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Running head: 651 final exam 1

Apsy 651 Final Exam

Lynne Cox

University of Calgary


Section 1

As schools embrace the philosophy, that every child is entitled to an education and every

student in their care receives quality instruction, educational institutions are being challenged to

meet the demands of the curriculum, while still meeting the demands of the individual learners.

According to the British Columbia Ministry of Education School Act (2008),

the purpose of the British Columbia school system is to enable all learners to develop

their individual potential and to acquire the knowledge, skills and attitudes needed to

contribute to a healthy, democratic and pluralistic society and a prosperous and

sustainable economy. To achieve this, the school system must strive to ensure that

differences among learners do not impede their participation in school, their mastery of

learning outcomes, or their ability to become contributing members of society. (p. 11)

All students must be viewed as equal in their desire to learn, fit in and accomplish

something. Educators continue to be faced with the huge challenge of meeting the wide range of

needs within their classroom. The curriculum demands and academic diversity among students

have some professionals questioning the appropriateness of placing the student with a diagnosis

into the mainstream classroom. When a student with a diagnosis comes into a classroom, are

classroom teachers only seeing the diagnosis as an instructional challenge, or does the diagnosis

provide the essential information that will support the individual student needs?


During course lectures, discussion board topics, presentations and course readings, we

have had the opportunity to discuss this issue related to childhood psychopathology. The

diagnosis topic has been particularly interesting for me because of the, maybe somewhat bias,

position I take towards assessment and purposeful inclusion. I believe the more we understand

the whole child, which includes their strengths and weaknesses, social and emotional needs and

their support system, the better we will be at providing them with a program in an environment

that truly meet their needs.

When an assessment for a child (developmentally age appropriate), is being considered

it is essential to ask what difference the assessment will make for the child’s success.

Theoretically assessments, which may result in a diagnosis, are done to establish a better

understanding of the child’s strengths and weaknesses; unfortunately there is another factor

which is often considered when an assessment is being completed; provincial ministry funding.

This opens the diagnosis topic up for heated debate; classification schemes, specific diagnostic

procedures and the very act of ‘labelling’.

In the first chapter of Mash & Barkley (2003), they review the concerns that researchers

and clinicians express about the current diagnostic and classification system;

(1) under representing disorder of infancy and childhood (2) inadequate in representing

the interrelationships and overlap that exist among many childhood disorder; (3) not

sufficiently sensitive to the developmental, contextual, and relational parameters that

are known to characterize most form of psychopathology in children; and (4) are

heterogeneous with respect to etiology. (p 31)

The two most common approaches to diagnosis and classification of child

psychopathology involve the use of categorical approaches (primarily based on informed clinical


consensus) and the empirically based ‘dimensional’ classification schemes. Child psychology

tends look at behaviour from a quantitative/continuous dimensional approach, where child

psychopathology takes a categorical approach.

Discussions continue amongst researchers and clinicians about which approach best

conceptualizes childhood disorders, but “it has been suggested that many childhood disorders,

such as anxiety, depression, ADHD, and the disruptive behaviour disorders, appear to reflect

dimensions of personality rather than categorical problems” (p 36). From this perspective, an

autism disorder (which historically has been looked at under a categorical approach), can be

looked at from a dimensional approach based on a continuum of social behaviour. Regardless of

which approach is taken, a diagnostic decision must be based on a comprehensive assessment of

the individual child.

Working in a high school environment, I have been questioned about the decision our

school makes when we are enrolling students with disabilities in classes where it is difficult for

them to do well. We are taking away time needed to work with other students in the classroom

and chances of the student completing the learning outcomes, even while on an adapted program,

are slim. The time spent with these students is jeopardising the quality of instruction other

students in the classroom are receiving. Teachers are feeling that we are doing a disservice to all

students by allowing those students with disabilities in the classroom. In this situation, has this

diagnosis of a learning disability served the students best interest?

We must evaluate and value the attitudes, beliefs and training teachers bring with them to

this dilemma. The attitudes and mental capacity of teachers are crucial to the success of inclusive

education and it is essential to recognize the concerns teachers bring forth. In this dilemma

teachers recognize the time constraints they are under and acknowledge the pressures of the


curriculum and the diversity within the classroom which does not allow adequate instruction for

all students. Positive collaboration and a school based team approach to a plan to support the

child will best support the various demands of the classroom.

