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Diagnostic and classification accuracy for mildly mentally handicapped children Carter, David E. 1989

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DIAGNOSTIC AND CLASSIFICATION ACCURACY FOR MILDLY MENTALLY HANDICAPPED CHILDREN by D a v i d E . C a r t e r B . E d . , U n i v e r s i t y o f B r i t i s h C o l u m b i a , 1973 M . E d . , U n i v e r s i t y o f B r i t i s h C o l u m b i a , 1982 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS OF THE DEGREE OF DOCTOR OF EDUCATION i n THE FACULTY OF EDUCATION Department o f E d u c a t i o n a l Psycho logy and S p e c i a l E d u c a t i o n We a c c e p t t h i s t h e s i s as conforming t o the r e q u i r e d s t a n d a r d THE UNIVERSITY OF BRITISH COLUMBIA November, 1989 © D a v i d E . C a r t e r , 1989 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of Educational Psychology and Special Education The University of British Columbia Vancouver, Canada Date February 8, 1990 DE-6 (2/88) ABSTRACT The purpose of t h i s study was t o examine the d i a g n o s t i c and c l a s s i f i c a t i o n accuracy of placement d e c i s i o n s f o r M i l d l y / E d u c a b l y M e n t a l l y Handicapped (M/EMH) c h i l d r e n i n B r i t i s h Columbia. Evidence from the U n i t e d S t a t e s suggests t h a t c l a s s i f i c a t i o n d e c i s i o n s are o f t e n made on the b a s i s of i d i o s y n c r a t i c student behaviours and the s u b j e c t i v e o p i n i o n s of e d u c a t o r s , not on the b a s i s of e m p i r i c a l evidence. Although Canadian s p e c i a l e d u c a t i o n p r a c t i c e i s o f t e n based on t h a t o f the U.S., no major study of the accuracy of d i a g n o s i s and c l a s s i f i c a t i o n has been undertaken i n t h i s c o u n t r y . Based on a review of the l i t e r a t u r e , i n t e r n a t i o n a l l y a ccepted c r i t e r i a f o r the d i a g n o s i s and c l a s s i f i c a t i o n of M/EMH students were formulated. In a d d i t i o n , v a r i a b l e s t h a t might i n f l u e n c e the use of these c r i t e r i a were i d e n t i f i e d . Elementary age students from two m e t r o p o l i t a n Vancouver s c h o o l d i s t r i c t s who had been suspected of being M/EMH d u r i n g a two-year p e r i o d served as s u b j e c t s (n=106). Of these 57 were c l a s s i f i f e d as M/EMH and 49 were c l a s s i f i e d as r e g u l a r e d u c a t i o n . An e v a l u a t i o n of IQ, ada p t i v e behaviour, r e a d i n g and a r i t h m e t i c achievement, maladaption, and v i s u a l and h e a r i n g a c u i t y was performed f o r each s u b j e c t . P r e l i m i n a r y data analyses p e r m i t t e d the fo r m a t i o n of an achievement composite score and the p o o l i n g of s u b j e c t s from the two d i s t r i c t s . Using an i n t e r n a t i o n a l l y accepted two-f a c t o r d i a g n o s t i c model, analyses were performed t o i n v e s t i g a t e the c l a s s i f i c a t i o n accuracy f o r the sample. C u t - o f f c r i t e r i a used with the t w o - f a c t o r model were a d j u s t e d t o those of both the American A s s o c i a t i o n f o r Mental D e f i c i e n c y and the d r a f t B.C. S p e c i a l E d u c a t i o n G u i d e l i n e s . Where s u b j e c t s c o u l d not be confirmed by the a p p l i c a t i o n of these models, sources of c l a s s i f i c a t i o n e r r o r were i d e n t i f i e d . Next, a s e r i e s of d i s c r i m i n a n t f u n c t i o n a n a l y s e s , each r e p r e s e n t i n g a h i s t o r i c a l s t e p i n the development of d i a g n o s t i c and c l a s s i f i c a t i o n models, were performed and the c l a s s i f i c a t i o n accuracy of each examined. F i n a l l y , a f u l l model of a l l measured v a r i a b l e s was examined u s i n g both a f o r c e d d i s c r i m i n a n t f u n c t i o n procedure and a step-wise t e c h n i q u e . The f i n d i n g s suggested t h a t a combination of the ad a p t i v e behaviour, IQ, and achievement v a r i a b l e s p r o v i d e d the h i g h e s t c l a s s i f i c a t i o n accuracy. T h i s r e s u l t i s c o n s i s t e n t w i t h much of the r e s e a r c h from the U.S. IQ s c o r e s were found to c o n s i s t e n t l y dominate c l a s s i f i c a t i o n d e c i s i o n s . In a d d i t i o n , academic achievement proved t o be a v a l i d p r e d i c t o r , e i t h e r i n combination w i t h s o c i a l a d a p t a t i o n or maladaption. However, maladaptive behaviour, whenever ent e r e d with s o c i a l a d a p t a t i o n , overwhelmed the l a t t e r as a d e s c r i m i n a t o r of group membership. The h i g h e s t c l a s s i f i c a t i o n r a t e f o r the t o t a l sample was 92.0% f o r the combination of adaptive behaviour, IQ, and academic achievement. Although v i s u a l and h e a r i n g a c u i t y were not found t o be r e l a t e d t o group membership, i t was d i s c o v e r e d t h a t t e s t i n g f o r these v a r i a b l e s was not o c c u r r i n g i n the d i s t r i c t s s t u d i e d i n accordance with accepted b e s t p r a c t i c e . A d i s p r o p o r t i o n a t e number of M/EMH students proved t o be u n t e s t a b l e u s i n g school-based a u d i o l o g i c a l and v i s u a l sweep t e s t i n g t e c h n i q u e s . In cases of u n t e s t a b i l i t y , the assumption t h a t the c h i l d can see and hear w i t h i n normal t o l e r a n c e s appears t o be made, and e f f o r t s t o use a l t e r n a t i v e t e s t i n g procedures are not pursued. In a d d i t i o n , v i s u a l and h e a r i n g t e s t i n g appears t o occur a f t e r the a d m i n i s t r a t i o n of s t a n d a r d i z e d c o g n i t i v e t e s t s , and not be f o r e , as b e s t p r a c t i c e s would d i c t a t e . The p r i n c i p a l c o n t r i b u t i o n s of t h i s r e s e a r c h are (1) t h a t i t i s the f i r s t major study of d i a g n o s t i c and c l a s s i f i c a t i o n accuracy with a Canadian M/EMH p o p u l a t i o n , ( 2 ) t h a t i t a d v i s e s the i n c l u s i o n of academic achievement as V a domain of adapti v e behaviour based on e m p i r i c a l evidence of the importance of t h a t v a r i a b l e i n d i a g n o s i n g M/EMH, and ( 3 ) i t examines the r o l e of a u d i t o r y and v i s u a l a c u i t y t e s t i n g i n M/EMH d i a g n o s i s and c l a s s i f i c a t i o n . v i TABLE OF CONTENTS Chapter Page Abstract i i L i s t of Tables x L i s t of Figures x i Acknowledgements x i i I. Introduction and Delineation of the Problem . . 1 Diagnosis and Placement Issues 1 Two-Factor Diagnostic Model for M/EMH . . . . 3 Reductions i n M/EMH Placements 4 Changes i n the Severity of D e f i c i t s i n M/EMH Populations 6 IQ Scores and Overrepresentation 7 Visual and Hearing Acuity 8 Academic Achievement. 9 Reduction of Professional Interest i n the M/EMH 9 Development of Special Education i n Canada . 10 PL94-142 as a Model for Canadian Special Education 14 Purpose of the Study 14 Research Questions 16 Delimitations of the Study 18 J u s t i f i c a t i o n for the Study 19 De f i n i t i o n of Terms 20 II . Review of the Literature 25 The Nineteenth Century 25 From IQ Tests to PL94-142 (1905-1973) . . . . 28 Development and Impact of IQ Testing . . . 28 Renewal of Interest i n Adaptive Behaviour . 31 Ca l l s for a Two-Factor Model 34 L i t i g a t i o n and Le g i s l a t i o n i n the U.S. . . 38 Achievement as a Domain of Adaptive Behaviour 4 2 Consideration of Hearing and Visi o n 44 Canadian Special Education Development . . . 47 Lack of Federal Education Authority . . . 47 PL94-142 as a Model 47 v i i TABLE OF CONTENTS (continued) Chapter Page Potential Effects of the Canadian Charter of Rights and Freedoms 48 Recent Studies on Diagnosis and Placement . 52 The Minnesota I n s t i t u t e Studies 52 Teacher Referrals 53 Psycho-Educational Evaluation and Interpretation 55 Order of Presentation and Test Influence . 61 Confirmation of Placements Using the Two-Factor Model 65 Summary of Three Studies 68 Chapter Summary 71 II I . Methodology 75 Design 75 Subjects 75 Selection of Subjects 75 Recruitment of Schools and Students . . . 81 Testing Procedures 81 Test Selection C r i t e r i a 81 Vineland Adaptive Behavior Scales . . . . 83 B r i t i s h Columbia Quick Individual Educational Test 86 Wechsler Intelligence Scale for Children -Revised 87 Pure Tone Audiometric Screening 89 Snellen Visual Acuity Test 91 Data C o l l e c t i o n 92 Examiner Training 92 Test Administration 9 3 Data Preparation 94 Data Entry 94 Data Analysis Procedures 95 Computer Support 96 IV. Results 97 Preliminary Analysis 97 Achievement Composite 97 Pooling of D i s t r i c t Data 100 v i i i TABLE OF CONTENTS (continued) Chapter Page Differences Between M/EMH and Regular Education Students 101 Demographic Characteristics 102 Correlation Matrix for Test Results . . . 104 Vineland, WISC-R, and BC QUIET 106 Snellen Visual Acuity Test 106 Pure Tone Audiometric Sweep Test 106 Comparison with AAMD and Proposed B.C. Two-Factor C r i t e r i a 110 U.S. Norms with Canadian Students . . . . 115 Discriminant Function Analyses 116 H i s t o r i c Models of C l a s s i f i c a t i o n . . . . 116 Step-Wise Discriminant Function Analyses . 120 V. Summary, Conclusions and Implications . . . . 125 Summary 125 Purpose 125 Procedure 126 Data Analysis and Results 127 Limitations of the Study 13 2 Conclusions and Implications 133 Two-Factor Model 134 M i s c l a s s i f i c a t i o n Rate 134 IQ, Maladaption and Achievement 134 An Erroneous Three-Factor Model 137 An Improved Two-Factor Model 13 8 Reasons to Use the Two-Factor Model . . . . 140 Visual and Hearing Acuity 141 General Findings 142 Alternate Testing Procedures 144 Recommendations for Practice 14 7 Basis for Recommendations 147 Recommendation 1 149 Recommendation 2 150 Directions for Further Research 151 Recommendation 1 151 Recommendation 2 152 Recommendation 3 152 Recommendation 4 153 ix TABLE OF CONTENTS (continued) Chapter Page REFERENCES 154 APPENDICES A. D i s t r i c t One Psychologist Case Log . . . 165 B. D i s t r i c t One Referral to Psychologist Form 167 C. D i s t r i c t Two Referral to Psychologist Form 171 D. Letter of Contact With School P r i n c i p a l s 176 E. Letter of Contact With Parents/ Guardians and Parent/Guardian Consent Form 179 F. B r i t i s h Columbia Ministry of Education Draft Special Education Guidelines f o r Identifying Mentally Handicapped Children 182 G. Procedure for Determining Relative Percentages from Standardized Canonical Discriminant Function C o e f f i c i e n t s 185 X LIST OF TABLES Page Ta b l e 1. Recruitment of S u b j e c t s 82 Table 2. C o r r e l a t i o n s Among BC QUIET Subtests and Achievement Composite by D i s t r i c t . . . 98 Table 3. Demographic C h a r a c t e r i s t i c s of Sample . . 103 Table 4. C o r r e l a t i o n M a t r i x f o r T e s t R e s u l t s . . . 105 Table 5. Means and Standard D e v i a t i o n s f o r T e s t R e s u l t s . 107 Table 6. S n e l l e n V i s i o n T e s t R e s u l t s 108 Table 7. Pure Tone Sweep Hearing T e s t R e s u l t s . . . 109 Table 8. C l a s s i f i c a t i o n R e s u l t s Using A.A.M.D. and Proposed B.C. G u i d e l i n e s I l l Table 9. Sources of E r r o r f o r Cu r r e n t Placements Compared With A.A.M.D. and Proposed B.C. G u i d e l i n e s 113 Tab l e 10. R e l a t i v e Percentages, C l a s s i f i c a t i o n M a t r i c e s , and Accuracy f o r H i s t o r i c M/EMH D i a g n o s t i c and C l a s s i f i c a t i o n Models 119 Table 11. R e s u l t s of Forced and Step-Wise D i s c r i m i n a n t F u n c t i o n Analyses f o r Models 5 and 6 122 x i LIST OF FIGURES Page Figure 1. Typical Referral and Diagnostic Procedures i n Seeking Placement into an M/EMH Class 17 Figure 2. Two-Factor Diagnostic Model for Mental Handciap 24 ACKNOWLEDGEMENTS S e v e r a l hundred persons - p a r e n t s , c h i l d r e n , s c h o o l and d i s t r i c t s t a f f - p a r t i c i p a t e d i n t h i s r e s e a r c h . Without the c o o p e r a t i o n of a l l these people and the w i l l i n g n e s s of s e n i o r o f f i c i a l s i n both d i s t r i c t s , t h i s d i s s e r t a t i o n would have been i m p o s s i b l e . I wish t o e s p e c i a l l y thank Dr. P. L e s l i e who served not on l y as c h a i r p e r s o n of my committee, but who a l s o acted w i t h g r e a t concern f o r me as a person d u r i n g some of the more d i f f i c u l t moments. I thank Dr. D. Willms f o r h i s a s s i s t a n c e throughout, and e s p e c i a l l y f o r h i s g r e a t p e r s o n a l p a t i e n c e i n the f i n a l data a n a l y s i s . I acknowledge a s p e c i a l debt of g r a t i t u d e t o Dr. R. Conry who w i l l i n g l y and most a b l y stepped i n t o f i l l a committee vacancy. I a l s o s t a t e my a p p r e c i a t i o n t o Dr. W. T. Rogers who, although unable t o remain wi t h the committee t o the ve r y end, was a va l u e d f r i e n d and mentor. My thanks go t o Dr. C. T. Wormeli, a long time f r i e n d , who was the primary i n s p i r a t i o n t o me i n d e c i d i n g t o attempt d o c t o r a l s t u d i e s . F i n a l l y , but most i m p o r t a n t l y , I thank my f a m i l y . To my wife Sharon, thanks f o r encouraging me t o do what I wanted so badly t o do, and f o r b e l i e v i n g i n my a b i l i t y t o do i t . In s p i t e of f i n a n c i a l and oth e r s t r e s s e s , she remained a b s o l u t e l y c o n s t a n t i n her l o v e , p r a y e r and x i i i s upport. To my c h i l d r e n , Nathan, Shaina, Dylan, and Andrew, although you d i d n ' t completely understand what i t was a l l about, you never f a i l e d t o encourage me t o be a "Doctor Dad. " 1 Chapter 1 I n t r o d u c t i o n and D e l i n e a t i o n of the Problem I n t r o d u c t i o n t o the Problem The placement of a c h i l d i n t o a s p e c i a l e d u c a t i o n program, a process expedited by t e s t i n g and l a b e l l i n g , has been d e s c r i b e d as "perhaps the most s e r i o u s d e c i s i o n t h a t educators can make." (Tymitz, 1984, p. 12) Dia g n o s i s and Placement Issues S p e c i a l e d u c a t i o n programmes f o r the M i l d l y / E d u c a b l y M e n t a l l y Handicapped (M/EMH) showed r a p i d growth d u r i n g the 1960's and 1970's. In B r i t i s h Columbia, s p e c i a l e d u c a t i o n programmes grew a t a r a t e s i x times t h a t of r e g u l a r s c h o o l programmes d u r i n g the 1960s. A s i g n i f i c a n t p o r t i o n o f t h a t growth was accounted f o r by students l a b e l l e d as M/EMH ( B a l l a n c e , K e n d a l l , & Saywell, 1972; K e n d a l l , 1980). T h i s r a p i d expansion of s p e c i a l e d u c a t i o n programmes r e q u i r e d t h a t s tudents who had p r e v i o u s l y not been r e c e i v i n g s p e c i a l e d u c a t i o n s e r v i c e s be l o c a t e d and d e c l a r e d e l i g i b l e . Throughout the 1970's, e s p e c i a l l y i n the U n i t e d S t a t e s , q u e s t i o n s about the c o r r e c t d e f i n i t i o n and procedures f o r assessment of M/EMH r e c e i v e d i n c r e a s i n g a t t e n t i o n . Both s t a t e and f e d e r a l education a u t h o r i t i e s a l l o c a t e d l a r g e amounts of r e s e a r c h funding f o r i n v e s t i g a t i o n s of d i a g n o s t i c 2 and placement procedures. At the same time that professional researchers were exploring these questions and po s i t i n g procedures for ensuring f a i r and accurate diagnostic and placement practices, court actions were being fought over these same issues. In both Diana (1972) and Larry P. (1972) versus the State of C a l i f o r n i a , minority group youngsters who had been placed into s p e c i a l education classes for M/EMH successfully sued school a u t h o r i t i e s . In t h e i r decisions, the courts noted the seriousness of inappropriate placements into s p e c i a l education programmes, st a t i n g that such placements could r e s u l t i n consonant loss of educational opportunity and unwarranted s o c i a l stigmatization. The courts upheld the a l l e g a t i o n that e x i s t i n g placement and assessment.practices were inappropriate, e s p e c i a l l y for minority group ch i l d r e n . J u d i c i a l decisions often excoriated s p e c i a l education services f o r inappropriate t e s t i n g procedures, the use of biased assessment instruments, lack of programme monitoring, and excessive zeal i n l a b e l l i n g children (MacMillan, 1982; Polloway & Smith, 1983; Reschly, 1988; Reschly, K i c k l i g h t e r & McKee, 1988). At the heart of these actions, as well as much of the professional debate, was the d e f i n i t i o n of mental retardation i t s e l f . At that time, the primary t o o l i n the 3 d i a g n o s i s o f M/EMH was the i n t e l l i g e n c e (IQ) t e s t . I t was t h e use o f IQ t e s t s more than any f a c t o r t h a t l e d t o c h a l l e n g e s t o d i a g n o s t i c and p lacement p r a c t i c e (Goodman, 1977; H a r t s h o r n e & H o y t , 1986; Hobbs, 1975; M e r c e r , 1972, 1973; R e s c h l y , K i c k l i g h t e r , & McKee, 1988; R e s c h l y , 1988) . T w o - F a c t o r D i a g n o s t i c Model f o r M/EMH The c u l m i n a t i o n b o t h o f c o u r t a c t i o n s and p r o f e s s i o n a l r e s e a r c h and debate came i n the passage o f P u b l i c Law 94-142 (PL 94-142) , the E d u c a t i o n o f A l l Handicapped C h i l d r e n A c t (1975) . Embodied i n t h i s a c t was t h e n o t i o n t h a t a m u l t i -f a c t o r , m u l t i - d i s c i p l i n a r y model f o r the d i a g n o s i s and placement o f s p e c i a l needs s t u d e n t s s h o u l d be f o l l o w e d . In t h i s mode l , a v a r i e t y o f f a c t o r s were i d e n t i f i e d as b e i n g o f un ique importance i n d i a g n o s i n g and p l a c i n g s t u d e n t s w i t h i n c a t e g o r i c a l l a b e l s o f h a n d i c a p . These f a c t o r s were t h e n a s s e s s e d by the members o f a m u l t i - d i s c i p l i n a r y team. The team was compr i sed o f members from a p p r o p r i a t e f i e l d s o f p r o f e s s i o n a l e x p e r t i s e who a c t i v e l y c o l l a b o r a t e d i n d e c i s i o n making . F o r M/EMH c h i l d r e n s p e c i f i c a l l y , a t w o - f a c t o r d i a g n o s t i c model based on the e q u a l c o - f a c t o r s o f g e n e r a l c o g n i t i v e a b i l i t y and a d a p t i v e b e h a v i o u r was c o n s i d e r e d b e s t p r a c t i c e ( M a c M i l l a n , 1982; Po l loway & S m i t h , 1983; R e s c h l y , 1982, 1986) . In the t w o - f a c t o r model s t u d e n t s t e s t e d must s c o r e below a s e t s t a n d a r d on b o t h an i n d i v i d u a l l y 4 a d m i n i s t e r e d i n t e l l i g e n c e t e s t and a t e s t o f a d a p t i v e b e h a v i o u r i n o r d e r t o be c l a s s i f i e d as m e n t a l l y h a n d i c a p p e d . T h i s t w o - f a c t o r model , which had been i n i t i a l l y p o s i t e d by the Amer ican A s s o c i a t i o n on Menta l R e t a r d a t i o n (AAMR) i n 1959 (Grossman, 1983), was r a p i d l y a c c e p t e d b o t h w i t h i n the U n i t e d S t a t e s and i n t e r n a t i o n a l l y as the most a p p r o p r i a t e d i a g n o s t i c mode l . R e f e r r i n g t o t h i s mode l , the N a t i o n a l A s s o c i a t i o n o f Schoo l P s y c h o l o g i s t s (NASP) d e s c r i b e d i t s use as "both mandatory and i n d i s p e n s a b l e " ( R e s c h l y , 1985, p . 353) . S i m i l a r views were put f o r w a r d by b o t h the Amer ican P s y c h i a t r i c A s s o c i a t i o n and the W o r l d H e a l t h O r g a n i z a t i o n (Grossman, 1983) . R e d u c t i o n s i n M/EMH Placements A l t h o u g h the t e n e t s o f b e s t p r a c t i c e and f e d e r a l law i n t h e U n i t e d S t a t e s c o n t i n u e t o demand the a p p l i c a t i o n o f the t w o - f a c t o r model w i t h i n a m u l t i - d i s c i p l i n a r y framework, t h e r e i s e v i d e n c e t o suggest t h a t these p r o c e d u r e s have not e f f e c t i v e l y s topped o r even s i g n i f i c a n t l y reduced i n a p p r o p r i a t e l a b e l l i n g and placement (Grade , C a s e y , & C h r i s t i a n s o n , 1985; K n o f f , 1983, 1 9 8 4 ; ) . A l t h o u g h i t has been noted t h a t w i t h i n the c l a s s i f i c a t i o n M/EMH t h e r e has been a r e d u c t i o n o f as much as 17% i n the t o t a l number o f c h i l d r e n l a b e l l e d and p l a c e d ( F o r n e s s , 1985; Lamber t , 1981; P o l l o w a y , E p s t e i n & C u l l i n a n , 1985) , r e c e n t a u t h o r s argue 5 t h a t t h i s r e d u c t i o n i s simply the r e s u l t of a more s t r i n g e n t a p p l i c a t i o n of the IQ requirement of the tw o - f a c t o r model. By l o w e r i n g the upper accepted range of IQ sc o r e s f o r M/EMH c l a s s i f i c a t i o n , s i g n i f i c a n t numbers of students are no longer l a b e l l e d as M/EMH. McMillan and Borthwick (1980) have noted t h a t the lowering of the upper IQ sc o r e f o r the M/EMH c l a s s i f i c a t i o n from 85 t o 75 does not n e c e s s a r i l y r e f l e c t a f a i r e r or more s o p h i s t i c a t e d d i a g n o s t i c and placement procedure. These authors suggest t h a t the e x c l u s i o n o f students whose IQ scores f a l l between 75 and 85 simply generates a more s e l e c t and " p a t e n t l y d i s a b l e d group" (p. 155). Indeed, G o t t l i e b (1981) has noted t h a t the upper end of the IQ range has, i n p r a c t i c e , moved w e l l below an IQ c u t - o f f o f 75, with the l a b e l of m i l d mental handicap appearing "to be r e s e r v e d f o r the lower end of the IQ range, u s u a l l y f o r c h i l d r e n having an IQ of about 65 or lower" (p.124). Consequently, authors concerned w i t h d i a g n o s i s , placement, and programming f o r M/EMH students have more r e c e n t l y c a l l e d a t t e n t i o n t o those students who were once, but perhaps no longer are served by the s p e c i a l e d u c a t i o n system. T h i s l a r g e group of students c o n s t i t u t e s what Mc M i l l a n (1988) d e s c r i b e d as "an unserved segment which i s * s o c i a l l y promoted' from grade t o grade with t h e i r academic d e f i c i e n c i e s b e i n g undetected or ign o r e d " (p. 280). 6 McMillan f u r t h e r suggests t h a t t h i s apparent o v e r s i g h t of an unserved group (high end M/EMH) i s f u r t h e r compounded by the a t t i t u d e of p r o f e s s i o n a l o r g a n i z a t i o n s "such as CEC ( C o u n c i l f o r E x c e p t i o n a l C h i l d r e n ) , (and) AAMD (American A s s o c i a t i o n on Mental D e f i c i e n c y ) ..-(which are) l e s s concerned w i t h m i l d mental r e t a r d a t i o n than with s e v e r e l y handicapped or LD ( l e a r n i n g d i s a b l e d ) " (p. 275). Changes i n the S e v e r i t y of D e f i c i t s i n M/EMH P o p u l a t i o n s W i t h i n the M/EMH c l a s s i f i c a t i o n , problems common throughout the f i e l d of s p e c i a l e d u c a t i o n have been seen. Grade e t a l . (1985), f o r example, have noted t h a t " c u r r e n t p r a c t i c e s i n s p e c i a l e d u c a t i o n can be c h a r a c t e r i z e d as i n c o n s i s t e n t and pr o b l e m a t i c a t each phase of the assessment and decision-making process - f o r [ s i c ] r e f e r r a l , t o t e s t i n g , f o r [ s i c ] i d e n t i f i c a t i o n / c l a s s i f i c a t i o n , t o d e c i s i o n making, f o r [ s i c ] e l i g i b i l i t y d e t e r m i n a t i o n and program p l a n n i n g " (p. 378). These ge n e r a l problems may be compounded f o r M/EMH students because o f the a l t e r a t i o n s t h a t have taken p l a c e i n b a s i c d e f i n i t i o n s of M/EMH, e s p e c i a l l y those a l t e r a t i o n s which have r e s u l t e d i n M/EMH c l a s s e s c o n t a i n i n g fewer c h i l d r e n i n the upper range of the M/EMH and b o r d e r l i n e c l a s s i f i c a t i o n s . M c M i l l a n and Meyers (1984), f o r example, argue t h a t the kin d s of students p r e s e n t l y e n r o l l e d i n M/EMH c l a s s e s are so u n l i k e those 7 e n r o l l e d p r i o r t o 1973 t h a t r e s e a r c h performed b e f o r e PL94-142, and on which much i n t e r v e n t i o n r e s e a r c h was based, may be i n v a l i d f o r today's M/EMH students (p. 478). 10 Scores and O v e r r e p r e s e n t a t i o n C h i l d s (1982) found t h a t even under l e g a l and p r o f e s s i o n a l c o n s t r a i n t s , up t o 88% of m i n o r i t y group c h i l d r e n and 80% of a l l other c h i l d r e n p l a c e d i n t o U.S. p u b l i c s c h o o l c l a s s e s f o r M/EMH c o u l d not be confirmed i n t h e i r placements through the use of the tw o - f a c t o r model, even though t h a t was the model which was r e q u i r e d f o r use i n making the o r i g i n a l placement d e c i s i o n s . These f i n d i n g s are c o n s i s t e n t with o b s e r v a t i o n s made by othe r r e s e a r c h e r s t h a t i t i s the IQ t e s t s c o r e t h a t appears t o be the primary determinant i n M/EMH placement. T u r n b u l l and T u r n b u l l (1986) have termed t h i s r e l i a n c e on ge n e r a l i n t e l l i g e n c e t e s t s c o r e s the "hypnotic e f f e c t (of) a student's IQ" (p. 179). Although, i n deference t o PL94-142, compliance i n a d m i n i s t e r i n g the second component of the tw o - f a c t o r model (ad a p t i v e behaviour) seems almost u n i v e r s a l i n the U n i t e d S t a t e s , i t i s o f t e n simply overwhelmed by the a t t r a c t i o n t h a t the IQ s c o r e appears t o h o l d over those r e s p o n s i b l e f o r making d i a g n o s t i c and placement d e c i s i o n s ( C h i l d s , 1982; 8 Knoff, 1984; Turnbull & Turnbull, 1986; Ysseldyke, Thurlow, Graden, Wesson, Algozzine, & Deno, 1983). Visual and Hearing Acuity The factors of v i s u a l and hearing acuity that should be considered i n making a v a l i d m u l t i - d i s c i p l i n a r y diagnosis and placement of M/EMH also appear to have been overlooked. I t has been repeatedly demonstrated that v i s i o n and hearing d i f f i c u l t i e s appear within the mentally handicapped population with greater-than-average frequency (Fulton & Lloyd, 1969; Nolan & Tucker, 1984; Rogow, 1988). Because of t h i s demonstrated r e l a t i o n s h i p between v i s u a l and auditory acuity and mental handicap, and also because undetected hearing and v i s u a l acuity problems can generate spurious t e s t scores, repeated c a l l s for the ca r e f u l examination of v i s i o n and hearing as part of the m u l t i - d i s c i p l i n a r y evaluation have been made (Fulton & Lloyd, 1969; Gearhardt & L i t t o n , 1979; Gerken, 1986; Hartshorne & Hoyt, 1977; President's Committee on Mental Retardation, 1970). Such evaluations have not, however, been emphasized either within the accepted two-factor diagnostic model or i n practice despite the f a c t that they are required by PL94-14 2 (Grossman, 1983). The United States l i t e r a t u r e on diagnosis and placement of M/EMH students i s s u r p r i s i n g l y void of 9 attempts to investigate the function of v i s u a l and hearing acuity i n diagnosis and placement. Academic Achievement In addition to the lack of consideration of the roles of v i s u a l and hearing acuity i n M/EMH diagnosis, academic achievement also appears to have been, u n t i l recently, overlooked. Although academic achievement can e a s i l y be argued as a c r i t i c a l component of adaptation to a school environment (Reschly, 1982, 1988; Reschly & Gresham, 1988), i t i s not i m p l i c i t l y a part of the two-factor diagnostic model. Many of the major tests of adaptive behaviour such as the Vineland - R (Sparrow, B a l l a , & C i c c h e t t i , 1984) and the Adaptive Behavior Inventory for Children (Mercer & Lewis, 1977), do not include achievement as a sub-domain of school adaptation. Yet the findings of Ysseldyke et a l (1983) suggest that lack of academic achievement may contribute heavily to teacher b e l i e f that a c h i l d may be mentally handicapped. The degree to which lack of academic achievement contributes to M/EMH r e f e r r a l s as well as the legitimacy of including academic performance as a domain of school adaptation i s i n need of study. Reduction of Professional Interest i n the M/EMH An examination of the special education l i t e r a t u r e " 10 shows t h a t d u r i n g the 1960s and 1970s i s s u e s r e l a t e d t o the v a l i d and r e l i a b l e d i a g n o s i s and placement of M/EMH c h i l d r e n were c e n t r a l concerns i n the f i e l d s of s p e c i a l e d u c a t i o n and e d u c a t i o n a l psychology ( B e r s o f f , 1982; Cruickshank, 1983; Csapo, 1980, 1981; M c M i l l a n , 1988; Mercer, 1965, 1973; Reschly, 1983, 1985). During the e a r l y 1980s, however, i n t e r e s t i n M/EMH c h i l d r e n , e s p e c i a l l y those a t the upper end o f t h a t c l a s s i f i c a t i o n , began t o wane. S e v e r a l authors have examined t h i s l a c k of i n t e r e s t (Forness, 1985; McMi l l a n , 1988; Polloway & Smith, 1983), and p o s s i b l e reasons f o r i t have been put f o r t h . These have i n c l u d e d a s h i f t o f p r o f e s s i o n a l a t t e n t i o n t o l e a r n i n g d i s a b i l i t i e s and more severe mental handicaps, and a p e r v a s i v e b e l i e f among s p e c i a l educators t h a t problems a s s o c i a t e d w i t h the M/EMH p o p u l a t i o n were r e s o l v e d i n the 1970s. Development o f S p e c i a l Education i n Canada I f , as d e s c r i b e d by McMillan (1988), M/EMH c h i l d r e n i n the U n i t e d S t a t e s have become the " s t e p c h i l d r e n " (p. 273) of s p e c i a l e d u c a t i o n , what of M/EMH c h i l d r e n i n Canada? Under the C o n s t i t u t i o n Act of 1867 (the B r i t i s h North America A c t ) , and l a t e r r e - a f f i r m e d i n the C o n s t i t u t i o n A c t of 1982, the ed u c a t i o n of school-aged c h i l d r e n i n Canada i s the s o l e and l e g a l r e s p o n s i b i l i t y of the p r o v i n c e s . As wit h a l l e d u c a t i o n a l l e g i s l a t i o n , s p e c i a l e d u c a t i o n law has 11 e v o l v e d s e p a r a t e l y i n each p r o v i n c i a l j u r i s d i c t i o n ( C r u i c k s h a n k , 1983; Csapo , 1980, 1981; P o i r i e r , Goguen, & L e s l i e , 1988) . C o n s e q u e n t l y t h e r e are d i f f e r e n c e s among p r o v i n c e s on such fundamental i s s u e s as the d e f i n i t i o n o f h a n d i c a p p i n g c o n d i t i o n s , p lacement p r a c t i c e s , and programming. A l t h o u g h some p r o v i n c e s and many l o c a l s c h o o l d i s t r i c t s have emulated the models deve loped i n the U n i t e d S t a t e s under the p r o v i s i o n s o f PL94-142 , P o i r i e r e t a l (1988) have no ted t h a t " . . . n o Canadian p r o v i n c e has gone so f a r as the U . S . A c t " (p. 73) . In a d d i t i o n , r e c e n t s t u d i e s have shown t h a t Canadian s t u d e n t performance on b o t h i n t e l l i g e n c e and achievement t e s t s i s s i g n i f i c a n t l y h i g h e r and w i t h l e s s d i s p e r s i o n t h a n t h a t o f U . S . s t u d e n t s (Holmes, 1981; P e t e r s , 1976; W o r m e l i , 1984). S i n c e the b e g i n n i n g o f the p e r i o d of r a p i d s p e c i a l e d u c a t i o n growth i n the 1960 ' s , Canadian s p e c i a l e d u c a t i o n r e s e a r c h e r s have drawn a t t e n t i o n t o the shor tcomings o f C a n a d i a n l e g i s l a t i o n . In a d d i t i o n , they have p o i n t e d out the l a c k o f e m p i r i c a l s t u d i e s on the e f f i c a c y o f Canad ian d i a g n o s t i c and placement p r a c t i c e s and p r o c e d u r e s (Csapo , 1980, 1981; H a l l & D e n n i s , 1968; L a z u r e & R o b e r t s , 1970; Goguen, 1980; P o i r i e r & Goguen, 1986; P o i r i e r e t a l . , 1988) . Csapo (1981) commented, " . . . t h e e d u c a t i o n o f hand icapped 12 children (in Canada) i s grievously neglected and s u f f e r i n g " (p. 197), while Cruickshank (1983) noted "there i s an increasing clamor i n the special education f i e l d for changes to be brought about" (p. 218). Such c a l l s for action have gone largely unanswered. Unlike the United States, i n Canada there has been neither the compunction of federal education law nor the danger of c o s t l y l i t i g a t i o n to stimulate more immediate action. However, the adoption of the Canadian Charter of Rights and Freedoms of the Canada Constitution Act (1982) now makes i t possible for handicapped individuals or groups representing them to challenge p r o v i n c i a l special education diagnostic and placement practices i n the Supreme Court of Canada which " . . . i s the supreme law of Canada and applies to p r o v i n c i a l education l e g i s l a t i o n and to school boards" ( P o i r i e r et a l . , 1988, p. 25). Canadian diagnostic and placement practices for M/EMH children w i l l l i k e l y f a l l under the same kind of scrutiny as did those i n the United States during the early 1970's. Predictably, the r e s u l t s obtained w i l l be " s i m i l a r to those attained i n the United States" ( P o i r i e r et a l . , 1988, p. 77). Carter and Rogers (1988) recently surveyed both p r o v i n c i a l and t e r r i t o r i a l laws and guidelines, as well as l o c a l school d i s t r i c t practices, with respect to the 13 d e f i n i t i o n , assessment, l a b e l l i n g , and r e - e v a l u a t i o n of M/EMH st u d e n t s . An important f i n d i n g of t h e i r r e s e a r c h i s t h a t t h e r e are important and even alarming d i f f e r e n c e s both between and w i t h i n p r o v i n c e s i n terms of p r a c t i c e s . Although our p e r u s a l of i n d i v i d u a l p r o v i n c i a l procedures c l e a r l y shows much t h a t i s encouraging, i t i s the a n a l y s i s of the Canadian p i c t u r e i n i t s e n t i r e t y t h a t i s of concern. Depending upon which j u r i s d i c t i o n a student r e s i d e s i n , the p o t e n t i a l f o r t h a t student being diagnosed as M/EMH u s i n g a r b i t r a r y procedures, of be i n g l a b e l l e d without r e f e r e n c e t o p o t e n t i a l l y i n v a l u a b l e data, and of being l e f t i n a s p e c i a l e d u c a t i o n programme without r e - e v a l u a t i o n i s hi g h , indeed too h i g h . (p. 21) Among the recommendations made by C a r t e r and Rogers (1988) i s one which i s c r i t i c a l t o t h i s study: " l o c a l s c h o o l d i s t r i c t a u t h o r i t i e s [should] examine t h e i r p r a c t i c e s u s i n g these same frames of r e f e r e n c e [even] where t h e i r m i n i s t r i e s of e d u c a t i o n are r e l u c t a n t t o do so" (p. 22). The frames of r e f e r e n c e r e f e r r e d t o are the standards i m p l i c i t i n U.S. PL94-14 2 which demand a tw o - f a c t o r d i a g n o s t i c model performed a f t e r t a k i n g i n t o c o n s i d e r a t i o n p o s s i b l e v i s u a l o r h e a r i n g anomalies. 