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Assessment and Identification | Early Identification and Intervention Programs | Evaluation and Assessment | Explosive Growth in the Other Health Impairment Category and Learning Disability Category | Disproportionate Representation of Minorities in Special Education | Universal Design Principles | Conclusion
The Commission finds that the IDEA establishes complex requirements that are difficult to effectively implement at the state and local level. Nowhere in IDEA is this more complex than in the eligibility determination process. Improving this process, coupled with research-based early intervention programs, may reduce the number of children who are identified as having a disability, particularly when early identification and intervention are in place and research-based interventions are provided before referral.
Recommendation—Identify and Intervene Early. Implement research-based, early identification and intervention programs to better serve children with learning and behavioral difficulties at an earlier age. Include early screening, prevention and intervention practices to identify academic and behavioral problems in young children.
Recommendation—Simplify the Identification Process. Simplify the IDEA identification and eligibility determination process, and clarify the criteria used to determine the existence of a disability, particularly high-incidence disabilities.
Recommendation—Incorporate Response to Intervention. Implement models during the identification and assessment process that are based on response to intervention and progress monitoring. Use data from these processes to assess progress in children who receive special education services.
Recommendation—Incorporate Universal Design in Accountability Tools. Ensure all tools used to assess students for accountability and the assessment of progress are designed to include any accommodations and modifications for students with disabilities.
Some of the complexity of IDEA reflects the proliferation of categories and assessment guidelines that vary in their implementation, often with little relation to intervention. There are 13 separate disability categories in IDEA. Many categories emerged as a result of advocacy group efforts to promote recognition for their specific constituency. The necessity of all 13 categories and their relation to instruction is not firmly established. To illustrate, consider that children with traumatic brain injuries could easily be classified under the “other health impairment” category. From the viewpoint of the assessment and identification process, there are three major types of disorders:
1) Sensory disabilities such as visual impairments, hearing impairments, deaf-blindness;
2) Physical and neurological disabilities such as orthopedic impairments, other health impairments, traumatic brain injury, multiple disabilities, autism; and,
3) Developmental disabilities such as specific learning disabilities (SLD), speech and language impairments, emotional disturbance, mild mental retardation and developmental delay.
This subdivision is not perfect. There are students with rare disorders in the “high-incidence” group, such as those with language disorders who do not speak, or who have a severe psychosis. But, the three-group subdivision facilitates understanding of identification practices under IDEA. Children with sensory disorders are identified on the basis of vision and hearing tests. Children with physical and neurological disorders are identified by parents and physicians through medical history and physical examinations. These two types of disorders are commonly referred to as “low-incidence“ disabilities and represent about 10 percent of all children served in IDEA.
In contrast, children with developmental disorders cannot be identified on the basis of acuity, physical or neurological findings. These disabilities are widely regarded as variations on normal development that are disabling when they interfere significantly with school performance and adaptive functions. Accounting for 90 percent of all students served under IDEA, these “high-incidence” disabilities are closely linked with teacher referral, but make heavy use of psychometric tests for identification, often in ways that are not linked with instruction. The Commission found compelling evidence supporting the existence of all four high-incidence disabilities and for attention deficit hyperactivity disorder (ADHD). There was compelling evidence that children with these disorders often develop disabilities and require special education services. There are objective criteria for identifying students with these disorders. However, the model for identification is like that used for obesity or hypertension, not measles or meningitis. The disorder is always a matter of degree on a dimension, not a disorder that you either have or do not have, and identification is ultimately a judgment based on the need for services.
This distinction between “low” and “high” incidence disabilities is critical to this section of the report and to other Commission considerations. Economist Julie Berry Cullen, Ph.D., found that increased funding was not related to the number of children identified with low-incidence disabilities.12 She found that funding increases for support of special education services did result in increased identification rates for high-incidence disabilities. However, her preliminary research findings indicated that increases in special education funding did not result in improvements in the quality of special education programs.
“There is no compelling reason to continue to use IQ tests in the identification of learning disabilities. And, if we eliminated IQ tests from the identification of individuals with learning disabilities, we could shift our focus on to making sure that individuals are getting the services that they need and away from the energy that’s going into eligibility determination.”
—Sharon Vaughn, Ph.D.
