
RtI frameworks have not been a reliable indicator of response to intervention
either (Ball and Christ 2012), and RtI data do not “provide sufficient data to
rule out or identify a disability” (CEC 2008, 74). Therefore, not only are there
differences across states in the methods and definitions used for eligibility
determination, there is questionable evidence supporting existing practices.
Similar to the patterns seen in referral data, Ysseldyke (1982) also found that
special education placement decisions were based more on social characterizations than student performance, and these findings have been replicated by
others (e.g., Gottlieb and Alter 1994; Klinger and Harry 2006) and are supported by the data revealing disproportionality within special education disability categories.
Adding to the subjectivity of the decision-making process, the student
must demonstrate an “educational need” for special education services (above
and beyond the disability diagnosis; IDEA 2004). For example, it is insufficient for a student to have a diagnosis of emotional disturbance. The student
must meet the criteria for the IDEA category of “emotional disturbance” and
have demonstrated a need for educational services. The assessment process
for documenting educational need is not standardized; this decision is made
by a team.
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Moving to More Useful Assessment Practices
in Special Education
In practice, then, there are several challenges and limitations to the special education eligibility determination and educational programming process. These challenges include subjectivity in the referral process, vague and inconsistent eligibility
criteria, and heterogeneity of cognitive and behavioral phenotypes within disability
categories. Also, disproportionate representation of racial and ethnic groups within
disability categories persists. In addition, there is a discrepancy between the intention of IDEA and the application of the regulations: Eligibility evaluation data
often are used for IEP goal development and educational planning when the
assessments were not designed for and are not necessarily useable for those purposes. Thus, our process for identifying and selecting students for special education
and related services arguably is insensitive to factors affecting opportunities to
learn and is too broad to account for the phenotypic, neurobiological, and environmental factors that also contribute to immediate and long-term outcomes.
Testing for selection and placement in special education, to date, could be
described as useful, for some students, if our purpose of that testing is to categorize learners. The initial evaluation data, arguably, are not useful, however, for
educators, specialists, parents, and students to identify the supports and strategies that will allow children to reach their potential; nor were the eligibility evaluation assessments designed to be used in that way, as they often yield summary
scores that are too broad and general for instructional planning but are efficient
for diagnostic purposes. We have a history of sorting or categorizing students, but
with the inclusion movement and the implementation of MTSS, how useful are
special education eligibility evaluations, as implemented under IDEA (2004)
regulations, today? Recent research findings in cognitive and developmental
neuroscience can help us to develop updated assessment practices that will more
accurately allow us to identify what services or instructional approaches will be
effective for whom under what circumstances.
For educational assessments in special education to be more useful, the data
arguably need to lead to better decisions and better outcomes for students. We
have overlap of skills and needs across disability categories (e.g., a child with autism
and a child with speech language impairment might need similar supports) and
heterogeneity within disability categories (e.g., two children with autism may have
very different language and social behavioral skills). We have relied on broad-based
categorizations and assessment practices for efficiency and accountability, but if we
reframe our thinking, potentially reallocate some of our initial evaluation resources,
and ask to what instructional approach is this student most likely to respond or how
can we support this student’s access to the curriculum, we will have more useful
educational assessment data for students with learning differences and disabilities.
“The greatest gains will not come from improved tasks that are still the same for all
students in all contexts and occasions, but improved tasks that are adapted to the
student, the context, the time, and the purpose” (Mislevy, this volume). More useful approaches can pave the path forward for individual children, allowing each
student to reach and continuously redefine the top of his or her potential.
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To achieve this end, we may need to adapt our comprehensive evaluation process and introduce a cascading system of testing, teaching, and evaluating (much
like dynamic assessment) to prioritize our use of testing to inform our practices
rather than to focus on classification or eligibility determination. This approach
moves away from a dichotomy between special education and general education
and instead views all academic and social learning, and associated supports, along
a continuum with educational assessment as useful evidence for decision-making.
We can use a system of methods and an approach that assumes important individual differences across the entire spectrum of learners. Learning differences are
inherent to the developing human brain, and all education should be special. To
make this shift, we can learn from other disciplines and think about assessment for
“precision education” (Brookman-Byrne 2018; Hart 2016; Williamson 2018).
Precision education
A tailored system of teaching and learning grounded in brain-based, psychological, and environmental components of learning and development is referred
to as precision education (Brookman-Byrne 2018). In 2015, President Obama
announced the Precision Medicine Initiative. In precision medicine, knowledge
about an individual’s genetic make-up, lifestyle, and environment is used to guide
treatment selection, medications, and dosages for each individual patient (rather
than to make treatment decisions based on diagnosis alone). In this model, each
patient gets “the right drug at the right dose at the right time” (Wei, Lee, and
Chen 2012). Hart (2016) argued that this initiative could be extended to education and to classifying disabilities; “precision education would provide educational researchers and practitioners the tools to better understand the complex
mechanisms underlying learning disabilities, allowing for a more effective
approach to education” (Hart 2016, 209). In this model, prevention and intervention methods would be based on a range of individual factors that are determined
through understanding not only the roles neurology, behavior, and psychology
play in the learning process but also which instructional materials and strategies
will best fit different profiles of learning (Williamson 2018).
In medicine, brain imaging techniques (e.g., fMRI; EEG) have been used for
identification and diagnosis, but now this technology also is being applied to predicting treatment response and mechanisms of change so that we can understand, at the level of the brain, how treatments work and who is likely to respond
to which treatments. Ultimately, this information could be used to design new
sensitive and efficient observational and behavioral tools to measure identified
characteristics and factors that predict who will respond to which treatments so
that we can be more efficient and precise in instructional planning and delivery
from the outset. For example, Yang and colleagues (2016) studied the effects of
pivotal response treatment on improving the social, communication, and play
skills of children between four and six years old with autism. While, on average,
most children showed improvements in pre-post changes of social responsiveness, an examination of the individual-level test data showed variation within
responsiveness to intervention. The neuroimaging data collected in this study
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revealed that they could predict, based on specific pretreatment brain activation
patterns, which children would respond more positively to treatment. It is important to note that the only source of the data that significantly predicted treatment
response was the pretreatment neuroimaging data. The behavioral and assessment data were not significant predicators, and the autism severity scores, as
measured by the Autism Diagnostic Observation Scale, were not significantly
correlated with brain activation patterns.
