Office Of Special Education Research Articles

Development, field testing, and initial validation of an adherence rubric for caregiver coaching

IntroductionThe translation and use of evidence-based practices (EBPs) within early intervention (EI) systems presents challenges. The Office of Special Education (OSEP) has emphasized results-driven accountability to expand state accountability from compliance to also include quality services that align with EBPs. OSEP’s results-driven accountability provided states the opportunity to design State Systemic Improvement Plans (SSIP) to strengthen the quality of EI services by increasing the capacity of EI systems to implement, scale-up, and sustain use of EBPs. Caregiver coaching is widely accepted as an EBP within EI settings, yet uptake and fidelity to coaching practices remains limited. Such widespread implementation of caregiver coaching is partially limited by a lack of measurement tools that operationalize behaviors consistent with coaching. In this study, we describe the development of the Kentucky Coaching Adherence Rubric-Revised (KCAR-R) and psychometric testing of the instrument.MethodsWe developed and tested the KCAR-R to measure fidelity of coaching practices within a state-wide professional development program, the Coaching in Early Intervention Training and Mentorship Program. We define operational elements of the KCAR-R and rubric design elements related to: creators; users and uses; specificity, judgment complexity; evaluative criteria; quality levels; quality definitions; scoring strategies; presentation; explanation; quality processes; accompanying feedback information; secrecy; and exemplars. With regard to psychometric validation of the KCAR-R, interrater reliability was analyzed using intraclass correlation coefficients across eight raters and 301 randomly selected video submissions. Internal consistency was evaluated using Cronbach’s alpha across 429 video submissions.ResultsResults showed 0.987 agreement, indicating excellent interrater reliability; item level internal consistency values ranged from 0.860 to 0.882. for scale if item deleted and 0.834 for the total scale.DiscussionFindings from this study showed that the KCAR-R operationalized behaviors that exemplify caregiver coaching and may serve as a resource for other states or programs to document the quality and fidelity of evidence-based EI services. To influence EI provider practices at a systems level, we used implementation science to guide our work and provide examples of how EI systems seeking ways to create sustainable quality services may build upon our approach.

Challenges Posed During and After the COVID-19 Pandemic: Implications for Special Education Teachers

The COVID-19 pandemic affected the ways in which school districts provide educational services to all students, especially students with disabilities. Eligible U.S. students with disabilities have a right to a free, appropriate public education (FAPE) under the Individuals with Disabilities Education Act (IDEA), and students with disabilities who are not eligible under the IDEA may also have a right to receive a FAPE under Section 504 of the Rehabilitation Act. School personnel need to attend to both of these important federal laws when providing educational services. Shortly after the pandemic began, the U.S. Department of Education, through the Office of Civil Rights and the Office of Special Education and Rehabilitation Services, issued guidance to school districts making it clear that despite school closures, school district personnel had to continue providing FAPE under the IDEA and Section 504. Following the return to school, the Office of Civil Rights investigated the Los Angeles Unified School District in California and the Fairfax County Schools for discriminating against students with disabilities by failing to provide educational services during the pandemic. In this article, we briefly review the guidance from the U.S. Department of Education and discuss important implications for teachers of students with disabilities.

On An International Level, What Are The Functions Of An Individualized Education Program (IEP) Or Transition Plan (TP)?

More than 45 years of IEP/TP research and a few focused on IEP/TP functions or roles. Yet, the quality of an IEP/TP relies on the functions that it fulfills to satisfy the needs of its different users (Petitdemange,1985). The Quebec Ministry of Education (MEQ, 2004) and the Office of Special Education and Rehabilitative Services within the U.S. Department of Education (in Eichler, 1999) explicitly identified and described six to seven IEP/TP functions. However, a literature review and practising environments highlighted a greater number of functions. The goal of this research is to identify the different functions that an IEP/TP should fulfill in regard to the different needs of its diverse users. With the use of pedagogical value analysis method (PVA), results show a synthesis of more than 700 functions organized in an IEP/TP Functional Specification Matrix (FSM). The IEP /TP FSM is useful to create, monitor and evaluate IEP/TPs.

