This is the first part in a two-part series. Come back next week to learn more from our experts and authors. Katherine is an 8 year old who attends public school. Following a traumatic event, she began to insist on wearing a helmet to school and during class. When school personnel requested she remove the helmet, she adamantly refused, expressing fear that the ceiling would fall and they would all be killed. Her grades have dropped considerably, and she is having problems socializing with peers. Her mother reports similar disruptions at home. Katherine’s grades have dropped to Ds and Fs, and her behavior has become disruptive in class. She cries frequently and has most recently expressed a desire to stay home from school. Jeremy is a fifth grader who currently receives special education services under the category of emotional disturbance (ED) and other health impaired (OHI). One year after his initial ED diagnosis, he was diagnosed with autism spectrum disorder (ASD). His original ED eligibility was based on violent behavior in kindergarten and first grade. Once it became evident that his violent outbursts were related to characteristics associated with his ASD diagnosis and appropriate interventions were put into place, Jeremy was able to function more effectively at school. His grades are above average, and he has not experienced any behavioral outbursts since second grade. His parents are planning to place him in a private school and have requested an evaluation to eliminate the ED diagnosis. They believe the OHI eligibility is the most appropriate eligibility for him; the school administration and teachers agree. Brian is a 15 year old who was expelled from his last school for calling in a bomb threat. The administration at his home school considers him occasionally volatile and “a constant liar.” His mother confirms the lying and additionally reports daily fights between Brian and her live-in boyfriend. She states that “he hangs with a bad crowd, and his behavior is out of control.” Brian’s teachers describe him as a loner who appears sad throughout the school day. His grades have dropped from Bs to Ds and Fs. These three cases exemplify the diversity and difficulty inherent with evaluating students who have been referred for a comprehensive assessment due to academic and/or behavioral concerns. History of ED Prevalence In the 2001-2002 school year, there were 6.3 million students in special education programs. Of these, 473,663 were classified as emotionally disturbed, according to the National Center for Education Statistics—a number that had increased 18.4% from the previous 10 years (1991-1992). By 2002, ED had become the fourth most prevalent of the 13 exceptionalities served by special education, and there was every indication that an increase in both number and proportion for this group would continue to occur. Instead, we began to see a decline. By the 2011-2012 school year, only 373,000 students were classified as having ED.  It appeared the numbers were dwindling. Yet, recent research has reported that parents and caregivers of more than 8 million school-aged children ages 4 to 17 years have sought help from a mental health professional or school staff member about their child’s emotional or behavioral difficulties. Clearly, questions arise. What accounts for the disparity between those asking for help and those receiving services? How do we account for what appears to be an under-identification of ED in the schools? What can we put in place to stop the decline and get those who require help the services they need? The Difficulty with ED Eligibility Students with emotional disturbance are especially difficult to assess and identify, and the evaluation itself is time consuming. Whether determining, changing, or removing eligibility, clinicians usually have an idea of who needs help emotionally. However, determining whether a student qualifies for special education services within the Individuals with Disabilities Education Act (IDEA) category of ED can be complicated. One of the greatest challenges in determining eligibility services involves the social maladjustment/emotional disturbance dichotomy. The term socially maladjusted (SM) has not been defined by IDEA. The federal definition of ED, which was written in 1957 and remains virtually unchanged, leaves the operationalization of the criteria set forth by IDEA to individuals and organizations in the field along with state and local educational agencies, who are responsible for implementing special education services. To further complicate matters, we have only recently begun to question the longstanding belief that SM students externalize their behaviors, while ED students internalize their behaviors. However, since ED was defined in 1957, neuroscience has shown that “brain differences underlie both internalizing and externalizing behaviors,” says Richard M. Marshall, EdD, PhD, author of the Pediatric Behavior Rating Scale (PBRS). “From a neurobiological perspective, therefore, the only difference between the two is the expression of behavior. There is little evidence that students with externalizing behaviors are any more capable of controlling their emotions or behavior than students with internalizing disorders. Yet students with internalizing disorders are provided with interventions, while students with externalizing behaviors are punished.” In addition to the difficulties defining and determining SM versus ED, the federal criteria definition includes two potential areas of ED eligibility that are very broad and have no clinical definition:
    • “An inability to build and maintain satisfactory interpersonal relationships with peers and teachers.”
    • “Inappropriate types of behavior or feelings under normal circumstances.”Also, the Office of Special Education Programs (OSEP) has never provided official guidelines for potential exclusionary criteria for an ED diagnosis such as severity, educational impact, and duration. Although some feedback on these issues has been provided, no formal guidelines have been published. The federal definition does allude to some clinical conditions (e.g., depression, anxiety, and schizophrenia), but it doesn’t provide guidelines for how these conditions should be diagnosed.Lastly, we cannot negate the fact that in the past, psychologists lacked psychometrically sound instruments to provide them with the hard data needed to substantiate a well-informed decision in regards to ED eligibility.
