Assignment 4 Psychology 486 / 686
Chapter 24: Developmental Disorders
Diagnosing Learning Disorders
While learning disorders can be debilitating for affected individuals, their
diagnosis is not always easy. Read about diagnosing learning disorders in
reading 1. Next, read how a program for identifying learning disabilities went
awry in reading 2. After you have read the articles, do your own literature search
to find additional information on diagnosing learning disabilities. Finally, write a
two-page paper that expresses your opinions on diagnosing learning disabilities.
Make sure you address the following questions. Given that early intervention is a
factor in success rates of learning disabled children, at what point should we start
testing for learning disabilities? Do you think that learning disabilities are being
over diagnosed? You should support your opinions with evidence from the
readings and at least two additional sources.
Reading 1:
Website: http://www.apa.org/monitor/oct04/learningdisabil.html
Monitor on Psychology
Volume 35, No. 9 October 2004
Debating learning-disability identification
Do quantitative tests used to determine learning disabilities leads to the
best outcomes for students?
BY KAREN KERSTING
Monitor Staff
Print version: page 54
Experts in detecting children's learning disabilities remain in two camps: One asserts
IQ tests are a critical tool in diagnosing children who need special attention, while
another faction asserts that the "response to intervention" (RTI) model holds more
promise. Speakers discussed the merits and pitfalls of both approaches at the 11th
Annual Institute for Psychology in the Schools, a pre-meeting workshop at APA's
2004 Annual Convention.
Diagnosing learning-disabled children is a complicated process, explained
psychologist Randy Kamphaus, PhD, of the University of Georgia. That's because
learning-disabled children often show normal or above average intelligence on IQ
tests, but fail to achieve academically. To pinpoint this difference, schools have
traditionally tested children and measured the discordance between their IQ and
their achievement, he said. But this protocol can be problematic for schools when
children with very high IQs but mid-level achievement receive learning-disability
services while other lower intelligence, lower achievement children go untreated.
That tension has led to the emergence of the RTI assessment model, which, instead
of measuring intelligence and achievement in numbers, identifies children who are
failing to succeed, gives them remedial assistance, attends to its effect and then
determines if further services are merited, Kamphaus said. But, he noted, the
technique lacks empirical support and doesn't detect all the children who need
services. RTI has also been shown to inappropriately identify children with mental
retardation or emotional problems as learning disabled. Moreover, it fails, he said, to
provide researchers a base with which to improve testing.
"While we can try to develop intelligence testing without numbers, it won't work," he
said. "The intelligence test is our stethoscope, like it or not."
Kamphaus advocated for limiting the number of students a school can deem learning
disabled and eligible for services. That, he believes, would force more accurate
diagnosis of the causes of a child's academic failure: Schools would have an incentive
to determine if learning problems were caused by other factors, like emotional
issues, because those alternate diagnoses could open more spots for truly learningdisabled children.
"Caps will encourage schools to think more critically of who merits a diagnosis of
learning disabled," Kamphaus said.
Alternatively, psychologist Linda Siegel, PhD, of the University of British Columbia,
argued for the RTI model's superiority to IQ testing. Her research on a classroom
screening model similar to RTI indicates that most elementary school children who
have academic trouble in an initial screening catch up with peers when offered a
small amount of classroom assistance. Those who don't improve, she finds, are then
easily identified and offered a range of assessments and interventions, which
subsequently rule out mental retardation and emotional problems. As such, schools
don't need to resort to mass quantitative testing, she said.
"The philosophy gets away from the screening model and focuses on outcomes,"
Siegel explained. "We find the kids who need our help this way. I have yet to be
convinced that there is some need for the IQ test [when diagnosing learning
disabilities]."