Federal Leadership Perspectives on the Early Years of Special Education

This article is part of a case study of federal leadership in special education from the perspective of those who served in the roles of assistant secretaries of the Office of Special Education and Rehabilitation Services (OSERS) and directors of the Office of Special Education Programs (OSEP), or their equivalents in the former U.S. Office of Education and later U.S. Department of Education. The perspectives cover the time period since the passage of the Education for All Handicapped Children Act of 1975 to amendments of Individuals with Disabilities Education Act (IDEA) in 1997 and the end of the Clinton administration in 2001. The participants detailed their (a) career and appointment, (b) vision for educating students with disabilities, (c) theory of change, (d) politics and financial constraints, (e) advocacy, and (f) views of the past, present, and future.

Amantadine May Reduce Aggression in TBI Patients

Back to table of contents Previous article Next article PsychopharmacologyFull AccessAmantadine May Reduce Aggression in TBI PatientsJoAnn BlakeJoAnn BlakeSearch for more papers by this authorPublished Online:26 Dec 2017https://doi.org/10.1176/appi.pn.2018.pp11b1AbstractIf carefully administered and monitored, amantadine could have a promising role in reducing aggression in people with chronic brain injury.The antiviral drug amantadine may reduce aggression in people with chronic traumatic brain injury (TBI)—defined as symptoms lasting for more than six months post-injury, according to a study published in the September/October issue of the Journal of Head Trauma Rehabilitation. The study did not find a beneficial effect on anger, another common behavioral symptom of chronic TBI.While patients reported improvements on amantadine, Flora Hammond, M.D., explained it can take longer for family and friends to conclude that aggressive behavior has changed. Indiana University“Several analyses of participant ratings demonstrated superior improvement in the magnitude and frequency of change in aggression” among individuals who took amantadine 100 mg twice daily compared with placebo, Flora M. Hammond, M.D., chair of the Indiana University School of Medicine Department of Physical Medicine and Rehabilitation, and colleagues wrote. Each study participant was required to enlist an observer—someone close enough to the participant with TBI to have regular interactions and witness behavior—to answer questions about changes in aggression and anger over the course of the trial. According to the study, the reported decrease in aggression in the amantadine group was based on reports from the perspective of the person with brain injury, not from the observer. “For observers, more so than for participants, the changes in aggressive behavior may need to be sustained over a longer time before observers are willing to conclude that the behavior has changed,” wrote Hammond in an email to Psychiatric News. Substantial improvements were found in both amantadine and placebo groups (70 percent versus 56 percent), suggesting that participation the trial alone had a positive impact on the patients. Aggression can have devastating effects on people’s lives and ability to function, Hammond said. “Having a variety of medications to choose from allows selection of the agent that may be most appropriate for the individual,” she wrote, adding that amantadine is cleared from the body by the kidneys and it should not be given to dialysis patients or individuals with inadequate creatinine clearance. The study included 118 patients with TBI who had moderate to severe aggression at baseline. Of these, 61 were randomized to amantadine and 57 to placebo. Anger and aggression were measured at treatment days 0, 28, and 60 using observer-rated and participant-rated State-Trait Anger Expression Inventory-2 (STAXI-2) and Neuropsychiatric Inventory-Agitation/Aggression domain (NPI-A) Most Problematic and Distress scores. The NPI-A domain asks whether during the preceding month the person “got upset, resisted activities, shouted, cursed angrily, slammed doors, kicked furniture, threw things, hurt or hit others, or was stubborn, uncooperative, or hard to handle.” Anger and aggression are related but are two distinct behaviors tested by the study. “Anger is a state of negative feeling that may be associated with hostile thoughts. Anger may be experienced internally or externally, but aggression is an externally expressed anger. Although anger and aggression may occur concurrently, they are not equivalent,” Hammond wrote. “Aggression may have important links to arousal modulation and function. Thus, medications that enhance arousal could also have modulating effect on aggression. In contrast, anger is likely to be a more static condition, and possibly mediated in part by serotonin,” she commented. The research was supported by the U.S. Department of Education, Office of Special Education and Rehabilitative Services, National Institute on Disability, Independent Living, and Rehabilitation Research grant. ■Back to Psychopharmacology Newsletter Table of ContentsBack to Psychopharmacology Newsletter Table of Contents ISSUES NewArchived

The clinical utility and construct validity of the NIH Toolbox Cognition Battery (NIHTB-CB) in individuals with disabilities.

