Exploring Clinical and Assessment Challenges

1. Exploring Clinical and Assessment Challenges Collaboration and Communication for School and Private Practice Psychologists on Evaluations

2. Why are we here? • Our information and knowledge we share is not always as helpful as we might wish • We often give parents incorrect or incomplete information or are not allowed to give it at all • We work often in parallel processes instead of collectively informing student/client needs • We serve clients/children best by understanding the roles and requirements we each have

3. Concepts and Definitions • differences between learning disorder and disability • gifted standards • how to manage children who do not qualify for or meet special education criteria; • clarifying IEP and 504 plan process and standards • strengths and weakness model of assessment and how that could impact decision making for diagnosis/ spec education labeling

4. Common frustrations • Different definitions • Different Agendas • Disorder versus disability • Where information comes from and what is missing

5. Private Practice Model • Referral from doctor, tutor, school or parent • Initial diagnostic evaluation • Psychological testing • Collection of collateral data • Identification of disorder or lack thereof • Referral for therapy, medication, tutoring, and/or consideration of accommodations/disability determination

6. Common Diagnoses • Differential diagnosis focus • Specific learning disorder – Difficulties in learning for six months or more in specific subject areas • Substantially and quantifiably below age; cause significant interference with school, work, or daily living as identified by standardized measures and clinical evaluation • Began during school even if they manifest later • Not better explained by other factors • ADHD • Emotional disorders (anxiety, depression, trauma)

7. Private Practice Niche • Get to see the parents interact with children • Have flexibility on extent and duration of testing • Can experience clients outside the school setting • Private environment that can limit stigma compared to being pulled from class • Not beholden to bureaucratic process

8. School Model • SLD History • MTSS vs Severe discrepancy • Disability determination process • Special education process understanding • Additional requirements • Conclusions • Gifted status

9. School Psychologist Niche • Comprehensive education material • View student/child in most common/frequent social environment • Natural environment view of child behaviors • Longitudinal data

10. SLD History • largest disability category • how MTSS came about B/C of a history of over-identifying LD • two required components in the state evaluation format

11. MTSS vs. Severe Discrepancy • Multi-Tiered Systems of Support - a framework for an intervention-based approach to a student’s presenting concern before moving to full evaluation; previously called Response to Instruction (RTI) but has become a more developed, standard model • Typically, a 3-tiered model for most schools • Interventions, over time, with repeated progress monitoring to gauge progress • If using MTSS as means to identify Specific Learning Disability, the school/district must first be approved by PA Dept. of Education

12. Designing Schoolwide systems

13. Severe Discrepancy • A statistically significant discrepancy exists between a student’s intellectual level and achievement level in any given area(s): • oral expression • listening comprehension • written expression • basic reading • reading fluency • reading comprehension • mathematics calculation • mathematics problem-solving

14. DETERMINATION OF SPECIFIC LEARNING DISABILITY • NOTE: This component must be completed when determining eligibility for Specific Learning Disability. The information must be attached to and/or incorporated into Sections 5 and 6 of the completed Evaluation Report. • Provide documentation for items 1-10.

15. Determination continued • The student does not achieve adequately for the student's age or does not meet State-approved grade-level standards in one or more of the following areas when provided with learning experiences and scientifically based instruction appropriate for the student's age or State approved grade level standards and level of English language proficiency: oral expression, listening comprehension, written expression, basic reading skill, reading fluency skills, reading comprehension, mathematics calculation, and mathematics problem-solving.

16. Determination continued • Check below to identify the process(es) used to determine eligibility. • Response to Scientific Research-Based Intervention (RtI). Document the criteria below. • The student does not make sufficient progress to meet age or State-approved grade-level standards in one or more of these areas: oral expression, listening comprehension, written expression, basic reading skill, reading fluency skills, reading comprehension, mathematics calculation, and mathematics problem-solving: •  Severe Discrepancy between Intellectual Ability and Achievement. Document the criteria below. • The student exhibits a pattern of strengths and weaknesses in performance, achievement or both relative to age, standards or intellectual development:

17. Determination continued • The instructional strategies used and the student-centered data collected: • The educationally relevant medical findings, if any: • The effects of the student's environment, culture, or economic background: • Data demonstrating that prior to referral or as part of the referral process for a specific learning disability, the student's regular education instruction was delivered by qualified personnel, including the English as a Second Language (ESL) program, if applicable: • Data based documentation of repeated assessments of achievement at reasonable intervals, reflecting progress during instruction, which was provided to the parents:

18. Determination continued • An observation in the student's learning environment (including the regular classroom setting) to document the student's academic performance and behavior in the areas of difficulty. Note the relationship of that behavior to the student's academic functioning: • Other data, if needed, as determined by the evaluation team: •   Include a statement for each item below to support the conclusions of the evaluation team that the findings are not primarily a result of • Visual, hearing, motor disability: • Intellectual Disability:

