Tag Archive for 'Treatment'

Function-based interventions for LD?

Most readers are likely familiar with the idea that one can, by carefully assessing the antecedents and consequences of a problem behavior, essentially determine what is causing that problem behavior to occur. Given that at least some—many?—students with Learning Disabilities (LD) have some problem-some behaviors, wouldn’t it be cool if there was an evidence base about using functional analysis techniques to document development of procedures for addressing the problem behaviors of students with LD?

In “A Systematic Review of Function-Based Interventions for Students with Learning Disabilities,” Professor John McKenna and his colleagues examined the research literature in search of that very evidence base. They were able to locate only a few studies that met the most rigorous standards, but those studies allowed them to conclude that this idea is a promising one. Here’s the source and the abstract with a hot DOI. I think the publisher (Wiley) may be allowing public access to the entire article, so try clicking on the PDF to download it. (I can’t tell, ’cause I’m working from my office, which has free access anyway; drop a comment to let me know.)

McKenna, J. W., Flower, A., Kim, M. K., Ciullo, S., & Haring, C. (2015). A systematic review of function-based interventions for students with learning disabilities. Learning Disabilities Research & Practice, 30, 15-28. DOI:10.1111/ldrp.12049

Students with learning disabilities (LD) experience pervasive academic deficits requiring extensive academic intervention; however, they may also engage in problem behaviors that adversely affect teaching and learning, thus lessening the potential impact of specialized instruction and supports. The learning deficits of students with LD are prevalent in the extant research, but behavioral needs appear to receive less attention. The authors report the results of a systematic review investigating the evidence-base for function-based interventions for students with LD using the What Works Clearinghouse (WWC) criteria for evaluating single-case studies. Fourteen studies with 17 participants met inclusion criteria, with the majority occurring in elementary settings. Although interventions tended to be effective, few included maintenance and generalization measures. Because of the small number of studies (n = 4) that met WWC design and effectiveness standards, the authors conclude that function-based interventions, although promising, cannot currently be considered an evidence-based practice for students with LD. Implications for practice, areas for future research, and study limitations are reported.

Ross Greene to speak in central Virginia

Over on EBD Blog, I have a post about a pending October-2013 talk by child psychologist Ross Greene, author of The Explosive Child and Lost at School. The talk is scheduled for 10 October 2013 at Piedmont Virginia Community College in Charlottesville (VA, US) and is free and open to the public. Read the post for details.

Is RTI reducing identification of LD?

According to Jennifer Radcliffe’s story for the Houston (TX) Chronicle, “Experts can’t explain drop in state’s special education numbers,” students with disabilities—and, especially, students with Learning Disabilities—

… seem to be disappearing in Texas.

The Lone Star State diagnosed just 8.8 percent of its public school students as having special needs in 2011, down from 12 percent in 2000. Texas now has the lowest percentage of special education students in the nation – a full 4 percentage points below the U.S. average. Urban giants like the Houston and Dallas school districts identify even fewer children at 7.9 percent and 7.7 percent, respectively.

Ms. Radcliffe describes Texas as an atypical state in the distribution of states on the basis of percentages of students identified as having disabilities. And she explains that people do not have adequate explanations for the observed declines. She asks experts for explanations. Under the heading “National rates steady,” she focuses on Learning Disabilities.

The largest category in special education is children with a “specific learning disability.” In Texas, that category peaked in 1999 at 266,934 children, but fell to 172,148 by 2011, according to Texas Education Agency data. Nationally, the percentage of 3- to 21-year-old students with learning disabilities dropped from 6.1 percent in 2000 to 4.9 percent in 2010, according to the latest federal data.

Overall, national special education rates remained steady at 13 percent in that same span.

That data has [sic] prompted different interpretations.

“It’s very encouraging,” said Jack Fletcher, a University of Houston professor who heads the Texas Center for Learning Disabilities. “I don’t think people fully understand why, but it does seem to coincide with the state and federal initiatives for beginning reading instruction.”

Teachers are putting forth a greater effort to provide all young children with solid reading instruction and intense intervention, preventing the need for many to be referred to special education, Fletcher said.

Later in her coverage, Ms. Radcliffe interviews Gene Lenz, director of federal and state education policy for the Texas Education Agency, who refers to response to intervention (or instruction; RTI) as a way of avoiding “over-diagnosing” students. She quotes Mr. Lenz as saying, “Districts are taking care to make sure [every effort is made to refer students only after they fail to respond to intervention is] 100 percent true before they place a label on a child.”

These and similar discussions about the relationships between RTI and identification of students as having LD got me to thinking about the topic anew. Of course, alert readers recognize that the topic’s been on the front element a few times in the past (e.g., Does RtI reduce numbers of children in special education? 25 Feb 2010). There are at least a couple of ways to look at these discussions about the relationships between RTI and identification rates.