A State-of-the-Science conference on measurement with disability populations recommended "...the development of cognitive and psychosocial outcome measures, using computer-adaptive testing...that are low in respondent burden and valid across patient populations," (Clohan et al., 2007, p. 1537). Following this recommendation, the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) prioritized the development of measures of cognitive functioning for individuals with disabilities, noting that measures of cognitive functioning "have not been developed for systemic application in the field of medical rehabilitation. Cognition is both a rehabilitation outcome and a factor related to broader functional and community outcomes for individuals with a wide variety of disabling conditions" (Office of Special Education & Rehabilitation Services, 2009, p. 37193). From this came the NIH Toolbox for the Assessment of Neurological and Behavioral Function project (NIH Toolbox) which provides a comprehensive set of cognitive, motor, sensory, and emotional health and function measures for use in clinical, longitudinal, and epidemiological research. The nine papers comprising this special section of Rehabilitation Psychology reflect the sustained collaborative efforts of more than two dozen investigators working at six sites over the past 8 years. They are an initial attempt to validate the NIHTB-CB in disability samples, and they provide initial evidence that the NIHTB-CB can be used with individuals who have TBI, SCI, or stroke. The articles published here reflect the fulfillment of recommendations made during a state-of-the-science conference in 2007. (PsycINFO Database Record

Transition guide provides career framework for disabled students

The Department of Education's Office of Special Education and Rehabilitative Services has issued a transition guide for postsecondary education and employment for students and young people with disabilities. OSERS “hopes that the information in this guide will assist families and their students and youths with disabilities in developing and pursuing their goals for adult life.”

Augmented input interventions for children with developmental disabilities: Clinical recommendations await conclusive data with respect to dosage, frequency, duration, and specific populations

Sennott, S. C., Light, J. C., & McNaughton, D. (2016). AAC modeling intervention research review. Research and Practice for Persons with Severe Disabilities, 41(2), 101–115.Source of funding and declaration of interests: Financial support for the research, authorship, and publication of the review was provided by the Office of Special Education Programs, Office of Special Education and Rehabilitation Services. The authors declared no conflicts of interest.

Introduction to Special Issue on the Center on Response to Intervention in Early Childhood

Learning to read is one of the most challenging skills for young children who are beginning their school careers. Reading incorporates a wide range of language-based and literacy-specific skills. When children have difficulty with any of the vocabulary, comprehension, or phonological skills that lead to fluent early reading, they are likely to have continued difficulty with learning that requires reading for academic content. Because reading fluency is expected by Grade 3, effective and developmentally appropriate instruction for vocabulary, comprehension, phonological awareness, and other early reading skills during the preschool years is essential. Furthermore, identifying those children who are not making adequate progress in acquiring the requisite language and pre-literacy skill sets and providing sufficient effective instruction to assist them in acquiring key skills, are important educational functions of preschool programs. The emergence of reading and related language skills as the cornerstone of preschool curricula is not surprising given the strong emphasis on reading in early elementary school.The challenge of teaching foundational skills for fluent reading is a daunting one. More than one third of children in middle- to low-income preschools will face some challenge in learning to read (Carta et al., 2015). Because language and literacy are multiplex skills, children vary widely in the ease with which they acquire the components of the literacy system and the amount of specific instruction needed to support their integrated learning of this skill set.In this Special Issue of the Journal of Early Intervention, Greenwood, Carta, Goldstein, McConnell, Kaminski, and their collaborators describe how the Center on Response to Intervention in Early Childhood (CRTIEC) addressed the challenges of creating and testing a multi-tiered system of supports (MTSS) for teaching language and literacy skills to preschoolers. This important work, funded through the U.S. Office of Special Education, is one of only a handful of preschool research and development projects that have focused on tiered systems of preacademic instruction. Although multi-tier systems for elementary reading and positive behavior support have been emergent for nearly a decade, building such systems at the preschool level has been delayed by the limited measures for preschoolers' language and literacy skills, limited evidence-based practices for Tier 2 and Tier 3 instruction, and wide variations in the extent that curricula for preschool instruction address reading and language. Further complicating the design of an MTSS is the need for systems of support that work across the range of settings in which young children are served.The articles in this Special Issue provide a comprehensive overview of the 5-year research process leading to the development of measures of language and reading skills for preschoolers for identification and progress monitoring, instructional interventions for vocabulary and story comprehension (Tier 2), and phonological processes and alphabetic principles (Tier 3). Additional research focused on describing the language and literacy skills of a relatively large sample of preschool children using Individual Growth and Development Indicators (IGDIs) in addition to standardized assessments to determine the number of children in need of instruction beyond Tier 1.This set of articles is unique in a number of ways. First, the introductory article (Greenwood et al., 2015) and the article describing Tier 1 instruction (Carta et al., 2015) provide a broad view of the contextual challenges faced in developing an MTSS for preschool settings. By describing the press for creating a response to intervention (RTI) model at the preschool level and the current state of program instruction and staff awareness of RTI principles and procedures, the first two articles introduce readers to the scope of work undertaken by the Center investigators and the implicit constraints on moving to a well-developed RTI system. …

