Identification and Evaluation of Children with Suspected Disabilities
Indicators of Children Who May Have a Suspected Disability and Need an Psycho-Educational Evaluation
With the changes in the DSM, the difficulties that families will have in getting services in the future, and the fact that most evaluations of children happen within the context of education, I thought to highlight the basics of the process of evaluation in schools. Because the access to services is enshrined in the law, it’s vitally important that families understand their rights and responsibilities, as well as identifying potential allies within the system.
First of all, there are several typical indicators that they system looks for when considering a student for special education services. Of the five indicators listed below, the one that seems to be the most obvious, or most obviously contributing to the problems in the classroom, will be the most direct path to a diagnosis.
The child’s rate of progress is not what is expected. Each state has norm-referenced achievement tests. They also have criterion-referenced tests. Norm-referenced tests measure achievement / progress against a typical student or group of students, and are based within a “bell curve.” Rarely, are special education students part of the group that creates a norm. Criterion-referenced tests measure students against learning outcomes - what students of a given grade should know about a specific tested subject. For rates of progress, where behaviour or a chronic illness is not an issue, evaluators tend to focus on Specific Learning Disabilities (SLD) eligibility factors.
The child’s level of performance is significantly discrepant from his/her peers. The problem with this indicator lies in the fact that scores for young children are much less reliable than for older students. This is because young children's moods and attention are more variable. Also, young children develop quickly and unevenly, so even an accurate score today could be wrong next month. This catch-all tends to be used to clarify the “why” of sub-standard progress.
The child has a physical or health condition affecting educational performance. This is the indicator most often associated with the Other Health Impairment (OHI) eligibility. What’s central to all the disabilities falling under OHI is that the child must have (a) limited strength, vitality, or alertness due to chronic health problems; and (b) an educational performance that is negatively affected as a result. You will also find deaf-blindness, deafness, hearing impairment, intellectual disability, multiple disabilities, orthopedic impairment, traumatic brain injury, and visual impairment here.
The child’s behaviour or interpersonal interactions are adversely affecting educational performance. This indicator is most often associated with autism (AUT) and emotional disturbance (ED) / emotionally and behaviourally disabled (EBD) eligibilities. The lines between AUT / ADD / ADHD / ED / EBD eligibilities used to be very blurry. Now, with the Text Revision, there are more distinct lines drawn around which behaviours belong to which eligibility.
The child’s response to classroom accommodations and modifications has not been successful. The key to this indicator is “why.” Why haven’t accommodations / modifications been successful. The answer to this question will eventually lead the evaluator to one of the other indicators, and thus an eventual determination.
Now that we know what evaluators are looking for, who may provide the initial referral for the evaluation? In the US, and many Western nations, there are normally three ways in which a student may be identified for an evaluation of a suspected disability that would require special education services.:
The student’s classroom teacher may identify that certain symptoms exist within the classroom that seem to indicate the presence of some problem. For example, the student’s work is below expectations for his or her grade or age, or the student’s behaviour is so disruptive that they are unable to learn.
The student’s parents may call or write to the school or to the director of special education and request that their child be evaluated. They may feel that the child is not progressing as they should or may notice particular problems in how their child learns. When parents note a problem and request an evaluation, the school must follow through on the assessment process. This is the parents’ legal right.
Other school personnel or outside professionals may suspect the presence of a learning or behaviour problem and ask the student’s parents for permission to evaluate the student individually. This may have resulted from a student scoring far below their peers on some type of screening measure and thereby alerting the school to the possibility of a potential problem. This often appears in schools with an MTSS infrastructure who conduct initial screening of students.
Remember, if you suspect that your child has a disability affecting their education, you can refer them to your school district for special education services. Even if a parent does not refer a child, a school district has the affirmative obligation to conduct evaluations of students suspected of needing special education or related services. This “child find” obligation extends to children who may be advancing from grade to grade.
It is important for parents to know that school districts and parents often view children’s progress through a very different lens. Districts, in general, may tend to underestimate student needs, as districts face counter-pressure to not over-classify students due often to economic considerations.
A strong psycho-educational evaluation for a student is critical. Instead of relying on school district evaluations, some parents with the means to do so may obtain private evaluations and present them to the school district. Or, if you disagree with a school district evaluation and provide appropriate notice and a request, a public school district must, subject to certain limitations, provide an independent educational evaluation at public expense.
As we continue to explore the changes to the DSM, we’ll unpack the various eligibilities, the changes in the new TR, and what to look out for when requesting / monitoring services.
— December 16, 2023 Note —
Some of the materials herein have made it into my book, No Place for Autism? It was released in February 2023 from Lived Places Publishing and is available at Amazon and other major book retailers worldwide.