Identification, Assessment, and

ClassificationChapter 3 in Education of Students with an Intellectual Disability:

Research and Practice; Foreman, Phil; 2009

Intellectual Disabilities

• The term “intellectual disabilities” is extremely broad. • People with this classification may range from • people who are not easily distinguished from the general population • people who have obvious and serious impairments

• Others may appear to have an intellectual disability when, in fact, they do not have one at all

Intellectual Disabilities (cont.)

• ID is not a medical diagnose• Classifications within ID may provide more specific information about

a person’s abilities• Positive use of classifications provide information for needed supports

– health, physical, educational, etc.• Negative use of classifications may cause us to underestimate a

person’s abilities or discriminate against them in some way

A Rose Is a Rose

• Many terms that were once acceptable for people with intellectual disabilities are not longer considered acceptable; some of the history is very interesting

• As I mentioned before, my BS Education degree in MR or “Mental Retardation”; my dad was president of NCARC (North Carolina Association for Retarded Citizens) for many years; my brother was classified as trainable mentally retarded.

Current Classifications

• Mild, moderate, and severe disabilities • current classification system used for educational purposes • impacts the amount of support offered

• Note Table 3.1 on p. 65. The simple classifications and explanations provide information about supports that will likely be needed. • Note the “approximate” terms. There are no fixed IQ or adaptive

behavior numbers. In other words, a one (1) point difference between a person with a tested IQ score of 69 and a person with an IQ score of 70 does not automatically classify one as intellectually disabled while the other is not.

PIMD (Profound Intellectual and Multiple Disabilities)

• If you are interested in this population, there are some excellent teachers at North Shelby where you may want to observe or volunteer. • Types of educational goals on the IEPs of these students may be• Communication goals• Social experiences

• With their typically developing peers• Within the community

• Physical goals

Classification Changes

• Classification changes reflect a movement away from the severity of one’s disabilities to the level of support services that are appropriate for one’s level of functioning.• Level of supports are based on helping a person maximize his/her

ability to function• Level of supports needed are fluid will change over time

Classification Changes (cont.)

• Failure moved to fault with the environment not meeting the needs of the student rather than being a fault within the person. This indicates a shift in thinking over the years.• This gets into some of the discussions we have had about societal

views of disabilities and how we can view “them” as “people first” rather than a separate category of people. As Horton says, “Don’t give up. I believe in your all. A person’s a person no matter how small” (Dr. Seuss in Horton Hears a Who!)

Intelligence Tests

• The results of an IQ test must be viewed as the results of a given test to a given person on a given day • The results provide only enough information for us to draw some

conclusions about one’s intelligence and may not be considered the final word.• Teachers should be more concerned about how children respond to

teaching; it then becomes our responsibility to adjust our classrooms and our teaching to optimize a child’s opportunities to learn and develop• Problems in assessments and results may be associated with problems

other than intelligence, such as attention, speech and motor, or behavioral issues.

Testing Jargon• Good tests are valid and reliable• Validity – the tests measure what they are supposed to measure• Reliability – the test results are similar on any given day as given by any

properly trained assessor.• Standard error of measurement (SEM) – on any given day, test results will

likely fall within this range. A SEM of 3 on the WISC-R will mean that a test score of 70 will likely result in a test score within the range of 67 – 73 on any given day for the same person. It has a slight chance of falling outside that range.• For those of you who took the SAT and PSAT in high school, you may

remember the SEM. If you took it again, your original test score sheet gave a likelihood of your scoring within a certain range on any subsequent tests.

Beware of Barriers

• There are many barriers to assessing intelligence in babies and toddlers• All assessments must be part of comprehensive assessments• Development is babies and toddlers is so sporadic that changes may

occur rapidly and new skills may emerge quickly• Development assessments for babies and toddlers should be viewed

as measures of a child’s current level of development rather than a predictor of future development• The younger the child, the greater the need for caution when using

test scores for future predictions

Moving On!

• The text describes several tests and pros and cons associated with the various instruments for infants and toddlers and school-age children. • There is no need to try to interpret all of that. • Skim over the information to get an idea of the business of fairly

testing for intellectual disabilities (pp. 72 [bottom] – 78)• Do know the definition for intellectual disabilities and the 3

components of the definition – be able to recognize testing for intelligence as compared to testing for adaptive behavior

Veronica – p. 74

• Veronica’s assessment case study on p. 74 is interesting. The author’s questions have more to do with assessment instrument questions. • Look at the story from the perspective of Veronica’s preschool

teacher. • Before results of her testing are completed, what type goals might you want

to consider for Veronica? • What changes do you think need to be made to meet Veronica’s needs?

