All T hing s E xo tic !! Clinic a l Dia g nosis of Me nta l - - PDF document

SLIDE 1

All T hing s E xo tic !!

Disc e rning Outside Dia g no sis(e s) Unde r Artic le 7 E lig ib ility

PRE SE NT E D BY: MONI CA J. CONRAD, M.A., J.D

• DR. JUL

I E ST E CK , PH.D, HSPP L E WI S K APPE S CHI L DRE N’ S RE SOURCE GROUP

1

Clinic a l Dia g nosis of Me nta l Disorde rs

vs.

Artic le 7 Spe c ia l E duc a tion E lig ibility:

De te r mining e ligibility for spe c ial e duc ation se r vic e s? 2

Sc e na rio:

Sixth g ra de g e ne ra l e duc a tio n stude nt, Ja ne , ha s b e e n g e tting into tro ub le a t

sc ho o l la te ly. She ha s a n a ttitude to wa rd he r te a c he r a nd ha s b e e n te lling he r te a c he r “no ” whe ne ve r she a sks he r to do so me thing . As a re sult, Ja ne e a rne d de te ntio n five time s in the mo nth o f Ja nua ry—ma inly fo r “no t fo llo wing instruc tio ns” a nd “ta lking b a c k” to a dults in the b uilding . On F e b rua ry 1st, Ja ne ’ s mo the r info rms the sc ho o l tha t Ja ne ha s b e e n c linic a lly dia g no se d with “o ppo sitio na l de fia nc e diso rde r” a nd sa ys tha t Ja ne will b e ne e ding spe c ia l e duc a tio n se rvic e s b e c a use o f he r ne wfo und e lig ib ility. How many of you have had a similar situation happe n: a pare nt info rms the sc ho o l that the ir c hild has be e n diagno se d by a do c to r/ psyc ho lo gist and want the ir c hild to re c e ive spe c ial e duc atio n se rvic e s?

3

Ba c kg round informa tion

T

he Dia g no stic a nd Sta tistic a l Ma nua l o f Me nta l Diso rde rs (DSM- 5) is a ma nua l use d b y me nta l he a lth pro fe ssio na ls to c linic a lly dia g no se me nta l diso rde rs

Ma ke dia g no sis b y c he c king o ff c rite ria – a sse ssme nt pro c e ss va rie s

wide ly (ie . c linic a l judg me nt)

Artic le 7 (pa rt 41) e sta b lishe s e lig ib ility c rite ria fo r spe c ia l e duc a tio n

e lig ib ility c a te g o rie s

Ma ke e lig ib ility de te rmina tio n using e lig ib ility c rite ria AND a n

a sse ssme nt pro c e ss

4

HOW DO T HE SE E L IGIBIL IT Y CRIT E RIA AL IGN?

L E GAL K E YS T O DI F F E RE NT I AT E D DI AGNOSI S Unde r Artic le 7

• (e ) T

he pub lic a g e nc y must e sta b lish, ma inta in, a nd imple me nt pro c e dure s to e nsure the fo llo wing : (1) Asse ssme nts a nd o the r e va lua tio n ma te ria ls a re a s fo llo ws: …(C) Use d fo r the purpo se s fo r whic h the a sse ssme nts o r me a sure s a re va lid a nd re lia ble…(E ) T e c hnic a lly so und instrume nts tha t ma y a sse ss the re la tive c o ntrib utio ns o f c o g nitive a nd b e ha vio ra l fa c to rs, in a dditio n to physic a l o r de ve lo pme nta l fa c to rs

• (7) E

duc a tio na l e va lua tio ns a re suffic ie ntly c ompre he nsive to ide ntify a ll o f the stude nt's spe c ia l e duc a tio n a nd re la te d se rvic e ne e ds whe the r or not c ommonly linke d to the disa b ility c a te g o ry in whic h the stude nt ha s b e e n c la ssifie d.

• (c ) Whe n de te rmining e lig ib ility fo r spe c ia l e duc a tio n a nd re la te d se rvic e s, the CCC

must: (2) not re ly on a ny sing le me a sure or a sse ssme nt a s the sole c rite rion fo r de te rmining e lig ib ility o r a ppro pria te e duc a tio na l se rvic e s.

5

E motiona l Disa bilitie s

6

SLIDE 2

Oppositiona l De fia nc e Disorde r (ODD)

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DSM- 5 Dia g nostic Crite ria (A) A pa tte rn of a ng ry/ irrita ble mood, a rg ume nta tive / de fia nt be ha vior, or vindic tive ne ss la sting a t le a st 6 months a s e vide nc e d by a t le a st four symptoms fro m a ny o f the fo llo wing c a te g o rie s, a nd e xhib ite d during inte ra c tio n with a t le a st one individua l who is not a sibling AND (B) the disturb a nc e in b e ha vio r is a sso c ia te d with distre ss in the individua l o r o the rs in his imme dia te so c ia l c o nte xt o r it impa c ts ne g a tive ly o n so c ia l, e duc a tio na l, o c c upa tio na l, o r o the r impo rta nt a re a s o f func tio ning .

