ERIC Identifier: ED389965
Publication Date: 1995-01-30
Author: de La Paz, Susan - Graham, Steve
Clearinghouse on Counseling and Student Services Greensboro NC.
Screening for Special Diagnoses. ERIC Digest.
Congress enacted Public Law 94-142, the Education for All Handicapped
Children Act, in November, 1975. It requires that all children with disabilities
receive a free and appropriate public education. Determining who has a
disability and who is eligible for special services, however, is not an exact
science. It is complicated by vague definitions and varying interpretations of
how to identify specific handicapping conditions (Hallahan & Kauffman,
1991). Nevertheless, recent government figures indicate that 7 percent of
children and youth from birth to 21 are identified as having a disability that
requires special intervention (Hunt & Marshall, 1994).
While practices differ greatly both across and within states (Adelman &
Taylor, 1993), screening is an important part of the assessment process mandated
by Public Law 94-142. Screening for the purpose of special diagnoses begins at
birth and continues throughout the school years. In the first few years of life,
most forms of screening center around developmental norms for physical,
cognitive, and language abilities. Many children with severe disabilities
(cerebral palsy, spina bifida, Down's syndrome, autism, severe sensory
impairments, or children with multiple disabilities, for example) are identified
early in life by physicians and other health professionals. However, other
children, such as those with learning disabilities, attention deficit disorders,
behavioral problems, and so forth, are usually not identified until they start
Most public schools periodically "screen" large groups of students, typically between kindergarten through third
grade, to identify children who may have a disability (as yet unidentified) or
may be at risk for school failure. For example, a student with an extremely low
test score on a standardized achievement test administered to all first graders
in a school may become the focus of further inquiry to determine the validity of
the screening observation and, if warranted, to determine the causes of the
child's difficulties. This may lead to a recommendation to conduct a formal
evaluation to decide if the child has a specific, identifiable disability. In
addition to systematically "screening" students, children with a "suspected" disability may also be identified through referrals by parents, teachers, or
other school personnel. Typically, a child who is having academic or behavioral
problems in the classroom may be referred for further testing to determine if a
disability is present. Before testing for diagnosis begins, however, the school
must obtain consent from the child's parents to do the evaluation.
While most children with a disability are identified by third grade, some are
not identified until the upper elementary grades or even junior or senior high
school. In some instances, a problem does not become evident until the demands
of school exceed the child's skills in coping with his or her disability. In
other cases, the disability may not occur until the child is older. For
instance, a disability may be acquired as a result of a traumatic brain injury
or as a result of other environmental factors. A disability may also not be
identified until a child is older because the procedures used for screening,
referral, testing, and/or identification are ineffective.
PROBLEMS AND SOLUTIONS FOR SCHOOL SCREENING
It is important
to understand that there is no standard or uniform battery of tests, checklists,
or procedures to follow for the identification of most students with
disabilities. While there is a basic structure to the identification process,
there is considerable variability in how students may come to be identified,
including the types of tests used in screening and the processes by which they
Critics have argued that the procedures used to identify children and youth
with special needs have resulted in over- as well as under-identification of
students with disabilities. As several studies have shown, a referred child
almost always qualifies for special education (Christenson, Ysseldyke, &
Algozzine, 1983). Over-identification has been particularly problematic in the
area of learning disabilities (Hunt & Marshall, 1994), as approximately half
of all students receiving special education services are identified as learning
disabled! In contrast, students with behavioral disorders appear to be
under-identified, particularly children who are compliant and nonaggressive but
suffer from problems such as depression, school phobia, or social isolation
(Walker et al., 1990).
To remedy problems of over- and under-identification, educators have begun to
institute several changes in the screening and referral process. One approach
has involved the development of better screening procedures. For example, Walker
and his colleagues (1990) devised a screening process, the Systematic Screening
for Behavioral Disorders, that relies on a three-step process. Teachers (1)
rank-order students along specified criteria and then (2) use checklists to
quantify observations about the three highest-ranked students. Then, (3) other
school personnel (for example, school psychologists or counselors) observe
children whose behaviors exceed the norm for the teacher's classroom. Referrals
are made for further evaluation only after the three-step process is completed.
A second common practice aimed at improving the identification process
involves the use of prereferral interventions (Chalfant, 1985). These
interventions have been developed to reduce the number of referrals to special
education and provide additional help and advice to regular education teachers.
Before initiating a referral for testing for special diagnosis, teachers first
attempt to deal with a child's learning or behavioral problems by making
modifications in the regular classroom. If these modifications fail to address
the difficulties the child is experiencing adequately and the teacher believes
that special services may be warranted, then the referral process is set into
motion. Currently, 34 of 50 states require or recommend some form of prereferral
intervention (Sindelar, Griffin, Smith, & Watanabe, 1992).
Two of the more common prereferral intervention approaches include Teacher
Assistance Teams, (TATs), and collaborative consultation. Both approaches
involve professionals helping regular educators deal with students who have
problems in their classroom; however, they differ in an essential way. TATs
typically consist of a team of three teachers with the referring teacher as the
fourth member. The TAT model provides a forum where teachers meet and brainstorm
ideas for teaching or managing a student. In contrast, most collaborative
consultation models employ school specialists (resource room teachers,
speech-language clinicians) who work directly with the referring teacher to
plan, implement, and evaluate instruction for target students in the regular
Screening procedures are an important part of the
assessment process to identify children and youth who have disabilities. Such
procedures must be used with care, however, as they provide only a preliminary
sign that a child has a disability. Additional testing is required to affirm or
disprove the presence of a handicapping condition. If a disability is identified
during follow-up assessment, the focus shifts to providing the student with an
Adelman, H., & Taylor, L. (1993). "Learning
problems and learning disabilities." Pacific Grove, CA: Brooks.
Chalfant, (1985). Identifying learning disabled students: A summary of the
National Task Force Report. "Learning Disabilities Focus," 1, 9-20.
Christenson, S., Ysseldyke, J., & Algozzine, B. (1982). Institutional
constraints and external pressures influencing referral decisions. "Psychology
in the Schools," 19, 341-345.
Hallahan, D., & Kauffman, J. (1991). "Exceptional children." Englewood
Cliffs, NJ: Prentice Hall.
Hunt, N., & Marshall, K. (1994). "Exceptional children and youth."
Boston, MA: Houghton Mifflin Company.
Mercer, C. (1991). "Students with learning disabilities." New York, NY:
Sindelar, P., Griffin, C., Smith, S., & Watanabe, A. (1992). Prereferral
intervention: Encouraging notes on preliminary findings. "The Elementary School
Journal," 92, 245-259.
Walker, H., Severson, H., Todis, B., Block-Pedego, A., Williams, G., Haring,
N., & Barckley, M. (1990). Systematic screening for behavior disorders
(SSBD): Further validation, replication, and normative data. "Remedial and
Special Education," 11, 32-46.