Vignette #1: Referrals
Frank wanted to help his supervisees avoid being obligated
to administer excessive standardized tests. Because student evaluation teams
obtained parental permission for specific test instruments without a
psychologist’s input, Frank advised his supervisees to serve on the student
development teams. This enabled the psychologists to generate appropriate
referral questions with the team and, when necessary, develop suitable
assessment plans that targeted specific referral questions.
Vignette #2: Discrepancy
Penelope turned to curriculum-based assessment when she
became frustrated with the lack of helpful information obtained during
psycho-educational evaluations. Standardized achievement test results
invariable indicated that students were performing at grade level, even when
they clearly could not meet teacher’s expectations. Parents, teachers and
Penelope could never understand that discrepancy.
Dilemma #1: Teammates?
There is a senior student on track to graduate this year
on your school psych practicum student’s re-evaluation caseload. He is
eligible for services under Orthopedic Impairment due to Spina Bifida. Your
practicum student noted in her chart review that the student was eligible for
OI and SLD in middle school only. Last spring at his annual IEP review,
his case manager wanted to "add the SLD" label back on. At the time,
you told her to wait until the fall for the re-evaluation. The student is
in general education classes performing well, but she is still asking for this. What
are the supervisory considerations? What should be done?
Dilemma #2:
Drawing the Line
Your practicum student comes to you to tell you that the
other school psychologist in your district has suggested that the three of you
develop a “standard battery” of tests for you to use for all new referrals.
Additionally, he wants you to share your budget to purchase some
neuropsychological standardized test kits so the district doesn’t have to make
expensive referrals to the local hospital. What
are the supervisory considerations? What should be done?
Reflection
Question #1: Measurement
How do competent school psychologists select evidence-based
and appropriate assessment tools? How have changes in cognitive theory
influenced this?
Reflection
Question #2: SLD Eligibility
What problems are associated with the discrepancy model of
diagnosing learning disabilities? What are the benefits of and concerns with
using cognitive testing?
Dilemma #2 - Drawing the line
ReplyDeleteThere are several issues that come to mind immediately when reviewing this dilemma. First is the idea of developing a "standard battery" of tests to use for all referrals. This flies in the face of almost all best practices we have discussed. When students are referred for case studies their cases should be scrutinized individually by the team to determine which assessments are required in order to answer the referral question. Developing a "standard battery" might in some cases result in significant over-testing of students or, on the flip side, might result in under-testing or the team missing important pieces of data that need to be obtained and evaluated in order to inform decisions regarding educational intervention and placement. No two students or their needs are the same and accordingly, no identical battery of tests should be given to students being referred.
The second issue arises around the idea of buying a set of neuropsychological assessments. This is fine as long as one of the psychologists is certified and trained to administer and interpret these tests and will be the only person doing so within the school setting.Practicing within the constraints of one's professional boundaries and abilities is important and a the regular Ed.S. degree with an NCSP endorsement does not qualify someone to administer neuropsychological testing.
As a supervisor I would first contact the other psychologist to make sure that the information I had received was correct. I would want to hear why the psychologist felt these steps were necessary and what was driving these decisions. I would discuss what I see as the ethical violations and make it known that I was not comfortable with other of these propositions. I would then separately discus these ethical and practical concerns with my practicum student. I would want to make sure the student was not put in the middle of this disagreement. Hopefully by discussing the issue with the other psychologist I would be able to change their mind. If they continued to try to move ahead with their plans I might enlist the help of our supervisor, the special education supervisor, or whoever fills that role, to ensure that we are delivering services in a legal and ethical manner.
Dilemma #2: Drawing the Line
DeleteHonestly, I think Amy's response is incredibly thorough and right on the mark-- I'm not sure how much more I can add. I think I would take a very similar, if not identical, approach to the one Amy described. It's certainly not best practice to assume that every student would benefit from the same battery of tests, and additionally, at the elementary level and in schools properly implementing RtI, more emphasis is often placed on curriculum based assessments and other such tools. I think many schools fail to spend sufficient time writing domains and carefully determining, as a team, which tests would be most appropriate. Time is a precious commodity in schools, and making sure we are as efficient and thoughtful as possible in the evaluation process is very important.
I also agree with Amy about being cautious when considering neuropsychological assessments. I think it is important that school psychologists have enough familiarity with that area of testing to suggest when a neuropsychological evaluation may be helpful, but it certainly requires more extensive consideration and planning than a decision to give a WISC, for example. Sometimes those referrals to local hospitals may be necessary considering the resources within the school.
