Special Education Outcomes for Students Attending a State-Funded Pre-K Program

Prevention Model Takes Off in Schools: A New Approach for Learning Disabilities

PurposeThe COVID-19 pandemic created novel challenges for school systems and students, particularly students with disabilities. In the shift to remote/distance learning, this report explores the degree to which children with disabilities did not receive the special education and related services defined in their individualized education program (IEP).MethodsPatients attending an outpatient tertiary care center for neurodevelopmental disabilities in Maryland were surveyed on the impact of the pandemic on educational services provision.ResultsNearly half (46%) of respondents qualified for special education and related services through an IEP before the start of the COVID-19 pandemic. Among those with IEPs, 48% attested to reduced frequency and/or duration of special education and/or related services during the pandemic. The reduction was greatest in occupational therapy services (47%), followed physical therapy services (46%), and special education services (34%).ConclusionThis survey of children with disabilities observes a substantial reduction in IEP services reported in their completed surveys. To address the observed reduction in IEP services, we sought additional education for clinicians on the rights of students with disabilities in anticipation of students’ re-entry to the classroom. A special education law attorney provided an instructional session on compensatory education and recovery services to prepare clinicians to properly inform parents about their rights and advocate for patients with unmet IEP services during the pandemic.

Special Education Eligibility: When Is a Speech-Language Impairment Also a Disability?

The number of children estimated to suffer mental health disorders, and therefore, creating the need for special education services for children with emotional and behavioral disorders (EBD), is between 5% and 25% of children under the age of 18 (Brauner & Stephens, 2006). Admittedly, not all children with EBD have been identified and served, but many children have been identified as eligible for special education services as part of IDEIA regulation. Children identified with EBD are eligible for a variety of special education services. These services may be applied to interventions (or treatments, in mental health terminology) delivered in a regular classroom (e.g., supplementary aids and services, positive behavior intervention plans), while other services may require selfcontained or pullout programming for all or part of the school day. Regardless of the method, the goal of special education is to improve the academic, behavioral, and emotional outcomes for children identified with EBD.Although the goal of special education is improved child outcomes, we agree with the conclusion of Kauffman and Badar (2013) that parents and children may be influenced by social stigma associated with the classification, which may cause families to neglect or even decline special education services. In an attempt to increase special education participation by lessening the stigma associated with EBD identification, Kauffman and Badar offer four suggestions aimed at changing the public perception of special education services including: (a) discussing with stakeholders (e.g., parents, children) differences in behavior resulting from treatment in clear, understandable terms; (b) recognizing the reality of such differences due to treatment and its impact on students' learning; (c) emphasizing to stakeholders the benefits of special education; and (d) working to implement specialized instructional interventions (or treatments) as intended and planned.We support these recommendations as eminently practical and because they are based on sound judgment and experience. These suggestions may help to reduce some stigma in individual cases. Our concern is that they address some of the indicators of stigma but not the underlying causes. They are, therefore, not likely to address the issue of stigma and its impact on children, families, and the discipline of special education more broadly. Thus, stigma is likely to remain because the causes have not been adequately addressed. And, like a disease, the symptoms, or stigma is likely to worsen; rendering the four recommendations of Kauffman and Badar increasingly less effective with time.The stigma problem associated with EBD is daunting. Accordingly, we suggest that the boldness required to address it should be commensurate with the ubiquity of concerns about special education reflected in the popular and professional media. Returning to the disease metaphor, invasive and uncomfortable treatments are now required to salvage the patient, which in this case is the special education enterprise for EBD.At the time of this writing (January 8, 2014) for example, a cover letter was released by the United States Secretary of Education Arnie Duncan, for a report calling on schools to reconsider and refrain from the widespread application of harsh disciplinary practices in schools (U.S. Department of Education, 2014). It included the following quote:Although students who receive special education services represent 12 percent of students in the country, they make up 19 percent of students suspended in school, 20 percent of students receiving out-of-school suspension once, 25 percent of students receiving multiple out-of-school suspensions, 19 percent of students expelled, 23 percent of students referred to law enforcement, and 23 percent of students receiving a school-related arrest, (p. i)The scientific literature on EBD-including works published by well-regarded special education researchers in this journal-is also replete with nonsupportive conclusions about special education participation. …

