RENEE BRADLEY
Welcome to the session on the classification approach. I'm Renee Bradley for the US Office Of Special Education Programs, and I'll be serving as your moderator for this session. During this session you will hear a 30 minute presentation by the author of the issue paper on this topic, followed by nine minute presentations from each of the paper respondents. There will be a 30 minute period for questions and answers at the end of this session. In order to provide ample time for the presentation, please reserve your questions until the end. This session is being video and audio taped for later broadcast. It is therefore imperative that we remain within the time limits assigned. In addition, if you would like to address a question to the presenter during the Q and A session, please use the microphone that will be circulated throughout the audience. Out first speaker today will be Dr. Jack Fletcher, who is a professor in The Department Of Pediatrics for the University Of Texas Houston Health Science Center, and Associate Director for the Center For Academic And Reading Skills. For the past 20 years, Dr. Fletcher, a child neuropsychologist, has completed research on many aspects of the development of reading, language and other cognitive skills in children. He has worked extensively on issues related to learning and attention problems, including definition, classification, neurobiological co-relates and most recently, intervention. Jack.
JACK FLETCHER
Thank you. Thank you. It's important to recognize that I'm not a pediatrician, I'm a psychologist, which is the first thing I'm gonna clarify. And I'm gonna do something that's a little bit unusual in a presentation like this, I'm going to tell you before hand what the take home message is not. There are three mistakes that people make, uh, when they hear these, uh, studies. What happened? I'm in a hurry. The first is, that it's very important to recognize that I work in schools, I evaluate children for learning disabilities, I go to interdisciplinary team meetings and I go to hearings, and I believe, uh, that identification is supposed to rely on more than test scores. I know that Idea says that. The problem is that it often doesn't. The second is that I believe that learning disabilities is real, but the current definition, the current classifications do not capture this reality. In particular, I believe that it is possible to question the approaches that we take to definition and classification without necessarily, uh, questioning the reality of LD. LD is real. I am not saying it's not by virtue towards the questions I'm going to raise today. And then finally I do not recommend that children be identified as LD based solely on low achievement, uh, definitions. In fact, I am skeptical that any single shot psychometric approach to definition will be effective or work for all children. Having said that, let's talk about classification. To understand the Federal definition of learning disabilities, we need to understand something about classification. Because the Federal definition itself is more than just a definition. It is a series of classification hypotheses. Now classification itself is an area of behavioral research. Classification is the process of forming groups from a large set of entities based on their similarities and dissimilarities. We take any of these that are heterogeneous and figure out ways to make them more homogeneous.
JACK FLETCHER
Classifications are always hypotheses, and they occur at the level of the independent variable. In classification research, we explicitly evaluate the basis for grouping. (WORD?) classifications can be differentiated according to variables not used to form the groups. In LD this could be things like the cognitive course of LD, response intervention or prognosis. But it's very important to understand that classifications are always evaluated by using things that aren't classification attributes. You are guaranteed assuring that a classification is valid if all you study is the process by which the group is formed. And then finally, classification is not identification. Identification is the process of assigning entities to an established classification. Identification procedures may be valid, even though the classification itself is not valid. How we define something may be valid, but the overall or over-arcing classification may not be. Here are the levels of classification for people with learning disabilities. We typically classify learning disabilities along several different dimensions. Learning disabled versus typically achieving, learning disabled versus mentally deficient, reading versus math disabled, IQ discrepant versus low achieving. Each level represents an implicit classification hypothesis that can be evaluated. And if you look at these four levels of classification and you simply ask a question, is LD real? Well, the two levels that you would look at are these. LD versus typically achieving, reading versus math disabled. And if you look at these, you get ample evidence that LD is a real disorder, part of a real classification. For example, here, all I've done is I've graphed performance by groups of children to find a typically achieving, reading disabled and math disabled. The only disorder they had no, (UNINTELLIGIBLE)
JACK FLETCHER
I've got cognitive skills down here like sustained attention procedural learning and concept formation, these are real important for math disabilities, philological awareness, real important for reading disability and then variables where the differentiation is not as clear like visual motor skills. And you can see that I can easily differentiate the two learning disabled groups on all these dimensions here, based solely on level of performance. I can also differentiate these groups here based on the quality, the shape, of these profiles. These are not the same shapes that you see here. And then I can also differentiate these two groups based on the shape of their profile. Look a the strength that this group has, the reading disabled group and procedural learning, the weakest of philological awareness. Uh, the weakness over here in procedural learning and concept formation in the math disability group. This is very strong evidence that indicates that learning disability classifications of this sort have discriminative validity and represent a viable classification. How well is this captured in the Federal definition of learning disabilities. Well, there are essentially three elements of classification in the Federal definition. The first is the discrepancy hypothesis, that IQ discrepancy represents an inclusionary criterion that differentiates children with learning disabilities from those who are IQ consistent children. Their achievement is poor, but it's consistent with their level of IQ. The second is the heterogeneity hypothesis, and simply formulated it's the hypothesis that there are seven different sub groups of lower, of, of academic deficits in the LD category. And the third is the exclusion hypothesis, which is that learning disabilities are different from achievement definitions that are due to mental deficiency, emotional disturbance, economic disadvantage, inadequate instruction.