• Ang ry/ irrita ble Mood
• Ofte n lo se s te mpe r
• I

s o fte n to uc hy o r e a sily a nno ye d

• I

s o fte n a ng ry a nd re se ntful

• Arg ume nta tive / De fia nt Be ha vior
• Ofte n a rg ue s with a utho rity fig ure s o r, fo r c hildre n a nd a do le sc e nts, with a dults
• Ofte n a c tive ly de fie s o r re fuse s to c o mply with re q ue sts fro m a utho rity fig ure s o r with rule s
• Ofte n de lib e ra te ly a nno ys o the rs
• Ofte n b la me s o the rs fo r his o r he r mista ke s o r b e ha vio r
• Vindic tive ne ss
• Ha s b e e n spite ful o r vindic tive a t le a st twic e within the pa st 6 mo nths

Conduc t Disorde r

8

DSM- 5 Dia g nostic Crite ria (A) A r e pe titive a nd pe rsiste nt pa tte rn of be ha vior in whic h the ba sic rig hts of othe rs or ma jor a g e - a ppropria te soc ie ta l norms or rule s a re viola te d, a s ma nife ste d b y the pre se nc e o f a t le a st 3 of the following 15 c rite ria in the pa st 12 months fro m a ny o f the c a te g o rie s b e lo w, with a t le a st 1 c rite rion pre se nt in the pa st 6 months AND (B) the disturb a nc e in b e ha vio r c a use s c linic a lly sig nific a nt impa irme nt in soc ia l, a c a de mic , or oc c upa tiona l func tioning.

• Ag g re ssion to Pe ople a nd Anima ls
• Ofte n b ullie s, thre a te ns, o r intimida te s o the rs
• Ofte n initia te s physic a l fig hts
• Ha s use d a we a po n tha t c a n c a use se rio us physic a l ha rm to o the rs (e .g . a b a t, b ric k, b ro ke n

b o ttle , knife , g un)

• Ha s b e e n physic a lly c rue l to pe o ple
• Ha s b e e n physic a lly c rue l to a nima ls
• Ha s sto le n while c o nfro nting a vic tim
• Ha s fo rc e d so me o ne into se xua l a c tivity
• De struc tion of Prope rty
• Ha s de lib e ra te ly e ng a g e d in fire se tting with the inte ntio n o f c a using se rio us da ma g e
• Ha s de lib e ra te ly de stro ye d o the rs’ pro pe rty (o the r tha n b y fire se tting )

Conduc t Disorde r (c ont.)

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DSM- 5 Dia g nostic Crite ria

• De c e itfulne ss or

T he ft

• Ha s b ro ke n into so me o ne e lse ’ s ho use , b uilding , o r c a r
• Ofte n lie s to o b ta in g o o ds o r fa vo rs o r to a vo id o b lig a tio ns (i.e . “c o ns” o the rs)
• Ha s sto le n ite ms o f no ntrivia l va lue witho ut c o nfro nting a vic tim (e .g . sho plifting , b ut witho ut

b re a king a nd e nte ring ; fo rg e ry)

• Se rious Viola tions of Rule s
• Ofte n sta ys o ut a t nig ht de spite pa re nta l pro hib itio ns, b e g inning b e fo re a g e 13 ye a rs
• Ha s run a wa y fro m ho me o ve rnig ht a t le a st twic e while living in the pa re nta l o r pa re nta l

surro g a te ho me , o r o nc e witho ut re turning fo r a le ng thy pe rio d

• I

s o fte n trua nt fro m sc ho o l, b e g inning b e fo re a g e 13 ye a rs

Bipola r Disorde r (T ype I)

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DSM- 5 Dia g nostic Crite ria F

• r a dia g no sis o f b ipo la r I

diso rde r, it is ne c e ssa ry to me e t the following c rite ria for a ma nic e pisode . T he ma nic e piso de ma y ha ve b e e n pre c e de d b y a nd ma y b e fo llo we d b y hypo ma nic o r ma jo r de pre ssive e piso de s.

• Ma nic E

pisode

• (A) A distinc t pe rio d o f a bnorma lly a nd pe rsiste ntly e le va te d, e xpa nsive , or irrita ble mood a nd

a b no rma lly a nd pe rsiste ntly inc re a se d g oa l- dire c te d a c tivity o r e ne rg y, la sting a t le a st 1 we e k a nd pre se nt mo st o f the da y, ne a rly e ve ry da y (o r a ny dura tio n if ho spita liza tio n is ne c e ssa ry).

• (B) During the pe rio d o f mo o d disturb a nc e a nd inc re a se d e ne rg y o r a c tivity, thre e (or more ) of the

following symptoms (fo ur if the mo o d is o nly irrita b le ) a re pre se nt to a sig nific a nt de g re e a nd re pre se nt a no tic e a b le c ha ng e fro m usua l b e ha vio r

• I

nfla te d se lf-e ste e m o r g ra ndio sity

• De c re a se d ne e d fo r sle e p (e .g . fe e ls re ste d a fte r o nly 3 ho urs o f sle e p)
• Mo re ta lka tive tha n usua l o r pre ssure to ke e p ta lking
• F

lig ht o f ide a s o f sub je c tive e xpe rie nc e tha t tho ug hts a re ra c ing

• Distra c tib ility (i.e . a tte ntio n to o e a sily dra wn to unimpo rta nt o r irre le va nt e xte rna l stimuli), a s re po rte d
• r o b se rve d
• I

nc re a se in g o a l-dire c te d a c tivity o r psyc ho mo to r a g ita tio n

• E

xc e ssive invo lve me nt in a c tivitie s tha t ha ve a hig h po te ntia l fo r pa inful c o nse q ue nc e s (e .g . e ng a g ing in unre stra ine d b uying spre e s, se xua l indisc re tio ns, fo o lish b usine ss inve stme nts)