The Commission could not identify firm practical or scientific reasons supporting the current classification of disabilities in IDEA. The intent of IDEA is to focus on the effective and efficient delivery of special education services. The Commission is concerned that federal implementing regulations waste valuable special education resources in determining which category a child fits into rather than providing the instructional interventions a child requires. The priority should always be to deliver services, with assessment secondary to this aim. When schools are encouraged by federal and state guidelines to focus on assessment as a priority—and often for gate keeping functions to control expenditures—the main victims are the students themselves, whose instructional needs are not addressed in the cumbersome assessment process. Thus, the overall Commission recommendation for assessment and identification is to simplify wherever possible and to orient any assessments towards the provision of services.
Early Identification and Intervention Programs
The Commission finds that locally driven, universal screening of young children is associated with better outcomes and results for all children. Effective and reliable screening of young children can identify those most at risk for later achievement and behavioral problems,13 including those most likely to be referred and placed in special education programs.14
Witnesses provided the Commission with compelling evidence indicating how early intervention can prevent disabilities in many children and ameliorate their impact in those who develop them. Although the focus of early intervention has largely been on reading, this is understandable given that up to 90 percent of children identified as SLD have reading as their primary area of difficulty.15 The Commission found compelling research sponsored by OSEP on emotional and behavioral difficulties indicating that children at risk for these difficulties could also be identified through universal screening and more significant disabilities prevented through classroom-based approaches involving positive discipline and classroom management. The Commission also found that these approaches are widely used in some states and that they are at a stage where increased implementation is feasible. The Commission’s findings parallel the work of the National Research Council report on minority students in special education, which found that early screening followed by effective interventions in the classroom prevented many disabilities.16 Most impressive were the results of large-scale clinical trials indicating that early intervention of reading skills in conjunction with positive behavior programs resulted in improved academic achievement and reduction in behavioral difficulties in high-risk, predominantly minority children.17
The Commission recommends states be given the flexibility to use IDEA funds to support early intervention programs and to combine IDEA funds with other sources of federal support for these programs. This flexibility to support early intervention programs is more fully described in the Special Education Finance section of this report.
“Services first, assessment later.”
—Commissioner Steve Bartlett
What all eligibility decisions require for children who receive special education under IDEA is a two-pronged determination: The child must be shown to have a condition (i.e., meets criteria for one of the 13 categories) and must also have demonstrable educational need (i.e., must have difficulty learning or adapting to the school environment). The high-incidence disability categories have more stringent requirements for eligibility. The process typically involves the formal administration of measures of intelligence, academic achievement and behavioral functioning. For emotional disturbance, certification by a licensed psychologist or psychiatrist in many states is necessary to establish potential eligibility. In contrast, testimony to the Commission indicated that ADHD should be assessed like other behavioral disorders and requires a clinical judgment, but children are potentially eligible with a physician’s signature as an “other health impairment.”18 The low-incidence disabilities also usually require the signature of a physician designating that the child has a particular condition and sometimes additional criteria for establishing a sensory disorder, but these are not dimensional disorders like ADHD.19 For all disabilities, the establishment of educational need is a judgment by the interdisciplinary team. Children are subsequently reevaluated every three years to ensure continued eligibility.
Federal statutes mandate timelines for eligibility decisions beginning with notification of the parents, who must provide permission for the evaluation. For a high-incidence disability, individuals with some postgraduate preparation—such as school psychologists, speech and language professionals and other ancillary professionals—often do the evaluations. A great deal of their time is spent completing eligibility evaluations, which reduces the amount of their time that can be devoted to direct services, such as behavioral interventions. The results of these assessments are rarely used to evaluate progress or relate in other meaningful ways to educational need. Testimony provided before the Commission and our review of recent research leads us to find that the cost of these evaluations is significant, ranging from about $800 to $8,000 in some sections of the country.20
The Commission stresses that each component of any assessment must be selected because of its relationship to educational need. We recommend three-year evaluations of eligibility be dropped in favor of short, yearly assessments addressing progress, which can be used to determine the need for continued services. This would shift the focus from continued eligibility to the impact on results and the possibility of exiting into a less restrictive environment. Since norm-referenced assessments of achievement and behavior are given to establish eligibility, these components should be repeated yearly to provide these targeted assessments. This information would provide school personnel and parents with information about how well the child is progressing in the special education program. Experts appearing before the Commission also recommended the use of continuous monitoring of progress using brief (one- to two-minute) assessment measures, which research by OSEP has shown enhances instructional outcomes and results for children with learning and behavioral difficulties.
