50% of SPED kids Mislabeled

I agree. In the LD field, I feel about half of the children who are put into the program are environmental casualties of either an inept school system or an inept raising. This 50% or so has been backed up by just how quickly they learn under direct instruction. I do not and cannot see how children gain three and four years growth per year can be called “learning disabled.” In our pass the blame society the label can be a very conventient and expedient excuse for nonperformance.

Thank you, Ken. My district has strong early reading instruction, as many of you have read in my numerous posts. The referrals to special have dropped in the 8-9 years since we implemented good first teaching, beginning when many teachers chose to implement Project Read, of their own accord. Now, the district fully supports primary grade reading instruction.

So, I still get students and they do make progress, albeit not 3-4 year gains in a year. Gains usually range 1-2 years, depending upon a number of factors, for students who were making 2-3 month gains prior to resource with good first teaching. I have wondered what is wrong with me, why can’t I get this wonderful “catch-up” progress that some folks are reporting.

Thank you. Now I can understand that if the school had done the job correctly in K-2, the child wouldn’t have landed in resource only to make huge gains when the appropriate instructional techniques were finally used.

The students that I am getting appear to have several related, but nontheless different, processing deficits. I really struggle to get all the pieces working in concert to produce accurate, fluent reading with good comprehension. These deficits the real LD youngsters have are not trivial.

Lastly, I think that we do have kids who have a mild deficit that effects P.A. When taught correctly, these kids do learn to decode words and if there is not a second, related, deficit in processing speed or sequencing sounds, etc. then the application of a good decoding program pretty well fixes these kids up. So, I think when good first teaching is present, we should only be getting kids who have 2 or more processing deficits and issues.

Interesting. My son’s Neuronet therapist says she generally doesn’t have children referred to her who don’t have deficits in at least three areas she evaluates. (vestibular/visual integration, visual perception, visual-auditory integration, auditory perception, fine motor sequencing). She says that kids can compenstate for one or two deficits but three or more really compromise functioning. My son, of course, has (had) significant deficits in all five areas!!!

Beth

My son has several deficits not as many as your son. Even with these deficits with the proper remediation of some of them he is a marginallly fair reg ed student.

Kids with even fewer deficits should never see the inside of sped class.

My son’s district does whole language and has a very high rate of LD kids (as per school social worker.) This to me is not a coincidence. We need a comprehensive study of using this system to teach reading and the rate of LD across all economic levels at various school districts.

NT

There are definitely different categories of “labeled” kids. You get far enough behind in reading and you’re not MR or ED, you must be LD (since, after all, inappropriate curriculum isn’t a choice.) Makes it tougher on the kids with LDs and the teachers too.

THough you’d have to account for some of the wildly varying ways in which kids qualify for sped, too.

Anitya,

It would be interesting to compare how your school’s student do on the STAR testing compared to other schools that have a similar economic profile. There is a site that I post that gives statistics of the educational level of the parents. I could post the site and you could compare your school to schools with the same parent educational profile. Of course you would not know what kind of language arts program they use.

Helen

http://www.greatschools.net/

Many, many school districts also intentionally mislabel children who are “qualified” for sped services under the wrong categories. For isntance, children with very specific conditions (like autism) may be labeled by the schools as MR or MI, rather than AU. Children who are high functioning (like Aspies) may be be labeled ED or BD. And Dyslexia, which has proven remediation methods available (albeit pricey) is not even a category at all.

Many schools intentionally mislabel these students so they do not have to develope programs which will specifically address the needs, because it is inconvenient to the staff, costs more money that using a generic dumping ground, and would force the “in house experts” to call in private consultants to set up and tweak programs that were geared towards the correct diagnosis.

Hey, we don’t mind labeling your child, he has deficits, and we can use the extra money, but don’t expect us to actually work on his needs…

Reminds me of that old joke about the fellow on his hands and knees, searching teground under the streetlight. I stopped to inquire and possibly help. He told me he drop his keys and was searching for them. I asked him where he dropped them and he replied “across the street.”

“Well why are you looking for them here if you dropped them over there?” I asked.

“Because,’ came his response, “the light is over here…”

My school is doing well for a relatively low SES school, I think our API hit about 690-something last year, however, we missed in two subgroups. API’s topout at 800. We are one of the lowest in my district, but as the “southern most” school, right by the freeway (the nice homes are north of the freeway away from the noise and the traffic) we don’t expect to be where the kids who live in half-million $$ to over $2,000,000 homes are.

For 2001 we scored average and 7/10 when compared to similar SES schools. The 2002 data is not online. I know we met our API number, but missed two subgroups. So, this year we are doing still more and shaving more and more time from science and SS to find the time to do it.