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DSM- 5 Dia g nostic Crite ria

• (C) the mo o d disturb a nc e is suffic ie ntly se ve re to c a use ma rke d impa irme nt in so c ia l o r
• c c upa tio na l func tio ning o r to ne c e ssita te ho spita liza tio n to pre ve nt ha rm to se lf o r o the rs, o r

the re a re psyc ho tic fe a ture s

• (D) T

he e piso de is no t a ttrib uta b le to the physio lo g ic a l e ffe c ts o f a sub sta nc e a b use (e .g . a drug o f a b use , a me dic a tio n, o the r tre a tme nt) o r to a no the r me dic a l c o nditio n

Bipola r Disorde r (T ype I) (c ont.) Disruptive Mood Dysre g ula tion Disorde r

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DSM- 5 Dia g nostic Crite ria (A) Se ve re re c urre nt te mpe r o utb ursts ma nife ste d ve rb a lly (e .g . ve rb a l ra g e s) a nd/ or be ha viora lly (e .g . physic a l a g g re ssio n to wa rd pe o ple o r pro pe rty) tha t a re g rossly out of proportion in inte nsity or dura tion to the

situa tion or provoc a tion (B) T he te mpe r o utb ursts a re inc onsiste nt with de ve lopme nta l le ve l (C) T he te mpe r o utb ursts o c c ur, o n a ve ra g e , thre e or more time s pe r we e k (D) T he mo o d b e twe e n te mpe r o utb ursts is pe rsiste ntly irrita ble or a ng ry most of the da y, ne a rly e ve ry da y, a nd is

• b se rva b le b y o the rs (e .g . pa re nts, te a c he rs, pe e rs).

(E ) Crite ria A- D ha ve be e n pre se nt for 12 or more months. T hro ug ho ut tha t time , the individua l ha s no t ha d a pe rio d la sting 3 o r mo re c o nse c utive mo nths witho ut a ll o f the sympto ms in Crite ria A-D. (F ) Crite ria A a nd D a re pre se nt in a t le a st two of thre e se tting s (i.e . a t ho me , a t sc ho o l, with pe e rs) a nd a re se ve re in a t le a st o ne o f the se . (G)T he dia g no sis sho uld no t b e ma de fo r the first time b e fo re a g e 6 ye a rs o r a fte r a g e 18 ye a rs. (H) By histo ry o r o b se rva tio n, the a g e a t onse t of Crite ria A- E is be fore 10 ye a rs. (I ) T he re ha s ne ve r b e e n a distinc t pe rio d la sting mo re tha n 1 da y during whic h the full sympto m c rite ria , e xc e pt dura tio n, fo r a ma nic o f hypo ma nic e piso de ha ve b e e n me t. (J) T he b e ha vio rs do no t o c c ur e xc lusive ly during a n e piso de o f ma jo r de pre ssive diso rde r a nd a re no t b e tte r e xpla ine d b y a no the r me nta l diso rde r (e .g . a utism spe c trum diso rde r, po sttra uma tic stre ss diso rde r, se pa ra tio n a nxie ty diso rde r, pe rsiste nt de pre ssive diso rde r (this dia g no sis c a nno t c o e xist with o ppo sitio na l de fia nt diso rde r o r b ipo la r diso rde r). (K ) T he sympto ms a re no t a ttrib uta b le to the physio lo g ic a l e ffe c ts o f a sub sta nc e o r to a no the r me dic a l o r ne uro lo g ic a l c o nditio n.

SLIDE 3

Artic le 7 E lig ibility Crite ria for E motiona l Disa bility 13

511 IAC 7- 41- 7 E motiona l Disa bility E L IGIBIL IT Y CRIT E RIA

(a )“E motiona l Disa bility” me a ns a n ina bility to le a rn or prog re ss tha t c a nno t b e e xpla ine d

b y c o g nitive , se nso ry, o r he a lth fa c to rs. T he stude nt e xhibits one (1) or more of the

following c ha ra c te ristic s ove r a long pe riod of time a nd to a ma rke d de g re e tha t a dve rse ly a ffe c ts e duc a tiona l pe rforma nc e:

(1)A te nde nc y to de ve lo p physic a l sympto ms o r fe a rs a sso c ia te d with pe rso na l o r sc ho o l pro b le ms (2)A g e ne ra l pe rva sive mo o d o f unha ppine ss o r de pre ssio n (3)An ina b ility to b uild o r ma inta in sa tisfa c to ry inte rpe rso na l re la tio nships (4)I na ppro pria te b e ha vio rs o r fe e ling s unde r no rma l c irc umsta nc e s (5)E piso de s o f psyc ho sis

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511 IAC 7- 41- 7 E motiona l Disa bility ASSE SSME NT

(b) E lig ibility for spe c ia l e duc a tion a s a stude nt with a n e motiona l disa bility sha ll be de te rmine d by the stude nt’s

