Download - Identifying Children with Learning Disabilities: A Comparison of Diagnostic Procedures across School Districts

Hammill Institute on Disabilities

Identifying Children with Learning Disabilities: A Comparison of Diagnostic Procedures acrossSchool DistrictsAuthor(s): Barry F. Perlmutter and Mildred V. ParusSource: Learning Disability Quarterly, Vol. 6, No. 3 (Summer, 1983), pp. 321-328Published by: Sage Publications, Inc.Stable URL: http://www.jstor.org/stable/1510443 .

Accessed: 10/06/2014 08:12

Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at .http://www.jstor.org/page/info/about/policies/terms.jsp

.JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range ofcontent in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new formsof scholarship. For more information about JSTOR, please contact [email protected].

.

Sage Publications, Inc. and Hammill Institute on Disabilities are collaborating with JSTOR to digitize,preserve and extend access to Learning Disability Quarterly.

http://www.jstor.org

This content downloaded from 91.229.229.89 on Tue, 10 Jun 2014 08:12:31 AMAll use subject to JSTOR Terms and Conditions

http://www.jstor.org/action/showPublisher?publisherCode=sage

http://www.jstor.org/stable/1510443?origin=JSTOR-pdf

http://www.jstor.org/page/info/about/policies/terms.jsp


IDENTIFYING CHILDREN WITH LEARNING DISABILITIES:

A COMPARISON OF DIAGNOSTIC PROCEDURES ACROSS

SCHOOL DISTRICTS

Barry F. Perlmutter and Mildred V. Parus

Abstract. Diagnostic procedures used to identify children (grades K-6) with learning disabilities in 14 school districts were studied and compared. The degree of uniformity in procedures for initial referral, testing, and diagnostic criteria, as well as differences in the selection of testing instruments by various districts were examined. Information was gathered through individual interviews with school personnel involved in the assessment of learning disabled children within each district. Although some similarities existed between districts, uniformity was lack- ing in important areas such as test selection, extent of testing, and cutoff scores on intelligence and other tests. These findings are discussed in terms of their implica- tions for the reliability of diagnoses across districts, as well as their meaning for researchers in the field.

Throughout its relatively short history the field of learning disabilities has been plagued with definition and identification problems. Various definitions have referred to children with learning disabilities as brain injured (Chalfant & Scheffelin, 1969; Clements, 1966; Strauss & Lehtinen, 1947), others have stressed performance deficits (Kirk, 1972). While recognizing that the basis for a learning disability is "intrinsic to the individual and presumed to be due to central nervous system dysfunction," the new professional definition (Hammill, Leigh, McNutt, & Larsen, 1981) still focuses on difficulties in ac- quiring and using various academically related abilities. According to this definition, the em- phasis when classifying individuals is on particular manifestations of the problem. Thus, rather than stressing the possible neurological causes of learning disabilities, the new definition focuses on symptoms and behaviors.

Given this focus on symptoms and behaviors, the question arises as to which criteria educators use to identify learning disabled children.

Presumably, a combination of achievement and ability test scores, and behavioral reports from teachers, social workers, and psychologists would yield sufficient information to allow for reliable diagnoses. Unfortunately, there appears to be little agreement on the exact meaning of specific combinations of test scores and behaviors.

In a recent study (Epps, McGue, & Ysseldyke, 1982), 18 well-qualified judges were presented with information on 99 children, 50 of whom had been identified by their schools as learning disabled (LD). Judges were provided with 42 test or subtest scores for each child, and were

BARRY F. PERLMUTTER, Ph.D., is Faculty Associate, Texas Tech University Health Sciences Center.

MILDRED V. PARUS, B.A., is a graduate student in the Dept. of History, Wayne State University. At the time of the study, Ms. Parus was an undergraduate student in Psychology.

Volume 6, Summer 1983 321



asked to indicate whether or not they believed a given child was LD. The results indicated that individual judges used different criteria when classifying children; generally, a lack of interjudge agreement was found. Of the 99 children, all but five were classified as LD by at least one judge. Further, of the five children rated as non- disabled by all judges, three had been classified as LD by their individual schools.

Several other studies by Ysseldyke, Algozzine, and their associates (Algozzine, Ysseldyke, & Hill, 1982; Ysseldyke & Algozzine, 1981; Ysseldyke, Algozzine, Richey, & Graden, 1982) have examined the relationship between types of information presented during assessment meetings and resultant diagnoses. Results show that data on individual children's performance seem to have little influence on the outcome of such meetings. These authors have also found that much of the information brought up during assessment meetings is irrelevant to the purpose of classifying the child, and that the ultimate diagnosis often depends more on referral information than on test scores. In one study these researchers concluded that: "The data provide little evidence to suggest that teams use specific, formal criteria when making eligibility decisions or that assessment results are used for purposes other than minimal professional credibility" (Ysseldyke, Algozzine, Richey, & Graden, 1982).