Reading 2:
Website: http://www.nytimes.com/1994/04/08/nyregion/a-disabilities-programthat-got-out-of-hand.html?sec=&spon=&pagewanted=1
The New York Times
April 8, 1994
A Disabilities Program That 'Got Out of Hand'
By MICHAEL WINERIP
Emily Fisher Landau, a member of a wealthy New York City real estate family, had long
wanted to create a model educational program for bright youngsters with learning
disabilities. Mrs. Landau herself experienced trouble reading as a girl, and it wasn't until
she was 56 years old that she was diagnosed as dyslexic. So a decade ago she chose the
Dalton School in Manhattan, one of the pre-eminent private schools in America, to create
a Fisher Landau learning disability program.
She donated more than $2 million. Over several years it paid for 14 full- and part-time
learning specialists in Dalton's kindergarten-to-third-grade school, a big remedial staff for
a primary school with 20 head teachers and 400 children. She financed research to
develop a screening test that would identify learning disabilities at an early age. And Mrs.
Landau gave hundreds of thousands of dollars to Columbia University Teachers College
and New York University to evaluate the program and publish scholarly papers, with
hopes that the model would be widely replicated.
The outcome of this grand experiment is a cautionary tale about special education. In the
last two decades, the learning disabilities field has boomed at both public and private
schools, spawning an industry of highly paid specialists who treat loosely defined reading
and language problems that no one knows very much about -- and that in some cases may
not need treatment. Today, virtually everyone at Dalton, including Gardner P. Dunnan,
the headmaster, agrees, "things got out of hand."
Dalton's new team of remedial specialists suddenly began finding enormous numbers of
bright little children with learning problems. In one three-year period, 77 of 215 Dalton
5-year-olds (36 percent) were labeled "at risk" during their second month of kindergarten
and given remedial help. That is far higher than the national rate for learning problems.
These were kindergartners with a mean I.Q. of 132, at a school that traditionally sends 40
percent of its seniors to Ivy League colleges. Parents who just a few months earlier had
been proud to have a 5-year-old accepted to Dalton and elated about the youngster's I.Q.
score were suddenly being told that a new Fisher Landau screening test indicated
"potential visual motor problems" or "sequencing ability deficits." A learning disability
industry grew at Dalton. Instead of being comforted by the school's remedial help, many
parents were unnerved and sought even more tutoring and therapy for their children after
school from private specialists at a rate of $75 to $200 an hour, said Dr. Gail Furman, the
former school psychologist.
By 1992, half of Dalton's students entering fourth grade had already received remedial
help. Several Dalton teachers describe their classrooms as being overrun by specialists.
One teacher, who had half her class diagnosed with learning problems, says she simply
gave up arguing with the specialists and used the Fisher Landau program for her entire
class. Other teachers battled back, refusing to let the specialists in their rooms. When
teachers gathered, they joked about how long it would be before the entire primary school
was diagnosed with learning disabilities. Jeannie Wang, a former Dalton kindergarten
teacher, said: "If you dig hard enough in any kid, you'll find a problem. If you want to
have something to write down, you'll find something to write down."
Then, in fall 1992, it abruptly ended. The kindergarten teachers revolted and refused to
use the screening test, saying too many children were being given harmful and unreliable
labels. Naomi Hill, the new primary school principal with a different educational
philosophy, dismantled much of the Fisher Landau program. Instantly, learning
disabilities at Dalton plummeted. This year, half a dozen kindergartners are getting extra
help from specialists; about 15 percent in first through third grades receive help. That
such a major shift could occur twice in one place in a decade is a stunning commentary
on how subjective the identification of learning disabilities can be and how little is known
about them.
Did It Help?
Despite the hundreds of thousands of dollars Mrs. Landau paid the universities, no one
today can say with objective certainty whether the remedial program actually helped
Dalton students. "We can't answer that question," said Steven Peverly, one of three
Columbia researchers who worked four years on the project. "In the field of education
there's this problem with research. People don't think about setting up controls. It's not
like science." Even the headmaster, Dr. Dunnan, who continues to call the program "a
large success," acknowledges it "was not a carefully controlled bit of research," adding "it
makes the legitimacy of what we did in the research world more suspect."