JACK FLETCHER
Each of these elements is a hypothesis that can be evaluated in classification and research, and what I'm gonna do is review the evidence for these three hypotheses for you. First, IQ discrepancy. The discrepancy hypothesis. Now if you hear the history, you'll hear abut the Isle Of Wight, uh, studies. These are studies that were done, uh, on the Isle Of Wight in the UK by Rudder And Uell (SP?) and they were pretty exciting because they seem to support the idea that IQ discrepancy was a valid marker for a specific form of reading disability. Rudder And Uell studied all the kids that were on the Isle Of Wight, uh, it's a large number of kids. What they found was a bi-level distribution reading scores. So they were able to differentiate general backwards reading from what they call specific reading retardation. So that there was a hop in the bottom, in the bottom of the distribution with a long tail represented, representing general backwards reading. In other words the distribution was not normal, and there was a long hop, but the hop itself were backwards readers, IQ consistent children. they found differences between backwards readers and specific reading retardates in things like prevalence, uh, gender, neurological finds, reading and spelling characteristics and prognosis. Note, however, that they were not different. These two groups were not different in most speech and language characteristics. They had similar impairments in the language area. And then keep in mind that the Isle Of Wight is the Isle Of Wight. It maybe an epidemiological sample, but it's not necessarily a representative sample. And just to illustrate, 36 percent of children were general backwards readers had a known or suspected central nervous system disorder, and many were mentally deficient. There were no exclusionary criteria applied in the Isle Of Wight studies because the question that Rudder And Uell were asking is whether there is a syndrome of specific reading retardation that stands out against the backdrop of all other forms of reading retardation.
JACK FLETCHER
And they basically concluded that there was evidence, uh, for this. Well, this has been very controversial, uh, both in terms of the issue of the bi-mobile distribution, and the issue of whether there are differences in the co-relates. In terms of whether there's a hop, uh, in the distribution of, uh, reading scores, there are now six different, five different epidemiological studies, I'm sure, in here. There are also three others that I haven't listed because they weren't actually published. Uh, across different regions of the country, going back to 1983, different international studies, and virtually all of these studies failed to find evidence for bimodality in the distribution of reading skills. Uh, in fact, the study that was concluded in 1992 by the Schiowitzes (SP?) at Yale, concluded that reading ability occurs along a continuum that blends imperceptibly with normal reading ability. It's a lower portion of a continuum of reading capabilities. Now this is a very important finding, because it says in essence that reading is a dimension that is normally distributed in our population. It says that we only need one theory to explain how kids learn to read an why some fail, and most importantly it raises the problem of where do you define disability. At what point in this continuum do you demarcate it, in order to show that some people are reading disabled and some people are not, and the problem is that any psychometric approach to this, which I'm not going to show you today, but it's in our paper, is inherently unstable because once you set that cut point, there are all these border line cases that hover around it that are unstable that will be discrepant on one day, not another, uh, and so on. And that's a really big problem.
JACK FLETCHER
Well, Rudder said, that in essence, in 1989, well, there's no hop but the hypothesis is still viable. And the question is whether we can identify characteristics that differentiate backwards readers from reading retardates. Well, let's look at some of this evidence. Take (WORD?) cognitive skills, uh, for example. Are there cognitive differences between children who are IQ discrepant, and IQ consistent? Well, there are three meta-analyses now that address this. One of them is being presented here, uh, by Doug And Lynn Fuchs and their colleagues, and the research questions they ask is not really a classification hypothesis. It's, is the reading performance of under achieving children with and without the learning disabilities labeled the same, or different. The Fuchs code is 79 studies comparing children labeled as LD with children who presumably had low reading achievement but no label. They had no specific criteria for reading disabilities and low achievement. They relied primarily on the label which is entirely appropriate because with the research question, uh, here, and they did not, this is the one that I think is important, did not differentiate variables used to form the groups from those that served as dependent variables. They were mostly interested in reading. They compared reading scores, uh, in a meta-analysis of children defined as LD versus children not defined as LD who presumably met some definition of low achievement. And this is what they found. In meta-analysis, the (WORD?) between point two, uh, around, around, between minus point two and point two are considered small and negligible, not meaningful. Not meaningful differences between the groups, and then those that are larger are considered to be more meaningful. And what was reported is an effect size in the moderate range of point six one for reading, but look at here. (UNINTELLIGIBLE) awareness, rapid naming, not used to define the groups, most reliable co-relates for reading that we know, uh, philological awareness in the negligible lane, rapid naming is in the small range. A second meta-analysis published in the year 2000, the Journal Of School Psychologists by Hopkins And Lee Swanson. They quoted 19 studies with stringent IQ and achievement criteria, uh, and this is what they, uh, found. Uh, look at (WORD?) reading, takes out a negligible effect size of point oh two, pseudo-word reading, small effect size of point two nine, philological processing was small (WORD?) was negligible.
JACK FLETCHER
Notice how much smaller the effect sizes are in reading than those that were reported in Fuchs. And then our meta-analysis, uh, which is not published but is under review, where we quoted 46 studies I which groups could be clearly identified as discrepant or low-achieving, but separated variables usually define the groups from those used to evaluate differences between the groups. We tested IQ discrepancy as a classification hypothesis. Now this is a lot of data, but what it boils down to is right over here in charge of these descriptions. Uh, for example, in the behavioral domain, we found negligible effects by differentiating groups. The overall effect for achievement as negligible, but it was heterogeneous and in essence we find small effects for some skills, like pseudo word reading and real word reading, but negligible effects for things like reading comprehension and math. Why would two groups that differ so much in IQ not differ in math? It's an interesting question. Any cognitive ability, if you look at these core skills which Joe Torgesen will tell you later at this meeting, are most closely related to reading. We had negligible effects for all four. No evidence for difference. In other analyses, we found that the overall difference in cognitive ability was about three tenths of a standard deviation, uh, which means that there is substantial overlap of IQ discrepant and lower achievement groups and perhaps most importantly, found that effect size variation of 12 different studies can be predicted simply by knowing the IQ and achievement criteria used to define, uh, the groups. In other words, it's sampling variation. And this is what you're talking about. This is the same slide I showed you earlier. All I've done is I've taken the kids in that slide and divided them into IQ discrepant and low achievement, uh, groups, and you can see that these groups are not very, uh, different. These are not statistically significant differences, uh, for example. Uh, and if I adjust for their vocabulary level right here, I eliminate every bit of difference between these two groups. What co-relates most highly with IQ? Vocabulary.