To examine the effects of bronchopulmonary dysplasia (BPD) and very low birth weight (VLBW) on the cognitive and academic achievement of a large sample of 8-year-old children. Infants who were VLBW and had BPD (n = 98) or did not have BPD (n = 75) and term infants (n = 99) were followed prospectively to age 8. Groups were compared on measures assessing 4 broad areas of functioning: intelligence, achievement, gross motor, and attentional skills. Measures included the Wechsler Intelligence Scale for Children III, the Woodcock Johnson Test of Achievement-Revised, the Bruininks-Oseretsky Test of Motor Proficiency, the Tactual Performance Test (spatial memory), and the Continuous Performance Test (attention). School outcomes were assessed by parent and teacher report, as well as from school records. Groups were comparable on socioeconomic status, sex, and race. The total sample of BPD, VLBW, and term children was compared on all outcome measures. In addition, neurologic risk was assessed in the present sample and included the following: intraventricular hemorrhage, echodense lesions, porencephaly, hydrocephalus, ventriculoperitoneal shunt, meningitis, and periventricular leukomalacia. Individual difference analyses were conducted for neurologically intact children in all 3 groups. Finally, treatment effects were examined by comparing BPD children who had received steroids as part of their treatment with BPD children who had not. The BPD group demonstrated deficits compared with VLBW and term children in intelligence; reading, mathematics, and gross motor skills; and special education services. VLBW children differed from term children in all of the above areas, except reading recognition, comprehension, and occupational therapy. Attentional differences were obtained between BPD and term children only. The BPD group (54%) was more likely to be enrolled in special education classes than VLBW (37%) or term children (25%). In addition, more BPD children (20%) achieved full-scale IQ scores <70, in the mental retardation range, compared with either VLBW (11%) or term (3%) children, with all VLBW children significantly more likely than term children to achieve IQs in the subaverage category. After controlling for birth weight and neurologic problems, BPD and/or duration on oxygen predicted lower performance IQ, perceptual organization, full-scale IQ, motor and attentional skills, and special education placement. The qualitative classification of BPD (present or absent) was a significant predictor for lower scores on measures of applied problems; motor skills; and incidence of speech-language, occupational, and physical therapies. Individual difference analyses were performed to ascertain whether differences between the risk groups were primarily attributable to neurologic complications. Even with the neurologically intact sample of BPD and VLBW children, differences between the term comparison group and both the BPD and VLBW groups were found for many outcome measures. When birth weight and neurologic complications were controlled, BPD and severity of BPD were associated with lower performance and full-scale IQ, poorer perceptual organization, attention, and motor skills, as well as lower school achievement and greater participation in special education, including occupational, physical, and speech-language therapies. Treatment protocol may in part be responsible for differences observed in our BPD sample. Steroid and nonsteroid groups of BPD children differed significantly in performance IQ (72.8 vs 84.8) and full-scale IQ (77.0 vs 85.2); perceptual organization (74.0 vs 85.2); Bruininks-Oseretsky Test of Motor Proficiency score (36.6 vs 44.7); and participation in special education (78% vs 48%), occupational therapy (71% vs 44%), and physical therapy (71% vs 41%). In every instance, BPD children who received steroids fared more poorly than BPD children who did not receive steroids. BPD and duration on oxygen have long-term adverse effects on cognitive and academic achievement above and be beyond the effects of VLBW. The problems that have been identified at 8 years of age highlight the need for continued monitoring of the learning, behavior, and development of BPD children to intervene with children who are at risk for school problems.

A disproportionate number of students from low socio-economic statuses (SES) are enrolled in special education as students with specific learning disabilities (SLD). Despite resources provided through special education, only a small percentage of students are exited before secondary school. This instrumental case study investigated the variables preventing impoverished, transition-aged students from leaving special education. This study sought to understand why low SES students identified with SLDs in reading before middle school, are unable to exit special education by transition-age through the exploration of SES, SLD criteria, and school characteristics. The sample population included special education students with Individualized Education Programs (IEP) that were enrolled in eighth-grade, itinerant and supplemental classes. This population also included general and special education teachers that teach reading/English Language Arts classes. The research questions were generated to examine the following: (1) Do special education programs/services address the negative effects of SES for transition aged students with SLDs? (2) Do special education programs/services impact the reading skills of impoverished transition aged students with SLD in reading? (3) What are teachers' perceptions of the classroom factors that impact impoverished, transition-aged students with SLD in reading from exiting special education programs/services? Analysis of archival documents studied included qualitative and quantitative data found in evaluation reports, IEPs, progress monitoring reports, websites, and report cards. Teacher surveys and a focus group included the collection of qualitative and quantitative data from closed-ended and open-ended questions. The results identified factors contributing to academic achievement and failure for low SES, transition-aged, special education students. Keywords: Special education, specific learning disabilities, socioeconomic status, transition, Individualized Education Plans, reading skills