Protocol for a Systematic Review: Behavioral, Psychological, Educational, and Vocational Interventions to Facilitate Employment Outcomes for Cancer Survivors

Protocol for a Systematic Review: Behavioral, Psychological, Educational, and Vocational Interventions to Facilitate Employment Outcomes for Cancer Survivors

Introduction to TBI Model Systems issue

The six articles contained within this issue are representative of the work of the 2007–2012 Traumatic Brain Injury Model Systems of Care (TBIMS), a programme funded by the US Department of Education, Office of Special Education and Rehabilitative Services, National Institute on Disability and Rehabilitation Research (NIDRR) since 1987. The TBIMS programme has successfully united rehabilitation centres, which provide comprehensive systems of care for individuals with TBI, into a collaborative network conducting research that ultimately improves the lives of individuals with disabilities, their families and their communities. The research activities of each TBIMS centre includes contributing data to a longitudinal database that contains over 10,000 participants, with the longest follow-up cohort being 25 years post-TBI, conducting collaborative research activities within the TBIMS and performing independent research studies that build upon the strengths of the individual institution and the population that it serves. Complete information about the TBIMS programme can be found at the National Data and Statistical Center for the TBIMS website (www.tbindsc.org) which contains extensive information about the TBIMS centres and the Model Systems Knowledge Translation Center website (www.msktc.org) which contains information about the TBI, Spinal Cord Injury and Burn Model Systems of Care. The TBIMS programme has been instrumental in advancing the evidence-base for TBI-related clinical and community-based service delivery. The 2007– 2012 TBIMS grant cycle’s research activities included 24 independent research projects, four modular studies that built upon the TBIMS national database collection effort as well as inter-TBIMS collaboration and two large-scale collaborative projects which were funded separately by NIDRR. The independent research projects primarily employed a randomized clinical trial study design (n1⁄4 18), with two studies using a questionnaire/correlative approach and the remaining five comprised of neuroimaging, quasi-experimental and secondary data analysis approaches. All of the TBIMS were required to participate in at least one modular project. The four that were selected for the 2007– 2012 grant cycle included a prospective study of the relationship between post-TBI fatigue and insomnia, the natural history of headache after TBI, an exploration of sexuality after TBI and a project determining the feasibility of including geographical identifiers (geo-codes) in the TBIMS national database. Finally, the two large-scale collaborative multi-site projects examined the effectiveness of amantadine in managing post-TBI irritability and aggression and a practice-based evidence study of the effectiveness of rehabilitation interventions on outcomes up to 1-year post-TBI. The articles contained within this issue are reflective of the research sophistication of the TBIMS. Four of the studies are single-site studies which investigate complex topics such as: the impact and genesis of post-TBI irritability on spousal and familial relationships (Hammond et al.); the correlation of pre-treatment use of compensatory strategies on activity limitations and cognitive impairment

PROTOCOL: Effectiveness of adult employment assistance services for persons with autism spectrum disorders

The incidence of Autism Spectrum Disorders (ASD) has been increasing over the last two decades. Currently, 1 in 110 children are identified with ASD in the United States (CDC, 2009). ASD refers to a range of neurological disorders that involve some degree of difficulty with communication and interpersonal relationships. The range of the spectrum for autism disorders is wide with those at the higher functioning end often able to lead relatively independent lives and complete academic programs even while demonstrating social awkwardness. Those at the lower functioning end of the autism spectrum often demonstrate physical limitations, may lack speech, and have the inability to relate socially with others. As persons with ASD age, options such as employment become increasingly important as a consideration for long-term personal planning and quality of life. While many challenges exist for persons with ASD in obtaining and maintaining employment, some research is showing that, with effective behavioral and social interventions, employment can occur (Schaller & Yang, 2005). In fact, about 37% of individuals with ASD report having been employed for 12 months or more, four years after exiting high school (Newman, Wagner, Cameto, & Knokey, 2009). However, several studies show that individuals with ASD are more likely to lose their employment for behavioral and social interaction problems rather than their inability to perform assigned work tasks (Dew & Alan, 2007; Hurlbutt & Chalmers, 2004; Unger, 1999). Research has been conducted in the area of autism and employment, but such research has not been reported in a comprehensive evidence review format before. Thus, a systematic review on the effectiveness of adult employment assistance interventions for individuals with ASD would not only demonstrate the extent and magnitude of the interventions’ effects, but also provide ideas for further research that can inform implementation and refinement of related employment-focused programs.

