Special Education Evaluations

  • Evaluations

    A medical evaluation, if necessary to "identify ALL of the child's special education and related services needs" SHOULD BE PART OF THE SCHOOL EVALUATION. Often schools will try and tell parents that something is not education related if its not directly related to academics, but as we all know, education goes far beyond simple academics.

    Stuff like remembering homework, being able to dress oneself, being able to participate socially, being able to open a door, and being able to find one's bus and walk a block by one's self to one's house is all about education, because that is what other, non-disabled students are expected to be able to do. So a "school eval" should never be thought of or allowed to be limited to what the schools call "education" -- that's nonsense. The two are inexorably intertwined.

    A full "medical" evaluation can, and should, include a full psychiatric evaluation when there are behavior problems/issues. There is often also a full neurological (not neuropsychological) evaluation to determine whether there are issues with the brain itself. And then often as part of a "full" medical evaluation, the psychiatrist or neurologist will order a thorough neuropsychological evaluation to see how the issues they have found are reflected in cognitive/brain functioning.

    If the medical (i.e., pediatrician, etc.) evaluation shows problems that may require psychiatric, neurological or neuropsychological evaluations, health insurance often covers. The prescribing pediatrician can argue with the health insurer on behalf of the family in this kind of case.

    School psychoeducational evaluations and Independent Educational Evaluations (IEEs)

    School or independent evaluations should assess children in all of the following areas, plus any others in which it appears that the child is experiencing difficulty:

    • Reading difficulty
    • Writing difficulty (both physical and getting info to page)
    • Math difficulty
    • Trouble mastering or displaying mastery of other academic content
    • Sensory Difficulty (including but not limited to hearing and sight)
    • Receptive Language
    • Expressive Language
    • Written Language
    • Assistive Technology
    • Physical impairments
    • Difficulty with balance, fine or gross motor skills
    • Communication difficulties and methods
    • Executive Function difficulty (planning, task completion, on task)
    • Behavior
    • Getting along with others
    • Independent functioning
    • Mental illness
    • Emotional disturbance

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  • Independent Educational Evaluations

    A parent’s right to request an Independent Educational Evaluation is one of the strongest rights in the federal and state laws.

    It is highly recommended that a parent ask for and receive approval by the school for an IEE before requesting a due process hearing.

    If you request that a school pay for an independent educational evaluation, there are two, and only two answers, that are legal:

    1. No. We think our evaluation is appropriate. Then the school files for a due process hearing in order to "prove" that their evaluation is appropriate and that your request for an IEE is unwarranted.

    2. Yes. We'll be happy to pay for that. Will you be picking the person on your own or do you need for us to give you an all-inclusive list of every possible evaluator?

    Is it legal for a school to say, "OK. We'll pay for your independent evaluation, but we want you to go see Dr. Expectinglotsofbusinessfrom us? Here's his number."

    No. In fact, the Office for Special Education (OSEP) addressed the 34 CFR 300.502(a)(2) requirement regarding independent evaluations in "Letter to Young" in 2003. OSEP said that there is nothing in the regulations prohibiting an LEA from providing parents with a list of qualified examiners. If, however, a LEA wants to limit parents to using the examiners on the district's list, the list must be exhaustive, i.e., all qualified examiners in the geographic location must be included on the list. Also, the LEA must include in its policy that parents must have the opportunity to demonstrate that unique circumstances may justify the selection of an IEE examiner who does not meet the LEA's qualification criteria and are not on the LEA's list of examiners. Also see 34 CFR 300.502(e).

    Controlling Possible Bias

    If you believe that you might run into a bias situation by using an evaluator handpicked by the school, choose an evaluator out of your immediate geographic area, i.e. if you live on either end of the state, go to Indianapolis. If you live in Indianapolis, go to Chicago or Louisville. This helps reduce the possibility that the evaluator might be expecting future business from the school and might shade his/her evaluation toward supporting the school’s position in an effort to secure continued future business from the school.

    Most evaluators will do a fair, honest job on their evaluations and, in fact, have a duty to do so. However, if you are concerned about possible bias, this geographic solution is a good one.

    Sample request letter for an independent evaluation:

    Dear _____:

    I / we are not satisfied with the [recent] evaluation performed by the school's evaluator [or the evaluator chosen by the district] on our child [name]. Among other things, we do not agree with X, Y, Z. [describe objections] With all due respect, we do not believe this evaluation accurately reflects our child's unique needs.

    In light of this, we are requesting that the district agree to pay for
    An independent evaluation of our son/daughter by [name of provider] who is
    A private [child psychologist / speech language pathologist / neuropsychologist / other ] located at [address] The anticipated cost of the evaluation is $____.

