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Evidence-Based Assessment and Intervention for Specific Learning Disabi Psychology Kate E. Jacobs, Dawn ity in School P. Flanagan, and Vincent C. Alfonso Introduc' n Historically, the approach to specific learning disability (SLD) identification not only differs from state to state within Australia but also di fers greatly from that in other countries such as the United States. In actuality, SLDs have not generally been formally recognized or funded in Australian schools. Consequently, identification of SLD does not usually form part of school pol- icy or procedure (Firth, Frydenberg, Steeg, & Bond, 2013), and Australian school psycholo- gists have reported minimal knowledge and skills in this area (Klassen, Neufeld, & Munro, 2005) However, community and political support for the formal recognition and funding of SLD stu- dents has been increasing in Australia more recently, with a 2010 report by the federal Dyslexia Working Group identifying the need for professional development for all school psychol- Excerpts of this chapter were adapted or reproduced with permission from Wiley, All rights reserved, K.E, Jacobs (2) Faculty of Education, Monash University, Wellington Road, Clayton, VIC 3800, Australia e-mail: kate jacobs@monashedu DP. Flanagan ‘St. John’s University, Queens, NY, USA VC. Alfonso Gonzaga University, Spokane, WA, USA © Springer International Publishing Switzerland 2017 M. Thielking, M.D. Terjesen (eds.), Handbook of Australian DOT 10.1007/978-3-319-45166-4_§ ogists in the recognition, assessment, and diag- nosis of SLD (Bond et al., 2010). Further, in 2015 a review of the Victorian Program for Students with Disabilities began, with a particu- Jar focus on the ability of the program to support students with dyslexia via the provision of addi- tional resources to schools (Victorian Department of Education and Training, 2015). It is thus timely to consider what constitutes evidence- based identification of SLDs, and how these defi- nitions may be applicable within the Australian school system. To achieve this goal, an examina- tion of the US context is useful since the process of SLD identification has been formally legi lated in this country for some time. Prior to elimination of the ability-achieve- ment discrepancy method of SLD identification from the Diagnostic and Statistical Manual of Mental Disorders—Fifth edition (DSM-5; American Psychiatrie Association, 2013), there had been moves within the United States toward a response-to-intervention (RTI) frame- work as well as analysis of an individual’s pat tern of cognitive and academic strengths and weaknesses (Sotelo-Dynega, Flanagan, & Alfonso, 2011). While the RTI framework pres- ents with many strengths, there are a number of salient weaknesses associated with using it as a stand-alone method of SLD identification. In contrast, the pattern of cognitive and academic strengths and weaknesses approach can be 145 n School Psychology, 46 KE. Jacobs et al. considered to provide a sound evidence-based framework for understanding the presentation and manifestation of SLD (e.g., Flanagan, Ortiz, & Alfonso, 2013). After defining SLD and outlining some of the frequently used classification systems currently available, prevalence rates of SLD in both Australia ‘and the United States will be presented. The histori- cal context for the current state of SLD identifi tion in the Australian educational system will then be outlined and contrasted with past and present methods of SLD identification in the United States. This includes the ability-achievement discrepancy method, RTI, and pattern of cognitive and academic strengths and weaknesses. Definition and Classification Systems of SLD in the United States Definitions of SLD date back to the mid to late 1800s within the fields of neurology, psychol- ogy, and education (Mather & Goldstein, 2008) The earliest recorded definitions of SLD were developed by clinicians, based on their observa- tions of individuals who experienced consider- able difficulties with the acquisition of basic academic skills, despite their average or above- average general intelligence, or those who lost their ability to perform specific tasks after a brain injury that resulted from either a head trauma or stroke (Kaufman, 2008). Given that clinicians at that time did not have the necessary technology or psychometrically defensible instrumentation to test their hypotheses about brain-based SLD, the medically focused study of SLD stagnated, leading to the development of socially constructed, educationally focused defi- nitions that presumed an underlying neurologi- cal etiology (Hale & Fiorello, 2004; Kaufman, 2008; Lyon et al., 2001). In 1963 Samuel Kirk addressed a group of educators and parents at the Exploration into the Problems of the Perceptually Handicapped Child conference in Chicago, Ilinois. At this confer- ence, Kirk presented a paper entitled “Learning Disabilities” that was based on his book, Educating Exceptional Children (Kirk, 1962). In this paper Kirk defined learning disabilities as a retardation, disorder, or delayed development in ‘one or more of the processes of speech, language, reading, writing, arithmetic, or other school sub- jects resulting from a psychological handicap ‘caused by a possible cerebral dysfunction and/or ‘emotional or behavioral disturbances. It is not the result of mental retardation, sensory deprivation, ‘or cultural and instructional factors. (p. 263) Kirk's conceptualization of SLD was accepted by the conference participants and since then has influenced many US organizations’ definitions of SLD, including the Learning Disabilities Association of America (LDA) and the Council for Exceptional Children (CEC), as well as fed- eral legislation (e.g., PLL. 94-142), In addition, 11 different definitions of SLD in use between 1982 and 1989 contained aspects of Kirk's 1962 defi- nition. Therefore, it is not surprising that a com- prehensive review of these definitions revealed more agreement than disagreement about the construct of SLD (Hammill, 1990). Interestingly, none of the definitions strongly influenced devel- opments in SLD identification, mainly because they tended to focus on conceptual rather than operational elements and focused more on exclu- sionary rather than inclusionary criteria, Table 1 illustrates the salient features of the most com- mon definitions of SLD that were proposed by the United States and international organizations and SLD researchers, beginning with Kirk's 1962 definition, The majority of definitions depict SLD as a neurologically based disorder or a dis- order in psychological processing that causes learning problems and manifests as academic skill weaknesses. In addition, most definitions indicate that SLD may co-occur with other disabilities. Although the definitions of SLD included in Table | vary in terms of their inclusion of certain features (e.g., average or better intelligence, evi- dent across the life span), the most widely used definition in the United States is the one included in the Individuals with Disabilities Education Act (IDEA) 2004 (Cortiella, 2009). Unlike other defi- nitions, the IDEA 2004 definition refers to a spe- cific learning disability (SLD), implying that the disability or disorder affects a specific academic skill or domain, Although in recent years, the term specific has been associated with the specific cognitive process or processes that are impaired, “a7 Evidence-Based Assessment an¢ intervention for Specific Learning Disability in School Psychology (penunu0s) r r Z sonmgestp aidan 410) HUD}. rs Gs stspiostp emdoou09. 