14 PL94-14 2 as a Model f o r Canadian S p e c i a l E d u c a t i o n R e p e a t e d l y , Canadian a u t h o r s (Csapo, 1980, 1981; Goguen, 1980; H a l l & D e n n i s , 1968; L a z u r e & R o b e r t s , 1970; P o i r i e r & Goguen, 1986; P o i r i e r e t a l . , 1988) have c a l l e d f o r the a d o p t i o n o f p r a c t i c e s l i k e those embodied w i t h i n PL94-142 i n the U n i t e d S t a t e s . As has been p o i n t e d o u t , Canad ian p r a c t i c e shows wide v a r i a t i o n both between p r o v i n c e s based on t h e i r unique l e g i s l a t i o n , and w i t h i n p r o v i n c e s , as l o c a l s c h o o l boards have sought t o implement a p p r o p r i a t e d i a g n o s t i c and placement p r o c e d u r e s . The e v i d e n c e i s t h a t , even though PL94-142 has shaped much o f Canad ian p r a c t i c e i n d i a g n o s i n g and p l a c i n g s t u d e n t s i n t o s p e c i a l c l a s s programmes f o r M/EMH, Canad ian d i a g n o s t i c and placement p r a c t i c e s w i t h r e s p e c t t o t h i s l a r g e g r o u p i n g o f s p e c i a l e d u c a t i o n s t u d e n t s have not been s t u d i e d s u f f i c i e n t l y . I f , as M c M i l l a n (1988) p o i n t s o u t , i n the U n i t e d S t a t e s t h e r e has been "an e x t r e m e l y l i m i t e d amount o f work p u b l i s h e d on t h i s (M/EMH) . . . g r o u p of c h i l d r e n " (p . 273) , t h i s same group o f c h i l d r e n i n Canada i s a t l e a s t i n need of immediate s t u d y . Purpose o f the Study The purpose o f t h i s s tudy was to examine the v a l i d i t y o f d i a g n o s t i c and assessment p r a c t i c e s w i t h r e s p e c t t o 15 M i l d l y / E d u c a b l y M e n t a l l y Handicapped c h i l d r e n . Using the accepted i n t e r n a t i o n a l standards of the two - f a c t o r d i a g n o s t i c model, and r e c o g n i z i n g the v i t a l , i f o f t e n o v e r l o o k e d importance o f determining v i s u a l and h e a r i n g a c u i t y as a p a r t of t h a t d i a g n o s t i c process, a study of students r e f e r r e d f o r c o n s i d e r a t i o n as M/EMH was conducted. As w i l l be shown i n Chapter 2, r e s e a r c h i n t o d i a g n o s i s and placement of M/EMH c h i l d r e n demonstrates f o u r major weaknesses, w i t h the f i r s t being s p e c i f i c t o the Canadian ed u c a t i o n m i l i e u : 1. s t u d i e s have been done on the U n i t e d S t a t e s p o p u l a t i o n , a p o p u l a t i o n demonstrated t o be d i f f e r e n t from the Canadian s c h o o l p o p u l a t i o n (Holmes, 1981; P e t e r s , 1976; Wormeli, 1984); 2. although many s t u d i e s have employed the two-f a c t o r model (IQ and adapti v e b e h a v i o r ) , few have i n c l u d e d the c r i t i c a l components of v i s u a l and h e a r i n g a c u i t y ; 3. s t u d i e s t h a t have i n c l u d e d measures o f ada p t i v e behaviour g e n e r a l l y have not i n c l u d e d academic achievement as an ada p t i v e domain; 4. the emphasis of r e s e a r c h has been on c h i l d r e n i n a p p r o p r i a t e l y p l a c e d i n t o M/EMH programmes ( f a l s e p o s i t i v e s ) but not on c h i l d r e n p o s s i b l y i n a p p r o p r i a t e l y 16 r e j e c t e d f o r M/EMH programmes ( f a l s e n e g a t i v e s ) . Research Questions T h i s study addresses these weaknesses by answering the f o l l o w i n g g e n e r a l r e s e a r c h questions based on a sample drawn from two l a r g e s c h o o l d i s t r i c t s i n the Pro v i n c e of B.C.: 1. Are t h e r e d i f f e r e n c e s between students r e f e r r e d f o r placement and p l a c e d i n programmes f o r the M/EMH and those r e f e r r e d and not placed? ( F i g u r e 1 r e p r e s e n t s a t y p i c a l placement d e c i s i o n g r i d f o r d e c i d i n g those p l a c e d versus not p l a c e d ) . More s p e c i f i c a l l y : a. are stud e n t s who have been assessed and p l a c e d as M/EMH co n f i r m a b l e i n t h a t placement, based on the standards of the t w o - f a c t o r d i a g n o s t i c model; and, b. can stud e n t s who have been assessed and not p l a c e d be confirmed as i n a p p r o p r i a t e f o r placement as M/EMH, based on the standards of the tw o - f a c t o r d i a g n o s t i c model; and, 2. What f a c t o r s p r o v i d e the best e x p l a n a t i o n of c u r r e n t placement d e c i s i o n s ? S p e c i f i c a l l y , what i s the c o n t r i b u t i o n o f the v a r i a b l e s IQ, adaptive behaviour, academic achievement, maladaption, and v i s u a l and h e a r i n g a c u i t y t o the placement of these students? 17 F i g u r e 1 T y p i c a l R e f e r r a l and D i a g n o s t i c procedures i n Seeking Placement i n t o an M/EMH C l a s s a R e f e r r a l of suspected M/EMH by classroom teacher p r i n c i p a l and p a r e n t a l consent obtained p s y c h o - e d u c a t i o n a l assessment performed by d i s t r i c t p s y c h o l o g i s t l a b e l as M/EMH 1 r e f e r t o d i s t r i c t s p e c i a l c l a s s s c r e e n i n g committee p l a c e i n t o M/EMH programme do not p l a c e i n t o M/EMH on-going e v a l u a t i o n p l a c e i n another catego r y do not l a b e l as M/EMH 1 do not r e f e r t o d i s t r i c t s p e c i a l c l a s s s c r e e n i n g committee END c o n s i d e r another category END r e t u r n t o r e g u l a r c l a s s I END apply t o another categor y do not apply I END a. Based on a metro Vancouver s c h o o l d i s t r i c t . b. S c r e e n i n g committees have the a u t h o r i t y t o p l a c e a c h i l d i n an a l t e r n a t i v e programme, p s y c h o l o g i s t s can o n l y r e q u e s t such a c t i o n o f a s c r e e n i n g committee. 18 These q u e s t i o n s were i n v e s t i g a t e d by comparing placement d e c i s i o n s a g a i n s t the standards of the AAMD two-f a c t o r d i a g n o s t i c model, with the IQ and ada p t i v e behaviour components a d j u s t e d t o two p o s s i b l e c u t - o f f c r i t e r i a ; s t a n d a r d s c o r e (s.s.) 75, r e p r e s e n t i n g the upper l i m i t of the AAMD c r i t e r i a (Grossman, 1983), and s.s. 69, r e p r e s e n t i n g the c u r r e n t B.C. M i n i s t r y of Edu c a t i o n d r a f t S p e c i a l E d u c a t i o n G u i d e l i n e s (see Appendix A). I t sho u l d be re c o g n i z e d t h a t i n the l i t e r a t u r e t h e r e i s c o n s i d e r a b l e v a r i a t i o n i n the standard s c o r e c u t - o f f c r i t e r i a used. The two c r i t e r i a s e l e c t e d f o r t h i s study ( t h a t of the A.A.M.D. and Proposed B.C. D r a f t G u i d e l i n e s ) were s e l e c t e d s i n c e the former i s the most c l e a r l y e s t a b l i s h e d i n t e r n a t i o n a l c r i t e r i o n , and the l a t t e r i s of l o c a l importance. In a d d i t i o n , data w i t h r e s p e c t t o each student's IQ, ada p t i v e behaviour, maladaptive behaviour, academic achievement, and v i s u a l and h e a r i n g a c u i t y were c o l l e c t e d and analyzed u s i n g a v a r i e t y of d i s c r i m i n a n t f u n c t i o n procedures. T h i s a n a l y s i s was used t o determine which of the measured v a r i a b l e s were c o n t r i b u t i n g t o a c t u a l placement d e c i s i o n s . D e l i m i t a t i o n s of the Study The study was conducted with students who had been r e f e r r e d f o r c o n s i d e r a t i o n as M i l d l y / E d u c a b l y M e n t a l l y 19 Handicapped i n two M e t r o p o l i t a n Vancouver s c h o o l d i s t r i c t s s i n c e May 1, 1987. A l l of these students were s t i l l i n the elementary s c h o o l system a t the time of data c o l l e c t i o n ( A p r i l 17 - May 26, 1989). The r e s t r i c t i o n of c u r r e n t s c h o o l placement was i n c l u d e d t o ensure t h a t the BC Quick I n d i v i d u a l E d u c a t i o n a l T e s t (BC QUIET), which i s an i n d i v i d u a l i z e d achievement t e s t designed f o r use w i t h elementary s c h o o l s t u d e n t s , c o u l d be used w i t h a l l s u b j e c t s . The r a t i o n a l e f o r the s e l e c t i o n of the BC QUIET and o t h e r assessment instruments i s p r o v i d e d i n Chapter 3. J u s t i f i c a t i o n f o r the Study As w i l l be demonstrated i n Chapter 2, t h e r e i s abundant evidence t o support the n o t i o n t h a t l a r g e numbers of students are i n a p p r o p r i a t e l y l a b e l l e d and p l a c e d i n t o M/EMH programmes i n the U n i t e d S t a t e s . T h i s occurs even i n the presence of s t r o n g f e d e r a l law, "best p r a c t i c e s , " and the t h r e a t of l i t i g a t i o n . Although t e s t s of adequate t e c h n i c a l q u a l i t i e s f o r a p p r o p r i a t e decision-making are a v a i l a b l e , t h e i r a p p l i c a t i o n o f t e n appears confounded by placement teams r e l y i n g too h e a v i l y on IQ scores and a l l o w i n g " c l i n i c a l judgement" t o sway d e c i s i o n s . In Canada, i n the absence of f e d e r a l law and a h i s t o r y of a g g r e s s i v e l i t i g a t i o n , educators have made c a l l s t o 20 emulate the procedures mandated i n the Un i t e d S t a t e s w i t h r e s p e c t t o the d i a g n o s i s and placement of M/EMH st u d e n t s . T h i s has been done i n the absence of s u b s t a n t i v e evidence t h a t c u r r e n t Canadian p r a c t i c e s are e i t h e r a p p r o p r i a t e or i n a p p r o p r i a t e . Using accepted i n t e r n a t i o n a l d i a g n o s t i c c r i t e r i a , and i n c l u d i n g measures of v i s u a l and a u d i t o r y a c u i t y which have not t y p i c a l l y been i n c l u d e d i n s t u d i e s of t h i s p o p u l a t i o n , t h i s r e s e a r c h comes a t a time of g r e a t p o t e n t i a l change i n Canadian s p e c i a l e d u c a t i o n . The m o t i v a t i o n f o r d e s i g n i n g t h i s study i s the author's o r i g i n a l b i a s , based on f i e l d experience, t h a t students are o f t e n l a b e l l e d and p l a c e d as M/EMH not because they meet the standards of the two f a c t o r d i a g n o s t i c model, but f o r o t h e r reasons. D e f i n i t i o n of Terms The f o l l o w i n g d e f i n i t i o n s w i l l be used throughout t h i s r e s e a r c h : Mental R e t a r d a t i o n (Mental Handicap): s i g n i f i c a n t l y subaverage g e n e r a l i n t e l l e c t u a l f u n c t i o n i n g e x i s t i n g c o n c u r r e n t l y with d e f i c i t s i n adapt i v e behaviour and manifested d u r i n g the developmental p e r i o d (Grossman, 1983, p. 11). General I n t e l l e c t u a l F u n c t i o n i n g : i s o p e r a t i o n a l l y d e f i n e d as the r e s u l t s o b t a i n e d by assessment wi t h one or 21 more of the i n d i v i d u a l l y a dministered s t a n d a r d i z e d g e n e r a l i n t e l l i g e n c e t e s t s developed f o r the purpose (Grossman, 1983, p. 11). S i g n i f i c a n t l y Subaverage General I n t e l l e c t u a l  F u n c t i o n i n g ; an IQ s c o r e below 70 on s t a n d a r d i z e d measures of i n t e l l i g e n c e ; however, i t i s o f t e n extended upward through IQ 75 t o a l l o w f o r e r r o r of measurement (Grossman, 1983, p. 11). D e f i c i t s i n Adaptive Behaviour: l i m i t a t i o n s i n an i n d i v i d u a l ' s e f f e c t i v e n e s s i n meeting standards of maturation, l e a r n i n g , p e r s o n a l independence, and/or s o c i a l r e s p o n s i b i l i t y t h a t are expected f o r h i s or her age l e v e l and c u l t u r a l group, as determined by c l i n i c a l assessment and, u s u a l l y , s t a n d a r d i z e d t e s t s of s o c i a l a d a p t a t i o n (Grossman, 1983, p. 11). M i l d (Educable^ Mental Handicap ( R e t a r d a t i o n 1 : an IQ s c o r e on t e s t s of g e n e r a l i n t e l l e c t u a l f u n c t i o n i n g of between 50 and 75 e x i s t i n g c o n c u r r e n t l y w i t h a d a p t i v e behaviour t e s t s c o r e s below approximately the t h i r d p e r c e n t i l e (Grossman, 1983, p. 11; Reschly, 1982, p. 234). Developmental P e r i o d : the p e r i o d of time between c o n c e p t i o n and the 18th b i r t h d a y (Grossman, 1983, p. 11). Hearing Loss: a " s i g n i f i c a n t h e a r i n g l o s s " i s d e f i n e d as a l o s s i n e i t h e r ear of 30 dB, a t any of 1,000, 2,000, or 4,000 Hz, on a sweep t e s t of h e a r i n g a c u i t y u s i n g a pure tone audiometer (Newby & Popelka, 1985, p. 286). V i s u a l Loss: two f a c t o r s must be taken i n t o c o n s i d e r a t i o n i n s c r e e n i n g s u b j e c t s : A. v i s u a l a c u i t y : the a b i l i t y of the c h i l d t o a c c u r a t e l y see and i n t e r p r e t v i s u a l s t i m u l i as measured by s t a n d a r d i z e d t e s t . A s c o r e of 20/40 ( c o r r e c t e d ) f o r c h i l d r e n aged f o u r t o grade t h r e e and a s c o r e of 20/30 or l e s s ( c o r r e c t e d ) f o r c h i l d r e n a t or above the f o u r t h grade i n both or the worst eye u s i n g accepted p r a c t i c e w i t h the S n e l l e n v i s u a l a c u i t y c h a r t (Randall & Lawrence, 1977, p. 56; Winzer, Rogow & David, 1987, p. 346). B. v i s u a l anomalies: w h i l e a d m i n i s t e r i n g the S n e l l e n v i s u a l a c u i t y t e s t , o r d u r i n g other opportune times, the examiner sh o u l d note any of the f o l l o w i n g : ( H a r l e y & R a n d a l l , 1977, p. 58) c r u s t s on the e y e l i d s c r u s t s among the ey e l a s h e s r e d or s w o l l e n e y e l i d s watery or d i s c h a r g i n g eyes s e n s i t i v i t y t o l i g h t reddened c o n j u n c t i v a l a c k of c o o r d i n a t i o n i n f o c u s s i n g the eyes e x c e s s i v e eye rubbing or brushing s q u i n t i n g s t a n d i n g e x c e s s i v e l y f a r from or c l o s e t o v i s u a l s t i m u l i . Two-factor D i a g n o s t i c Model: a d e t e r m i n a t i o n of mental handicap based on the simultaneous f i n d i n g of s i g n i f i c a n t l y low g e n e r a l i n t e l l e c t u a l f u n c t i o n i n g and a d a p t i v e behaviour on a p p r o p r i a t e l y s e l e c t e d and a d m i n i s t e r e d s t a n d a r d i z e d t e s t s . T h i s model i s r e p r e s e n t e d i n f i g u r e 2 (Grossman, 1983, p. 12). 24 F i g u r e 2 Two-factor D i a g n o s t i c Model  f o r Mental H a n d i c a p 3 General I n t e l l e c t u a l A b i l i t y (IQ) Retarded Not Retarded A d a p t i v e Behaviour Retarded D i a g n o s i s : D i a g n o s i s : " r e t a r d e d " "not r e t a r d e d " Not * Retarded D i a g n o s i s : D i a g n o s i s : "not r e t a r d e d " "not r e t a r d e d " a adapted from Grossman, 1983, p. 12. 25 Chapter 2 Review of the L i t e r a t u r e I t i s i r o n i c t h a t d u r i n g the 1960s and 1970s the major i s s u e s t h a t c o n f r o n t e d s p e c i a l e ducation and mental r e t a r d a t i o n concerned m i l d l y m e n t a l l y r e t a r d e d (MMR) c h i l d r e n , while today t h a t same group of c h i l d r e n are the s t e p c h i l d r e n of s p e c i a l e d u c a t i o n . (McMillan, 1988, p. 273) The l i t e r a t u r e review i s d i v i d e d i n t o f o u r s e c t i o n s : (1) an h i s t o r i c a l review of e a r l y concepts and d e f i n i t i o n s of mental handicap from the n i n e t e e n t h c e n t u r y ; (2) an examination of the r e l a t i v e r o l e s of IQ and a d a p t i v e behaviour from the i n t r o d u c t i o n of the f i r s t IQ t e s t i n 1905 up u n t i l the passage of U.S. P u b l i c Law 94-142 i n 1973; (3) a review of the development of Canadian s p e c i a l e d u c a t i o n ; and, (4) a review of t h r e e major s t u d i e s conducted s i n c e the passage of PL94-142 which are c e n t r a l t o t h i s r e s e a r c h . The Nineteenth Century Although the h i s t o r i c a l study of mental handicap i s a f a s c i n a t i n g one, and one which has been d e a l t w i t h a b l y by many authors (Gearheart & L i t t o n , 1979; Grossman, 1983; 26 Sloan, 1963), i t i s the h i s t o r y of one aspect of the e d u c a t i o n of m e n t a l l y handicapped c h i l d r e n subsequent t o the b e g i n n i n g of the n i n e t e e n t h century t h a t i s s a l i e n t t o t h i s study. That aspect i s the d e f i n i t i o n of what c o n s t i t u t e d a mental handicap i n g e n e r a l , and a M i l d or Educable Mental Handicap i n p a r t i c u l a r , and the way i n which assessment p r a c t i c e s intended t o r e f l e c t the l a t t e r were formulated and a p p l i e d . Although s e r i o u s e f f o r t s have been made by a v a r i e t y of c u l t u r e s t o understand and address the needs of m e n t a l l y handicapped i n d i v i d u a l s , i t i s the development of the t w o - f a c t o r model, one which i n c l u d e s both low g e n e r a l c o g n i t i v e a b i l i t y a long with s i g n i f i c a n t d e f i c i t s i n a d a p t i v e behaviour, t h a t i s of concern t o t h i s study. In 1799, the French p h y s i c i a n Jean I t a r d had h i s f i r s t c o n t a c t w i t h V i c t o r , the so c a l l e d "Wild Boy of Aveyron." T h i s twelve year o l d f e r a l c h i l d had p r e v i o u s l y been diagnosed as having " i n c u r a b l e and i r r e v e r s i b l e " mental r e t a r d a t i o n (Gearheart & L i t t o n , 1979, p. 3). I t a r d b e l i e v e d t h a t " s e n s a t i o n t r a i n i n g " c o u l d b r i n g about improvement i n V i c t o r . Although a f t e r almost f i v e years of i n t e n s i v e i n t e r v e n t i o n I t a r d concluded t h a t he had f a i l e d t o b r i n g about s i g n i f i c a n t improvement, the French Academy of Sc i e n c e s h i g h l y commended h i s e f f o r t s i n t h i s area of " e d u c a t i o n a l s c i e n c e " (Gearheart & L i t t o n , 1979, p.4). 27 In a d d i t i o n t o compassionately a d d r e s s i n g the circumstances of t h i s u n f o r t u n a t e boy, I t a r d ' s work i s important f o r two reasons: f i r s t l y , t h a t he s c i e n t i f i c a l l y and m e t h o d i c a l l y sought t o b r i n g about improvement i n a s e r i o u s l y d i s a b l e d c h i l d , and secondly t h a t h i s " s e n s a t i o n t r a i n i n g , " which was broken down i n t o f i v e "aims" c l e a r l y addressed s o c i a l a d a p t a t i o n as the fundamental need i n V i c t o r ' s l i f e . Indeed, i n h i s h i e r a r c h i c a l l i s t of aims f o r V i c t o r ' s e d u c a t i o n , I t a r d p l a c e d "to i n t e r e s t him i n s o c i a l l i f e " as the f i r s t aim, and "to extend h i s range of thought" as the t h i r d aim ( C l e l a n d , 1978, pp. 6-7). I t a r d ' s f i v e aims c l e a r l y foreshadowed the r o l e s of a d a p t i v e behaviour and g e n e r a l i n t e l l i g e n c e t h a t form the b a s i s f o r the most u n i v e r s a l l y accepted d e f i n i t i o n of mental handicap today. The importance of I t a r d ' s work i n a n t i c i p a t i n g c u r r e n t t h i n k i n g i n the area of mental handicap cannot be underestimated. In a d d i t i o n t o h i s emphasis on a d a p t i v e behaviour, and h i s use of what we might now term g e n e r a l i n t e l l i g e n c e as a c o - f a c t o r , the methods of education t h a t he employed, p a r t i c u l a r l y h i s emphasis on the m o d i f i c a t i o n of and a d a p t a t i o n t o the environment, are contemporary. As C l e l a n d (1978) p o i n t s out i n d i s c u s s i n g I t a r d ' s foreword t o h i s book The Wild Boy of Aveyron, " I t a r d ' s W i l d Boy was the f i r s t t e x t t o focus on t e a c h i n g methods f o r the r e t a r d e d ; i t 28 i s s t i l l , i n many r e s p e c t s , one of the b e s t ^methods' t e x t s " (p. 272). In a d d i t i o n to I t a r d , o t h e r s t r o n g advocates of the r o l e of s o c i a l a d a p t a t i o n and the a m e l i o r a b i l i t y of mental handicap were prominent i n the n i n e t e e n t h c e n t u r y . Among these were Sequin, a p u p i l of I t a r d ' s , V o i s i n , and M o n t e s s o r i , who, although her work i s most commonly a s s o c i a t e d w i t h the education of n o n - d i s a b l e d c h i l d r e n , began her work wit h the m e n t a l l y handicapped. From 10 t e s t s t o PL94-142 (1905 - 1973 1 By the t u r n of the 19th century, governments were becoming i n c r e a s i n g l y i n t e r e s t e d i n the parameters of mental r e t a r d a t i o n . T h i s i n t e r e s t was sparked by the p r o v i s i o n of u n i v e r s a l p u b l i c s c h o o l e d u c a t i o n and the d e s i r e t o i d e n t i f y , f o r the purposes of a s s i s t i n g or e x c l u d i n g , m e n t a l l y handicapped c h i l d r e n (Rush, Rose, & Greenwood, 1988) . Development and Impact of 10 T e s t i n g In 1904, the French government c o n t r a c t e d A l f r e d B i n e t t o d e v i s e a means whereby, through some form of t e s t i n g , m e n t a l l y handicapped students c o u l d be d i f f e r e n t i a t e d from those who were capable of academic success w i t h i n the r e g u l a r e d u c a t i o n programme. The r e s u l t s of h i s r e s e a r c h came i n 1905 w i t h the p r o d u c t i o n of the Binet-Simon S c a l e of 29 I n t e l l i g e n c e , the f i r s t IQ t e s t . The development and overwhelming acceptance o f the IQ t e s t , i t has been argued, was r e s p o n s i b l e f o r the development of the contemporary c o n s t r u c t of Mild/Educable Mental Handicap (Reschly, 1988). I t has subsequently been h e l d r e s p o n s i b l e f o r the emphasis p l a c e d on IQ sc o r e s to the detriment of ot h e r v a l u a b l e e d u c a t i o n a l i n f o r m a t i o n (Reschly, 1988; T u r n b u l l & T u r n b u l l , 1986; Knoff, 1984). Rec e n t l y , however, MacMillan (1982) has p o i n t e d out t h a t s p e c i a l c l a s s programmes f o r M/EMH c h i l d r e n were e s t a b l i s h e d i n the U n i t e d S t a t e s as e a r l y as 1890, approximately 15 years b e f o r e the p u b l i c a t i o n of the B i n e t -Simon S c a l e . M a c M i l l a n suggests t h a t the development of t h i s p a r t i c u l a r c l a s s i f i c a t i o n o f mental handicap was not t r i g g e r e d by B i n e t ' s work. I t appears patent t h a t educators, p r i o r t o the a v a i l a b i l i t y o f the IQ t e s t , diagnosed and p l a c e d c h i l d r e n i n t o programmes designed t o serve m i l d l y m e n t a l l y handicapped c h i l d r e n . Nonetheless, i t can s t i l l be c o n v i n c i n g l y argued t h a t the a v a i l a b i l i t y of an instrument such as the B i n e t and l a t e r the American S t a n f o r d - B i n e t , p r o f o u n d l y a c c e l e r a t e d the d i a g n o s i s and placement of l a r g e numbers of M/EMH c h i l d r e n . Sapon-Shevin (1989), i n summarizing contemporary views o f the r o l e of the IQ t e s t i n l a b e l l i n g m i l d l y handicapped stud e n t s , has 30 suggested t h a t although the IQ t e s t i t s e l f i s not a "iriischevievous" (p. 87) instrument, when combined with D i f f e r e n t i a l funding f o r s p e c i a l e d u c a t i o n and the need f o r a s c i e n t i f i c b a s i s t o support s e g r e g a t i o n ( i t may) have p r o v i d e d an i n c e n t i v e f o r c l a s s i f y i n g as many students as p o s s i b l e as mentally r e t a r d e d , (p. 87) Acc o r d i n g t o Cronbach (1970), the i n t r o d u c t i o n of the S t a n f o r d - B i n e t S c a l e s of I n t e l l i g e n c e i n t o the U n i t e d S t a t e s was welcomed " e n t h u s i a s t i c a l l y " (p. 201) with the instrument q u i c k l y becoming " . . . c e n t r a l t o r e s e a r c h and p r a c t i c e ...indeed from 1920 t o 1940 the main f u n c t i o n of the c l i n i c a l p s y c h o l o g i s t was to x g i v e B i n e t s ' i n s c h o o l s and other i n s t i t u t i o n s " (p. 201). Cronbach goes on to l i n k c e r t a i n s p e c i f i c concepts about the nature of mental r e t a r d a t i o n d i r e c t l y t o t h i s p r a c t i c e o f ^ g i v i n g B i n e t s ' . In s p i t e o f the e a r l i e r work of I t a r d , V o i s i n , and Sequin i n which the r o l e of a d a p t i v e behaviour was g i v e n prominence over the r o l e of g e n e r a l i n t e l l i g e n c e , and i n s p i t e of the c l e a r b e l i e f by these e a r l i e r r e s e a r c h e r s and educators t h a t mental r e t a r d a t i o n was amenable t o i n t e r v e n t i o n , the m a j o r i t y of p s y c h o l o g i s t s u s i n g the B i n e t S c a l e s d i s a g r e e d . These p r a c t i t i o n e r s r e l i e d on IQ s c o r e s v i r t u a l l y alone f o r the purposes of d i a g n o s i s and placement and " u s u a l l y h e l d the view t h a t a 31 person's r a t e of mental development, and the l e v e l he w i l l u l t i m a t e l y reach, are e s s e n t i a l l y f i x e d " (Cronbach, 1970, p. 202) as a r e s u l t of t h e i r IQ . T h i s argument was an important component of a debate which would co n t i n u e throughout t h i s century, t h a t of the so c a l l e d "nature-n u r t u r e c o n t r o v e r s y " ( L e f r a n c o i s , 1988, pp. 142-143). Renewal of I n t e r e s t i n Adaptive" Behaviour I t has been suggested t h a t the concept of s o c i a l a d a p t a t i o n r e f l e c t e d i n the work of I t a r d , V o i s i n , and Sequin was q u i t e e f f e c t i v e l y r e p l a c e d by the IQ t e s t . Although the IQ t e s t had become an overwhelming f o r c e i n d i a g n o s i n g and p l a c i n g c h i l d r e n as M/EMH, i t cannot be concluded t h a t B i n e t h i m s e l f was i n s e n s i t i v e t o the i d e a of s o c i a l a d a p t a t i o n as an important component i n the d e f i n i t i o n of mental r e t a r d a t i o n . T h i s was c l e a r l y r e f l e c t e d i n the i n t e r v e n t i o n methodology which B i n e t h e l p e d develop f o r use w i t h mentally handicapped c h i l d r e n . "Mental O r t h o p e d i c s , " a p h i l o s o p h y s e t out i n B i n e t ' s Modern Ideas  About C h i l d r e n ( c . 1910, i n C l e l a n d , 1978, p. 9), c l e a r l y demonstrated t h a t B i n e t r e c o g n i z e d t h a t mental r e t a r d a t i o n was not n e c e s s a r i l y a f i x e d a t t r i b u t e , but one which c o u l d be s o c i a l l y determined and which was amenable to c o r r e c t i v e a c t i o n . An i n d i v i d u a l i s normal when he i s able to conduct 32 h i m s e l f i n l i f e without heed of the g u a r d i a n s h i p of another, and i s able t o perform work s u f f i c i e n t l y remunerative t o supply h i s p e r s o n a l needs, and f i n a l l y when h i s i n t e l l i g e n c e does not exclude him from the s o c i a l rank of h i s p a r e n t s . As a r e s u l t of t h i s , an a t t o r n e y ' s son who i s reduced by h i s i n t e l l i g e n c e t o the c o n d i t i o n of a menial employee i s a moron; l i k e w i s e the son of a master mason, who remains a s e r v a n t of 30 y e a r s , i s a moron; l i k e w i s e a peasant, normal i n o r d i n a r y surroundings of the f i e l d s , may be c o n s i d e r e d a moron i n the c i t y . ( B i n e t , 1909, p.266) In s p i t e of such c l e a r statements by the " f a t h e r of i n t e l l i g e n c e t e s t s , " i t i s apparent t h a t i n the arena of d i a g n o s i s and placement d e c i s i o n making - the domain of the p s y c h o l o g i s t - a u n i - f a c t o r model was being used i n d e t e r m i n i n g mental handicap, with t h a t one f a c t o r b e i n g g e n e r a l i n t e l l i g e n c e as measured by an IQ t e s t . By the l a t e 1930s and e a r l y 1940s two authors r a i s e d s e r i o u s c h a l l e n g e s t o the s t a t e t h a t d i a g n o s t i c and placement p r a c t i c e s had reached by re-emphasizing the importance of a d a p t i v e behaviour i n the d e f i n i t i o n of a mental handicap. T r e d g o l d (1937), whose views on the euthanasia of s e v e r e l y handicapped c h i l d r e n l a t e r t a r n i s h e d h i s r e p u t a t i o n , p r o v i d e d what has come to be c a l l e d a " b i o l o g i c a l " 33 d e f i n i t i o n , but one which nonetheless emphasized the role of s o c i a l adaptation. (Mental retardation i s) ...a state of incomplete mental development of such a kind and degree that the in d i v i d u a l i s incapable of adapting himself to the normal environment of his fellows i n such a way as to maintain existence independently of supervision, control, or external support, (p. 4) Doll (1941), the author of the Vineland Social Maturity Scale, the f i r s t device for the qu a n t i f i c a t i o n of d e f i c i t s i n adaptive behaviour, proposed a more complete d e f i n i t i o n of mental handicap, suggesting that the following s i x c r i t e r i a must be met i n order that a mental handicap i s said to e x i s t . These are that the i n d i v i d u a l : 1. i s s o c i a l l y incompetent, 2. i s mentally subnormal, 3. i s developmentally arrested, and that these d e f i c i e n c i e s : 4. obtain at maturity, 5. are of c o n s t i t u t i o n a l o r i g i n , 6. are e s s e n t i a l l y incurable (p. 215). Both Tredgold and Doll c l e a r l y c a l l e d for a return to a d e f i n i t i o n of mental handicap that included s o c i a l adaptation as an important i f not c r i t i c a l component. 34 B i n e t , as p r e v i o u s l y d i s c u s s e d , r e c o g n i z e d the importance of s o c i a l a d a p t a t i o n as a c o - f a c t o r with g e n e r a l i n t e l l e c t u a l a b i l i t y . The c a l l s of these people f o r the i n c l u s i o n of s o c i a l a d a p t a t i o n , and the abandonment of a s i g n i f i c a n t l y low IQ s c o r e alone as i n d i c a t i v e of mental handicap, were met with a h o s t i l e r e a c t i o n from much of the e d u c a t i o n a l and p s y c h o l o g i c a l community. Those who advocated the use of the IQ s c o r e alone argued t h a t the i n c l u s i o n of s o c i a l a d a p t a t i o n i n the d i a g n o s i s of mental handicap was non-e m p i r i c a l , unmeasurable, and u n s c i e n t i f i c , w h i l e the IQ t e s t , they argued, c o n t a i n e d a l l of these c h a r a c t e r i s t i c s (Goodman, 1977) . C a l l s For a Two-Factor Model By the l a t e 1960s and e a r l y 1970s, the d e f i c i e n c i e s of t h i s u n i - d i m e n s i o n a l model were becoming i n c r e a s i n g l y apparent. Mercer (1965) argued t h a t the s o c i a l environment i n which a person l i v e s i s the most important f a c t o r i n the d e t e r m i n a t i o n of a mental handicap. S t r e s s i n g t h a t i t i s the a b i l i t y of the i n d i v i d u a l t o adapt t o a p a r t i c u l a r environment t h a t i s the c r i t i c a l v a r i a b l e i n whether a person i s m e n t a l l y handicapped, she s t a t e d "a person may be m e n t a l l y r e t a r d e d i n one system and not m e n t a l l y r e t a r d e d i n another. He may change h i s l a b e l by changing h i s group" (p. 21) . 