Attention-Deficit/Hyperactivity Disorder

<h4>EXCERPT</h4> <p>Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobiological disorder that many clinicians address in their practices. ADHD has a prevalence rate in American youths that ranges from 4% to 12%, depending on the sampling design and restrictiveness of the definition of ADHD used. The impact of ADHD can include academic failure, delinquency, and low occupational performance. There is evidence to support at least the short-term efficacy of medication and behavioral therapy for children with ADHD. However, there is less evidence for long-term benefits.</p> <h4>ABOUT THE GUEST EDITOR</h4> <p>Mark L. Wolraich, MD, is the CMRI/Shaun Walters Professor of Pediatrics and the Director of the Section of Developmental-Behavioral Pediatrics at Oklahoma University Health Sciences Center and the Child Study Center. He received his MD from SUNY Syracuse Health Sciences Center. His residency training in pediatrics was split between the SUNY Syracuse Health Sciences Center and the University of Oklahoma, followed by a fellowship in the care of handicapped children at the University of Oregon. Dr. Wolraich was a pediatric faculty member at the University of Iowa for 14 years and at Vanderbilt University for 11 years, where he was Director of the Division of Child Development and the Director of the Child Development Center.</p> <p>His research has been funded by the National Institutes of Health and Mental Health, Maternal and Child Health Research Program, National Institute on Disabilities and Rehabilitation Research, the Center for Disease Control and Prevention, and the Office of Special Education and Rehabilitation.</p> <p>Dr. Wolraich has been active nationally in the American Academy of Pediatrics (AAP), where he participated on the Committee on Quality Improvement-Subcommittee on Attention-deficit/hyperactivity Disorder (ADHD). He currently serves on the AAP’s ADHD Advisory Committee, served on the Executive Committees of the Sections on Developmental-Behavioral Pediatrics and the Children with Disabilities, and chaired the Task Force on Coding Mental Health in Children, the Committee on Psychosocial Aspects of Child and Family Health and the Child, and the Child and Adolescent Health Action Group. Currently, he chairs the AAP’s Committee Forum Management Committee. Dr. Wolraich is a member and past president of the Society for Developmental and Behavioral Pediatrics. He contributed to obtaining board certification for Developmental-Behavioral Pediatrics and served on the Subboard of Developmental-Behavioral Pediatrics of the Board of Pediatrics. He currently serves on the Program for Maintenance of Certification in Pediatric Specialties-Advisory Committee of the Board.</p> <p>Dr. Wolraich was the co-editor of <cite>Advances in Developmental and Behavioral Pediatrics</cite> (1982-1992). He has authored numerous journal articles and book chapters, including articles in the <cite>New England Journal of Medicine</cite>, <cite>Pediatrics</cite>, and the <cite>Journal of the American Medical Association</cite>. He has edited a number of books including a textbook: <cite>Disorders in Development and Learning</cite> for its third edition, the <cite>DSM-PC Child and Adolescent Version</cite>, and co-edited <cite>Behavioral Pediatrics</cite>. Most recently, he is the senior editor for a textbook titled <cite>Developmental-Behavioral Pediatrics: Evidence and Practice</cite>.</p>