20 ‘senda “ommapeaeuoN ssuiaigoud emdoou03 ssuiaygoxd Smm9proy upyeods pur Buuoise] Z ueds 911 om) sore. 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Jacobs et al. 48 (6002) wrag pre s - ~ s s s + , , 7 Bupneds (0660) » s - s s s , - s a - s s s s , + su stem (eg6) soumqestar Sune] Zi , r y s s = , = = (9361) roomy as s s 2 ZA rs ~ s as - Tse sispiosp —— swiajgod —swoqgord —Suppods nds oy, ssanoid siseq Auge Aoundasosip emdoouos —jemydoouo> — ommoproy ue omssore — yeorfoyoysxsd —eorSojomoy pesos yuourDAaIYe 20 ‘aden Sumsisr] opis —& Ur sOpIOsiCy sferone AUG) “ormapeseuoN, seo W \uyop C17 J0 sammieay wares Evidence-Based Assessment anc intervention for Specific Learning Disability in School Psychology 149 not the academic area affected (Flanagan et al., 2013). According to IDEA 2004, SLD is defined as follows: The term “specific learning disability” means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which disorder may ‘manifest itself in the imperfect ability to listen, think, speak, read, spell, or do mathematical caleue lations. Such a term includes such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia Such a term does not include a learning problem that is primarily the result of visual, hearing, or ‘motor disabilities; of mental retardation; of emo- tional disturbance; or of environmental, cultural, economic disadvantage, (IDEA 2004, § 602.30, Definitions) Because definitions of SLD do not explicitly guide how a condition is identified or diagnosed, classification systems of SLD were developed. Three of the most frequently used classification systems for SLD are described next, “Classification criteria are the rules that are applied to determine if individuals are eligible for a particular diagnosis” (Reschly, Hosp, & Schmied, 2003, p. 2). Although the evaluation of SLD in school-aged children in the United States is guided by the mandate of IDEA 2004 and its attendant regulations, diagnostic criteria for SLD are also included in the DSM-5 (American Psychiatric Association, 2013) and the International Classification of Diseases (ICD-10; World Health Organization, 2006). Table 2 includes the type of learning disorders and clase sification criteria for SLD in each system. Noteworthy is the fact that all three systems use somewhat vague and ambiguous terms, which interfere significantly with the efforts of practi- tioners to identify SLD reliably and validly (Kavale & Forness, 2000, 2006) Despite the existence of various classification systems, students aged 3-21 years who experi- ence learning difficulties in US schools are most typically evaluated according to IDEA 2004 specifications (IDEA 2004, § 614) to determine if they qualify for special education services. Because the classification category of SLD as described in the IDEA statute includes imprecise terms, the United States Department of Education (USDOE) published the federal regulations (34 CER, Part 300) with the intent of clarifying the statute and providing guidance to state educ tional agencies (SEA) as they worked to develop their own regulations, The guidelines provided by the 2006 federal regulations were more detailed in their specifications of how an SLD should be identified. These guidelines are dis- cussed later in this chapter. The Prevalence of SLD With regard to prevalence, the number of chil- dren in the United States identified as having SLD has tripled since the enactment of the Education for All Handicapped Children Act of 1975 (PLL. 94-142; Cortiella, 2009); however, the incidence of SLD in the school-age population has remained at about 4% for many years (see Decker, Hale, & Flanagan, 2013). The USDOE has collected data on students who have qualified for special education services since 1975, The most current data show that 2.6 million school-aged children are classified as SLD. This figure represents nearly 4% of the approximate 66 million students currently enrolled in the nation’s schools. Furthermore, of all students who have been classified with an educationally disabling condition, 43 % are clas- sified as SLD (United States Department of Education, 2008). Table 3 shows that none of the other 12 IDEA 2004 disability categories approx imates the prevalence rate of SLD in the popula- tion, a trend that has been consistent since 1980 (USDOE, 2006). For a more thorough discussion of the prevalence of SLD in the United States, see Decker et al. (2013). While comparable Australian data to that pre~ sented in Table 3 for the United States is not cur- rently available, this is soon to be redressed due to the recent launch of the Nationally Consistent Collection of Data on School Students with Disability initiative. Beginning in 2015, all gov- emment and non-government schools in Australia are required to participate annually in the national data collection which will provide nationally consistent data on the number of stu- KE. 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Jacobs et al. Table 3 Percentage of students with disabilities in the United States’ school-age population Students ages 6-21 years served under IDEA 2004 Percentage of IDEA disability Percentage of otal school category all disabilities enrollment Specificleaming 43.4 3.89 disability Speech orlanguage 19.2 17 impairment Other health 10.6 095 ‘impairment Mental retardation 8.3 074 Emotional disturbance 7.4 0.67 Autism 43 0.39 Multiple disabilities 2.2 0.20 Developmental delay 1.5 03, ages 3-9 years only Hearing impairments 1.2 oun Orthopedic 10 0.09 ‘impairments Visual impairments 0.44 0.04 ‘Traumatic brain injury 0.40 0.04 Deaf-blindness 0.02 0.00 Source: US Department of Education, Office of Special Edueation Programs, Data Analysis System (DANS). Washington, DC: IES National Center for Educational Statisties. Available from http:/inces.ed.gov/das dents with disabilities enrolled in Australian schools, as well as where they are located and the broad level of support they are provided with in school (Australian Government Department of Education and Training, 2015). Within Australia, students with both general and spe= cific learning difficulties are estimated to consti- tute the largest cohort of students within mainstream classrooms that require learning support (Westwood, 2008). Specifically, between 16 and 20% of the school-age population in Australia are considered to be experiencing gen- eral learning difficulties (ie., low academic achievement resulting from a myriad of extrinsic factors such as cultural and/or language differ- ences, inadequate instruction, or economic dis- advantage), whereas a smaller subset of these students (4-5 %) are considered to have an SLD (Graham & Bailey, 2007; Louden et al., 2000) This latter estimate is consistent with the US prevalence rate reported above and indicates that within every average-sized Australian classroom (OECD, 2013), there is approximately one stu- dent with a