Definitions Data Are Unclear, Estimates Vary
Nationwide, estimates of the number of children with learning disabilities vary between 7
and 15 percent, with enormous differences from district to district, depending on the
specialists, a district's wealth, local politics and the fashionability of learning disabilities
at the moment. In Montgomery County, Maryland's richest school district, about half the
children in special education are classified with learning disabilities; in Baltimore, the
state's poorest district, less than 20 percent are. Robert Slavin, a Johns Hopkins
researcher, says in many wealthy districts a learning disability has become a socially
acceptable way for a parent to get extra help for a child. "Whether the child actually has a
learning disability or is a low achiever or slow to mature is a very fuzzy issue," he says.
Because the scientific knowledge is limited and definitions fuzzy, he says, "If there are
30 spots for learning disabilities, you will magically have 30 learning disability students.
If there are 60, you'll have 60."
Dyslexia Often Mentioned
While the learning disability most often mentioned is dyslexia -- the brain's processing of
letters and symbols backward -- dyslexia accounts for a tiny portion of learning problems.
More common is the child who will score high on abstract reasoning tests and low on fine
motor or organizational skills like difficulty repeating a pattern or sequence. Basically,
the child appears intelligent but has trouble picking up the mechanics of reading or
writing. The "why" is the great unknown. Sometimes it is just different maturity rates.
Most children are not ready to walk at 9 months, and most children are not ready to read
at 5 years. It may be minor emotional troubles or uneven intellectual ability, problems
that can usually be handled by classroom teachers. In a small percentage, the brain's
processing mechanism is off kilter, and intensive support from a learning disability
specialist is necessary, perhaps for years. With so many variables, efforts to screen young
children for learning problems haven't been very useful, Professor Slavin said. "If you
test kindergarten kids, invariably you'll make many, many mistakes."
The Benefactor Offering the Help She Never Got
It never occurred to Emily Fisher Landau that there could be a time when too many
learning disabilities would be diagnosed too soon. She was educated in pre-World War II
America, when virtually no one recognized such problems. "I wasn't reading in fourth
grade and no one picked it up," she says. "I got through high school by faking it all the
way." Mrs. Landau's wealth shielded her. She married at 19, became an art collector and
serves on the boards of the Whitney Museum and the Metropolitan Opera. But after
dyslexia was diagnosed in her 50's and she learned to read better, she says she felt an
obligation to aid children like herself. At the time, learning disability programs were
shifting into high gear in public schools, to the point that today 22 cents of every dollar
spent by New York City schools goes to special education. Learning disability is the most
common diagnosis among special education students in the city's public schools.
While Mrs. Landau gave money to a few private schools, she gave most of it to Dalton,
"because if the best schools could be open about having bright children with learning
problems, other schools would be more apt to follow. It was like coming out of the
closet."
The Rich and Influential
Situated on the Upper East Side of Manhattan, Dalton serves many of New York's richest
and most influential families. About 600 children apply for 95 kindergarten places.
Among those who've had children at the school are Ruth Bader Ginsburg, Dustin
Hoffman, Yoko Ono, Diana Ross, Isaac Stern, Robert Redford and Tom Brokaw. In
1984, Mrs. Landau's money was used to create the screening test. One developer, Francee
Sugar, says it was intended to be a "very gentle" assessment, and in the early period was
administered by a few specialists who came to know the children well. The kindergarten
teachers used the results to aid their classroom observations. These learning specialists
trained teachers to help the children. In retrospect, Ms. Sugar says, after the first three
years, the teachers were prepared to do most of the remedial work and the specialists
should have withdrawn from most of their classroom duties. But well-financed
bureaucracies do not wither. By the late 1980's, in addition to the 14 full- and part-time
learning specialists (earning up to $80,000) the program had a full-time director and
secretary at Dalton, its own Fisher Landau board and an outside executive director to
oversee finances. Because Mrs. Landau wanted to replicate the program, she hired
Columbia Teachers College.