Dyslexia is specifically named as an LD in the definition of LD. Think of dyslexia as more of a medical term and LD as the educational classification for students who have processing deficits that interfere with learning in specific areas. Aspie’s are considered part of the autism spectrum, so they can be placed under that category.

Finally, we are seeing a significant loosening of the application of the diagnostic criteria for autism. I believe I read that the DSM IV did actually reduce the number of criteria that needed to be present to warrant the diagnosis. Further, we are finding that outside evaluators are liberally applying the label to children who meet some, but not all, of the autism characteristics. I think of these as partial. On a “partial” the child often will just as easily fit into a language disability or an LD.

I teach a boy who was diagnosed based only upon his parent’s perceptions. Parents are educated and well-read. Naturally, when parents completed the behavioral ratings, they identified problems that have NEVER surfaced at school. The autism traits that are present at school are extremely minimal, there is no measurable social skills deficit (though the child often prefers to play alone) nor is there a measurable language deficit. He does not have repetitive behaviors. He really does very little that looks autistic. He is a highly anxious child, he does race through his work, though it is neat and he does have some conceptual-thought issues. Is that autism? I think we can question the validity of the diagnosis. He might rather be a child who has an anxiety disorder which effects some school tasks. At home, he pulls parents’ chains, so they see him as much worse than at school where we do not “enable” him.

I have to take the opposite position to you, Dad. We are getting a plethora of youngsters who are being labled autistic (usually HFA) who only show partial symptoms. It is really a very difficult call to make when you do have to define what is and what is not “autism.”

If you merely treat the child, based upon his strengths and needs, then you can still provide appropriate supports and services, regardless of what you label him.

We have a K child whom I believe is HFA, but he is not diagnosed. We are trying, but dad is so far in denial he won’t consider and mom has to sneak around behind his back to fill out the rating forms. Meanwhile, we have him placed as language delayed and the SLP and I, with help from the OT, give him good services. He is making progress and I do believe that we are meeting his needs at school, regardless of the handicapping condition we are using for eligibility.

What is interesting about your theory (an over diagnosis of autism bsed upon a loosening of criteria) is that none of the most recent studies will support this. We hear this as a major criticism most often from academics who do not work with children with autism full time (epidiomologists for instance).

The criteria for autism has actually remain little changed from DSM-III (early 80’s) to DSM-IV (early 90’s). There was a revision in the late 80’s, which added a new category PDD-NOS (DSM-III R) and the DSM-IV recognized Asperger’s for the first time (despite more than 40 years of recognition in Europe).

Whether there are loose cannons who too readily label children so their parents can get services for them is a completely seperate matter. That will vary widely depending upon where you are. It is for that reason that I would prefer the qualified professionals who are fully experience make the diagnosis of autism, or a least confirm one made by other sources. Hand in hand with that should be the schools accurately labeling and servicing these children (which is NOT happening, by a recent report to Congress the NIH stated less than 10% of autistic kids in this country are getting the type of services they need for remediation, and a great many of those who are will be the ones served by private organizations such as Marino’s in FL, WEAP in WI or Princeton in NJ).

When the CDC went to Brick in 1996, (final study published in 1999) they determined that the rate of prevalance there was 4/1,000 for core autism and 6.7/1,000 for full Spectrum. This did not represent a cluster however, because they were also aware of numerous other communities in NJ with similar rates.

When UC-Davis put together their survey of the caseload increase in CA, two of the criticism were misdiagnosis (either past or present skewing the numbers) or migration. The follow up report showed that the change from DSM-III to DSM-IV did NOT alter the quality of the diagnosis, better than 90% accuracy using current standards were found to have been true in both the mid 80’s year resurveyed and the late 90’s year, and also found that CA has been servicing mostly native born CA kids with autism (again better than 90%).

In the Atlanta study, the CDC again found a much higher than anticipated prevalance, mirroring the numbers found in Brick. An interesting item in the Atlanta study was that of the autistic kids identified by the CDC (confirmed dx), 40% were not diagnosed until they got to school, and another 18% were not diagnosed until the CDC came to town. Imagine that in a metropolitan area like Atlanta, with it’s scores of professionals that over half the kids with core disorder autism would have missed the opportunity for EI, a time when all experts agree remediation has the greatest impact and can work in the shortest amount of time.