SLD. The Historical Context for the Current State of SLD Identification in Australia ‘The current state of formal recognition and support for students with SLD in Australia can be traced back to the 1970s when a govern- ment appointed Select Committee on Specific Leaming Difficulties was formed to inguire into all aspects of learning difficulties (Cadman, 1976). Having grappled with the notion of learn- ing disability as a diagnostic category, the com- mittee decided insufficient evidence existed to support the notion that some learning diffi- culties experienced by students were intrinsic, rather than extrinsic, in origin. Consequently, the decision was made to use the more generic, and all-encompassing term of learning difficul- ties to refer to students who experience academic difficulties in the areas of literacy and numeracy (Elkins, 2007; Graham & Bailey, 2007; Skues & Cunningham, 2011). Though evidence in sup- port of the neurological, and therefore intrinsic, nature of SLD continues to accumulate (e.g., Butterworth & Kovas, 2013; Kucian et al., 2006), the effects of this decision are still felt within the Australian educational system where students with SLD are not guaranteed special educ: tion funding (Graham & Bailey, 2007; Rohl & Rivalland, 2002; Skues & Cunningham, 2011). Rather the policy within Australia is for school principals to exercise autonomy over the alloca- tion of additional government funds to support students with disabilities within their schools (Commonwealth of Australia, 2015), Further, most Australian state and territory edu- cation systems do not distinguish between learn- ing difficulties and learning disabilities Elkins, 2002), with the particular terminology being employed varying greatly between the different education systems within Australia, as well as between different schools within the one educa- tion system (Rivalland, 2000). Furthermore, it has Evidence-Based Assessment anc intervention for Specific Learning Disability in School Psychology 153 also been found that not only can staff within one school use different terminology, but when the same terms are used by different staff, different types of students are identified as experiencing learning difficulties, including students with ow general cognitive ability, those suffering from behavioral disorders such as attention deficit hyperactivity disorder (ADHD), as well as stu- dents originating from culturally and linguistically diverse backgrounds (Rohl & Rivalland, 2002). The implication of such a diverse and nonspe~ cific array of definitions being employed within the Australian educational system is that confu- sion exists among educational professionals as to what exactly constitutes a learning difficulty. Further, it appears valid to conclude that there likely exists a general lack of awareness regard- ing the fact that some learning challenges stem from permanent underlying neurological impair- ments that are largely unaffected by intervention (Skues & Cunningham, 2011). Thus, while the academic manifestations of learning difficulties and learning disabilities are the same (i.e., below- average academic achievement in literacy and/or numeracy), the underlying causes are fundamen- tally different. Adequate understanding and rec- ognition of this is important since different causes result in differential trajectories, thus requiring varied forms of support and intervention. Thus, it is vital that the assessment methods used to iden- tify SLD adequately differentiate this condition from different causes of learning difficulties, such as below-average general cognitive ability, inadequate instruction, or cultural and linguistic differences, just to name a few tis important to note however that while SLD is not a formally recognized or funded category within the Australian educational system at pres- ent, these students are protected by the Disability Discrimination Act. 1992 (Australian Government, 1992) and the subsequent education standards amendment in 2005 (Australian Government, 2005). This federal legislation pro- vides a framework by which to ensure that all students with disabilities, including SLD, can access education on the same basis as other stu- dents via the provision of reasonable adjust- ments. However, the extent to which such legislation truly protects the rights of students with SLD can be considered questionable given that only broad guidelines are provided, with the process of interpretation and implementation being left to state and local education bodies (Cumming, 2012). Indeed, a recent review of the Disability Standards for Education 2005 reported that “A large number of submissions were received from parents of school-aged children with learning disabilities who expressed frustra- tion at the limited effective supports available to their children” (Commonwealth of Australia, 2015, p. ii). Likely resulting from the fact that students with SLD in Australian schools do not attract funding, systematic identification of SLD rarely forms part of school procedure (Firth et al., 2013). This is in contrast to the publicly funded disorders of severe language disorder and intel- Jectual disability which are regularly assessed for by school-based professional staff such as speech pathologists and psychologists (Skues & Cunningham, 2011). Indeed some Australian school psychologists have expressed uncertainty regarding what their role is in SLD identification and have questioned whether they possess suffi- cient knowledge and training to provide services in this area (Klassen et al., 2005), In a recent study, Meteyard and Gilmore (2015) surveyed 203 Australian practitioners (including school psychologists) whose profes sional responsibilities included assessment of stu- dents suspected of SLD, with the aim of investigating the theoretical models currently being used to conceptualize and identify SLD. Participants were asked to indicate the extent to which four major theoretical models of SLD identification influenced their practices; (1) significant discrepancies between IQ and aca- demic achievement, (2) persistent low academic achievement, (3) intraindividual profile variation, and (4) lack of response to evidence-based inter- vention. While lack of response to evidence-based intervention was the most endorsed theoretical model, with 81% of respondents indicating it as important or extremely important, the remaining three models were similarly strongly endorsed by a half to two-thirds of participants. The authors 154 KE. Jacobs et al. suggested that the “simultaneous endorsement of a range of theoretical perspectives reflects a lack of clarity about the best way to approach SLD diagnosis” (p. 7) among Australian practitioners. While formal and consistent procedures for the identification of SLD are largely nonexistent within Australian schools, there is a national concerted effort to identify students experienc- ing learning difficulties more generally. This occurs via annual standardized assessment of reading, writing, and mathematics in years 3, 5, 7, and 9 using the National Assessment Program—Literacy and Numeracy (NAPLAN). However, as Skues and Cunningham (2011) point out, such methods are not attuned to iden- tifying students whose academic underachieve- ment