These kinds of imaging data provide a brain-based target for intervention
design and implementation, but they also suggest that some of our assessment
measures may not be capturing the behaviors and skills most predictive of positive responses to different instructional approaches. If we could design tests and
tools that measure the constructs identified through research in cognitive and
developmental neuroscience that are predictive of treatment response, we could
more efficiently select and adapt our instructional strategies. Through this
approach, we mostly likely will again identify subgroups of children (with common neural patterns and behaviors), but rather than classifying children based on
a disability diagnosis, children will be identified based on a combination of indicators that have been linked to success with specific intervention approaches.
Rather than to diagnose or determine special education eligibility, “the goal will
be to classify … early using combinations of the indicators, and provide a personalized, or differentiated, intervention” (Hart 2016, 210).
The concept of precision education is ambitious, and controversial, but potential benefits of precision education also include more sensitive and reliable
assessment measures that will capture differences both within and across disability categories (e.g., autism), adapted interventions for those at risk for a disability,
and learning materials and instructional strategies more precisely tailored to
students (Brookman-Byrne 2018).
Conclusion
The current educational system—uniform instruction, broad assessment, inconsistent disability classifications—is not meeting the needs of all students (Hart
2016), or perhaps the real needs of most students. Furthermore, in some ways, the
current federal legislation for students with disabilities (IDEA 2004) does not
provide the context for us to efficiently use assessment to inform the implementation of tailored, high quality, educational programming because the initial emphasis of this legislation was to ensure equitable access to education at a time when
students were being denied access to public schools because of their complex
medical or learning needs or were being segregated to different schools because
of their race. Thus, resources were spent on identification, classification, and
­eligibility determination. Now that all children have access to public education,
perhaps we are ready to push forward to ensure all children have access to appropriate and meaningful educational opportunities that take into account the brainbased, psychological, and environmental influences on their learning and
development. “Whereas integration was the prominent theme in decades past,
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today we are accountable for education that is meaningful, formative, results-­
oriented, and individualized for all students, not just those with diagnosed
­disabilities” (Esteves and Rao 2008, 2, emphasis in original). Such meaningful,
formative, and individualized education for all students requires a different
approach to assessing what students have learned and how students learn.
How might we move away from assessment for classification? We could use
the framework within the IDEA (2004) that emphasizes individualized educational programming and “appropriate education” and begin to use a precision
education approach, but future research is needed to inform changes to our
educational assessment procedures. This research includes (1) integrating and
translating findings from cognitive and developmental neuroscience to better
understand individual differences in neural connectivity patterns and biomarkers
that may predict learning; (2) creating measures with developmental sensitivity
that consider and predict development and learning in context; and (3) implementing effective methods for training future education researchers and practitioners in multidisciplinary approaches to measurement and assessment. This
new approach could provide the critical information educators need to deliver
the tailored educational programs that all students deserve.
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Beddow, and Alexander Kurz, 93–105. New York, NY: Springer.
Gottlieb, Jay, and Mark Alter. 1994. Special education in urban America: It’s not justifiable for many.
Journal of Special Education 27:453–65.
Harry, Beth, and Mary G. Anderson. 1995. The disproportionate placement of African American males in
special education programs: A critique of the process. Journal of Negro Education 63:602–19.
Hart, S. A. 2016. Precision education initiative: Moving towards personalized education. Mind, Brain,
Education 10:209–11.
Hoover, John J. 2010. Special education eligibility decision making in response to intervention models.
Theory into Practice 49:289–96.
Individuals with Disabilities Education Improvement Act, 20 U.S.C. § 1400 (2004).
Klinger, Janette K., and Beth Harry. 2006. The special education referral and decision-making process for
English language learners: Child study team meetings and placement conferences. Teachers College
Record 108:2247–81.
Lerner, Janet W., and Beverly H. Johns. 2012. Learning disabilities and related mild disabilities: Teaching
strategies and new directions. 12th ed. Belmont, CA: Wadsworth Cengage Learning.
Marston, Douglas. 2005. Tiers of intervention in responsiveness to intervention: Prevention outcomes and
learning disabilities identification patterns. Journal of Learning Disabilities 38:539–44.
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groups. July. Available from https://nces.ed.gov/programs/raceindicators/indicator_rbd.asp.
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SPED 450
Emotional and Behavioral Disorders
Attention Deficit Hyperactive Disorder
What is Emotional Disturbance?
Individuals with Disabilities Education Act (2004):
“(4)(i) Emotional disturbance means a condition exhibiting one or more of the following characteristics over a
long period of time and to a marked degree that adversely affects a child’s educational performance:
(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.
(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
(C) Inappropriate types of behavior or feelings under normal circumstances.
(D) A general pervasive mood of unhappiness or depression.
(E) A tendency to develop physical symptoms or fears associated with personal or school problems.
(ii) Emotional disturbance includes schizophrenia. The term does not apply to children who are socially
maladjusted, unless it is determined that they have an emotional disturbance under paragraph (c)(4)(i) of this
section.”
300.8 (c)(4)
How Common it is? (Prevalence)
• Approximately 7.1 percent of all student ages 6 – 21 in special
education
• Debate over accuracy of amount
• Gender, ethnic, and socioeconomic factors influence prevalence
■
White males more than white females
■
Black females more than white females
■
Black males overrepresented
Brum, C. (2018)
Emotional
Characteristics
■
Anxiety disorder
–
Separation anxiety disorder
–
Generalized anxiety disorder
–
Phobia
–
Panic disorder
–
Obsessive-compulsive disorder
–
Post-traumatic stress disorder
Brum, C. (2018)
Emotional Characteristics
■ Mood disorder
– Depression
– Suicide
– Bipolar disorder
■ Oppositional defiant disorder
■ Conduct disorder
■ Schizophrenia
Brum, C. (2018)
Behavioral Characteristics
Externalizing behaviors
Internalizing Behaviors
■ Aggression
■ Withdrawal
■ Acting out
■ Depression
■ Noncompliant behaviors
■ Anxiety
■ bullying
■ Obsessions
■ Compulsions
Brum, C. (2018)
Below grade level in reading, math,
and writing
Rated low on self-control social skills
measures
Cognitive &
Academic
Characteristics
Higher rates of being held back in a
grade
Many have expressive and/or
receptive language disorders
Dropout rate is 52% compared to 31%
for students without disabilities
Brum, C. (2018)
Biological Causes
• Temperament
Causes
Environmental
Considerations
• School factors
• Behavior Intervention Plans
• Family factors
• Poverty
• Unemployment
• Single parent household
Brum, C. (2018)
Evaluation
Rating scales, personality inventories, and observations.