JACK FLETCHER
What about other areas? Prognosis, uh, for example. This is data from The Connecticut Longitudinal Study looking at kids all the way from kindergarten to adulthood. Uh, these kids are now about 22 years of age. We defined them, uh, into groups of kids who met low achievement definitions, uh, normal, statistically achieving kids, and kids who met discrepancy definitions. Uh, notice that there is not a whit of difference in the long term growth of reading skills between these two groups of kids despite the fact that they have IQ differences of about 18, uh, points. No difference in prognosis, in fact, that's probably an artifact of regression to the mean. Treatment validity. Does IQ or IQ discrepancy predict, uh, response to outcome? Here are six studies looking at relationships with word recognition outcome, you know, mostly since 1998 or so and you see that there's essentially no relationship in virtually all of these studies except for the study by Barbara, where only one of the three outcome measures, uh, uh, yielded an effect and explained only five percent of the variance. Only one study looked at IQ discrepancy, but there's substantial overlap here, and that was Frank Vellutino's study. And he concluded that the IQ achievement discrepancy does not reliably distinguish between disabled and non-disabled readers, children who were found to be difficult and easy to remediate, and it does not predict response to remediation. Now everybody's question immediately is what happens if you study comprehension? Well, there are much smaller relation ships of IQ in some studies with comprehension outcomes. But think about what's driving that IQ score? It's vocabulary, and vocabulary's a very robust predictor of reading comprehension skill.
JACK FLETCHER
What about other forms of learning disability? For example, here are our same variables here, cognitive variables here, in terms of a mass disability group defined as being IQ discrepant or low achievement. The shape of these profiles is not different. The level of performance is different, because of this big difference here that you see in vocabulary. Well, actually vocabulary has nothing to do with math performance in these kids. It's all these variables over here, problem solving, concept formation and things of that sort. In fact, they got the vocabulary, uh, difference which is a product of the definition itself. Because IQ tests contain vocabulary that I eliminate this difference right here. Speaking language, uh, disorders. This is has been studied extensively in the large-scale, uh, studies by (SOUNDS LIKE) Bruce Tomlin. And this is what he concluded. The children with general language delay closely paralleled the specifically language impaired group, current diagnostic methods and standards for specific language impairment do not result in a group of children who's profiles of language achievement are unique. And a working group from The National Institute Of Deafness And Communication Disorders recently published a paper in which they concluded that there was little validity to what's called cognitive referencing, or the comparison of language scores, uh, to language but to, to some sort of index of aptitude, like IQ, for example. This is where the field, where many in the field are, those who have studied this in a very systematic sort of way and summarized actually seven years ago by Keith Stanovitch and Linda Segal, neither the (WORD?) nor the (WORD?) indicators of poor reading are co-related in a reliable way with IQ discrepancy. It is a classification hypothesis that has very weak validity at best. Heterogeneity, disorders of oral expression, listening comprehension, written expression, basic reading, reading comprehension, mathematics calculation or mathematics reasoning. The question is, are there seven sub-groups of learning disabilities? Well, think about, for example, oral expression and listening comprehension. First of all, these are problems that are essentially assumed under speech and language impalement. And when I talk about this, I'm only questioning whether they belong in a classification of children with learning disabilities.
JACK FLETCHER
I recognize that there's overlap. I'm simply pointing out that disorders of listening and speaking are essentially speech and language disorders, and there's another classification, uh, for these kids. But, uh, more importantly listening comprehension usually parallels reading comprehension. So why would you talk simultaneously about problems with listening comprehension or listening, and reading comprehension? This needs to be looked at. Basic reading and reading comprehension. This is probably the strongest evidence that we have, uh, for, for the heterogeneity hypothesis. These are essentially different sorts of problems. We're talking about word level versus text level disorders, and there's good evidence to talk about differentiating these two sorts of problems. The difficulty is that this does not address fluency. And we have good evidence now for three forms of disability in reading that co-occur and occur in isolation, disorders involving word recognition, comprehension and fluency. What are we gonna do about fluency? It's important that disorders in a classification occur in isolation so that it's not simply co-morbidity and so that you can identify what the prototype, uh, would be, that would drive a classification. Math. Talks about math calculation and reasoning. The big problem with classification of the math disability is that we don't know what the marker variable is. With word level disorders it's word recognition. With reading comprehension, it's comprehension of text, although that's difficult to assess. What component of math tells you that somebody is disabled? Is it, for example, computational difficulty? Is computational disability a marker for math? That's always the way I've approached it, and the way you would do classification research is you would systematically test this, as a, as a hypothesis, which we've been trying to do.
