Tag Archive for 'Assessment'

Students with EBD Hit Hardest by Texas Cap in Special Ed Enrollment

According to reports Brian M. Rosenthal published in the Houston (TX, US) Chronicle, since the early 2000s when the Texas Education Agency (TEA) essentially limited enrollment in special education to 8.5% of the school population, the category of students with disabilities that saw the largest decline in enrollment was emotional disturbance.

Mr. Rosenthal published a series of articles reporting his investigation of systematic denial of services to students with disabilities in Texas beginning in September 2016. The TEA created a system for rating local education agencies’ special education programs that included a benchmark for how many students should be be enrolled. In an installment published 19 November 2016 and entitled “Mentally ill lose out as special ed declines,” he begins the report with the story of Alston Jeffus, an adolescent who is on his way home after spending months in a state hospital. Here are a few paragraphs from Mr. Rosenthal’s article:

The Texas Education Agency’s decision to set an 8.5 percent target for special education enrollment has led schools to cut services for children with all types of disabilities, but mentally ill students like Alston have been disproportionately affected, the Houston Chronicle has found.

Federal law requires schools to provide counseling, therapy, protection from discipline and other support to children with “emotional disturbances,” including severe anxiety, depression, bipolar disorder and post-traumatic stress disorder. Today, however, Texas schools serve 42 percent fewer of those students, relative to overall enrollment, than when the TEA set the benchmark in 2004.

It is a bigger drop than has occurred in almost any other disability category.

In all, an estimated 500,000 school-age children in Texas have a serious mental illness that interferes with their functioning in family, school or community activities, according to the state Health and Human Services Commission.

Only 30,034 receive special education services.

There is a lot more to this story (subscription may be required). I recommend it to readers. Also, I encourage readers haven’t been following Mr. Rosenthal’s excellent reporting on this matter to catch up; the Chronicle published a guide to the series.

Summary of workshop on measuring SED in children

On 1 February 2016, the US National Academy of Sciences published a booklet that summarized the presentations and discussion at a workshop on measuring serious emotional disturbance in children. Some readers of EBD Blog probably will want to secure a (free) copy. The accompanying image, which is a 2013 infographic from the US Centers for Disease Control, appears on page 19 of the report. The following is the recommend citation for the report:

National Academies of Sciences, Engineering, and Medicine. (2016). Measuring Serious Emotional Disturbance in Children: Workshop Summary. K. Marton, Rapporteur. Committee on National Statistics and Board on Behavioral, Cognitive, and Sensory Sciences, Division of Behavioral and Social Sciences and Education. Board on Health Sciences Policy, Institute of Medicine. Washington, DC: The National Academies Press.


Briefer, accurate diagnosis of Autism is possible

Using machine-learning techniques, Professor Dennis Wall and colleagues were able to achieve highly accurate classification of children with Autism that only required a small selection of items from the Autism Diagnostic Observation Schedule-Generic (ADOS). The ADOS, a semi-structured and standardized assessment used with children suspected of having Autism, has four 30- to 60-minute parts where children are observed for social interaction, communication, play, and imaginative use of materials; it is very widely used in diagnosis of Autism, Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS), and non-spectrum disorders. As they reported in Translational Psychiatry, Professor Wall’s team was able to determine that 8 of the 29 items in Module 1 of the ADOS were sufficient to classify autism with 100% accuracy.
Continue reading ‘Briefer, accurate diagnosis of Autism is possible’

Parent questionnaire picks up ASD at age one

According to a report published 10 July 2012 in Autism: The International Journal of Research & Practice by Lauren Turner-Brown and her colleagues of the University of North Carolina, their First Year Inventory (FYI) completed by parents when their children were only one year old correctly identified nine children who were later found to have Autism Spectrum Disorders.

Initially almost 1200 parents completed the FYI—a 63-item questionnaire that only requires about 10 minutes to fill out—when their children were 12 months old and agreed to participate in later research; at the time they completed the FYI the researchers had no scales to indicate whether scores indicated risk. At follow-up within 6 months of the the children’s third birthday, almost 700 then completed additional assessments—Social Responsiveness Scale–Preschool Version and the Developmental Concerns Questionnaire. Using these data (which they scored liberally so they wouldn’t miss possible cases), the researchers identified children at risk for developmental disorders.