• They did not always follow the IDEA definition
Scale for Assessing Emotional Disturbance
– Follows 5 elements from IDEA
■
Inability to learn
■
Inability to build or maintain satisfactory relationships
■
Inappropriate behavior
■
Unhappiness or depression
■
Physical symptoms or fears
Brum, C. (2018)
ADHD
Individuals with Disabilities Education Act (2004):
“(9) 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–
(i) 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, sickle cell anemia, and Tourette syndrome; and
(ii) Adversely affects a child’s educational performance.”
300.8 (c)(4)
ADHD
American Psychological Association (2000):
■ Persistent pattern of inattention and/or hyperactivityimpulsivity more frequent and severe than typical
■ Manifest before age 7, duration at least 6 months, present in 2
or more settings, not attributed to other disability
Brum, C. (2018)
Approximately 69% of school-age
children have
AD/HD
Prevalence of
ADHD
More boys than
girls
Latinos less likely
to receive AD/HD
diagnosis
Approximately 35% adults have
AD/HD
Brum, C. (2018)
Characteristics of ADHD
Intellectual Functioning
and Academic
Achievement:
Approximately 20% of
students with ADHD are
also identified as having a
intellectual disability
IQ ranges of students with
ADHD tend to be 7 – 10
points below the norm (IQ
100)
Approximately 21% of
elementary students with
ADHD have also been
identified as having
intellectual disabilities (IQ
score 70 and below)
Five percent also have a
speech/language disorder
Students with ADHD often
have impairments
associated with
motivation, memory, and
goal-directed behavior
Brum, C. (2018)
Characteristics of ADHD
Behavioral, Social and Emotional:
■ Potential co-existing conditions include: Anxiety disorder,
conduct disorder or obsessive-compulsive disorder
• Specific challenges may include:
■
Conflicts with parents, teachers, and peers
■
Difficulty with social cues
■
Increased risk-taking behavior
■
Higher rates of tobacco dependence
■
Significantly higher likelihood of receiving behavior management
programs, mental health services, social work services, and family
counseling
Brum, C. (2018)
Causes of ADHD
Does NOT cause ADHD:
■ Lack of self control
■ Poor parenting
■ Too much television or video
games
■ Too much sugar
■ Living in a fast-paced
culture
Potential Causes of ADHD:
■ Heredity
•
Twin studies
• Brain differences
• Environmental Causes
•
Prenatal factors
Brum, C. (2018)
Evaluation of ADHD
AD/HD determined by a
pediatrician and a
psychiatrist or psychologist
Teachers may be asked to
complete a behavior rating
checklist as part of the
evaluation
• Conner’s Rating Scale – R
Once presence is
determined, there are
assessments to help to
determine the nature and
extent of services.
• ADDES-3
Brum, C. (2018)
Video
Sir Ken Robinson: Do Schools Kill Creativity?

Brum, C. (2018)
END.
SPED 450
Emotional and Behavioral Disorders
Attention Deficit Hyperactive Disorder
What is Emotional Disturbance?
Individuals with Disabilities Education Act (2004):
“(4)(i) Emotional disturbance means a condition exhibiting one or more of the following characteristics over a
long period of time and to a marked degree that adversely affects a child’s educational performance:
(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.
(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
(C) Inappropriate types of behavior or feelings under normal circumstances.
(D) A general pervasive mood of unhappiness or depression.
(E) A tendency to develop physical symptoms or fears associated with personal or school problems.
(ii) Emotional disturbance includes schizophrenia. The term does not apply to children who are socially
maladjusted, unless it is determined that they have an emotional disturbance under paragraph (c)(4)(i) of this
section.”
300.8 (c)(4)
How Common it is? (Prevalence)
• Approximately 7.1 percent of all student ages 6 – 21 in special
education
• Debate over accuracy of amount
• Gender, ethnic, and socioeconomic factors influence prevalence
■
White males more than white females
■
Black females more than white females
■
Black males overrepresented
Brum, C. (2018)
Emotional
Characteristics
■
Anxiety disorder
–
Separation anxiety disorder
–
Generalized anxiety disorder
–
Phobia
–
Panic disorder
–
Obsessive-compulsive disorder
–
Post-traumatic stress disorder
Brum, C. (2018)
Emotional Characteristics
■ Mood disorder
– Depression
– Suicide
– Bipolar disorder
■ Oppositional defiant disorder
■ Conduct disorder
■ Schizophrenia
Brum, C. (2018)
Behavioral Characteristics
Externalizing behaviors
Internalizing Behaviors
■ Aggression
■ Withdrawal
■ Acting out
■ Depression
■ Noncompliant behaviors
■ Anxiety
■ bullying
■ Obsessions
■ Compulsions
Brum, C. (2018)
Below grade level in reading, math,
and writing
Rated low on self-control social skills
measures
Cognitive &
Academic
Characteristics
Higher rates of being held back in a
grade
Many have expressive and/or
receptive language disorders
Dropout rate is 52% compared to 31%
for students without disabilities
Brum, C. (2018)
Biological Causes
• Temperament
Causes
Environmental
Considerations
• School factors
• Behavior Intervention Plans
• Family factors
• Poverty
• Unemployment
• Single parent household
Brum, C. (2018)
Evaluation
Rating scales, personality inventories, and observations.
• They did not always follow the IDEA definition
Scale for Assessing Emotional Disturbance
– Follows 5 elements from IDEA
■
Inability to learn
■
Inability to build or maintain satisfactory relationships
■
Inappropriate behavior
■
Unhappiness or depression
■
Physical symptoms or fears
Brum, C. (2018)
ADHD
Individuals with Disabilities Education Act (2004):
“(9) 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–
(i) 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, sickle cell anemia, and Tourette syndrome; and
(ii) Adversely affects a child’s educational performance.”