JACK FLETCHER
In terms of the disorder of math reasoning, what part of math does not involve reasoning or concepts? How do you measure math reading or math concepts? This is a very difficult, uh, construct and it's questionable as to whether it belongs. There is evidence for types of math disabilities that you can see most clearly if you evaluate math disability in isolation versus reading and math disability together. Reading and math disability together is a more pervasive disturbance of language and working memory. It picks up components of both. This represents a problem learning, representing and retrieving math facts as opposed to math without reading disability which represents difficulties in the acquisition and use of strategies and procedures. We are very close to having an accurate resource base to talk about criteria for these sorts of disorders. Written expression is a real problem. Are we talking about problems with spelling, problems at a textual level or problems with hand writing. And the major issue here is the independence from children with reading disability, math disability, and attention deficit disorder. Many of these kids have problems with written expression, and do these problems occur in isolation? People like Steve Graham and (SOUNDS LIKE) Virginia Bernard who are actively researching, uh, this area, I think, will have evidence about this fairly soon. Uh, bit this is certainly a viable hypothesis. There is evidence for heterogeneity, is the bottom line. What about the exclusion criteria? These are factors that cannot be the primary cause of LD, sensory problems, mental deficiency, emotional disturbance, environmental and cultural economic disadvantage or inadequate instruction. The most important thing to understand about these criteria, is that they cannot be the primary cause, as they're evaluated in an interdisciplinary team. I'm not talking about that. I'm talking about a classification question, which is, essentially, are reading and math disorders different in kids who might fit these exclusionary criteria. Do we need different programs, for example, for children who are served in Title One programs versus children who are served in LD programs, versus children who are not served and are called slow learners, for example. Well, the evidence does not support that. Essentially the cognitive correlates and the instructional needs of academic difficulties with children who have underachievement that's attributable to emotional disturbance. It's usually co-morbidity to have both a learning disability and an emotional problem, to economic disadvantage, it looks the same, or to inadequate instruction, do not appear to be different than those who are defined with LD. Ed Kavale said in 1990, 1988, since culturally disadvantaged children have been shown to exhibit the behavioral characteristics of LD, it is difficult to determine why the culturally disadvantaged group is categorically excluded from the LD classification.
JACK FLETCHER
Children from lower SDS levels with LD type behaviors have little chance of receiving LD diagnoses and treatment with an increased likelihood of being labeled retarded. They're not clearly identifiable as separate entities. We make certain decisions about policy in terms of how we serve kids, but we need to be careful about what this says about the cause of learning disabilities. Inadequate instruction is the one that's the most puzzling because inadequate instruction causes learning disabilities. It is a primary environmental cause. But it's rarely used in eligibility decisions. Response to good instruction may be the best indicator of a true disability, and early intervention prior to, to identification may be essential if you take this question here seriously. So, in terms of exclusion, intervention needs, response to intervention or mechanisms where by interventions work do not appear to vary according to the classic exclusionary factors. And as a classification hypothesis, exclusion appears to lack validity. Now this gets even more complicated when we think about what causes learning disabilities. And the point here is that the boundaries of causation are blurred. It is not nature versus nurture, genetics versus the environment, it's some of both in most people. Historically, learning disabilities have been attributed to intrinsic neurobiological factors within the child largely because of exclusionary factors. The known causes have been eliminated from consideration. But think about this. Think about the brain imaging. Think about the genetic studies first. We know from the genetic studies that have been done in Colorado that only about 50 percent of the variants in reading outcomes can be explained according to, to genetic factors.
JACK FLETCHER
That means that the other 50 percent is environmental. And what are the environmental factors, this illiteracy environment in which the child develops, and it's instruction. And instruction's really very important. This, for example, is from some of the functional imaging studies that, that people enjoy looking at, uh, quite a bit. This is from magnetic source imaging, which is a modality that we have at The University Of Texas, where we've been systematically evaluate (SIC), uh, kids, uh, with, uh, learning disabilities. And here we see a very characteristic profile that you'll see in all of any study using any modality of functional neuro-imaging. And that is, if you look at you're, uh, your good readers here, you notice the last hemisphere, you notice activation here in the basal temporal area, superior temporal jar, Wernicke's Area and the angular jar. This is neural net work that mediates word recognition and it's laterlized, mostly in the left hemisphere and not the right hemisphere. But look what happens in kids that have reading problems. It's over here in the other hemisphere, and we're not gonna talk a lot about why that is or why you might see these big, lateralized effects. What we're gonna talk about is what happens when you teach kids, uh, to read and the answer is that this pattern changes. It's reversible. Uh, these, and, we have a group of kids, there are now about ten of them, who went to a very intense, 8-week intervention, about 80 hours of instruction. We imaged them before and after, uh, intervention. Before you see the very characteristic, uh, reading disability profile, a little activation over here in the left hemisphere. Afterwards, lots of activation over here. Before, after. One of our kids is 17 years of age. And this, this is, uh, same sort of method from kids who are at risk for reading disability who are imaged at the end of kindergarten, doing a letter sound task. And you'll notice that we see the same sort of pattern of more activation over here on the right, in the at risk child, not in the not at risk child. We believe that with instruction, as these children learn to read, that this pattern will change to this one. So to conclude, the Federal classification of LD is outdated and not in line with research.
JACK FLETCHER
There is little evidence for discrepancy as an inclusionary criterion. There is support for hetero, for the heterogeneity hypothesis, but domains need revision and a single definition does not appear feasible. We need different definitions for reading disability, for math disability and so on. The exclusionary criteria is not valid from a classification perspective. We need domain specific inclusionary treatments oriented definition. Here's a very quick example of a definition of word-level reading disability, uh, developed by a research committee from the IDA. Dyslexia is a specific language based disorder characterized by difficulties in the development of accurate, influent, single word decoding skills, usually associated with insufficient biological processing abilities. You met, how do you assess this? You measure reading, you measure biological processing, you look at this and you develop a treatment plan. It's a treatment oriented definition. the concept of intelligence and learning disability is outmoded. IQ tests lead to a focus on eligibility by which children are sorted by IQ, not achievement. It's been called milk and jug, uh, thinking. Children, uh, do learn at levels that are higher than those predicted by IQ tests. IQ is not a measure of aptitude or an indicator of a response to intervention, and they will be an outcome of the same processes that lead to LD. Most importantly is we do not need IQ tests to identify children with learning disabilities and we could probably change the definition and change how children are assess in schools in a way that's much more efficient and cost effective. We need to develop a consensus process to formulate a new classification of children with learning disabilities.