“The real tragedy is that conceptualizations of LD have not changed over 30 years despite the completion of significant research in the past 15 years. What we know from research now needs to be implemented.”
—G. Reid Lyon, Ph.D., Jack M. Fletcher, Ph.D., et al., “Learning Disabilities: An Evidence Based Conceptualization.” Paper presented at the Rethinking Special Education for a New Century Conference, Washington, DC
Explosive Growth in the Other Health Impairment Category and Learning Disability Category
In the past 10 years, the largest increases in students identified for IDEA services were for the other health impairment (OHI) category (319 percent), the orthopedic impairment category (45 percent) and the specific learning disabilities category (36 percent). Some of the growth in the OHI category is the result of the growth in children identified as having ADHD, where a physician's signature is generally sufficient to trigger the eligibility process. However, ADHD is a clinical judgment that has very specific diagnostic criteria. It is widely believed that many children who are identified through this process are not adequately evaluated. Moreover, in most states the school cannot establish eligibility even though many school psychologists are eminently qualified to identify ADHD. Medications should have nothing to do with identification and must be done in consultation with a physician. The other factor in the increase in OHI and orthopedic impairment categories, outlined in testimony by Mark Batshaw, is the increased survival rate of significantly premature infants and the greater recognition of genetic and neurological factors that cause low-incidence disabilities.21 For high-incidence disabilities, the rate of SLD and ADHD in premature infants without neurological abnormalities is two to three times higher than in the overall population.
The lack of consistently applied diagnostic criteria for SLD makes it possible to diagnose almost any low- or under-achieving child as SLD depending on resources and other local considerations. Researchers appearing before the Commission uniformly testified that the current definition of SLD in federal regulations is ambiguous and unrelated to intervention. Based solely on psychometric tests, these experts were not able to identify reliable methods for distinguishing children with the label of SLD from children who were not mentally deficient, but with low achievement. To paraphrase Stuebing, et al., the IQ discrepancy model provides an arbitrary subdivision of the reading-IQ distribution that is fraught with statistical and other interpretative problems.22 A clinical judgment by the interdisciplinary team is always required for any high-incidence disability.
“I would like to encourage this Commission to drive a stake through the heart of this over reliance on the discrepancy model for determining the kinds of children that need services. It doesn't make any sense to me. I've wondered for 25 years why it is that we continue to use it and over rely on it as a way of determining what children are eligible for services in special education.”
—Commissioner Wade Horn
As a result, the Commission fully supports expert recommendations made repeatedly in testimony and the scientific literature that the current methods of assessing the presence of SLD be changed. The Commission recommends that appropriate steps be taken to amend current federal regulations to indicate that IQ achievement discrepancies (and therefore IQ tests) are not necessary for the identification of children as having a learning disability. Similar practices in some states for children with speech and language impairments should also be discouraged.23
Eliminating IQ tests from the identification process would help shift the emphasis in special education away from the current focus, which is on determining whether students are eligible for services, towards providing students the interventions they need to successfully learn. There is little justification for the ubiquitous use of IQ tests for children with high-incidence disabilities, except when mild mental retardation is a consideration, especially given their cost and the lack of evidence indicating that IQ test results are related meaningfully to intervention outcomes.
The Commission believes that the current approach to all high-incidence disabilities needs to shift from a failure model to a prevention model. Former OSEP director Thomas Hehir and many others have characterized the approach to the specific learning disability category as a “wait to fail” model. Despite the evidence showing that many children with SLD and behavior problems have much better outcomes with early identification and intervention, many schools do not assess children for these difficulties prior to the third grade. Experts at the 2001 OSEP Learning Disabilities Summit described the enormous variation in how closely schools follow state regulations for eligibility in the high-incidence disorders, with teacher referral clearly being the most salient variable determining who eventually is served. Regardless, few children evaluated for a high-incidence disability fail to receive (or actually need) an IQ test.