300.8 (c)(4)
ADHD
American Psychological Association (2000):
■ Persistent pattern of inattention and/or hyperactivityimpulsivity more frequent and severe than typical
■ Manifest before age 7, duration at least 6 months, present in 2
or more settings, not attributed to other disability
Brum, C. (2018)
Approximately 69% of school-age
children have
AD/HD
Prevalence of
ADHD
More boys than
girls
Latinos less likely
to receive AD/HD
diagnosis
Approximately 35% adults have
AD/HD
Brum, C. (2018)
Characteristics of ADHD
Intellectual Functioning
and Academic
Achievement:
Approximately 20% of
students with ADHD are
also identified as having a
intellectual disability
IQ ranges of students with
ADHD tend to be 7 – 10
points below the norm (IQ
100)
Approximately 21% of
elementary students with
ADHD have also been
identified as having
intellectual disabilities (IQ
score 70 and below)
Five percent also have a
speech/language disorder
Students with ADHD often
have impairments
associated with
motivation, memory, and
goal-directed behavior
Brum, C. (2018)
Characteristics of ADHD
Behavioral, Social and Emotional:
■ Potential co-existing conditions include: Anxiety disorder,
conduct disorder or obsessive-compulsive disorder
• Specific challenges may include:
■
Conflicts with parents, teachers, and peers
■
Difficulty with social cues
■
Increased risk-taking behavior
■
Higher rates of tobacco dependence
■
Significantly higher likelihood of receiving behavior management
programs, mental health services, social work services, and family
counseling
Brum, C. (2018)
Causes of ADHD
Does NOT cause ADHD:
■ Lack of self control
■ Poor parenting
■ Too much television or video
games
■ Too much sugar
■ Living in a fast-paced
culture
Potential Causes of ADHD:
■ Heredity
•
Twin studies
• Brain differences
• Environmental Causes
•
Prenatal factors
Brum, C. (2018)
Evaluation of ADHD
AD/HD determined by a
pediatrician and a
psychiatrist or psychologist
Teachers may be asked to
complete a behavior rating
checklist as part of the
evaluation
• Conner’s Rating Scale – R
Once presence is
determined, there are
assessments to help to
determine the nature and
extent of services.
• ADDES-3
Brum, C. (2018)
Video
Sir Ken Robinson: Do Schools Kill Creativity?

Brum, C. (2018)
END.
Determining Specific Learning Disability
Eligibility: An Overview
Audience: Educators, Other District/School Staff | Topic: English Learners, Special Education | Hosted by: Office of Special
Education
On-Demand format
Presented by Veronica Fiedler
Watch
39:07
Learning Outcomes
Participants will…
be able to distinguish between MTSS and RtI and understand how they are interrelated.
develop an understanding of how to build a body of evidence through an RtI process in order to determine eligibility
for Specific Learning Disability.
review considerations for ELs during the eligibility process for special education services.
Study Guide
The topics below are topics main points that will be reiterated on the quiz should you choose to take it for a certificate.
Components of MTSS Process
What is RtI?
4 Steps of problem solving process
What is a normed assessment?
Progress Monitoring
English Learners in regards to oral language and literacy skills.
Quiz & Certificate
To receive a certificate for watching this video please complete a short quiz on CDE’s Moodle Site. Click here to access the
Quiz for Determining SLD Eligibility Video.
Contact Information
Veronica Fiedler
[email protected]
Certificate
1 CDE contact hour will be awarded after the completion of a 10 question quiz with a score of 80% or higher.
< Return to On-Demand Resources
< Return to Professional Development Home Page
Edit this PD item
This tool features professional development opportunities offered by CDE. Please contact us with any questions.
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School supports
The 13 disability categories
under IDEA
By Andrew M.I. Lee, JD
At a Glance
The Individuals with Disabilities Education Act (IDEA) requires public schools to provide
special education services to eligible students.
IDEA covers 13 disability categories.
Not every student who struggles in school qualifies.
The Individuals with Disabilities Education Act (IDEA)
requires public schools to provide special education and
related services to eligible students. But not every child
who struggles in school qualifies. To be covered, a child’s
school performance must be “adversely affected” by a
disability in one of the 13 categories below.
1. Specific learning disability (SLD)
The “specific learning disability” (SLD) category covers a
specific group of learning challenges. These conditions
affect a child’s ability to read, write, listen, speak, reason, or
do math. Here are some examples of what could fall into
this category:
Dyslexia
Dyscalculia
Written expression disorder (you may also hear this
referred to as dysgraphia)
SLD is the most common category under IDEA. In the 2018–
19 school year, around 33 percent of students who
qualified did so under this category.
2. Other health impairment
The “other health impairment” category covers conditions
that limit a child’s strength, energy, or alertness. One
example is ADHD , which impacts attention and
executive function.
Conversations with
expert Rayma Griffin
947 Members
Ask our expert your questions about getting the
most from IEPs and 504 plans.
Learn more
3. Autism spectrum disorder (ASD)
ASD is a developmental disability. It involves a wide range
of symptoms, but it mainly affects a child’s social and
communication skills. It can also impact behavior.
4. Emotional disturbance
Various mental health issues can fall under the “emotional
disturbance” category. They may include anxiety disorder,
schizophrenia, bipolar disorder, obsessive-compulsive
disorder, and depression . (Some of these may also be
covered under “other health impairment.”)
5. Speech or language impairment
This category covers difficulties with speech or language .
A common example is stuttering. Other examples are
trouble pronouncing words or making sounds with the
voice. It also covers language problems that make it hard
for kids to understand words or express themselves.
6. Visual impairment, including blindness
A child who has eyesight problems is considered to have a
visual impairment. This category includes both partial sight
and blindness. If eyewear can correct a vision problem,
then it doesn’t qualify.
7. Deafness
Kids with a diagnosis of deafness fall under this category.
These are kids who can’t hear most or all sounds, even with
a hearing aid.