35 Mercer (1965) s t u d i e d two i n s t i t u t i o n a l i z e d groups of persons l a b e l l e d as mentally r e t a r d e d . These two groups were matched f o r i n t e l l i g e n c e , age, sex, e t h n i c i t y , and number of years spent i n the i n s t i t u t i o n . She found t h a t m e n t a l l y handicapped i n d i v i d u a l s who were r e l e a s e d t o t h e i r f a m i l i e s came from markedly lower socio-economic group f a m i l i e s , w h i l e those from hi g h e r socio-economic f a m i l i e s tended t o be r e t a i n e d w i t h i n the i n s t i t u t i o n i n d i s p r o p o r t i o n a t e l y l a r g e numbers. Mercer a l s o confirmed e a r l i e r s t u d i e s t h a t noted t h a t the c h i l d r e n of lower s o c i o -economic f a m i l i e s who were l a b e l l e d as m e n t a l l y handicapped were so l a b e l l e d a t a l a t e r age than the c h i l d r e n o f h i g h e r socio-economic s t a t u s f a m i l i e s . She r e p o r t e d t h a t n e a r l y 80% of the h i g h s t a t u s c h i l d r e n had been l a b e l l e d as r e t a r d e d by age s i x , w h ile o n l y 36% of the low s t a t u s c h i l d r e n had been l a b e l l e d . Here, i t was argued, was c l e a r evidence t o support the b e l i e f t h a t mental handicap was, a t l e a s t i n l a r g e degree, s o c i a l l y determined s i n c e low s o c i o -economic s t a t u s c h i l d r e n were slower t o be r e c o n g i z e d w i t h i n t h e i r poorer environments, and were deemed s u i t a b l e f o r r e t u r n t o t h a t environment more q u i c k l y than were the h i g h s t a t u s c h i l d r e n . Based on t h i s r e l a t i o n s h i p between s o c i o -economic s t a t u s and mental r e t a r d a t i o n , Mercer argued t h a t the use of IQ t e s t s alone i s i n a p p r o p r i a t e , s i n c e the IQ 36 t e s t s would not be able to capture the degree to which a person i s able to adapt to t h e i r s o c i a l environment. Mercer went on (1973) to argue strenuously for the inc l u s i o n of measures of s o c i a l adaptation, as well as to make allowances for the c u l t u r a l and s o c i a l bias that were inherent i n both i n t e l l i g e n c e tests and tests of s o c i a l adaptation. She noted that, s t a t i s t i c a l l y , using a generally accepted cut-off c r i t e r i o n on standardized i n t e l l i g e n c e t e s t s , 2.5% of a l l school age children would be l a b e l l e d as mentally handicapped. However, when using both measures of IQ and s o c i a l adaptation, t h i s figure could be reduced by as much as 10 to 20 percent o v e r a l l , with the population of students making up the difference being commonly referred to as the "six hour retarded" (President's Committee on Mental Retardation, 1970), namely those who are considered as retarded only for the hours when they are inside a school building. Mercer c r i t i c i z e d the diagnostic and placement practices of the early 1970s on two primary grounds. F i r s t l y , that the IQ tes t score was often the sole c r i t e r i o n used, with adaptive behaviour being largely ignored, and secondly, that the IQ tests themselves were severely flawed. Mercer, more than any other author, addressed the issue of the psychometric c r i t e r i o n as a determinant of mental 37 r e t a r d a t i o n , p a r t i c u l a r l y i n r e f e r e n c e t o m i n o r i t y groups. Her p o s i t i o n was t h a t there were b i a s e s i n "...measures of i n t e l l i g e n c e t h a t f a v o r the Anglo, middle c l a s s c h i l d " (Huberty, R o l l e r , & Ten Brink, 1980, p. 256). In her own words: ...The primary c r i t e r i o n f o r mental r e t a r d a t i o n -the IQ t e s t - i s i n a c c u r a t e and, when i t i s used on m i n o r i t y groups, u n f a i r . However r e t a r d a t i o n i s measured, m i n o r i t y groups s u f f e r as a r e s u l t of the Anglo, m i d d l e - c l a s s content of the t e s t s ...While the s c h o o l s do most of the l a b e l l i n g , they do not agree wi t h o t h e r agencies on the proper c r i t e r i a f o r mental r e t a r d a t i o n . (Mercer, 1972, p.44) Si n c e the i n t r o d u c t i o n of the B i n e t and S t a n f o r d - B i n e t i n t e l l i g e n c e t e s t s , the IQ score has been the primary, and i n many, i f not most cases, the o n l y t o o l used i n d e c l a r i n g c h i l d r e n m e n t a l l y handicapped. Beginning w i t h B i n e t , c o n s i s t e n t and p e r s u a s i v e c a l l s were made f o r the a d d i t i o n a l c o n s i d e r a t i o n of adapt i v e behaviour. Despite these c a l l s , the IQ t e s t has been the instrument of c h o i c e f o r s c h o o l and c l i n i c a l p s y c h o l o g i s t s i n making d i a g n o s t i c d e c i s i o n s . The reasons f o r t h i s c h o i c e are perhaps b e s t summed up i n the c r i t i c i s m s t h a t proponents of the IQ t e s t alone d i r e c t e d a t t e s t s of a d a p t i v e behaviour: t h a t they were u n s c i e n t i f i c and 38 r e f l e c t e d a c o n s t r u c t t h a t was unmeasurable. By e x t e n s i o n , the proponents of IQ t e s t s would argue t h a t these were c h a r a c t e r i s t i c s i n h e r e n t a l s o i n IQ t e s t s . As Langone (1986) has noted: On the one hand p r o f e s s i o n a l s b e l i e v e t h a t a person's a b i l i t y t o f u n c t i o n i n s o c i e t y i s a b e t t e r measure of competence than an i s o l a t e d score on a s t a n d a r d i z e d i n t e l l i g e n c e s c a l e . Conversely, the l a c k of o b j e c t i v i t y c u r r e n t l y i n h e r e n t i n the measurement of a d a p t i v e b e h a v i o r may weaken the argument f o r i t s use. (p. 6) L i t i g a t i o n and L e g i s l a t i o n i n the U.S. The 1970s, was a decade of r a p i d change i n s p e c i a l e d u c a t i o n . T h i s change, although foreshadowed by much of the work of T r e d g o l d , D o l l , and Mercer, was brought about p r i m a r i l y through c o u r t a c t i o n , e s p e c i a l l y L a r r y P. versus R i l e s (1972) and Diana versus the S t a t e of C a l i f o r n i a (1972). In both of these a c t i o n s , m i n o r i t y group youngsters who had been p l a c e d i n programmes f o r the m e n t a l l y handicapped on the b a s i s of low i n t e l l i g e n c e t e s t s c o r e s sued s c h o o l a u t h o r i t i e s . In both a c t i o n s i t was s u c c e s s f u l l y argued t h a t c u l t u r a l l y and r a c i a l l y b i a s e d assessment procedures l e d t o the i n a p p r o p r i a t e placement of these c h i l d r e n i n t o s p e c i a l e d u c a t i o n programmes wit h a 39 consequent l o s s of e d u c a t i o n a l o p p o r t u n i t y and s o c i a l s t i g m a t i z a t i o n . The c o u r t s i n both cases heard l a r g e volumes of p r o f e s s i o n a l evidence. In the L a r r y P. case, f o r example, the c o u r t t r a n s c r i p t was 10,000 pages long, much of t h a t b e i n g the evidence of expert witnesses (Reschly, 1982). Court r u l i n g s were c o n s i s t e n t l y i n favour of the p l a i n t i f f s . Although much of the focus of these famous cases was on s p e c i f i c m i n o r i t y groups ( e s p e c i a l l y B l a c k ) , the d e t a i l e d a n a l y s i s g i v e n i n the c o u r t s t o major i s s u e s r e l a t e d t o s p e c i a l e d u c a t i o n p r a c t i c e s , both placement and i n s t r u c t i o n a l , s hould not be underestimated. Reschly (1982) noted t h a t i n c l u d e d w i t h i n these cases were such i m p l i c i t i s s u e s as the n a t u r e - n u r t u r e debate, whether mental r e t a r d a t i o n was a f i x e d or dynamic c o n d i t i o n , and the e f f i c a c y of s p e c i a l c l a s s programmes. The f e d e r a l government, i n response t o these c o u r t a c t i o n s and t o mounting pressure from s p e c i a l needs advocacy groups and s p e c i a l e d u c a t i o n p r o f e s s i o n a l s , enacted i n 1973 The E d u c a t i o n of A l l Handicapped C h i l d r e n A c t , PL94-142. T h i s a c t c a l l e d f o r i n c r e a s e d access t o a f r e e and a p p r o p r i a t e e d u c a t i o n f o r d i s a b l e d s t u d e n t s , mandated t h a t p a r e n t a l / g u a r d i a n involvement be s t r e s s e d , and c a l l e d f o r major changes i n d i a g n o s t i c and l a b e l l i n g p r a c t i c e s . I t a l s o p r o h i b i t e d the use of any s i n g l e t e s t instrument i n 40 making l a b e l l i n g and placement d e c i s i o n s , and c l e a r l y i n d i c a t e d t h a t m u l t i - f a c t o r , m u l t i - d i m e n s i o n a l assessments were t o be used (Knoff, 1984). Although under no l e g a l compunction to do so, the American A s s o c i a t i o n on Mental D e f i c i e n c y (AAMD) proposed the f o l l o w i n g d e f i n i t i o n of mental r e t a r d a t i o n , one which had been promoted by t h a t o r g a n i z a t i o n s i n c e the 1950s. (Mental R e t a r d a t i o n i s ) s i g n i f i c a n t l y subaverage i n t e l l e c t u a l f u n c t i o n i n g e x i s t i n g c o n c u r r e n t l y w i t h d e f i c i t s i n a d a p t i v e behaviour and manifested d u r i n g the developmental y e a r s . (Grossman, 1983, p. 11) G e n e r a l l y regarded today as the most a c c e p t a b l e s t a n d a r d f o r the i d e n t i f i c a t i o n of a mental handicap, t h i s t w o - f a c t o r d e f i n i t i o n has been adopted by the World H e a l t h O r g a n i z a t i o n , the American P s y c h i a t r i c A s s o c i a t i o n , and by most s t a t e departments of education (Grossman, 1983). The N a t i o n a l A s s o c i a t i o n of School P s y c h o l o g i s t s (NASP) u n o f f i c i a l l y underscored the importance of t h i s model i n i t ' s Best P r a c t i c e s Manual (Thomas & Grimes, 1985) by i n c l u d i n g an a r t i c l e which s t a t e s t h a t the use of the two-f a c t o r model i n the d i a g n o s i s of a mental handicap i s "...both a mandatory and i n d i s p e n s a b l e component of mental r e t a r d a t i o n c l a s s i f i c a t i o n and programming. There i s l i t t l e argument on t h a t p o i n t " (Reschly, 1985, p. 353). 41 I m p l i c i t i n the two-factor model as d e s c r i b e d by Grossman (1983) i s the equal i n c l u s i o n of ad a p t i v e behaviour and IQ. I t i s r e q u i r e d by the model t h a t s i g n i f i c a n t d e f i c i t s i n ad a p t i v e behaviour must e x i s t c o n c u r r e n t l y w i t h s i g n i f i c a n t d e f i c i t s i n IQ. For a c h i l d t o be l a b e l l e d as me n t a l l y handicapped both c r i t e r i a must be met, making each f a c t o r both necessary and equal. I t i s n o t a b l e , however, t h a t a l t h o u g h i n the r e s e a r c h l i t e r a t u r e c u t - o f f s c o r e s f o r low IQ are g e n e r a l l y those suggested by the AAMD (IQ 70 -75), the AAMD does not pro v i d e d i r e c t guidance i n det e r m i n i n g c u t s c o r e s f o r adaptive behaviour t e s t s . Although r e s e a r c h e r s t y p i c a l l y adopt an ada p t i v e behaviour c u t - o f f s c o r e o f p e r c e n t i l e rank 2.5 - 3.0, matching the IQ c u t - o f f s c o r e p r o v i d e d by the AAMD, c l e a r d i r e c t i o n to do so has not been p r o v i d e d . Although the two- f a c t o r model c l e a r l y i s the most accepted d i a g n o s t i c c r i t e r i o n , (with some debate b e g i n n i n g about the i n c l u s i o n of achievement data) s e v e r a l authors have r e c e n t l y c h a l l e n g e d the e n t i r e t w o - f a c t o r c o n s t r u c t . Shinn (1988) and Tucker (1985), i n c a l l i n g f o r the abandonment of the tw o - f a c t o r model, r e f e r t o i t as a " p s y c h o m e t r i c a l l y based i d e n t i f i c a t i o n procedure" (Shinn, 1988, p. 61). T h e i r argument i s t h a t psychometric i n f o r m a t i o n has the p r o p e n s i t y f o r e x c e s s i v e b i a s , as was 42 demonstrated i n the l i t i g a t i o n of the 1970s, and t h a t i t does not a c c u r a t e l y p r e d i c t the performance of c h i l d r e n a f t e r they are p l a c e d i n s p e c i a l education programmes. These authors argue f o r the g e n e r a l abandonment of such psychometric procedures and t h e i r replacement by "curriculum-based models" (Shinn, 1988, p. 61). Although i t has been demonstrated i n the l i t e r a t u r e t h a t such models can s u c c e s s f u l l y diagnose student needs (Tucker, 1985), the use of the model alone f o r d i f f e r e n t i a t i o n of s p e c i a l needs ve r s u s non s p e c i a l needs students has not been w e l l supported. Curriculum-based measures have important uses i n making c u r r i c u l a r d e c i s i o n s , i n m o n i t o r i n g student progress and, indeed, are u s e f u l as an academic component of a m u l t i - f a c t o r d i a g n o s t i c procedure. At present, however, t h e r e i s no c o m p e l l i n g evidence i n the l i t e r a t u r e t o support the replacement of the accepted AAMD tw o - f a c t o r d i a g n o s t i c model w i t h c u r r i c u l u m - b a s e d assessment procedures a l o n e . Achievement as a Domain of Adaptive Behaviour In d i s c u s s i o n s of the d e f i n i t i o n of a d a p t i v e behaviour, T r e d g o l d (1937) emphasized t h a t a p p r o p r i a t e s o c i a l a d a p t a t i o n i n v o l v e s " ( t h e student) adapting h i m s e l f t o the normal environment of h i s f e l l o w s " (p. 4 ) . Since t h a t time, and w i t h the development of a number of p o p u l a r l y used s t a n d a r d i z e d measures of s o c i a l a d a p t a t i o n , d i s c u s s i o n with 43 r e s p e c t t o the i n c l u s i o n of academic achievement as a l e g i t i m a t e sub-domain of s o c i a l a d a p t a t i o n has o c c u r r e d . Many of the most popular measures of s o c i a l a d a p t a t i o n such as the V i n e l a n d Adaptive Behavior S c a l e s , simply-do not f o r m a l l y t e s t f o r academic achievement. Although some i n d i v i d u a l items on a d a p t i v e t e s t s do query achievement t a s k s ( i e : the student can p r i n t t h e i r f i r s t and l a s t name), these t e s t s do not p r o v i d e the examiner with a more s o p h i s t i c a t e d achievement measuring d e v i c e . I t c o u l d be argued t h a t the producers of a d a p t i v e behaviour s c a l e s assume t h a t those a s s e s s i n g students w i l l t e s t academic p r o f i c i e n c y through other means. I f t h i s i s the case, i t r e s u l t s i n such measures of academic achievement not forming p a r t of the t o t a l a d a p t i v e t e s t s c o r e . In consequence, academic achievement does not e n t e r i n t o the formal t w o - f a c t o r d i a g n o s t i c model f o r making placement d e c i s i o n s . Both Grossman (1983) and Reschly (1982) have suggested t h a t r e f e r e n c e to the "standards of l e a r n i n g " (Grossman, 1983, p. 11) of a student's peer group are a p p r o p r i a t e l y a p a r t of a d a p t i v e behavior. T h i s s u g g e s t i o n complemented the o b s e r v a t i o n s made i n the Ysseldyke e t a l . s t u d i e s , where low achievement and i d i o s y n c r a t i c classroom behaviour were found t o be primary determinants of a t e a c h e r ' s d e c i s i o n t o r e f e r 44 s t u d e n t s f o r psychometric t e s t i n g . T h i s case f o r the i n c l u s i o n of measures of academic achievement has been made by Reschly (1988, 1986) who argued s t r e n u o u s l y f o r the i n c l u s i o n of b a s i c academic achievement as a v a l i d sub-domain of o v e r a l l a d a p t i v e behaviour. Reschly p o i n t e d out t h a t s e v e r e l y d e f i c i e n t r e a d i n g and a r i t h m e t i c s k i l l s are maladaptive w i t h i n the r e g u l a r classroom environment. Achievement t e s t r e s u l t s , he argued, r e f l e c t the "standards of l e a r n i n g " component of the AAMD d e f i n i t i o n of a d a p t i v e behaviour and should t h e r e f o r e be i n c l u d e d i n a v a l i d measure of s o c i a l a d a p t a t i o n . I f b a s i c c o g n i t i v e o p e r a t i o n s and l i t e r a c y s k i l l s are emphasized by a l l s o c i o c u l t u r a l groups, i f these s k i l l s are taught to a l a r g e degree i n s c h o o l s e t t i n g s , and i f these s k i l l s are very important t o adequate a d a p t i v e behavior ...then the s c h o o l s e t t i n g and academic achievement must be viewed as i n t e g r a l , e s s e n t i a l components of adaptive b e h a v i o r . (p. 354) C o n s i d e r a t i o n of Hearing and V i s i o n I t has l o n g been r e c o g n i z e d t h a t students w i t h lower IQ s c o r e s s u f f e r from a d i s p r o p o r t i o n a t e l y h i g h i n c i d e n c e of h e a r i n g and v i s u a l impairments (Brooks, 1978; Cunningham & McArthur, 1982; Mykelbust, 1954; Nolan and Tucker, 1984, 1981). Mykelbust (1954) r e p o r t e d t h a t nine per cent of 45 s t u d e n t s r e f e r r e d t o a h e a r i n g c l i n i c had IQ sc o r e s below 70, w h i l e such students o n l y r e p r e s e n t e d approximately two per cent of the p o p u l a t i o n i n s c h o o l s . Not o n l y i s the r e c o g n i t i o n t h a t v i s u a l and h e a r i n g d i s o r d e r s occur more f r e q u e n t l y i n the me n t a l l y handicapped p o p u l a t i o n important. The p o t e n t i a l e f f e c t s t h a t such o r g a n i c d y s f u n c t i o n s , when unknown, can have on placement d e c i s i o n s i s c r i t i c a l . Brooks (1978) has p o i n t e d out with r e f e r e n c e t o h e a r i n g a c u i t y , t h a t i n the case of men t a l l y handicapped and oth e r " h a r d - t o - t e s t " s u b j e c t s , " p s y c h o l o g i c assessment and a u d i o l o g i c assessment must go hand-in-hand. Without a knowledge of the c a p a b i l i t i e s and l i m i t a t i o n s of the c h i l d (any) e v a l u a t i o n may be meaningless or even m i s l e a d i n g " (p. 130). Although p s y c h o l o g i s t s a d m i n i s t e r i n g s t a n d a r d i z e d p s y c h o - e d u c a t i o n a l t e s t s are u s u a l l y c a r e f u l i n t e s t s e l e c t i o n when d e a l i n g w i t h a youngster who has obvious o r g a n i c pathology such as b l i n d n e s s , deafness, or c e r e b r a l p a l s y (Tucker & Nolan, 1984, p. 374), i t i s not patent from the l i t e r a t u r e t h a t such i s the case w i t h the M/EMH p o p u l a t i o n . T h i s , i n s p i t e of the demonstrated f a c t t h a t h e a r i n g and v i s u a l a c u i t y d e f i c i t s are experienced by t h i s p o p u l a t i o n a t a s i g n i f i c a n t l y higher r a t e than the t y p i c a l p o p u l a t i o n . As Nolan & Tucker (1984) p o i n t out with r e s p e c t t o a u d i t o r y impairment: 46 A l l too o f t e n the l a c k of response t o sound, speech i n p a r t i c u l a r , i s put down to the c h i l d ' s mental c a p a c i t y r a t h e r than h e a r i n g i n t e g r i t y , t h i s d e s p i t e the f a c t t h a t numerous s t u d i e s have h i g h l i g h t e d t h a t the i n c i d e n c e of h e a r i n g l o s s i n such groups i s s i g n i f i c a n t l y h i g h e r than i n the normal p o p u l a t i o n . ...The comment t h a t t h e r e i s l i t t l e p o i n t i n a s s e s s i n g h e a r i n g i n the mentally handicapped because they are u s u a l l y u n t e s t a b l e and have no problem wi t h h e a r i n g anyway, i s simply untrue and t o t a l l y unacceptable, (p. 92) The comments made with r e s p e c t t o a u d i t o r y impairment can be re a s o n a b l y made f o r v i s u a l impairment, e s p e c i a l l y i n the way t h a t l o s s of sensory i n p u t can e a s i l y confound the r e s u l t s of s t a n d a r d i z e d t e s t s . Hartshorne & Hoyte (1986) p o i n t out t h a t i t i s e s s e n t i a l t o e i t h e r c o n f i r m v i s u a l and h e a r i n g a c u i t y w i t h i n normal l i m i t s or t o q u a n t i f y sensory l o s s b e f o r e embarking on a programme of p s y c h o l o g i c a l t e s t i n g . To assess a student who has an unknown but s i g n i f i c a n t v i s u a l and/or h e a r i n g l o s s may r e s u l t i n the s e l e c t i o n of i n a p p r o p r i a t e t e s t s , and the f a l s e i n t e r p r e t a t i o n of low t e s t s c o r e s as i n d i c a t i v e o f mental as opposed t o sensory d i s a b i l i t y . The same o b s e r v a t i o n has 47 been made with r e s p e c t t o academic assessment (Gerken, 1986). Canadian S p e c i a l Education Development  Lack of F e d e r a l Education A u t h o r i t y Under the p r o v i s i o n s of the C o n s t i t u t i o n A c t of 1867 ( f o r m e r l y the B r i t i s h North America A c t ) , and l a t e r as r e a f f i r m e d i n s e c t i o n 93 of the C o n s t i t u t i o n A c t of 1982, e d u c a t i o n of a l l s c h o o l age c h i l d r e n i n Canada i s the s o l e and l e g a l r e s p o n s i b i l i t y of the p r o v i n c e s . As with a l l e d u c a t i o n a l l e g i s l a t i o n , s p e c i a l e d u c a t i o n l e g i s l a t i o n has n e c e s s a r i l y e v olved s e p a r a t e l y i n each of these j u r i s d i c t i o n s (Csapo, 1980, 1981; Cruickshank, 1983; P o i r i e r e t a l . , 1988). Consequently, t h e r e are d i f f e r e n c e s among the p r o v i n c e s on such fundamental i s s u e s as the d e f i n i t i o n and programming f o r s p e c i a l needs c h i l d r e n , and the r i g h t s of these c h i l d r e n and t h e i r p a r e n t s . U n l i k e the U n i t e d S t a t e s , t h e r e i s no law l i k e PL94-142 a t the f e d e r a l l e v e l . PL94-142 as a model In an examination of the Canadian l i t e r a t u r e i n s p e c i a l e d u c a t i o n s i n c e the 1960s, co n s t a n t r e f e r e n c e s to the shortcomings of Canadian s p e c i a l e d u c a t i o n are encountered, w i t h such comments o f t e n being framed as comparisons w i t h the U.S. s i t u a t i o n (Csapo, 1980, 1981; Goguen, 1980; H a l l & Dennis, 1968; Lazure & Roberts, 1970; P o i r i e r & Goguen, 48 1986; P o i r i e r e t a l . , 1988). Repeatedly authors c o n t r a s t the p r o g r e s s made i n American s p e c i a l e d u c a t i o n w i t h the l a c k of progress i n Canada. Csapo (1980) noted "...the e d u c a t i o n o f handicapped c h i l d r e n ( i n Canada i s ) g r i e v o u s l y n e g l e c t e d and s u f f e r i n g from a l a c k of c l e a r n a t i o n a l p o l i c y " (p.197). L a t e r , i n a r e p o r t commissioned by the Canadian Teacher's F e d e r a t i o n , Csapo (1981) went on t o s t a t e , Most of a l l , t e a c h e r ' s f e d e r a t i o n s are a s k i n g m i n i s t r i e s t o assume l e a d e r s h i p and c l a r i f y i t ' s [ s i c ] t h i n k i n g on matters r e l a t i n g t o i n t e g r a t i o n , t o p r o v i d e o r g a n i z a t i o n a l models, d e f i n i t i o n s of handicaps and procedures f o r i d e n t i f i c a t i o n , implementation and e v a l u a t i o n , (p.215) P o t e n t i a l e f f e c t s of the Canadian Charter o f R i g h t s and Freedoms The p r o g r e s s i n s p e c i a l e d u c a t i o n made i n the U n i t e d S t a t e s was p r o p e l l e d by two f o r c e s ; l i t i g a t i o n and f e d e r a l e d u c a t i o n a l law. N e i t h e r of these f o r c e s has been i n f l u e n t i a l i n Canada. Not only i s t h e r e no f e d e r a l e d u c a t i o n law i n Canada c o n s t i t u t i o n a l l y , t h e r e i s a l s o a t r a d i t i o n of j u r i s p r u d e n c e t h a t seldom sees a c t i o n s taken a g a i n s t e d u c a t i o n a l a u t h o r i t i e s . Even when such a c t i o n s do occur, t h e r e i s a h i s t o r y of the c o u r t s u p h o l d i n g the 49 e d u c a t i o n a l a u t h o r i t i e s (Bales, 1985; Cruickshank, 1983; MacKay, 1985). There i s , though, a p o t e n t i a l f o r i n f l u e n c e s such as those found i n the U n i t e d S t a t e s t o be f e l t i n Canada. Although the C o n s t i t u t i o n Acts of 1867 and 1982 v e s t e d a u t h o r i t y over e d u c a t i o n t o the p r o v i n c e s , the C h a r t e r of R i g h t s and Freedoms w i l l l i k e l y o v e r r i d e t h a t a u t h o r i t y . Furthermore, s i n c e i t i s apparent t h a t "...the new C h a r t e r i s the supreme law of Canada and a p p l i e s to p r o v i n c i a l e d u c a t i o n l e g i s l a t i o n and t o s c h o o l boards" ( P o i r i e r e t a l . , 1988, p.25), i t may be i n c r e a s i n g l y u t i l i z e d t o c h a l l e n g e the d i s p a r a t e laws and r e g u l a t i o n s governing s p e c i a l e d u c a t i o n a c r o s s Canada. Evidence of such use of the C h a r t e r of R i g h t s and Freedoms i s b e g i n n i n g t o be seen. In the case of Elwood  ver s u s H a l i f a x County-Bedford (1987), an i n i t i a l c o u r t o r d e r was awarded t o the f a m i l y of a m e n t a l l y and p h y s i c a l l y handicapped student, s t a t i n g t h a t the c h i l d be i n t e g r a t e d i n t o a r e g u l a r classroom i n h i s neighbourhood s c h o o l pending f u r t h e r c o u r t proceedings. Although the case was u l t i m a t e l y s e t t l e d i n favour of the Elwood f a m i l y i n an out of c o u r t s e t t l e m e n t , i t i s b e l i e v e d t h a t the t h r e a t of a C h a r t e r of R i g h t s based c o u r t a c t i o n l e d to t h a t s e t t l e m e n t (MacKay, 50 1987; Fraser, 1987). As MacKay (1987), one of the Elwood's lawyers has stated: The Elwood case w i l l be a landmark case i n the educational rights of disabled children i n Canada. . . . i t i s a c l a s s i c i l l u s t r a t i o n of the out of court uses of the Charter of Rights as an important negotiating tool for students and parents. There i s no doubt i n my mind that there would have been no agreement i n the Elwood case had we not been prepared to go to court under the Charter of Rights, (p. 110) Very recently, i n a case involving a family who f e l t that the Vancouver School Board was not providing s u f f i c i e n t l y for t h e i r learning disabled c h i l d , s u i t was launched i n B. C. Supreme Court against the Board to recover the costs of sending t h e i r c h i l d to a private school for dyslexic c h i l d r e n . In t h i s case Justice Trainor stated, "although school boards are under a duty to provide s u f f i c i e n t accommodation and t u i t i o n , t h i s does not mean there i s a duty to provide the best education" (Odam & Bula, 1989, p. A l ) . J u s t i c e Trainor found that the Board had made reasonable e f f o r t s to a s s i s t the c h i l d , and that the educational r i g h t s of the c h i l d had not been v i o l a t e d by the Board refusing to pay for his private education. Although 51 the C h a r t e r of R i g h t s and Freedoms i s not e x p l i c i t l y -r e f e r r e d t o i n r e p o r t s of t h i s case, i t i s apparent t h a t the r i g h t s of both the c h i l d and the Board were being c o n s i d e r e d . In a commentary on whether the board had v i o l a t e d the r i g h t s of the c h i l d i n t h i s case, Bula (1989) s t a t e d "(based on t h i s d e c i s i o n ) ...boards ca n ' t be l i a b l e f o r e v e r y t h i n g " (p. A12). I t i s reasonable t o suggest t h a t precedents l i k e the Elwood case may have had a b e a r i n g on the Vancouver d e c i s i o n as c o u r t s attempt t o d e l i n e a t e what does and does not c o n s t i t u t e the reasonable e d u c a t i o n a l r i g h t s of s p e c i a l needs students as guaranteed by the C h a r t e r . C l e a r l y , a p a t t e r n of r e s o l v i n g the e d u c a t i o n a l r i g h t s of both s t u d e n t s and s c h o o l boards through r e d r e s s t o the c o u r t s can be observed. That the Elwood and Vancouver cases were each s e t t l e d d i f f e r e n t l y o n l y i n d i c a t e s t h a t the c o u r t s , based on the Charter of R i g h t and Freedoms, are s e e k i n g t o determine the parameters of the e d u c a t i o n a l r i g h t s of s p e c i a l needs c h i l d r e n . The C h a r t e r of R i g h t s and Freedoms has been, and should continue t o be, c e n t r a l t o the r e s o l u t i o n of the r e l a t i v e r i g h t s of both s p e c i a l needs stu d e n t s and the s c h o o l systems t h a t serve them. 52 Recent S t u d i e s on Diagnosis and Placement  The Minnesota I n s t i t u t e S t u d i e s . In the l a t e 1970s, the U n i t e d S t a t e s Department of Education c a l l e d f o r r e s e a r c h p r o p o s a l s i n t o the e f f i c a c y of s p e c i a l e d u c a t i o n i n t e r v e n t i o n s . Ysseldyke e t a l . (1983), presented a r e s e a r c h p l a n i n which they c r i t i c i z e d the focus of the government's c a l l f o r r e s e a r c h . Addressing l e a r n i n g d i s a b l e d (LD) s t u d e n t s , the authors suggested t h a t r e s e a r c h i n t o programme e f f i c a c y was " a t best premature" (p. 75), s i n c e the procedures being used i n d i a g n o s i s and placement of LD s t u d e n t s showed "tremendous v a r i a b i l i t y i n c r i t e r i a " (p. 76). Because of t h i s v a r i a b i l i t y i n d i a g n o s t i c p r a c t i c e , the authors argued t h a t r e s e a r c h done on the e f f i c a c y of s p e c i f i c programme i n t e r v e n t i o n s "were i n c a p a b l e of g e n e r a l i z a t i o n " (p. 76). Based on t h i s argument, the authors proposed a comprehensive s e t of r e s e a r c h s t u d i e s i n t o the decision-making p r o c e s s . A f t e r s e v e r a l i n i t i a l s t u d i e s , the authors s p e c i f i e d f i v e l e v e l s of d e c i s i o n -making r e l a t e d t o the p r o v i s i o n of s p e c i a l e d u c a t i o n s e r v i c e s . These were d e c i d i n g : (1) who t o r e f e r f o r e v a l u a t i o n , (2) who to d e c l a r e e l i g i b l e f o r s e r v i c e , (3) how to p l a n s p e c i f i c i n t e r v e n t i o n s , 53 (4) how much students were b e n e f i t t i n g from i n t e r v e n t i o n s , and (5) how e f f e c t i v e s p e c i f i c programmes of i n s t r u c t i o n were. Of these, the f i r s t two are important f o r the p r e s e n t r e s e a r c h . Over the space of f i v e y ears, and a f t e r more than 100 i n d i v i d u a l s t u d i e s , the authors found t h a t two s p e c i f i c p o i n t s i n the d i a g n o s t i c process were c r i t i c a l i n d e t e r m i n i n g whether a c h i l d would be l a b e l l e d and p l a c e d r e g a r d l e s s of suspected d i s a b i l i t y . These were (1) a t the p o i n t of classroom teacher r e f e r r a l (p. 80), and (2) a t the p o i n t where ps y c h o - e d u c a t i o n a l t e s t r e s u l t s were i n t e r p r e t e d (p. 77). Teacher r e f e r r a l s . Ysseldyke e t a l . (1983) conducted a n a t i o n a l survey of d i r e c t o r s of s p e c i a l e d u c a t i o n , r e q u e s t i n g r e f e r r a l and placement data f o r s p e c i a l c l a s s programmes i n g e n e r a l . They found t h a t on an annual b a s i s , from two t o s i x percent of the t o t a l s c h o o l p o p u l a t i o n would be r e f e r r e d f o r a psycho-educational e v a l u a t i o n . Of t h a t number, 92% would a c t u a l l y be t e s t e d , with 73% of these b e i n g d e c l a r e d e l i g i b l e f o r s p e c i a l e d u c a t i o n placement. A f t e r n o t i n g the very h i g h p r o b a b i l i t y of r e f e r r e d s t udents b e i n g both t e s t e d and p l a c e d , the authors p o s i t e d two p o s s i b l e reasons f o r t h e i r o b s e r v a t i o n s : (1) t h a t t h e r e 54 was a combination of extreme "accuracy i n both r e f e r r i n g and t e s t i n g " (p. 80); and (2) the f i g u r e s r e f l e c t e d the e f f i c i e n c y of the placement apparatus of s c h o o l systems i n a c t i n g on the requests of classroom t e a c h e r s , i r r e s p e c t i v e of the a c t u a l needs of the students. To i n v e s t i g a t e these p o s s i b i l i t i e s , the authors conducted s e v e r a l d e t a i l e d s t u d i e s i n which r e f e r r i n g t e a c h e r s were i n t e r v i e w e d t o determine t h e i r reasons f o r making the o r i g i n a l r e f e r r a l . Upon examination of the te a c h e r ' s responses, they were found t o s t a t e t h e i r reasons f o r such r e f e r r a l s i n "vague and nebulous t e r m i n o l o g y " (p.80), o f t e n c i t i n g s o c i a l concerns about the c h i l d ' s home and f a m i l y . When asked what they expected from t h e i r o r i g i n a l r e f e r r a l s , the t e a c h e r s were c l e a r e r , t y p i c a l l y s t a t i n g t h a t they "wanted t e s t i n g and placement" (Ysseldyke e t a l . , p. 80). The authors found t h a t the classroom t e a c h e r s had "made no s y s t e m a t i c e f f o r t t o a l t e r i n s t r u c t i o n a l p l a n s f o r the s t u d e n t s " (pp. 80-81), but t h a t the most fundamental reasons f o r r e f e r r a l s were found t o be i d i o s y n c r a t i c , based on behaviour produced by the r e f e r r e d student t h a t tended t o i r r i t a t e the r e f e r r i n g t e a c h e r . "When we i n v e s t i g a t e d the s p e c i f i c determinants of r e f e r r a l , we found t h a t t e a c h e r s tend t o r e f e r students who bother them" (p. 81). 