Division of International Special Education and Services (DISES) Information Brief February 2021

In this qualitative comparative case study, we drew from institutional theory and cultural historical activity theory to explore how educators wrote, used, and conceptualized the role of Individualized Education Programs (IEPs) for students with specific learning disabilities within secondary inclusive settings. We found that students’ IEPs were responding to institutional pressures to educate students within inclusive settings. However, the content of the students’ IEPs offered limited guidance on the activity of providing students with special education supports and services. With this being said, the IEPs still played distinctive roles in each school’s unique activity system for educating students within inclusive classrooms. Our findings illuminate a dynamic interaction between institutional pressures and the activity of providing students with a special education.

Contrasting adult literacy learners with and without specific learning disabilities This study of 311 adult education (AE) learners found 29% self-reported having a specific learning disability (SLD). Significant differences in demographic, academic, and life experience variables between the adult learners with and without SLD included: prior participation in special education, having both an SLD diagnosis and a high school diploma, low reading scores, middle age, and negative perceptions about limitations due to reading abilities. A post-hoc regression analysis found SLD status significantly contributes to variance in reading level when controlling for age and IQ. From these findings we conclude that SLD status should be considered an educationally relevant variable in adult education that warrants a diagnostic or clinical teaching approach.

In the United States, the Individuals with Disabilities Education Act (IDEA) lists fourteen disabilities for which a student is eligible for special education services: autism, deaf-blindness, deafness, developmental delay, emotional disturbance, hearing impairment, intellectual disability, orthopedic impairment, other health impairment, specific learning disability, speech or language impairment, traumatic brain injury, visual impairment, and multiple disabilities. Services include individualized education programs consisting of assessments, interventions, and other related services. Technologies help level the learning playing field, as they can facilitate the person’s functional academic and social capabilities across settings. Particularly as technological options have increased, there is a greater possibility of matching the technology with the learning need. Thus, the intersection of assistive technology, portable devices, disabilities, K–16 communities, and special education results in the needed topic of portable technologies for formal special education. In addition, the geographic scope is largely the United States, with some Canadian overlap. The term “portable technology” generally denotes a stand-alone device that may be carried easily in one hand, such as a cell phone, small audio or video player, signal device, or laptop computer. Sometimes the terms “mobile” or “handheld” are used instead of “portable.” In educational circles, the term “mobile learning” (or “m-learning”) refers to learning activities in which the learner actively incorporates these portable or mobile devices. Therefore, for the purposes of this bibliography, computer peripherals, wheelchairs, and other appliances (such as cochlear implants) are excluded. The bibliography emphasizes fundamental texts, systematic literature reviews, and scholarly research mainly since 2016. For very similar studies, the most rigorous one was selected for inclusion; furthermore, pilot students’ single-subject cases were avoided. It should be noted that various usage studies constitute the majority of citations. Rigorous assessment concerning the impact of portable technologies on student success is uneven, and, in particular, postsecondary assessment of special education services using portable technologies is limited. Legislative history, often best archived on websites, provides legal context. Although many valuable organizations discuss portable technologies for special education, generally only research-centric ones are included in this bibliography; other resources in the bibliography, such as Grey House Publishing’s Complete Resource Guide for People with Disabilities (cited under Overviews) do list relevant organizations.

This study examined the effectiveness of participating in special education on the academic outcomes of students with disabilities. A sample of 575 students from a large, urban school district were followed longitudinally as they transitioned between general and special education to evaluate whether receiving special education services was associated with improvements in academic trajectories. Using student fixed effects models of within-person change over time, individuals’ performance on standardized tests were compared before, during, and/or after special education placement. Results indicate that test scores of students with disabilities improved after being enrolled in special education. Additionally, students exiting special education exhibited a sustained trajectory of academic growth, suggesting that participation in special education in this district was associated with enduring improvements over time.