8. Hearing impairment
The term “hearing impairment” refers to a hearing loss not
covered by the definition of deafness. This type of loss can
change over time. Being hard of hearing is not the same
thing as having trouble with auditory or language
processing.
9. Deaf-blindness
Kids with a diagnosis of deaf-blindness have both severe
hearing and vision loss. Their communication and other
needs are so unique that programs for just the deaf or
blind can’t meet them.
10. Orthopedic impairment
An orthopedic impairment is when kids lack function or
ability in their bodies. An example is cerebral palsy.
11. Intellectual disability
Kids with this type of disability have below-average
intellectual ability. They may also have poor
communication, self-care, and social skills. Down
syndrome is one example of a condition that involves an
intellectual disability.
12. Traumatic brain injury
This is a brain injury caused by an accident or some kind of
physical force.
13. Multiple disabilities
A child with multiple disabilities has more than one
condition covered by IDEA. Having multiple issues creates
educational needs that can’t be met in a program
designed for any one disability.
Learn how to find out if a child is eligible for special
education . When kids are found eligible, the next step will
be to create an Individualized Education Program (IEP). For
kids who are in preschool or younger, you may want to
learn about early intervention .
Key Takeaways
Each of the 13 disability categories in IDEA can cover a range of difficulties.
Dyslexia, dyscalculia, and written expression disorder fall under the “specific learning
disability” category.
“Other health impairment” can cover ADHD.
Related topics
School supports
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About the Author
Andrew M.I. Lee, JD is an editor and attorney who strives to help
people understand complex legal, education, and parenting
issues.
Reviewed by
Rayma Griffin, MA, MEd has spent 40 years working with children
with learning and thinking differences in the classroom and as an
administrator.
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Guest Editorial
Specific Learning Disabilities: Issues that Remain
Unanswered
INTRODUCTION
Specific learning disabilities (SLDs) are defined as
“heterogeneous group of conditions wherein there is a
deficit in processing language, spoken or written, that
may manifest itself as a difficulty to comprehend, speak,
read, write, spell, or to do mathematical calculations
and includes such conditions as perceptual disabilities,
dyslexia, dysgraphia, dyscalculia, dyspraxia and
developmental aphasia.”[1]
DISTINCTION BETWEEN
TERMINOLOGIES – DISORDER,
DISABILITY, DIFFICULTY, AND SLOW
LEARNER
The terms learning disorders, learning disability (LD),
and learning difficulty are often used interchangeably
but differ in many ways. Disorder refers to significant
problems faced by children in academic areas, but
this is not sufficient to warrant an official diagnosis.
The word “disorder” is a medical term as mentioned
in the Diagnostic and Statistical Manual of Mental
Disorders,[2] and International Statistical Classification
of Diseases and Related Health Problems,[3] both of
which are considered authoritative guides for mental
health professionals.
issues; English being their second language and not
their mother tongue; ineffective instruction; high
absenteeism; or inadequate curricula. These children
have the potential to achieve age-appropriate levels
once they are provided support and evidence-based
instruction.[7]
Students with below average cognitive abilities whom
we cannot term as disabled are called “slow learners.”
The slow learning child is not considered mentally
retarded because he is capable of achieving a moderate
degree of academic success even though at a slower rate
than the average child.[8]
TYPES OF LEARNING DISABILITIES
Reading disability (also known as dyslexia) is the
most common LD, accounting for at least 80% of all
LDs.[9] Reading should be taught; it is not an innate
entity. Reading requires the ability to understand
the relationship between letters and the associated
sound, which is known as phonetics. Dyslexia reflects
a specific problem in processing individual speech
sounds (e.g., the ssss sound, the mmm sound) in
words (phonemes). There can also be problems
with holding sounds in sequence in short-term
memory (e.g., holding the sequence of sounds in a new
word in mind long enough to recognize it). Children
with a reading disability may also have difficulties
with reading fluency, resulting in reading skills that
are accurate but effortful and slow.[9]
The word “disability” in SLDs is a legal term
that is mentioned in the Right of Persons with
Disabilities Act (RPWD Act, 2016),[4] notification
issued by the Ministr y of Social Justice and
Empowerment (Department of Empowerment of
Persons with Disabilities) and Individuals with
Disabilities Education Act (United States federal
law). [5] These federal laws protect the rights of
students with disabilities. To receive special disability
certificates and services under these acts, a student
must be a “child with a disability.”[6] SLD is an official
clinical diagnosis where the individual meets certain
criteria as assessed by a professional (psychologist,
pediatrician, etc.).
Dyscalculia is generally characterized by difficulty in
learning or understanding mathematical operations.
A student with arithmetic disorder might have difficulty
organizing problems on the page; following through
on multiple step calculations such as long division;
transposing numbers accurately on paper or on to a
calculator, such as turning 89 into 98; distinguishing
right from left; and using mathematical calculation
signs. They may also be confused about basic operations
and facts.[9]
Children with “learning difficulties” underachieve
academically for a wide range of reasons, including
factors such as behavioral, psychological, and emotional
Dysgraphia is generally characterized by distorted
writing despite thorough instruction. A student
with dysgraphia exhibits inconsistent and illegible
© 2018 Indian Psychiatric Society – South Zonal Branch | Published by Wolters Kluwer – Medknow
399
Kohli, et al.,VVXHVLQVSHFL¿FOHDUQLQJGLVDELOLWLHV
writing, mixing upper and lowercase letters, and
writing on a line and inside margins. He or she might
have fine motor difficulties such as trouble holding
the pencil correctly, inability to use scissors well, or
coloring inside the lines.[9] Overall writing does not
communicate at the same level as his or her other
language skills.[9]
[10,11]
LDs are associated with psychological comorbidities.
Approximately 30% of children have behavioral and
emotional problems. [12] Children with SLD are at
an increased risk of hyperactivity. There is a strong
relationship between inattentiveness and reading
disabilities. The comorbidity of attention deficit
hyperactivity disorder (ADHD) in children with LD
varies from about 10% to as high as 60% depending
on the sample taken.[13,14] Co-occurrence of major
depressive disorder (MDD) and LDs was studied in 100
children age 9–12 years. It was seen that 62% of children
with MDD had LD, whereas only 22% of children
without depression had LD.[15] The comorbidity of
LD with both internalizing and externalizing disorders
implicates the need for cognitive and behavioral
approaches in the remediation programs offered to
dyslexic children. Diagnosis at an early age results in
boosting self-confidence and social competency.[16]
LDs do not become evident till the child starts going
to school. Many children do not exhibit any signs
until they engage in tasks which require certain kind
of cognitive processing which becomes apparent then.