55 The most s i g n i f i c a n t f i n d i n g of t h i s p o r t i o n of the Minnesota s t u d i e s , then, has to do with the power of the classroom t e a c h e r i n determining who w i l l be p l a c e d i n t o s p e c i a l e d u c a t i o n programmes. N a t i o n a l l y , g i v e n t h a t 92% of a l l s t u d e n t s r e f e r r e d f o r psycho-educational assessment are i n f a c t t e s t e d , and t h a t of these, 73% are l a b e l l e d and p l a c e d , i t i s patent t h a t the o r i g i n a l d e c i s i o n t o make a r e f e r r a l , a s t e p found t o be i n the c o n t r o l of the classroom t e a c h e r and o f t e n made f o r c a p r i c i o u s reasons, i s the g r e a t e s t determinant i n a c h i l d e n t e r i n g a s p e c i a l e d u c a t i o n programme. I t i s c l e a r t h a t the most important d e c i s i o n made i n the e n t i r e assessment process i s the d e c i s i o n by a r e g u l a r classroom teacher t o r e f e r a student f o r assessment. Once a student i s r e f e r r e d , t h e r e i s a h i g h p r o b a b i l i t y t h a t the student w i l l be assessed and p l a c e d i n s p e c i a l e ducation. (Ysseldyke e t a l . , 1983, p. 80) Ps y c h o - e d u c a t i o n a l e v a l u a t i o n and i n t e r p r e t a t i o n . Ysseldyke e t a l . (1983) found t h a t although " c o n s i d e r a b l e time, e f f o r t and money go i n t o the a d m i n i s t r a t i o n o f l a r g e numbers of t e s t s " (p. 82), such expenditures do not guarantee a p p r o p r i a t e d i a g n o s i s . Although "there are t e c h n i c a l l y adequate norm-referenced t e s t s t h a t can be used t o make 56 d e c i s i o n s about students . . . f o r the most p a r t , these are now r e s t r i c t e d t o the domains of i n t e l l i g e n c e and academic achievement" (p. 81). They found t h a t many t e s t s of p e r s o n a l i t y and l e a r n i n g s t y l e s t y p i c a l l y used by p s y c h o l o g i s t s were t e c h n i c a l l y inadequate. I t was noted t h a t the personnel most l i k e l y t o a d m i n i s t e r and i n t e r p r e t p s y c h o - e d u c a t i o n a l t e s t s , s c h o o l p s y c h o l o g i s t s and s p e c i a l e d u c a t i o n t e a c h e r s , although u s u a l l y t e c h n i c a l l y q u a l i f i e d t o do so, may have an i n f l a t e d view of t h e i r a b i l i t y t o i n t e r p r e t t e s t r e s u l t s . T h i s was p a r t i c u l a r l y t r u e f o r p s y c h o l o g i s t s and s p e c i a l e ducation t e a c h e r s who were o f t e n found t o r e v e r t t o what they termed " c l i n i c a l judgement" i n i n t e r p r e t i n g t e s t r e s u l t s , e s p e c i a l l y s u b - t e s t p r o f i l e s of IQ t e s t s . The authors s t a t e , Placement d e c i s i o n s made by teams of i n d i v i d u a l s have l i t t l e t o do wit h the data c o l l e c t e d on st u d e n t s . We were ab l e t o demonstrate t h a t the d e c i s i o n s t h a t are made are more a f u n c t i o n of n a t u r a l l y o c c u r r i n g p u p i l c h a r a c t e r i s t i c s than they are data based, (p. 78) To i n v e s t i g a t e the accuracy of c l i n i c a l judgement, the authors performed an i n t e r e s t i n g experiment i n which student t e s t i n f o r m a t i o n was presented t o two groups of people, l a b e l l e d e x p e r t s and non-experts. The expert group was comprised of p s y c h o l o g i s t s , p s y c h o m e t r i s t s , and t e a c h e r s of 57 l e a r n i n g d i s a b l e d s t u d e n t s . The non-expert group was made up of undergraduate students with no experience or course work i n ed u c a t i o n or psychology. Each group of 18 persons was asked t o read t e s t i n f o r m a t i o n , and to decide whether or not the c h i l d r e n r e p r e s e n t e d by the t e s t m a t e r i a l were l e a r n i n g d i s a b l e d (LD) or non-LD. Using e x i s t i n g f e d e r a l c r i t e r i a f o r LD c l a s s i f i c a t i o n , i t was found t h a t the expert group was o n l y 50% acc u r a t e i n c o r r e c t l y l a b e l l i n g LD st u d e n t s , w h i l e the non-expert group was 75% ac c u r a t e (p. 82) . Each p a r t i c i p a n t was a l s o asked t o r a t e the c o n f i d e n c e t h a t they had i n t h e i r a b i l i t y t o d i s c e r n a l e a r n i n g d i s a b i l i t y from the i n f o r m a t i o n presented. Although the p s y c h o l o g i s t s were no more accurate than t h e i r other p r o f e s s i o n a l c o l l e a g u e s , and c e r t a i n l y l e s s a c c u r a t e than the non-expert group, they r e p o r t e d a very h i g h l e v e l of c o n f i d e n c e i n t h e i r " c l i n i c a l judgement" accuracy (p. 82). The authors noted t h a t while many t e s t instruments u t i l i z e d i n the d i a g n o s t i c process have i n d i v i d u a l t e c h n i c a l accuracy, e s p e c i a l l y IQ and achievement t e s t s , many do not. Of those t h a t do possess these q u a l i t i e s , t h a t accuracy i s d i s r u p t e d by the way i n which t e s t r e s u l t s a re i n t e r p r e t e d , and by the i n o r d i n a t e c o n f i d e n c e t h a t p r o f e s s i o n a l s p l a c e i n t h e i r a b i l i t y t o use " c l i n i c a l judgement." 58 Ysseldyke e t a l . concluded, on the b a s i s of t h e i r f i v e -year study t h a t , "there are s i g n i f i c a n t problems i n c u r r e n t assessment and decision-making p r a c t i c e s " (p. 87). The authors f i r s t argued t h a t the s p e c i a l e d u c a t i o n r e f e r r a l and placement system was designed p r i m a r i l y t o remove c h i l d r e n from r e g u l a r c l a s s programmes because of t h e i r i n a b i l i t y t o f i t i n t o those programmes b e h a v i o u r a l l y . I f the reasons f o r t h i s l a c k of programme f i t were such t h a t s p e c i a l c l a s s placement c o u l d address and c o r r e c t them, and then promptly r e t u r n the student t o the r e g u l a r e d u c a t i o n environment, the r e f e r r a l and placement process might be u s e f u l . The authors suggested t h a t i n most i n s t a n c e s t h a t was not the case. Beginning w i t h classroom teacher r e f e r r a l s , c h i l d r e n were s e l e c t e d f o r psycho-educational assessment f o r what were o f t e n a r b i t r a r y reasons, most o f t e n f o r behaviours t h a t the t e a c h e r found i r r i t a t i n g . R e f e r r a l s were made without r e f e r e n c e t o s p e c i f i c r e g u l a r classroom l e a r n i n g problems, and t h e r e was l i t t l e evidence of s p e c i f i c p r e - r e f e r r a l i n t e r v e n t i o n s t r a t e g i e s b e i n g t r i e d . The o n l y c o n s i s t e n t l y a r t i c u l a t e d reasons f o r r e f e r r a l appeared t o be t o have the c h i l d p l a c e d i n t o s p e c i a l education, which might a l s o be worded, x t o get the c h i l d out of the r e g u l a r c l a s s . ' The authors c h a l l e n g e d the assumption t h a t s tudents and t e a c h e r s are b e s t served by t h i s p r o c e s s . 59 Even as the reasons f o r r e f e r r i n g a student f o r assessment appeared t o be a r b i t r a r y , so too d i d the process of t e s t i n g and l a b e l l i n g . Although the authors noted t h a t s t a n d a r d i z e d t e s t s of s a t i s f a c t o r y r e l i a b i l i t y and v a l i d i t y were a v a i l a b l e , and even though most t e s t i n g personnel had the t r a i n i n g t o competently a d m i n i s t e r and i n t e r p r e t them, the impact of what they termed " c l i n i c a l judgement" tended t o i n t e r f e r e . Based i n a c o n f i d e n c e t h a t c l i n i c a l judgement i s an a p p r o p r i a t e d i a g n o s t i c t o o l , i t was apparent t h a t the a ccuracy of d i a g n o s t i c and placement p r a c t i c e s as e x e r c i s e d by s c h o o l p s y c h o l o g i s t s and other e d u c a t i o n a l p r o f e s s i o n a l s was l a c k i n g . The Minnesota s t u d i e s served t o h i g h l i g h t t h r e e important p o i n t s w i t h r e f e r e n c e t o t h i s study: 1. s t u d i e s of s p e c i a l e d u c a t i o n programme e f f i c a c y without r e f e r e n c e t o a s o l i d understanding of the d i a g n o s t i c and placement p r a c t i c e s t h a t put c h i l d r e n i n t o s p e c i a l e d u c a t i o n programmes are premature and s e r i o u s l y undermine the g e n e r a l i z a b i l i t y of any such s t u d i e s ; 2. c r i t e r i a f o r r e f e r r a l , assessment, and placement d e c i s i o n making appear to be a r b i t r a r y , w i t h the 60 c r i t i c a l f a c t o r i n s e e i n g a c h i l d l a b e l l e d and p l a c e d l y i n g with the o r i g i n a l teacher d e c i s i o n to r e f e r . Upon completion of t h a t step, placement i n t o s p e c i a l e d u c a t i o n programmes i s most o f t e n forthcoming; and 3. although t e c h n i c a l l y adequate t e s t s are a v a i l a b l e , i t i s apparent t h a t the way t e s t s are i n t e r p r e t e d by d i a g n o s t i c p r o f e s s i o n a l s i s as important, i f not more important, than the t e s t r e s u l t s themselves. A study of d i a g n o s t i c and placement p r a c t i c e s must focus not j u s t on the instruments used, but on the way t h a t such instruments are used. The use of s t a n d a r d i z e d t e s t s i n making e d u c a t i o n a l placement d e c i s i o n s i s a procedure which i s intended t o ensure f a i r n e s s of s e l e c t i o n and a p p r o p r i a t e n e s s of placement. The s t u d i e s of the Minnesota I n s t i t u t e p o i n t out t h a t the d i a g n o s t i c and placement process appears t o be contaminated by b i a s e s of both t e a c h e r s and placement teams. C a p r i c i o u s reasons o f t e n appear to be the motive f o r teacher r e f e r r a l s , w h i l e placement teams which are designed t o c o u n t e r a c t such c a p r i c e appear to be as a r b i t r a r y as the t e a c h e r s by r e l y i n g on " c l i n i c a l judgement." The s u g g e s t i o n c l e a r l y i s t h a t placement teams are s t r o n g l y i n f l u e n c e d by p s y c h o l o g i s t s and p s y c h o l o g i s t s are s t r o n g l y i n f l u e n c e d by 61 r e l i a n c e on an i n t a n g i b l e and demonstrably u n r e l i a b l e c l i n i c a l sense. Order of P r e s e n t a t i o n and T e s t I n f l u e n c e Knoff (1984), u s i n g a s i m u l a t i o n study, i n v e s t i g a t e d the r o l e t h a t both the types of assessment data and the order of t h e i r p r e s e n t a t i o n had i n i n f l u e n c i n g committee placement d e c i s i o n s f o r M/EMH st u d e n t s . Knoff noted t h a t both PL94-142 as w e l l as the t e n e t s of best p r a c t i c e as o u t l i n e d by the AAMD " i n s i s t on IQ and ada p t i v e behavior assessments f o r cases of suspected mental r e t a r d a t i o n " (p. 123). F o l l o w i n g the accepted t w o - f a c t o r d i a g n o s t i c model, the author assembled f o u r case s t u d i e s on p o t e n t i a l M/EMH c a n d i d a t e s . Each case study i n c l u d e d r e s u l t s from the f o l l o w i n g : (1) WISC-R IQ; (2) AAMD-SE Adaptive Behavior S c a l e ; (3) Daberon s c r e e n i n g r e a d i n g t e s t s ; (4) Bender-G e s t a l t t e s t of v i s u a l - m o t o r i n t e g r a t i o n ; and, (5) Goodenough-Harris Drawing T e s t . The author assembled f o u r groups of 2 0 persons each as f o l l o w s : group 1: p s y c h o l o g i s t t r a i n e e s ; group 2: p s y c h o l o g i s t p r a c t i t i o n e r s ; group 3: s p e c i a l educator t r a i n e s s ; and, group 4: s p e c i a l educator p r a c t i t i o n e r s . Each member of the groups was gi v e n a b o o k l e t c o n t a i n i n g the case s t u d i e s . The case s t u d i e s were arranged w i t h i n the bo o k l e t s i n random order, and each i n d i v i d u a l was asked t o 62 independently review the case s t u d i e s and t o make placement d e c i s i o n s f o r each by a s s i g n i n g the case t o one of 10 d e s c r i b e d placement o p t i o n s . These ranged from " f u l l time r e g u l a r c l a s s with no b a s i c change i n t e a c h i n g procedures or support s e r v i c e s " through to " f u l l time s p e c i a l c l a s s f o r t r a i n a b l e m e n t a l l y r e t a r d e d s t u d e n t s " (p. 124). Employing a 2 x 2 x 2 x 4 x 2 A n a l y s i s of V a r i a n c e balanced f o r repeated measures ( p r o f e s s i o n x s t a t u s x order x case x d e c i s i o n ) , the author found t h a t t h e r e were no s i g n i f i c a n t d i f f e r e n c e s between any of the f o u r groups i n placement d e c i s i o n making, wit h each group t e n d i n g to favour l e a s t r e s t r i c t i v e placement o p t i o n s from the l i s t . However, i n a n a l y z i n g the r e l a t i v e e f f e c t s of presented p s y c h o - e d u c a t i o n a l i n f o r m a t i o n , i t was noted t h a t IQ t e s t r e s u l t s , r e g a r d l e s s of the order i n which such r e s u l t s were presented, o f t e n a c t e d as "a f r e e v a r i a b l e " (p. 127), always having the most s i g n i f i c a n t e f f e c t on placement s e l e c t i o n . Furthermore, a d a p t i v e behavior i n f o r m a t i o n , although not i n f l u e n c i n g placement d e c i s i o n s as s t r o n g l y as d i d the IQ s c o r e s d i d a c t as a c o - f a c t o r with IQ. IQ s c o r e s were demonstrated t o be i n t e r a c t i n g with other v a r i a b l e s r e g a r d l e s s of the o r d er of t e s t score p r e s e n t a t i o n , w h i l e a d a p t i v e behaviour s c o r e s , although not having as s t r o n g an 63 e f f e c t as IQ were demonstrated to be c o n s i s t e n t l y i n i n t e r a c t i o n with IQ r e g a r d l e s s of placement. The e f f e c t of adaptive behaviour s c o r e s , u n l i k e t h a t of IQ s c o r e was found to be more s i g n i f i c a n t when presented f i r s t . The authors a l s o found t h a t a d d i t i o n a l i n f o r m a t i o n presented, other than t h a t of IQ and a d a p t i v e behavior, d i d not appear t o i n f l u e n c e placement d e c i s i o n s . In examining the i n t e r a c t i o n between IQ and a d a p t i v e behavior s c o r e s , Knoff s t a t e s : The complexity of the r e l a t i v e i n f l u e n c e s of IQ and Adaptive Behavior S c a l e data on e d u c a t i o n a l placement d e c i s i o n s i s e v i d e n t over the f o u r case s t u d i e s . ...Four s e p a r a t e p a t t e r n s of IQ/Adaptive Behavior i n f l u e n c e were noted on the f o u r case s t u d i e s . School p s y c h o l o g i s t s , s p e c i a l educators, and c h i l d study teams, t h e r e f o r e , should r e c o g n i z e t h a t e d u c a t i o n a l placement d e c i s i o n s p o t e n t i a l l y can be a f f e c t e d d i s p r o p o r t i o n a t e l y by d i a g n o s t i c data and by the p r e s e n t a t i o n order of t h i s data and should c o n s i d e r t h e i r e f f e c t s on the team process and on sound e d u c a t i o n a l programming, (p. 127) K n o f f ' s study, while l i m i t e d both i n i t s s i z e as w e l l as i n the f a c t t h a t i t was a s i m u l a t i o n and t h e r e f o r e not 64 f u l l y g e n e r a l i z a b l e t o r e a l placement team d e c i s i o n making, nonetheless r e i n f o r c e s two important concepts: f i r s t l y , i t supported the n o t i o n t h a t the use of the c o - f a c t o r s IQ and ad a p t i v e behavior as demanded by best p r a c t i c e s , can e f f e c t i v e l y make e d u c a t i o n a l placements f o r M/EMH st u d e n t s ; and second, i t demonstrated t h a t , while a p p r o p r i a t e programme s e l e c t i o n s took p l a c e , IQ sc o r e s operate as a more-than-equal c o - f a c t o r , which, w h i l e not overwhelming a d a p t i v e b e h a v i o r i n f o r m a t i o n , c e r t a i n l y appeared t o dominate i t . These r e s u l t s support the concerns of Ysseldyke e t a l . (1983) who note t h a t IQ s c o r e s , e s p e c i a l l y when used as a b a s i s f o r " c l i n i c a l judgement" may l e a d t o i n a c c u r a t e diagnoses rendered with i n o r d i n a t e c o n f i d e n c e by s c h o o l p s y c h o l o g i s t s and s p e c i a l e ducators. Concerns s i m i l a r t o those d i s c u s s e d have r e c e n t l y been addressed by Reynolds e t a l . (1987) who, i n r e f e r r i n g t o the i d e n t i f i c a t i o n and placement of c h i l d r e n i n t o s p e c i a l e d u c a t i o n c l a s s e s , suggested t h a t t h r e e f o u r t h s of such placements were i n a p p r o p r i a t e , having been based on f a u l t y t e s t i n t e r p r e t a t i o n and/or c l i n i c a l judgement, wi t h t h e i r o n l y t r u e handicapping c o n d i t i o n being t h a t of a "judgmental handicap." 65 I t must be r e c o g n i z e d t h a t the e f f i c a c y of e d u c a t i o n a l placements made i s not the concern i n these s t u d i e s . That was the p o i n t made by Ysseldyke e t a l . (1983) i n t h e i r c o u n t e r - p r o p o s a l t o the U.S. f e d e r a l i n i t i a t i v e c a l l i n g f o r programme e f f i c a c y s t u d i e s . Rather, these s t u d i e s were examining the f i r s t c r i t i c a l s tep i n programme e f f i c a c y -the s e l e c t i o n of i n d i v i d u a l s t o be p l a c e d . In each case, what was be i n g c o n s i d e r e d was the accuracy of placement d e c i s i o n s based on an e s t a b l i s h e d s e l e c t i o n c r i t e r i a . In the case of M/EMH students t h a t was the tw o - f a c t o r d i a g n o s t i c model as s p e c i f i e d i n law and i n best p r a c t i c e s . C o n f i r m a t i o n o f Placements U s i n g the Two-Factor Model C h i l d s (1982) s t u d i e d a random sample of 50 students between the ages o f f i v e and e i g h t who were e n r o l l e d i n programmes f o r M/EMH students i n the Rocky Mountain Region of the U n i t e d S t a t e s . C h i l d s noted t h a t , although PL94-142, b e s t p r a c t i c e s , and p r o f e s s i o n a l o r g a n i z a t i o n s a l l c l e a r l y c a l l e d f o r the use of the two-factor d i a g n o s t i c model f o r mental handicap, c a r e f u l a n a l y s i s of the adapt i v e behavior of c h i l d r e n e n r o l l e d i n s p e c i a l c l a s s programmes f o r M/EMH students had not taken p l a c e . The author demonstrated t h a t between 1974 and 1978 on l y 5.3% of r e s e a r c h s t u d i e s i n c l u d e d both a d a p t i v e behavior and i n t e l l i g e n c e f o r deter m i n i n g mental handicap. Furthermore, he noted t h a t o f 41 s t a t e s 66 r e p o r t i n g i n 1980, o n l y 15 i n c l u d e d a d a p t i v e behavior i n t h e i r s t a t e d e f i n i t i o n of mental handicap. C h i l d s notes, " s i n c e the i n c l u s i o n of ad a p t i v e behavior i n the d e t e r m i n a t i o n of mental r e t a r d a t i o n has been e s t a b l i s h e d as a necessary c o n s i d e r a t i o n . . . ( i t i s necessary) ...to examine the adapt i v e behavior of educable m e n t a l l y r e t a r d e d c h i l d r e n and i t s r e l a t i o n s h i p t o the d i a g n o s i s o f mental r e t a r d a t i o n as a two-dimensional concept" (p.109). C h i l d s i n t e r v i e w e d the parents of a l l f i f t y s u b j e c t s , and a d m i n i s t e r e d t o them the Adaptive Behavior Inventory f o r C h i l d r e n (ABIC). A 2 x 3 x 3 x 2 f a c t o r i a l ANOVA d e s i g n i n c o r p o r a t i n g the independent v a r i a b l e s of sex, r a c e , IQ, and placement was performed. The c r i t e r i o n f o r a student having s i g n i f i c a n t l y impaired a d a p t i v e behavior was s e t i n accordance w i t h g e n e r a l l y accepted p r a c t i c e a t the t h i r d p e r c e n t i l e . C h i l d s found t h a t there was a r e l a t i o n s h i p between IQ sc o r e s and ABIC s c o r e s , with decreases i n one being a s s o c i a t e d w i t h decreases i n the o t h e r . However, of the 50 c h i l d r e n , a l l of whom had been o f f i c i a l l y diagnosed and p l a c e d as M/EMH, o n l y ten c o u l d be confirmed i n t h a t placement when ad a p t i v e behavior was used as a necessary and equal c o - f a c t o r with IQ, as i m p l i c i t i n the tw o - f a c t o r 67 d i a g n o s t i c model. Thus, o v e r a l l , on the a p p l i c a t i o n of the tw o - f a c t o r model, 80% of the students s t u d i e d c o u l d be s a i d t o have been i n c o r r e c t l y p l a c e d . Furthermore, when students from m i n o r i t y group backgrounds were examined s e p a r a t e l y , the misplacement r a t e was found t o be even h i g h e r , w i t h 88% not b e i n g c o n f i r m a b l e as M/EMH u s i n g the t w o - f a c t o r d i a g n o s t i c model. In h i s d i s c u s s i o n of these r e s u l t s , C h i l d s r a i s e d two q u e s t i o n s : f i r s t , was the use of a c u t - o f f s c o r e of the t h i r d p e r c e n t i l e f o r adaptive behavior too hig h , and thus r e s p o n s i b l e f o r the h i g h misplacement r a t e s found; and, secondly, what would be the e f f e c t s o f d e c l a s s i f y i n g up t o 80% of the t o t a l M/EMH p o p u l a t i o n i f these r e s u l t s a c c u r a t e l y r e f l e c t c o n d i t i o n s w i t h i n M/EMH c l a s s e s i n gen e r a l ? Other q u e s t i o n s not addressed by C h i l d s , emerge from h i s study. Given the ages of the c h i l d r e n s t u d i e d , and the date of the r e s e a r c h (data c o l l e c t i o n o c c u r r e d i n 1980), each of these c h i l d r e n should have been p l a c e d u s i n g a two-f a c t o r d i a g n o s t i c model as mandated by PL94-142 and i r r e s p e c t i v e of s t a t e d e f i n i t i o n s of M/EMH. I f t h a t were the case, d i d t h e i r a d a p t i v e behaviour s c o r e s improved markedly s i n c e t h e i r e nrollment, or, were such t e s t s not g i v e n i n o r i g i n a l l y p l a c i n g the c h i l d r e n ? I f they were 68 g i v e n , were they were ignored or not weighted e q u a l l y w i t h IQ-? Summary of Three S t u d i e s Given the comments by Ysseldyke e t a l . (1983) t h a t "placement d e c i s i o n s made by teams of i n d i v i d u a l s have very l i t t l e t o do w i t h the data c o l l e c t e d on s t u d e n t s " (p. 78), and t h a t of Knoff (1984) t h a t the i n t e r a c t i o n between a v a i l a b l e psychometric i n f o r m a t i o n , p a r t i c u l a r l y IQ and a d a p t i v e behavior i n f o r m a t i o n , i s complex and can have a marked e f f e c t on sound e d u c a t i o n a l p l a n n i n g (p. 127), i t i s s u r p r i s i n g t h a t C h i l d s d i d not draw g r e a t e r a t t e n t i o n t o the r o l e a d a p t i v e b e h a v i o r data p l a y e d i n i n a p p r o p r i a t e l y l a b e l l i n g and p l a c i n g the c h i l d r e n i n h i s sample. Knoff c l e a r l y r e c o g n i z e s the p o t e n t i a l f o r the IQ - a d a p t i v e b e h a v i o r i n t e r a c t i o n b e i n g r e s p o n s i b l e f o r i n a p p r o p r i a t e placements i n t o s p e c i a l c l a s s e s . Future r e s e a r c h should continue t o document the i n t e r a c t i o n between assessment data and s p e c i a l e d u c a t i o n placement d e c i s i o n s ...the i n t e r a c t i o n between the i n f l u e n c e of IQ and a d a p t i v e behavior data and the s i g n i f i c a n t determinants and d e f i n i t i o n s of mental r e t a r d a t i o n . (Knoff, 1984; p. 127) Although K n o f f s 1984 study c l e a r l y c a l l s f o r f u r t h e r study of the i n t e r a c t i o n between IQ and a d a p t i v e behavior, 69 i t i s o n l y i n the l a s t few years t h a t such a c a l l has been responded t o . T h i s response comes not i n the form of new s t u d i e s i n t h i s area, but i n a vi g o r o u s c a l l f o r new s t u d i e s . MacMillan (1988), f o r example, notes t h a t the concerns about M/EMH students t h a t were r a i s e d a t the time of the Diana and L a r r y P. cases have not been r e s o l v e d , "the concerns over . . . t h e i r e d u c a t i o n r a i s e d i n the 1960s and 1970s are every b i t as v a l i d today" (p. 282). S i m i l a r l y , R e s chly (1988) i n r e f e r r i n g t o the l a s t 20 years of assessment and placement i s s u e s surrounding M/EMH students notes t h a t these i s s u e s are s t i l l " u n r e solved" (p. 285). Recent concerns about the r o l e of academic achievement i n the measurement of adapt i v e behaviour i s another i s s u e t h a t s h o u l d be addressed. Although a g e n e r a l l y accepted d e f i n i t i o n of a d a p t i v e behaviour has been g i v e n (Grossman, 1983, p.11), t h e r e i s s t i l l c o n s i d e r a b l e debate i n the l i t e r a t u r e w i t h r e s p e c t t o academic achievement as a component of ad a p t i v e behaviour (Reschly, 1988; Reschly & Gresham, 1987; Reschly, 1982). Reschly (1988) has argued c o n v i n c i n g l y t h a t s i n c e academic performance i s an i n t e g r a l p a r t of the s o c i a l domain of s c h o o l s , and s i n c e weaknesses i n academic performance are o f t e n the t r i g g e r f o r a s c h o o l r e f e r r i n g a c h i l d f o r placement c o n s i d e r a t i o n , i t i s a p p r o p r i a t e t o i n c l u d e measures o f academic performance 7 0 w i t h i n the e v a l u a t i o n of a d a p t i v e behaviour. Reschly s t a t e s , Perhaps the most important i s s u e here ( i n d e c i d i n g what t o i n c l u d e w i t h i n a measure of s o c i a l a d a p t a t i o n ) i s whether or not the domain f u n c t i o n a l academic s k i l l s i s i n c l u d e d , and i t i s i n t h i s area t h a t the most disagreement appears t o occur. I have argued t h a t f u n c t i o n a l academic s k i l l s should be i n c l u d e d as a p a r t of the c o n c e p t i o n of a d a p t i v e b ehavior. I t i s a c r i t i c a l domain f o r s c h o o l age c h i l d r e n and youth. I n c l u s i o n of t h i s domain i s c o n s i s t e n t with AAMR c l a s s i f i c a t i o n . (1988, p. 291) An examination of the l i t e r a t u r e on the development of measures of a d a p t i v e behavior does not r e v e a l a defense f o r the e x c l u s i o n of achievement as an a d a p t i v e domain. Rather i t would appear t h a t s i n c e many w e l l s t a n d a r d i z e d i n d i v i d u a l i z e d achievement t e s t s are a v a i l a b l e , the producers of a d a p t i v e measures have l e f t t h a t domain alone, or i f they have i n c l u d e d i t , i t has been d e a l t with i n a v e r y a b b r e v i a t e d manner. T h i s may be a w e l l i n t e n t i o n e d e f f o r t not t o compete with e x i s t i n g achievement t e s t s , but has the e f f e c t of e l i m i n a t i n g achievement i n f o r m a t i o n as a p a r t of a d a p t a t i o n t o the s c h o o l environment as f a r as the t w o - f a c t o r model i s concerned. 71 In an examination of the most commonly used measures of a d a p t i v e behavior, i t i s noted t h a t the m a j o r i t y do not i n c l u d e a b a s i c r e a d i n g and a r i t h m e t i c component, while those few t h a t do ( i e . the Comprehensive T e s t s of Adaptive Behavior (CTAB) i n c l u d e o n l y b r i e f t e s t s . R eschly's argument t h a t s i n c e a primary b u s i n e s s of s c h o o l i n g i s the t e a c h i n g of academics, and t h a t weaknesses i n academics o f t e n serve as t r i g g e r s f o r r e f e r r a l s t o s p e c i a l c l a s s placement, i s c o m p e l l i n g . T h i s author i s c h o o s i n g to f o l l o w these arguments and to i n c l u d e t e s t i n g of academic s k i l l s i n the r e s e a r c h d e s i g n . Chapter Summary T h i s c h a p t e r t r a c e d the development of the d e f i n i t i o n o f mental handicap from the b e g i n n i n g of the 19th c e n t u r y up t o the p r e s e n t w i t h s p e c i a l r e f e r e n c e t o the r e l a t i v e r o l e s t h a t IQ and a d a p t i v e behavior have p l a y e d i n t h a t development. In the 19th c e n t u r y I t a r d , Sequin, and V o i s i n a l l gave primacy of p l a c e t o d e f i c i t s i n s o c i a l a d a p t a t i o n , with l a c k o f g e n e r a l c o g n i t i v e a b i l i t y b e i n g an important but secondary c o n s i d e r a t i o n . I t was demonstrated t h a t although A l f r e d B i n e t (1910), the " f a t h e r of IQ t e s t s " was a s t r o n g proponent of the r o l e of s o c i a l a d a p t a t i o n i n a d e f i n i t i o n o f mental handicap, the widespread use of i n t e l l i g e n c e t e s t s 72 by p s y c h o l o g i s t s r e s u l t e d i n a d i m i n u t i o n of the r o l e of a d a p t i v e behavior as an important f a c t o r i n d i a g n o s i n g a mental handicap. Beginning with T r e d g o l d (1937) and D o l l (1941), authors began t o c a l l f o r a r e t u r n to e s t a b l i s h i n g d e f i c i t s i n measured a d a p t i v e behavior as a c o - f a c t o r w i t h g e n e r a l i n t e l l i g e n c e i n d e f i n i n g a mental handicap. The e f f o r t s of these authors, and l a t e r of Mercer (1972) t o c l e a r l y r e -e s t a b l i s h i n c l u s i o n of a d a p t i v e behavior was met with some s c e p t i c i s m and even r i d i c u l e , with opponents viewing c o n s i d e r a t i o n of s o c i a l a d a p t a t i o n as being u n s c i e n t i f i c . By the e a r l y 1970s c o u r t a c t i o n s i n the U n i t e d S t a t e s r e s u l t e d i n renewed i n t e r e s t i n s o c i a l a d a p t a t i o n . In 1975, the U n i t e d S t a t e s f e d e r a l government passed PL94-142, an e d u c a t i o n a l law which r e s t r i c t e d the r o l e of IQ t e s t s i n l a b e l l i n g e x c e p t i o n a l c h i l d r e n and which c l e a r l y demanded a t w o - f a c t o r d i a g n o s t i c model f o r M/EMH. T h i s t w o - f a c t o r model i s now the w i d e l y accepted i n t e r n a t i o n a l standard f o r the i d e n t i f i c a t i o n of mental handicap. In Canada, a d i f f e r e n t c o n s t i t u t i o n a l s t r u c t u r e and l e g a l t r a d i t i o n has i n h i b i t e d more r a p i d development of s p e c i a l e d u c a t i o n p r a c t i c e . The r e c e n t adoption of s e c t i o n 15 of the Canadian Charter of R i g h t s and Freedoms makes c h a l l e n g e s to d i a g n o s t i c and placement p r a c t i c e s a t the 73 n a t i o n a l l e v e l a p o s s i b i l i t y , with comparisons t o the standards of U.S. PL94-142 being a l i k e l y b a s i s f o r such c h a l l e n g e s . Three r e s e a r c h s t u d i e s conducted i n the l a s t e i g h t years were examined. The r e s u l t s of a f i v e year study by Ysseldkye e t a l . (1983) l e d t o the c o n c l u s i o n t h a t c h i l d r e n are r e f e r r e d f o r c o n s i d e r a t i o n as s p e c i a l e d u c a t i o n c a n d i d a t e s f o r reasons t h a t o f t e n have n o t h i n g to do with the programmes i n which they are u l t i m a t e l y p l a c e d . Behaviours i r r i t a t i n g t o classroom t e a c h e r s appear t o be the most common reasons f o r r e f e r r i n g c h i l d r e n f o r psycho-e d u c a t i o n a l e v a l u a t i o n . The authors r e p o r t t h a t once a r e f e r r a l i s made, d i a g n o s t i c teams w i l l tend t o c o n f i r m placements based on q u e s t i o n a b l e c l i n i c a l judgements. Knoff (1984) i n v e s t i g a t e d the way i n which p s y c h o e d u c a t i o n a l i n f o r m a t i o n e f f e c t s placement d e c i s i o n s . He found t h a t , although both IQ and ada p t i v e behavior data were of importance i n determ i n i n g c l a s s i f i c a t i o n as M/EMH, IQ s c o r e s had s i g n i f i c a n t l y more power i n swaying d e c i s i o n making than d i d adapt i v e behavior, and t h a t the order i n which t e s t i n f o r m a t i o n was presented was of importance i n det e r m i n i n g placement outcomes. C h i l d s , (1982) i n examining the adapt i v e behavior p r o f i l e s of elementary aged students e n r o l l e d i n M/EMH 74 programmes found evidence t h a t although a t w o - f a c t o r model of d i a g n o s i s should have been used i n p l a c i n g c h i l d r e n , the a p p l i c a t i o n of t h a t same two f a c t o r model a f t e r placement r e s u l t e d i n very h i g h (80% - 88%) d e c l a s s i f i c a t i o n r a t e s . The l i t e r a t u r e reviewed demonstrated t h a t the use of a two- f a c t o r d i a g n o s t i c model has been c a l l e d f o r f o r almost 200 y e a r s . In t h i s century, IQ t e s t s c o r e s have tended t o overshadow concerns f o r measured adap t i v e behavior, and even though l e g i s l a t i o n and bes t p r a c t i c e s now c l e a r l y demand the use of IQ and measured s o c i a l a d a p t a t i o n as equal co-f a c t o r s , IQ s c o r e s s t i l l tend t o dominate placement d e c i s i o n making. Although t h e r e i s much evidence t o suggest t h a t the d i a g n o s t i c and placement p r o c e s s , from classroom t e a c h e r r e f e r r a l t o the p s y c h o l o g i s t ' s c l i n i c a l judgement, i s s e r i o u s l y flawed, t h a t i s not grounds f o r abandoning study of t h a t p r o c e s s . Great e f f o r t has been expended t o develop d i a g n o s t i c models t o make the placement process f a i r and e f f e c t i v e . The problem appears t o be a tendency w i t h i n the system t h a t a d m i n i s t e r s t h a t model t o subvert i t s i n t e n t . 