Intermission

• This is a natural break in Chapter 3 readings. • This next section covers pages 79 – 96.

Adaptive Behavior

• “The current AAIDD definition refers to “significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills” (Luckasson et al., 2002).” (Foreman, 2009)• How do children measure according to intelligence levels?• How do children manage in day to day activities?• Problems in both must be present for a child to be categorized as

having an intellectual disability (along with these problems manifesting themselves prior to the child becoming 18 years old)

Adaptive Behavior (cont.)

• A measure of how a child functions in everyday life• More directly observable than intellectual functioning• Related to how the child functions in his/her environment• Information is generally gathered from an informant who is familiar with

the child (unlike the professionals who must administer intelligence tests)• The child may not need to be present for adaptive behavior assessments

to be completed (unlike intelligence tests)• The responses to a variety of questions related to the different

developmental domains are gathered and the information is compared to development of similarly aged children

Adaptive Skills (cont.)• 3 categories of adaptive skills are measured• Conceptual skills

• Communication• Language• Academic

• Social skills• Interactions• Social problem-solving• Leisure skills

• Practical skills• Personal skills• Self-help• Daily living skills• Safety• Travel

Adaptive Behavior (cont.)

• Children with adaptive behaviors in the bottom 3% as compared to children of the same age are considered to have significant adaptive behavior delays.• There is generally a high correlation between a person’s intellectual

functioning and his/her adaptive behavior functioning• The adaptive behavior component has prevented some people who

are able to function well in society from being labeled with an intellectual disability.• Most likely to occur for people with borderline IQ scores

Measuring Adaptive Behaviors

• These instruments are described on pp. 81 – 87• Pros and cons of each instrument are addressed• Information is gathered from people familiar with the child being assessed• Cultural expectations must be taken into account • Some instruments are designed to diagnose an intellectual disability, not

for program planning or assessment of effectiveness of interventions.• Others are designed in ways that may be used for program planning and

evaluation, assisting in diagnosis and classification, assessment of progress, and identifying needed supports

Assessing Support Needs

• Paradigm shift from identifying a person’s deficits to identifying and providing needed supports.• Supports Intensity Scale (SIS) (Thompson et all.; 2004)• Can be used to identify the equipment and supports that help

individuals further their goals associated with quality of life and integration into community

4-Step Process (Thompson et al.; 2002)

• Identify goals• Determine needed supports• Develop support plan based on individual needs• Monitor progress

• This model is designed to be used for older people, but similar models are in place for children as documented through their IFSPs or IEPs

Support Model Pitfalls

• Support needs assessments are generally subjective• Support needs are subject to funding• Experienced and trained raters may have more reliable results

Support Model Positives• Person centered• Emphasizes quality of life• Encourages inclusion

Dual Diagnosis

• Just as with the “regular” population, people with ID are may have a diagnosis of psychiatric disorders, mental illness or behavioral disorders.• Some causes may be

• The result of their experiences as a person with ID• A direct result of their ID• A genetic or biochemical abnormality

• Some illnesses may be undiagnosed if they are not recognized as separate from the diagnosis of ID• There may be a higher prevalence of some mental health disorders in

people identified with ID

Dual Diagnosis (cont.)

• The author discusses several tools that are currently available globally for medical doctors to diagnosis mental illness in people with ID• There are other tools available for helping diagnose students with

self-injurious and aggressive behaviors.

Dual Diagnosis (cont.) Teacher Role

• Teachers have a frontline role in the diagnosis of dual behaviors• Through referrals based on classroom concerns• Through communication with parents who have concerns• Through observations using checklists, frequency counts, or other observation

tools• Through follow-up such as ensuring medications are taken, changes in

behavior following treatment changes, implementing positive behavior support, recognition of side effects, etc.• As part of the interdisciplinary team who review and carry out the student’s

IEP (Individualized Education Plan)

References

• Foreman, Paul. (2009) Education of Students with an Intellectual Disability: Research and Practice. Charlotte, NC., Information Age Publisher. • Luckasson, R., Borthwick-Duffy, S., Buntinx, W., Coulter, D., Ellis, C., Reeve,

A., et al. (2002). Mental retardation: Definition, classification and supports (10th ed.). Washington, DC: American Association on Mental Retardation.• Thompson, J.R., Bryant, B.R., Craig, E., Campbell, E., Hughes, C., Rotholz, D.,

et al. (2004). Supports Intensity Scale. Washington, DC: American Association on Mental Retardation.• Thompson, J. R., Hughes, C., Schalock, R., Silverman, W., Tasse, M. J.,

Bryant, B., et al. (2002). Integrating supports in assessment and planning. Mental Retardation, 40(5), 390–405.