• CCC. T

his de te rmina tion sha ll be ba se d on the multidisc iplina ry te a m’s e duc a tiona l e va lua tion re ports de sc rib e d in 511 I AC 7-40-5(e ), whic h inc lude s the following: (1) An a sse ssme nt o f the fo llo wing : (A) Curre nt a c a de mic a c hie ve me nt a s de fine d in 511 I AC 7-32-2 (B) E motiona l a nd be ha viora l func tioning (2) A so c ia l a nd de ve lo pme nta l histo ry tha t ma y inc lude , b ut is no t limite d to , the fo llo wing : (A) Co mmunic a tio n skills; (B) So c ia l inte ra c tio n skills; (C) re le va nt fa mily a nd e nviro nme nta l info rma tio n; (D) Re spo nse s to se nso ry e xpe rie nc e s; (E ) Pa tte rns o f e mo tio na l a djustme nt; (F ) unusua l o r a typic a l b e ha vio rs (3) A func tiona l be ha vior a sse ssme nt a s de fine d in 511 I AC 7-32-41 tha t inc lude s a n a na lysis o f a ny inte rve ntio ns use d to a ddre ss the b e ha vio rs le a ding to the re fe rra l fo r the e duc a tio na l e va lua tio n (4) Ava ila b le me dic a l a nd me nta l he a lth info rma tio n tha t is e duc a tio na lly re le va nt (5) Any othe r a sse ssme nts a nd informa tion, c o lle c te d prio r to re fe rra l o r during the e d. e va lua tio n, ne c e ssa ry to : (A) Addre ss whe the r the stude nt’ s ina b ility to le a rn o r pro g re ss is c a use d b y c og nitive , se nsory, or he a lth fa c tors (B) De te rmine e lig ib ility fo r spe c ia l e duc a tio n a nd re la te s se rvic e s; a nd (C) I nfo rm the stude nt’ s CCC o f the stude nt’ s spe c ia l e duc a tio n a nd re la te d se rvic e s

Artic le 7 E lig ibility Crite ria for E motiona l Disa bility

Ca se L a w

• So c ia l ma la djustme nt is no t g e ne ra lly e no ug h to q ua lify unde r the Artic le 7 de finitio n o f E

D; the re must b e a c a usa l c o nne c tio n b e twe e n the q ua lifying me nta l he a lth c o nditio n a nd e duc a tio na l diffic ultie s

S

e e W.G. v. NY City De pt o f E duc ., 801 F .Supp.2d 142 (S.D.N.Y. 2011) (“ina ppro pria te b e ha vio r tha t is a ttrib uta b le to so c ia l ma la djustme nt, ra the r tha n to a n inde pe nde nt e mo tio na l disturb a nc e , is insuffic ie nt to wa rra nt re c o g nitio n a nd a c c o mmo da tio n o f a n [E D] disa b ility.”).

S

e e Spring e r v. F a irfa x Co unty Sc ho o l Bo a rd, 134 F .3d 659 (4th Cir. 1998) (ho lding a c hild no t e lig ib le fo r spe c ia l e duc a tio n b e c a use he wa s so c ia lly ma la djuste d a nd did no t ha ve a n E D)

• T

he ke y phra se fo r de te rmining whe the r a n o utside dia g no sis o f a me nta l he a lth issue (e .g . ODD, Co nduc t Diso rde r) q ua lifie s a s a n Artic le 7 disa b ility is whe the r the c o nditio n “adve r se ly affe c ts a c hild’s e duc ational pe r for manc e .”

E

duc atio nal pe rfo rmanc e

15

Spe c ific L e a rning Disa bilitie s

16

Dysle xia

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DSM- 5 Dia g nostic Crite ria

• Unde r the DSM-5, “Dysle xia is an alte rnative te rm use d to re fe r a patte rn o f le arning diffic ultie s c harac te rize d by

pro ble ms with ac ute o r flue nt wo rd re c o gnitio n, po o r de c o ding, and po o r spe lling abilitie s. I f dysle xia is use d to spe c ify this partic ular patte rn o f diffic ultie s, it is impo rtant to spe c ify any additio nal diffic ultie s that are pre se nt, suc h as re ading c o mpre he nsio n o r math re aso ning.” it is a SUBSE

T

• f “spe c ific le a rning disorde r,” whic h is dia g no se d a s fo llo ws:

(A) Diffic ultie s le a rning a nd using a c a de mic skills, a s indic a te d b y the pre se nc e o f a t le a st onc e of the following symptoms tha t ha ve pe rsiste d for a t le a st 6 months, de spite the pro visio n o f inte rve ntio ns tha t ta rg e t tho se diffic ultie s: (1) Ina c c ura te or slow a nd e ffortful word re a ding (2) Diffic ulty unde rsta nding the me a ning of wha t is re a d (e .g . ma y re a d te xt a c c ura te ly b ut no t unde rsta nd the se q ue nc e , re la tio nships, infe re nc e , o r de e pe r me a ning s o f wha t is re a d). (3) Diffic ultie s with spe lling (4) Diffic ultie s with writte n e xpre ssio n (5) Diffic ultie s ma ste ring numb e r se nse , numb e r fa c ts, o r c a lc ula tio n (6) Diffic ultie s with ma the ma tic a l re a so ning (B) T he a ffe c te d a c a de mic skills a re sub sta ntia lly a nd q ua ntifia b ly b e lo w tho se e xpe c te d fo r the individua l’ s c hro no lo g ic a l a g e , a nd c a use sig nific a nt inte rfe re nc e with a c a de mic o r o c c upa tio na l pe rfo rma nc e , o r with a c tivitie s o f da ily living , a s c o nfirme d b y individua l a sse ssme nt. (C) T he le a rning diffic ultie s b e g in during sc ho o l-a g e ye a rs b ut ma y no t b e c o me fully ma nife st until the de ma nds fo r tho se a ffe c te d a c a de mic skills e xc e e d the individua l’ s limite d c a pa c itie s (D) T he le a rning diffic ultie s a re no t b e tte r a c c o unte d fo r b y inte lle c tua l disa b ilitie s, unc o rre c te d visua l o r a udito ry o r o the r me nta l o r ne uro lo g ic a l diso rde rs o r la c k o f instruc tio n