Attention-deficit/hyperactivity Disorders

<P>Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobiological disorder that primary care pediatricians address in their practices. ADHD has a prevalence rate in American youths that ranges from 4% to 12%, depending on the sampling design and restrictiveness of the definition of ADHD used. The impact of ADHD can include academic failure, delinquency, and low occupational performance. There is evidence to support at least the short-term efficacy of medication and behavioral therapy for children with ADHD. However, there is less evidence for long-term benefits.</P><H4>ABOUT THE GUEST EDITOR</H4><P>Mark L. Wolraich, MD, is the CMRI/Shaun Walters Professor of Pediatrics and the Director of the Section of Developmental-Behavioral Pediatrics at Oklahoma University Health Sciences Center and the Child Study Center. He received his MD from SUNY Syracuse Health Sciences Center. His residency training in pediatrics was split between the SUNY Syracuse Health Sciences Center and the University of Oklahoma, followed by a fellowship in the care of handicapped children at the University of Oregon. Dr. Wolraich was a pediatric faculty member at the University of Iowa for 14 years and at Vanderbilt University for 11 years, where he was Director of the Division of Child Development and the Director of the Child Development Center.</P><P>His research has been funded by the National Institutes of Health and Mental Health, Maternal and Child Health Research Program, National Institute on Disabilities and Rehabilitation Research, the Center for Disease Control and Prevention, and the Office of Special Education and Rehabilitation.</P><P>Dr. Wolraich has been active nationally in the American Academy of Pediatrics (AAP), where he participated on the Committee on Quality Improvement-Subcommittee on Attention-deficit/hyperactivity Disorder (ADHD). He currently serves on the AAP’s ADHD Advisory Committee, served on the Executive Committees of the Sections on Developmental-Behavioral Pediatrics and the Children with Disabilities, and chaired the Task Force on Coding Mental Health in Children, the Committee on Psychosocial Aspects of Child and Family Health and the Child, and the Child and Adolescent Health Action Group. Currently, he chairs the AAP’s Committee Forum Management Committee. Dr. Wolraich is a member and past president of the Society for Developmental and Behavioral Pediatrics. He contibuted to obtaining board certification for Developmental-Behavioral Pediatrics and served on the Subboard of Developmental-Behavioral Pediatrics of the Board of Pediatrics. He currently serves on the Program for Maintenance of Certification in Pediatric Specialties-Advisory Committee of the Board.</P><P>Dr. Wolraich was the co-editor of <cite>Advances in Developmental and Behavioral Pediatrics</cite> (1982-1992). He has authored numerous journal articles and book chapters, including articles in the <cite>New England Journal of Medicine</cite>, <cite>Pediatrics</cite>, and the <cite>Journal of the American Medical Association</cite>. He has edited a number of books including a textbook: <cite>Disorders in Development and Learning</cite> for its third edition, the <cite>DSM-PC Child and Adolescent Version</cite>, and co-edited <cite>Behavioral Pediatrics</cite>. Most recently, he is the senior editor for a textbook titled <cite>Developmental-Behavioral Pediatrics: Evidence and Practice</cite>.</P>

Clinicians Speak Up at IDEA Hearings

Clinicians Speak Up at IDEA Hearings

Sir Ludwig Guttmann Lecture: Trends in spinal cord injury rehabilitation outcomes from model systems in the United States: 1973–2006

Consecutive case series with 5-year follow-up. To evaluate the spinal cord injury (SCI) model systems program in the United States by documenting improvements in treatment outcomes over time. SCI model systems throughout the United States. Initial data were collected on 24 332 patients injured between 1973 and 2006. Follow-up data were collected on 9225 of these patients 5 years post-injury. All data were grouped by calendar year. Descriptive statistics included means and percentages. Multiple linear or logistic regression was used to assess outcome trends after adjusting for demographics and injury severity. Acute care and rehabilitation lengths of stay declined dramatically over time (P<0.01). Mean functional independence measure motor score at discharge and gain during rehabilitation decreased, whereas gain per day increased (P<0.01). The probability of neurologic improvement from admission to discharge increased. Odds of medical complications decreased during in-patient treatment, but increased post-discharge (P<0.05). Rehospitalizations declined over time (P<0.01). Community integration improved. First year mortality rates improved, but longer term mortality rates showed no improvement since 1982. Steady improvements have occurred for many treatment outcomes. Newer and more effective methods of prevention and treatment need to be developed to target those outcomes that have not improved and remain suboptimal.

Cultural Competence Revisited: Nursing Students with Disabilities

The demographic profile of students in nursing schools is changing in relation to many different cultural backgrounds. Despite the potential for students with disabilities to enrich the nursing profession, nurse educators may be perpetuating historical attitudes, values, and practices that exclude students with disabilities from gaining admission or identifying themselves as people with disabilities. Educators in nursing schools continue to ask whether people with disabilities have a place in the nursing profession, while the more salient question is, "When will people with disabilities have a place in the nursing profession?" More important, as we create environments that welcome students with disabilities into the nursing profession, how does the quality of nursing care improve and become more appropriate for people with different cultural experiences? The purpose of this article is to present the value of recruiting students with disabilities into nursing schools in, order to enhance culturally competent nursing care.