    Please advise if the district will pay for this independent evaluation that we consider to be essential. In the event that the district refuses to pay or fails to advise of approval within 10 days, we reserve the right to secure and pay for the requested independent evaluation. If we have to go that route, we will have no choice but to request that the district reimburse us.

    Please advise.

    Thank you

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  • LD & 18-point discrepancy model

    The Board of Special Education Appeals posted on its website on 09-28-04 an excellent statement for parents of learning disabled kiddos who are being denied services because they're not "bad enough" yet. The hearing number is 1415.04 and the full text is available at http://ideanet.doe.state.in.us/legal/appeals.html.

    "Although the School often employed appropriate assessment instruments with respect to the Student, its continual reliance upon an 18-point discrepancy from the so-called "LD Guidelines" is a substantive procedural defect that denied the Student a FAPE. The "LD Guidelines" never possessed any scientific bases, was unreliable, was invalid and directly interfered with the function of the Case Conference Committee. The employment of this long-discredited standard resulted in an application of a sole criterion for determining eligibility, which contravenes both State and Federal law. 511 IAC 7-26-8; 511 IAC 7-25-3(i). The Office of Special Education Programs notified the Indiana Department of Education over twelve (12) years ago that the "LD Guidelines" were contrary to the requirements of the IDEA. The Department of Education notified all affected parties then and continues to do so -- that the LD Guidelines and the attendant 18-point discrepancy are invalid and are not to be used. The School in this matter is charged with knowing this."

  • Neuropsych vs Psychoeducational

    Why Neuropsychological Evaluations In Lieu of Psychoeducational Evaluations?

    Susan Crum-Norris, Ph.D.

    (Note: The following item is being used with permission and the views expressed herein are those of the author.)

    There are five major reasons why a thorough neuropsychological evaluation performed by an pediatric neuropsychologist is superior to a psychoeducational evaluation. These are the inadequate range of a psychoeducational evaluation, The training of the personnel performing psychoeducational evaluations, the narrow focus of psychoeducational evaluations, the level of performance model employed in psychoeducational evaluations, and the failure of psychoeducational evaluations to assess brain behavior relationships.

    In terms of inadequate range generally, psychoeducational test batteries do not thoroughly cover the range of abilities which need to be assessed if one is to obtain an accurate profile of the nature and degree of an individuals abilities and disabilities. Even when extensive batteries such as the Woodcock Johnson are employed, school personnel typically omit many of the subtests, or use one primary measure as their assessment tool without verifying performing through the administration of confirming measures.

    The individuals administering tests within school districts vary significantly in the fields of their professional training and most importantly in their psychometric sophistication. For example, some schools have teachers, special education consultations, speech language teachers or school psychologists all of whom may administer psychological tests. A major limitation which results from this diversity of testers is a decreased reliability of the obtained results.

    Psychoeducational assessments focus almost exclusively on the demands of the typical classroom situation, often paying little or no attention to the individual's ability to adapt to social relationships within the family, or with age peers, long-term learning and social developmental demands in the community, informal learning situations or employment settings. They neglect to address the fact that the ultimate purpose of education is to prepare young people to be functionally independent contributing members ofsociety not to prepare them for proficiency in conforming to highly structured situations with narrow demands. Thus, their focus is too narrow to be of true benefit.

    Psychoeducational evaluations are normally interpreted primarily from a level-of-performance perspective in a theoretical manner with high emphasis on the face validity of the tests administered. But, there is absolutely no evidence to show that what a child can produce when assessed one on one inan distraction free environment without peer pressure is in any means a reflection of what that child's level of performance will be in real-life situations.

    Finally, psychoeducational evaluations do not assess brain behavior relationships. It is important to include measures which evaluate the relationship between the brain's functioning and the observed deficits because they help us to identify which are likely to respond to remediation and which are more likely to benefit from mastery of compensatory techniques. Such evaluations include a neurological evaluation (as opposed to an examination by a general practitioner), an audiological evaluation (in addition to any evaluation done by a speech language pathologist, an evaluation by a physical therapist, an evaluation by an ophthalmologist, and a neuropsychological evaluation. It may also include an MRI or a EEG or Spect Scan.

    The scope of a neuropsychological evaluation is significantly greater than that of a psychoeducational evaluation. It includes the level of performance evaluation where the individual's level of achievement is compared to age or grade peers, but, it moves beyond this level to include: a sign analysis, a profile analysis, a body side comparison and to look at adaptive functioning. In terms of sign analysis a good neuropsychological battery includes testing for signs (specific deficits) that are indicative of cerebral dysfunction. In other words, it looks to see whether the types of errors the individual makes are the types of errors which occur almost exclusively among brain-damaged subjects. This permits one to rule out issues such as inadequate instruction, lack of educational exposure or emotional factors. It also includes a profile analysis where the trained clinician is searching for patterns and relationships among test scores which localize the dysfunction in certain areas of the brain or which are symptomatic of certain types of disorders. In other words, does the subject show striking variability in socres on different test which fits a pattern that relates to the known functions of the anterior and posterior regions of the brain, the cerebral and subcortical regions of the brain, or of the two cerebral hemispheres, or areas within the cerebral hemispheres?

