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

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<ul><li><p>Hammill Institute on Disabilities</p><p>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: .Accessed: 10/06/2014 08:12</p><p>Your use of the JSTOR archive indicates your acceptance of the Terms &amp; Conditions of Use, available at .</p><p> .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</p><p> .</p><p>Sage Publications, Inc. and Hammill Institute on Disabilities are collaborating with JSTOR to digitize,preserve and extend access to Learning Disability Quarterly.</p><p> </p><p>This content downloaded from on Tue, 10 Jun 2014 08:12:31 AMAll use subject to JSTOR Terms and Conditions</p><p></p></li><li><p>IDENTIFYING CHILDREN WITH LEARNING DISABILITIES: </p><p>A COMPARISON OF DIAGNOSTIC PROCEDURES ACROSS </p><p>SCHOOL DISTRICTS </p><p>Barry F. Perlmutter and Mildred V. Parus </p><p>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. </p><p>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 learn- ing disabilities as brain injured (Chalfant &amp; Scheffelin, 1969; Clements, 1966; Strauss &amp; Lehtinen, 1947), others have stressed perfor- mance deficits (Kirk, 1972). While recognizing that the basis for a learning disability is "intrinsic to the individual and presumed to be due to cen- tral nervous system dysfunction," the new pro- fessional definition (Hammill, Leigh, McNutt, &amp; 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 par- ticular manifestations of the problem. Thus, rather than stressing the possible neurological causes of learning disabilities, the new definition focuses on symptoms and behaviors. </p><p>Given this focus on symptoms and behaviors, the question arises as to which criteria educators use to identify learning disabled children. </p><p>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. </p><p>In a recent study (Epps, McGue, &amp; 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 </p><p>BARRY F. PERLMUTTER, Ph.D., is Faculty Associate, Texas Tech University Health Sciences Center. </p><p>MILDRED V. PARUS, B.A., is a graduate stu- dent in the Dept. of History, Wayne State University. At the time of the study, Ms. Parus was an undergraduate student in Psychology. </p><p>Volume 6, Summer 1983 321 </p><p>This content downloaded from on Tue, 10 Jun 2014 08:12:31 AMAll use subject to JSTOR Terms and Conditions</p><p></p></li><li><p>asked to indicate whether or not they believed a given child was LD. The results indicated that in- dividual judges used different criteria when classifying children; generally, a lack of inter- judge 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. </p><p>Several other studies by Ysseldyke, Algozzine, and their associates (Algozzine, Ysseldyke, &amp; Hill, 1982; Ysseldyke &amp; Algozzine, 1981; Ysseldyke, Algozzine, Richey, &amp; 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 infor- mation 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, &amp; Graden, 1982). </p><p>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 learn- ing 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 assess- ment devices, it is not surprising to find a measure of confusion among diagnostic teams. </p><p>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 </p><p>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. </p><p>METHOD Subjects </p><p>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 in- cluded. 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 </p><p>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 in- volved in the study. </p><p>RESULTS Frequency of Test Administration </p><p>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 ad- ministering 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 </p><p>The average number of tests reportedly given to students suspected of learning disabilities </p><p>322 Learning Disability Quarterly </p><p>This content downloaded from on Tue, 10 Jun 2014 08:12:31 AMAll use subject to JSTOR Terms and Conditions</p><p></p></li><li><p>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 