They invited families of those at risk (as well as a few not-at-risk children so that the psychologists, who were kept naive about the purposes of the assessments, doing the assessments would have a few “ringers” in the group) to visit the research site for additional assessments. Assessments included the Mullen Scales of Early Learning and the Autism Diagnostic Observation Schedule; parents completed a clinical interview, the Vineland Scales of Adaptive Behavior (2nd Edition), and an autism spectrum diagnostic checklist of symptoms according to Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition.

Using these data, the researchers were able to identify the the nine cases of ASD (6 with Autism, 3 with PDDNOS). (Of course, some had been diagnosed in the community.) In addition, they found that over 40 children apparently had been diagnosed or treated for non-ASD developmental problems, and over 80 more children were in a group they called “Developmental Concerns” meaning that “that parents reported some concern or that a professional had noted some concern about the child” (p. 9). In total, that is roughly 18% of their 700 participating children.

“These results indicate that an overwhelming majority of children who screen positive on the FYI indeed experience some delay in development by age three that may warrant early intervention,” Grace Baranek, senior developer of the FYI, said.

Now that Professor Turner-Brown and her colleagues have been able to follow this sample of children into early childhood, they can see how their instrument predicts developmental problems, and they will be able to begin using it more practically. Additional payoff will come as they are able to follow the children into the school years.

Although this research team is focusing on Autism and ASD, it may be that their larger contribution will be the benefits of screening for a wide spectrum of disorders. Early detection and intervention is likely to be beneficial for problems beyond ASD!

Turner-Brown, L. M., Baranek, G. T., Reznick, J. S., Watson, L. R., & Crais, E. R. (2012). The First Year Inventory: A longitudinal follow-up of 12-month-old to 3-year-old children. Autism, 16. Published online before print July 10, 2012. doi: 10.1177/1362361312439633

The UNC Med School’s press release provided the quotes I’ve used here: Questionnaire completed by parents may help identify 1-year-olds at risk for autism. The FYI questionnaire was developed by the Program for Early Autism Research, Leadership & Service (PEARLS) team. One can learn more about the FYI from the PEARLS Web site.

Research participation opportunities

In an accompanying PDF I have listed studies that are currently seeking children (both female and male) with Emotional of Behavioral Disorders (especially autism spectrum disorders) as participants (some include adults, as well) that are registered with ClinicalTrials.gov, a service of the US National Institutes of Health (NIH). The studies have diverse purposes: They may be observing different events (whether overt behavior or neurochemical activity) or they may be testing different therapies (ranging from behavioral to medical methods). Many are sponsored at least in part by the NIH, but some have funding from universities or even private industries. Because of its affiliation with NIH, ClincialTrials.gov is more likely to represent medically oriented studies and studies that use rigorous scientific methods (i.e., randomized clinical trials or RCTs), but this is not exclusively the case. Readers should examine the studies carefully.

The list is not exhaustive (I used “autism” in the search, so there are many more studies that could be located by using other terms), and I’ve provided only some of the data about each study in the table, but you can learn a fair bit about individual studies. For example, one can learn about study number NCT00198107 that is entitled “Evaluating the Effectiveness of Aripiprazole and D-Cycloserine to Treat Symptoms Associated With Autism.” It focuses on individuals with Autistic Disorders and examines an intervention (in this case, comparing drugs called Aripiprazole D-cycloserine to placebo in a randomized design with double-blind (Subject, Caregiver, Investigator, Outcomes Assessor) | Primary Purpose: procedures. The study began 1-Sep-05 and will end 1-Sep-11 (making it odd that it is still listed as open, no?).

To locate additional information about a particular study, copy the NCT ID number, go to ClinicalTrials.gov, and enter that number into the search box. Download the PDF here (10 pages).

Screening teens

Writing under the headline “Pros and cons of screening teens for depression,” Brendan Borrell examined some of the issues that sometimes roar around surveying youths to identify those who are depressed or at risk for depression. Mr. Borrell’s article, which is one in a series of articles about depression appearing in the Los Angeles Times, addressed concerns such as parental reservations about testing of their children without permission, false positive identification of a high percentage of students, and the absence of adequate treatment for many who need help.

Mr. Borrell established the importance of the issue in his lead:

By the time a teenager graduates high school, about one out of nine of his or her peers has attempted suicide. Suicide is the third leading cause of death among young people, behind car accidents and homicide, and 10% to 12% of teens ponder suicide every day.

Continue reading ‘Screening teens’