A lot of research and efforts are being done in the field
of LDs in the western world. However, in India, the
experience and research are limited. The government
and educational authorities are also progressing toward
the betterment of education system. There are many
gray areas in this field which need more efforts, clarity,
understanding, and discussion.
TEACHERS’ ATTITUDE, TEACHING
METHODS, AND PRACTICES
Despite the fact that millions of people around
the world suffer silently from SLD, there remains
widespread confusion and misinformation with regard
to identification of and interventions for SLDs. Due to
this, children do not enjoy their school life and resist
going to school. Some efforts have been made, like the
one by National Council of Educational Research and
Training in 2015, when a handbook on the inclusion
of children with special needs was prepared. It was a
very sincere effort in which a series of workshops were
held in different parts of the country, involving regular
school teachers, teacher educators, special educators,
400
and experts from universities and nongovernmental
and governmental organizations.[17] The handbook
emphasized access and participation of children in
the learning process, more than just placing them in
schools. The question arises how far these efforts are
being implemented successfully.
A study conducted in Haridwar, India (2015),[18] showed
that 67% of teachers had no knowledge of LDs. Overall,
teacher educators who participated in that study had
a low level of knowledge about SLDs, irrespective of
their gender or teaching experience. Another study
conducted in Chandigarh on the perception of teachers
about LDs showed some positive results. Approximately
67.5% teachers perceived that they do encounter
children with LD in the school, 43.8% supported
special schools for such children, and 36.3% were in
favor of integrated education. About one-fifth of the
teachers were ready to undergo special skill training
for teaching students with learning disorders.[19] The
level of awareness among teachers was explored in
Puducherry (UT).[20] The study found that the teachers
in the inclusive classroom require skill training to impart
education to students with SLD. The data showed
that in an inclusive education setup, the information
regarding SLD is average. The authors recommended
the Government of India to implement intensive and
methodical training to fulfill the educational needs.[20]
This is certainly important because when we talk about
inclusive education, we must have means to support
the idea to the fullest. Teachers should be sensitized
and trained to screen for this problem at the primary
school level itself so that remediation can be started at
an early stage.
There is a huge difference in private and government
school setups. In private schools, there is a counselor and
special educator with a specialization in intervention
for SLDs, but this facility is lacking in government
schools. The students of private schools usually belong
to middle and high socioeconomic status, paying hefty
fees for education. These schools are better equipped
to provide all the necessary services to the students.
On the contrary, in government schools, the majority
of the students are from lower socioeconomic status,
with parents who are completely unaware of the concept
of SLD. They are not able to avail these services and
remain underprivileged. This is very disheartening
because the teachers are also not keen to put in extra
efforts to help these students. Many policies and rules
are made only on paper, but implementation is missing.
In today’s society, there are schools which are
result-oriented and focus on producing “toppers.”
They are not interested in keeping the so-called “slow
child” in their classrooms. This attitude hinders the
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Kohli, et al.,VVXHVLQVSHFL¿FOHDUQLQJGLVDELOLWLHV
child’s learning progress and results in worsening of
prognosis of the problem. SLDs result in unexpected
academic underachievement. Teaching authorities are
demanding and lack patience for slow learners. The
teacher certification programs in India are short of
sufficient courses in special education to prepare general
teachers for inclusive classrooms. Owing to the lack of
proper training in the area and lack of familiarity with
reading process and areas of reading skills which require
assessment, creativity and “trial and error” are what
guide the course of remediation.[21]
Teaching methods and styles adopted by the teachers
differ from school to school and also have regional
differences. [15] Some schools focus on phonetics
and teach accordingly; some adopt the traditional
rote learning pattern in which the child crams the
alphabets without understanding their formation and
sound. Rote learning methods focus on grades and
good marks, ignoring the overall development of the
child. Multisensory teaching aids, visual and auditory
cues, computer software providing text-to-text and
speech-to-text capabilities, and so on are restricted
to only a few schools which can afford to provide
such quality teaching practices.[22] It is very difficult
to achieve this technological sophistication in all the
classrooms in a developing country like India which
suffers from wide economic disparity and fluctuating
literacy rate. Resultantly, again the question arises
whether the learning disorder is confounded by faulty
teaching practices or due to the natural course of the
problem. Sight word teaching, phonemic awareness
difficulties, or specialized vision problems can also
cause reading difficulty and are often mistaken for true
organic dyslexia. Teaching methods such as sight words
result in reading difficulty that mimic dyslexia. This
method inhibits the development of left–right reading
and eye jumps all around the word. According to the
American Child Development Institute, “Children who
have an average or above average IQ and are reading
one and a half grades or more below grade level may
be dyslexic.” “True dyslexia affects about 3%–6% of
the population. Yet in some parts of the country, up
to 50% of the students are not reading at grade level.
The reason for most children not being able to read at
grade level could be ineffective reading instruction. The
child with dyslexia is often a victim of having SLD and
is being exposed to ineffective instruction as well.”[23]
In France, it was proved that schools that taught with
whole word method produced more students with
dyslexia than schools teaching with phonics. The brains
of dyslexic students can be retrained with phonics.[24]
In India, teachers are not trained enough to understand
this and help the students in need. Traditional teaching
methods such as spelling games and cursive writing
exercises during vacations have almost disappeared.
The expectations of parents and early induction of
children into school have resulted in more damage
than gains.
SHORTAGE OF SPECIAL EDUCATORS
Central Board of Secondary Education (CBSE) had
made it mandatory for all the affiliated schools to
appoint a special educator so that children with
LDs could be assimilated with other students. It was
ultimately seen that it was a big challenge for the schools
to find qualified professionals in this area. According
to school authorities, special educators are experienced
in teaching physically challenged students; they lack
theoretical and practical skills required for teaching
learning disabled students. The teaching methods have
to be tailor-made for these students since they have
behavioral problems as well.[25]
In 2016, Special Educators’ Forum of India had
submitted a charter of demands to various education
departments of every state. This was done because the
government had not created a post of special educators
or made it mandatory for the schools to appoint them.[26]
In a recent report, it came to light that in Delhi, out
of 927 posts of special educators, 432 are still vacant.