Dysg ra phia

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DSM- 5 Dia g nostic Crite ria

• Dysg ra phia is a writte n la ng ua g e diso rde r in se ria l pro duc tio n o f stro ke s to fo rm a ha ndwritte n le tte r tha t invo lve s no t
• nly mo to r skills b ut a lso la ng ua g e skills— finding , re trie ving , a nd pro duc ing le tte rs, whic h is a sub wo rd le ve l la ng ua g e
• skill. I

t ma y inte rfe re with spe lling a nd/ o r c o mpo sing , b ut individua ls with o nly dysg ra phia do no t ha ve diffic ulty with re a ding (Be rning e r e t a l. 2015)

• Unde r the DSM-5 it is a SUBSE

T

• f “spe c ific le a rning disorde r,” a nd de fine d a s “ a spe c ific le a rning disorde r” with

impa irme nt in writing e xpre ssion, whic h is dia g no se d a s fo llo ws: (A) Diffic ultie s le a rning a nd using a c a de mic skills, a s indic a te d b y the pre se nc e o f a t le a st onc e of the following symptoms tha t ha ve pe rsiste d for a t le a st 6 months, de spite the pro visio n o f inte rve ntio ns tha t ta rg e t tho se diffic ultie s: (1) I na c c ura te o r slo w a nd e ffo rtful wo rd re a ding (2) Diffic ulty unde rsta nding the me a ning o f wha t is re a d (e .g . ma y re a d te xt a c c ura te ly b ut no t unde rsta nd the se q ue nc e , re la tio nships, infe re nc e , o r de e pe r me a ning s o f wha t is re a d). (3) Diffic ultie s with spe lling (4) Diffic ultie s with writte n e xpre ssion* (5) Diffic ultie s ma ste ring numb e r se nse , numb e r fa c ts, o r c a lc ula tio n (6) Diffic ultie s with ma the ma tic a l re a so ning (B) T he a ffe c te d a c a de mic skills a re sub sta ntia lly a nd q ua ntifia b ly b e lo w tho se e xpe c te d fo r the individua l’ s c hro no lo g ic a l a g e , a nd c a use sig nific a nt inte rfe re nc e with a c a de mic o r o c c upa tio na l pe rfo rma nc e , o r with a c tivitie s o f da ily living , a s c o nfirme d b y individua l a sse ssme nt. (C) T he le a rning diffic ultie s b e g in during sc ho o l-a g e ye a rs b ut ma y no t b e c o me fully ma nife st until the de ma nds fo r tho se a ffe c te d a c a de mic skills e xc e e d the individua l’ s limite d c a pa c itie s (D) T he le a rning diffic ultie s a re no t b e tte r a c c o unte d fo r b y inte lle c tua l disa b ilitie s, unc o rre c te d visua l o r a udito ry o r o the r me nta l o r ne uro lo g ic a l diso rde rs o r la c k o f instruc tio n

SLIDE 4

Not me ntione d in the DSM- 5

19

Dia g nosis Wha t is it? Commonly- use d dia g nosis c rite ria

Ce ntra l Auditory Proc e ssing Disorde r (CAPD) T he re duc e d o r impa ire d a b ility to disc rimina te , re c o g nize

• r c o mpre he nd

c o mple x so unds, suc h a s tho se use d in wo rds, e ve n tho ug h the pe rso n's he a ring is no rma l. F

• ur ma jo r b e ha vio ra l te sts use d to ide ntify CAPD, inc luding :
• (1) a udito ry disc rimina tio n te sts: de te rmine sub tle diffe re nc e s in a va rie ty o f

so unds.

• (2) dic ho tic te sts: e va lua te a pe rso n’ s a b ility to se pa ra te o r c o mb ine so unds

pre se nte d to b o th e a rs a t the sa me time .

• (3) te st o f a udito ry pa tte rn o f spe e c h: pro vide s info rma tio n a b o ut a stude nt’ s

e ffe c tive ne ss in ide ntifying c ue s in spe e c h.

• (4) lo w re dunda nc y te st: a sse sse s a n individua l’ s a b ility to sc re e n o ut

b a c kg ro und no ise a nd unde rsta nd ra pid spe e c h (De Bo nis & Mo nc rie ff, 2008). Nonve rba l L e a rning Disorde r (NL D

• r NL

VD) A diso rde r whic h is usua lly c ha ra c te rize d b y a sig nific a nt disc re pa nc y b e twe e n hig he r ve rb a l skills a nd we a ke r mo to r, visua l- spa tia l a nd so c ia l skills. I t ha s b e e n c o mpa re d to a le ss se ve re Aspe rg e r’ s Syndro me .

• (1) NVL

D c a n b e c o nc e ptua lize d a s a n imb a la nc e in thinking skills—inta c t line a r, de ta il o rie nte d, a uto ma tic pro c e ssing with impa ire d a ppre c ia tio n o f the b ig pic ture , g e sta lt o r unde rlying the me .(

• (2) I

t is no t ne a rly a s c o mmo n a s la ng ua g e -b a se d le a rning disa b ilitie s, b ut this ma y b e a phe no me no n c re a te d b y e nviro nme nta l de ma nds (i.e . o ur so c ie ta l de ma nds fo r pre c isio n skills in re a ding a ssure tha t e ve n the mo st sub tle la ng ua g e -b a se d L D c a se s a re ide ntifie d)

• (3) T

ypic a lly so c ia l/ psyc hia tric c o nc e rns a re ra ise d b e fo re a c a de mic pro b le ms a re ide ntifie d.

