Assignment 4 -
Psychology 486 / 686
Chapter 24: Developmental Disorders
Diagnosing Learning Disorders
While learning disorders can be debilitating for affected individuals, their diagnosis is not always easy. Read about diagnosing learning disorders in reading 1. Next, read how a program for identifying learning disabilities went awry in reading 2. After you have read the articles, do your own literature search to find additional information on diagnosing learning disabilities. Finally, write a two-page paper that expresses your opinions on diagnosing learning disabilities. Make sure you address the following questions. Given that early intervention is a factor in success rates of learning disabled children, at what point should we start testing for learning disabilities? Do you think that learning disabilities are being over diagnosed? You should support your opinions with evidence from the readings and at least two additional sources.
Reading 1:
Website: http://www.apa.org/monitor/oct04/learningdisabil.html
Monitor on Psychology
Volume 35, No. 9 October 2004
Debating learning-disability identification
Do quantitative tests used to determine learning disabilities leads to the best outcomes for students?
BY KAREN KERSTING
Monitor Staff
Print version: page 54
Experts in detecting children's learning disabilities remain in two camps: One asserts IQ tests are a critical tool in diagnosing children who need special attention, while another faction asserts that the "response to intervention" (RTI) model holds more promise. Speakers discussed the merits and pitfalls of both approaches at the 11th Annual Institute for Psychology in the Schools, a pre-meeting workshop at APA's 2004 Annual Convention.
Diagnosing learning-disabled children is a complicated process, explained psychologist Randy Kamphaus, PhD, of the University of Georgia. That's because learning-disabled children often show normal or above average intelligence on IQ tests, but fail to achieve academically. To pinpoint this difference, schools have traditionally tested children and measured the discordance between their IQ and their achievement, he said. But this protocol can be problematic for schools when children with very high IQs but mid-level achievement receive learning-disability services while other lower intelligence, lower achievement children go untreated.
That tension has led to the emergence of the RTI assessment model, which, instead of measuring intelligence and achievement in numbers, identifies children who are failing to succeed, gives them remedial assistance, attends to its effect and then determines if further services are merited, Kamphaus said. But, he noted, the technique lacks empirical support and doesn't detect all the children who need services. RTI has also been shown to inappropriately identify children with mental retardation or emotional problems as learning disabled. Moreover, it fails, he said, to provide researchers a base with which to improve testing.
"While we can try to develop intelligence testing without numbers, it won't work," he said. "The intelligence test is our stethoscope, like it or not."
Kamphaus advocated for limiting the number of students a school can deem learning disabled and eligible for services. That, he believes, would force more accurate diagnosis of the causes of a child's academic failure: Schools would have an incentive to determine if learning problems were caused by other factors, like emotional issues, because those alternate diagnoses could open more spots for truly learning-disabled children.
"Caps will encourage schools to think more critically of who merits a diagnosis of learning disabled," Kamphaus said.
Alternatively, psychologist Linda Siegel, PhD, of the University of British Columbia, argued for the RTI model's superiority to IQ testing. Her research on a classroom screening model similar to RTI indicates that most elementary school children who have academic trouble in an initial screening catch up with peers when offered a small amount of classroom assistance. Those who don't improve, she finds, are then easily identified and offered a range of assessments and interventions, which subsequently rule out mental retardation and emotional problems. As such, schools don't need to resort to mass quantitative testing, she said.
"The philosophy gets away from the screening model and focuses on outcomes," Siegel explained. "We find the kids who need our help this way. I have yet to be convinced that there is some need for the IQ test [when diagnosing learning disabilities]."
Reading 2:
Website: http://www.nytimes.com/1994/04/08/nyregion/a-disabilities-program-that-got-out-of-hand.html?sec=&spon=&pagewanted=1
The New York Times
April 8, 1994
A Disabilities Program That 'Got Out of Hand'
By MICHAEL WINERIP
Emily Fisher Landau, a member of a wealthy New York City real estate family, had long wanted to create a model educational program for bright youngsters with learning disabilities. Mrs. Landau herself experienced trouble reading as a girl, and it wasn't until she was 56 years old that she was diagnosed as dyslexic. So a decade ago she chose the Dalton School in Manhattan, one of the pre-eminent private schools in America, to create a Fisher Landau learning disability program.