This fault came into light when a mother of two sons
with disability studying in a government school filed
a complaint that her sons have not learned anything,
instead they have become a source of entertainment
for the students. Students and teachers bully them and
authorities turn a deaf ear to them.[27] Special educators
equipped with individualized educational program are
the need of the hour to tackle the situation.
PROBLEMS WITH LANGUAGES
In the Oriental world, the LDs were considered a
problem of English-speaking countries.[22] Due to lack
of awareness and reportedly lower incidence rates in
Asian countries like India and China, not many efforts
were made in this field. Researchers in the Western
world attributed this problem to the overcrowded
classrooms and backward teaching strategies.[28] On
the other hand, eastern researchers attribute it to the
phonetic complexity of English language which resulted
in problems in language adaptability.
Spelling–sound correspondence is direct in Hindi
language, which means that we write what we speak.
But in case of English, there are certain notorious traits
of the language which makes it complex and it becomes
necessary to remember the arbitrary spellings and
words. For example, there are a lot of words in English
language with silent letters which makes the language
much more difficult, because here the person needs
Indian Journal of Psychological Medicine | Volume 40 | Issue 5 | September-October 2018
401
Kohli, et al.,VVXHVLQVSHFL¿FOHDUQLQJGLVDELOLWLHV
to remember formations such as psychology, pseudo,
pneumonia, and walk. Those children having difficulty
in process of learning find it difficult to comprehend.
People reading and writing Hindi and other regional
languages also do suffer from learning difficulties. It
is seen equally in other languages as well. The child is
unable to learn orthography, syntax, and phonetics of
language because of which it becomes imperative for
the teachers to adopt such teaching practices and for
the school authorities to facilitate the learning process
of these children.
LACK OF STANDARDIZED ASSESSMENT
TOOLS
India is a multilingual country, so it is important to
assess the problem of SLD in a child’s mother tongue.
There are numerous batteries used for the assessment
of LDs, with their own merits and demerits. Some
of the batteries are widely used for assessment,
but there is a lack of well-established norms for
all subtests, and these norms are based on a very
small sample which makes generalization difficult
like the AIIMS SLD: Comprehensive Diagnostic
Battery and NIMHANS Index for Specific Learning
Disabilities. Many batteries are prepared in regional
languages (e.g., Marathi, Gujarati and Kannada) which
lack nationwide applicability. Some batteries can
only be administered on students of English medium
schools like NIMHANS Index for Specific Learning
Disabilities, whereas in India about 100.4 million
students study in Hindi medium schools.[29] The
content used in the batteries is not standardized.
Existing batteries have not included all the age groups
for assessment, which makes assessment difficult,
especially when the student is to be assessed in tenth
or twelfth board classes for the issuance of a certificate
for availing benefits.
COMPLEXITY OF GRADATION IN
LEARNING DIFFICULTY AND DISABILITY
According to standard assessment procedure for learning
disorders, one class is taken as one standard deviation.
So if a child is performing two classes below his actual
standard/class, then he or she is diagnosed as LD, and if
the performance is one class below, then it is diagnosed
as learning difficulty not amounting to disability. Now,
various education boards, including CBSE[30] The Indian
Certificate of Secondary Education ICSE, Kerala Board,
and Maharashtra Board, provide various concessions for
students with LD; but there are no facilities for students
with learning difficulty. The awareness among policy
makers regarding this point of differentiation is limited.
There is no provision for students with difficulties. Lack
402
of support from school authorities and parents worsen
the situation. Students are not able to avail relaxations
and suffer silently. Pediatricians and psychiatrists
rely on clinical psychologists to distinguish students
with learning difficulty and disability. This confusion
creates problems for the process of certification and
intervention. The problems of students with learning
difficulty not amounting to disability needs to be dealt
with specialized techniques of intervention at early
stages by a special educator and a parent together.
PROVISIONS FOR SPECIFIC
LEARNING-DISABLED STUDENTS
After a series of consultation meetings and drafting
process, the Rights of People with Disabilities Act,
2016 was passed by both the houses of the Parliament.
It was notified on December 28, 2016 after receiving
presidential assent. The list was expanded and it
included SLDs in it. A bill was introduced in Rajya
Sabha on March 24, 2017, entitled “The Children
with Specific Learning Disabilities (Identification and
Support in Education).” It highlighted the need for
special facilities in educational institutions, setting
up detection and remediation centers, guidelines for
certification of children with SLDs, and so on.[31]
On January 15, 2018, the Ministry of Social Justice
and Empowerment (Department of Empowerment
of Persons with Disabilities) issued a notification
regarding the procedure to be followed while certifying
people with disabilities. The Gazette laid emphasis on
screening, diagnosis, and certification of SLD. Figure 1
gives the summary of standard operating procedure of
certification for SLDs.[1]
This effort by the Government of India deserves
appreciation as it has highlighted the importance of
certification and has tried to standardize it. Despite
this step, there are certain issues which are a matter
of concern. Psychiatrists have been excluded from the
procedure of certification. Students with academic
difficulties or scholastic decline are usually referred
to Child and Adolescent Psychiatry clinics from the
school. A team of psychologists and psychiatrists
carry out the complete assessment of the students
referred from schools. It is highly recommended that
psychiatrists should also be included into the procedure
along with pediatricians and psychologists because
they have specialized training in mental health and
developmental disorders of children and adolescents.