The Commission recommends that the identification process for children with high-incidence disabilities be simplified. Assessments that reflect learning and behavior in the classroom are encouraged, with less reliance on the assessment of IQ that is now predominant. A key component of the identification process, especially to establish education need and make this decision less subjective, should be a careful evaluation of the child’s response to instruction. Children should not be identified for special education without documenting what methods have been used to facilitate the child’s learning and adaptation to the general education classroom. The child’s response to scientifically based interventions attempted in the context of general education should be evaluated with performance measures, such as pre- and post-administration of norm-referenced tests and progress monitoring. In the absence of this documentation, the Commission finds that many children who are placed into special education are essentially instructional casualties and not students with disabilities.
To prevent the wrong children from being served, the Commission recommends that current regulations be modified so that the student’s response to scientifically based instruction is part of the criteria for diagnosing the existence of SLD. The Commission also recommends that this concept be extended to other high-incidence disabilities. This recommendation is consistent with the emphasis on early screening and intervention advanced throughout this report. The Commission notes that the development of these models is uneven and that technical assistance from OSEP will be critical for implementation of this recommendation. Parents should always have the right to request an evaluation, and current placement decisions should be respected. But, the outcomes of children for whom placement is a consideration or who are placed in special education should always be monitored to determine whether the child is making progress.
Disproportionate Representation of Minorities in Special Education
A particularly disturbing finding is that children of minority status are over-represented in some categories of special education. This is especially apparent for African American males in high-incidence categories such as mental retardation and emotional disturbance. The recent National Research Council report on minority representation in special education found that African American children are twice as likely as whites and American Indians/Alaskan natives to be identified for the mental retardation category. In the emotional disturbance category, black students are about half more likely than white students to be classified in this category. The Commission did not find significant evidence for over-representation of minorities in the learning disabilities category. The magnitude of the over-representation problem varied across state and local education agencies within all high-incidence categories. However, the Commission found no consistent evidence for over-representation of minorities in low-incidence categories.
The Commission found that several factors were responsible for this over-representation, including the reliance on IQ tests that have known cultural bias. This may result in more minority children being identified in the mental retardation category as opposed to the SLD category. Minority children are much more likely to be placed in the emotional disturbance category because of behavioral characteristics associated with the cultural context in which a child is raised. A major factor is the role of teacher referral. In some studies, teachers refer more than 80 percent of children who are placed in a high-incidence category. To the extent that teachers are not prepared to manage behavior or instruct those with learning characteristics that make them “at risk” in general education, minority children will be more likely to be referred.
To help address this problem, the Commission again recommends all children be screened for learning and behavioral difficulties in the early grades. Compelling testimony was presented indicating that such screening is possible and would serve both to promote early intervention and to reduce the role of teacher referral in identification for high-incidence disabilities. We make recommendations to improve teacher preparation concerning this issue in the Teacher and Administrator Preparation section of our report. This approach more effectively addresses this matter in ways that will result in fewer minority children inappropriately placed in special education programs.
Despite the fact that IDEA requires participation of students with disabilities in statewide assessments, children with disabilities are often excluded from these assessments to establish the accountability and progress of public schools. This is a major problem, as such assessments generally are designed without consideration of modifications or accommodations students with disabilities may need to complete the assessment. Thus, when students with disabilities request modifications, the request is denied because it would presumably invalidate the test or, if the request is granted, the test results are rejected from accountability considerations as invalid results.
This barrier must be removed to allow the appropriate modifications and accommodations students with disabilities may require. The Commission recommends that all measures used to assess accountability and educational progress be developed according to principles of universal design so that modifications and accommodations are built into the test that will not invalidate the results. Guidelines to states and schools should specifically outline modifications and accommodations that are reasonable and explain why some modifications and accommodations cannot be provided, such as reading a reading assessment to a child with a reading disability.
The Commission recommends amending IDEA to improve the methods used to locate, identify and assess children who are suspected of having a disability. In addition, regulations must be issued that are consistent with the best scientific evidence to assist parents, educators and administrators in serving children with disabilities. Any amendment must align requirements for accountability, the inclusion of people with disabilities and adequate yearly progress to those adopted in the No Child Left Behind Act. Such amendments must also indicate that early intervention is the responsibility of both general and special education. Accountability for children with disabilities should continue as part of the No Child Left Behind Act, which should include referrals from and exits out of special education for both regular and special education.