is unexpected, a core and defining feature of SLD. Thus students and parents must often venture outside of the school system to seek assessment and diagnosis of SLD (Al-Yagon et al., 2013; Skues & Cunningham, 2011), with services provided by volunteer or publicly funded organizations or by private practitioners (Greaves, 2000). Unsurprisingly, the methods of assessment and diagnosis used by these differ- ent providers who exist outside of the school system vary greatly, likely resulting in confu- sion and uncertainty on the part of the consumer trying to decide between the different providers (Greaves, 2000). Tn 2009, as a result of a forum held at the Parliament House in Canberra, a working party was formed and charged with the task of propos« ing a national dyslexia agenda. The final report, titled Helping People with Dyslexia: A National Action Agenda, was submitted tothe Parliamentary Secretary in 2010 and provided a variety of recommendations covering the defini- tion and recognition of dyslexia which included school and teacher training and support; assess- ment; support and accommodations for individu- als, families, and professional staff; community awareness; employment and training; and research funding. While the report refers specifi- cally to the SLD subtype of dyslexia, its conclu- sions and recommendations are applicable to all varieties of SLD which can affect achievement in reading, writing, and/or mathematics With regards to the process of assessment and diagnosis in Australia, the Dyslexia Working Group stated the following: In Australia at present, children and adults with dyslexia have no specified pathways to achieve diagnosis and support. In the education system there are few qualified to diagnose, and the wait time for school psychologists is up to a year Individuals theretore have to fund their own diag ‘nosis and subsequent support. On a user pays basis, only the financially secure can afford this. (Bond etal., 2010, pp. 8-9) Consequently, the Dyslexia Working Group (Bond et al., 2010) provided the following rec- ommendations in relation to the assessment of dyslexia: 1. Access to early, systematic, dyslexia assess- ‘ment made available (o all students identified {risk for dyslexia by teachers 2. Initial screening and assessment of such at- risk students to be undertaken within the school environment, followed by in-depth assessment by appropriately trained profes- sionals (such as psychologists) 3. The development of professional develop- ment programs for all school psychologists to assist them with the provision of appropriate ‘assessment and support services to the schools in which they work Past and Present Methods of SLD Identification in the United States ‘The current state of SLD identification in Australia is thus vastly different to that found in the United States where the process is highly for malized and regulated. Although the definition of SLD has remained virtually the same in the United States for the past 35 years, the methodol- ‘ogy used to identify SLD changed in 2004 with the reauthorization of IDEA. According to the 2006 federal regulations (34 CFR § 300.307- 309), a state must adopt criteria for determining that a child has SLD; the criteria (a) must not require the use of a severe discrepancy between intellectual ability and achievement, (b) must Evidence-Based Assessment anc intervention for Specific Learning Disability in School Psychology 155 permit the use of a process based on a child’s response to scientific research-based. interven- tions, and (c) may permit the use of other alterna- live research-based procedures for determining whether a child has SLD. Many controversies have ensued since the publication of the three options for SLD identification. The controversies have been written about extensively as they per- tain to the exact meaning of the guidelines, the specifications of a comprehensive evaluation, the implications of using response to intervention (RTI) as the sole method for SLD identification, and the lack of legal knowledge among decision- makers. These controversies will therefore not be repeated here (see Fletcher, Barth, & Stuebing, 2011; Gresham, Restori, & Cook, 2008; Kavale, Kauffman, Bachmeier, & LeFever, 2008; Reschly et al., 2003; Reynolds & Shaywitz, 2009a, 2009b; Zirkel & Thomas, 2010 for a summary), The three options that are currently being imple- mented across the United States are described briefly here. Ability-Achievement Discrepancy A discrepancy between intellectual ability and aca- demic achievement continues, in one form or another, to be central to many SLD identification approaches because it assists in operationally defining unexpected underachievement (e.g., Kavale & Flanagan, 2007; Kavale & Fomess, 1995;Lyonetal., 2001; Wiederholt, 1974; Zitkel & Thomas, 2010), Despite being a laud- able attempt at an empirically based method of SLD identification, the traditional ability-achievement (or IQ-achievement) discrepancy method was fraught with problems (e.g., Aaron, 1997; Ceci, 1990, 1996; Siegel, 1999; Stanovich, 1988; Stemberg & Grigorenko, 2002; Stuebing et al., 2002), many of which are bulleted in Table 4, The failure of the ability- achievement discrepancy method to identify SLD relie ably and validly was summarized well by Ysseldyke (2005), who stated, Professional associations, advocacy groups, and. ‘government agencies have formed task forces and. task forces on the task forces to study identification. of students with LD. We have had mega-analyses, of meta-analyses and syntheses of syntheses, Table 4 Salient problems with the ability-achievement discrepancy method + Fuils to adequately differentiate between students with SLD from students who are low achievers ‘+ Based on the erroncous assumption that IQ is a near perfect predictor of achievement and is synonymous with an individual's potential ‘+ Applied inconsistently across states, districts, and schools, rendering the diagnosis arbitrary and capricious + A discrepancy between ability and achievement may be statistically significant, but not clinically relevant + Isa wait-to-fail method because discrepancies between ability and achievement typically are not evident until the child has reached the third oF fourth grade + Does not identify the area of processing deficit + Leads to overidentification of minority students + Does not inform intervention Source: Flanagan and Alfonso (2011). Essentials of Specific Learning Disability Identification, Hoboken, NI: Wiley ‘Neatly all groups have reached the same conclusion: ‘There is little empirieal support for test-based dis- crepancy models in identification of students as LD. (p. 125) Thus, the fact that states could no longer require the use of a severe discrepancy between intellectual ability and achievement (IDEA 2004) was viewed by many as a welcomed change to the law. The void left by the elimination of the discrepancy mandate was filled by a method that, allowed states to use a process based on a child’s response to intervention to assist in SLD identification Response to Intervention (RTI) The concept of RTI grew out of concems about how SLD is identified. For example, traditional methods of SLD identification, mainly ability- achievement discrepancy, were applied