75 Chapter 3 Methodology This chapter describes s p e c i f i c procedures for c o l l e c t i n g and analyzing the data. This description i s divided into f i v e major sections: (1) Design, (2) Testing Procedures, (3) Data Co l l e c t i o n , (4) Data Preparation, and (5) data analysis procedures. Design Subjects Students who had been referred for consideration as Mildly/Educably Mentally Handicapped (M/EMH) i n two Metro Vancouver school d i s t r i c t s since May 15, 1987 and who were s t i l l e n rolled at the elementary school l e v e l at the time of data c o l l e c t i o n ( A p r i l 15 - May 26, 1989) served as subjects. The r e s t r i c t i o n to current elementary school enrollment ensured that the BC Quick Individual Educational Test (BC QUIET), which i s designed for use with elementary school students only, could be used with a l l subjects. Selection of Subjects After obtaining appropriate permission from the University of B r i t i s h Columbia and the superintendents of the two school d i s t r i c t s , subject selection procedures were undertaken. Because of differences i n record-keeping p r a c t i c e s i n the two sch o o l d i s t r i c t s , somewhat d i f f e r e n t s e l e c t i o n procedures were r e q u i r e d i n each d i s t r i c t . D i s t r i c t 1. In D i s t r i c t 1, each s c h o o l p s y c h o l o g i s t (n = 7) i s r e q u i r e d t o keep a case l o g (see Appendix A). As new r e f e r r a l forms are r e c e i v e d by the p s y c h o l o g i s t (see Appendix B), r e f e r r a l i n f o r m a t i o n i s perused and an i n i t i a l s u s p i c i o n of p o s s i b l e p r e s e n t i n g problem (M/EMH, Behaviour D i s o r d e r e d , e t c . ) i s made. Where more than one problem i s suspected, they are l i s t e d i n descending o r d e r based on the s u s p i c i o n of t h e i r c o n t r i b u t i o n to the student's d i f f i c u l t i e s . For example, i n rev i e w i n g the r e f e r r a l of a s u b j e c t , the p s y c h o l o g i s t may note f a c t o r s l e a d i n g t o the s u s p i c i o n t h a t the primary p r e s e n t i n g problem i s a M i l d Mental Handicap, w h i l e a Behaviour Problem i s a secondary f a c t o r . In D i s t r i c t 1, the case l o g s are sent t o the c e n t r a l o f f i c e approximately every three months where they are en t e r e d i n t o a computer f i l e . In t h i s d i s t r i c t , a p r i n t o u t of a l l r e f e r r a l s logged s i n c e May 15, 1987 was o b t a i n e d . The names of s u b j e c t s f o r whom the primary s u s p i c i o n was t h a t of a mental handicap (there were none f o r whom s u s p i c i o n of a mental handicap was a secondary s u s p i c i o n ) were then taken from t h i s l i s t . Using the c e n t r a l o f f i c e computer, the names of s u b j e c t s s e l e c t e d were t r a c k e d , and 77 l i s t s of those currently placed i n M/EMH classes ( n = 28) and not placed i n M/EMH classes ( n = 22) were compiled. I t was found that of students o r i g i n a l l y suspected as being M/EMH, 12 were not available for inclusion either because they had moved into d i s t r i c t secondary schools (n = 4) or because they had moved out of the d i s t r i c t (n = 8) (see Table 1). D i s t r i c t 2. In D i s t r i c t 2, case logs l i k e those found i n D i s t r i c t 1 are not used. In t h i s d i s t r i c t , each psychologist (n = 9) receives r e f e r r a l forms (see Appendix C) through the central special education o f f i c e , and proceeds with the r e f e r r a l without a formal r e g i s t r a t i o n of suspicion. Although the l i s t of subjects a c t u a l l y placed into M/EMH classes since May 15, 1987 was ava i l a b l e , there was no record of i n i t i a l suspicions. However, i n discussions with the D i s t r i c t P r i n c i p a l i n charge of Special Education and a former d i s t r i c t psychologist now working i n the D i s t r i c t Research Department, i t was determined that i t would be possible to estab l i s h i n i t i a l suspicions. A l l r e f e r r a l s to the school psychologists over the target time period (n = 1412) were f i l e d i n the d i s t r i c t s p e c i a l education o f f i c e . Using information contained on the r e f e r r a l s , the following c r i t e r i a for e s t a b l i s h i n g suspicion of M/EMH were agreed upon: (1) Peabody Picture 78 Vocabulary T e s t s c o r e s below the t e n t h p e r c e n t i l e ; (2) ane c d o t a l comments w r i t t e n by the p r i n c i p a l , classroom t e a c h e r and/or l e a r n i n g a s s i s t a n c e teacher i n d i c a t i n g concerns about mental handicap, low a b i l i t y , or need f o r s p e c i a l c l a s s placement because of l a c k of academic p r o g r e s s ; and (3) where r e f e r r a l forms c o n t a i n e d Wechsler I n t e l l i g e n c e T e s t s c o r e s (n = 205, 14.5%), a F u l l S c a l e IQ of l e s s than 80. A l l of the above c r i t e r i a had t o be met f o r a student t o be suspected as M/EMH. Where o n l y p a r t i a l i n f o r m a t i o n was a v a i l a b l e (n = 1207, 85.5%), any two of the th r e e c r i t e r i a had t o be met. In no cases was i n f o r m a t i o n from l e s s than two of the c r i t e r i a a v a i l a b l e . In d i s c u s s i o n s w i t h the D i r e c t o r of S p e c i a l E d u c a t i o n Programmes and a p s y c h o l o g i s t i n D i s t r i c t 1, t h i s procedure was found t o p a r a l l e l t h a t used by D i s t r i c t 1 p s y c h o l o g i s t s when f i l l i n g i n t h e i r case l o g s . Of the 1412 r e f e r r a l s made i n D i s t r i c t 2, 155 (10.9%) were c l a s s i f i e d as suspected M/EMH u s i n g the above c r i t e r i a . To c o n f i r m the s e l e c t i o n of these s u b j e c t s as l e g i t i m a t e l y s u spected M/EMH, an i n t e r - r a t e r r e l i a b i l i t y study was conducted. A random sample of 40 r e f e r r a l forms, which had been i n i t i a l l y c l a s s i f i e d as suspected M/EMH, were mixed wit h a random sample of 40 r e f e r r a l forms which had not been i n i t i a l l y c l a s s i f i e d as suspected M/EMH. A s c h o o l 7 9 psychologist with three years experience i n D i s t r i c t 2 volunteered to sort the forms into two groups: suspected M/EMH and not suspected M/EMH. After the sort was completed, the i n t e r - r a t e r agreement was calculated. The re s u l t s were as follows: agreement between rater 1 (researcher) and rater 2 (psychologist) was 95.0% (n = 76). Of the cases where disagreement occurred (n - 4), two occurred when rater 1 l i s t e d a c h i l d as suspected M/EMH and rater 2 disagreed, and two occurred where rater 1 l i s t e d a c h i l d as not suspected M/EMH and rater 2 disagreed. This l e v e l of agreement was considered high enough that a l l of the subjects i n i t i a l l y i d e n t i f i e d as suspected M/EMH were retained. Following i d e n t i f i c a t i o n of suspected M/EMH students, a search was made of a l l current special education l i s t s i n D i s t r i c t 2 to determine which of the suspected M/EMH subjects were s t i l l enrolled i n elementary l e v e l M/EMH classes i n the d i s t r i c t . For those subjects not enrolled, the following procedure was used: the p r i n c i p a l or secretary of the school from which the r e f e r r a l to a psychologist form was o r i g i n a l l y received was contacted. If the student was s t i l l e nrolled i n that school that information was recorded. If the subject was no longer enrolled, the school was asked to check t h e i r records to determine where the c h i l d had 80 t r a n s f e r r e d t o . I f the c h i l d had t r a n s f e r r e d out of the d i s t r i c t (n = 19), or i f they had moved t o a d i s t r i c t secondary s c h o o l (n = 3), t h e i r name was d e l e t e d from the l i s t of p o s s i b l e s u b j e c t s . I f they had t r a n s f e r r e d w i t h i n D i s t r i c t 2, the sc h o o l t o which they had t r a n s f e r r e d was co n t a c t e d . In 12 i n s t a n c e s , m u l t i p l e moves w i t h i n the d i s t r i c t were checked t o l o c a t e the s u b j e c t . For the purposes of t h i s study, f i n a l i d e n t i f i c a t i o n of M/EMH students was made by checking d i s t r i c t r e c o r d s t o v e r i f y t h a t students were r e c e i v i n g M/EMH fundi n g from the M i n i s t r y of Edu c a t i o n . T h i s c l a r i f i e d s i t u a t i o n s where students were h e a v i l y i n t e g r a t e d i n t o r e g u l a r c l a s s programmes, and where students were housed i n c l a s s e s t h a t d i d not c a r r y the M/EMH d e s i g n a t i o n , but where the students were so funded. T h i s s i t u a t i o n o c c u r r e d p r i m a r i l y i n D i s t r i c t 1 where s e v e r a l students were l i s t e d as being funded as M/EMH and who indeed met p r o v i n c i a l c r i t e r i a f o r M/EMH, but who were housed i n " n o n - c a t e g o r i c a l " c l a s s e s . For a s u b j e c t t o be co n s i d e r e d non M/EMH , they were not l i s t e d under any s p e c i a l education funding category, (e.g. l e a r n i n g d i s a b l e d , m o d e r a t e l y / t r a i n a b l y m e n t a l l y handicapped), and were e n r o l l e d i n a r e g u l a r e d u c a t i o n classroom. Recruitment of Schools and Students After the i d e n t i f i c a t i o n of subjects for in c l u s i o n i n the study, l i s t s of involved schools were drawn up, and a l e t t e r was sent to the p r i n c i p a l of each school (see Appendix D). A l l p r i n c i p a l s agreed to p a r t i c i p a t e i n the study. Upon receipt of p r i n c i p a l approval, l e t t e r s to be forwarded by the school p r i n c i p a l s to the parents/guardians of each subject were sent to the schools. Letters contained a description of the study and sought permission from the parents for i n c l u s i o n of t h e i r c h i l d i n the study (see Appendix E). Table 1 indicates the number of students i d e n t i f i e d i n each of the d i s t r i c t s , available for t e s t i n g , receiving parental consent, and excluded through i l l n e s s or unwillingness to pa r t i c i p a t e both by group (M/EMH and regular education) and for the t o t a l sample. Testing Procedures Test Selection C r i t e r i a Tests were selected on the basis of two c r i t e r i a : (1) that they possess adequate r e l i a b i l i t y and v a l i d i t y , and (2) that they be commonly administered i n the diagnosis of M/EMH. The following tests were selected: Table 1 Recruitment of Subjects D i s t r i c t 1 D i s t r i c t 2 Total M/EMHa REGED M/EMH REGED M/EMH REGED Number of students i d e n t i f i e d 28 27 55 50 83 77 Number of students moved out of d i s t . or to secondary 7 5 12 10 19 15 No parental consent 1 4 5 7 6 11 Number of available students 20 18 38 33 58 51 Number of students absent or refused to p a r t i c i p a t e 1 0 0 2 1 2 Subjects tested 19 18 38 31 57 49 % of available 95.0 100 .0 100.0 93.9 98 . 3 96.1 a. Mildly/Educably Mentally Handicapped b. Regular Education 83 Vineland Adaptive Behavior Scales (VABS); BC Quick Individual Educational Test (BC QUIET); Wechsler Intelligence Scale for Children - Revised (WISC-R); Pure Tone Audiometric Test (PTAT); and the Snellen Visual Acuity Test (Schnellen) plus observations of v i s u a l anomalies. Vineland Adaptive Behavior Scales The Vineland Adaptive Behavior Scales (VABS) (Sparrow, B a l l a , & C i c c h e t t i , 1984) i s reported as being a useful instrument for screening and c l a s s i f i c a t i o n decisions, and i s described by Campbell (1985) as "one of the best o v e r a l l measures of adaptive behavior" (p. 1214). S p l i t - h a l f r e l i a b i l i t i e s f o r the Adaptive Behavior Composite are reported as ranging from .89 to .98, with a median value of .86, while t e s t - r e t e s t and in t e r r a t e r r e l i a b i l i t y c o e f f i c i e n t s are reported as .99 and .98, respectively. In t h e i r recent Canada-wide study, Carter and Rogers (1988) found that the VABS i s the most commonly used te s t of adaptive behaviour i n Canada (p. 17). The VABS i s a recent r e v i s i o n of the Vineland Social Maturity Scale, f i r s t developed by Doll (1935). I t i s organized around four behavioural domains: Communication, Daily L i v i n g S k i l l s , S o c i a l i z a t i o n , and Motor S k i l l s . 84 Within each behavioural domain the te s t u t i l i z e s a developmental schedule to provide an outline of de t a i l e d performances with respect to the a b i l i t y of an in d i v i d u a l to assume r e s p o n s i b i l i t y and look after t h e i r p r a c t i c a l needs within that domain. Items within each domain are arranged i n order of ascending d i f f i c u l t y , and as such provide a basis for some task analysis and programme planning. The instrument i s administered through an interview with a person f a m i l i a r with the subject (often the classroom teacher) following procedures l a i d out i n the administration and scoring manual. Total t e s t scores are reported as an o v e r a l l composite Social Age (SA) and Social Quotient (SQ). Depending upon the subject, from 20 to 60 minutes are required for administration. In addition to the ov e r a l l t e s t composite score and domain scores, an additional subtest of maladaptive behavior i s included i n the VABS. The Maladaptive Domain i s described by the authors as "descriptive categories that indicate the frequency of maladaptive behaviors" (p. 23). The respondent i s asked to indicate whether a series of described maladaptive behaviours are usually, occasionally, or never observed i n the c h i l d . This subtest does not form part of any of the previously discussed four domain scores or the o v e r a l l t e s t composite score. The Maladaptive domain 85 i s broken i n t o two p a r t s . P a r t one c o n t a i n s 27 items a d d r e s s i n g l e s s severe maladaption such as thumb suc k i n g , over a c t i v i t y , temper tantrums (Sparrow e t a l . , p. 24) while p a r t two c o n t a i n s nine items measuring more severe maladaption "seldom e x h i b i t e d by non-handicapped i n d i v i d u a l s " (Sparrow, e t a l . , p. 24). These i n c l u d e p u b l i c masturbation, s e l f i n j u r y , r o c k i n g , and other r i t u a l i z e d b ehaviours (Sparrow, e t a l . , 1984, p. 296). These behaviours are more u s u a l l y a s s o c i a t e d with s e v e r e l y and p r o f o u n d l y m e n t a l l y handicapped, a u t i s t i c , and s e v e r e l y behaviour d i s o r d e r e d students ( C l e l a n d , 1978; Gearheart & L i t t o n , 1979; Hal l a h a n & Kauffmann, 1988). Only the scores o b t a i n e d from p a r t one of the Maladaption s u b t e s t are compared t o the n a t i o n a l s t a n d a r d i z a t i o n sample used f o r the development of the VABS. Separate norms based on more s e v e r e l y d i s a b l e d s u b j e c t s are pr o v i d e d f o r p a r t two. The t o t a l s c o r e f o r p a r t one of the maladaptive domain i s compared a g a i n s t the norms f o r ten age groups (from c h r o n o l o g i c a l age 5 - 0 t o 18 - 11) and the degree of maladaption i s c a t e g o r i z e d as e i t h e r n o n s i g n i f i c a n t ( p e r c e n t i l e rank < 50), i n t e r m e d i a t e l y s i g n i f i c a n t ( p e r c e n t i l e rank 51 - 84), or s i g n i f i c a n t ( p e r c e n t i l e rank 85 and above). The r e l i a b i l i t i e s of the Maladaptive Domain, p a r t one, u s i n g both s p l i t - h a l f and t e s t - r e t e s t r e l i a b i l i t y e s t i m a t e s are s i m i l a r t o those f o r the other Domain s c o r e s , w i t h the Maladaptive Domain c o e f f i c i e n t s r a n g i n g from .77 to .88 and a median va l u e of .86. That the maladaptive domain i s not i n c l u d e d i n the c a l c u l a t i o n of the V i n e l a n d Adaptive Behavior Composite score i s i n d i c a t i v e of the o v e r a l l c o n s t r u c t of s o c i a l a d a p t a t i o n u t i l i z e d both i n t h i s instrument and as d e s c r i b e d i n the l i t e r a t u r e (Grossman, 1983; Mercer, 1973; Langone, 1986). However, d e s p i t e i t s l i m i t a t i o n s the d e c i s i o n was taken to i n c l u d e the a d m i n i s t r a t i o n of p a r t one of the Maladaptive s c a l e i n t h i s r e s e a r c h , p a r t i c u l a r l y as i t might r e f l e c t on the concerns r a i s e d i n the l i t e r a t u r e with r e s p e c t to the r o l e t h a t i d i o s y n c r a t i c student behaviour p l a y s i n i n i t i a t i n g t e a c h e r r e f e r r a l s . B r i t i s h Columbia Quick I n d i v i d u a l i z e d E d u c a t i o n a l T e s t A f t e r comparison wi t h s e v e r a l other commonly used i n d i v i d u a l i z e d achievement t e s t s (the Woodcock-Johnson Ps y c h o e d u c a t i o n a l B a t t e r y - P a r t I I , Peabody I n d i v i d u a l Achievement T e s t , Woodcock Reading Mastery T e s t s , KeyMath D i a g n o s t i c A r i t h m e t i c T e s t ) , the B r i t i s h Columbia Quick I n d i v i d u a l E d u c a t i o n a l T e s t (BC QUIET) (Wormeli, 1984) was found t o s a t i s f y most c l o s e l y the t e s t s e l e c t i o n c r i t e r i a . The BC QUIET was developed as an i n d i v i d u a l l y a d m i n i s t e r e d , s t a n d a r d i z e d s c r e e n i n g instrument f o r use w i t h c h i l d r e n i n S 7 grades one t o seven. I t i n c l u d e s measures of achievement i n r e a d i n g (with separate s u b - t e s t s f o r word i d e n t i f i c a t i o n and passage comprehension), a r i t h m e t i c , and s p e l l i n g , but does not r e p o r t a t e s t composite s c o r e . The passage comprehension s u b - t e s t i s not a d m i n i s t e r e d t o grade one s t u d e n t s . The BC QUIET i s based on c u r r i c u l u m and m a t e r i a l s i n g e n e r a l use i n the p r o v i n c e of B.C. (Wormeli, 1984, p. 9) . A d m i n i s t r a t i o n time f o r t h i s t e s t ranges from 20 to 45 minutes. I n t e r n a l c o n s i s t e n c y r e l i a b i l i t y f o r the v a r i o u s s u b - t e s t s u s i n g a s p l i t - h a l f technique i s r e p o r t e d as r a n g i n g from .68 t o .97, with a median va l u e of .86, comparing f a v o u r a b l y with other achievement t e s t instruments c o n s i d e r e d . E m p i r i c a l v a l i d a t i o n of the BC QUIET u s i n g d i s c r i m i n a n t f u n c t i o n a n a l y s i s demonstrated t h a t "the BC QUIET e f f e c t i v e l y d i s c r i m i n a t e s p u p i l s who r e q u i r e remedial s e r v i c e s from those who do not" (Wormeli, 1984, p. 133). F i n a l l y , the BC QUIET i s the o n l y a v a i l a b l e s t a n d a r d i z e d achievement t e s t based on B r i t i s h Columbia c u r r i c u l a . Wechsler I n t e l l i g e n c e S c a l e f o r C h i l d r e n - Revised The WISC-R (Wechsler, 1974) was found to possess e x c e l l e n t r e l i a b i l i t y and v a l i d i t y (Bortner, 1985; Detterman, 1985; W i t t , 1985), and i s c l e a r l y the most commonly used instrument f o r the purpose of M/EMH placement i n Canada ( C a r t e r & Rogers, 1988, p. 17). 88 The WISC-R i s a s t a n d a r d i z e d , i n d i v i d u a l l y a d m i n i s t e r e d t e s t o f g l o b a l i n t e l l i g e n c e based on a c o n c e p t u a l i z a t i o n of i n t e l l i g e n c e as a "mu l t i d i m e n s i o n a l and m u l t i f a c e t e d e n t i t y r a t h e r than an independent, u n i q u e l y d e f i n e d t r a i t " (Weschler, 1975, p.5). The WISC-R enjoys prominent s t a t u s among i n d i v i d u a l i n t e l l i g e n c e t e s t s (Bortner, 1985; Dettermann, 1985; W i t t , 1985; ), being d e s c r i b e d by Bortner (1985) as "...the b e s t s t a n d a r d i z e d , most o b j e c t i v e l y a d m i n i s t e r e d and sc o r e d t e s t of i t s k i n d " (p. 1713), and by W i t t (1985) as occupying " a " p o s i t i o n of preeminence i n the t e s t i n g community . . . ( i t i s ) r e c o g n i z e d as the q u i n t e s s e n t i a l t e s t i n g instrument ...the s u b j e c t of l i t e r a l l y thousands of r e s e a r c h s t u d i e s " (p. 1716). I t i s inte n d e d f o r c h i l d r e n between the ages of s i x and seventeen, and produces 12 s u b - t e s t s c o r e s , s i x of which are c l a s s i f i e d as V e r b a l and s i x as Performance. One each of the V e r b a l and Performance s u b - t e s t s ( D i g i t Span and Mazes, r e s p e c t i v e l y ) are o p t i o n a l i n t e s t a d m i n i s t r a t i o n . R e l i a b i l i t y c o e f f i c i e n t s f o r F u l l S c a l e , V e r b a l and Performance s c o r e s are r e p o r t e d as "high ...across the e n t i r e age range, the average c o e f f i c i e n t s being .94, .90, and .96 r e s p e c t i v e l y " (Wechsler, 1974, p. 27). R e l i a b i l i t i e s f o r each of the s u b - t e s t s are h i g h , r a n g i n g 89 from .77 to .86 for the Verbal sub-tests and from .70 to .85 for the Performance sub-tests (Wechsler, 1974, pp. 27-29). Although other tests can and are used with suspected M/EMH students, i t i s clear that the WISC-R i s the t e s t of choice (Detterman, 1985, p. 1715). In Canada, for example, Carter and Rogers (1988) found that i t was the most chosen t e s t instrument for the diagnosis of M/EMH i n 92.2% of reporting school d i s t r i c t s (p. 17). Pure Tone Audiometric Screening; The use of pure tone audiometry as an e f f i c i e n t and e f f e c t i v e means of screening youngsters for hearing problems i s well established (American Academy of Ophthalmology and Otolaryngology, 1972; American Speech & Hearing Association, 1985; Fulton & Lloyd, 1969; Jerger, 1984; Newby & Popelka, 1985). Considerable information can be derived from the s k i l l f u l use of a properly c a l i b r a t e d pure tone audiometer: Pure-tone audiometry provides an index to. the basic functional r e l a t i o n s h i p between a person and his environment i n terms of auditory input and stimulation ...considerable information for the diagnosis of hearing impairments can be obtained from pure-tone data. (Fulton & Lloyd, 1969, p. 1) Although many guidelines for sweep screening c r i t e r i a e x i s t (American Academy of Ophthalmology and Otolaryngology, 9 1969, p. 30; American Speech and Hearing Association, 1975, 1985; Fulton & Lloyd, 1969, p. 2), recent evidence supports the deletion of such t e s t i n g at 500 Hz because of background noise t y p i c a l l y encountered i n school s i t u a t i o n s , and at 4,000 Hz because of a high incidence of f a l s e i d e n t i f i c a t i o n (Newby & Popelka, 1985, p. 284). The p a s s / f a i l c r i t e r i a selected for t h i s study r e f l e c t most c l o s e l y those recommended by Downs (1969) but with the f a i l dB l e v e l raised from 20 to 30 to allow for high l e v e l s of ambient noise experienced while t e s t i n g i n school buildings. In t h i s study auditory sweep screening was performed with a properly c a l i b r a t e d pure tone audiometer using accepted procedures both for machine operation and control of ambient noise (Bess & McConnell, 1981, pp. 51-52; Newby & Popelka, 1985, pp. 116-127). Complete parameters for the p a s s / f a i l c r i t e r i a of the pure tone audiometric t e s t i n g are given i n Chapter 1. Where a subject f a i l e d the f i r s t sweep te s t , a second t e s t was conducted approximately three weeks l a t e r to allow possible interference from colds and middle ear infe c t i o n s to subside. Where such individuals f a i l e d on the second t e s t administration, the school p r i n c i p a l was contacted and advised to inform both the parents and the public health nurse so that appropriate further action could be taken. 91 Snellen Visual Acuity Test The majority of school screening programmes for v i s u a l acuity problems are based on the Snellen t e s t (Rogow, 1988, p. 35) along with observations for other overt v i s u a l anomalies (Harley & Lawrence, 1977, p. 58). Although the Snellen t e s t was developed i n 1862, i t has proved to be as r e l i a b l e as seemingly more sophisticated instruments for the purposes of screening school aged children for v i s u a l defects. Harley and Lawrence (1977) report that i n a t e s t of 1,215 students, each of whom was assessed with the Snellen, Massachusets Vision Test, Telebinocular t e s t , Ortho-Rater, Sight-Screener, and near v i s i o n t e s t , the correlations for distance v i s u a l acuity when compared to ophthalmic findings were highest for the Snellen and the Massachusets V i s i o n Test. Although a v a l i d c r i t i c i s m of the Snellen i s that i t does not address near v i s i o n and other p o t e n t i a l v i s u a l problems, i t remains the most widely used school screening device. It was therefore considered appropriate to u t i l i z e the Snellen as the standardized screening instrument of v i s u a l acuity i n t h i s study. Along with the Snellen Test, measures of overt v i s u a l anomalies were also used. Although the Snellen r e s u l t s formed the measure for the v i s u a l acuity variable, review of the l i t e r a t u r e revealed that best practices demand the 92 r e p o r t i n g of c e r t a i n v i s u a l anomalies even where the S n e l l e n t e s t i s passed. The o b s e r v a t i o n s of v i s u a l anomalies suggested by Ha r l e y and Randal (1977, p. 58) were made f o r each s u b j e c t , and cases of o v e r t v i s u a l anomalies (n = 2) were drawn t o the a t t e n t i o n of the s c h o o l p r i n c i p a l w i t h the recommendation t h a t a r e f e r r a l f o r an o p h t h a l m o l o g i c a l e v a l u a t i o n be made. Data C o l l e c t i o n Examiner T r a i n i n g The author conducted a l l a d m i n i s t r a t i o n s of the WISC-R. The WISC-R r e q u i r e s l e v e l "C" t r a i n i n g (Cronbach, 1970, p. 18) and, i n the case of M/EMH students, experience i n a d m i n i s t r a t i o n with low f u n c t i o n i n g c h i l d r e n . T h i s i n v e s t i g a t o r has both l e v e l "C" t r a i n i n g and s i x years e x p e r i e n c e as a p s y c h o l o g i s t a s s e s s i n g low f u n c t i o n i n g c h i l d r e n w i t h the WISC-R. A d m i n i s t r a t i o n of a l l other t e s t instruments was shared between the author and a l e v e l "B" examiner (Cronbach, 1970, p. 18) t r a i n e d i n the a d m i n i s t r a t i o n and s c o r i n g of these i n s t r u m e n t s . The l e v e l "B" examiner i s a l i c e n s e d B.C. sc h o o l t e a c h e r with experience as a r e s e a r c h a s s i s t a n t . T r a i n i n g i n the a d m i n i s t r a t i o n of the VABS, BC QUIET and S n e l l e n was p r o v i d e d by the r e s e a r c h e r . T r a i n i n g i n the use of the pure tone audiometer was pr o v i d e d by a p r o f e s s o r i n 93 the Department of E d u c a t i o n a l Psychology and S p e c i a l E d u c a t i o n of the U n i v e r s i t y of B r i t i s h Columbia. T e s t A d m i n i s t r a t i o n Before t e s t i n g , each s u b j e c t ' s (n = 106) s c h o o l and d i s t r i c t o f f i c e r e c o r d s were checked t o see whether a WISC-R had been a d m i n i s t e r e d s i n c e May 15, 1987 and whether a BC QUIET had been performed w i t h i n the p r e v i o u s s i x months. The r e s u l t s of 101 WISC-R (95.3%) and 16( 15.1%) BC QUIET a d m i n i s t r a t i o n s were found, u s u a l l y summarized i n a p s y c h o l o g i c a l r e p o r t . In a l l cases, e f f o r t s t o l o c a t e the o r i g i n a l t e s t p r o t o c o l s were made. A t o t a l of 37 WISC-R and te n BC QUIET p r o t o c o l s were found; these p r o t o c o l s were examined f o r e r r o r s i n c a l c u l a t i o n of c h r o n o l o g i c a l age, b a s a l and c e i l i n g c u t - o f f p o i n t s , a d d i t i o n , and c a l c u l a t i o n of d e r i v e d s c o r e s . Of the t h r e e WISC-R p r o t o c o l s found t o c o n t a i n e r r o r s , two co n t a i n e d e r r o r s s u f f i c i e n t t o a l t e r the F u l l S c a l e standard s c o r e s (s.s.) by more than 3 ( e r r o r s of s.s. 4 and 5 r e s p e c t i v e l y ) . As these s c o r e s were those used i n making placement d e c i s i o n s , i t was decid e d t o r e t a i n them, and not t o r e - a d m i n i s t e r the WISC-R t o these s u b j e c t s . In the case of the BC QUIET, no e r r o r s were found among the t e s t p r o t o c o l s reviewed. Each s u b j e c t was a d m i n i s t e r e d the WISC-R (where needed, n = 5), BC QUIET (where needed, n = 90), the Pure Tone Audiometric Sweep T e s t , and the S n e l l e n 94 Visual Acuity Test plus eye function observations (both n = 106). Except for one subject, each subject's teacher was interviewed for the purpose of completing the VABS. In the one instance, the student's classroom teacher refused to be interviewed; the school v i c e - p r i n c i p a l , who was well acquainted with the subject, agreed to be interviewed instead. Data Preparation Scorer r e l i a b i l i t y was checked as follows: 1. The investigator randomly selected 25% of the subjects evaluated by the assistant, and re-scored t e s t protocols and, i n the case of the Snellen and PTAT, re-administered these t e s t s . No errors were found. 2. An independent party checked the addition and conversion to standard scores on a l l WISC-R, VABS, and BC QUIET protocols. Of the f i v e WISC-R te s t s , none were found to contain errors, of the 106 VABS tests administered, 12 (11.3%) were found to contain errors, and of the 90 BC QUIETS, four (4.4%) were found to contain errors. A l l VABS and BC QUIET errors were corrected before data entry. Data Entry A summary information sheet containing a l l t e s t r e s u l t s was maintained for each c h i l d . This sheet was coded to 95 p r o t e c t c o n f i d e n t i a l i t y . The accuracy of t e s t s c o r e t r a n s f e r from t e s t p r o t o c o l s t o the summary sheets was v e r i f i e d by an independent p a r t y . No e r r o r s were found. Data were t r a n s f e r r e d t o a computer f i l e w ith 100% v e r i f i c a t i o n by an independent p a r t y . F i v e e r r o r s were d e t e c t e d and c o r r e c t e d . 'Data A n a l y s i s Procedures The data a n a l y s i s was completed i n fo u r s t a g e s . F i r s t , a s e r i e s of p r e l i m i n a r y analyses were conducted t o determine the c o r r e c t n e s s of forming an achievement composite scor e and o f p o o l i n g data ac r o s s the two d i s t r i c t s . Second, a d e s c r i p t i v e summary of demographic and t e s t i n f o r m a t i o n was compiled f o r the t o t a l sample and by group (M/EMH or non-M/EMH). T h i r d , placement d e c i s i o n s u s i n g IQ and Adaptive Behaviour Composite r e s u l t s and e x i s t i n g t w o - f a c t o r d i a g n o s t i c c r i t e r i a were compared t o a c t u a l placements. L a s t l y , a s e r i e s of d i s c r i m i n a n t f u n c t i o n a n a l y s e s were completed t o study the d i f f e r e n c e s between students l a b e l l e d M/EMH and those not l a b e l l e d with r e s p e c t t o the p r e d i c t o r v a r i a b l e s . D i s c r i m i n a n t f u n c t i o n a n a l y s i s i s a procedure which may be used when the dependent v a r i a b l e c o n s i s t s of one o r more d i s c r e t e groups, i n t h i s case M/EMH or r e g u l a r e d u c a t i o n s t u d e n t s . A n a l y s i s i s made t o determine the v a r i a b l e or combination of v a r i a b l e s ( r e f e r r e d t o as 96 discriminating or predictor variables) which best predict membership i n the groups, with a minimal number of incorrect assignments to those groups (Ferguson, 1981; Klecka, 1980; Tatsuoka, 1970, 1971). Given the sequential nature of the analyses, with the analyses at each step dependent upon the r e s u l t s of the analysis at a preceeding step, a description of the analysis i s provided with the presentation of the r e s u l t s i n the next chapter. Computer Support A l l computer analyses were performed on the AMDAHL 5860 computer maintained by the Computing Sciences D i v i s i o n of the University of B r i t i s h Columbia, using the S t a t i s t i c a l Package for the So c i a l Sciences extended version (SPSS-X) (Nie, 1975). 97 Chapter 4 R e s u l t s T h i s chapter i s d i v i d e d i n t o t h r e e major s e c t i o n s . F i r s t , a s e r i e s of p r e l i m i n a r y analyses are used t o determine the a p p r o p r i a t e n e s s of forming an achievement composite and f o r p o o l i n g the data across d i s t r i c t s . Second, d i f f e r e n c e s between M i l d l y / E d u c a b l y M e n t a l l y Handicapped (M/EMH) and Regular Education students w i t h r e s p e c t t o demographic and t e s t r e s u l t s are examined. F i n a l l y , group membership i s examined i n comparison t o the t w o - f a c t o r d i a g n o s t i c model with c u t - o f f c r i t e r i a s e t t o two p o s s i b l e l e v e l s , and a s e r i e s of d i s c r i m i n a n t f u n c t i o n a n a l y s e s are used t o d i s c o v e r those p r e d i c t o r v a r i a b l e s or combination of p r e d i c t o r v a r i a b l e s which b e s t d e s c r i b e c u r r e n t placement p r a c t i c e w i t h the sample s t u d i e d . P r e l i m i n a r y A n a l y s i s  Achievement Composite To determine the a p p r o p r i a t e n e s s of forming an achievement composite score f o r the BC QUIET, two a n a l y s i s procedures were used. F i r s t , the c o r r e l a t i o n s between the BC QUIET s u b t e s t s and an achievement composite formed from the mean of these s u b - t e s t s were examined w i t h i n each d i s t r i c t . The r e s u l t s are d i s p l a y e d i n Table 2. The c o r r e l a t i o n s between the s u b t e s t s range from .75 to .90 i n 98 Table 2 Correlations Among BC QUIET Subtests and  Achievement Composite by D i s t r i c t ' Test Test Kean c S.D. 1 2 3 4 1. Composite 24.7 32.2 .94 . 90 .90 2 . Arithmetic 13.0 18.9 .93 .75 . 90 3 . Word I.D. 12.3 17 . 4 .82 . 58 .82 4. Pass. Comp. 10.2 14.1 . 92 .77 .77 Mean d 19 . 9 9.8 11.1 9.4 S.D. 27 . 9 14.9 16.0 14.9 a. A l l cor r e l a t i o n s s i g n i f i c a n t at .01 l e v e l of s i g i f i c a n c e . b. D i s t r i c t 1 correlations above diagonal; D i s t r i c t 2 below. c. D i s t r i c t 1. d. D i s t r i c t 2. 