Again, what happens in any one small corner can be contrary to the general trend. But I will leave you with a compilation of the numbers reported to the Feds by the states. It shows a great disparity in the veracity of the individual states in their labeling of these children. The actual increase in prevalance over the decade of the 90’s was between 250 and 350%. Some states show increases during the same time of more than 10 times that rate. What this represents are families who have (most likely due to the internet) learned of the inaccuracies of their LEA’s in this regard, and also learned that they can have this problem corrected.

http://www.vaccinationnews.com/Scandals/Feb_15_02/GallupPressRelease.htm

http://www.garynull.com/Documents/autism_99.htm

Anitya wrote:

>> He is a highly anxious child, he does race through his work, though it is neat and he does have some conceptual-thought issues. Is that autism? I think we can question the validity of the diagnosis. He might rather be a child who has an anxiety disorder which effects some school tasks. At home, he pulls parents’ chains, so they see him as much worse than at school where we do not “enable” him.<<

I’m not saying this never happens; I’m sure it does. But please remember that there is another possible explanation for this exact same scenario. Many kids can “hold it together” behaviorally during the school day only to fall apart in the “safe” enviroment of the home. Both my NLD kid and the ADD/Anxiety/LD one hve done this. Neither has EVER been a behavior “problem” at school.

Fortunately, our school was willing to take our onservations seriously, and provide the help my kids needed and a better environment at school. Almost “like magic”, the concerning behaviors we saw at home disappeared (or lessened drastically) when the children were in a more appropriate educational setting.

Maybe if this child’s parents were less educated in these matters, and less pro-active in addressing thier child’s needs you WOULD see more concerning behavior in the school setting as well.

Karen

Sorry Karen, thanks for the input, but I don’t agree with you at all. I do believe this child has anxiety and I do believe he shares this at home. However, I do not believe this child is autistic. I also believe the child knows very well how to pull the parents’ chain.

I am a parent, too. My 15 year old is the model of good behavior in public and at school. She is courteous, considerate, etc. People comment on what a nice girl she is. (Frankly I can see little manifestations of her issues, but on the whole she is really very nice.) At home we see the unpleasant side, she yells and has temper tantrums, which she recovers from quickly if I pretty well ignore her. No, she doesn’t dare do this at school, she does it at home where it is safe because we (I) have permitted her to get away with this since she was a toddler because I repeatedly gave in to her temper tantrums, from infancy, because they shake me up so badly. Now I have to deal with this behavior in a 15 year old. It is totally my fault and I will be the first to admit to it.

I am sorry, I do NOT think this fact that children will show manipulative behaviors at home to mom and dad makes them disabled. I also think that when the assessment procedure only includes feedback from the parents who are very anxious themselves, you may get a skewed result. A balanced assessment of a child being considered as autistic (particularly high functioning) should include feedback, if possible, from individuals who know the child but who do not have the emotional, subjective connection to the child that the parents will naturally have.

I do think that if and when a parent comes in and tells us that school situations are increasing the child’s stress, and that this is coming out at home, the teachers should listen to this and work with the parents to make adjustments. We happily do this.

While there are many “could be this” and “could be that,” I feel that we know this case pretty well.

Karen,

I had the exact same thing happen. When my son was having a hard time in his class this year he was exhibiting some negative behavior at home. The IEP team members said he was just manipulating me. He was very well behaved with them.

I told them that was not possible because this was definitely new and he was exhibiting signs of real anxiety. This was totally new for him. He has just never been an anxious kid before. The behavior changed when he was placed in the right environment at school.

I am glad I pushed and didn’t buy into their theory. If I had he would probably have become what they thought he was. I think kids have a remarkable ability to live up or down to adults expectations.

This has been a very interesting thread. What I think is that we see things both ways. There are those out there to give a quick label but there are also others who do not want to give such a “dreadful” diagnosis as autism. The difficulties with labels is sometimes where do you draw the line, there is such overlap it is hard to tell what is what. I agree with Anitya that IF the proper services are being privided the label does not matter. I have a son in 4th grade who carries a diagnosis of PDD-NOS, his school category is OHI since they do not recognize the PDD-NOS label. He still gets outstanding service and has made tremendous gains and that is what is important. He more then meets enough of the criteria in the DSM for a diagnosis of Autism but since he has made improvements and has a normal IQ no one in this area wants to give him the diagnosis of Autism because PDD-NOS seems more hopeful. He does have an IQ split between verbal and performance, he does have a discrepency between ability and achievement, he does have social skills deficits that interfere with learning, he has sensory intergration issues, an uneven profile, rocks, hums, ect. The school consitantly consults the Autism specialist they have in the district about him. He is currently being evaluated for assistive technololgy to help him with written communication. I consider myself lucky though because not all districts do this. He even is in a self contained cross categorical classroom which has been a really good fit for him. He continues to learn and grow at an acceptable rate.