One of the long-term consequences of many genetic and acquired disorders in early brain development is the need for special education support in elementary school and beyond. In the United States, federal law ‘requires public schools to make available to all eligible children with disabilities a free appropriate public education in the least restrictive environment appropriate to their individual needs' (Individuals with Disabilities Education Act [IDEA]).1 This is implemented in the form of an Individualized Education Program (IEP) which is established and updated yearly for each student in one of 14 federal disability categories. The National Education Association [NEA] (which represents teachers and other educational professionals) supports the IDEA, recognizing that a ‘full continuum of placement options and services’ should be considered for each student’.2 One of the important components of the IDEA is the determination as to whether or not students with special needs should spend most or all of their time in educational classrooms with non-disabled students. The IDEA mandates placement in the least restrictive environment in which the child's needs can be met. The term ‘inclusion’ (a word which does not actually appear in the law itself) is what the IDEA is designed to accomplish, that is the provision of support and resources that enable children with disabilities to belong to and be recognized as members of their educational communities. It is important to keep in mind that the IDEA states a preference for placement in general education and for attendance at the neighborhood school. The IEP team must justify any time the child spends outside of general education, and a child can be removed from general education only if he or she cannot be educated satisfactorily there, even with the provision of supplementary aids/services and programmatic modifications/support. Currently in the United States 75% of children with disabilities spend part or all of their school day in a general education classroom. While this is a remarkable achievement in the drive to optimize opportunities for all children, it may create a number of challenges in the individual classroom. Laws and initiatives are formulated at the national and state levels, while policy decisions are implemented in local school districts and schools, often by superintendents and principals who may differ on interpretation and focus. Therefore, the specifics of inclusion (‘inclusive classroom’) may vary across school districts and schools. More than 6 million children in the United States receive educational services based on the IDEA.2 In an era of diminished financial resources, funding is a reality which cannot be ignored.3 Available funding affects the quality and quantity of educational services for typically developing children as well as those with special needs. Providing services in an inclusive classroom may require less funding than in a special education environment, and with the variability in state and local resources, any opportunity to save money may be embraced. However, inclusive education should not be based on financial considerations. For many teachers who serve as the regular education component of the inclusive classroom there is a no more controversial topic than what the inclusive classroom should look like: who should be included and for what extent of the academic day.4 Parents, teachers, and administrators who ardently support full inclusion believe that it is the best educational model to prepare all children for the real world. On the other side are those who believe that inclusion of children with special needs in a regular education classroom should be made on a student-by-student basis. As both positions are held passionately, at times final decisions in regard to educational placement may not easily be reached. These decisions have important implications for the individual child, his or her classmates, teachers and other school professionals, and those interested in the broader implications for a well-educated society and adult workplace. Current research supports the concept that peer interaction between students with special needs and regular education students is an advantage of inclusion for both populations, and that best teaching practices of differentiation and modification of instruction meet all students' needs more effectively.5 Those who express concerns about inclusion often argue that the extra time required to meet the needs of the disabled students impedes the learning progress of the non-disabled students. Decision-making in regard to inclusion is confounded by the requirements of federal laws such as No Child Left Behind6 and initiatives such as Common Core State Standards,7 a set of national educational benchmarks in language arts and mathematics from kindergarten through 12th grade which most states have adopted. For example, providing the least restrictive environment for children and meeting the achievement requirements of No Child Left Behind can be at odds with each other.8 For example, a child with autism might be placed in a grade school inclusive classroom, with both academic and social goals on the IEP, given recognized abilities at a higher level than students in a classroom solely for children with autism. An autism specialist assigns an instructional assistant to give this student a chip every 3 to 5 minutes for appropriate behavior. As a reward when five chips have been earned, the autism specialist requests that the student be allowed to play with Play-Doh during classroom teaching time. This might be unacceptable to the general education teacher and the special education co-teacher because of the impact on other students and the demands of a stringent academic curriculum dictated by the required standards of learning. In this situation, time given to this playtime is an important social development goal for the child with autism, but can mean time extracted from academic learning. This example highlights the importance of establishing an appropriate reward system in these situations. What I (DWW) have learned, as a regular education teacher who also teaches children with varying and sometimes multiple disabilities, is that the recommendations for inclusion made by the NEA, the American Federation of Teachers (AFT), and the Association for Supervision and Curriculum Development (ASCD) are not always taken into consideration in school models. In conversations with numerous regular education teachers in a well regarded school district, I discovered that few had received any formal professional development training before being assigned to the inclusive classroom; most had the same number of students as the general education classrooms at their grade levels; and very few received extra planning time to coordinate with specialists. Here is an example of an inclusive first grade classroom in a suburban Northern Virginia school district. Of the 21 students in the classroom, three students have an autism spectrum disorder (one of whom also has severe language and emotional delays); one student has emotional disabilities; one has cerebral palsy; one has visual motor integration problems; one student has identified attention-deficit–hyperactivity disorder (ADHD) without medication; and 14 regular education students. All seven of the students with IEPs require speech and language support as well as intervention from special education specialists. Three receive occupational therapy support; and one physical therapy and adaptive physical education support. (By the end of the school year, of the 14 without IEPs, two students were diagnosed on the autism spectrum scale and one student with severe ADHD, bringing the total of special needs students to 10.) While the ideal for the inclusive classroom would be a natural balance of students with and without disabilities, as in this ‘real-world’ situation, this was not the case. In this classroom the students variably read from beginning first grade to ready-for-third-grade levels. There were children adept at working with numbers in the thousands and students who could not count beyond the number 10. Some could work independently or in small groups at learning stations, while others fell on the floor in tantrums or wandered aimlessly without adult guidance. The daunting challenge for the teacher(s) in this classroom was to successfully meet the educational, social, emotional, and physical needs of such a varied group of students while maintaining the intrinsic motivations and rewards of teaching which are the joy and satisfaction of seeing students succeed. From a teacher's perspective, this is when it is imperative to follow the recommendations of educational researchers to ‘remember, with responsible inclusion the responsibility is first and foremost to the student.’9 That means to each student in the classroom – special education and regular education students. All should be making appropriate academic progress for an inclusive classroom to be considered a successful learning environment. Socialization should not be the only consideration for placement. A special education teacher and/or instructional assistants are usually present in the inclusive classroom in order to fulfill the IEP goals of the special needs students. Ideally, the special education teacher and regular education teacher share the responsibility for planning, instruction, and assessment. In order for the inclusive classroom to be successful the class size should be smaller than a regular education class; extra time for planning between all the professionals servicing students should be provided; and regular education teachers in inclusive classrooms should be given extra training. Students with severe disabilities may not be best served in the inclusive classroom because of their high level of need and the impact of this on other students' learning. Guidelines for responsible inclusion programs should examine the following components: students, human and material resources, continuum of services and most effective models, program evaluation, professional development, school philosophy, curriculum, and role definition for general and special education teachers. In the first grade classroom described above, the teacher was not given extra training, was not provided with extra planning time, did not have a smaller class load, and was not consulted when the students were assigned to her class. Several months into the school year and 2 days before this first grade teacher was to receive her student with cerebral palsy, she was told that the child was in a wheelchair and would have a fulltime assistant (nursing-trained but not instructionally trained). The plan was that the physical therapist, occupational therapist, and adaptive Physical Education teacher would meet with the teacher and make recommendations after they had time to work with the child and determine her levels of ability. The teacher immediately began searching the internet for information about cerebral palsy and the consequences it has on children. That was the extent of the teacher training provided to a teacher who would be responsible for her first student with cerebral palsy. The entire classroom had to be rearranged to accommodate a wheelchair and to give this new student access to every learning station, the morning meeting corner, and the classroom library. For this teacher, involving the students in adapting the environment was a very effective way of preparing them for the child's needs. The students followed the lead of the teacher and welcomed the new student with enthusiasm and warmth. As this teacher recognized, ‘It is not what a kid is, but what a kid needs’10 that is most critical to the education process – acknowledging the needs of all children in an inclusive classroom. Every child, with or without an IEP, requires special attention at some point in a school day. In this regard what is learned is more important than where it is learned. As advocates for children, pediatricians are in an excellent position to provide advice and recommendations in regard to inclusion, given their understanding of child/family dynamics as well as biological factors in brain development. Parents often ask whether an inclusive classroom is the right choice for their children. To provide guidance and recommendations, pediatricians need to understand the varied perspectives of students, families, teachers, school personnel, and the local community as well as the specific requirements of underlying legislative and administrative mandates as implemented in individual schools.11 From the pediatric perspective, establishing a family-centered medical home is an important component of care. ‘In a family-centered medical home, the pediatric care team works in partnership with a child and a child's family to ensure that all of the medical and non-medical needs of the patient are met. Through this partnership the pediatric care team can help the family/patient access, coordinate, and understand specialty care, educational services, out-of-home care, family support, and other public and private community services that are important for the overall health of the child and family.’12 Providing advice and recommendations in regard to possible inclusion should be an integral part of the medical home as it is envisioned. When all these factors are considered, pediatricians can play an important role in the placement of their patients in classrooms. They can discuss with parents the importance of the NEA,13 AFT,14 and ASCD15 recommendations for smaller class size, specific teacher training, additional planning time, and the continuum of services that should be available. They can recommend that parents visit schools (specifically the inclusive classroom at their child's grade level) and provide information that can be shared with teachers to further their understanding of the underlying causes of motor, cognitive, and behavioral impairments. Well-informed parents make effective advocates for their children.16 Parents are informed when an IEP is written with mutually defined goals and the child's attainment of each goal is reevaluated at the end of 1 year. Pediatricians can assure parents that any portion of the IEP can be readdressed at any time within that year. Parents may share their child's IEP goals with their pediatrician to determine if they are realistic goals. For example, the above mentioned first grade student with cerebral palsy had an IEP goal, added by the parent, that she learn to write her name using a pencil. The classroom teachers were uncertain that this was a realistic goal. Consultation with the child's pediatrician would have been helpful to provide an opinion in this regard. Pediatricians can also serve both as advocates for children as well as bridges when conflicts arise between school recommendations and parental wishes. Pediatricians can ensure that the parents are well informed about best practices in effective classrooms with inclusion. They can prepare parents to ask such questions as, ‘How will my child be safely removed from the school during fire drills and in case of emergencies?’ ‘How will my child be provided the special bathroom and hygiene requirements dictated by the needs of a child with cerebral palsy?’ ‘Is there playground equipment provided that adapts to the physical needs of my child and allows him to participate with peers at recess?’ For some children the inclusive classroom may not meet their needs effectively. Special education needs classrooms offer a reduced pupil to teacher ratio and teachers with specific training for special needs students. In these situations after all the facts are known, pediatricians should not be afraid to speak up and recommend alternative placement. Finally, there may be differences between the legal mandates of IDEA and the reality ‘on the ground’ in individual schools and classrooms. It should be remembered that it is illegal under the IDEA to make decisions based on the nature or severity of the child's disability, on administrative convenience, or on the configuration of the service delivery system. Parents need to be aware that they have legal recourse if they are not satisfied with their child's educational placement. In conclusion, this opinion is meant to highlight the complexity of this issue, and not to provide a ‘solution’. All stakeholders – parents, teachers, and administrators – should be included in the decision-making of the educational placement of a child with special needs. What all children learn from exposure together must be balanced carefully with the needs of each individual student, to promote long-term success in school in the workplace and more broadly in society. Well-informed pediatricians can have an active voice in promoting educational goals for their patients. We appreciate a number of Kennedy Krieger Institute professionals and others outside the Institute who provided input into this opinion, including Bridget Buttram, Marge Fessler, W. Ben Jackson III, Mark Mahone, Leslie Margolis, Elaine Stashinko, Melissa Tochterman, Fran Tolley, and Steve Wilcox. Denise Wilcox's experience as an educator spans four decades, preceding the Individuals with Disabilities Education Act of 1975, and encompasses the transition from self-contained special education classes through mainstreaming, pull out programs, and inclusion. Her post graduate degree is in Counseling and Development, with concentrations in special education and reading. All of her experience as an educator has been in mostly affluent suburban Washington, DC school systems. She has taught all elementary grades from kindergarten through sixth and has served as the grade level inclusion teacher for 5 years.