(1) One might start by looking at RTI as an independent variable. If (musing) RTI were a faithfully implemented approach to managing instructional programming (good screening, powerfully tiers of instruction, careful monitoring, flexible regrouping, strong administrative support, and so forth), what outcomes would one reasonably expect it to affect? Let’s make a list (and here I invite readers to expand my tentative list):

  1. Higher achievement, especially at the lower tail of the distribution;
  2. Fewer disciplinary referrals;
  3. Fewer absences;
  4. Fewer tardies;
  5. Higher self-concept outcomes;
  6. Fewer referrals for special ed;
  7. Fewer placements in special ed;
  8. [your dependent variable goes here…].

(2) Alternatively, if one had reduced identification rates, one would have to examine myriad possible causes for that reduction. Why might the percentage of students with, let’s say, SLD, have declined? Let’s make a list (and here, again, I invite readers to expand my tentative list):

  1. Teachers, those imperfect tests, have gotten the message that referring kids is bad;
  2. Musical diagnoses: Percentage of kids with autism (Shattuck, 2006) or ADHD has increased;
  3. RTI has been effective;
  4. Political systems have changed, leading to new biases (Wiley & Siperstein, 2011);
  5. The measurement systems themselves have changed;
  6. [your independent variable goes here…].

So, rather than looking at the situation with the preconception that RTI leads to reduced identification (i.e., RTI ==> lower SLD identification), I’m thinking we ought to be reflective about this issue. In one case, as illustrated in the first image, one is essentially looking at the matter from point of view of the independent variable, sort of looking forward in time. In the other case, one is looking from the effect, looking backward in time (see the second image).

I’d like to see the effects of RTI on these other dependent variables. Some clever data analysts ought to be able to conduct a quasi-regression discontinuity design on a grand scale to assess the effects of RTI in Florida, Texas, or elsewhere, no? Wouldn’t some of these outcomes be just as (or even more likely) to show the benefits of RTI than special education identification, which identifications are made by committees and other hard-to-model factors?

And, I’d like to see some stellar statistical models of variations in identification. In addition, to what extent is what’s being seen in prevalence today different from what was seen when Hallahan and colleagues reported about variation in rates of identification some years ago. Are the differences within the same ranges? Could any changes be essentially normal variation?

References

Shattuck, P. T. (2006). The contribution of diagnostic substitution to the growing administrative prevalence of autism in US special education. Pediatrics, 117, 1028-1037 doi: 10.1542/peds.2005-1516.

Wiley, A., & Siperstein, G. (2011). Seeing red, feeling blue: The impact of state political leaning on state identification rates for emotional disturbance. Behavioral Disorders, 36, 195-207.

Block those bullies

httpv://www.youtube.com/watch?v=WQp8N7P8zsU&hl
Language Warning!
Do not click play if the words n- – – – or
f- – – – offend you.

As the beginning of school approaches, many schools will be considering what to do about bullying, a problem the plagues many students with Learning Disabilities (LD). But, what do we know about the connections between special ed and bullying? Can bullying mess up a student’s IEP? Here’s a little background and some suggested resources.

As one might suspect, one of the difficulties for students with LD is that they are perceived as victims of bullies. Nabuzoka and Smith’s (1993) analysis of sociometric data from ~180 pre-adolescent students, about 20% of whom had LD, showed that those with LD were more likely to be victims of bullying than their non-disabled peers, despite not being judged more aggressive. Estell et al. (2009) reported that teachers considered fifth-grade students with high-incidence disabilities likely to be victims of bullies. However, both teachers and the students’ peers rated them to as likely to be bullies. Those students with disabilities who behaved aggressively were the ones who were more likely to be nominated as bullies.
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Subtyping LD

Have you been hearing a lot about subtypes of LD lately? Perhaps it’s just that I’ve been especially alert to it, but it seems I’ve heard a lot of mentions about subtypes of Learning Disabilities in the last few weeks. I want to write a longer, more thorough discussion of the topic, but I’ve found myself repeating a few foundational comments, so I thought I ought to post them here and let others have a go at them.

First, the idea of subtypes of LD is essentially a given. It has to do with the heterogeneity of LD. Because LD is essentially an umbrella category for a diverse array of learning disabilities (note the plural), there are bound to be subgroups. Some students will have problems primarily with reading, some primarily with arithmetic and mathematics, some with writing, others with combinations of these. That makes for lots of subgroups right there. That is, one could start with dyslexia, dyscalculia, and dysgraphia!
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What about including students with LD?

I’ve seen a couple of messages recently in which inclusion or mainstreaming has been lamented. One of them appeared on Bignity, the new group blog devoted to students with disabilities. In it Jaime Openden talks about the importance of having all teachers prepared to work with students with disabilities and her misgivings about mainstreaming.

For better or worse, mainstreaming is the direction our educational system has been heading in for years. Mainstreaming to me is like communism or a giant hot fudge sundae with the works. Sounds pretty sweet in theory; in practice, not so much.