Educators are experiencing severe problems reliably classifying possible LD children. One diagnostic problem relates to the lack of ex- clusivity of symptoms. Unfortunately, many behaviors present in LD children are also found in children with emotional or developmental disabilities, as well as in the mentally retarded, minorities, and the culturally deprived. The new professional LD definition specifies that a learning disability, while it "may occur concomitantly with other handicapping conditions," is necessarily different from other such conditions. However, given the overlap among diagnostic categories plus the myriad of available assessment devices, it is not surprising to find a measure of confusion among diagnostic teams.

The present study was undertaken to assess the degree of confusion that has likely been generated by the lack of a strict set of criteria for evaluating children suspected of learning disabilities. An attempt was made to determine

the extent of agreement and disagreement among school diagnostic staff as to the proper procedures and diagnostic instruments involved in determining which students should be classified as LD.

METHOD Subjects

Fourteen school districts in lower Michigan participated in the study - one urban, one rural-suburban, and 11 suburban districts in the Detroit metropolitan area. One rural district out- side the Detroit metropolitan area was also included. The populations (K-12) of the districts ranged from 1,605 to 26,964 children. LD populations for which data are presented include primarily white 5- to 12-year-old students en- rolled in grades K-6. Procedure

School psychologists, teacher consultants, and other professionals involved in identifying LD children were contacted and personally inter- viewed using a questionnaire developed specifically for this study. The instrument was administered orally to insure that identical areas were discussed with all school personnel involved in the study.

RESULTS Frequency of Test Administration

While information provided by all 14 districts is included in this section, data on how often specific tests were used are included for only 13 districts. (Data from one district were incomplete and, consequently, were not included in these tabulations.) All 14 school districts reported administering standardized achievement tests to all students in grades K-6 at regular intervals. Preliminary routine assessments of audio and visual acuity for students experiencing academic difficulty were also performed in all 14 districts. Half the districts reported performing preliminary neurological assessments of these students. Ad- ditionally, 11 districts reported that social workers, psychologists, or other professionals routinely collected developmental histories on such children. In all cases, the majority of initial referrals were reported to have come from teachers. Number of Tests Administered

The average number of tests reportedly given to students suspected of learning disabilities

322 Learning Disability Quarterly



ranged from two in one district to 13 in another. The maximum number of tests administered by individual districts ranged from 3 to 16, with most giving a maximum of 6-10 tests. The minimum number administered ranged from 2 to 11, although only two districts reported a minimum greater than 5. Two districts, reporting that they had no maximum number of tests, maintained that they gave as many tests as were necessary according to the needs of individual children. Most districts reported administering an average of 3 to 5 tests per student referred for evaluation. The popularity of individual tests of intelligence is detailed in Table 1. Information on tests of

auditory, visual-spatial, motor, math, spelling, and sensory integration deficits is contained in Table 2. Parental Involvement

All districts required written consent from parents or guardians before formal testing was begun. Half the districts reported that parents or guardians had input early in the evaluation process. In one district a psychologist held an infor- mal preliminary evaluation prior to parental input, two districts reported that the principal and/or teacher conducted a preliminary evaluation, while another responded that preliminary evaluations were undertaken by the multidisci-

TABLE 1

Number of Districts (by Grade) Using Particular Intelligence Tests

Grades K-i McCarthy Scales of

Percent of Stanford- Children's Slosson Time Given Binet WPPSI WISC-R Abilities IQ Test

100% 2 3 3 1 75-99% 2 3 2 1 50-74% 1 3 25-49% 1 1 1 1-24% 5 2 1

Total Using Test 10 10 8 3 1

Grade 2 100% 2 6

75-99% 1 6 50-74% 25-49% 1-24% 4 1 1


Grades 3-6 100% 2 8

75-99% 5 50-74% 25-49% 1-24% 3





plinary team (M-Team) prior to parental input. Three districts reported that parents or guardians had input prior to the Individual Educational Planning Committee (IEPC) meeting. IEPC Composition