JACK FLETCHER
We need to focus on results because kids should improve, uh, when they're, uh, placed in special education. We have little evidence that they do. Low achievement definitions will not be adequate. There is no basis for establishing cut points, and they are inherently unstable and LD is real. The changes in how we think about LD are needed. When the discrepancy formula disappears from the educational scene, so will the concept of LD. Ha. The notion of discrepancy has led to a confounding, most clearly seen in the suggestion that there are more similarities than differences between LD and low achieving students. Such a suggestion calls into question the very notion of LD. Wrong. We can question classification without questioning the viability of the construct. And definitions may be valid when classifications are not. IQ discrepancy validly identifies children with a learning disability. The classification is what's not valid. And we should rejoice that, that LD as a construct holds up independently of different approaches to definition. The issue is how do we take what we know and develop model classifications? I think we need a consensus process to do this. Under achievement and learning disabilities is expected, not unexpected, and is expected because of what we know from research. It's like talking about yellow fever before we knew that mosquitos spread the disease, or inflation without knowing its relationship with spending, for example. It reflects the accumulation of research over the past three years. Let's line up the classification with research. Otherwise, why do it? Thank you very much. (APPLAUSE)
RENEE BRADLEY
Thanks, Jack. Our first respondent this afternoon is Dr. Deborah Speece, who currently holds the rank of Professor in The Department Of Special Education at The University Of Maryland. Dr. Speece's research interests include classification issues in learning disabilities, the development of children at risk for school failure, and contextual features that influence school performance. Our next respondent is Dr. Linda K. Elksin, who is the immediate past president of The Council For Learning Disabilities, and co-editor of Assessment For Effective Intervention. She is a Professor Of Education at The Citadel in Charleston South Carolina, and serves on the editorial boards of Learning Disabilities Quarterly, and Exceptionality and Intervention In School And Clinic. Our final respondent is Dr. Nancy Larson, who has been the Minnesota State Learning Disabilities Coordinator for the past eight years. Nancy is responsible for overseeing the development in implementation of state guidelines and rules, as well as for insuring field input into learning disabilities.
DEBORAH SPEECE
Good afternoon. Uh, did you get all that? There are three things that I wish to emphasize in my response to the paper by Fletcher and his colleagues. Convergence with other perspectives, expansion of points raise, and caution with respect to the implications of their position. First, convergence. It is serendipitous that I've received the Fletcher paper as I finished data analysis for a study on experts opinion on the definition of reading disability. Hedges And Washington noted that convergence of evidence between research and expert opinion provides validation for both, uh, sources. (WORD?), it is instructed to compare the conclusions of Fletcher and his colleagues and the opinions of experts who are members of editorial boards for journals and learning disabilities and reading. And I hope some of you were my subjects in that study. We've asked these professionals among other things to select components of a definition of reading disability for practice. I selected the most important component, and to indicate whether exclusion criteria should be part of the definition. Fletcher and his colleagues offered three conclusions, first, IQ achievement discrepancy is not a valid criteria, criterion for LD classification.
DEBORAH SPEECE
Second, exclusionary causes are not positive indicators of LD. Third, the classification of LD will likely include responsiveness to instruction, with respect to the validity of IQ achievement that's, um, with respect to the validity of IQ achievement, uh, validity, 70 percent of our experts, and this first line, 70 percent of our experts, uh, believe that IQ achievement discrepancies should not be part of the definition there by supporting pressured positions. Because in the second point, on exclusion clauses, 75 percent of our respondents believe exclusion criteria should be used, which contradicts the Fletcher position. On closer inspection of the expert data, it was clear that our experts rejected the criteria, (UNINTELLIGIBLE) from his colleagues found to be least supportable. Specifically, emotional behavioral disability, cultural differences and economic disadvantage. These criteria were selected by fewer than 30 percent of the experts, there by lending some support to the view that exclusion criteria are not useful. With respect to the third conclusion in response to instruction, two thirds of our experts agreed that treatment validity defined in part as responsiveness to instruction, should be a component of the reading, uh, disability definition. This is surprising finding given the recent appearance of treatment validity in discussions of identification. I will return to this point in consideration of expanded approaches to identifying LD. The other point of the claimant that responsiveness to instruction can play an important role in the identification of LD, leads to my second theme, expansion. And could you cover up all but the first line, please?
DEBORAH SPEECE
Responsiveness to treatment represents a critically important ingredient to definitions of LD. Definitions in classification of LD focus exclusively on (UNINTELLIGIBLE) of exclusion, to the exclusion of the role of contextual factors including instruction. That it took decades to begin to acknowledge the role of context in LD, puts our field in the of must social sciences. Duncan And Ryan first commented that social science research is far from definitive about whether context matters, despite the fact that context such as families never (WORD?) in school are essential to making the child fully human. Fletcher and his colleagues provide a coherent explanation of the problems associated with a view of learning disabilities that neglects the effects of context generally, and instruction specifically. What is missing in the discussion is reference to an existing model developed by Beck And Lynn Fuchs, that provides conceptual specificity to the link between LD and the lack of responsiveness to instruction. Undoubtedly this map, model, and I know now that it was, was talked about in Frank Gresham's paper, however it requires mention here because of its potential to address several points raised by Fletcher, including that responsiveness to instruction be considered a classification criteria for LD. Briefly, the treatment solidity model requires continual monitoring of academic progress of all children in a classroom, identifying children who failed to respond given a generally effective instructional program and intervening within the general education classroom with the identified children. Children who fail to demonstrate progress after well-designed and implemented general education intervention, would be candidates for more intensive instruction in special education, and may be considered learning disabled or at risk for learning disabilities.