    The body side comparisons included in a neuropsychological evaluation involve administration of tasks which evaluate the adequacy of motor and sensory-perceptual functions on the two sides of the body with identical tasks (adjusting for dominance) to determine if they reveal lateralized disparities that exceed expected limits for subjects with normal brain functions. This demonstrates whether the deficits imply dysfunction or damage in the cerebral hemisphere contralateral to the defective side of the body.

    Finally, when looking at adaptive functioning, the neuropsychologist is working to determine how any cerebral dysfunctions impact upon the individual's day to day functioning in their routine environments. Differentiating deficits which are a psychological reaction to neurological problems and need to be treated with therapy and environmental modification form those which are a direct result of the neuropathology and need to be addressed through remediation (speech language therapy, occupational therapy, cognitive rehabilitation, physical therapy, neurofeedback) and compensatory mechanisms such as special educational instruction.

    A neuropsychological evaluation can not only identify whether or not there is a learning disability or ADHD or another condition, but, it can o ften identify the subtype of learning disability - ie. Verbal linguistic learning disability or a nonverbal learning disability. It can identify whether a child has a dysphonetic or dyseidetic form of dyslexia, a mix dyslexia, a restricted receptive dyslexia, a dyseidetic or visual perceptual dyslexia, a phonetic dyslexia or a normal diagnostic profile with a child performing below level because of social, motivational and educational factors as opposed to neurobehavioral deficits. A good neuropsychological evaluation can identify whether there are problems not only with attentional functions, but, whether these problems involve orienting responses, selective attention, single focus attention, sustained attention or vigilance, divided attention, hemi-attention or sustained concentration. It can tell you whether perceptual motor problems involve motor impersistence, simple, complex or disjunctive psychomotor speed. It can identify agnosia, form blindness, defective visual analysis, impaired facial recognition, and can differentiate between achromotopsia and impaired color naming. It can investigate problems with spatial localization, visual neglect, ideational apraxia and constructive apraxia. It can identify whether there is aphasic agraphia or apraxia agraphia. It can reveal auditory agnosia, word deafness, problems with figure ground discrimination, problems with prosody.

    In the area of memory it can hone in on problems with sensory registration, echoic or iconic storage, active or working memory and long term or remote memory. It terms of cognition a thorough neuropsychological evaluation can identify whether a child can discriminate stimulus characteristics, has mastered concrete concepts, defined concepts, rules or higher order rules.

    A neuropsychological evaluation can tell you about how a person approaches problem solving, information gathering, what their retrieval strategies are, their openness to insight and flexibility, how well they can brainstorm, how well they can identify patterns or sequences, how well they can analyze a situation and restate the problem in a format that will permit them to scan effectively for clues so that they can estimate, predict, project, examine their assumptions, elaborate upon information and evidence fluency, flexibility or originality when interacting with their environment.

    Now I know that not every neuropsychologist does the kind of in-depth thorough neuropsychological evaluations I am talking about. But, if you are going to get an evaluation, ask the individual to see five or six of their former evaluations with identifying information removed. Make certain it includes all of the above and that they give specific recommendations for both remediation and compensation both in school and at home. And, for the skeptics among you, I am not plugging my field or my practice. I am retired, but I know how many children I was able to help because a thorough evaluation finally identified the issues and mapped out a plan of intervention.

    To give just a few examples, I had one patient referred to me for Depression who, indeed had all the signs of depression, but, no family history and no disturbing life circumstances that could explain the findings. I did a neuropsychological evaluation with a EEG which were both contraindicative of depression, but, pointed to a viral infection. Further blood work revealed a long-term undiagnosed case of Lyme disease, which remediated completely with appropriate medical intervention. In another case, I had a number of children from the same school district evidencing signs of ADHD and being treated unsuccessfully for this condition with medication. I became suspicious when I realized none of the children had shown signs of ADHD prior to entering school. A neuropsychological evaluation with EEG confirmed my suspicious that something more than ADHD was involved, and blood tests combined with dental measures of lead in teeth revealed the children were suffering from lead poisoning. Which happened to come from old pipes in the school district having been soldered with lead. Not all neuropsychological evaluations are the same and not every neuropsychologist would have correctly identified these problems, but, I can guarantee you that a psychoeducational evaluation would never have caught such problems, and consequently, the appropriate interventions could not have been pursued.

    Reprinted with permission from Susan Crum-Norris, Ph.D.

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