Since the composition of the IEPC is left large- ly up to individual districts, differences in types of persons asked to serve on these committees are inevitable. The only point of agreement between the districts in the present study was that committees needed to contain at least one psychologist. In addition, 13 districts also included the child's regular classroom teacher, nine included a teacher consultant familiar with the problems of special populations; six "always" and two "sometimes" included the principal; three "always" and three "sometimes" included a

speech pathologist; four "always" and three "sometimes" included a social worker; six included a special education teacher; one "always" and one "sometimes" included a reading consultant; one "always" and one "sometimes" included a counselor. Finally, two districts "sometimes" included a parent or guar- dian of the child. Types of Tests Administered

For most districts testing covered intelligence, auditory, visual-spatial, and mathematical ability, spelling, sensory integration, and fine/gross- motor skills. For grades K-l, the most frequently used intelligence tests were the Stanford-Binet, WPPSI, and the WISC-R. The McCarthy Scales of Children's Abilities and the Slosson In- telligence Test were used less often. At grades

TABLE 2

Number of Districts Using Individual Tests in Diagnosing Specific Disabilities

Percent of Time Test Is Given Total

Test Name 1-24% 25-49% 50-74% 75-99% 100% Using Test

Auditory Deficits Detroit Tests of Learning Aptitude 1 1 1 3

Illinois Test of Psycholinguistic Abilities 3 1 1 5

Peabody Picture Vocabulary Test 1 1 3 5

Test of Language Development 2 1 1 4

Wepman 4 2 2 8

WISC-R Subtests 2 2 4 Woodcock-Johnson 2 1 2 5

Visual-Spatial Deficits

Beery 2 1 3 6

Bender-Gestalt 1 2 2 7 12

Benton 2 1 3

Motor-Free Visual Perception Test 1 1 1 3

WISC-R Subtests 2 3 5 Woodcock-Johnson 1 2 3

Continued




Table 2 (Continued)

Percent of Time Test Is Given Total

Test Name 1-24% 25-49% 50-74% 75-99% 100% Using Test

Fine /Gross-Motor Deficits Bender-Gestalt 1 2 2 7 12

Developmental Test of Visual-Motor Integration 1 1 1 3

Jordan Left-Right Reversal 1 1 1 3

WISC-R Subtests 3 4

Math Deficits

Brigance Inventory of Basic Skills 1 1 2

Keymath Diagnostic Arithmetic Test 3 3 4 1 11

Peabody Subtests 1 3 4 WRAT 2 3 3 3 11 WISC-R Subtests 1 1 2 Woodcock-Johnson 4 4 8

Spelling Deficits

Brigance Inventory of Basic Skills 1 1 2

Peabody Individual Achievement Test 2 2 1 5

Test of Written Language 3 1 1 1 6

WRAT 2 3 1 2 5 13 Woodcock-Johnson 1 1 1 4 7

Sensory Integration Deficits Bender-Gestalt 1 3 4

Illinois Test of Psycholinguistic Abilities 1 1 2

Quick Neurological Screening Test 1 1 2

WISC-R Subtests 1 3 4 Woodcock-Johnson 2 1 1 2 6




2-6 the WISC-R enjoyed the most popularity. Among tests reportedly given to students sus-

pected of specific auditory deficits, the Wepman was used most frequently, whereas the Bender- Gestalt was most popular for pupils suspected of visual-spatial deficits. The WRAT and Keymath Diagnostic Arithmetic Test were reportedly given most often if mathematical deficits were suspected. The WRAT enjoyed the most popularity for assessing spelling deficits. The test most frequently used in assessing sensory integration deficits was the Woodcock-Johnson. The Bender-Gestalt was used most when children were suspected of fine/gross-motor deficits. Diagnosis

Following testing a determination was routinely made as to the child's diagnosis. Districts reported that in order to be classified as LD, a child had to demonstrate severe discrepancies between his/her ability and achievement levels. However, each district set its own criteria by which a given child would be considered to ex- hibit severe discrepancies. IQ was considered normal if it fell in the 90-110 range. Four districts used one standard deviation difference between the child's achievement and ability levels as the criterion, while four adhered to two standard deviations for classifying children as LD. Four districts used no fixed criteria on test scores, but based their determination solely on professional judgment. One district considered a child to be LD if he/she was functioning at 50 percent of the grade level of his/her peers.