99 D i s t r i c t 1, and from .58 to .93 i n D i s t r i c t 2. The c o r r e l a t i o n s between the s u b t e s t s and the achievement composite range from .82 t o .94 across the two d i s t r i c t s . While the c o r r e l a t i o n s between the r e a d i n g s u b t e s t s and the a r i t h m e t i c s u b t e s t were weaker than between the r e a d i n g s u b t e s t s , they were c o n s i d e r e d s a t i s f a c t o r y enough to c o n s i d e r combining the s u b t e s t scores t o form an achievement composite. To account f o r the a t t e n u a t i n g e f f e c t s due to u n r e l i a b i l i t y (Lord & Novick, 1968, p. 70) the lowest and h i g h e s t c o r r e l a t i o n s were c o r r e c t e d u s i n g the r e l i a b i l i t i e s f o r the r e s p e c t i v e s u b t e s t s r e p o r t e d f o r the BC QUIET (Wormeli, 1983, p. 119). The lowest was .62 between Word I d e n t i f i c a t i o n and A r i t h m e t i c i n D i s t r i c t 2, w h i l e the h i g h e s t was .98 between A r i t h m e t i c and Passage Comprehension i n D i s t r i c t 1. These were c o n s i d e r e d s t r o n g . Second, a p r i n c i p a l components a n a l y s i s showed t h a t a s i n g l e f a c t o r accounted f o r 82.0% of the v a r i a n c e i n the s e t of t h r e e BC QUIET s u b t e s t s . The f a c t o r l o a d i n g s were v i r t u a l l y i d e n t i c a l f o r each of the s u b t e s t s : .88 f o r A r i t h m e t i c , .89 f o r Word I d e n t i f i c a t i o n , and .94 f o r Passage Comprehension. A p r i n c i p a l components a n a l y s i s was a l s o conducted s e p e r a t e l y f o r each d i s t r i c t . These f a c t o r l o a d i n g s were found t o be v i r t u a l l y i d e n t i c a l , w i t h the f i r s t f a c t o r e x p l a i n i n g 85.0% of the v a r i a n c e i n D i s t r i c t 1 100 and 80.0% of the variance i n D i s t r i c t 2. Based on these r e s u l t s , there i s strong evidence that forming a s t a t i s t i c a l composite by summing the scores of the subtests i s appropriate, and that decision was taken. Pooling of d i s t r i c t data To decide whether to pool the data across school d i s t r i c t s , discriminant function analyses were performed to te s t whether the relationships between group membership (M/EMH versus regular education) and each predictor variable d i f f e r e d i n the two d i s t r i c t s . This was accomplished by determining whether there was a s t a t i s t i c a l l y s i g n i f i c a n t i n t e r a c t i o n between d i s t r i c t membership and each predictor v a r i a b l e . For example, the f i r s t model that was tested included FSIQ, a dummy variable representing d i s t r i c t , and a district-by-FSIQ i n t e r a c t i o n term. For a l l of the eight models tested, the d i s t r i c t dummy variable and the int e r a c t i o n term did not s i g n i f i c a n t l y predict group membership at a sig n i f i c a n c e l e v e l of .05. This implies that the realtionships between group membership and the predictors d i d not d i f f e r s i g n i f i c a n t l y between d i s t r i c t s . Also, a f u l l model with a l l eight of the predictor variables, the d i s t r i c t dummy variable, and the eight d i s t r i c t - b y - p r e d i c t o r i n t e r a c t i o n terms was tested using the Mahanabolis D step-wise technique. None of the int e r a c t i o n 101 terms or the d i s t r i c t membership v a r i a b l e were r e t a i n e d i n the model. These r e s u l t s a l s o suggest t h a t t h e r e were no s i g n i f i c a n t d i f f e r e n c e s i n the r e l a t i o n s h i p s between group membership and the p r e d i c t o r v a r i a b l e s , and t h e r e f o r e , a l l subsequent a n a l y s e s were based on pooled d a t a . D i f f e r e n c e s Between M/EMH and Regular E d u c a t i o n Students A f t e r making d e c i s i o n s w i t h r e s p e c t t o the fo r m a t i o n of the achievement composite and p o o l i n g data a c r o s s d i s t r i c t s , the demographic and t e s t r e s u l t s o b t a i n e d f o r the t o t a l sample were examined. F o l l o w i n g t h i s , a n a l y s e s were performed t o address the r e s e a r c h q u e s t i o n s p o s i t e d i n Chapter 1. These q u e s t i o n s were: 1. Are t h e r e d i f f e r e n c e s between st u d e n t s r e f e r r e d f o r placement and p l a c e d i n programmes f o r the M/EMH and those r e f e r r e d and not placed? More s p e c i f i c a l l y : a. are stud e n t s who have been a s s e s s e d and p l a c e d as M/EMH c o n f i r m a b l e i n t h a t placement, based on the standards of the t w o - f a c t o r d i a g n o s t i c model; and, b. can stud e n t s who have been ass e s s e d and not p l a c e d be confirmed as i n a p p r o p r i a t e f o r placement as M/EMH, based on the standards of the t w o - f a c t o r d i a g n o s t i c model; and, 2. What f a c t o r s p r o v i d e the be s t e x p l a n a t i o n of c u r r e n t placement d e c i s i o n s ? S p e c i f i c a l l y , what i s the c o n t r i b u t i o n of the v a r i a b l e s IQ, a d a p t i v e behaviour, 102 academic achievement, maladaption, and v i s u a l and h e a r i n g a c u i t y t o the placement of these s t u d e n t s ? The f i r s t two qu e s t i o n s ( l a and l b ) were i n v e s t i g a t e d through the a p p l i c a t i o n of the t w o - f a c t o r d i a g n o s t i c model wit h the c u t - o f f c r i t e r i a f o r IQ and a d a p t i v e behaviour s e t t o the upper extreme o f the AAMD parameters (st a n d a r d s c o r e 75) and t o the standards c u r r e n t l y p o s i t e d by the d r a f t M i n i s t r y o f Ed u c a t i o n G u i d e l i n e s ( s t a n d a r d s c o r e 69). The second q u e s t i o n was examined by the use of a s e r i e s of d i s c r i m i n a n t f u n c t i o n analyses i n which v a r i a b l e s are i n c l u d e d f i r s t i n an h i s t o r i c a l sequence r e f l e c t i n g t he development o f d i a g n o s t i c models of M/EMH, and then through the use of both f o r c e d and step-wise d i s c r i m i n a n t f u n c t i o n a n a l y s e s . These l a t t e r a n a l y s e s were used t o determine which p r e d i c t o r v a r i a b l e s b e s t e x p l a i n the c l a s s i f i c a t i o n d e c i s i o n s made f o r the p o p u l a t i o n under study. Demographic C h a r a c t e r i s t i c s The demographic c h a r a c t e r i s t i c s o f the t o t a l sample sepa r a t e d by M/EMH and r e g u l a r e d u c a t i o n are summarized i n Table 3. As p r e v i o u s l y d i s c u s s e d , an a n a l y s i s of between d i s t r i c t d i f f e r e n c e s r e v e a l e d t h a t t he data c o u l d be pooled a c r o s s d i s t r i c t s without l o s s of i n f o r m a t i o n . T a b l e 3 shows t h a t males outnumbered females by approximately 3 t o 2, and 103 Tab l e 3 Demographic C h a r a c t e r i s t i c s of Sample In f o r m a t i o n Regular Educ. M/EMH n = 49 n 57 T o t a l n - 106 Sex Male 30(61.2%) Female 19(38.8%) Chron. Age Mean (yy-mm) 9-7 S.D. (months)24.66 Race A s i a n 2(4.1%) B l a c k 0(0.0%) Caucasian 43(87.8%) East I n d i a n 4 (.8.2%) 33(57.9%) 24(42.1%) 9-0 24.68 1(1.8%) 1(2.0%) 49(86.0%) 6(10.5%) 63(59.4%) 43(40.6%) 9-4 25.09 3(2.8%) 1(0.9%) 92(86.8%) 10(9.4%) 104 the r a t i o of males t o females was s i m i l a r i n both groups. The mean age of M/EMH students was seven months l e s s than t h a t of the r e g u l a r e d u c a t i o n s t u d e n t s , w h i l e the v a r i a t i o n i n age w i t h i n each group was approximately e q u a l . The m a j o r i t y of st u d e n t s were of Caucasian r a c i a l o r i g i n 86.8%), w i t h non-Caucasian students making up o n l y 13.1% of the t o t a l sample. Non-Caucasian s t u d e n t s had approximately equal r e p r e s e n t a t i o n i n the M/EMH (14.3%) and Regular E d u c a t i o n (13.1%) groups. The number of non-Caucasian students p r e s e n t i n the sample was s m a l l enough t h a t i n v e s t i g a t i o n of race as a p r e d i c t o r of group membership was c o n s i d e r e d i n a p p r o p r i a t e . C o r r e l a t i o n M a t r i x f o r T e s t R e s u l t s . T a b l e 4 shows the means, s t a n d a r d d e v i a t i o n s , and the c o r r e l a t i o n m a t r i x f o r the v a r i a b l e s IQ, ABC, Achievement, Maladaption (VMS), S n e l l e n V i s u a l A c u i t y t e s t ( V i s i o n ) , and Pure Tone Aud i o m e t r i c Sweep t e s t ( H e a r i n g ) . As i s shown, p o s i t i v e c o r r e l a t i o n s r a n g i n g from .43 to .64 were found between IQ, ABC and Achievement, w h i l e n e g a t i v e c o r r e l a t i o n s were observed between these same v a r i a b l e s and VMS, V i s i o n and Hearing. In the case of V i s i o n and Hearing, weak c o r r e l a t i o n s were found with IQ, ABC, and Achievement, ra n g i n g from -.02 t o -.12. C o r r e l a t i o n s between V i s i o n , Table 4 C o r r e l a t i o n M a t r i x f o r T e s t R e s u l t s 3 T e s t 1 2 3 4 5 6 1. FSIQ 1.00 .64 .45 -.44 -.08 -.05 2. ABC 1.00 .43 -.48 -.12 -.07 3. Ach. 1. 00 -.31 -.02 -.07 4. VMS 1.00 .07 .05 5. V i s i o n 1.00 . 22 6. Hearing 1.00 Mean 79.8 74.6 21.56 1.7 .21 .10 S.D. 14.7 18.1 29 . 38 0.8 .62 .43 a. p o i n t b i s e r i a l c o r r e l a t i o n 106 Hearing, and VMS were p o s i t i v e , but weak, r a n g i n g from .05 to .22. VMS was n e g a t i v e l y c o r r e l a t e d with IQ, ABC, and Achievement, the c o r r e l a t i o n s ranged from -.31 t o -.48. V i n e l a n d . WISC-R and BC QUIET. Tab l e 5 shows f o r each group the means and standard d e v i a t i o n s f o r the V i n e l a n d A d a p t i v e Behavior Composite (ABC), V i n e l a n d M a l a d a p t i v e s c a l e s (VMS), WISC-R, and the BC QUIET. With the e x c e p t i o n of the V i n e l a n d M a l a d a p t i ve s c a l e , the M/EMH st u d e n t s had lower mean s c o r e s w i t h l e s s s c o r e v a r i a b i l i t y than d i d the r e g u l a r e d u c a t i o n s t u d e n t s . On the Maladaptive S c a l e , M/EMH stude n t s had h i g h e r mean s c o r e s , r e f l e c t i n g a g r e a t e r i n c i d e n c e i n s o c i a l l y i n a p p r o p r i a t e behaviour. S n e l l e n v i s u a l a c u i t y t e s t . R e s u l t s of the S n e l l e n v i s u a l a c u i t y t e s t are d i s p l a y e d i n Table 6. As i s shown, 82.1% o f a l l s u b j e c t s passed t h e i r f i r s t S n e l l e n v i s u a l a c u i t y t e s t , w h i l e 6.6% were u n t e s t a b l e and 11.3% f a i l e d . Of the seven u n t e s t a b l e s t u d e n t s , s i x (85.7%) were i n the M/EMH group. A l l seven of the students who were u n t e s t a b l e on the f i r s t a d m i n i s t r a t i o n were a l s o found t o be u n t e s t a b l e on the second, w h i l e one student who had f a i l e d t e s t one passed t e s t two. Pure Tone A u d i o m e t r i c sweep t e s t . The r e s u l t s of the pure tone a u d i o m e t r i c sweep t e s t i n g are summarized i n Ta b l e 7. Of 107 Table 5 Means and Standard D e v i a t i o n s f o r T e s t R e s u l t s T e s t Regular Educ. mean s.d, M/EMH mean s.d. T o t a l mean s.d, Vi n e l a n d 0 1 Composite Maladaptive WISC-R C V e r b a l IQ P e r f . IQ F u l l Sc. IQ B.C. QUIET d A r i t h m e t i c Word I.D. Pass. Comp. 85.2 1.3 87.1 95. 3 90.8 22 . 3 19.9 19.0 16.4 0.5 10 . 9 13.9 10.7 21.4 18.8 17.0 65.4 1.9 68.9 72 . 5 70.1 3 . 2 5.2 2.9 14.1 0.8 9.9 12.1 10.4 6 . 0 11.5 5.3 74.6 1.7 77.4 83.1 79.8 11.9 11.9 9.9 18 .1 0.8 13.8 17.3 14 .7 17.6 16.9 14.3 a. Expressed i n s . s . (mean = 100; s.d. = 15). b. 1 = not maladapted; 2 = moderately maladapted; 3 = s i g n i f i c a n t l y maladapted. c. Expressed i n s.s. (mean = 100; s.d. = 15). d. Expressed i n Normal Curve E q u i v a l e n t s (mean = 50; s.d. = 21). 1 0 8 T a b l e 6 S n e l l e n V i s i o n T e s t R e s u l t s R e s u l t s T e s t 1 T e s t 2 M/EMH (n = 57) (n = 13) Un t e s t a b l e Pass F a i l 6(10.5%) 44(77.7%) 7(12.3%) 6(10.5%) 1(1.8%) 6(10.5%) Regular Ed. (n = 49) (n = 6) Un t e s t a b l e Pass F a i l 1(2.0%) 43(87.6%) 5(10.2%) 1(2.0%) 0(0.0%) 5(10.2%) T o t a l (n = 106) (n = 19) Un t e s t a b l e Pass F a i l 7(6.6%) 87(82.1%) 12(11.3%) 7(6.6%) 1(0.9%) 11(10.4%) Percent of students p a s s i n g : M/EMH 78.9% Regular e d u c a t i o n 87.8 Note. Only students who e i t h e r f a i l e d or were u n t e s t a b l e a t t e s t 1 were a d m i n i s t e r e d t e s t 2. 109 Table 7 Pure Tone Sweep Hearing T e s t R e s u l t s R e s u l t s T e s t 1 Te s t 2 M/EMH (n = 57) (n = 13) Un t e s t a b l e Pass F a i l 6(10.5%) 44(77.7%) 7(12.3%) 6(10.5%) 1(1.8%) 6(10.5%) Regular Ed. (n = 49) (n = 3) Un t e s t a b l e Pass F a i l 1(2.0%) 46(93.9%) 2(4.1%) 1(2.0%) 0(0.0%) 2(4.1%) T o t a l (n = 106) (n - 16) Un t e s t a b l e Pass F a i l 7(6.6%) 90(84.9%) 9(8.5%) 7(6.6%) 1(0.9%) 8(7.5%) Percent of students p a s s i n g : M/EMH 78.9% Regular e d u c a t i o n 93.9% Note. Only students who e i t h e r f a i l e d or were u n t e s t a b l e a t t e s t 1 were a d m i n i s t e r e d t e s t 2. 110 the r e g u l a r e d u c a t i o n students, 93.9% passed t e s t one, compared with o n l y 77.7% of the M/EMH stu d e n t s . Of the M/EMH stu d e n t s , 10.5% were u n t e s t a b l e on t e s t 1, and 2.0% of r e g u l a r e d u c a t i o n students were u n t e s t a b l e . A l l those who were e i t h e r u n t e s t a b l e (n = 7) or who f a i l e d t e s t 1 (n = 9) were r e t e s t e d . A l l s u b j e c t s who were u n t e s t a b l e on t e s t 1 were u n t e s t a b l e on t e s t 2, while s i x of the nine students (5.7% o f the t o t a l ) who had f a i l e d t e s t 1 a l s o f a i l e d t e s t 2. Only one s u b j e c t who f a i l e d the f i r s t a d m i n i s t r a t i o n passed the second. Incidences of u n t e s t a b i l i t y were h i g h e s t (10.5%) f o r the M/EMH group. The r e g u l a r e d u c a t i o n group had a much lower i n c i d e n c e o f u n t e s t a b i l i t y (2.0%). The same seven students who proved t o be u n t e s t a b l e f o r h e a r i n g were a l s o u n t e s t a b l e f o r v i s i o n . For both the S n e l l e n and pure tone sweep t e s t i n g , u n t e s t a b l e s u b j e c t s o c c u r r e d more f r e q u e n t l y w i t h i n the M/EMH group by a 6:1 r a t i o . Comparison With AMMD and Proposed B.C. Two-Factor C r i t e r i a The e x t e n t of agreement between c u r r e n t placement and placement determined by a p p l y i n g (a) the AAMD g u i d e l i n e s and (b) the proposed B.C. G u i d e l i n e s (see Appendix F) i s d i s p l a y e d i n Table 8. C l a s s i f i c a t i o n as M/EMH with the AAMD tw o - f a c t o r model r e q u i r e s students t o have standard s c o r e s I l l T a b l e 8 C l a s s i f i c a t i o n R e s u l t s Using A.A.M.D.and Proposed B.C. G u i d e l i n e s A.A.M.D. G u i d e l i n e s 3 Current Placement Regular Ed M/EMH n Regular E d u c a t i o n 45(93.8%) 3(6.7%) 48 M/EMH 21(36.8%) 36(63.2%) 57 Proposed B.C. G u i d e l i n e s 1 3 C u r r e n t Placement Regular Ed M/EMH n Regular E d u c a t i o n 47(97.9%) 1(2.1%) 48 M/EMH 37(64.9%) 20(35.1%) 57 Percent of cases c o r r e c t l y c l a s s i f i e d : a. 77.1% b. 63.8% a. Both IQ and ABC l e s s than or equal t o s. s . 75. b. Both IQ and ABC l e s s than s.s. 69. 112 i n both IQ and ABC l e s s than or equal t o 75. The t a b l e shows t h a t the o v e r a l l agreement between c u r r e n t placement and placement a c c o r d i n g t o the AAMD g u i d e l i n e s was 77.1%. Large d i s c r e p a n c i e s are seen between the r e g u l a r e d u c a t i o n and M/EMH groups: the c l a s s i f i c a t i o n accuracy f o r M/EMH stude n t s i s 63.2%, while t h a t of r e g u l a r e d u c a t i o n placements i s 93.8%. Thus i f the AAMD c r i t e r i a had been used, fewer students would have been c l a s s i f i e d as M/EMH. When the lower M/EMH c u t - o f f c r i t e r i a proposed i n the d r a f t B.C. G u i d e l i n e s o f standard score 69 was a p p l i e d , the t o t a l c l a s s i f i c a t i o n accuracy dropped t o 63.8%. The low e r i n g o f the c u t - o f f c r i t e r i a from 75 t o 69 r e s u l t e d i n a marginal i n c r e a s e i n accuracy f o r r e g u l a r e d u c a t i o n students (93.8% t o 97.9%) but i n a l a r g e decrease i n accuracy f o r M/EMH students (63.2% t o 35.1%). I f the proposed B.C. g u i d e l i n e s had been a p p l i e d , 65% of the sample c u r r e n t l y i n s p e c i a l programmes would have been i n r e g u l a r e d u c a t i o n . Sources of disagreement between the AAMD g u i d e l i n e s , d r a f t B.C. S p e c i a l Education g u i d e l i n e s , and c u r r e n t placements were i n v e s t i g a t e d . The r e s u l t s of t h i s i n v e s t i g a t i o n are summarized i n Table 9 For the students e n r o l l e d i n r e g u l a r e d u c a t i o n but c l a s s i f i e d as M/EMH ac c o r d i n g t o the AAMD model, one each was m i s c l a s s i f i e d by 113 Tab l e 9 Sources of E r r o r f o r Current Placements Compared With  A.A.M.D. and Proposed B.C. G u i d e l i n e s Current C l a s s i f i c a t i o n 1. AAMD Parameters V i o l a t e d Regular Ed M/EMH T o t a l IQ 1(33.3%) 11(52.4%) 12(50.0%) Ad . Behaviour 1(33.3%) 6(28.6%) 7(29.2%) IQ and Ad. Behaviour 1(33.3%) 4(19.0%) 5(20.8%) n 3 21 24 2. Proposed B.C. G u i d e l i n e s V i o l a t e d IQ 0(0.0%) 19(51.4%) 19(50.0%) Ad . Behaviour 0(0.0%) 0(0.0%) 0(0.0%) IQ and Ad. Behaviour 1(100.0%) 18(48.6%) 19(50.0%) n 1 37 38 Note. Percentages g i v e n are % of column t o t a l s . 114 having too low an IQ, too low an adaptive behaviour composite s c o r e , and both of these too low. In c o n t r a s t , 11 of the M/EMH students c l a s s i f i e d as r e g u l a r s tudents by the AAMD model were m i s c l a s s i f i e d because they had IQ sco r e s g r e a t e r than 75; s i x because of adaptive behaviour composite s c o r e s g r e a t e r than 75; and f o u r because both IQ and ada p t i v e behaviour composite s c o r e s were g r e a t e r than 75. More than seven out of ten of the students l a b e l l e d as M/EMH have IQ sco r e s e i t h e r alone or i n combination with a d a p t i v e behaviour composite s c o r e s which are above those o f the AAMD g u i d e l i n e s . Each case i n which c u r r e n t placement was not confirmed was examined t o d i s c o v e r which parameters had been v i o l a t e d . The r e s u l t s o f t h i s i n v e s t i g a t i o n are a l s o d i s p l a y e d i n Table 9. For the AAMD model, v i o l a t i o n s of the IQ parameter accounted f o r 50% of a l l m i s c l a s s i f i c a t i o n s , w h i l e IQ and Adaptive Behaviour combined were r e s p o n s i b l e f o r 70.8% o f e r r o r s . Under the more r i g o r o u s B.C. g u i d e l i n e s , the source o f e r r o r f o r the one i n s t a n c e i n which a r e g u l a r e d u c a t i o n , stud e n t was found t o be m i s c l a s s i f i e d was caused by t h a t student having both IQ and adapt i v e behaviour s c o r e s below the standard s c o r e 69 c u t - o f f . Sources of m i s c l a s s i f i c a t i o n f o r M/EMH students were dominated by v i o l a t i o n s of the IQ 115 parameter alone (51.4%) or i n combination w i t h v i o l a t i o n s of the a d a p t i v e behaviour parameter (48.6%). No v i o l a t i o n s of the a d a p t i v e behaviour parameter alone were found. U.S. norms with Canadian students At t h i s p o i n t i n the data a n a l y s i s i t became a p p r o p r i a t e t o c o n s i d e r the use of U.S. normed t e s t s ( i e . WISC-R and ABC) with the p o p u l a t i o n sample under study. I t has been demonstrated t h a t Canadian students s c o r e d i f f e r e n t l y on U.S. normed i n t e l l i g e n c e t e s t s than do American students (Holmes, 1981; P e t e r s , 1976; Kennet, 1972). At the elementary l e v e l , Canadian students have been found t o s c o r e h i g h e r than t h e i r U.S. c o u n t e r p a r t s by between 3.4 and 9.8 IQ p o i n t s depending on student age, w h i l e the s c o r e v a r i a n c e of Canadian students was l e s s than t h a t of U.S. students ( s . d . 12.4 - 12.9 versus 15.0) (Holmes, 1981, p. 114). T h i s makes the a p p l i c a t i o n of the proposed B.C. G u i d e l i n e s c u t - o f f c r i t e r i a of s.s. 69 q u e s t i o n a b l e because " f i v e times as many c h i l d r e n s c o r e 70 or below u s i n g B.C. norms than u s i n g American norms" (Holmes, 1981, p. 114). T h i s problem with the use of f o r e i g n i n t e l l i g e n c e t e s t norms may apply a l s o t o t e s t s of a d a p t i v e behaviour. At present no s t u d i e s have been conducted t o determine the adequacy of U.S. a d a p t i v e behaviour norms wit h Canadian s t u d e n t s . Because complete 116 Canadian norms are not a v a i l a b l e f o r e i t h e r the WISC-R or the V i n e l a n d , i t i s p a t e n t l y more a p p r o p r i a t e t o u t i l i z e the l e s s r i g o r o u s AAMD g u i d e l i n e of standard s c o r e 75 than the proposed c u t - o f f c r i t e r i a of 69 which, while p r o v i d i n g g r e a t p r o t e c t i o n a g a i n s t i n a p p r o p r i a t e l y l a b e l l i n g students as M/EMH, d i s q u a l i f i e s s i g n i f i c a n t numbers of M/EMH students from s p e c i a l e d u c a t i o n s e r v i c e s . D i s c r i m i n a n t F u n c t i o n Analyses  H i s t o r i c Models of C l a s s i f i c a t i o n Based on the review of the l i t e r a t u r e presented i n Chapter 2, i t was observed t h a t f o u r s e q u e n t i a l models of M/EMH d i a g n o s i s have evolved. In the n i n e t e e n t h c e n t u r y , a d a p t i v e behaviour alone served as the d i a g n o s t i c c r i t e r i o n , w h i l e i n the e a r l y p a r t of the t w e n t i e t h century, IQ alone was the c r i t e r i o n . Between the 1930s and the e a r l y 1970s the concept o f the tw o - f a c t o r model i n c l u d i n g IQ and ada p t i v e behaviour was developed. F i n a l l y , i n the 1980s, d i s c u s s i o n of the i n c l u s i o n of measured academic achievement began. Each of these h i s t o r i c a l models i s d i s p l a y e d i n the f o l l o w i n g e q u a t i o n s : A Model 1 Y = b Q + b-^ AB A Model 2 Y = b Q + b xX IQ 117 A Model 3 Y = b 0 + b-^ + b 2X IQ AB Model 4 Y = b Q + b xX + b 2X + b 3X IQ AB Ach where: AB = V i n e l a n d Adaptive Behavior Composite IQ = WISC-R F u l l S c a l e IQ Ach = BC QUIET Composite Achievement Score Each of these models was i n v e s t i g a t e d by a p p l y i n g i t t o the sample under i n v e s t i g a t i o n as f o l l o w s : 1. D i s c r i m i n a n t f u n c t i o n analyses were performed. For each of the f o u r models, a l l v a r i a b l e s were allowed t o e n t e r the equations 2. Using the procedure d e s c r i b e d i n Appendix G, the s t a n d a r d i z e d c a n o n i c a l d i s c r i m i n a n t f u n c t i o n c o e f f i c i e n t s o b t a i n e d f o r each v a r i a b l e w i t h i n the model were converted t o r e l a t i v e percentages. 3. C l a s s i f i c a t i o n m a t r i c e s were formed f o r each model, i n which c l a s s i f i c a t i o n accuracy f o r both r e g u l a r e d u c a t i o n and M/EMH placements were r e p o r t e d . 4. The percentage of cases c o r r e c t l y c l a s s i f i e d by each model was c a l c u l a t e d . The r e s u l t s of these analyses are r e p o r t e d i n Table 10. As i s shown i n T a b l e 10, whenever IQ s c o r e s e n t e r i n t o a model, they dominate t h a t model. In Model 3, where IQ and 118 ABC alone are used, the r e l a t i v e percentage of p r e d i c t i o n h e l d by IQ i s 58.3%, while the ABC f a c t o r accounts f o r 41.7%. In model 4, where Achievement i s added t o the pr e v i o u s model, the achievement f a c t o r accounts f o r 34.5% o f the p r e d i c t i o n , but t h i s f a c t o r o n l y reduces the r e l a t i v e percentage o f IQ by 10.7%. The ABC f a c t o r i s , however, reduced from 41.7% t o onl y 17.8%, a drop of 23.8%. A l s o as shown i n Table 10, a t each s t e p o f the h i s t o r i c a l development of the d i a g n o s t i c and c l a s s i f i c a t i o n models f o r M/EMH, i n c r e a s e s i n o v e r a l l c l a s s i f i c a t i o n accuracy were seen. Each s t e p i s found t o s i g n i f i c a n t l y p r e d i c t c l a s s i f i c a t i o n (p < .001). Some v a r i a t i o n i s seen i n the c l a s s i f i c a t i o n accuracy by group. For r e g u l a r e d u c a t i o n s t u d e n t s l i t t l e d i f f e r e n c e i s observed i n c l a s s i f i c a t i o n a ccuracy between the ada p t i v e behaviour alone (79.6%) and IQ alone (80.9%) models. For the M/EMH group, however, Model 2 c o r r e c t l y c l a s s i f i e s 11.8% more students than does Model 1. For r e g u l a r e d u c a t i o n students, the combination of the IQ and ad a p t i v e behaviour f a c t o r s of the AAMD tw o - f a c t o r model (Model 3), but without the AAMD c u t - o f f s c o r e s , i n c r e a s e s c l a s s i f i c a t i o n accuracy by 6.3% over Model 2, wh i l e the M/EMH c l a s s i f i c a t i o n r a t e drops s l i g h t l y (3.7%) between these two models. 119 Tab l e 10 R e l a t i v e Percentages,, C l a s s i f i c a t i o n M a t r i c e s , and Accuracy  f o r H i s t o r i c M/EMH D i a g n o s t i c and C l a s s i f i c a t i o n Models 1. SDFCF a and r e l a t i v e percentages f o r h i s t o r i c models D i a g n o s t i c / C l a s s i f i c a t i o n Models Model 1 Model 2 Model 3 Model 4 (n = 1 0 6 ) b (n = 101) (n - 101) (n - 100) PV C SDFC(rel%) SDFC(rel%) SDFC(rel%) SDFC(rel%) ABC 1.00(100.0) ' - - 0.68(41.7) 0.26(17.9) IQ - - 1.00(100.0) 0.95(58.3) 0.69(47.6) Ach - - - - - - 0.50(34.5) 2. C l a s s i f i c a t i o n r e s u l t s o f d i s c r i m i n a n t f u n c t i o n a n a l y ses P r e d i c t e d Placement Model 1 Model 2 Model 3 Model 4 Reg. M/EMH Reg. M/EMH Reg. M/EMH Reg. M/EMH A c t u a l Reg(n) 39 10 38 9 41 6 42 4 (%) 79.6 20.4 80. 9 19.1 87.2 12 . 8 91.3 8.7 M/EMH(n) 12 45 5 49 7 47 4 50 (%) 21.1 78. 9 9.3 90.7 13.0 87. 0 7.4 92 . 6 3. Percent of cases c o r r e c t l y c l a s s i f i e d Model 1 Model 2 Model 3 Model 4 79.3% 86.1% 87.1% 92.0% a. S t a n d a r d i z e d D i s c r i m i n a n t F u n c t i o n C o e f f i c i e n t . b. V a r i a t i o n i n n i s caused by students who were e i t h e r u n t e s t a b l e or d e c l i n e d t e s t i n g . c. P r e d i c t o r V a r i a b l e . 120 The a d d i t i o n of Achievement as a t h i r d p r e d i c t o r v a r i a b l e (Model 4), decreased c l a s s i f i c a t i o n accuracy f o r the r e g u l a r e d u c a t i o n students by 2.1%, but r e s u l t e d i n an i n c r e a s e o f 3.7% f o r the M/EMH stud e n t s . The a d d i t i o n o f the VMS, V i s i o n and Hearing v a r i a b l e s r e s u l t s i n an o v e r a l l decrease i n c o r r e c t c l a s s i f i c a t i o n of 3.6%, t o 87.1%. Thus, u s i n g t h i s s e r i e s of f o r c e d p r e d i c t o r v a r i a b l e s , i t i s seen t h a t the the be s t p r e d i c t i v e combination f o r r e g u l a r e d u c a t i o n students i s the two- f a c t o r model (Model 3). For the M/EMH stu d e n t s , however, the a d d i t i o n o f the achievement v a r i a b l e t o the two f a c t o r model r e s u l t s i n a hi g h e r r a t e of c o r r e c t c l a s s i f i c a t i o n . T h i s a d d i t i o n of the achievement t e s t t o the t w o - f a c t o r model r e s u l t e d i n the h i g h e s t o v e r a l l c l a s s i f i c a t i o n accuracy of 92.0%. Step-Wise D i s c r i m i n a n t F u n c t i o n Analyses In the p r e v i o u s s e c t i o n of t h i s chapter, Models 1, 2, 3, and 4 r e f l e c t e d the h i s t o r i c a l development of d i a g n o s t i c and c l a s s i f i c a t i o n models. I t was decided t h a t an i n v e s t i g a t i o n of the r o l e of p r e d i c t o r v a r i a b l e s o t h e r than those i n c l u d e d i n these models was a p p r o p r i a t e . These a d d i t i o n a l p r e d i c t o r v a r i a b l e s were: maladaption, v i s u a l a c u i t y , h e a r i n g a c u i t y , and c h r o n o l o g i c a l age. Two d i s c r i m i n a n t f u n c t i o n techniques were s e l e c t e d f o r t h i s 121 i n v e s t i g a t i o n . F i r s t , a l l of the p r e d i c t o r v a r i a b l e s (Adaptive Behaviour Composite, F u l l S c a l e IQ, Achievement Composite, Maladaption, V i s u a l A c u i t y , Hearing A c u i t y and C h r o n o l o g i c a l Age) were entered i n t o a f o r c e d d i s c r i m i n a n t f u n c t i o n a n a l y s i s . The s t a n d a r d i z e d d i s c r i m i n a n t f u n c t i o n c o e f f i c i e n t s were then used t o determine the r e l a t i v e percentage v a l u e of each v a r i a b l e . F i n a l l y , a c l a s s i f i c a t i o n m a t r i x f o r t h i s model (Model 5) was assembled. F o l l o w i n g t h i s procedure, these same v a r i a b l e s were ente r e d i n t o a step-wise discrimanant f u n c t i o n a n a l y s i s usxng the Mahalanobis D technique. In t h i s procedure, o n l y the b e s t combination of p r e d i c t o r v a r i a b l e s i s r e t a i n e d w i t h i n the model. Retained v a r i a b l e s were then examined, and the r e l a t i v e percentage v a l u e s of each c a l c u l a t e d and a c l a s s i f i c a t i o n m a t r i x f o r t h i s model (Model 6) generated. The r e s u l t s of both of these procedures are gi v e n i n Tab l e 11. As i s seen from Table 11, i n Model 5, when a l l of the v a r i a b l e s are f o r c e d i n t o the d i s c r i m i n a n t f u n c t i o n a n a l y s i s , the IQ, Achievement, and Maladaption v a r i a b l e s dominate, w i t h IQ acc o u n t i n g f o r 39.3% of the p r e d i c t i o n , Achievement f o r 26.2%, and Maladaption f o r 15.8%. Adaptive 122 Tabl e 11 R e s u l t s o f Forced and Step-Wise D i s c r i m i n a n t F u n c t i o n  A nalyses f o r Models 5 and 6 1. SDCF a and r e l a t i v e percentages f o r models 5 and 6 Model 5 Model 6 (forced) (step-wise) P r e d i c t o r V a r i a b l e SDFC ( r e l . %) SDFC ( r e l . %) ABC 0.13 7.1 d i s c a r d e d IQ 0.72 39.3 0.73 46.5 Ach 0.48 26.2 0.49 31.2 VMS 0.29 15.8 0.35 22.3 V i s 0.01 0.5 d i s c a r d e d Hrg 0.14 7.7 d i s c a r d e d Chr. Age 0. 06 3.4 d i s c a r d e d 2. C l a s s i f i c a t i o n r e s u l t s of d i s c r i m i n a n t f u n c t i o n analyses P r e d i c t e d Placement Model 5 Model 6 Reg. M/EMH Reg. M/EMH A c t u a l Reg (n) 40 6 39 7 (%) 87.0 13.0 84.8 15.2 M/EMH(n) 5 44 4 50 (%) 10.2 89.8 7.4 92.6 3. Percent of cases c o r r e c t l y c l a s s i f i e d Model 5 88.4 Model 6 89.0 123 Behaviour, which i s the necessary second component of the AAMD tw o - f a c t o r d i a g n o s t i c model, accounts f o r o n l y 7.1% of the p r e d i c t i o n , l e s s than Hearing (7.7%). V i s i o n and C h r o n o l o g i c a l Age accounted f o r l i t t l e of the p r e d i c t i o n (0.5% and 3.4% r e s p e c t i v e l y ) . The combination o f p r e d i c t o r v a r i a b l e s i n c l u d e d i n Model 5 c o r r e c t l y c l a s s i f i e d 88.4% of the t o t a l sample, w i t h v e r y s i m i l a r c o r r e c t c l a s s i f i c a t i o n r a t e s f o r both r e g u l a r e d u c a t i o n (87.0%) and M/EMH (89.9%) s t u d e n t s . When compared t o Model 4 (Table 10), i t i s noted t h a t the a d d i t i o n o f the Maladaption, V i s i o n , Hearing and C h r o n o l o g i c a l Age v a r i a b l e s r e s u l t s i n an o v e r a l l decrease i n c o r r e c t c l a s s i f i c a t i o n o f 3.6% (from 92.0% t o 88.4%), w i t h the r e g u l a r e d u c a t i o n and M/EMH groups showing s i m i l a r d e c l i n e s (2.2% and 2.8% r e s p e c t i v e l y ) . Model 6, i n which the Mahalanobis D step-wise technique was used, r e s u l t e d i n onl y the v a r i a b l e s IQ, Achievement, and Maladaption being r e t a i n e d as a s i g n i f i c a n t p r e d i c t o r combination. The combination of these t h r e e v a r i a b l e s p r e d i c t e d p r e s e n t group membership wi t h 89.0% accuracy, w i t h s t r o n g e r p r e d i c t i o n f o r the M/EMH group (92.6%) than f o r the r e g u l a r education group (84.8%). An important o b s e r v a t i o n i s t h a t the step-wise procedure r e t a i n e d Maladaption as a v a l i d p r e d i c t o r w h i l e d i s c a r d i n g 124 the Adaptive Behavior Composite, while Model 4, i n which Adaptive Behaviour was f o r c e d i n t o combination with IQ and Achievement, r e s u l t e d i n a hig h e r o v e r a l l c l a s s i f i c a t i o n a ccuracy than was achieved with Model 6. I t i s apparent t h a t the Maladaption v a r i a b l e , when allowed i n t o the d i s c r i m i n a n t f u n c t i o n a n a l y s i s with Adaptive Behavior, dominates t h a t v a r i a b l e , and r e s u l t s i n i t s e x c l u s i o n from the f i n a l p r e d i c t i v e combination- For both Models 5 and 6, the t h r e e v a r i a b l e s t h a t c l e a r l y dominate c u r r e n t placements are IQ, Achievement and Maladaption. However, as was shown i n T a b l e 10, i n the absence of Maladaption, the combination of Adaptive Behavior Composite, IQ, and Achievement p r o v i d e s the h i g h e s t c l a s s i f i c a t i o n accuracy. 