As a supervisor, I would explain all of this to my practicum student, and involve the student in a meeting with myself and the other psychologist. If consensus cannot be reached, I would ask other staff/administration within the special education department to join the discussion as well, and stress to my practicum student the importance of collaborating and never making decisions in isolation. Especially when it comes to sharing and spending financial resources, care must be taken to ensure that the purchases would be sufficiently valuable to our work and appropriate for us to administer.
Dilemma #1 - Teammates?
ReplyDeleteI think this situation can be used as a great teaching moment for the practicum student. However, I believe the supervising psychologist would need to take a large role in overseeing the re-evaluation with her practicum student because it seems to be a complicated situation. In particular, the psychologist may need to have multiple discussions with the student's case manager to ensure she understands the complexities of the case and the issues with adding the SLD label back on to the student.
In terms of adding SLD back on, it doesn't seem to be warranted. If the student is performing well in general education classes, it appears that this student doesn't need the additional support he may gain from being labeled as such. Additionally, if the student did need more intensive academic intervention, he should go through RTI to obtain this support. There is a reason that he was previously exited from being SLD, so the issues may now be completely different than before. The RTI process may be enough support to keep the student on track academically and the SLD label may be unneccessary. In either case, the psychologist would need to explain this to the case manager, as well as try to gain mor insight into why the teacher is pushing for the SLD label.
Dilemma 1- Teammates
ReplyDeleteThe main supervisory consideration in this case is if the SLD label is appropriate or not. One should not simply “add a label” if one is needed. Asking the case manager to wait until an appropriate time to add the label was effective but now it needs to be addressed. If a student is on track to graduate and has been successful in classes, it appears that an SLD label may be inappropriate. It would be important to encourage your practicum student to consider these options prior to a domain meeting so that when the domain arrives, she/he can be ready for the case managers input. It would also be important to make sure the practicum student, case manager as well as the parents understand the definition of educational impact when it comes to eligibility. I also agree with Emily on this one that with the RTI process, a SLD label may be completely unnecessary in that the student can get the support he/she needs through the general education setting with tiered supports.
Dilemma #1- Teammates?
ReplyDeleteEmily S. I think you bring up a really good point about the importance of the supervisor in overseeing this situation. It sounds like it may become quite contentious if the case manager continues to push for the SLD label without going through the RtI process. This would be a challenging situation for a practicum student to handle independently.
It sounds like it would be a disservice to the student to add the SLD label simply because he was given services under the label in the past. I wonder if in this situation the case manager might be trying to expedite the process of qualifying the student (i.e. not utilizing RtI) for services to ensure he has them in place after he graduates. The case manager may have good intentions, but seems to have a simplistic view of how to ensure this student is supported. According to the information provided the student is on track to graduate. It would be important to understand the supports and accommodations that may benefit this student and can be provided without an SLD label. I agree with Emily S. that the psychologist and practicum student should try to better understand why the case manager is pushing the SLD label.
Reflection Question 2- SLD Eligibility
ReplyDeleteOne of the main problems with using the discrepancy model for qualifying students with SLD is the lack of responsiveness to student needs. Using cognitive and achievement testing does not examine the core instruction the student received and the additional interventions provided to help the child catch up to peers. If a student is behind in reading from an early age and does not receive adequate support, his/her deficit will get bigger with time. Instead of intervening early, the discrepancy model requires the school to wait until the student's deficit is too wide and he or she needs special education services. The student may not have had an SLD, but just required some additional support early in his or her school career.
Another problem with using the discrepancy model that I've seen in the field is that students who need support do not qualify due to the lack of discrepancy in their IQ and achievement scores. Because students have below average intelligence (but not low enough to be considered to have an intellectual disability)and their achievement in corresponding low, students who need additional intensive support in school are not qualified for special education. These low expectations allow students to be behind their peers without accountability to the school.
One of the concerns I would have with standardized testing and cognitive testing is that culture and background have a strong influence on test performance. A student with without exposure to certain experiences may perform lower on IQ tests, even if their actual IQ is higher. Overreliance on this one measure to determine a student's eligibility is problematic. I do think that cognitive assessments can provide information on strengths and weaknesses that cannot always be found with curriculum based measurements. Recently, we found a student eligible for SLD. We administered a WISC due to concerns with cognitive abilities. The results showed us that processing speed specifically was a concern. Many staff were concerned with the student's behavior in the class and this information helped them understand the student better. So there can be benefits to cognitive assessments as long as they are used with clinical judgement.
Reflection Question #1: Measurement
ReplyDeleteDecreasing dependence on global measures of intelligence obtained through cognitive testing has facilitated a greater focus on assessment of specific academic, social, and other relevant skills students need to be successful in school. Now that we know a student's processing speed or perceptual reasoning, for instance, is likely to be fairly fixed we are no longer looking to remediate them in the hopes that doing so will cause the student to make gains in multiple areas. We know through research that targeted intervention addressing specific areas of need is much more efficacious, and so a competent school psychologist uses assessment tools that measure those specific skills deficits.