DISCUSSION Results of our survey revealed similarities in

diagnostic procedures in that all districts used standardized achievement tests and teacher referrals, and communicated at some point with the referred child's parents. However, except for certain tests which enjoyed popularity, districts did not agree on how to identify specific disabilities. Thus, differences were found in (a) number of tests given, (b) use of tests and subtests, (c) use of intelligence tests, (d) choice of testing instruments, (e) cutoff points for determining learning disabilities, (f) composition of multidisci- plinary teams, and (g) the point at which parents were consulted during the diagnostic process. In addition, while some districts established specific guidelines for determining which students should

be classified as LD, others relied almost entirely on clinical judgment.

The teacher played a major role in the identification process. Thus, teacher referrals con- stituted the majority of initial contacts and teacher assessments made up the primary diagnostic screening device used by most districts. In addition, many districts provided forms for teachers to fill out on suspected students' classroom activities.

Once a student was referred for testing a key member of the M-team, usually a psychologist, decided which tests would be used to assess the cause of the child's problem. Certain tests enjoyed popularity across school districts. The Bender-Gestalt proved most popular in diagnosing visual-spatial, sensory integration, and fine/ gross-motor deficits. The WRAT was most popular for diagnosing mathematical and spelling deficits. In this respect, some districts indicated that the WRAT was helpful in testing older children who were capable of taking paper and pencil tests, while the Woodcock-Johnson was useful for younger children because it did not re- 'quire written responses. The Wepman, which has been used in diagnosing auditory deficits for over 20 years, was still found to be popular among districts. However, the Woodcock- Johnson seemed to be gaining in popularity, not only for diagnosing auditory deficits, but for visual-spatial, mathematical, spelling, and sensory integration deficits as well.

However, several possible problems have re- cently come to light related to the use of the Woodcock-Johnson as a device for identifying learning disabilities (Ysseldyke, Algozzine, & Shinn, 1981). Additionally, the use of tests of visual and/or auditory perception for diagnosing learning disabilities is itself a questionable prac- tice. According to the new professional definition, learning disabilities are manifested by problems with "listening, speaking, reading, writing, reasoning or mathematical abilities." Validity studies relating visual and auditory test results to problems in these areas are needed if their use is to be continued with confidence.

As revealed in our data, districts often demon- strated diversity in crucial areas. For example, it appeared that some districts administered as few as three or four tests, while others used an average of six or seven to identify LD children. One district claimed to have given an average of




13 tests to children suspected of learning disabilities.

Even within districts, different tests were sometimes preferred by individual examiners. In one district, one psychologist preferred the Stanford-Binet, while another chose the WISC- R or WPPSI for measuring intellectual skills. Generally though, the Stanford-Binet appeared to be losing popularity as a means of establishing IQ in LD children. Thus, many districts tended to use this test only with very young children or when mental retardation was suspected.

The primary testing focus appeared to be in areas of classroom work such as reading, mathematical, and spelling skills. Other procedures were used to enhance information from standardized tests including: parental reports, developmental histories, classroom observa- tions, hearing, vision, and neurological assessments, teacher reports on academic performance and behavior, and information from speech pathologists.

Another important area in which districts were often found to differ was in establishing cutoff points for determining learning disabilities. While all of them refused to diagnose as LD a student with a tested IQ below 70, some were willing to so classify children in the 70-85 range. Others preferred to refer to these students as "slow learners". Most districts, however, elected to withhold diagnoses of such children until further testing could be completed a year or two later. Unfortunately, little uniformity was noted in the classification of children judged to be of normal intelligence. Some districts used a yardstick of one standard deviation difference between performance and ability, as measured by standardized tests, others demanded a difference of two standard deviations for classification; still others relied more on the examiner's clinical judgment. As a result, some children are diagnosed as LD by their school district, but would not be so classified if they merely attended a different school.

Another area examined in this study was the construction and operation of M-Teams. Primary members of these teams usually included psychologists, regular classroom teachers, special education teachers, principals, speech pathologists, and social workers. Most districts used some form of preliminary screening team, often including the principal and/or classroom

teacher, and sometimes parents, to informally discuss whether further testing was necessary. Most M-Teams were not rigidly constructed showing flexibility in selection of team members.

Diversity was also found to exist in the organi- zation of special education resource rooms. While some districts maintained separate classes for LD students, others mixed LD with emo- tionally impaired (El), educably mentally impaired (EMI), and/or physically otherwise han- dicapped impaired (POHI) children.

CONCLUSIONS The identification problem influences research

on LD populations as well as school classification systems. In a review of 229 articles Harber (1981) found that "in more than two-fifths of the studies involving LD subjects, the criteria for such classification were not provided," and that "studies which did operationally define learning disabilities utilized a wide range of criteria" (p. 372). In a further condemnation of classification systems used in research on learning disabilities, Kavale and Nye (1981), after having reviewed 307 studies, concluded that "the learning disabilities research literature presents a divergent picture of the nature and characteristics of learning disabilities and reflects a lack of consensus regarding standard identification criteria" (p. 383).

