Special ed: Diagnoses vs. education

Miriam Freedman, author of Fixing Special Education questions “the need for expensive and extensive diagnoses” of “specific learning disability” (SLD) in an Education Week interview.

Instead of ever more detailed diagnostic reports, let’s focus our scarce public resources on improving teaching for all students, including students with disabilities, through ‘best practices,’ diagnostic teaching, targeted instruction, meaningful standards and accountability, and the response to intervention (RtI) model, especially in the early grades. Let’s focus on teaching all students how to read, write and do math first.

Half of special education students are supposed to have a SLD, usually a reading problem. When students are taught well, fewer end up with a learning disability diagnosis.

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  1. Paul Hoss says:

    Pardon my naivete but, why are children of poverty more likely to be diagnosed as LD? Forgive me if I have asked a politically incorrect question. I simply would like an answer.

    Why are all LD teachers in Massachusetts exempt from working with their caseload students (the neediest students in our midst, nonetheless) for the first and last month of the school year? These kids need all the help they can get and to not service them (as prescribed in their IEPs, no less) for eighty percent of the school year does not seem to make sense.

  2. palisadesk says:

    Not sure I understand Paul Hoss’ math — surely 2 months is 20% of the school year, not 80%? I don’t know why teachers would not be working with students *all* year, though in some jurisdictions the paperwork involved may necessitate some release time for its completion.

    However, the answer to why children from low-SES backgrounds are more likely to be diagnised with “LD” (and other problems) is pretty straightforward. Environmental conditions associated with poverty are often a factor. Two poor neighborhoods in my district have a high concentration of pollutants in the soil (lead and cadmium especially), and although several attempts have been made to remove topsoil in those areas, children there are far more likely to have unacceptably high levels of lead in their systems. This is known to cause brain damage. It’s no surprise that a higher than average percentage of kids in those schools have learning problems, both “LD” and cognitive delay. The leafy suburbs have other problems, but lead toxicity is rarely one of them.

    Low-income families often have less adequate prenatal care (or none at all), poor diets, exposure to airborne toxins. Low-birthweight babies are more common in low-income areas, and they are more prone to developmental difficulties and learning problems. Some learning difficulties have a fairly well-documented hereditary basis, and affected individuals are more likely to have lower incomes and raise their families in poorer areas.

    Although the diagnosis of LD is supposed to exclude children whose schooling has been inadequate, in my experience this distinction is rarely applied. Thus, some children in low-income areas with very inadequate schools are instructional casualties; it’s not always possible to disentangle the variables.

    I was surprised to learn, however, that Fetal Alcohol Syndrome is actually statistically more common in the middle class. Middle class women have the money for drinking, never mind the stereotypes about “welfare moms.” Their offspring, if FAS-affected, may be given diagnoses of LD, ADHD, Conduct Disorder or ODD (Oppositional Defiant Disorder), rather than FAS, which is not a recognized exeptionality in most SPED dictionaries.

    Families with higher incomes have more advantages that mitigate whatever learning obstacles their children encounter, so that kids who have some “LD” characteristics, as many do, don’t meet criteria for a “diagnosis.” The same child, in a poor family, does not have the home enrichment, tutoring, etc. that enables the better-off child to succeed in school.

    Environmental factors, both the physical environment and health issues, plus usually inferior educational opportunities and services, predispose low-SES kids to more “LD” than more middle class kids. The number that are truly genetically based is probably quite small in all income groups.

  3. Paul Hoss says:


    My apologies for the math oversight. My mind was racing too fast. And thank you for your explaining my question regarding the connection between low SES and LD. That was very helpful.

  4. It all depends on what model you use to identify LD. For myself, I’m not wildly convinced of the RtI model. The data supports only early reading identification and intervention and seems to operate on the “magic wand” theory of sped remediation.

    What about math and RtI? Data is not as strong there. Writing? Ditto. How do you apply RtI to reevaluation, what do you do with reevals in a secondary setting, and when you hit the third tier of RtI, do you qualify for sped based on RtI measures only, or do you perform sped evaluation at that point? (in which case which model do you follow–discrepancy or Patterns of Strengths and Weaknesses?). These are questions I’ve not had adequately answered in the literature, and they’re questions which need an answer.

    I’m rather fond of the PSW (Patterns of Strengths and Weaknesses) model myself. It adheres more closely to the original concepts of LD–an easily identifiable difference amongst cognitive areas with at least three strengths and one weakness, and achievement scores that correlate strongly with the academic areas that the weakness is tied into. It’s based very heavily on Cattell-Horn-Carroll intelligence theories, but having had worked with the model for about three years after working with the discrepancy model, and having had data on kids IDed through both the discrepancy model and the PSW model, I think the PSW model more clearly identifies performance problems tied into cognitive disabilities.


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