That is when things got out of control. The screening test began to dominate, first the
Columbia research, then the remedial program, then the entire primary school. Those
involved offer many reasons for how the "very gentle" screening turned into what one
called "a total monster." It was the most concrete part of the remedial program, a series of
tests that could be administered in 39 minutes and was easily duplicable by other schools.
"When schools heard about our program," Ms. Sugar says, "the first thing they'd say,
'Can we have a copy of the screening?' " Developing a model screening was also a
convenient way for Dalton to show its gratitude to its benefactor. "This was to be the
Emily Fisher Landau Screening," says Dr. Furman. "It's like the Wechsler I.Q. test. Your
name's carried on."
Glory Days The Program In Action
It was all very intoxicating. Dalton's specialists flew to national conferences and touted
the program. Dalton received 50 visits a year from educators wanting to see the Fisher
Landau program in action. Mrs. Landau recalls going to an opera benefit and sitting
across from the wife of a famous musician, who said to her: "There really is an Emily
Fisher Landau? You're a celebrity! We know your name from Dalton."
To accommodate the researchers, the screening process grew more formalized. Every
October, the kindergartners were escorted from their classrooms to be tested by one of 17
examiners. Ms. Sugar suspects so many scores indicated deficits because of the way the
testing was done. "These little kids were taken down to the basement of the school four
floors below their class, usually with a stranger," she says. "There were kids who became
uneasy." She adds: "Some of the specialists met with the parents about the screening and
blew the importance of the results out of proportion. Parents and teachers were upset."
Ms. Sugar, who is still at the school, was asked why she didn't complain about the
changes in the screening process. She said these decisions were made by the Fisher
Landau director, Susan Etess. Ms. Etess says she didn't realize there was a problem
because no one on her staff complained. "Maybe I was naive," she said.
During the late 1980's Mary Kelly was one of three Columbia professors evaluating the
program. She was asked in a recent interview whether the 36 percent of kindergartners
being identified with learning problems reflected the actual situation. "These young kids
are not reliable test takers," she says. "A lot more kids got help because of the screening
than actually needed it. There weren't many with dramatic problems." Professor Kelly
adds, "The attitude was it didn't hurt to give them help even if they don't need it."
This attitude eventually split the primary school in half. Dr. Dunnan, Ms. Sugar, Ms.
Etess and Professor Kelly were among those who believed the remedial program being
offered was "benign," and worth giving to many who didn't need it, because this insured
that those who did need help would get help. The other view, expressed in interviews by
seven current and former teachers and administrators, is that providing reading and
writing drills to kindergartners who aren't ready to absorb them is a waste of time and can
damage a child's (and parents') confidence.
'I Thought I Had No Choice'
The control that the specialists achieved at the school amazed Jeannie Wang, a former
kindergarten teacher, who started at Dalton in 1991. "I had one of the learning specialists
in my class virtually every day," she said. "I thought I had no choice and this is what I
had to do. I was outnumbered." Though Ms. Wang believes kindergartners are too young
to be grouped by ability, the specialists divided her class of 19 into three groups based on
the screening. The lower third received tutoring for reading and writing. "Of course the
children knew what was going on," says Ms. Wang. "I think they felt bad they were in the
lowest reading group. The parents would say, 'Oh my gosh, my child has visual motor
problems?' "
Some students' self-esteem may have been affected, according to a recently completed
N.Y.U. study at Dalton. In the 92-93 fourth grade, the half that had participated in the
Fisher Landau program scored lower on tests measuring their self-esteem in reading and
spelling than fourth graders who had received no Fisher Landau help. Teachers reported a
lower opinion of the "scholastic competence" of Fisher Landau participants. Ms. Wang
believes most of her supposed "low" kidnergartners' problems would have disappeared as
they matured without the specialists' help. For many, the sign that the learning disability
specialists had taken control of the school came in 1991, when the principal left, and Ms.