We investigated the prevalence of receipt of special education services among children with congenital heart defects (CHDs) compared with children without birth defects. Children born from 1982 to 2004 in metropolitan Atlanta with CHDs (n = 3744) were identified from a population-based birth defect surveillance program; children without birth defects (n = 860 715) were identified from birth certificates. Cohorts were linked to special education files for the 1992-2012 school years to identify special education services. Children with noncardiac defects or genetic syndromes were excluded; children with CHDs were classified by presence or absence of critical CHDs (ie, CHDs requiring intervention by age one year). We evaluated the prevalence of receipt of special education services and prevalence rate ratios using children without birth defects as a reference. Compared with children without birth defects, children with CHDs were 50% more likely to receive special education services overall (adjusted prevalence rate ratio [aPRR] = 1.5; 95% confidence interval [CI]: 1.4-1.7). Specifically, they had higher prevalence of several special education categories including: intellectual disability (aPRR = 3.8; 95% CI: 2.8-5.1), sensory impairment (aPRR = 3.0; 95% CI: 1.8-5.0), other health impairment (aPRR = 2.8; 95% CI: 2.2-3.5), significant developmental delay (aPRR = 1.9; 95% CI: 1.3-2.8), and specific learning disability (aPRR = 1.4; 95% CI: 1.1-1.7). For most special education services, the excess prevalence did not vary by presence of critical CHDs. Children with CHDs received special education services more often than children without birth defects. These findings highlight the need for special education services and the importance of developmental screening for all children with CHDs.