19. Special Education Understanding • Prong 1 vs. Prong 2 requirements of Ch. 14 • Prong 1 is the presence of a disability • Prong 2 is the demonstrated need for Specially Designed Instruction (SDI) • Examples of a physician Rx for special education • School information that may not have been shared or made known to an outside evaluator • Review of grades, historical grades, attendance, nurse or counselor office visits

20. Conclusions • CONCLUSIONS – Determination of Eligibility and Educational Needs • Complete A or B or C. • A. The student does not have a disability and therefore is NOT ELIGIBLE for special education. OR • B. The student has a disability but does not need specially designed instruction, and therefore is NOT ELIGIBLE for special education. • OR • C. The student has a disability AND is in need of specially designed instruction, and therefore IS ELIGIBLE for special education. • 1. Disability Category • Primary disability category: • Secondary disability category(s), if any:

21. Additional Required Components of an Evaluation Report • big issue with ESL kids who are struggling, and parents or teachers want them identified as having a disability • DETERMINING FACTORS – A student must not be found to be eligible for special education and related services if the determining factor for the student’s disability is any of those listed below. Respond Yes or No to, and provide evidence for, each determining factor re appropriate instruction and English proficiency

22. Gifted • Ch 16 governs the implementation of gifted education regulations in PA. • Not mandated in federal law, only in PA law • Also has Prong 1 vs. Prong 2 requirement, Prong 2 being Specially Designed Instruction

23. Gifted Conclusions • Conclusions and recommendations for specially designed instruction to Gifted • Individualized Education Program (GIEP) team • not gifted and therefore is NOT ELIGIBLE for gifted placement and programming • The student is gifted but does not need specially designed instruction, and therefore is NOT ELIGIBLE for gifted placement and programming • The student is gifted AND is in need of specially designed instruction, and therefore IS ELIGIBLE for gifted placement and programming

24. Gifted Requirements • IQ of 130 or above • Ability and achievement test scores • Rates of acquisition and retention • Achievement, performance, expertise in one or more academic areas as evidenced by excellence of products, portfolio or research, as well as criterion-referenced team judgment • Learning strengths including specialized skills, interests and aptitudes relevant to the student’s suspected giftedness- • Higher level thinking skills • Academic creativity • Leadership skills • Intense academic interest • Communication skills • Foreign language aptitude • Technology expertise

25. Gifted programs • Typical delivery of gifted programming includes: • Pull out programs to a resource room one a week or once every six days • Academic competitions • Field trips • Curriculum compacting • Cluster grouping • Independent study • Grade/subject acceleration • Tiered assignment • Honor level classes • AP classes • CHS classes • Enrichment

26. Small group case reviews • Break into groups of four to six and review a specific case • Present the case • Identify potential diagnosis, whether you believe it meets disorder, disability status • Thoughts, questions, gaps in data

27. Common Private Practice Evaluation • Extended clinical interview with parents & child • Self and parent report inventories • Tests that screen basic skills & functioning • Complete IQ test • Multiple achievement tests • Tests of symptoms/personality; executive functioning; vocational; auditory/visual processing tasks • Brief collateral data from referring clinician

28. Common School based evaluation • Parent and Teacher evaluation forms • Grades and standardized tests • Classroom observation • IQ whole or basic as applicable • Achievement test, whole or basis as applicable • Self evaluation inventories as applicable • Social/emotional/behavioral assessment

29. The twice exceptional child • Superior to gifted cognitive abilities • Wide gaps • Between abilities and achievement • Between areas of ability • Between standardized testing and grades • Between abilities, achievement or grades versus emotional experience • Not applicable to most services

30. Private Practice Pet Peeves • Parent and teacher rating scales are used as clinical inventory rather than extended interview/collateral data • Partially completed tests • Lack of behavioral explanation of test performance • No differential diagnosis process • Accommodations versus adaptation

31. School Psychologist Pet Peeves • Accuracy of parent reporting for school performance • Refusing a Release of Information • Offering a special education diagnosis rather than considerations for a school team to use

32. What does it mean to be…. • What does it mean to be: • Gifted • Learning disabled • Emotionally disabled • How do we help these children? • Special education • Gifted education • Advanced academic models

33. Discussion suggestions • Rx from physician saying student has ADHD • Rx saying a student needs special ed • A student with ADHD or depression that is well managed, is achieving and doing well – no need for SDI. • Parent requesting eval for SAT accommodations when the student is in 10th or 11th grade and has had a successful education career thus far. • An IQ of 130 but school can meet needs • ESL students who struggle but don’t have a disability

34. Advanced Academic Programs • But what if those program options were not held in reserve for gifted students but were available to all, as needed?  • You would not need to “qualify” in order to access such options • “The concept of giftedness is not necessary for, and in fact, acts as a barrier to the education of advanced learners in K-12 schools.” Beyond Gifted Education: Designing and Implementing Advanced Academic Programs; Betsey McCoach, Matthew McBee, Michael D. Matthews, Scott J. Peters, 2013.

35. Collaboration model • how private practice and school psychologists can work more effectively together • Audience participation

36. Common misperceptions • 504 versus IEP