Reflecting on how this course has shaped my understanding of diagnosis and the effects

of labelling, I know I will approach difficult situations with a better understanding of my own

beliefs. As I continue to work with students and teachers in identifying the ‘labelled’ students’

purpose in the classroom, I will look to my guiding principles from a

Phenomenological/Humanistic Perspective. Everyone is valuable and deserves respect. Helping

the student recognize their purpose in the classroom will help them set and achieve their personal

goals. Every student is unique. It is our responsibility, as educators and school psychologists to

help define, support and recommend strategies for all students to establish and reach their goals.

Having a thorough understanding of the child’s strengths, weaknesses and needs will better

support the student as they develop their potential. As students learn to understand their own

sense of purpose and strengths, they will learn to be stronger self advocators.

I don’t feel classroom teachers are intentionally trying to discriminate students with a

diagnosis, but are trying to do the right thing ethically by not putting students into situations

where there is potential for failure. This is why it is essential we continue to advocate and

educate all parties involved.

In one of our classes we talked about terminology. We are always trying to change the

terminology, where in fact we should be trying to change the perception. I found Dr.

MacDonald’s statement very powerful as it could easily be part of my personal mission

statement. Although there are many diagnosis that a parent or child may find difficult to hear, I

believe there is usually relief that comes with the explanation for the behaviours. As educators


and potential school psychologists our role is to act as effective collaborators. The child, parents

and classroom teachers need to work together to effectively support the child’s learning. A

diagnosis for a child will help guide a support team as they attempt to provide the most optimal

learning environment for that individual child.

On our class discussion board there was a question about labelling and how the older

student may feel singled out because they have a learning disability. In the past four years I have

worked with a male student who has a diagnosis which includes Fetal Alcohol, Attention Deficit

Hyperactivity Disorder and a Reading Disability. This student also has excellent coordination, is

very athletic, has aspirations and can be helpful when he chooses. The greatest success for this

student came once there was an honest reflection about his reading disability. The student began

to recognize that if he acknowledged the disability and accepted the support and

accommodations that were being offered; he could raise the classroom expectations, and be

closer to achieving his goals. Although this is just a small piece of his individual program it was

the beginning of his success. He had such a false perception that because he struggled with

reading and had this learning disability, he would always appear ‘dumb’. He has now accepted

the term reading disability, and sees that he can be successful if he agrees to the accommodations

and support. His perception of learning disabilities is beginning to change.

As this student’s perception of learning disabilities is beginning to change I see my

personal challenge to continue changing the perception of disabilities amongst many of my

colleagues. I find it challenging to have experienced teachers trying to accommodate the student

with a learning disability in a way that no one else in the classroom would notice. There are

classrooms where the teacher does not want education assistance support, as they are concerned


the older student will feel singled out. This issue is a part of my professional plan as I continue to

advocate for students and their right to develop their individual potential.

Continuing to develop my understanding of childhood disorders and the principles of

assessment and behaviour change is the basis for my professional plan. I am very passionate

when it comes to the child’s right to an individual program and purposeful inclusion. I know that

having a strong understanding of childhood disorders and the theories and research that have

guided the study of child development and psychopathology will have more of an affect for

change. Explaining how the child with autistic disorder can have negative or inappropriate

behaviours directed into positive behaviours with a program based on behaviour therapy will

better support the change that I feel needs to occur.

I do believe most people in education want what is right for the child. I also witness some

of us in education can be very narrow in our thinking and ways we work with children. I think

part of this narrow thinking is the lack of education. There is a strong support for assessment for

learning, yet the pressure of the curriculum continues to drive the lesson. My personal goal this

year has been to arrange workshops and information sessions where the staff can participate in

professional development that will help us understand and work with kids that have specific

needs. Many of the strategies that are used to work with kids with childhood disorders would

benefit the whole class. Although the visual schedule at the front of the classroom is there for the

child with an Asperger’s diagnosis all of the kids in the classroom will benefit. I think as a

classroom teacher it is our responsibility to be current in the research for what is best practice for

the child with a ‘diagnosis’.