Come back next week to learn more on this topic from our experts.
vas_erSometimes, measuring a client’s or student’s overall intellectual ability isn’t as simple as administering the RIAS-2 , the TOGRA, or the RAIT. Sometimes, very young children; those who speak English as a second language; and those with communication or speech disorders, attention disorders, autism spectrum disorders, traumatic brain injury, and other conditions have difficulty on traditional tests of IQ—and they may be underserved simply because they can’t be tested accurately. The Vocabulary Assessment Scales (VAS) offer an alternate way to assess overall intellectual ability by measuring expressive and receptive vocabulary ability. Research has shown that vocabulary ability correlates strongly with cognitive ability, so professionals can confidently use data from the VAS to estimate general intelligence in individuals ages 2 years, 6 months to 95 years. The VAS correlates strongly with the Reynolds Intellectual Assessment Scales (RIAS), a trusted measure of general intelligence. Help uncover your client’s intellectual abilities and get them the help they need to succeed. With very little motor skill required, and no reading or writing necessary, the test is suited for those who have difficulties taking traditional IQ tests. The VAS uses modern, engaging photographs (not outdated line drawings, like other picture vocabulary tests) to gauge expressive and receptive language ability. It offers digital stimuli (available on an iPad) to engage younger clients, and scoring is available on PARiConnect, our digital assessment platform. The VAS-Expressive asks test-takers to look at a picture and answer, “What is this?” Items were generated so the number of possible one-word answers was limited. The VAS-Receptive asks test-takers to respond to questions like, “point to the frog” when presented with an array of four possible answers. There are few overlapping items between the receptive and expressive versions, which helps reduce practice effects. In addition, each test includes two equivalent forms (A and B) with no overlapping items and reliable change scores, making it a useful tool for measuring response to intervention (RTI) in school-based reading programs, medical settings, or after injury or illness. The VAS is the only picture vocabulary test that provides a composite score and a reliable change score. It also features less complicated basal and ceiling rules, so it’s easier to administer and score than similar measures. Each test only takes about 15 minutes to administer, and normative data are provided for 28 different age groups and for Grades K-12 (spring and fall). For more information about the VAS, visit www.parinc.com or call 1.800.331.8378.
Whether you need to screen, diagnose, or track individuals on the autism spectrum, the PDD Behavior Inventory™ (PDDBI™) family of products has what you need. The original PDDBI was developed to assess both problem behaviors as well as appropriate social, language, and learning/memory skills. The two newest supplements to the product line expand its use, making it even easier to diagnose, track, and assess autism spectrum disorder. Now available! The PDDBI Professional Manual Supplement: Autism Spectrum Decision Tree (ASD-DT) The ASD-DT is designed to enhance the diagnostic power of the PDDBI. Once a parent or teacher has completed the Extended Form, the ASD-DT allows you to use those scores to complete the branches of a decision tree that ultimately results in a diagnostic category. An algorithm is used to transform PDDBI scores into subgroups of ASD (Atypical ASD, Minimally Verbal ASD, or Verbal ASD) as well as non-ASD subgroups. Intervention suggestions and further recommendations are provided for all subgroups. The ASD-DT is designed to be used with individuals ages 1:6 to 12:5 years. Now available! The PDDBI Professional Manual Supplement: Adolescent Normative Data This new supplement extends the age range of the PDDBI normative data to age 18:5 years. Ideal for use when monitoring progress over time, this extension to the normative data can be used with both parent and teacher ratings on the PDDBI. The standardization sample includes individuals from a range of racial and ethnic backgrounds and geographic regions. The adolescent normative data are appropriate for use when either the standard or extended items are administered. Whether you are a PDDBI user who wants to expand its use in your practice or are new the PDDBI family of products, visit www.parinc.com today to order the materials you need!  
The latest test from popular author Cecil R. Reynolds, PhD, the new Reynolds Interference Task (RIT) is a test of complex processing speed that assesses general neuropsychological integrity.  It is suitable for measuring the effects of traumatic brain injury, stroke, dementia, Alzheimer’s disease, and brain tumors. It is also useful as a measure of attention and complex processing speed deficits and as a rapid means of measuring recovery from concussion. Measurement of speeded processing is popular in psychological testing, and most measures are exceedingly simple. Measuring how quickly one can perform simple tasks that, given unlimited time, almost everyone would complete perfectly is a reflection of speeded processing. The RIT adds a layer of cognitive processing difficulty—inhibition and attention-shifting—to simple tasks, which slows performance and requires extra mental effort, making the tasks more complex and thus more indicative of cognitive flexibility and selective attention. The RIT features two timed Stroop-style subtests, Object Interference and Color Interference, which combine to provide a Total Score. This provides greater coverage, enhanced consistency, and more reliability than similar measures featuring a single subtest. It was designed to provide continuity of measurement across a wide age range, so it is appropriate for individuals ages 6 to 94 years. The subtests require minimal motor demand and can be administered in just 90 seconds. Like intelligence and memory assessments, mental speeded processing (or decision speed) can be a crucial contributor to the diagnostic process for a variety of disorders, particularly those associated with compromised neuropsychological integrity. Conormed with the Reynolds Intellectual Assessment Scales, Second Edition (RIAS-2), the RIT includes a large standardization sample (N = 1,824) representative of the 2012 U.S. Census and includes reliable change and discrepancy scores. It’s the best of all possible psychometric worlds. For more information, visit www.parinc.com or call 1.800.331.8378.