Etess, the Fisher Landau director, also became acting primary school principal. "The tail
wagged the dog," Ms. Sugar said.
The Fall Losing Faith In the Program
Then, like some extraordinary tower built on a shaky foundation, it all came tumbling
down. Teachers are the foundation of any school, and too many simply did not believe in
what was going on. Ms. Sugar, Dr. Furman, Prof. Sharon Weinberg of New York
University and several teachers estimated that by the 1991-92 year, a majority of teachers
resented and distrusted the program. Typical was Ms. Wang, who says, "My goal was to
use the specialists only when absolutely necessary."
There was angry infighting between anti- and pro-Fisher Landau camps. Dr. Dunnan, the
headmaster, put it this way: "It got out of hand, which is when we began to think it's time
to dissemble the protective shell around the Fisher Landau program and let it continue as
a part of the school." The Fisher Landau director's position was eliminated. Its board has
not met in a year. A new principal, Naomi Hill, who had gained national recognition at
Public School 87 in Manhattan, was hired. Though Dr. Dunnan would not permit her to
speak with a reporter, many say she was stunned by the way the screening was being
used and became determined to return control to her teachers.
The Teachers Revolt
In fall 1992, the five kindergarten teachers said they no longer wanted to use the Fisher
Landau screening. Ms. Hill concurred. Today the specialists are deployed when requested
by the teachers: the program's original intent. Dr. Dunnan called the changes part of "a
very consistently planned evolution of the program." This is not a universal view. Says
Caryl Frankenberger, a member of the Fisher Landau board, "I don't care what Gardner
says, this program disintegrated."
Why was it allowed to get out of control? Dr. Furman, the former school psychologist,
believes the answer is money. First, she says, Mrs. Landau's generosity provided funding
way out of proportion to the need. Then, she says, the specialists had a strong financial
incentive to keep it going. Some worked with Dalton students on a private basis after
school for large fees, she says; others referred the students to colleagues with the
expectation that the favor would probably be returned some day. "If you're a psychologist
or specialist on the Dalton list, it can make a person's career," she says. "It's worth a lot of
money." The N.Y.U. study indicates of the 37 fourth graders who had received FisherLandau help by 1992-93, at least 11 also got outside private tutoring or therapy.
No Control Group
What can the research definitively say about the Fisher Landau program? Not much,
concede the Columbia and N.Y.U. professors. A control group was never established
within the school or with another school. Once the screening identified a possible
problem, the child received Fisher Landau help. There was no attempt to contrast the
long-term progress of students receiving Fisher Landau help with similarly diagnosed
children who got no help. Dr. Dunnan says it would not have been ethically possible to
identify some children at Dalton as needing help, and then not help them.
And while some researchers, like Professor Slavin of Johns Hopkins, have successfully
set up control groups by using comparable schools, this was not done by the Fisher
Landau researchers. So, while the recent N.Y.U. study indicates that Fisher Landau
students who lagged on standardized tests in the early grades had caught up with many of
their classmates by seventh grade, it's hard to say why. Maybe it was the Fisher Landau
tutoring. Maybe it was normal maturity. Maybe it was all the after-school tutoring.
"There are a lot of uncontrolled variables," says Professor Weinberg. "That's why these
caveats are listed in the study." Still, Dr. Dunnan embraced the N.Y.U. study, writing
Mrs. Landau in January that "we have known since its inception that the program was a
large success" and the N.Y.U. study "confirms our own thoughts."
This school year the kindergarten teachers again did not want to use the screening, but
Dr. Dunnan directed them to because the data was needed for research. The kindergarten
teachers administered the screening themselves and handed over the data, but did not use
the results for any classroom purpose. Dr. Dunnan says he is very pleased that the
screening is about to be published, although there are those who find it paradoxical that
as it is becoming available nationally, Dalton's kindergarten teachers want nothing to do
with it. "Ironic?" said Professor Weinberg of N.Y.U. "Yes. There's a great deal of irony.
No question about it."