DEBORAH SPEECE
Fuchs And Fuchs provided a complete analysis of this process including preliminary data. What is of interest to the present discussion is how this model supports pints raised by Fletcher. These points include reunion of research and practice, focus on behaviors relevant to instruction, acknowledgement that LD may be best indexed within academic domains, and focus on inclusion criteria rather than exclusion criteria. This seems to me to represent a substantial convergence and expansion of ideas in an ares that has created more anxieties than agreement. Other methods of conceptualizing response to treatment, I mean, are possible and should be studied. The primary issue, however, is that we can use the points of agreement to guide an expanded field of LD, that recognizes that classification is a dynamic process and that LD is a developmental phenomenon. The second point under expansion, and if you could just pull that down, Renee, is the need to consider a more comprehensive view of validity in a second potential of any classification approach. In the discussion of validity, Fletcher and his colleagues (WORD?) their arguments in the realm of construct validity. This is appropriate because context, uh, construct validity is the cornerstone of any discussion on validity. However, analysis of classification validity needs to be expanded to include other facets of validity as defined by Messick (SP?), and I'm not going to go through all four, uh, cells there. But briefly, Messick proposed that assessment of validity depends on, put this out from the computer cells, that you.
DEBORAH SPEECE
So Messick proposed that assessment of validity depends not only on traditional psychometric evidence, but also on the consequences of test use. In a present context, this means the consequences of applying a particular method of LD classification. In Messick's terms this terms this would mean an analysis of value complications of LD classification, and the social consequences of LD classification. These factors are located in the second row of the matrix. For example, though validity of the IQ achievement discrepancy formula as a classification criterion, should be assessed not only with hypothesis related to low achievement, that is, construct validity, but also in terms of the consequences of applying the criterion. Specifically, we know that it is difficult for young children to qualify for special education under the discrepancy criterion. This option violates what many report as important value, the ability of a classification system to identify children for services before they experience repeated failure. In terms of social consequences, the discrepancy formula as applied in schools, results in over representation of males and minority children. However, steady set use researcher defined samples did not find these biases suggesting that over representation of males and minorities is an unintended, innate consequence of school identification. These examples illustrate that the (WORD?) criterion may not pass muster on several facets of validation and provide important evidence with which to evaluate the validity of classification criteria. The examples also emphasize Messick's requirement that both intended and unintended consequences be evaluated. I suggest the adoption of an expanded view because Messick's views emphasize that both data and logic are required. Because consequences of a classification need careful consideration, and because he held the enterprise brings with it a host of value and beliefs that go often unstated and unexamined. Analysis of validity via the (WORD?) requires that values and beliefs be examined as carefully as data.
DEBORAH SPEECE
Hypothesis testing is critical, but a view of validity that encompasses and expands traditional approaches will be from the classification systems that is more comprehensive and acceptable to the many intended audiences. Admittedly, there is little work on construct validity. But if we are to begin anew with consensus committees, let's be sure to incorporate a comprehensive and contemporary view of what is required to establish validity. My time is up, but we made eight points. Thank you. Uh, my final theme sounds a call for caution, and there are two points I want to make. Uh, uh, there is action in Jack's paper, and I don't think he should be, uh, solving all of our problems, but what is absent is what should we do, but how should we replace discrepancy. And I think we need to seriously consider that if we drop discrepancy practitioners may then conclude that LD is not real. If we don't have criteria, it must not exist. Now, they very clearly said that they believe LD is a real phenomenon. But we have to consider if we drop it, we need to replace it with something. And finally, what we don't know, uh, what we don't know about the classification of LD is, um, let me say this to the camera, what we know is stopped by what we don't know. Okay? Most of our information, unfortunately, within the area of reading with young children. Okay, so we need to look at all the children as well. Thank you.
LINDA ELKSNIN
We respondents have to talk quickly. First of all, I think that we really do need to thank, uh, Jack Fletcher and Reed Lion (SP?) for re-energizing the field of learning disabilities, and forcing us, uh, to really reconsider some of our practice. And in that say, I will also say that, uh, it was difficult to respond to this paper, because it kind of incorporated everything that was included in the other eight white papers. So I've been somewhat selective relative to what I want to talk about today. But I think in the simplest terms, uh, Fletcher et. al. based on the results of the NICHD research that focuses on early reading, have concluded several things.
LINDA ELKSNIN
First of which, Jack talked about at great length earlier, and that is that there's little difference between our low achieving students and our learning disabled students. Uh, based upon that they propose that we eliminate discrepancy and exclusion components from the Federal definition identification criteria, and then I think something that was not addressed early on that I'd like to address and that is that school districts begin to offer services using special education as a mechanism for so many students that we consider to be low achievers as opposed to being learning disabled. The reality is, at the present time we serve almost three million students with learning disabilities. Many of these students represent the lowest performing of low achievers, not necessarily of basic reading skill, which has been addressed by the NICHD sponsored studies, but also reading comprehension, mathematics calculation and written expression. The other factor is that these students are probably what Joe Torgesen refers to as treatment resisters. They are students who require intensive intervention, even with the NICHD research, Torgesen admits that there are between two and six percent of students who will remain poor readers despite NICHD fund of prevention intervention. That's something that we need to keep in mind. The interventions required by the lowest of the low achievers are not restricted to beginning reading instruction, and in fact the greatest increases, I think, were, uh, mentioned today by, uh, Pasternak, and that is that students within the age ranges of 12 to 17 account for the largest number of students. These are students that we need to focus our attention on, content with (WORD?) to the use of longer strategies and through teacher to provide advanced organization and explicit practice opportunities.