The second appeared in correspondence on the mailing list associated with Association for Direct Instruction. These are the DI folks, people who are, with some justification, pretty well convinced that they know how to teach students with learning problems successfully, to help them succeed. It’s a bit longer and covers a lot more concerns.

I am still teaching in xxxx county and special education is a mess….in fact teaching in FL is not fun at all anymore. The state and county have gone test crazy. I have not been able to implement Reading Mastery correctly with all its components for several years now. We have to leave our ESE kids in the classroom for instruction and we are supposed to co-teach in the reg ed room. Often our kids sit there with dazed expressions on their faces. They do not pass the state’s FCAT reading test. They cannot spell. They have difficulty writing a complete sentence with correct grammar, punctuation, capitalization and spelling. But conventions don’t matter on FCAT writing, Next year we planned to put about 12 of our severely learning disabled, ASD, and IND (Intellectually disabled….formerly educably mentally handicapped….formerly mentally retarded….it’s the same thing…..I think they change the name so lay people won’t know what it means) 3rd, 4th & 5th graders who are reading at a beginning first grade level back into a self contained ESE classroom which I volunteered to teach. I was so excited because I really do love to teach….but then the bigwigs in the ESE department said they all have to be in regular homerooms because they learn so much from being in reg ed and the “research shows that they don’t learn as much in a self contained ESE room because the curriculum is not rigorous enough”. What research are they talking about? I just would like the time I need to teach these kids to read and to understand a little math….they can’t add or subtract……they didn’t have one-to-one correspondence by the third and fourth grades!! Being in reg ed homerooms means that I will have to deal with the schedules of six or more teachers to try to find the time to teach…..and I won’t get to teach them science and social studies at their reading levels.

Lots of people interested in LD are full-speed-ahead advocates for having students with LD included full time. Others have reservations, arguing that students with LD need specialized instruction delivered in classroom environments that are not available in the mainstream.

What about you? What are your thoughts? What are the pros and cons in your experience?

Testing fraud of a different sort

In a puzzling case of a student who appears to have had problems throughout the primary grades and did not get help until fourth grade, Liz Ditz asks the question, How Often Does This Happen? Teacher accused of testing fraud to avoid special education referral for her student. Not until the parents had pushed for years were the child’s problems recognized. Was this a well-meaning, but misguided teacher? Has anti-LD sentiment become so strong that folks cheat to keep kids from having the label?

Reading comprehension help for ADHD high schoolers

In “Improving the Reading Recall of High School Students With ADHD,” Joseph W. Johnson, Robert Reid, and Linda H. Mason report the results of an intensive study in which they examined the effects of teaching high-school students a comprehension strategy as a part of a self-regulated strategy development model. They found that systematically preparing the students to use what they dubbed the “Think Before Reading” (TWA) strategy helped the students with recall of passages’ main ideas and details connected to them.

Students with attention-deficit/hyperactivity disorder (ADHD) often have difficulty with reading comprehension. This multiple baseline across participants design with multiple probes study examined the effectiveness of a multicomponent reading comprehension strategy (TWA: Think Before Reading, Think While Reading, Think After Reading) taught following the self-regulated strategy development model on social studies expository text recall of three high school students with ADHD. Results showed improvement in the number of main ideas and percentage of supporting details recalled. Gains were maintained and some improvement occurred at 2- and 4-week follow-ups. Implications for future research and practice are discussed.

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LearningRx in the popular press

Sandy Hausman, Charlottesville (VA, US) reporter for WVTF (one of the local public radio stations available in my listening area), carried a story about LearningRx and Learning Disabilities this morning. Unlike the credible coverage provided by many reporters for popular-but-unproven therapies for LD and other disorders, Ms. Hausman provided a sensible and balanced story about LearningRx. Here’s the blurb from WVTF’s Web site

Americans spend millions of dollars keeping our bodies in shape. Now a Charlottesville man is offering a workout for the brain. His center–part of a nationwide franchise–promises to help children and adults improve their concentration, memory, reasoning, and other mental skills. Sandy Hausman has the story.

Unlike many reporters who too-often fall for pop-psych and pop-ed theories (as regularly noted in other posts here on LD Blog), Ms. Hausman gets many facts right (e.g., prevalence of LD), phrases her report carefully (describes LearningRx reports as “internal studies”), includes appropriate caveats along with personal-interest angles, and even incorporates alternative explanations from the experts she interviews.

This is an example of journalism done better. Listen to an MP3 of Ms. Hausman’s report and explore WVTF.org.

A success story

In “From illiterate to role model” Carla Rivera provides one of those examples worth passing along to others. Ms. Rivera, who reports for the Los Angeles Times, described the case of John Zickefoose, a man who at 30 years of age was not able to read to his own children, read their report cards, read prescription labels, or to order from a menu. As a boy he was diagnosed as having dyslexia but, after adult literacy studies, he participates in book clubs, writes his own speeches, and is an advocate for his local library.

Now, as Ms. Rivera reported, Mr. Zickefoose will serve as a member of his local school board.
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