125 Chapter 5 Summary, Conclusi o n s and I m p l i c a t i o n s In t h i s f i n a l chapter a summary of the purposes, procedures, r e s u l t s , and l i m i t a t i o n s of the study are g i v e n ; c o n c l u s i o n s and i m p l i c a t i o n s are presented; recommendations f o r p r a c t i c e are pr o v i d e d ; and d i r e c t i o n s f o r f u t u r e r e s e a r c h are suggested. Summary Purpose The purpose of t h i s study was t o examine the v a l i d i t y of d i a g n o s t i c and c l a s s i f i c a t i o n p r a c t i c e s w i t h r e s p e c t t o M i l d l y / E d u c a b l y M e n t a l l y Handicapped (M/EMH) c h i l d r e n . Research conducted i n the U n i t e d S t a t e s suggests t h a t c l a s s i f i c a t i o n d e c i s i o n s f o r M/EMH students are o f t e n i n a c c u r a t e . Classroom t e a c h e r s were f r e q u e n t l y found t o r e f e r c h i l d r e n t o s p e c i a l c l a s s placements f o r i d i o s y n c r a t i c reasons, w h i l e p s y c h o l o g i s t s r e s p o n s i b l e f o r d i a g n o s i n g and l a b e l l i n g s tudents tended to p l a c e r e l i a n c e more on " c l i n i c a l judgement" than on the c a r e f u l use of o b j e c t i v e d a t a . Although U.S. law p r e s c r i b e s a two- f a c t o r (IQ and adap t i v e behaviour) d i a g n o s t i c and c l a s s i f i c a t i o n model f o r M/EMH st u d e n t s , t h i s model i s o f t e n ignored. L i t t l e r e s e a r c h has been done on the d i a g n o s i s and c l a s s i f i c a t i o n of M/EMH students i n Canada. Since r e c e n t 126 c o u r t a c t i o n s based on the Canadian Charter of R i g h t s and Freedoms suggest t h a t d i a g n o s t i c and placement d e c i s i o n s w i l l i n c r e a s i n g l y come under c r i t i c a l s c r u t i n y , i t was dec i d e d t h a t an i n v e s t i g a t i o n of the d i a g n o s t i c and placement p r a c t i c e s w i t h M/EMH students i n a Canadian s e t t i n g was a p p r o p r i a t e . Procedure Based on the review of the l i t e r a t u r e , the c r i t e r i o n o f the t w o - f a c t o r d i a g n o s t i c model f o r M/EMH was s e l e c t e d as the b a s i s f o r study o f the c l a s s i f i c a t i o n p r o c e s s . In a d d i t i o n t o the IQ and adaptive behaviour components of the two - f a c t o r model, ot h e r v a r i a b l e s i d e n t i f i e d i n the l i t e r a t u r e as important t o the d i a g n o s i s and c l a s s i f i c a t i o n p r o cess were i d e n t i f i e d and examined. These were academic achievement, maladaptive behaviour, and v i s u a l and h e a r i n g a c u i t y . Research s u b j e c t s were students e n r o l l e d i n two m e t r o p o l i t a n Vancouver s c h o o l d i s t r i c t s . In d i s t r i c t 1, p s y c h o l o g i s t r e c o r d s of suspected M/EMH students were a v a i l a b l e , w h i l e i n d i s t r i c t 2, a procedure f o r examining d i s t r i c t r e f e r r a l r e c o r d s and f o r r e - c r e a t i n g i n i t i a l r e f e r r a l s u s p i c i o n s was e s t a b l i s h e d . In the l a t t e r case, an i n t e r - r a t e r r e l i a b i l i t y study demonstrated the v a l i d i t y o f t h i s procedure. A l l had been suspected of being M/EMH 127 w i t h i n the l a s t two y e a r s . These s u b j e c t s (n = 106) formed two groups; those who had been l a b e l l e d as M/EMH (n = 57) and those who had been r e t a i n e d w i t h i n the r e g u l a r e d u c a t i o n programme (n - 49). Each s u b j e c t ' s r e c o r d s were perused, demographic i n f o r m a t i o n was obtained, and r e c e n t IQ data, where a v a i l a b l e , were recorded. The f o l l o w i n g t e s t s were ad m i n i s t e r e d : (1) WISC-R (n = 5), (2) BC QUIET (n = 90), V i n e l a n d Adaptive Behavior S c a l e s (n = 106), (3) V i n e l a n d Maladaptive Behaviour S c a l e s (n = 106), (4) S n e l l e n V i s u a l A c u i t y t e s t (n - 106), (5) Pure Tone Audiometric sweep t e s t (n = 106), and (6) r e - e v a l u a t i o n s with both the S n e l l e n (n = 19) and Pure Tone t e s t s (n = 16). Data A n a l y s i s and R e s u l t s Achievement composite. The f e a s i b i l i t y of forming an achievement composite sco r e from the word i d e n t i f i c a t i o n , passage comprehension and a r i t h m e t i c s u b - t e s t s of the BC Quick I n d i v i d u a l E d u c a t i o n a l T e s t (BC QUIET) was i n v e s t i g a t e d . Two a n a l y s i s procedures were used. F i r s t , the c o r r e l a t i o n s between the s u b t e s t s and an achievement composite formed from those s u b t e s t s was examined w i t h i n each d i s t r i c t . Then, the h i g h e s t and lowest c o r r e l a t i o n s were c o r r e c t e d f o r a t t e n u a t i o n u s i n g the s u b t e s t r e l i a b i l i t i e s r e p o r t e d f o r the BC QUIET. Second, a p r i n c i p a l components a n a l y s i s showed t h a t a s i n g l e f a c t o r 128 accounted f o r 82.0% of the v a r i a n c e i n the s e t of t h r e e B.C. QUIET s u b t e s t s , w i t h v i r t u a l l y i d e n t i c a l f a c t o r l o a d i n g s f o r each of the s u b t e s t s w i t h i n each of the d i s t r i c t s . Based on these f i n d i n g s the formation of an achievement composite was co n s i d e r e d a p p r o p r i a t e . P o o l i n g data a c r o s s d i s t r i c t s . Data were then analyzed w i t h r e s p e c t t o p o o l i n g across d i s t r i c t s . D i s c r i m i n a n t f u n c t i o n a n a l y ses were performed t o t e s t whether the r e l a t i o n s h i p s between group membership and each p r e d i c t o r v a r i a b l e d i f f e r e d i n the two d i s t r i c t s . In each case a p r e d i c t o r v a r i a b l e , a dummy v a r i a b l e r e p r e s e n t i n g d i s t r i c t , and d i s t r i c t - b y - p r e d i c t o r v a r i a b l e i n t e r a c t i o n term were t e s t e d u s i n g the Mahalanobis D technique. In no i n s t a n c e s d i d the i n t e r a c t i o n term p r e d i c t group membership a t the .05 s i g n i f i c a n c e l e v e l . In a d d i t i o n , a f u l l model i n c l u d i n g a l l e i g h t of the p r e d i c t o r v a r i a b l e s , the d i s t r i c t dummy v a r i a b l e , and the e i g h t d i s t r i c t - b y — p r e d i c t o r i n t e r a c t i o n terms was t e s t e d u s i n g the same Mahalanobis D procedure. None of the i n t e r a c t i o n terms or the d i s t r i c t membership were r e t a i n e d w i t h i n the model. These r e s u l t s suggested no s i g n i f i c a n t d i f f e r e n c e s between group membership and the p r e d i c t o r v a r i a b l e s , and the d e c i s i o n t o po o l the data a c r o s s d i s t r i c t s was taken. 129 V i s u a l and h e a r i n g a c u i t y . R e s u l t s of the S n e l l e n v i s i o n and pure tone audiometric h e a r i n g t e s t s were examined t o see whether t h e r e was a r e l a t i o n s h i p between c l a s s i f i c a t i o n d e c i s i o n s and v i s u a l and h e a r i n g a c u i t y . Although a r e l a t i o n s h i p between these v a r i a b l e s and M/EMH placement d e c i s i o n s c o u l d not be demonstrated, a d i s p r o p o r t i o n a t e group of u n t e s t a b l e s u b j e c t s was found. O v e r a l l , seven s u b j e c t s proved t o be u n t e s t a b l e on both the Pure Tone Audiometric Sweep t e s t and the S n e l l e n v i s u a l a c u i t y t e s t . S i x o f the seven were e n r o l l e d i n M/EMH c l a s s e s . I t was noted t h a t i n only 3 . 8 % of a l l cases (n = 4), were documented e f f o r t s t o have more s o p h i s t i c a t e d h e a r i n g and/or v i s u a l a c u i t y t e s t i n g performed a f t e r a s u b j e c t had proved u n t e s t a b l e . I t was a p p a r e n t l y assumed t h a t u n t e s t a b l e s u b j e c t s were able t o see and hear w i t h i n normal t o l e r a n c e s . Furthermore, i t c o u l d not be shown t h a t r e g u l a r use of v i s u a l and h e a r i n g a c u i t y data o c c u r r e d p r i o r t o the a d m i n i s t r a t i o n of psychometric t e s t s . Rather, t e s t i n g appeared t o c o n s t i t u t e checking the students r e c o r d s t o see whether a s c h o o l wide sweep t e s t had been performed i n the p r e v i o u s few years, and r e c o r d i n g t h a t data o n l y as a r e q u i s i t e t o making r e f e r r a l t o a s p e c i a l e d u c a t i o n s c r e e n i n g committee. 130 C l a s s i f i c a t i o n accuracy. Each s u b j e c t ' s IQ and ada p t i v e behaviour composite score was examined, and based on the standard s c o r e s , s u b j e c t s were c l a s s i f i e d by the two-f a c t o r d i a g n o s t i c model u s i n g the c u t - o f f c r i t e r i a o f both (1) the American A s s o c i a t i o n on Mental D e f i c i e n c y (AAMD), and (2) the d r a f t B.C. S p e c i a l Education Guidebook. E r r o r s i n c l a s s i f i c a t i o n were examined t o determine which two-f a c t o r parameters were v i o l a t e d . The c l a s s i f i c a t i o n a ccuracy of a s e r i e s of models r e p r e s e n t i n g the h i s t o r i c development o f M/EMH c l a s s i f i c a t i o n models (see Chapter 2) was then e x p l o r e d through a s e r i e s of d i s c r i m i n a n t f u n c t i o n a n a l y s e s . Based on the argument t h a t the s t a n d a r d s c o r e c u t - o f f c r i t e r i o n of 75 i s more a p p r o p r i a t e f o r B.C. stude n t s than the standard s c o r e 69 c u t - o f f c u r r e n t l y proposed i n the B.C. S p e c i a l Education ( d r a f t ) G u i d e l i n e s , the former c u t - o f f c r i t e r i o n was used. O v e r a l l c o r r e c t c l a s s i f i c a t i o n o c c u r r e d i n only 77.1% of a l l cases, w h i l e i n c o r r e c t c l a s s i f i c a t i o n s among students c u r r e n t l y e n r o l l e d i n M/EMH c l a s s e s were almost one i n f o u r . V i o l a t i o n s of the AAMD IQ parameter were found t o be r e s p o n s i b l e f o r 70.4% o f the m i s c l a s s i f i c a t i o n s , e i t h e r alone (52.4%), or i n combination w i t h Adaptive Behaviour (19.0%) H i s t o r i c models. As d e s c r i b e d i n Chapters 2 and 3, a s e r i e s o f f o u r h i s t o r i c models f o r the c l a s s i f i c a t i o n o f 131 M/EMH students were drawn from the l i t e r a t u r e . These models were an a l y z e d i n the sequence i n which they appeared h i s t o r i c a l l y , being l a b e l l e d Models 1 through 4 ( i e . A d a p t i v e Behaviour alone (19th c e n t u r y ) ; IQ alone ( f i r s t h a l f of 20th c e n t u r y ) ; IQ and adaptive behaviour ( l a t e r 20th c e n t u r y ) ; and IQ, Adaptive Behaviour and Academic Achievement (1980s)). C o r r e c t c l a s s i f i c a t i o n was found t o improve a t each h i s t o r i c s t e p . Regular education c l a s s i f i c a t i o n accuracy was g r e a t e s t w i t h the IQ and ABC model (87.2%), w h i l e the M/EMH c l a s s i f i c a t i o n r a t e was h i g h e s t w i t h the IQ, ABC and Achievement composite model (92.6%). Although the IQ and ABC model c o r r e c t l y c l a s s i f i e d more r e g u l a r e d u c a t i o n students than d i d any other model, the a d d i t i o n of a measure of academic achievement had an important impact. The expansion of the h i s t o r i c t w o - f a c t o r model through the i n c l u s i o n of achievement r e s u l t e d i n the h i g h e s t r a t e o f c o r r e c t c l a s s i f i c a t i o n f o r M/EMH students as w e l l as f o r the t o t a l sample (92.0%). F u l l Model A n a l y s i s . A f u l l model which i n c l u d e d the v a r i a b l e s ABC, IQ, Achievement, Maladaption (VMS), V i s i o n , Hearing, and C h r o n o l o g i c a l Age were analyzed u s i n g two te c h n i q u e s . In the f i r s t a l l of the v a r i a b l e s were f o r c e d i n t o a d i s c r i m i n a n t f u n c t i o n a n a l y s i s (Model 5). In the 132 second (Model 6), these same v a r i a b l e s were i n c l u d e d i n a step-wise d i s c r i m i n a n t f u n c t i o n a n a l y s i s u s i n g the p . . . Mahalanobis D technique to determine the order i n which they d i s c r i m i n a t e d group membership, and t o f i n d the v a r i a b l e or combination of v a r i a b l e s t h a t most a c c u r a t e l y p r e d i c t e d t h a t membership. Model 5 showed t h a t the thr e e most important d i s c r i m i n a t i n g v a r i a b l e s i n determining present group placement were IQ (39.3%), Achievement (26.2%), and Maladaption (15.8%). Adaptive Behaviour accounted f o r o n l y 7.1% o f the p r e d i c t i o n i n Model 5, l e s s even than Hearing (7.7%). O v e r a l l c l a s s i f i c a t i o n accuracy with t h i s model was 88.4%. In Model 6, o n l y The IQ, achievement composite, and maladaption v a r i a b l e s were r e t a i n e d a f t e r the step-wise procedure was completed. T h i s combination of v a r i a b l e s c o r r e c t l y p r e d i c t e d group membership f o r the sample wi t h 89.0% accuracy. M/EMH membership was p r e d i c t e d w i t h 92.6% accuracy and r e g u l a r education membership with 84.8% accuracy. L i m i t a t i o n s of the Study L i m i t a t i o n s t o the study r e l a t e t o r e p r e s e n t a t i v e n e s s , sample s i z e , and p o s s i b l e treatment e f f e c t s . F i r s t , the r e -c r e a t i o n of the M/EMH decision-making process i n d i s t r i c t 2, 133 even though supported through an i n t e r r a t e r r e l i a b i l i t y study, i s a weakness of the desig n . Although s t r o n g agreement was achieved between the two r a t e r s , t h i s may not adequately r e p r e s e n t the d e c i s i o n s made i n the f i e l d by the nine p s y c h o l o g i s t s employed i n D i s t r i c t 2. Secondly, the p o s s i b l e treatment e f f e c t s of stud e n t s being i n e i t h e r the M/EMH or l e f t i n the r e g u l a r e d u c a t i o n programmes between the time of r e f e r r a l f o r psycho-e d u c a t i o n a l assessment and the time t h a t they were t e s t e d f o r t h i s study cannot be accounted f o r . For example, i t i s p o s s i b l e t h a t the students e n r o l l e d i n the M/EMH c l a s s e s have made s i g n i f i c a n t gains i n t h e i r a d a p t i v e behaviour o r achievement as a r e s u l t of t h a t placement, w h i l e the r e v e r s e might a l s o be t r u e . T h i r d l y , s u b j e c t s t e s t e d had a l r e a d y spent some time i n t h e i r r e s p e c t i v e placements subsequent t o being c o n s i d e r e d as p o s s i b l y M/EMH. The p o s s i b l e treatment e f f e c t s of e i t h e r b e i n g r e t a i n e d w i t h i n a r e g u l a r education classroom or be i n g p l a c e d i n t o an M/EMH classroom cannot be accounted f o r w i t h i n t h i s study. C o n c l u s i o n s and I m p l i c a t i o n s C o n c l u s i o n s and i m p l i c a t i o n s based on the r e s e a r c h r e s u l t s p r e s e n t e d i n Chapter 4 f o l l o w . These w i l l be pres e n t e d under t h r e e headings: (1) tw o - f a c t o r model, (2) 134 v i s u a l and h e a r i n g a c u i t y , and (3) summary of recommendations f o r p r a c t i c e and r e s e a r c h i n B.C. Two-Factor Model M i s c l a s s i f i c a t i o n Rate The a p p l i c a t i o n of the two-factor model u s i n g the AAMD c u t - o f f c r i t e r i o n of s.s. l e s s than or equal t o 75 t o the M/EMH group r e s u l t s i n a c o r r e c t c l a s s i f i c a t i o n r a t e of o n l y 63.2%. Thus, 36.8% of the students p r e s e n t l y l a b e l l e d and e n r o l l e d as M/EMH i n t h i s sample are not a p p r o p r i a t e l y p l a c e d a c c o r d i n g t o t h i s i n t e r n a t i o n a l l y accepted s t a n d a r d . When the more r i g o r o u s c u t - o f f c r i t e r i a of the proposed B.C. G u i d e l i n e s are a p p l i e d , the m i s c l a s s i f i c a t i o n r a t e r i s e s s i g n i f i c a n t l y t o 64.9%. 10, Maladaption and Achievement I t was demonstrated i n Model 6, t h a t the thr e e f a c t o r s a c c o u n t i n g f o r 92.6% of the placements i n t o M/EMH programmes i n t h i s sample are FSIQ, Achievement, and Maladaption (Table 11). Each of these w i l l be d e a l t with s e p a r a t e l y . 10. In each o f the s i x models presented i n Chapter 4, the IQ s c o r e was found t o dominate. Regardless of ot h e r v a r i a b l e s e n t e r e d w i t h IQ, i t c o n s i s t e n t l y ranked f i r s t . T h i s f i n d i n g p a r a l l e l s those r e p o r t e d i n Chapter 2 (Knoff, 198 4; M a c M i l l a n , 198 2; Reschly, 1988; T u r n b u l l & T u r n b u l l , 1986). I t i s a l s o noted t h a t , based on the r e l a t i v e 135 percentages found f o r each v a r i a b l e under the s i x models s t u d i e d , not o n l y d i d 10 dominate each model, i t tended to be reduced i n importance l e a s t of a l l v a r i a b l e s s t u d i e d when ot h e r v a r i a b l e s were added. For example, when Achievement was added t o the IQ and adaptive behaviour model (Model 3), the r e l a t i v e percentage of the IQ v a r i a b l e was reduced by o n l y 10.7%, w h i l e t h a t of adaptive behaviour was reduced by 23.8%. C l e a r l y , i n t h i s study, IQ has been found t o be both a c o n s i s t e n t l y dominant and robust f a c t o r i n c l a s s i f y i n g c h i l d r e n as M/EMH. Maladaption. In the r e s e a r c h of Ysseldyke e t a l . (1983), i t was s t a t e d t h a t the primary reason f o r t e a c h e r i n i t i a t i o n of r e f e r r a l s t o s p e c i a l e d u c a t i o n programmes was i d i o s y n c r a t i c , w i t h t e a c h e r s t e n d i n g t o r e f e r s tudents "who bother them" (p. 80). The presence of a measure of s o c i a l maladaption as a v i a b l e p r e d i c t o r of c l a s s i f i c a t i o n (Models 5 and 6), and one which d i s p l a c e s a measure of s o c i a l a d a p t a t i o n as a v a l i d p r e d i c t o r , i s an important f i n d i n g . I t has been shown t h a t teacher response to i n a p p r o p r i a t e student behaviour i s the key f a c t o r i n the u l t i m a t e d e c i s i o n t o i d e n t i f y a c h i l d as s p e c i a l needs. A d e c i s i o n i s then supported and e x p e d i t e d by the t e s t i n g and s c r e e n i n g process (Reschly, 1982; Ysseldyke e t a l , 1983; Tymitz, 1984). The presence of the Maladaption t e s t s c o r e 136 as a v a l i d and important p r e d i c t o r of group placement f o r t h i s sample, and one which s t a t i s t i c a l l y d i s p l a c e s s o c i a l a d a p t a t i o n when run i n comp e t i t i o n with i f , i s i n d i c a t i v e of a s i m i l a r p r o c e s s ; one i n which s o c i a l l y i n a p p r o p r i a t e behaviours have become a p a r t of the r e f e r r a l and placement p r o c e s s . Measured s o c i a l a d a p t a t i o n , the key second component of the tw o - f a c t o r model, simply f a i l e d t o d i s c r i m i n a t e student placements when p l a c e d i n c o m p e t i t i o n w i t h maladaption. T h i s suggests a phenomenon i n Canada l i k e t h a t seen i n the Un i t e d S t a t e s , t h a t many students are r e f e r r e d , t e s t e d , and l a b e l l e d as M/EMH not because they meet an accepted c r i t e r i o n , but because they demonstrate b e h a v i o u r s t h a t bother t e a c h e r s . Achievement. A s t r o n g argument has been made i n favour of the i n c l u s i o n of academic achievement as a v a l i d component of measured s o c i a l a d a p t a t i o n (Grossman, 1983; Reschly, 1982, 1986, 1988; Reschly & Gresham, 1987). In t h i s study, composite academic achievement, u s i n g a B.C. normed t e s t , was found t o be a v a l i d c o - f a c t o r w i t h IQ and Ada p t i v e Behaviour i n c o r r e c t l y p r e d i c t i n g 92.0% of M/EMH placement d e c i s i o n s . Although the maladaption t e s t measures a v a r i a b l e which ought not p r e d i c t membership, i t i s argued t h a t academic achievement i s a v a r i a b l e t h a t should r e p l a c e maladaption. 137 A c l a i m has been made (Grossman, 1983; Reschly, 1982, 1986, 1988; Reschly & Gresham, 1987) t h a t achievement i s a p a r t o f s o c i a l a d a p t a t i o n t o a sc h o o l environment. In t h i s study i t i s apparent t h a t academic performance i s a very important v a r i a b l e i n both r e f e r r i n g and p l a c i n g s tudents. Indeed, the case i s made t h a t i n the absence of s o c i a l a d a p t a t i o n , a combination of maladaptive behaviours and academic achievement d e f i c i t s has emerged as a f u n c t i o n a l measure o f s o c i a l a d a p t a t i o n a t the sc h o o l l e v e l . The M/EMH stud e n t s i n t h i s study appear t o have been r e f e r r e d and p l a c e d on the b a s i s of i d i o s y n c r a t i c classroom behaviour, coupled w i t h academic weaknesses, and as confirmed through the use of IQ t e s t s c o r e s . However, t h i s process i s not anchored t o the AAMD standard s c o r e c u t - o f f c r i t e r i o n . An Erroneous T h r e e - F a c t o r Model E i g h t y - n i n e per cent of the s u b j e c t ' s placement d e c i s i o n s can be accounted f o r by a combination of IQ, Achievement, and Maladaption. The IQ score i s a v a r i a b l e q u a n t i f i e d , u s u a l l y , by s c h o o l p s y c h o l o g i s t s . Achievement and Maladaption are v a r i a b l e s observed, and to some degree measured by classroom t e a c h e r s . I t i s the classroom t e a c h e r who u s u a l l y makes the i n i t i a l d e c i s i o n to r e f e r a c h i l d f o r assessment. I t i s patent t h a t t h a t d e c i s i o n i s based on a combination of i n a p p r o p r i a t e student behaviours and poor 138 academic achievement. F u n c t i o n a l l y , these two v a r i a b l e s appear t o merge t o form a type of s o c i a l maladaptation measure which i s then supported through the a d m i n i s t r a t i o n of an IQ t e s t . I t i s t h i s process of teacher o b s e r v a t i o n s of maladaptive behaviour and academic achievement, supported by p s y c h o l o g i s t ' s i n t e r p r e t a t i o n s of IQ t e s t s , and d e c i s i o n making d i r e c t e d by d i s t r i c t p o l i c i e s and procedures, t h a t r e s u l t s i n one out of f o u r students c u r r e n t l y p l a c e d i n M/EMH c l a s s e s b e i n g i n a p p r o p r i a t e l y l a b e l l e d They may be helped or h i n d e r e d by t h e i r placement, but they have a r r i v e d by way of a flawed p r o c e s s , one which does not r e c o g n i z e d i a g n o s t i c "best p r a c t i c e s , " and which does not c h a l l e n g e the r e g u l a r e d u c a t i o n programme or other components of the s p e c i a l e d u c a t i o n system to meet t h e i r needs. An Improved Two-Factor Model The c r i t i c a l l y important f a c t o r of IQ appears s o l i d l y i n p l a c e i n the d i s t r i c t s s t u d i e d . What i s r e q u i r e d i s the i n c l u s i o n w i t h IQ of measured Adaptive Behaviour. I t has been noted (Chapter 2) t h a t few adaptive behaviour t e s t s i n c l u d e measures of academic achievement. The s u g g e s t i o n has been made (Reschly 1982, 1986, 1988; Reschly & Gresham, 1987) t h a t the concept of adaptive behaviour, c e r t a i n l y a t the s c h o o l age l e v e l , must i n c l u d e a measure of academic achievement as a l e g i t i m a t e domain of a d a p t a t i o n . T h i s r e s e a r c h supports t h a t i d e a . Not only i s i t reasonable t o say t h a t v e r y poor academic achievement i s not good a d a p t a t i o n t o the classroom, t e a c h e r s r e c o g n i z e i t as such. I f , as Ysseldyke e t a l . (1983) have p o i n t e d out, bad behaviour t r i g g e r s r e f e r r a l s f o r t e s t i n g , the same i s proved t r u e i n t h i s study both f o r maladaptive behaviour and poor academic performance. That s o c i a l a d a p t a t i o n has not emerged as a p r e d i c t o r when examined along with s o c i a l maladaption i s i n d i c a t i v e t h a t p s y c h o l o g i s t s and o t h e r s i n charge of ps y c h o e d u c a t i o n a l e v a l u a t i o n s r e l y on c l i n i c a l judgement and the r e p o r t e d p e r c e p t i o n s and o b s e r v a t i o n s of classroom t e a c h e r s , r a t h e r than on e m p i r i c a l measures of s o c i a l a d a p t a t i o n . Teacher o b s e r v a t i o n of classroom behaviour, both s o c i a l and academic i s c e n t r a l t o the educative process r e g a r d l e s s of the type of student i n v o l v e d . In order to saf e g u a r d a g a i n s t the k i n d s of misplacements seen i n t h i s study, as w e l l as t o improve the model used i n measuring a d a p t i v e behaviour, i t i s suggested t h a t academic s k i l l s be i n c l u d e d as a f a c t o r i n measured adap t i v e behaviour. For students who are suspected of being i n the M/EMH range, a composite r e a d i n g and a r i t h m e t i c s c o r e should be a f a c t o r i n measured s o c i a l a d a p t a t i o n . Although f u r t h e r r e s e a r c h i s r e q u i r e d t o determine the b e s t l o a d i n g t h a t achievement should have as a domain of ad a p t i v e behaviour, i t i s suggested t h a t the use of a v a l i d and r e l i a b l e measure of academic achievement weighted e q u a l l y w i t h an adaptive behaviour composite i s an ap p r o p r i a t e i n t e r i m s t e p , p a r t i c u l a r l y s i n c e a t e s t o f achievement w i t h B.C. norms i s r e a d i l y a v a i l a b l e . Thus, IQ would remain as an equal f a c t o r with adaptive behaviour, i n keeping w i t h the AAMD two- f a c t o r model, pr o v i d e d t h a t the adapti v e behaviour composite score i s c a l c u l a t e d w i t h an achievement composite s c o r e weighted e q u a l l y w i t h a d a p t i v e behaviour. Reasons t o use the two-factor model. The maintenance of students w i t h s p e c i a l needs i n r e g u l a r classrooms, as much as t h e i r maintenance i n s p e c i a l education programmes, r e q u i r e s some form of i d e n t i f i c a t i o n t o determine e l i g i b i l i t y f o r f u n d i n g . Without access t o funding, s p e c i a l s e r v i c e s , r e g a r d l e s s of which environment they are o f f e r e d i n , w i l l s u f f e r . The presen t system of d i a g n o s i s and c l a s s i f i c a t i o n of M/EMH students i s s e r i o u s l y flawed and may be doing c o n s i d e r a b l e damage t o c h i l d r e n . That those students who are m i s c l a s s i f i e d have s p e c i a l needs i s not c a l l e d i n t o q u e s t i o n . Doubtless these s t u d e n t s have some demonstrated e d u c a t i o n a l needs, c e r t a i n l y i f they d i d not they would not have been taken through the r e f e r r a l , t e s t i n g , c l a s s i f i c a t i o n , and placement process. The 141 pr e v i o u s d i s c u s s i o n suggests t h a t they are e x p e r i e n c i n g academic achievement problems, and may be showing a t y p i c a l student behaviour. What i s c a l l e d i n t o q u e s t i o n i s the ap p r o p r i a t e n e s s o f l a b e l l i n g non-M/EMH students " r e t a r d e d " i n o r d e r t o o b t a i n these s e r v i c e s . C l e a r l y e i t h e r d i f f e r e n t c l a s s i f i c a t i o n s of e x c e p t i o n a l i t y should be c o n s i d e r e d i n seeki n g s p e c i a l e d u c a t i o n s e r v i c e s f o r such s t u d e n t s , o r b e t t e r l e v e l s of r e g u l a r education i n s t r u c t i o n and sup p o r t should be implemented t o meet the needs of these c h i l d r e n w i t h i n the r e g u l a r e d u c a t i o n programme. The l a b e l l i n g of students as M/EMH does not, of i t s e l f , a s s i s t s t udents i n e d u c a t i o n a l l y meaningful ways. In s t e a d , the pragmatic a p p l i c a t i o n of l a b e l l i n g as a means of o b t a i n i n g money f o r the p r o v i s i o n of e d u c a t i o n a l s e r v i c e s i s the primary reason f o r the c l a s s i f i c a t i o n p r o c e s s . However, giv e n the p o t e n t i a l l y n e g ative e f f e c t s of being l a b e l l e d as M/EMH, the use of a l a b e l f o r pragmatic funding reasons should be more c a r e f u l l y r e g u l a t e d . V i s u a l and Hearing A c u i t y S i m i l a r f i n d i n g s , c o n c l u s i o n s and recommendations emerged from the study with r e s p e c t t o both v i s u a l and he a r i n g a c u i t y . F i r s t , g e n e r a l f i n d i n g s , common t o both v i s i o n and h e a r i n g w i l l be presented, and then s e p a r a t e recommendations f o r a s s e s s i n g u n t e s t a b l e s u b j e c t s made. 142 General f i n d i n g s A s t a t i s t i c a l a s s o c i a t i o n between h e a r i n g and v i s u a l a c u i t y and M/EMH c l a s s i f i c a t i o n d e c i s i o n s was not found. However, two f i n d i n g s of t h i s study are of importance. F i r s t , more than one i n 10 M/EMH students were found t o be u n t e s t a b l e u s i n g the pure tone audiometric sweep t e s t and the S n e l l e n v i s u a l a c u i t y t e s t . Secondly, although both of the d i s t r i c t s r e q u i r e t h a t student's h e a r i n g and v i s i o n be checked b e f o r e s c r e e n i n g f o r entry i n t o M/EMH c l a s s e s , n e i t h e r d i s t r i c t r e q u i r e s t h a t p s y c h o l o g i s t s o b t a i n t e s t r e s u l t s b e f o r e performing i n i t i a l p s y c ho-educational e v a l u a t i o n s . S i n c e d e c i s i o n s about whether t o proceed w i t h a r e f e r r a l t o M/EMH are based on these e v a l u a t i o n s , t h e r e i s no requirement t o ensure t h a t c r i t i c a l v i s u a l and h e a r i n g a c u i t y t e s t i n g has been done before the important d e c i s i o n t o r e f e r a c h i l d f o r placement i s made. Where such t e s t i n g does take p l a c e , normal p r a c t i c e appears t o take the form of r e l y i n g on the most r e c e n t school-wide s c r e e n i n g of v i s i o n and hea r i n g performed by the p u b l i c h e a l t h department which the m a j o r i t y of stu d e n t s pass. In o n l y 3.8% (n = 4) of the cases examined c o u l d i t be demonstrated t h a t s p e c i a l requests were made f o r v i s i o n and h e a r i n g t e s t i n g beyond t h a t normally performed on a l l s c h o o l c h i l d r e n . A l l of the students found t o be u n t e s t a b l e 143 i n t h i s study had been p l a c e d i n t o t h e i r c u r r e n t programmes i n the absence of any o b j e c t i v e measures of sensory a c u i t y . I t i s concluded t h a t h e a r i n g and v i s u a l a c u i t y , as they r e l a t e t o the d i a g n o s i s and placement of M/EMH s t u d e n t s , i s not c o n s i d e r e d important enough by those t e s t i n g and p l a c i n g students t o take the e x t r a time and e f f o r t t o ensure t h a t examination beyond t h a t performed r o u t i n e l y i n the s c h o o l s i s undertaken. Although requirements f o r the i n c l u s i o n of such data b e f o r e s c r e e n i n g i n t o s p e c i a l programmes are i n p l a c e , they o f t e n take the form of u s i n g outdated s c h o o l -wide sweep t e s t r e s u l t s . Furthermore, s u b j e c t s found t o be u n t e s t a b l e w i t h such sweep procedures are very seldom r e f e r r e d f o r more s o p h i s t i c a t e d assessment. I n s t e a d , the assumption appears t o be t h a t , i f the c h i l d i s u n t e s t a b l e , he can't be t e s t e d a t a l l , and by d e f a u l t h i s h e a r i n g and v i s i o n are t r e a t e d as w i t h i n normal l i m i t s . A d m i n i s t e r i n g e d u c a t i o n a l l y s i g n i f i c a n t t e s t s , the r e s u l t s o f which may i n l a r g e measure determine a c h i l d ' s e d u c a t i o n a l f u t u r e , without p r i o r i n v e s t i g a t i o n of v i s u a l and h e a r i n g a c u i t y i s i n a p p r o p r i a t e . I n d i c a t i o n t h a t a c h i l d ' s sensory i n t e g r i t y has been screened s h o u l d not be a requirement f o r p l a c i n g t h a t c h i l d ' s needs b e f o r e a c l a s s i f i c a t i o n and placement committee; i t should be a 144 requirement b e f o r e any psycho-educational t e s t i n g t a k e s p l a c e . The l i t e r a t u r e supports the use of the pure tone a u d i o m e t r i c sweep t e s t and S n e l l e n v i s u a l a c u i t y t e s t as ways o f s c r e e n i n g l a r g e p o p u l a t i o n s of students f o r sensory d e f i c i t s . However, f o r students who are o f t e n d i f f i c u l t t o t e s t , and who have hig h e r than average f r e q u e n c i e s o f middle ear i n f e c t i o n s , such as the M/EMH (Nolan & Tucker, 1984, 1981; Cunningham & McArthur, 1982; Brooks, 1978) such sweep t e s t i n g i s o f t e n i n s u f f i c i e n t . That more than 10% of the M/EMH students i n t h i s study were u n t e s t a b l e u s i n g s t a n d a r d sweep procedures u n d e r l i n e s t h i s problem. To d e c l a r e a student u n t e s t a b l e f o r sensory a c u i t y and t o then proceed w i t h the a d m i n i s t r a t i o n of psycho-educational t e s t s assuming t h a t t h e i r sensory a c u i t y i s w i t h i n normal l i m i t s i s p a t e n t l y i n a p p r o p r i a t e . A l t e r n a t e T e s t i n g Procedures Hearing t e s t s . There are s e v e r a l a l t e r n a t i v e procedures f o r t e s t i n g students found t o be u n t e s t a b l e u s i n g sta n d a r d sweep procedures. Students f o r whom r e l i a b l e sweep t e s t procedures cannot be obtained should be r e f e r r e d t o a competent a u d i o l o g i s t or other a p p r o p r i a t e l y t r a i n e d person f o r a h e a r i n g e v a l u a t i o n before psycho-educational t e s t i n g proceeds. Such procedures i n c l u d e (1) p l a y audiometry (Bess 145 & McConnell, 1981; Roesser & Northern, 1981); (2) speech s c r e e n i n g ( G r i f f i n g , Simonton, & Hedgecock, 1967); (3) a c o u s t i c impedance audiometry (Northern, 1984; J e r g e r , 1970); and (4) a c o u s t i c r e f l e c t r o m e t r y (Bess, 1986; T e e l e & T e e l e , 1984). Such procedures should always be used p r i o r t o the a d m i n i s t r a t i o n of psycho-educational t e s t s f o r c l a s s i f i c a t i o n purposes when accurate sweep t e s t i n g i s i m p o s s i b l e . The b e s t course of a c t i o n i s t o arrange a r e f e r r a l t o an a p p r o p r i a t e a u d i o l o g i s t . V i s i o n t e s t s . The same obs e r v a t i o n s made w i t h r e s p e c t t o the t e s t i n g of a u d i t o r y a c u i t y apply t o v i s u a l a c u i t y . Where st u d e n t s are found to be u n t e s t a b l e u s i n g the S n e l l e n t e s t , r e c o u r s e t o o t h e r t e s t procedures p r i o r t o the a d m i n i s t r a t i o n o f psycho-educational t e s t s s h o u l d be made. The l i t e r a t u r e suggests t h a t when a c h i l d e i t h e r f a i l s a sweep v i s i o n t e s t , or i s found to be u n t e s t a b l e , or i s too young t o respond t o techniques commonly used i n sweep t e s t i n g , r e f e r r a l t o an o p t o m e t r i s t , p r e f e r a b l y one s p e c i a l i z i n g i n p e d i a t r i c optometry i s a p p r o p r i a t e ( H a l l a h a n & Kaufmann, 1988; Barraga, 1983). Techniques used t o t e s t such a youngster can i n c l u d e the D i a g n o s t i c Assessment Procedure (Barraga, 1983), o c u l a r examination, and p l a y o p h t h a l m o l o g i c a l procedures (Hallahan & Kaufmann, 1988). 