Second, the Gazette mentions which tests shall be used
for the assessment of IQ for uniformity, but in case of
SLD assessment, it should be left to the discretion and
experience of the psychologists. Instruments that are to
be used should be latest and should have norms that can
Indian Journal of Psychological Medicine | Volume 40 | Issue 5 | September-October 2018
Kohli, et al.,VVXHVLQVSHFL¿FOHDUQLQJGLVDELOLWLHV
SCREENING- Teachers shall carry out the screening
and if anomaly is detected, child is referred to the school
committee/Principal .After this they refer the student to a
Pediatrician for SLD assessment
DIAGNOSIS- Team consisting of a Pediatrician and a
Clinical/Rehabilitation Psychologist
Detailed neurological assessment by a Pediatrician
(normal visual acuity and hearing)
IQ Assessment by Psychologist using specific tests
like MISIC/WISC-III
SLD Assessment if IQ>85 using specific tests and
giving the level of severity
MEDICAL AUTHORITY FOR CERTIFICATIONThe Medical Superintendent or Chief Medical Officer
or Civil Surgeon or any other equivalent authority
as notified by the State Government
Pediatrician or Pediatric Neurologist
Clinical or Rehabilitation Psychologist
Occupational therapist or Special Educator or
Teacher trained for assessment of SLD
VALIDITY OF CERTIFICATE – The certification
will be done for children aged eight years and
above only. The child will have to undergo
repeat certification at the age of 14 years
and at the age of 18 years. The certificate
issued at 18 years will be valid life-long
Figure 1: 6JG UETGGPKPI FKCIPQUKU CPF EGTVKſECVKQP RTQEGFWTG HQT
5RGEKſENGCTPKPIFKUCDKNKVKGU
misuse of these provisions and certification. This is a
sensitive issue which needs to be handled carefully.
There are others who are not aware of these concessions,
and the child keeps struggling with disability.
STIGMA AND LABELING
In India, acceptance of children suffering from LDs
in schools largely depends on the capability of the
schools to provide necessary services to the children
and the attitude of the teachers to put some sincere
efforts to help these children. Inclusion, therefore,
has rather become selective inclusion of children with
disabilities in the mainstream, especially in private
schools.[33] These children suffer from many behavioral
problems and certain comorbid conditions such as
ADHD which is again not known to many. They
are labeled as dull, lazy, mischievous, troublesome,
and so on without knowing the actual reason behind
this. Social attributes play a very important role in
the overall course of illness. Acceptance from society,
peers, teachers, and so on affect their successful
inclusion.[34] The label of LD carries its own burden,
baggage, and complications.
OVERLAP WITH SCHOOL DROPOUT
be generalized to the population concerned. The same
tests cannot be used in the entire country because of a
wide range of sociodemographic and regional differences
which can influence test results.
Initiative steps have been taken by CBSE to provide
a concession for LD students. These concessions are
in the form of a scribe and complementary time,
exemption from a third language, flexibility in choosing
subjects, permission to use calculators in mathematics,
and provision to read out question paper to a student
with dyslexia. These students are also exempted from
spelling errors and from writing answers in detail, and so
on. According to the recent circular issued by CBSE, no
school can deny admission to students with disabilities
in mainstream education. It has also recommended
regular in-service training of teachers in inclusive
education at elementary and secondary level, as per
CBSE guidelines.[30] Many other boards and state boards
are also offering concessions, but there is no uniformity
in rules for demanding certificates. Some boards
demand only a certificate of SLD and some require a
detailed report along with the certificate; some need
renewal while some accept one-time certification.[32]
There are pros and cons of these provisions. Some
parents have a mindset of demanding certificates
even when their children do not have a, LD. They
do not focus on remedial intervention. This leads to
It is difficult to treat various students who drop out
from the school as a homogeneous group. Dropping
out from the school can be attributed to factors such
as low socioeconomic status, behavioral issues, LDs,
or intellectual disability. There is a lot of overlap
between these categories. There are students who are
first-generation learners. According to the National
Policy on Education, 1986, these students should be
allowed to set their own pace of learning and should
be given remedial supplementary instructions.[35] Their
slow pace of acquiring information may be due to their
background which is not stimulating enough to induce
learning, but these children can often be diagnosed with
SLDs. This again creates confusion.
GOVERNMENT POLICIES AND
APPLICABILITY
Sarva Shiksha Abhiyaan aimed at universalization of
elementary education “in a time bound manner,” as
mandated by the 86th Amendment to the Constitution of
India, making free and compulsory education to children
between the ages of 6 and 14 years a fundamental right.
It was decided under this scheme that no student shall
be failed and will be promoted to the next class.[36] This
is very important and necessary initiative; but because
of this, LD remains undiagnosed and untreated for a
longer period of time. Child’s problems aggravate because
Indian Journal of Psychological Medicine | Volume 40 | Issue 5 | September-October 2018
403
Kohli, et al.,VVXHVLQVSHFL¿FOHDUQLQJGLVDELOLWLHV
parents do not bother until the child fails, and school
authorities do not bother till the school result is affected.
Since a child is promoted to next class without the need
of minimum passing marks, parents and teachers become
complacent and wake up only at secondary levels, and
the child’s problem remains unnoticed. Some parents
try to get away with their child’s problem by availing
certificates of disability without any extra efforts which
are actually required to be invested in.
Accommodations which are now being given to
students with LDs in the classrooms are sometimes
regarded as unfair by parents of students without SLD.
It is important to make the parents aware of the fact
that these concessions and accommodations are not
unfair advantages to students. In fact, if appropriate
and timely concessions are not used, students could
be branded as having LDs, creating serious negative
impact to their achievement and self-concept. The
parents can be sensitized on the above issues through
parent–teacher meetings and other awareness programs
conducted in the school.
4.
5.
6.
7.
8.
9.
10.
CONCLUSION
11.
To understand LDs fully, it is necessary to examine
the problem in black and white with all its shades of
gray. These gray areas are the practical and experiential
difficulties when dealing with these children in Child
and Adolescent clinics. Constructing a standardized
assessment battery, keeping in view of the diversity
of Indian culture, is a mammoth task. Having a
thorough insight into the overlapping areas can clear
misconceptions and guide assessment, intervention,
and welfare benefits to those children who genuinely
deserve them.
12.
13.
14.
Adarsh Kohli, Samita Sharma, Susanta K. Padhy
15.
Department of Psychiatry, PGIMER, Chandigarh, India
16.
Address for correspondence: Dr. Adarsh Kohli
Professor, Clinical Psychology, Department of Psychiatry,
PGIMER, Chandigarh – 160 012, India.
E-mail: [email protected]
17.
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