She donated more than $2 million. Over several years it paid for 14 full- and part-time learning specialists in Dalton's kindergarten-to-third-grade school, a big remedial staff for a primary school with 20 head teachers and 400 children. She financed research to develop a screening test that would identify learning disabilities at an early age. And Mrs. Landau gave hundreds of thousands of dollars to Columbia University Teachers College and New York University to evaluate the program and publish scholarly papers, with hopes that the model would be widely replicated.
The outcome of this grand experiment is a cautionary tale about special education. In the last two decades, the learning disabilities field has boomed at both public and private schools, spawning an industry of highly paid specialists who treat loosely defined reading and language problems that no one knows very much about -- and that in some cases may not need treatment. Today, virtually everyone at Dalton, including Gardner P. Dunnan, the headmaster, agrees, "things got out of hand."
Dalton's new team of remedial specialists suddenly began finding enormous numbers of bright little children with learning problems. In one three-year period, 77 of 215 Dalton 5-year-olds (36 percent) were labeled "at risk" during their second month of kindergarten and given remedial help. That is far higher than the national rate for learning problems. These were kindergartners with a mean I.Q. of 132, at a school that traditionally sends 40 percent of its seniors to Ivy League colleges. Parents who just a few months earlier had been proud to have a 5-year-old accepted to Dalton and elated about the youngster's I.Q. score were suddenly being told that a new Fisher Landau screening test indicated "potential visual motor problems" or "sequencing ability deficits." A learning disability industry grew at Dalton. Instead of being comforted by the school's remedial help, many parents were unnerved and sought even more tutoring and therapy for their children after school from private specialists at a rate of $75 to $200 an hour, said Dr. Gail Furman, the former school psychologist.
By 1992, half of Dalton's students entering fourth grade had already received remedial help. Several Dalton teachers describe their classrooms as being overrun by specialists. One teacher, who had half her class diagnosed with learning problems, says she simply gave up arguing with the specialists and used the Fisher Landau program for her entire class. Other teachers battled back, refusing to let the specialists in their rooms. When teachers gathered, they joked about how long it would be before the entire primary school was diagnosed with learning disabilities. Jeannie Wang, a former Dalton kindergarten teacher, said: "If you dig hard enough in any kid, you'll find a problem. If you want to have something to write down, you'll find something to write down."
Then, in fall 1992, it abruptly ended. The kindergarten teachers revolted and refused to use the screening test, saying too many children were being given harmful and unreliable labels. Naomi Hill, the new primary school principal with a different educational philosophy, dismantled much of the Fisher Landau program. Instantly, learning disabilities at Dalton plummeted. This year, half a dozen kindergartners are getting extra help from specialists; about 15 percent in first through third grades receive help. That such a major shift could occur twice in one place in a decade is a stunning commentary on how subjective the identification of learning disabilities can be and how little is known about them.
Did It Help?
Despite the hundreds of thousands of dollars Mrs. Landau paid the universities, no one today can say with objective certainty whether the remedial program actually helped Dalton students. "We can't answer that question," said Steven Peverly, one of three Columbia researchers who worked four years on the project. "In the field of education there's this problem with research. People don't think about setting up controls. It's not like science." Even the headmaster, Dr. Dunnan, who continues to call the program "a large success," acknowledges it "was not a carefully controlled bit of research," adding "it makes the legitimacy of what we did in the research world more suspect."
Definitions Data Are Unclear, Estimates Vary
Nationwide, estimates of the number of children with learning disabilities vary between 7 and 15 percent, with enormous differences from district to district, depending on the specialists, a district's wealth, local politics and the fashionability of learning disabilities at the moment. In Montgomery County, Maryland's richest school district, about half the children in special education are classified with learning disabilities; in Baltimore, the state's poorest district, less than 20 percent are. Robert Slavin, a Johns Hopkins researcher, says in many wealthy districts a learning disability has become a socially acceptable way for a parent to get extra help for a child. "Whether the child actually has a learning disability or is a low achiever or slow to mature is a very fuzzy issue," he says. Because the scientific knowledge is limited and definitions fuzzy, he says, "If there are 30 spots for learning disabilities, you will magically have 30 learning disability students. If there are 60, you'll have 60."