LINDA ELKSNIN
The other issue is I think we need to separate out, and I think this was done earlier as well, the concept of LD versus how we've operationalized the definition. Uh, some of the work that Lee Swanson has done clearly indicates that even novices as well as experts, have an implicit understanding of what a learning disability is and what the characteristics are. The problems with the LD classification stem from not how we've conceptualized LD, but how it's been operationalized by practitioners. There are a couple of implications, I think, that are, uh, important for practice. The first has to be that we do, we do some reliance and discrepancy formulas per se. That those are not going to be productive in terms of getting us a great understanding of how to classify and understand the population of one of the disabled students that we come and see, serve. That we need to get eligibility teams in schools, the flexibility to use proactive professional judgement. I know that's another topic of one of the Wight papers during this LD summit. Thirdly, we need to focus on effective cognitive skills, which may be a difficult undertaking in how these skills contribute to how students learn to read right and to do mathematics. not just our students with LD, but also our low achieving students as well.
LINDA ELKSNIN
And then finally, when it come to the critical judgement piece, I think we've kind of lost track of the fact that if we look at other professionals for people in the area of mental health, we need to acknowledge the importance of clinical judgement in the classification process just as psychiatrists do when you look at a DSM four. In other words, if you look at the DSM it talks about the idea that the diagnostic criteria that are included are meant to serve as sidelines to the, to be informed by clinical judgement and not meant to be used in a cookbook fashion, which is what happens when we rely exclusively on discrepancy formula, and IQ involved in discrepancy. Fletcher and his colleagues also talk a lot about response to treatment, and I think this is probably one of the more positive aspects of the paper. But the issue of developing a definition that's treatment oriented I think it's not one that we're gonna easily be able to accommodate. They argue that alternative definitions of learning disabilities quote should provide specific criteria indicating that the child has a particular type of LD, and that they point towards a set of potential interventions. However, the fact that the Federal definition of LD fails to prescribe treatment is irrelevant. Uh, very few definitions or (WORD?) patient's systems include treatment recommendations, and that might include all the other IDA disability definitions, as well as none educational classification systems, such as the DSM Four. Rather than treatment intervention of begin the focus of definitions, our definition, I know Nancy Larson will address this, are used to really make entitlement decisions including whether or not there's a presence of, of disability and whether or not the student is eligible for special education services. Obviously, we're gonna need different assessment information for post entitlement decisions, such as intervention planning. And the cost of a learning disability, for example, the individuals inability to store, organize, acquire, retrieve, express or manipulate information will go a long way in helping us to determine the intervention approach. Several implications for research. The first thing is that, again, we need to reduce the efforts to validate the discrepancy formulas as this is unlikely to lead to specification of recognizable, learning this disability's behavior. The second thing is that, in my mind, when you can increase our efforts to identify the cogent processes that mediate discrepancies and non-discrepancies among poorly performing students as a whole, including students with learning disability.
LINDA ELKSNIN
And finally, probably the most exciting thing, and that's was mentioned by Deb earlier, is that we need to focus on how students respond to intervention, and have that be part of the assessment process. We do have an arsenal of powerful strategies and methods to teach students with learning disabilities. Some of the work that Lee Swanson has done clearly suggests that direct instruction, cogitative strategies instruction work with our students. But there is a big gap between what we know works and what is used out in the schools. So another purpose would be to examine the ways that we can support and sustain effective instructional practices in the schools, which is something that (SOUNDS LIKE) Wes Gerston has, um, examined a recent issue of LD Research And Practice. And finally, one of the problems we had in interpreting LD research is that the subject's are inconsistently and inaccurately described. If we select LD subjects strictly on the basis of public school identification criteria, that is just a sample of convenience, we really get a post hoc interpretation of subject characteristics and past performance. And Federal agencies could go a long way in directing this issue by requiring minimum standard, uh, universal protocol for describing participants in Federally funded LD research. And this has been suggested by some of Jack's colleagues, (UNINTELLIGIBLE) Council For Learning Disability and goes as far back as Barbara Keos (SP?), (UNINTELLIGIBLE) marker variables when we present our research.
LINDA ELKSNIN
In some ways, radical changes in ways in which we identify and classify students with learning disabilities appears to be unwarranted at this time. The problems that we have, really, are due to the operationalization of the definition, not to the definition itself. The results, uh, Jack talked a lot about the unexpected underachievement and IQ achievement discrepancy. It really depends upon which body of research you look at. There are some studies that do support that concept. So it is equivocal at this point. It only focuses on reading for the most part, and you had mentioned some of the other areas, by the emphasis has been on reading, particularly early reading. And then our students with LD are going to require intensive intervention because they often are the treatment resistors that, um, we need to find better ways of serving in either special or general education. Uh, and, Renee says I can do one more, so that's not to say that we can't improve practice by discouraging reliance and over reliance on formulas and cut off scores, by trying to determine the cognitive processes that mediate performance and to, uh, examine response to intervention and offer ways to insure that the good work that NICHD and others are doing are getting into the schools and teachers are actually using (WORD?) intervention strategy. (APPLAUSE)
NANCY LARSON
Hi. I've had a lot of people with a very technical orientation precede me, and I'm want you to know that I'm very honored to be here and humbled by the presence of some of the people who have done so much research over the course of time. But I want to talk to you about remodeling. I'm from Minnesota, can you tell? I have spent the better portion of this last year remodeling and I got to thinking about this presentation, wait a minute, uh-oh. And after thinking about the remodeling of LD, something that has gone on ever since I entered the process, and I got to thinking about building (UNINTELLIGIBLE) an analogy, and certainly the preponderance of the discussion has occurred around researchers and policy makers, but largely researchers. The policy, actually, has remained the same since 94-142, and the two iterations of idea, but the researchers constantly send us new questions and of course that's very healthy. The, the team members that are not present ever consistently in this practice seems to me to be the teachers. So the practitioners are left out of this process all together. And I think that any kind of, uh, discussion about reinventing LD in any capacity really needs to include the, the field. The field is suffering, the field needs to be part of this, a part of this discussion. Of course, we have stages of building I discovered, in my little remodeling session. Over the course of the year we have the foundation in rock, carpentry, plumbing and electrical, finished carpentry, paying the contractor and moving in. We have yet to move in, by the way. The foundation for this discussion is entitlement. And any change in classification, any tweaking in definition automatically will result in the field into changing entitlement.