inconsis- tently across states and often ed to misidentification of students, as well as overidentification of minor ity students (e.g., Bradley, Danielson, & Hallahan, 2002; Leaming Disabilities Roundtable, 2005; President's Commission on Excellence in Special Education, 2002). Such difficulties with traditional 156 KE. Jacobs et al. methods led to a “paradigm shift” (Reschly, 2004) that was based on the concept of treatment valid- ity, “whereby it is possible to simultaneously inform, foster, and document the necessity for and effectiveness of special treatment” (Fuchs & Fuchs, 1998, p. 207) At the most general level, RTI is a multitiered approach to the early identification of students with academic or behavioral difficulties. For the purpose of this chapter, we focus on RTI for a demic difficulties only. The RTT process begins with the provision of quality instruction for all students in the regular education classroom, along with universal screening to identify stu- dents who are at risk for academic failure, pri- marily in the area of reading (Tier 1). Students who are at risk for reading failure—that is, those who have not benefitted from the instruction pro- vided to all students in the classroom—are then given scientifically based interventions, usually following a standard treatment protocol (Tier II) Tf a student does not respond as expected to the intervention provided at Tier II, he or she may be identified as a nonresponder and selected to receive additional and more intensive interven- tions in an attempt to increase his or her rate of Iearning. When one type of intervention does not appear to result in gains for the student, a new intervention is provided until the desired response is achieved. The inclusion of RTI in the law as an allow- able option for SLD identification has created perhaps the most controversy since IDEA was reauthorized in 2004. This is because in districts that follow an RTI-only approach, students who repeatedly fail to demonstrate an adequate response to increasingly intensive interventions are deemed to have SLD by default. Such an approach does not appear to be in compliance with the regulations. For example, according to the regulations, states must (a) use a variety of assessment tools and strategies to gather relevant functional, developmental, and academic infor- mation (34 CFR § 300.304[b][1)); (b) not use any single measure or assessment as the sole criterion for determining whether a child has a disability (34 CFR § 300.304[b][2}}; (©) use technically sound instruments that may assess the relative contribution of cognitive and behavioral factors, in addition to physical or developmental factors (34 CER § 300.304b][3]); (€) assess the child in all areas related to the suspected disability (34 CER § 300,304{c][4)); (e) ensure that the evalua- tion is sufficiently comprehensive to identify all of the child’s special education and related ser- vices needs (34 CFR § 300.304{c][6]); and () ensure that assessment tools and strategies pro- vide relevant information that directly assists per- sons in determining the needs of the child (34 CFR § 300.304[c][7)). Although the use of RTI as a stand-alone method for SLD identification is inconsistent with the intent of the law, this type of service delivery model has been an influential force in US schools for about a decade, particularly with respect to shaping Tier I and Tier IT assessments for intervention in the general education setting, ‘The emphasis in an RTI model on ensuring that students are benefitting from empirically based instruction and verifying theit response to instruction, via a systematic collection of data, has elevated screening and progress-monitoring procedures to new heights and has led many to embrace this type of service delivery model for the purposes of both prevention and remediation. In essence, RTI serves to improve accountability through data demonstrating whether or not learn- ing has improved, and sufficient progress has been made, Table 5 highlights some of the most salient strengths and weaknesses of the RTI s vice delivery model regarding its use in the SLD identification process. Alternative Research-Based Procedures for SLD Identification The third option included in the 2006 regulations allows “the use of other alternative research-based procedures” for determining SLD (§ 300.307[a)). Although vague, this option has been interpreted by some as involving the evaluation of a “pattern of strengths and weaknesses” in the identification of SLD via tests of academic achievement, cogni- live abilities, and neuropsychological processes (Hale et al., 2010; Hale, Flanagan, & Naglieri, 2008; Zirkel & Thomas, 2010). Several empiri- cally based methods of SLD identification that are Evidence-Based Assessment anc intervention for Specific Learning Disability in School Psychology 197 Table 5 Strengths and weaknesses of RTI Salient weaknesses of RTI as Salient strengths of a stand-alone method of SLD. RTI service delivery identification model ‘+ Lack of research on which * Focus is on the RTI model works best, provision of more standard treatment effective instruction protocol or problem- solving model, or under what circumstances each model should be used + Lack of agreement on what * curricula, instructional ‘methods, or measurement tools should be used Allows schools to intervene early to ‘meet the needs of struggling learners + Confusion surrounding + Collected data better What constitutes an informs instruction ‘empirically based than data generated approach by traditional abilty-achievement discrepancy method + Lack ofagreementon + Helps ensure that the What methods work across student's poor grades and academic academic content areas performance is not due to poor instruction * Different methods of + Holds educator’s response/nonresponse accountable for lead to different children documenting being labeled as repeated responders/nonresponders assessments of + Noconsensus on howto student's ‘ensure treatment integrity achievement and + Nojindication of atrue —-—_‘PogTess during positive (SLD instruction identification) in an RTT model Source: Learning Disabilities Association of America, white paper (Hale et al., 2010) consistent with the third option have been devel- oped, such as Flanagan and colleagues’ dual dis- crepancy/consistency operational definition of SLD (Flanagan et al.,2013) and Hale and Fiorello’s Concordance-Discordance Model (Hale, Kirby, Wycoft, & Fiorello, 2011) Figure 1 provides an illustration of the three com- mon components of third-method approaches to SLD identification (Flanagan, Fiorello, & Ortiz, 2010; Hale et al., 2008), The two bottom ovals depict academic and cognitive weaknesses, and their hori- zontal alignment indicates that the level of perfor- ‘mance in both domains (academic and cognitive) is expected to be similar or consistent. The double- headed arrow between the bottom two ovals indi- cates that there exists an empirical or otherwise clearly observable and meaningful (ecologically valid) relationship between the academic and cogni- tive deficits, as the cognitive deficit is presumed to interfere with the acquisition and development of the academic skill in question. The oval depicted at the top of Fig. | represents