• (4) While the o ve rla p is no t c o mple te , NVL

D c hildre n ma y me e t the c rite ria fo r Pe rva sive De ve lo pme nta l Diso rde r No t Othe rwise Spe c ifie d (PDD NOS), Aspe rg e r's Diso rde r, o r Sc hizo typa l Pe rso na lity (Dinkla g e , 2017). Be c a use no t in the DSM-5, the re a re no c le a rly de fine d c linic a l c rite ria fo r dia g no sis; a c c o rding to the lite ra ture , the se a re the mo st g e ne ra lly a g re e d upo n!

Not me ntione d in the DSM- 5

20

Dia g nosis Wha t is it? Commonly- use d dia g nosis c rite ria

Se nsory Proc e ssing Disorde r

Whe n the re is a pro b le m in the pro c e ss o f re c e iving a nd inte rpre ting se nso ry info rma tio n it is re fe rre d to a s a Se nso ry Pro c e ssing Diso rde r ( SPD), o r se nso ry inte g ra tive dysfunc tio n. I ndividua ls with SPD ha ve g re a t diffic ultie s in pe rfo rming e ve ryda y ta sks a nd in func tio ning in a c a de mic , vo c a tio na l, re c re a tio na l a nd so c ia l se tting s (Ba ile r, 2010). An e va lua tio n fo r SPD invo lve s sta nda rdize d te sting , de ta ile d c linic a l

• b se rva tio ns, a nd pa re nt-re po rt me a sure s to g a ug e se nso ry

impa irme nt a nd the impa c t o n func tio ning in ho me o r sc ho o l. T ypic a l a sse ssme nts inc lude the fo llo wing :

• SP3D o r Se nso ry Pro c e ssing T

hre e Dime nsio ns sc a le a nd ha s b o th a re spo nde nt surve y (pa re nt o r se lf re po rt me a sure ) a nd a pe rfo rma nc e a sse ssme nt (ne w in 2017)

• Se nso ry I

nte g ra tio n a nd Pra xis T e sts (SI PT )

• Mille r F

unc tio n a nd Pa rtic ipa tio n Sc a le s (MF UN)

• Bruininks-Ose re tsky T

e st o f Mo to r Pro fic ie nc y™ - Se c o nd E ditio n

• Mo ve me nt Asse ssme nt Ba tte ry fo r Childre n - Se c o nd E

ditio n (Mo ve me nt ABC-2)

• Mille r Asse ssme nt fo r Pre sc ho o le rs (MAP)
• Go a l-Orie nte d Asse ssme nt o f L

ife Skills (GOAL ) NOT E : o fte n ide ntifie d a nd c a te g o rize d b y a n o c c upa tio na l the ra pist with a dva nc e d tra ining in se nso ry pro c e ssing a nd inte g ra tio n Be c a use no t in the DSM-5, the re a re no c le a rly de fine d c linic a l c rite ria fo r dia g no sis; a c c o rding to the lite ra ture , the se a re the mo st g e ne ra lly a g re e d upo n!

21

Artic le 7 E lig ibility Crite ria for Spe c ific L e a rning Disa bility

511 IAC 7- 41- 12 Spe c ific L e a rning Disa bility E L IGIBIL IT Y CRIT E RIA (a ) “Spe c ific le a rning disa b ility” me a ns a disorde r in one (1) or more of the ba sic psyc holog ic a l proc e sse s involve d

in unde rsta nding or in using la ng ua g e , spoke n or writte n, tha t a dve rse ly a ffe c t the stude nt's e duc a tiona l pe rforma nc e, inc luding c o nditio ns re fe rre d to , o r pre vio usly re fe rre d to , a s pe rc e ptua l ha ndic a ps, b ra in injury, minima l b ra in dysfunc tio n, dysle xia , a nd de ve lo pme nta l a pha sia . As fo llo ws, a spe c ific le a rning disa b ility: (1) Ma nife sts itse lf whe n the stude nt doe s not a c hie ve a de qua te ly for the stude nt's a g e o r to me e t sta te a ppro ve d g ra de le ve l sta nda rds in o ne (1) o r mo re o f the fo llo wing a re a s, whe n pro vide d with le a rning e xpe rie nc e s a nd instruc tio n a ppro pria te fo r the stude nt's a g e o r sta te a ppro ve d g ra de le ve l sta nda rds: (A) Re a ding disa bility, whic h is a spe c ific le a rning disa b ility tha t is ne urolog ic a l in orig in a nd ha s a c o ntinuum o f se ve rity. I t is c ha ra c te rize d b y diffic ultie s with a c c ura te or flue nt, or both, word re c og nition a nd by poor spe lling a nd de c oding a bilities. A re a ding disa b ility ma y b e due to diffic ultie s in the fo llo wing : (i) Ba sic re a ding skills. (ii) Re a ding flue nc y skills. (iii) Re a ding c ompre he nsion.