NANCY LARSON
That most directly affects parents, students and teachers. It very little affects the people who are in this room or myself as a policy person. But it directly affects large groups of students. I think that that's the essential thing to keep in mind. That's the thing that was not really mentioned. That's an element that wasn't really mentioned in this lecture study. And it is of tremendous concern. The other accusation over the course of time is that LD, and everyone's mentioned this, is not real, that it's a fabrication and a construct in the minds of researchers or theorists, and that always brings us to the issue of when is a disability not a, not a disability. In other words, when is something funded as a disability and that's where the field as a whole goes is directly to pragmatic matters. So if LD is in fact watered down, altered or changed, and we have this resultant change in entitlement, we will have quite an uproar in the field and we need to be prepared, as my colleagues pointed out, for the, for the implicit changes that will occur if there are changes in definition or classification. For all other disability areas, um, criteria is a state function. For learning disabilities it's a Federal function. Why? I'm not too sure. But when we talk about a classification, we are talking about two elements, one definitional and the other is criterion oriented. And actually, there is a third element that pops into most state interpretations of Federal rules and that would be evaluation methodology. So we really have three pieces in the continuum. Rough carpentry, and I know why they call them rough. They immediately came to my house, ripped off all of the siding and then we had a monsoon in Minnesota, so it was a very exciting. (UNINTELLIGIBLE) as a court issue in LD, and it is, um, very much part of our definitional consideration. And the other piece that Fletcher et. al. alluded to is that kids identified under the discrepancy model and formula, are too, kids with disabilities. And it is not a mild disability. And we do discuss this constantly as if it were a mild disability.
NANCY LARSON
And the issue around determining characteristics is to determine what those characteristics are throughout the life span of the individuals with a learning disability. I am bothered, this is third point, by curriculum based disability definitions, meaning that for all other disabilities we have a notion or a core notion of what that disability is. For learning disabilities we want to break it out into reading disability and math disability and so on disability. It is a problem for the field. You cannot both have a curricular definition and a philosophical definition that is at a core concept. It is very confusing as it plays out in application in the field. Is a disability to do with reading? Well, no. Because 13 other categories tell us differently. They tell us that we have to have a sever effect on curriculum in order to provide special education and related services. So that is another consideration. And the next, are we going to continue, now, just a second. I'm changing to my final in electrical. Uh, to continue with our roof use of terminology, which is, it is very important to have precise terminology when, when moving the rule or law or notion to the field. The application is all involved in the terminology. So, if we use, I'm gonna talk just a second about disempowering language, but if we use terms like, reading disability to mean disability, and what is autism? And what is MMI? And what is anything else that is a disability under Federal rule. Okay, that seems to mean more of a curricular disability. The disempowering language piece is all about, uh, calling things reading retardation and I realize that the studies in Fletcher et. al. use these, these pieces, these terms.
NANCY LARSON
Mental deficiency. Those are terms that will instantaneously alienate a large segment of the population that we serve. So be careful about disempowering language, I think, also is, is very essential. And the interchangeable, uh, terminology piece is really around reading disability, dyslexia and learning disability. And they are used in this paper interchangeably and it does confuse the field when we have more than one term for the same classification. I'm going to skip underachievement since we already had that discussion. Never mind. And I'm going to talk about The Matthew Effect. The Matthew Effect goes something like this, for teachers in the field. If teachers right this minute cannot implement, uh, idea 976, consider what any tweaking to the definition will do, will have a cumulative effect in terms of how they are able to operationalize what ever it is that has developed at the Federal level. So eventually they'll have a cumulative negative effect field application. This is the meat and potatoes of my existence. It is, it takes an incredibly long period of time to trickle down to the masses whatever changes are going on, especially in research. There is no time out there, I'm here to tell you, there is no time, no one has time to read the research, and if they do, they give it a cursory effect. It's not that they're not interested, it is that they have no time. And the next piece that anyone will ask you is, gee, to whose benefit is it to tweak classification systems to reconceptualize, to draw new charts in learning disabilities. Does it help the teacher who's actually doing the teaching? Does it help clarify pieces for parents as they operationalize a learning disability. And the last question is just a question I've wondered about for a long, long time. Is uniformity in definition useful, or not useful? In other words, is it useful to have a uniform definition across states, when in reality in lots of other policy pieces we, uh, are very much promoting states individual, uh, individual rights to determine their own fate, if you will. So that would be another question. Does that actually add to our field or subtract from our field?
NANCY LARSON
The gist of this issue for me is the third bullet there, which is give me the money. If we are shifting resources, general ed wants those resources. Uh, and so does everybody else. They are, uh, we're in an age where there's lessening public support for public education. It is a real problem when you change entitlements, you change the money flow. And everybody's going to want to be in the give me the money business. So I think that's the final consideration I've got for today. Um, I have a few more slides, but we'll just stop here so everyone can have their, their question and answer session. Thank you.
[END OF TAPE]