Dyslexia Often Mentioned
While the learning disability most often mentioned is dyslexia -- the brain's processing of letters and symbols backward -- dyslexia accounts for a tiny portion of learning problems. More common is the child who will score high on abstract reasoning tests and low on fine motor or organizational skills like difficulty repeating a pattern or sequence. Basically, the child appears intelligent but has trouble picking up the mechanics of reading or writing. The "why" is the great unknown. Sometimes it is just different maturity rates. Most children are not ready to walk at 9 months, and most children are not ready to read at 5 years. It may be minor emotional troubles or uneven intellectual ability, problems that can usually be handled by classroom teachers. In a small percentage, the brain's processing mechanism is off kilter, and intensive support from a learning disability specialist is necessary, perhaps for years. With so many variables, efforts to screen young children for learning problems haven't been very useful, Professor Slavin said. "If you test kindergarten kids, invariably you'll make many, many mistakes."
The Benefactor Offering the Help She Never Got
It never occurred to Emily Fisher Landau that there could be a time when too many learning disabilities would be diagnosed too soon. She was educated in pre-World War II America, when virtually no one recognized such problems. "I wasn't reading in fourth grade and no one picked it up," she says. "I got through high school by faking it all the way." Mrs. Landau's wealth shielded her. She married at 19, became an art collector and serves on the boards of the Whitney Museum and the Metropolitan Opera. But after dyslexia was diagnosed in her 50's and she learned to read better, she says she felt an obligation to aid children like herself. At the time, learning disability programs were shifting into high gear in public schools, to the point that today 22 cents of every dollar spent by New York City schools goes to special education. Learning disability is the most common diagnosis among special education students in the city's public schools.
While Mrs. Landau gave money to a few private schools, she gave most of it to Dalton, "because if the best schools could be open about having bright children with learning problems, other schools would be more apt to follow. It was like coming out of the closet."
The Rich and Influential
Situated on the Upper East Side of Manhattan, Dalton serves many of New York's richest and most influential families. About 600 children apply for 95 kindergarten places. Among those who've had children at the school are Ruth Bader Ginsburg, Dustin Hoffman, Yoko Ono, Diana Ross, Isaac Stern, Robert Redford and Tom Brokaw. In 1984, Mrs. Landau's money was used to create the screening test. One developer, Francee Sugar, says it was intended to be a "very gentle" assessment, and in the early period was administered by a few specialists who came to know the children well. The kindergarten teachers used the results to aid their classroom observations. These learning specialists trained teachers to help the children. In retrospect, Ms. Sugar says, after the first three years, the teachers were prepared to do most of the remedial work and the specialists should have withdrawn from most of their classroom duties. But well-financed bureaucracies do not wither. By the late 1980's, in addition to the 14 full- and part-time learning specialists (earning up to $80,000) the program had a full-time director and secretary at Dalton, its own Fisher Landau board and an outside executive director to oversee finances. Because Mrs. Landau wanted to replicate the program, she hired Columbia Teachers College.
That is when things got out of control. The screening test began to dominate, first the Columbia research, then the remedial program, then the entire primary school. Those involved offer many reasons for how the "very gentle" screening turned into what one called "a total monster." It was the most concrete part of the remedial program, a series of tests that could be administered in 39 minutes and was easily duplicable by other schools. "When schools heard about our program," Ms. Sugar says, "the first thing they'd say, 'Can we have a copy of the screening?' " Developing a model screening was also a convenient way for Dalton to show its gratitude to its benefactor. "This was to be the Emily Fisher Landau Screening," says Dr. Furman. "It's like the Wechsler I.Q. test. Your name's carried on."