generally average (or better) cognitive or intellectual ability. The double-headed arrows between the top oval and the two bottom ovals in the figure indicate the presence of a statisti- cally significant or clinically meaningful difference in measured performance between general cognitive ability and the areas of academic and cognitive weak- ness. The pattern of cognitive and academic strengths and weaknesses represented in Fig. 1 retains and reflects the concepts of specific (cognitive processing 1S woseax pe up ‘Souapssuoo)Koueds.ostp-enp w A poysPU sssourye pu sy/090) Jo WIE Al (G20uoea paar uw sqinounp Beas} 099 mp) rapeseed 1 29uruO} 24 INBWIDAIIIIE IUBPEOY ‘ortegeas yo sme (onset GIS Jo woRtUYap Puoneiado (3/CKC) Aouarstsuo9 KouRdaxosip/renp ,sonTealjo> pur URFeUREL 9 e142 KE. Jacobs et al. 160 (ponunves) 921981, Evidence-Based Assessment anc intervention for Specific Learning Disability in School Psychology 161 tening comprehension, and oral expression. Most of the abilities measured at Level I represent an individual's stores of acquired knowledge. These specific knowledge bases (e.g., quantitative knowledge, reading and writing ability, vocabu- lary knowledge, and general domain-specific knowledge) develop largely as a function of formal instruction, schooling, and educationally related experiences (Carroll, 1993; Schneider & McGrew, 2012). Typically, these cight arcas of academic achievement are measured using stan- dardized, norm-referenced tests. Nevertheless, it is important to realize that data on academic performance should come from multiple sources (see Table 6, Level I, column 4), such as clini- cal observations, work samples, parent or teacher report, and so forth. Following the collection of data on academic performance, it is necessary to determine whether the student has a Weakness or deficit in one or more specific academic abilities. A weakness is typically defined as performance on standardized, norm-referenced tests that falls below average (where average is defined as stan- dard scores between 90 and 109 [inclusive], based on a scale having a mean of 100 and standard deviation of 15). Therefore, a weakness is associ- ated with standard scores of 85-89. Interpreting scores in this very narrow range usually requires clinical judgment, as abilities associated with these scores may or may not pose significant problems for the individual. A deficit is often defined as performance on norm-referenced tests, that falls greater than one standard deviation below the mean (ie., standard scores <85). Determining whether a student has a weak- ness or deficit usually involves making norma- tive-based comparisons of the — student's performance against a representative sample of same-age or same-grade peers from the general population. If weaknesses or deficits in the stu- dent’s academic performance are not found, then the issue of SLD may be moot because such weaknesses are a necessary component for diag- nosis. When weaknesses or deficits in academic performance are found (irrespective of the par- ticular methods by which they are identified), the process advances to Level IL Level II: Exclusionary factors— evaluation of potential primary and contributory causes of academic skill weaknesses or deficits Level IT involves evaluating whether any docu- mented weaknesses or deficits found through Level I evaluation are or are not primarily the result of factors that may be, for example, largely external to the individual, noncognitive in nature, or the result of a condition other than SLD. Because there can be many reasons for weak or deficient academic performance, causal links to SLD should not be ascribed prema- turely. Instead, reasonable hypotheses related to other potential causes should be developed. For example, cultural and linguistic differences are two common factors that can affect both test performance and academic skill acquisition adversely and result in achievement data that appear to suggest SLD. In addition, lack of motivation, social/emotional disturbance, per formance anxiety, psychiatric disorders, sensory impairments, intellectual disability, and medical conditions (e.g., hearing or vision problems) also need to be ruled out as potential explana- tory correlates to any weaknesses or deficits identified at Level jote that because the process of SLD deter- mination does not necessarily occur in a strict linear fashion, evaluations at Levels 1 and IL often take place concurrently, as data from L Tis often necessary to understand performance at Level I. The circular arrows between Levels I and II in Table 6 are meant to illustrate the fact that interpretations and decisions that are based on data gathered at Level I may need to be informed by data gathered at Level IT. Ultimately, at Level II, the practitioner must judge the extent to which any factors other than cognitive impair- ‘ment can be considered the primary reason for academic performance difficulties. If perfor- mance cannot be attributed primarily to other factors, then the second criterion necessary for establishing SLD according to the operational definition is met, and assessment may continue to the next level. vel 162 KE. Jacobs et al. Level Ill: Weaknesses or deficits cognitive abilities or neuropsychological processes The criterion at this level is similar to the one specified in Level I except that it is evaluated with data from an assessment of cognitive abili- ties and neuropsychological processes (refer to Ortiz, Flanagan, & Alfonso, 2015, for a compre- hensive list of standardized tests that can be used to measure the many cognitive abilities and neu- ropsychological processes implicated in aca- demic achievement). Analysis of data generated from the administration of standardized tests rep- resents the most common method available by which cognitive and neuropsychological func- tioning in children is evaluated. However, other types of information and data are relevant to cog- nitive performance (see Table 6, Level III, col- umn 4), Practitioners should actively seek out and gather data from other sources as a means of providing corroborating evidence for standard- ized test findings. For example, when test find- ings are found to be consistent with the student's performance in the classroom, a greater degree of confidence may be placed on test performance because interpretations of cognitive deficiency have ecological validity —an important condition for any diagnostic process (Flanagan et al., 2013). ‘A particularly salient aspect of the DD/C defini- tion is that a weakness or deficit in one or more cognitive abilities or processes underlies difficul- ties in academic performance and skill develop- ment. Because research demonstrates that the relationship between the cognitive dysfunction and the manifest learning problems is causal in nature (eg., Fletcher, Taylor, Levin, & Satz, 1995; Hale et al., 2010; Hale & Fiorello, 2004), data analysis at this level should seek to ensure that identified weaknesses or deficits on cognitive and neuropsy- chological tests bear an empirical relationship to those weaknesses or deficits on achievement tests identified previously. It is this very notion that makes it necessary to draw upon cognitive and neuropsychological theory and research (c.g., Flanagan, Ortiz, Alfonso, & Mascolo, 2006; McGrew & Wendling, 2010; Schneider & McGrew, 2012 to inform methods of SLD identification and increase the reliability and validity of the SLD diagnostic process. Theory and its related research, base not only specify the relevant constructs that ‘ought to be measured at Levels I and Il of the DDIC definition, but also predict the manner in which they are related, Furthermore, application of current theory and research provides a substantive empirical foundation from which interpretations and conclusions may be drawn. Because new data are gathered at Level III, it is likely possible to evaluate the exclusionary factors that could not be evaluated earlier (e.g., imtellectual disability). The circular arrows between Levels Il and III in Table 6 are meant to illustrate the fact that interpretations and deci sions that are based on data gathered at Level ITT may need to be informed by data gathered at Level II. Likewise, data gathered at Level III are often necessary to rule out (or in) one or more exclusionary factors listed at Level Il in Table 6. Reliable and valid identification of SLD depends in part on being able to understand academic per- formance (Level 1), cognitive performance (Level IID), and the many factors that may facili« tate or inhibit such performances (Level I), Level IV: A pattern of strengths and weaknesses characterized by a dual discrepancy/consistency (DD/C) This level of evaluation revolves around a the- ory- and research-guided examination of perfor ‘mance across academic skills, cognitive abilities, and neuropsychological processes to determine whether the student’s pattern of strengths and weaknesses is consistent with the SLD construct. When the process of SLD identification has reached this level, three necessary criteria for SLD identification have already been met: (a) one or more weaknesses or deficits in academic performance, (b) one or more weaknesses or defi- cits in cognitive abilities and/or neuropsycholog- ical processes, and (¢) exclusionary factors determined not to be the primary causes of the academic and cognitive weaknesses or deficits What has not been determined, however, is whether the pattern of results is marked by an empirical or ecologically valid relationship between the identified cognitive and academic weaknesses, whether the individual displays gen- Evidence-Based Assessment anc intervention for Specific Learning Disability in School Psychology 163 erally average ability to think and reason, whether the individual's learning difficulty is domain- specific, and whether the individual's under- ‘achievement is unexpected, These four additional SLD markers, depicted in Fig. 1, are discussed below. Relationship between cognitive and academic weaknesses A student with an SLD possesses specific cogni- tive and academic weaknesses or deficits. When these weaknesses are related empirically or when there is an ecologically valid relationship between them, the relationship is referred to as a below- average cognitive aptitude-achievement consis- tency (Flanagan et al., 2006; Flanagan, Ortiz, Alfonso, & Mascolo, 2002). This consistency is a necessary marker for SLD because SLD is caused by cognitive processing weaknesses or deficits (eg., Hale et al., 2010). Thus, there is a need to understand and identify the underlying cognitive ability or processing problems that contribute significantly to the individual’s academic difficulties. ‘The term cognitive aptitude within the context of the DD/C definition represents the specific cognitive ability or neuropsychological process- ing weaknesses or deficits that are empirically related to the academic skill weaknesses or defi- cits. For example, if a student's basic reading skill deficit is related to cognitive deficits in pho- nological processing (a narrow auditory proces ing [Ga] ability) and rapid automatic naming (a narrow long-term storage and retrieval [Gir] abil- ity), then the combination of below-average nar row Ga and Glr performances represents his or her cognitive aptitude for reading. Moreover, the finding of below-average perfor« mance on measures of phonological processing, rapid automatic naming, and basic reading. skill represents a below-average cognitive aptitude- achievement consistency. The concept of cognitive aptitude-achieve- ment consistency reflects the notion that there are documented relationships between specific cog- nitive abilities and processes and specific aca- skills. Therefore, the finding of below-average performance in related cognitive basic demic and academic areas is an important marker for SLD. The horizontal alignment of the bottom two ovals in Fig. 1 demonstrates that the identified areas of cognitive and academic weaknesses or deficits are related. The criteria for establishing a below-average cognitive aptitude-achievement consistency in the DD/C definition are as follows: + “Below-average” performance (ie., less than 89 and mote typically at least a standard devie ation or more below the mean) in the specific cognitive and academic areas that are consid- ered weaknesses or deficits * Bither evidence of an empirical relationship between the specific cognitive and academic areas or an ecologically valid relationship between these areas. To validate the relation between the cognitive and academic areas of weakness, practitioners can document the manner in which the cognitive weakness or deficit manifests in academic difficulties in the classroom (sce Flanagan et al., 2013 for more information). Generally average ability to think and reason (g) A specific learning disability is just that—spe- cific. tis not general. As such, the below-average cognitive aptitude-achievement consistency ‘ought to be circumscribed and represents a very different level of functioning as compared to the individual’s cognitive capabilities or strengths in other areas. Indeed, the notion that individuals with SLD are of generally average or better over- all cognitive ability is well known and has been written about for decades (e.g., see Bateman, 1965). In fact, the earliest recorded definitions of learning disability were developed by clinicians based on their observations of individuals who experienced considerable difficulties with the acquisition of basic academic skills, despite their average or above-average general intelligence. According to Monroe (1939 ef. Mather, 2011, p. 23) “The children of superior mental capacity who fail to learn to read are, of course, spectacu- Jar examples of specific reading difficulty since 164 KE. Jacobs et al. they have such obvious abilities in other fields”. Indeed, “all historical approaches to SLD empha- size the spared or intact abilities that stand in stark contrast to the deficient abilities” (Kaufman, 2008, pp. 7-8, emphasis added). The criterion of overall average or better ability in cognitive domains is necessary for differential diagnosis. By failing to differentially diagnose SLD from other conditions that impede learning, such as intellectual disability and overall below-average ability to learn and achieve, the SLD construct loses its meaning, and there is a tendency (albeit well intentioned) to accept anyone under the SLD rubric who has learning difficulties for