mini- mum 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 </p><p>auditory, visual-spatial, motor, math, spelling, and sensory integration deficits is contained in Table 2. Parental Involvement </p><p>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 pro- cess. In one district a psychologist held an infor- mal preliminary evaluation prior to parental in- put, two districts reported that the principal and/or teacher conducted a preliminary evalua- tion, while another responded that preliminary evaluations were undertaken by the multidisci- </p><p>TABLE 1 </p><p>Number of Districts (by Grade) Using Particular Intelligence Tests </p><p>Grades K-i McCarthy Scales of </p><p>Percent of Stanford- Children's Slosson Time Given Binet WPPSI WISC-R Abilities IQ Test </p><p>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 </p><p>Total Using Test 10 10 8 3 1 </p><p>Grade 2 100% 2 6 </p><p>75-99% 1 6 50-74% 25-49% 1-24% 4 1 1 </p><p>Total Using Test 7 0 13 1 0 </p><p>Grades 3-6 100% 2 8 </p><p>75-99% 5 50-74% 25-49% 1-24% 3 </p><p>Total Using Test 5 0 13 0 0 </p><p>Volume 6, Summer 1983 323 </p><p>This content downloaded from on Tue, 10 Jun 2014 08:12:31 AMAll use subject to JSTOR Terms and Conditions</p><p></p></li><li><p>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 </p><p>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 com- mittees needed to contain at least one psycholo- gist. 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 </p><p>speech pathologist; four "always" and three "sometimes" included a social worker; six in- cluded 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 </p><p>For most districts testing covered intelligence, auditory, visual-spatial, and mathematical abili- ty, 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 </p><p>TABLE 2 </p><p>Number of Districts Using Individual Tests in Diagnosing Specific Disabilities </p><p>Percent of Time Test Is Given Total </p><p>Test Name 1-24% 25-49% 50-74% 75-99% 100% Using Test </p><p>Auditory Deficits Detroit Tests of Learning Aptitude 1 1 1 3 </p><p>Illinois Test of Psycholinguistic Abilities 3 1 1 5 </p><p>Peabody Picture Vocabulary Test 1 1 3 5 </p><p>Test of Language Development 2 1 1 4 </p><p>Wepman 4 2 2 8 </p><p>WISC-R Subtests 2 2 4 Woodcock-Johnson 2 1 2 5 </p><p>Visual-Spatial Deficits </p><p>Beery 2 1 3 6 </p><p>Bender-Gestalt 1 2 2 7 12 </p><p>Benton 2 1 3 </p><p>Motor-Free Visual Perception Test 1 1 1 3 </p><p>WISC-R Subtests 2 3 5 Woodcock-Johnson 1 2 3 </p><p>Continued </p><p>324 Learning Disability Quarterly </p><p>This content downloaded from on Tue, 10 Jun 2014 08:12:31 AMAll use subject to JSTOR Terms and Conditions</p><p></p></li><li><p>Table 2 (Continued) </p><p>Percent of Time Test Is Given Total </p><p>Test Name 1-24% 25-49% 50-74% 75-99% 100% Using Test </p><p>Fine /Gross-Motor Deficits Bender-Gestalt 1 2 2 7 12 </p><p>Developmental Test of Visual-Motor Integration 1 1 1 3 </p><p>Jordan Left-Right Reversal 1 1 1 3 WISC-R Subtests 3 4 </p><p>Math Deficits </p><p>Brigance Inventory of Basic Skills 1 1 2 </p><p>Keymath Diagnostic Arithmetic Test 3 3 4 1 11 </p><p>Peabody Subtests 1 3 4 WRAT 2 3 3 3 11 WISC-R Subtests 1 1 2 Woodcock-Johnson 4 4 8 </p><p>Spelling Deficits </p><p>Brigance Inventory of Basic Skills 1 1 2 </p><p>Peabody Individual Achievement Test 2 2 1 5 </p><p>Test of Written Language 3 1 1 1 6 </p><p>WRAT 2 3 1 2 5 13 Woodcock-Johnson 1 1 1 4 7 </p><p>Sensory Integration Deficits Bender-Gestalt 1 3 4 </p><p>Illinois Test of Psycholinguistic Abilities 1 1 2 </p><p>Quick Neurological Screening Test 1 1 2 </p><p>WISC-R Subtests 1 3 4 Woodcock-Johnson 2 1 1 2 6 </p><p>Volume 6, Summer 1983 325 </p><p>This content downloaded from on Tue, 10 Jun 2014 08:12:31 AMAll use subject to JSTOR Terms and Conditions</p><p></p></li><li><p>2-6 the WISC-R enjoyed the most popularity. Among tests reportedly given to students sus- </p><p>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 enjoy...</p></li></ul>


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