IDEA Part B Final Regulations Released: ED Sidesteps Federal Role, Sends Many Issues to States

IDEA Part B Final Regulations Released: ED Sidesteps Federal Role, Sends Many Issues to States

From Zero to a Hundred in a Split Second: Understanding Aggression in an Eight-Year-Old Child

Xavier is an eight-year-old American boy of Italian ancestry in a second-grade inclusion classroom at a public elementary school. He carries diagnoses of a severe language-based learning disorder (LD) and attention-deficit/hyperactivity disorder (ADHD). He lives with his mother, twin sister, and older teenage brother; his parents are in the process of divorcing. The Office of Special Education referred Xavier to a child psychiatrist (NR) for evaluation due to its increasing concerns about both his academic progress and his level of impulsivity and aggressive behavior (biting, head butting, kicking, throwing chairs, and running unsupervised down the street outside the school). Although many of these behaviors are not new, this referral was prompted by increasing concerns about safety. The evaluation included record reviews, interviews with parents and school personnel, and a classroom observation of Xavier. Several examples will illustrate the behavioral challenges that Xavier presents. During recess, Xavier was trying to explain to a teacher that his ball had gone over the

Adolescents with Learning Disabilities: Unique Challenges and Reasons for Hope

THE CASE FOR STUDYING ADOLESCENTS WITH LEARNING DISABILITIES Historically, most of the professional literature in the field as well as federal funding initiatives in research and program development have been directed at younger students with learning disabilities (LD). The prevailing assumption (or hope) has been that if intervention took place at a young age, many of the manifestations of the learning disability would be minimized or avoided altogether in later years (Kirk & Elkins, 1975). The recent shift from aptitude-achievement discrepancy to responsiveness-to-intervention (RTI) identification models underscores the value that the field places on early prevention strategies and avoiding wait-to-fail approaches (e.g., Vaughn & Fuchs, 2003). However, the field has learned that adolescents with LD have enduring and unique characteristics that are manifested in differing ways as development and setting demands change (e.g., Brinckerhoff, Shaw, & McGuire, 1992; Lenz & Deshler, 2005; Mellard & Deshler, 1991). When the five LD Institutes were funded by the Office of Special Education (OSEP) in 1978, the one at Kansas University focused on older students. The baseline of data available on these older students was almost nonexistent at the time. Hence, we sought to answer many foundational questions related to the salient characteristics of these learners and basic instructional practices that led to significant student outcomes (e.g., Deshler, Schumaker, Alley, Warner, & Clark, 1982). While valuable lessons emerged from that research, the surface was barely scratched (Warner, Schumaker, Alley, & Deshler, 1980). As a result, several have argued (e.g., Deshler, 2001) that there are compelling reasons to continue to focus on the unique issues facing adolescents with LD. Similarly, there are reasons not to put all of our field's eggs in the early-identification and intervention basket. First, even though an impressive array of reading interventions have been developed for younger students (e.g., Foorman, Francis, Novy, & Liberman, 1991), it is unlikely that these methods will be successfully implemented to scale nationally given our field's poor record of implementing educational innovations (e.g., Elmore, 1996). Thus, in spite of the effectiveness of existing interventions, the chance of bringing any innovation to broad-scale implementation with fidelity is remote. As a result, many students will not receive the intervention and will move on to later grades with significant, unaddressed deficits. Second, even if children with LD receive quality interventions during their early years, in all likelihood, their disability will endure into adolescence and adulthood. The need for effective intervention strategies for these older individuals is as great as, if not greater than, the need for interventions for younger children because of all the emotional overlays that generally emerge as individuals mature and continue to encounter significant failure. Hence, it is critical that the LD field develops a research and intervention agenda that is designed to address multiple aspects of the condition of LD across multiple age ranges. As compelling as the case for early intervention can be, if that case is made at the expense of addressing the equally problematic and unique set of problems presented by older-aged individuals, the long-term effects of such a policy will be devastating for thousands of individuals with LD. ENCOURAGING PROGRESS ON THE INTERVENTION FRONT During the past 25 years, despite the relatively limited attention paid to older students, significant progress has been made in designing and validating interventions for adolescent populations. For example, at the University of Kansas Center for Research on Learning, we have conducted over 20 studies (1) (e.g., Schumaker & Deshler, in press; Schumaker & Deshler, 2003) to address two basic questions: (a) Can adolescents with LD be taught to use complex learning strategies? …