reasons other than specific cognitive dysfunction (e.g., Beringer, 2011; Kavale et al, 2008; Kavale & Flanagan, 2007; Reynolds & Shaywitz, 2009a, 2009b). While the underlying causes of the leaming difficulties of all students who struggle academically should be investigated and addressed, an accurate SLD diag- nosis is necessary because it informs instruction. While it may be some time before consensus is reached on what constitutes “average or better ability” for the purpose of SLD identification, a student with SLD, generally speaking, ought to be able to perform academically at a level that approximates that of his or her more typically achieving peers when provided with individual- ized instruction as well as appropriate accommo- dations, curricular modifications, and the like. In addition, in order for a student with SLD to reach performances (in terms of both rate of learning and level of achievement) that approximate his or her non-disabled peers, he or she must possess. the ability to learn compensatory strategies and apply them independently, which often requires higher-level thinking and reasoning, including intact executive processes (McCloskey, Perkins, & Van Divner, 2009). Individuals with SLD can overcome or bypass their disability under certain circumstances. Special education provides (or ought to provide) the mechanism to assist the stu- dent with SLD in bypassing his or her processing deficits through individualized instruction and intervention and through the provision of appro- priate curricular and instructional modifications, accommodations, and compensatory strategies. However, to succeed in bypassing or minimizing the effects of an individual’s SLD in the edue: tional setting to the point of achieving at or close to grade level, overall average cognitive or intel- lectual ability is very likely requisite (see Fuchs & Young, 2006, for a discussion of the mediating effects of IQ on response to intervention), Of course, it is important to understand that while at least average overall cognitive ability is likely necessary for a student with SLD to be suc- cessful at overcoming or minimizing his or her cognitive processing deficits, many other factors may facilitate or inhibit academic performance, including motivation, effort, determination, per- severance, familial support, quality of individua ized instruction, student-teacher relationship, and existence of comorbid conditions (see Flanagan et al., 2013 for a discussion) Determining otherwise average or better abil- ity to think and reason (or average or better g) for a student who has a below-average cognitive aptitude-achievement consistency is not a straightforward task; however, there is no agreed upon method for doing so. The main difficulty in determining whether or not an individual with specific cognitive weaknesses has otherwise average overall ability or g is that current intelli- gence and cognitive ability batteries typically provide only one total test score. Moreover, the total test score is an aggregate of all (or nearly all) abilities and processes measured by the instrument. As such, in many instan dent's specific cognitive weaknesses or deficits attenuate the total test score on these instruments, which often masks overall cognitive ability or capacity. Although intelligence and cognitive ability batteries have become more differenti- ated, offering a variety of specific cognitive ab ity composites, the manner in which they summarize overall intellectual or cognitive abil- ity remains largely the same as that of their pre~ decessors. Therefore, Flanagan and colleagues developed a program called the Pattern of Strengths and Weaknesses Analyzer (PSW-A) that generates a composite akin to a total test composite on an intelligence test but without the attenuating effects of the individual’s cognitive weaknesses (Flanagan et al., 2013). The latest version of the PSW-A is now part of the Cros es, the stu- Evidence-Based Assessment anc intervention for Specific Learning Disability in School Psychology 165 Battery Assessment Softw: Ortiz et al., 2015). The PSW-A provides a g-value, which indi- cates the likelihood that the individual has at least average overall ability to think and reason (or average g), particularly for the purpose of learn- ing and performing academic, grade-level tasks. However, the PSW-A also provides what has been called a “Facilitating Cognitive Composite” or FCC, The FCC is akin to the total test score yielded by current intelligence and cognitive ability batteries. The FCC is an aggregate of the individual's intact abilities only. Therefore, the is intended to provide an estimate of overall intellectual/cognitive capacity in the absence of the potential attenuating effects of those specific cognitive abilities or processes in which the indi- vidual performed poorly. Even if it is determined that an individual has overall average ability to think and reason (top oval in Fig. 1) along with a below-average cogni- tive aptitude-achievement consistency (two bot tom ovals in Fig. 1), these findings alone do not satisfy the criteria for a pattern of strengths and weaknesses consistent with the SLD construct. This is because it is not yet clear whether the dif- ferences between the score representing overall ability and those representing specific cognitive and academic weaknesses or deficits are signifi- cant, meaning that such differences are reliable differences (i¢., not due to chance). Moreover, it is not yet clear whether the cognitive area of weakness is domain-specific and whether the academic area of weakness (or underachieve- ment) is unexpected, fe System (X-BASS; Cognitive deficits that interfere with learning are domain-specific SLD has been described as a condition that is domain-specific, That is, areas of cognitive weak- ness or deficit are circumscribed, meaning that while they interfere with learning and achieve- ‘ment in a specific academic skill, they are not pervasive and do not affect all or nearly all areas of cognition. According to Stanovich (1993), “The key deficit must be a vertical faculty rather than a horizontal faculty —a domain-specific pro- cess rather than a process that operates across a variety of domains” (p. 279). It is rare to find an operational definition that specifies a criterion for determining that the condition is “domain-spe- cific.” Some suggest that this condition is sup- ported by a statistically significant difference between an individual's overall (average or bet- ter) cognitive ability and a score representing the individual's cognitive area of weakness (¢.g., Naglieri, 2011). However, a statistically signifi- cant difference between two scores means only that the difference is not due to chance; it does not provide information about the rarity or infre+ quency of the difference in the general popula- tion, Some statistically significant differences are common in the general population; others are not. Therefore, to determine if the cognitive area that was identified as a weakness by the evaluator is domain-specific, the difference between the individual’s actual and expected performance in this area should be uncommon in the general population (ie., should occur in

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