22

Artic le 7 E lig ibility Crite ria for Spe c ific L e a rning Disa bility

511 IAC 7- 41- 12 Spe c ific L e a rning Disa bility E L IGIBIL IT Y CRIT E RIA (Cont.)

(B) Writte n e xpre ssion disa bility, whic h is a spe c ific le a rning disa b ility tha t is ne uro lo g ic a l in o rig in a nd ha s a c o ntinuum o f se ve rity. Writte n e xpre ssio n is a c o mple x do ma in tha t re q uire s the inte g ra tio n o f the fo llo wing : (i) Ora l la ng ua g e . (ii) Writte n la ng ua g e . (iii) Co g nitio n. (iv) Mo to r skills. (C) Ma th disa bility, whic h is a spe c ific le a rning disa b ility tha t is ne uro lo g ic a l in o rig in a nd ha s a c o ntinuum o f se ve rity. T he a b ility to pe rfo rm ma the ma tic a l c o mputa tio ns a nd re a so ning re q uire s multiple c o re c o g nitive pro c e sse s. A ma th disa b ility ma y b e due to diffic ultie s in the fo llo wing : (i) Ma the ma tic s c a lc ula tio n. (ii) Ma the ma tic s pro b le m so lving . (D) Ora l e xpre ssion disa bility, whic h is a spe c ific le a rning disa b ility tha t: (i) is ne uro lo g ic a l in o rig in; (ii) ha s a c o ntinuum o f se ve rity; a nd (iii) is c ha ra c te rize d b y de fic its in using e xpre ssive la ng ua g e pro c e sse s to me dia te le a rning o f: (AA) re a ding ; (BB) writing ; (CC) spe lling ; o r (DD) ma the ma tic s; skills. (E ) L iste ning c ompre he nsion disa bility, whic h is a spe c ific le a rning disa b ility tha t: (i) is ne uro lo g ic a l in

• rig in; (ii) ha s a c o ntinuum o f se ve rity; a nd (iii) is c ha ra c te rize d b y diffic ultie s in using re c e ptive

la ng ua g e pro c e sse s to me dia te le a rning o f: (AA) re a ding ; (BB) writing ; (CC) spe lling ; o r (DD) ma the ma tic s;

23

Artic le 7 E lig ibility Crite ria for Spe c ific L e a rning Disa bility

511 IAC 7- 41- 12 Spe c ific L e a rning Disa bility

E L IGIBIL IT Y CRIT E RIA (Cont.) AND (2) Ca n be e vide nc e d throug h e ithe r of the following : (A) I nsuffic ie nt pro g re ss to me e t a g e o r sta te a ppro ve d g ra de le ve l sta nda rds in o ne (1) o r mo re o f the a re a s ide ntifie d in sub divisio n (1) whe n using a pro c e ss b a se d o n the stude nt's re spo nse to sc ie ntific , re se a rc h b a se d inte rve ntio n. (B) A pa tte rn o f stre ng ths a nd we a kne sse s in pe rfo rma nc e o r a c hie ve me nt, o r b o th, re la tive to : (i) a g e ; (ii) sta te a ppro ve d g ra de le ve l sta nda rds; o r (iii) inte lle c tua l de ve lo pme nt; tha t is de te rmine d b y the g ro up to b e re le va nt to the ide ntific a tio n o f a spe c ific le a rning disa b ility. T he multidisc iplina ry te a m is pro hib ite d fro m using a se ve re disc re pa nc y b e twe e n a c a de mic a c hie ve me nt a nd g lo b a l c o g nitive func tio ning to me e t this re q uire me nt.

24

Artic le 7 E lig ibility Crite ria for Spe c ific L e a rning Disa bility

511 IAC 7- 41- 12 Spe c ific L e a rning Disa bility

ASSE SSME NT (b) E lig ibility for spe c ia l e duc a tion a s a stude nt with a spe c ific le a rning disa bility sha ll b e de te rmine d b y the stude nt's CCC. T his de te rmina tio n sha ll b e b a se d o n the multidisc iplina ry te a m's e duc a tio na l e va lua tio n re po rt de sc rib e d in 511 I AC 7-40-5(e ) a nd 511 I AC 7-40-5(g ), whic h inc lude s the fo llo wing : (1) An a sse ssme nt of c urre nt a c a de mic a c hie ve me nt a s de fine d a t 511 I AC 7-32-2. (2) An obse rva tion o f the stude nt in the stude nt's le a rning e nviro nme nt, inc luding the g e ne ra l c la ssro o m se tting , to do c ume nt the stude nt's a c a de mic pe rfo rma nc e a nd b e ha vio r in the a re a s o f diffic ulty. T he multidisc iplina ry te a m ma y do e ithe r o f the fo llo wing : (A) Use info rma tio n fro m a n o b se rva tio n in ro utine c la ssro o m instruc tio n a nd mo nito ring o f the stude nt's pe rfo rma nc e tha t wa s do ne b e fo re the stude nt wa s re fe rre d fo r a n e duc a tio na l e va lua tio n. (B) Ha ve a t le a st o ne (1) me mb e r o f the multidisc iplina ry te a m, o the r tha n the stude nt's g e ne ra l e duc a tio n te a c he r, c o nduc t a n o b se rva tio n o f the stude nt's a c a de mic pe rfo rma nc e in the g e ne ra l e duc a tio n c la ssro o m a fte r: (i) the c hild ha s b e e n re fe rre d fo r a n e duc a tio na l e va lua tio n; a nd (ii) pa re nta l c o nse nt fo r the e duc a tio na l e va lua tio n ha s b e e n o b ta ine d. I n the c a se o f a stude nt

• f le ss tha n sc ho o l a g e o r o ut o f sc ho o l, a te a m me mb e r must o b se rve the stude nt in a n

e nviro nme nt a ppro pria te fo r a stude nt o f tha t a g e . (3) Ava ila b le me dic a l info rma tio n tha t is e duc a tio na lly re le va nt.