The problem of improper or unreliable identification procedures is of concern to both frontline school personnel and researchers in the field. We cannot expect reliable diagnoses until and unless identification procedures become more standardized. School personnel can only classify children using procedures they have been taught, instruments they have been provided, and criteria that have been dictated by their train- ing programs.

As Algozzine, Ysseldyke, and Shinn (1982) pointed out, while the current federal guidelines specify that the discrepancy between ability and achievement must be "severe" for a child to be labeled learning disabled, they do not address the issue of the level of discrepancy needed for this distinction. Thus, the critical task of diagnosing children suspected of being LD is left up to the clinical judgment of diagnostic teams. In order to achieve reliable diagnoses a clear and unambiguous definition, with minimal overlap between learning disabilities and other areas of




exceptionality, must be supported with widely accepted assessment instruments. Additionally, criteria used when interpreting these instruments, that is, a universal understanding of what a "severe" discrepancy is, must be incorporated within our understanding of the distinguishing characteristics of children with learning disabilities.

If there is disagreement and uncertainty among researchers in the field, it should come as no surprise that individual districts do not agree on how to diagnose and deal with potential LD students. One recurring complaint heard while conducting this study was that the ambiguity of the definition made it difficult to be confident in any given diagnosis. With the new professional definition, part of this problem should be alleviated. However, while recognizing that LD children are not a homogeneous group, some agreement regarding tests used for identification and cutoff scores for those tests is needed if reliable diagnosis is to be a reasonable objective.

REFERENCES Algozzine, B., Ysseldyke, J. E., & Hill, C. Psycho-

educational decision making as a function of the amount of information reviewed. Psychology in the Schools, 1982, 19, 328-334.

Algozzine, B., Ysseldyke, J. E., & Shinn, M. Identi- fying children with learning disabilities: When is a

discrepancy severe? Journal of School Psychology, 1982, 20, 299-305.

Chalfant, J., & Scheffelin, M. Central processing dysfunction in children: A review of research. National Institute of Neurological Disease and Stroke Monographs, 1969, No. 9.

Clements, S. Minimal brain dysfunction in children: Terminology and identification. Phase one of a three part project. Washington, DC: United States

Department of Health, Education and Welfare, 1966.

Epps, S., McGue, M., & Ysseldyke, J. E. Interjudge agreement in classifying students as learning disabled. Psychology in the Schools, 1982, 19, 209-220.

Hammill, D. D., Leigh, J. E., McNutt, G., & Larsen, S. C. A new definition of learning disabilities.

Learning Disability Quarterly, 1981, 4, 336-342.

Harber, J. Learning disability research: How far have we progressed? Learning Disability Quarterly, 1981, 4, 372-382.

Kavale, K., & Nye, C. Identification criteria for learn-

ing disabilities: A survey of the research literature.

Learning Disability Quarterly, 1981, 4, 383-388. Kirk, S. Educating exceptional children (2nd ed.).

Boston: Houghton Mifflin, 1972. Strauss, A., & Lehtinen, L. Psychopathology and

education of the brain-injured child. New York: Grune and Stratton, 1947.

Ysseldyke, J. E., & Algozzine, B. Bias among professionals who erroneously declare students eligible for special services. Journal of Experimental Educa-

tion, 1982, 50, 223-228.

Ysseldyke, J. E., & Algozzine, B. Diagnostic classification decisions as a function of referral information. Journal of Special Education, 1981, 15, 429-435.

Ysseldyke, J. E., Algozzine, B., Richey, L., &

Graden, J. Declaring students eligible for learning disability services: Why bother with the data? Learn-

ing Disability Quarterly, 1982, 5, 37-43.

Ysseldyke, J. E., Algozzine, B., & Shinn, M. Validity of the Woodcock-Johnson Psycho-Educational Battery for learning disabled youngsters. Learning Disability Quarterly, 1981, 4, 244-249.

Requests for reprints should be addressed to: Barry F. Perlmutter, Texas Tech University Health Sciences Center, Regional Academic Health Center at Amaril- lo, School of Medicine/Dept. of Pediatrics, 1400 Wallace Blvd., Amarillo, TX 79106.




Download - Identifying Children with Learning Disabilities: A Comparison of Diagnostic Procedures across School Districts

Top Related