146 The b e s t r e c o u r s e i s t o arrange a r e f e r r a l t o a competent opto m e t r i c or o p h t h a l m o l o g i c a l s p e c i a l i s t . Those who pass. I t has been noted t h a t approximately 80% of a l l of the s u b j e c t s screened i n t h i s r e s e a r c h passed both the S n e l l e n and Pure Tone Audiometric Sweep t e s t s . These f i g u r e s may not adequately r e p r e s e n t what a c t u a l l y o ccurs i n p r a c t i c e . As mentioned, i t appears t h a t the c o l l e c t i o n of h e a r i n g and v i s u a l a c u i t y i n f o r m a t i o n i s an a f t e r t h o u g h t , taken between a c t u a l t e s t i n g and the f i l l i n g i n of the a p p l i c a t i o n f o r s p e c i a l education s e r v i c e s forms. I t i s apparent t h a t r e l i a n c e i s o f t e n p l a c e d on h e a r i n g and v i s u a l a c u i t y r e s u l t s t h a t are not r e c e n t . In one case, the use of S n e l l e n t e s t r e s u l t s more than t h r e e years o l d were used i n the a p p l i c a t i o n of a c h i l d . Best p r a c t i c e s i n s c r e e n i n g c h i l d r e n f o r s p e c i a l education programmes, indeed whenever d e t a i l e d and p o s s i b l y c r i t i c a l p s y c h o e d u c a t i o n a l t e s t s are a d m i n i s t e r e d , should r e q u i r e t h a t t e s t i n g be r e c e n t , and c e r t a i n l y no more than one year o l d (Bess & McConnell, 1981; Barraga, 1983). Furthermore, where a c h i l d i s found t o be u n t e s t a b l e , the procedures o u t l i n e d i n the s e c t i o n s above s h o u l d be f o l l o w e d before t e s t i n g b e g i n s . I t w i l l be argued t h a t t h i s i s a time consuming procedure, and indeed i t i s . However, the r e s u l t s of g e n e r a t i n g s p u r i o u s t e s t s c o r e s , of l a b e l l i n g and i n a p p r o p r i a t e l y p l a c i n g a 147 c h i l d because of a h e a r i n g or v i s i o n a c u i t y d e f i c i t make the use o f such time e s s e n t i a l . Recommendations f o r P r a c t i c e  B a s i s f o r Recommendations R e f l e c t i n g the f i n d i n g s of many U.S. authors (Knoff, 1984; M a c M i l l a n , 1982; Reschly, 1988; T u r n b u l l & T u r n b u l l , 1986), IQ s c o r e s appear t o dominate placement d e c i s i o n s . I f the AAMD t w o - f a c t o r d i a g n o s t i c model were u n d e r l y i n g placement d e c i s i o n s , i t would be expected t h a t the a d a p t i v e behaviour composite sco r e should have c o n s i s t e n t l y emerged as a v a l i d d i s c r i m i n a t o r of student c l a s s i f i c a t i o n s . While a d a p t i v e behaviour d i d not emerge as a d i s c r i m i n a t o r o f group placement i n the presence of measured maladaption, academic achievement, a v a r i a b l e t h a t i s arguably a v a l i d domain of sch o o l s o c i a l a d a p t a t i o n (Reschly, 1982, 1986, 1988; Reschly & Gresham, 1987) d i d . T h i s r e l a t i o n s h i p between academic achievement and c l a s s i f i c a t i o n as M/EMH supports the argument t h a t poor academic performance serves as a t r i g g e r f o r r e f e r r a l s t o M/EMH programmes. The i n c l u s i o n of a v a l i d and r e l i a b l e measure o f academic performance as a sub-domain o f s o c i a l a d a p t a t i o n i s supported. The f i n d i n g t h a t maladaptive behaviour i s a p r e d i c t o r of M/EMH c l a s s i f i c a t i o n i s of c o n s i d e r a b l e i n t e r e s t , as i s 148 i t s e f f e c t on s o c i a l a d a p t a t i o n when the two are run i n c o m p e t i t i o n . The V i n e l a n d Adaptive Behavior S c a l e s do not i n c l u d e the Maladaptive S c a l e i n the c a l c u l a t i o n o f the o v e r a l l a d a p t i v e composite s c o r e . Indeed, the maladaptive s c a l e i s not c o n s i d e r e d t o be a sub-domain of a d a p t i v e behaviour. Although maladaptive behaviours can be a s s o c i a t e d w i t h lowered adaptive f u n c t i o n i n g (Sparrow, e t a l , 1984), they are not considered as v a l i d measures o f s o c i a l a d a p t a t i o n . T h i s i s p a r t i c u l a r l y s i g n i f i c a n t when i t i s noted t h a t the presence of a t y p i c a l b e haviours, w h i l e a s s o c i a t e d w i t h m e n t a l l y handicapped s t u d e n t s , i s c e r t a i n l y not e x c l u s i v e t o t h a t p o p u l a t i o n . The f a c t t h a t maladaption o v e r r i d e s s o c i a l a d a p t a t i o n as a p r e d i c t o r of M/EMH placement suggests t h a t r e f e r r a l s of students f o r M/EMH placement may, i n p a r t , occur because of the presence of d i s r u p t i v e behaviours i n the r e g u l a r classroom. That a measure o f s o c i a l l y i n a p p r o p r i a t e behaviour as r e p o r t e d by classroom t e a c h e r s serves as a p r e d i c t o r o f M/EMH c l a s s i f i c a t i o n , suggests t h a t i n a p p r o p r i a t e s t u d e n t behaviours are f u e l l i n g , a t l e a s t i n p a r t , i n a p p r o p r i a t e placements i n t o M/EMH c l a s s e s . Thus, i n s t e a d of "...the standards o f p e r s o n a l independence and s o c i a l r e s p o n s i b i l i t y " (Grossman, 1973, p.11) s e r v i n g as a determinant of M/EMH placement, " u n d e s i r a b l e b e h a v i o r s " 149 (Sparrow, e t a l . , 1984, p. 3) are s e r v i n g t h a t f u n c t i o n . The f i n d i n g s o f t h i s study are t h a t u n d e s i r a b l e student behaviour, a l o n g w i t h poor academic achievement, forms a primary b a s i s f o r l a b e l l i n g c h i l d r e n as m e n t a l l y handicapped and p l a c i n g them i n s p e c i a l education classrooms. R e f e r r a l s made on the b a s i s o f these two v a r i a b l e s , o f t e n without o b j e c t i v e v e r i f i c a t i o n , are supported by IQ s c o r e s performed without r e f e r e n c e t o sensory a c u i t y i n f o r m a t i o n , o r t o i n t e r n a t i o n a l l y r e c o g n i z e d c u t - o f f c r i t e r i a . P r e s e n t p r a c t i c e i n c l a s s i f y i n g students as M/EMH r e s u l t s i n l a r g e numbers of stud e n t s being i n a p p r o p r i a t e l y l a b e l l e d as " r e t a r d e d . " A c l e a r p a t t e r n of o v e r i d e n t i f i c a t i o n has emerged. Recommendation 1 That the tw o - f a c t o r d i a g n o s t i c model, wi t h the c u t - o f f c r i t e r i a f o r each f a c t o r s e t t o the upper l i m i t s suggested by the AAMD (sta n d a r d score 75), and with v a l i d measures of academic achievement i n c l u d e d as 50% of o v e r a l l s o c i a l a d a p t a t i o n , be adopted. S u p p o r t i v e statement. The evidence of t h i s study supports the AAMD two-factor d i a g n o s t i c model as be i n g the most a p p r o p r i a t e . In a d d i t i o n to the support t h a t t h i s model r e c e i v e s i n t e r n a t i o n a l l y , f o r the p o p u l a t i o n s t u d i e d i t p r o v i d e d the h i g h e s t l e v e l of p r o t e c t i o n a g a i n s t 150 i n a p p r o p r i a t e l y l a b e l l i n g c h i l d r e n as M/EMH. The use of the c u r r e n t l y suggested standard score 69 c u t - o f f i s i n a p p r o p r i a t e f o r use i n B r i t i s h Columbia and s h o u l d be abandoned. Throughout, every e f f o r t should be made t o a v o i d the use of " c l i n i c a l judgement" i n making placement d e c i s i o n s . Repeatedly, c l i n i c a l judgement has been shown t o be both an i n e f f e c t i v e and dangerous t o o l i n d e c i s i o n making. The use of a v a r i e t y of o b j e c t i v e e v a l u a t i o n techniques s h o u l d be the b a s i s of sound d i a g n o s t i c and placement p r a c t i c e . Recommendation 2 E d u c a t i o n a l p o l i c y should be a r t i c u l a t e d t h a t guarantees t h a t student's v i s u a l and h e a r i n g a c u i t y has been as s e s s e d a p p r o p r i a t e l y before the a d m i n i s t r a t i o n of psycho-e d u c a t i o n a l t e s t s , t h a t such i n f o r m a t i o n be no more than s i x months o l d , and t h a t i n cases where students are found u n t e s t a b l e u s i n g normal s c h o o l procedures, r e f e r r a l f o r s p e c i a l i s t assessment be made. Su p p o r t i v e statement. Psycho-educational t e s t s can have tremendous e f f e c t s i n the l i v e s of s t u d e n t s . The importance of q u a n t i f y i n g sensory a c u i t y has been c l e a r l y demonstrated. Where students f a i l sweep t e s t i n g , p s y c h o l o g i s t s s h o u l d not proceed with t e s t i n g u n t i l the 151 r e s u l t s o f more d e t a i l e d i n v e s t i g a t i o n s of h e a r i n g and v i s u a l a c u i t y have been performed. Where students are found t o be u n t e s t a b l e , an assumption t h a t the c h i l d i s not s e n s o r i a l l y i mpaired should never be made. R e f e r r a l t o a p p r o p r i a t e persons capable of t e s t i n g d i f f i c u l t t o t e s t students should be made, and f u r t h e r t e s t i n g not performed u n t i l r e s u l t s are r e c e i v e d . Under no circumstances should any c h i l d be a d m i n i s t e r e d a ps y c h o - e d u c a t i o n a l t e s t without v i s u a l and h e a r i n g a c u i t y i n f o r m a t i o n b e i n g a v a i l a b l e which i s l e s s than s i x months o l d and which has addressed problems of u n t e s t a b i l i t y . D i r e c t i o n s f o r Fu r t h e r Research Based on the r e s u l t s of the presen t study, s e v e r a l recommendation f o r f u r t h e r r e s e a r c h are p r o v i d e d . In each case, a b r i e f r a t i o n a l e f o r the recommendation i s g i v e n . Recommendation 1 A r e p l i c a t i o n of t h i s study but with a l a r g e r sample s i z e drawn from a wider v a r i e t y of s c h o o l d i s t r i c t s and from o t h e r Canadian p r o v i n c e s should be undertaken. T h i s study s h o u l d seek t o g u a n t i f y a l l p r e d i c t o r v a r i a b l e s under study b e f o r e s u b j e c t s begin t h e i r e d u c a t i o n a l placements t o e l i m i n a t e p o s s i b l e treatment e f f e c t s generated by those placements. 152 The c u r r e n t study was r e s t r i c t e d t o two m e t r o p o l i t a n s c h o o l d i s t r i c t s . The i n c l u s i o n of an a p p r o p r i a t e mix of urban and r u r a l d i s t r i c t s , drawn from more p r o v i n c e s would improve the g e n e r a l i z a b i l i t y of r e s u l t s , as would c o n t r o l f o r treatment e f f e c t s . Recommendation 2 An i n v e s t i g a t i o n of the reasons teachers r e f e r s t u d e n t s as suspected M/EMH i s needed. T h i s r e s e a r c h suggests t h a t maladaptive behaviour and poor academic achievement are major determinants of placement d e c i s i o n s . T h i s hypothesis c o u l d be i n v e s t i g a t e d by t r a c k i n g r e f e r r a l s back t o the o r i g i n a t i n g t e a c h e r and a n a l y z i n g how and why the r e f e r r a l s are made. Recommendation 3 An i n v e s t i g a t i o n o f the e f f i c a c y of placements i n t o M/EMH programmes should be made. The p r e s e n t study d i d not examine the e f f i c a c y o f M/EMH versus r e g u l a r e d u c a t i o n placements. A l o n g i t u d i n a l study i n which pre and post c l a s s i f i c a t i o n measures o f i n t e l l i g e n c e , s o c i a l a d a p t a t i o n and achievement are made may address the q u e s t i o n o f placement accuracy not j u s t i n terms of a c l a s s i f i c a t i o n standard but a l s o i n terms of c l a s s i f i c a t i o n e f f i c a c y . 153 Recommendation 4 An i n v e s t i g a t i o n of the accuracy of c l a s s i f i c a t i o n d e c i s i o n s f o r M o d e r a t e l y / T r a i n a b l y M e n t a l l y Handicapped (M/TMH) ver s u s M/EMH i s needed. T h i s study has focussed on the accuracy of p l a c i n g a student i n e i t h e r M/EMH or r e g u l a r education programmes. A t the lower end of the M/EMH range, d e c i s i o n s t o c l a s s i f y a student as M/EMH or M/TMH are r e g u l a r l y made. 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Weschler I n t e l l i g e n c e S c a l e f o r  C h i l d r e n - Revised. New York: P s y c h o l o g i c a l C o r p o r a t i o n . Witt, J . C. (1985). Review of the Wechsler I n t e l l i g e n c e S c a l e f o r C h i l d r e n - Revised. In J . M i t c h e l l ( E d . ) , The N i n t h Mental Measurements Yearbook. Volume I I (pp. 1713-1714). L i n c o l n , Nebraska: U n i v e r s i t y of Nebraska. Witt, J . C. & Martens, B. K. (1984). Adaptive b e h a v i o r : T e s t s and assessment i s s u e s . School Psychology Review, (13)4, S t r a t f o r d , CT., 478-484. Wormeli, C. T. (1983). BC QUIET - B.C. Quick I n d i v i d u a l  E d u c a t i o n a l T e s t . Vancouver, B.C.: The Education C l i n i c , U n i v e r s i t y of B r i t i s h Columbia. Wormeli, C. T. (1984). Development of the B r i t i s h Columbia  Quick I n d i v i d u a l E d u c a t i o n a l T e s t . D o c t o r a l d i s s e r t a t i o n . Vancouver, B.C.: U n i v e r s i t y of B r i t i s h Columbia. Ysseldyke, J . , Thurlow, M., Graden, J . , Wesson, C., A l g o z z i n e , B., & Deno, S. (1983). G e n e r a l i z a t i o n s from f i v e years of r e s e a r c h on assessment and d e c i s i o n making: the U n i v e r s i t y of Minnesota I n s t i t u t e . E x c e p t i o n a l C h i l d r e n Q u a r t e r l y . 4(1), 75-93. APPENDIX A D i s t r i c t One P s y c h o l o g i s t Case L o g Currant Walt Lltt Previous Malt Ll*t Opanad Cloaad Ra-Opan Consultlnq W i t h Taachar A> taxing Providing Tharapy Work-up Ratarrat to Spac. Prograa HonItor Inq Casa Araa I V M 2 Araa 3 —I > m 3 O <. r— > —I o X -« m — _ O .1 A 8 APPENDIX B D i s t r i c t One R e f e r r a l t o P s y c h o l o g i s t Form KEY CODES: CRAPE (OR CODE ONLY IF IN SPECIAL CLASS); K - 12 Primary = PS Intermediate « IS Junior Secondary * JS Senior Secondary • SS CASE STATUS; Yes = Y No " N ACTION BEING TAKEN: New Action • ACT Continuing Act ion •= CON Completed Act ion • FIN No Act ion « NO PROBLEM AREA; Limited Intel lectual Functioning • MH Learning D i s a b i l i t i e s - LD Ciftedness » C Behaviour: Social Relationships • SB Work At t i tude » WB Other « OTH SCHOOL D I S T R I C T NO. D I S T R I C T PSYCHOLOGIST R E F E M A T T O R M D A T E : DISTRICT PSYCHOLOGIST: PUPIL'S NAME: BIRTHDATE: F I R S T LANGUAGE: A G E : SCHOOL: S E X : 169 GRADE: DIV: Y j M—7 D~ TEACHER: PARENTS OR GUARDIANS: Mother's Name: Father 's Name: WRITTEN PARENTAL PERMISSION GRANTED FOR ASSESSMENT OR DIRECT SERVICES: Yes PHONE: No Home Mother's Work No. HOME ADDRESS: MEDICATION REGULARLY TAKEN: POSSIBLE SIDE EFFECTS: Father's Work No. (Postal Code) OTHER SPECIAL PROGRAMME PERSONNEL OR OUTSIDE AGENCIES CURRENTLY INVOLVED: Speech/Language Pathologist Teacher of the Hearing Impa1red_ Physiotherapist Teacher of Visua l ly Impaired Elementary Counsellor Other SIBLINGS: AGE: AGE: GR: GR: AGE: AGE: GR: GR: SCHOOL HISTORY: ( ) Number of school moves ( ) 4 year primary program ( ) Repeated; grade(s) Last year ' s teacher: ( ) Accelerated; grade(s) ( ) Enriched; grade(s) ( ) Special Class; type School: OTHER SERVICES PRESENTLY OFFERED: ( ) L . A . ; No. of hours/week ( ) E . S . L . ; No. of hours/week ( ) Special Class; type Other addit ional service: ( ) Group (_ Language 1n home: ) Individual Integrated subjects: Oate: Pr inc ipa l Date Forwarded to D i s t r i c t Psychologist : Date Action Taken: I n i t i a l Action Taken: cc : School G4 F i l e D i s t r i c t Psychologist REASON FOR REFERRAL - WHAT ARE YOUR MAIN CONCERNS? EXPECTATIONS FROM REFERRAL - WHAT SPECIFICALLY WOULD YOU LIKE TO SEE RESULT FROM THIS REFERRAL?: CLASSROOM TEACHER'S OBSERVATIONS: CLASSROOM TEACHER: L . A . TEACHER'S/COUNSELLOR'S OBSERVATIONS: (Including test resu l t s , corrective measures t r i ed . ) L . A . TEACHER/COUNSELLOR: PRINCIPAL'S COMMENTS: DISTRICT PSYCHOLOGIST'S NOTES: HANDICAPPING CONDITION: (To be completed by Psychologist) S100 88/01 APPENDIX C D i s t r i c t Two R e f e r r a l t o P s y c h o l o g i s t Form 172 PUPIL REFERRAL FOR SPECIAL EDUCATION SERVICES NAME: M • F • GRADE: BIRTHDATE: SCHOOL: TEACHER: DIV.: ROOM: HOME ADDRESS: POSTAL CODE: TELEPHONE: DATE OF REFERRAL: PARENTS/GUARDIANS: NAMES & AGES OF SIBLINGS: (1) (2) (3) (4) (5) ALL INFORMATION MUST BE PROVIDED BEFORE ACTION CAN BE TAKEN PLEASE SUBMIT IN DUPLICATE TYPE OF SERVICE REQUESTED (Please check one or more) • Psychoeducational Assessment • Another placement (specify) • Occupational Therapy Consultation • Psychoeducational Consultation REASON FOR REFERRAL What questions do you hope to have answered by this referral? This section MUST be completed by the School Based team. TEACHER: Signature: L.A. TEACHER: Signature: COUNSELLOR: Signature: PRINCIPAL: Signature: SPEECH/LANGUAGE PATHOLOGIST: Signature: E.S.L. TEACHER/OTHER: (Language spoken at home: Signature: 173 Efforts by school personnel within the current school year (Please check and Indicate dates) • • a a Parent conference _ Learning assistance E.S.L. instruction Counsellor intervention • Speech/Language therapy • Visits by helping teacher _ • Parent helper • Other (specify) Previous efforts by school personnel (Please check and Indicate dates) a D • D D • Counsellor intervention Reading enhancement . Speech therapy Visits by helping teacher Referral for special services S.A.E.C.E. D Remedial reading • Special class O E.S.L. instruction • Other (specify) ACADEMIC INFORMATION Please provide information as requested. • Reading (1) Present reading program and instructional level: (2) Describe achievement and progress: • Arithmetic (1) Describe achievement and progress: 174 0 Language (1) Describe strengths (e.g. spoken language, written language, listening comprehension): (2) Concerns: • Behavloral/Soclal (1) Describe strengths: (2) Concerns: SCHOOL INTERVENTIONS Academic Describe any special curriculum programs or academic assistance that has been provided for the pupil. How long has this program/these programs been used with this pupil and what gains have been made as a result? Behavloral/Soclal Describe special help or special behavioral/social programs the pupil has received or is currently receiving. How long has this program/these programs been used with this pupil and what gains have been made as a result? 175 SCHOOL HISTORY Names and dates of other schools attended (attach copy of PR card if desired) School Location Dates YES YES YES Specify Did pupil attend Kindergarten? NO Has pupil repeated a grade? NO Has pupil a history of excessive absence or tardiness? NO If "YES," when did it start? TESTING HISTORY Report the most recent results for each test. If achievement testing is more than one year old. please update prior to submission of referral. PEABODY PICTURE VOCABULARY TEST-REVISED (PPVT-R) Date: Form: Standard Score: Percentile:. DURRELL ANALYSIS OF READING DIFFICULTY Date: Oral Reading: Silent Reading: Listening Comprehension: (please include) Flash Words: Word Analysis: Spelling: Grade Placement Grade Score Grade Score Grade Score Grade Score Grade Score Grade Score GROUP ACHIEVEMENT TEST Name of Test: Scores: Date: WECHSLER INTELLIGENCE SCALE FOR CHILDREN-REVISED (WISC-R) Date: Full Scale IQ: Verbal IQ: Performance IQ: OTHER: APPENDIX D L e t t e r o f C o n t a c t W i t h S c h o o l P r i n c i p a l s THE UNIVERSITY OF BRITISH COLUMBIA F A C U L T Y O F EDUCATION 2125 M A I N M A L L UNIVERSITY CAMPUS A 7 7 VANCOUVER. B.C.. CANADA '' ' V6T 1Z5 date D a v i d E . C a r t e r ft S t u d y o f D i a g n o s t i c and Placement P r a c t i c e s T o : The p r i n c i p a l , S c h o o l Dear _ , A f t e r a p p l i c a t i o n to the S c h o o l B o a r d , I have r e c e i v e d the p e r m i s s i o n of to c o n t a c t you by l e t t e r . I am a d o c t o r a l s t u d e n t in the Department o f E d u c a t i o n a l P s y c h o l o g y / S p e c i a l E d u c a t i o n a t the U n i v e r s i t y of B r i t i s h C o l u m b i a . Under the s u p e r v i s i o n of D r . P . L e s l i e , D r . T . Rogers and D r . D. W l l l m s , I am c o n d u c t i n g a s t u d y o f the a c c u r a c y o f d i a g n o s t i c and p lacement p r a c t i c e s In making e d u c a t i o n a l d e c i s i o n s about c h i l d r e n . Two g r o u p s o f s t u d e n t s are i n c l u d e d i n the s t u d y : <1) e l e m e n t a r y age c h i l d r e n who have r e c e i v e d s t a n d a r d i z e d , i n d i v i d u a l e d u c a t i o n a l assessments s i n c e September , 1987, and who a r e c u r r e n t l y e n r o l l e d in r e g u l a r c l a s s e l e m e n t a r y programmes, and (2) e l e m e n t a r y aged s t u d e n t s who have r e c e i v e d s t a n d a r d i z e d i n d i v i d u a l e d u c a t i o n a l a s se s sments over the same t i m e , and who are c u r r e n t l y e n r o l l e d In e l e m e n t a r y s p e c i a l e d u c a t i o n programmes. We w i s h t o i n c l u d e a random sample o f s t u d e n t s from group 1, and a l l o f the s t u d e n t s i n group 2. E a c h s t u d e n t i n the s t u d y w i l l be a d m i n i s t e r e d an i n d i v i d u a l i z e d assessment g i v e n by e i t h e r myse l f or a q u a l i f i e d r e s e a r c h a s s i s t a n t under my s u p e r v i s i o n . A l l t e s t i n g w i l l be c o n d u c t e d by e x p e r i e n c e d and l i c e n s e d t e a c h e r s a c t i n g as r e s e a r c h a s s i s t a n t s . The s t u d y w i l l p r o v i d e v a l u a b l e i n f o r m a t i o n w i t h r e s p e c t to the use o f s t a n d a r d i z e d , I n d i v i d u a l e d u c a t i o n a l a s s e s s m e n t s . E a c h s t u d e n t i n c l u d e d In the s t u d y w i l l be APPENDIX E L e t t e r o f C o n t a c t W i t h P a r e n t s / G u a r d i a n s and P a r e n t / G u a r d i a n Consent Form T H E UNIVERSITY OF BRITISH COLUMBIA F A C U L T Y OF E D U C A T I O N tlZS M A I N M A L L UNIVERSITY CAMPUS VANCOUVER. B.C.. CANADA 180 V6T 1Z5 A S t u d y o f D i a g n o s t i c and P lacement P r a c t i c e s Dear P a r e n t / G u a r d i a n , I am a d o c t o r a l s t u d e n t i n t h e Department o f E d u c a t i o n a l P s y c h o l o g y / S p e c i a l E d u c a t i o n a t t h e U n i v e r s i t y o f B r i t i s h C o l u m b i a . Under t h e s u p e r v i s i o n o f D r . P . L e s l i e , D r . T . R o g e r s and D r . D . W i l l m s , I am c o n d u c t i n g a s t u d y o f t h e a c c u r a c y o f d i a g n o s t i c and p l a c e m e n t p r a c t i c e s i n making e d u c a t i o n a l d e c i s i o n s about c h i l d r e n . Two g r o u p s o f s t u d e n t s a r e i n c l u d e d i n t h e s t u d y : (1) e l e m e n t a r y age c h i l d r e n who have r e c e i v e d s t a n d a r d i z e d , i n d i v i d u a l e d u c a t i o n a l a s s e s s m e n t s s i n c e S e p t e m b e r , 1 9 8 7 , and who a r e c u r r e n t l y e n r o l l e d i n r e g u l a r c l a s s e l e m e n t a r y programmes, a n d (2) e l e m e n t a r y aged s t u d e n t s who h a v e r e c e i v e d s t a n d a r d i z e d i n d i v i d u a l e d u c a t i o n a l a s s e s s m e n t s o v e r t h e same t i m e , and who a r e c u r r e n t l y e n r o l l e d i n e l e m e n t a r y s p e c i a l e d u c a t i o n programmes. We w i s h t o i n c l u d e a random sample o f s t u d e n t s f r o m g r o u p 1, and a l l o f t h e s t u d e n t s i n group 2 . E a c h s t u d e n t i n t h e s t u d y w i l l be a d m i n i s t e r e d an i n d i v i d u a l i z e d a s se s sment g i v e n b y e i t h e r m y s e l f o r a q u a l i f i e d r e s e a r c h a s s i s t a n t u n d e r my s u p e r v i s i o n . A l l t e s t i n g w i l l be c o n d u c t e d by e x p e r i e n c e d and l i c e n s e d t e a c h e r s a c t i n g a s r e s e a r c h a s s i s t a n t s . The s t u d y w i l l p r o v i d e v a l u a b l e i n f o r m a t i o n w i t h r e s p e c t t o t h e u s e o f s t a n d a r d i z e d , i n d i v i d u a l e d u c a t i o n a l a s s e s s m e n t s . E a c h s t u d e n t i n c l u d e d i n t h e s t u d y w i l l be a d m i n i s t e r e d t h e f o l l o w i n g t e s t s : B r i t i s h C o l u m b i a Q u i c k E d u c a t i o n a l A c h i e v e m e n t T e s t ( r e a d i n g a n d a r i t h m e t i c s u b t e s t s o n l y ) S n e l l e n v i s u a l a c u i t y t e s t P u r e T o n e H e a r i n g A c u i t y T e s t The t o t a l t e s t i n g t i m e f o r t h i s b a t t e r y o f t e s t s i s e s t i m a t e d a t a p p r o x i m a t e l y 45 m i n u t e s t o 1 h o u r . I n a d d i t i o n , a s m a l l g r o u p o f s t u d e n t s ( e s t i m a t e d . a t 10%) who h a v e n o t h a d a t e s t o f g e n e r a l c o g n i t i v e a b i l i t y s i n c e S e p t e m b e r , 1987 , w i l l be a d m i n i s t e r e d t h e W e c h s l e r I n t e l l i g e n c e S c a l e s f o r C h i l d r e n - R e v i s e d . T h i s w i l l b e a d m i n i s t e r e d s e p a r a t e l y f r o m t h e o t h e r t e s t b a t t e r y , a n d i s * e s t i m a t e d t o t a k e f r o m 1 t o 1 1/2 h o u r s . C l a s s r o o m t e a c h e r s APPENDIX F B r i t i s h C o l u m b i a M i n i s t r y o f E d u c a t i o n D r a f t S p e c i a l E d u c a t i o n G u i d e l i n e s f o r I d e n t i f y i n g M e n t a l l y Handicapped C h i l d r e n 183 Spec—1 Education Manual DRAFT ONLY STUDENTS WITH MENTAL HANDICAPS ( 3 . 2 0 . 3 . 2 1 . 3 " DEFINITION Pr imar i l y because their cognitive development differs from that o f the i r peers , s tudents wi th menta l handicaps require additional resources tn order to develop the i r abil i t ies to the fullest extent. W i t h ongoing support , these s tudents c a n become valuable contributors to school and community life. The classification system for mental retardation Is based. In part, o n degrees o f intelligence as measured on one or more standardized tests. Levels of retardat ion are based an the IQ score. For purposes of determining program funding tn B.C. the following classifications are currently used. (AAMD 1 9 7 3 ) Class i f ica t ions of Retardation b v Amer ican Associat ion on M e n t a l De f i c i ency k_t Range by Test Level of Re ta rda t ion S tandard Deviat ion Range Blnet Wechsler M i l d - 3 . 0 0 to - 2 . 0 1 Modera te - 4 . 0 0 to - 3 . 0 1 Severe P r o f o u n d 5 2 - 6 8 5 5 - 6 9 3 6 - 5 1 4 0 - 5 4 B.C. Sped E s t i m a t e d Category preva lence 3 . 2 7 1 . 3 5 % 3 2 0 . 3 6 % 3 2 1 . 0 9 % - 5 . 0 0 t o - 4 . 0 1 • 5 . 0 1 and below 2 0 - 3 5 2 5 - 3 9 1 9 and 2 4 and below below IDENTIFICATION AND ASSESSMENT T h e Ident l f lcaUon of bo th severely a n d moderately menta l ly h a n d i c a p p e d s tuden t s win l i k e l y o c c u r before they enter the school sys tem. T h e i n i U a l identif icat ion m a y occur at b i r th If definite physical characterist ics are evident . And measurable delays to a chi ld ' s general cognitive development w i l l o c c u r I n the first five years of _ie. A complete assessment of the ch i ld , involving a n Inter-d isc ip l inary team, should be obtained as early as possible, preferably before the c h i l d reaches school age. M i l d l y menta l ly handicapped s tudents may not necessarily be Identified before they enter the school t rys tem. especially tf their verbal and social s k i l l s are not delayed sigrUfkartih/.rrhe handicap may . however, appear later i n life a s a resu l t of i l lness , accident, or trauma.) Special Education Manual DRAFT ONLY In order to assess mentally handicapped students tt i s first necessary to observe t h e l e a r n i n g strengths and needs of the student. T h e f i n d i n g s f r o m these o b s e r v a t i o n s m a y Indicate w h e n a n d i f the s tudent r e q u i r e s a d d i t i o n a l educat ional support so that the student may attain age-appropriate coping s k i l l s a n d develop educational potential. T h e second step is a formal psychoeducational assessment to determine the s t u d e n t ' s level of f u n c t i o n i n g . A t m i n i m u m , assessment s h o u l d i n c l u d e m e a s u r e s of mental ability a n d adaptive behaviour. T h e most frequently used tests i n assessing mental abi l i ty are the Stanford-Blnet(revlsed). a n d the Wechsler Intelligence Scale for Children(revised). T h e r e s u l t s of these tests are only general indicators of present m e n t a l development, a n d schools are urged to use them with extreme caution. A s s e s s m e n t of adaptive behaviour should include s u c h i n s t r u m e n t s as the V i n e l a n d S o c i a l M a t u r i t y Scale a n d the Adaptive Behavior F u n c t i o n i n g Index (A_A_M.D.). The assessment should provide a profile of the ch i ld ' s performance level i n a l l s k i n areas. The purpose of the assessment is to a i d In the placement of a student a n d i n program design. A menta l abi l i ty score alone is not sufficient for a diagnosis of m e n t a l h a n d i c a p . U n l e s s students are equally delayed i n their adaptive behaviour a n d funct ioning, they s h o u l d n o t be considered mentally handicapped. Before placement decisions are made, students should have a recent i n d i v i d u a l psychoeducat ional assessment, w h i c h Includes information regarding academic a n d life s k i l l s . language, perceptual disorders, personal a n d s o c i a l adjustment a n d specific aptitudes. It ts considered good practice to formally re-assess these s t u d e n t s at least every three years. Results of the assessment s h o u l d be reported to a n d discussed with parents or guardians. A m e d i c a l assessment provides a n indication of v isual , auditory, motor or other p h y s i c a l def ic i ts , a n d s h o u l d be carried out on a l l s t u d e n t s p r i o r to t h e i r p lacement . P a r e n t a l a p p r o v a l m u s t be o b t a i n e d I n w r i t i n g before a n i n d i v i d u a l psychoeducat ional assessment a n d before any medical or psychological reports are obtained. Parents o r guardians should also be consul ted w h e n t h e school-b a s e d team o r distr ict team determines the "most enabling environment" for the c h i l d . APPENDIX G P r o c e d u r e f o r D e t e r m i n i n g R e l a t i v e P e r c e n t a g e s from S t a n d a r d i z e d C a n o n i c a l D i s c r i m i n a n t F u n c t i o n C o e f f i c i e n t s 186 Two p r o c e d u r e s were r e v i e w e d i n s e l e c t i n g t h e p r o c e d u r e f o r c a l c u l a t i n g p r e d i c t o r v a r i a b l e p e r c e n t a g e s . K l e c k a (1981) o u t l i n e d a sys tem f o r compar ing t h e r e l a t i v e m a g n i t u d e o f t h e e i g e n v a l u e o f each p r e d i c t o r v a r i a b l e ( p . 3 5 ) . I n t h i s p r o c e d u r e t h e r a t i o between s e l e c t e d e i g e n v a l u e s i s examined t o p r o v i d e a measure o f t h e " d i s c r i m i n a t i n g power t h a t e a c h has" ( p . 3 5 ) . A f u r t h e r s t e p s u g g e s t e d i n t h i s t e c h n i q u e i s t o c o n v e r t t h e e i g e n v a l u e s t o r e l a t i v e p e r c e n t a g e s by summing them t o f o r m a measure o f t h e t o t a l d i s c r i m i n a t i n g power o f t h e p r e d i c t o r v a r i a b l e s , and t h e n d i v i d i n g e a c h i n d i v i d u a l e i g e n v a l u e by t h i s t o t a l . T h i s p r o c e d u r e was p r e v i o u s l y q u e s t i o n e d by T a t s u o k o (1971) who n o t e d t h a t t h e c a l c u l a t i o n o f r e l a t i v e p e r c e n t a g e s w i t h o u t c o m p a r i s o n t o a s t a n d a r d i z e d s c a l e i s i n a p p r o p r i a t e . The wide v a r i a t i o n i n t h e m e t r i c o f t h e p r e d i c t o r v a r i a b l e s u s e d i n t h i s s t u d y (IQ s c o r e s , Normal C u r v e E q u i v a l e n t s , e t c . ) would make c o m p a r i s o n s on t h e b a s i s o f u n s t a n d a r d i z e d r e s u l t s i n a p p r o p r i a t e . A s e c o n d p r o c e d u r e s u g g e s t e d by K l e c k a (1981 , p . 2 9 ) was s e l e c t e d as t h e most a p p r o p r i a t e way o f a d d r e s s i n g t h i s p r o b l e m . I n t h i s p r o c e d u r e , t h e s t a n d a r d i z e d c a n o n i c a l d i s c r i m i n a n t f u n c t i o n c o e f f i c i e n t s o b t a i n e d from t h e d i s c r i m i n a n t f u n c t i o n a n a l y s e s p r o v i d e d t h e b a s i s f o r c o m p u t a t i o n o f r e l a t i v e p e r c e n t a g e s . The s t a n d a r d i z e d c o e f f i c i e n t s f o r a l l o f t h e v a r i a b l e s a r e summed and t h e n d i v i d e d i n t o t h e s t a n d a r d i z e d c o e f f i c i e n t o f e a c h p r e d i c t o r 187 v a r i a b l e . T h i s p r o v i d e s a p e r c e n t a g e measure o f t h e amount o f c o n t r i b u t i o n o f each p r e d i c t o r t o t h e t o t a l d i s c r i m i n a n t f u n c t i o n . 

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