School psychologists need to consider both standardized, normed assessments like CBM, achievement tests, and ratings scales as well as more informal measures such as observational data and classroom assessments in order to assess student needs. School psychologists always need to look at special factors affecting a student, such as being and English language learner, being from a non-majority race or culture, as well as seeing if there are any established or suspected medical, cognitive, or mental health needs when choosing assessment tools. Checking which populations a given was normed with and validated for is an example of one very important step in choosing evidence- and research-based assessment tools.
One thing I think that would make CBM in particular a more effective tool for assessing the specific academic needs of (especially older) students would be to increase the alignment between CBM measures and common core standards by developing and norming a variety of new measures.
Emily,
DeleteI think you did a great job outlining the steps in choosing and administering evidence and research based assessment tools. I think it's interesting that you bring up common core standards. This is something that has been introduced to my district this year and we are moving towards implementation of these standards throughout our schools. I have felt that teachers are the main focus of professional development of common core standards and think that psychologists and other support staff are not fully included in the conversation. If the teachers are adjusting and creating their curriculum to meet these standards, our curriculum based assessments should reflect these standards as well. I hope that assessment tools for psychologists are developed to align with these standards, just as you stated. Great post!
Susan
Reflection Question #2
ReplyDeleteI think the discrepancy model of diagnosing learning disabilities works in some cases in which there is a large and specific discrepancy. However, it does not provide detailed information as to how a student responds to different types of instruction or interventions or their performance on specific curriculum goals. Additionally, when a student is cognitively low and achieving on par with their assessed cognitive ability, they still may need extra help and supports but not be qualified based on the lack of a discrepancy.
A benefit of cognitive testing is it gives concrete numbers and ranges and it can give examiners insight into the student’s hardwiring. However, it is only a starting point. It does not necessarily respond to the referral question or give school-specific information. It also does not typically give the team an answer to all the questions. A student has low processing speed—why and how can we best help them? In most cases, these questions can only be answered with further probing. It is the team’s job to collect more information to adequately assess how to tailor a program to the needs of the child. Finally, cognitive testing is biased. Many people, parents in our district especially, seem to feel more secure when they have their child’s “IQ score.” In many cases, cognitive assessments rely heavily on a student’s language and cultural experiences. Thereby not providing an accurate assessment of all students’ abilities. It is important to really tailor the evaluation to the needs of the child. Just as one-size-fits-all doesn’t work in education it also doesn’t work in assessment.
I think these questions lead to changing how school’s perceive the role of special education.
Vignette #1
ReplyDeleteI think Frank's idea is a wonderful way to get more school psychologist input into the team meetings. I think that our role as school psychologists can often be confused in the minds of other staff members and having a school psychologist on the team will definitely clear some of these questions up. It would also allow the interns a chance to share the wide variety of assessments that can be used for evaluating the students and how each assessment is unique. This will provide the interns with the opportunity to choose assessments that are appropriate for the student in question and that will yield results that ultimately assist the school in helping that student succeed.
In the high school I am working in, some teachers and staff think that the school psychologist's role is to just evaluate any student that is referred to him with a standardized assessment battery. My supervisor has tried to explain that we can't just assess every student that teachers have concerns about. There needs to be some guidelines put in place such as the amount of student growth when interventions have been implemented or cut-off scores on the MAP testing that will help identify which students may need to be evaluated further.
Vignette #1
DeleteObviously I'm biased, but like Kari, I think it's a no-brainer that school psychologists should be part of the team that decide referral questions and evaluation tools. I didn't realize this was sometimes not the case- at my practicum and internship sites the psychologist has always been present at the domain meeting where the evaluation was mapped out (except in speech-only instances). School psychologists are uniquely qualified to utilize and interpret a wide variety of assessment tools- far beyond the "standardized" battery Kari referred to. It's doing an injustice to the student to have people who aren't qualified in this area make crucial decisions about how the evaluation will look. I agree with Kari that this would be great experience for the intern, and could perhaps give them more credibility within the school.
Personally, however, I don't feel like I quite have the knowledge and experience necessary to make these decisions entirely on my own. Each site I've been at has had different evaluation tools available to me, and I am only now starting to learn about the novel ones at my internship site. Nonetheless, I've enjoyed the process of brainstorming with my supervisor about which assessment tools make sense for a given case. We've been able to minimize gratuitous testing in some instances, though we have ended up agreeing to testing we wouldn't have otherwise selected at the team's urging. This speaks to the fact that, even with the psychologist present, that person is still just one member of the team and needs to take into account everyone's opinion. Regardless, there's no doubt in my mind that the psychologist should be a part of that team.