Response to Intervention (RtI) consists of multi-tiered instructional delivery systems in which educators provide research-based interventions to students that increase in intensity depending on students' instructional response. RtI is currently being implemented in schools across the United States. RtI's shift away from standardized testing offers new opportunities to consider the ways in which African American students are serviced within the general education setting, the assessment methods deemed appropriate when considering African American students for special education under the Specific Learning Disability category, and how multi-tiered intervention can address the overrepresentation of African American students in special education. This article provides an overview of a three-tiered RtI model, explores the promises and challenges of using RtI with African American students, and delineates a research and direct service delivery agenda to facilitate the development of RtI models that consider the educational needs of African American students.Keywords: African American studies, early childhood/elementary, learning and academic achievement, special education and disabilityMethods used to assess African American students, particularly in relation to special education, have generated controversy among educators, parents, and policymakers for decades (Graves & Mitchell, 201 1; Valencia & Suzuki, 2001). Such controversy stems, in part, from perceptions that standardized measures of intelligence, which are often used to help determine students' eligibility for special education services, are biased toward African Americans, and the use of these measures contributes to the disproportionate representation (i.e., over or underrepresentation of specific groups in disability categories) of African Americans in special education (Keams, Ford, & Linney, 2005; Larry P. v. Riles, 1979; Pitre, 2009; Powers, Hagans-Murillo, & Restori, 2004). The Individuals with Disabilities Education Improvement Act of 2004 (IDEIA, 2004) along with No Child Left Behind's (NCLB, 2001) emphasis on accountability through mandated monitoring of academic outcomes for the most vulnerable student populations, including students with disabilities, has brought Response to Intervention (Rtl) to the forefront of policy and practice (Meyers, Meyers, Graybill, Proctor, & Huddleston, 2012). Rtl models consist of multi-tiered instructional delivery systems in which educators provide, and assess frequently the impact of, research-based interventions to students that increase in intensity depending on students' instructional response. IDEIA 2004 encourages states and local educational agencies to use processes, similar to Rtl, that provide instructionally relevant assessment data to identify a specific learning disability (SLD). Therefore, Rtl can serve as an alternative to the traditional assessment method (i.e., administration of standardized intelligence and achievement tests) used to identify students for special education under the category of SLD (Hartlep & Ellis, 2012; IDEIA, 2004). Although Rtl is now one option for assessing African American students for SLD, in order to implement Rtl in a culturally responsive manner, educators, parents, policymakers, and researchers must carefully and seriously consider both the benefits and challenges of Rtl for African American students.In this article, the authors explore the promises and perils of using a three-tiered Rtl model with African American students. The discussion is framed around SLD assessment and classification decision-making because IDEIA 2004 endorses Rtl for SLD identification only, and almost half of African American students identified for special education are serviced under the SLD category (U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office of Special Education Programs, 2011). To provide context as well as a rationale for Rtl, a brief discussion is presented regarding intelligence testing in relation to African American students and the special education identification and placement process. …

A Brief Measure of Language Skills at 3 Years of Age and Special Education Use in Middle Childhood