SLIDE 5

25

Artic le 7 E lig ibility Crite ria for Spe c ific L e a rning Disa bility

511 IAC 7- 41- 12 Spe c ific L e a rning Disa bility

ASSE SSME NT (c ont.) (1) A so c ia l a nd de ve lo pme nta l histo ry tha t ma y inc lude , b ut is no t limite d to , the fo llo wing : (A) Co mmunic a tio n skills. (B) So c ia l inte ra c tio n skills. (C) Re spo nse s to se nso ry e xpe rie nc e s. (D) Re le va nt fa mily a nd e nviro nme nta l info rma tio n. (E ) Pa tte rns o f e mo tio na l a djustme nt. (F ) Unusua l o r a typic a l b e ha vio rs. (2) An a sse ssme nt o f pro g re ss in the g e ne ra l e duc a tio n c urric ulum tha t inc lude s a n a na lysis of a ny inte rve ntions use d to a ddre ss the a c a de mic c onc e rns le a ding to the re fe rra l fo r the e duc a tio na l e va lua tio n. (3) Any o the r a sse ssme nts a nd info rma tio n, c o lle c te d prio r to re fe rra l o r during the e duc a tio na l e va lua tio n, ne c e ssa ry to : (A) a ddre ss the e xc lusio na ry fa c to rs liste d in sub se c tio n (a )(3); (B) de te rmine e lig ib ility fo r spe c ia l e duc a tio n a nd re la te d se rvic e s; a nd (C) info rm the stude nt's CCC o f the stude nt's spe c ia l e duc a tio n a nd re la te d se rvic e s ne e ds.

26

Artic le 7 E lig ibility Crite ria for Spe c ific L e a rning Disa bility

511 IAC 7- 41- 12 Spe c ific L e a rning Disa bility

ASSE SSME NT (c ont.) (c ) Othe r a sse ssme nts a nd info rma tio n, c o lle c te d prio r to re fe rra l o r during the e duc a tio na l e va lua tio n unde r sub se c tio n (b )(6), ma y pe rta in to the fo llo wing : (1) F

• r diffic ultie s with re a ding , the fo llo wing :

(A) De c o ding . (B) Pho no lo g ic a l a wa re ne ss. (C) Pho no lo g ic a l me mo ry. (D) Pho no lo g ic a l pro c e ssing . (E ) Ortho g ra phic pro c e ssing . (F ) Re a ding flue nc y (ra te a nd a c c ura c y). (G)Re a ding c o mpre he nsio n. (2) F

• r diffic ultie s with writte n e xpre ssio n, the fo llo wing :

(A) Ha ndwriting , whic h e nc o mpa sse s the fo llo wing : (i) F ine mo to r skills. (ii) Visua l-mo to r c o o rdina tio n. (iii) Visua l a nd wo rking me mo ry. (iv) Pho no lo g ic a l a nd o rtho g ra phic pro c e ssing . (B) Spe lling , whic h e nc o mpa sse s the fo llo wing : (i) Pho no lo g ic a l a nd o rtho g ra phic pro c e ssing . (ii) Writte n spe lling a b ility. (C) Co mpo sitio n, whic h e nc o mpa sse s the fo llo wing : (i) Ora l la ng ua g e . (ii) Re a ding a b ility. (iii) Atte ntio n. (iv) Me mo ry. (3) F

• r diffic ultie s with ma th, the fo llo wing : (A) No nve rb a l pro b le m so lving . (B) Wo rking me mo ry. (C) L
• ng -te rm

me mo ry. (D) Pro c e ssing spe e d. (E ) Atte ntio n.

L e g a l Ana lysis

OSE

P Opinio n L e tte r, 2016.

I

DE A do e s no t pro hib it te rms o f dysle xia , dysc a lc ulia , a nd dysg ra phia .

T

he re is no re q uire me nt unde r the I DE A tha t the disa b ility la b e l o r “dia g no sis” b e g ive n to stude nts, so lo ng a s stude nt is re g a rde d a s ha ving a disa b ility a nd re c e ive s se rvic e s.

Sc ho o ls must e nsure tha t stude nts a re a sse sse d in a ll a re a s re la te d to the

suspe c te d disa b ility, inc luding a s a ppro pria te , a c a de mic pe rfo rma nc e .

“T

he re is no pro visio n in the I DE A tha t g ive s a pa re nt the rig ht to dic ta te the spe c ific a re a s tha t the pub lic sc ho o l must a sse ss a s pa rt o f the c o mpre he nsive e va lua tio n; [the sc ho o l] is o nly re q uire d to a sse ss the c hild in pa rtic ula r a re a s re la te d to the c hild’ s suspe c te d disa b ility, a s it de te rmine s a ppro pria te .

27

Que stio ns

Monic a Conra d

L e wis Ka ppe s

Phone : 317- 639- 1210 219- 648- 2072

mc onra d@le wis- ka ppe s.c om

• Dr. Julie Ste c k, Ph.D., HSPP

Childre n’s Re sourc e Group

Phone : 317- 575- 9111

jste c k@c hildre nsre sourc e g roup.c om

28