To reiterate what the British Columbia Ministry of Education School Act states, the

school system is to enable all learners to develop their individual potential and to acquire the

knowledge, skills and attitudes needed to contribute to a healthy, democratic and pluralistic

society and a prosperous and sustainable economy. It will be our role as the school psychologist

to assess, diagnose, recommend strategies, and collaborate with the school and family to support

the child as they develop their potential. When working in this profession you must be aware of

your own values and biases as they may interfere in your commitment to the principles and

standards that guide our profession.


Section 2

Education systems spend vast amounts of time, energy and money in developing

curriculum and educational programs to try and meet the needs of all children. This can be a

challenge as there is not a one size fits all approach that can be used. The way our brains

processes information is extremely complex.

I have been employed with the public school system for over 15 years, and have always

been a strong advocate for students and their individual learning, social, and emotional needs.

This discipline is constantly changing and becoming more complex as we try to meet the diverse

challenges that students bring. Having had the opportunity to work with kids at the beginning

and end of their grade schooling has given me insight as I recognize the importance and

necessity of a complete assessment and individual programming. “The study of the etiology and

maintenance of psychopathology in children continues to be the subject matter of psychology,

medicine, psychiatry, education, and numerous other disciples”(Mash & Barkley, 2003, p. 6).

When working with a multi-disciplinary team to develop individual programs, it is

necessary to understand that the child's needs must be understood within the context of family,

school and social and cultural environment from which they come. A foundational understanding


of child development, critical and creative thinking skills, effective teaching, learning strategies

and assessment are integral requirements when developing programs. This paper will compare

and contrast the conceptual nature and scope of Learning disabilities and Autistic Disorder.

My interest in the conception of learning disabilities and autistic disorders arises from my

desire to have a better insight and understanding of both disabilities. With a greater knowledge of

current research I can be a stronger advocate to those students with a learning disability or

present with a Pervasive Development Disorder. My experience in the educational system has

found that although most teachers want to provide the best possible education program for their

students, the lack of understanding and education around these two disabilities often gets in the

way of delivering an optimum learning experience for the child.

The Alberta Education initiative (2009) vision statement reads “One inclusive education

system where each student is successful”. An “inclusive education system” is a way of thinking

and acting that demonstrates acceptance of, and belonging for, all students. As educators and

school psychologists it is imperative we educate and support teachers and support staff, in

developing individual programs that will truly meet the learning needs of the child who has been

identified with a learning disability. All students are capable of learning given the appropriate

interventions. These interventions involve understanding a student’s characteristics, using a

variety of instructional approaches, teaching students learning strategies, providing appropriate

accommodations and using time flexibility. If the tools are available we need to provide, allow

and encourage the child to use them.

The general features of a learning disability can often be hidden or very subtle. The

Learning Disabilities Association of Canada states that an individual must be diagnosed with


average to above average intellectual functioning, there is not sensory deprivation, (meaning

there are no issues to hearing or vision) and assessments were not reflective of extrinsic

influences (such as cultural differences, linguistic factors or insufficient or inappropriate

instruction). The disorder is marked by significant difficulties in the acquisition and use of

listening, speaking, reading, writing, reasoning or mathematical deficits.

In British Columbia a learning disability is identified using the criteria from the DSM-V-

TR. There must be a significant discrepancy (two standard deviations) between the student’s

cognitive potential and academic achievement and learning problems must significantly

interfere with academic achievement or activities of daily living that require reading,

mathematical, or writing skills.

The problem with the ability-achievement discrepancy model measure is that it is not

totally reliable. When using the two standard deviations, or 30 point discrepancy, what do you do

with hard cut off points? If results are border line, do you give the learning disabilities diagnosis?

This model has also been criticized as not being conducive to allow for early identification and

intervention. Developmental factors suggest ability-achievement testing not be done below grade

three, unless there are signs of other developmental disabilities, for example autism. Some kids

develop faster and some are slower, so testing at such an early age, it may not identify if the

results are showing a true learning disability or whether it is a developmental issue. This model

has been subject to the terminology of the “wait-to-fail” model that focuses on discrepancy and

lack of progress in order to qualify for services.

The Learning Disabilities Association uses the term significant, but defining significant

can be very subjective. In some provinces ‘Response to Intervention’, an intervention originating


in the United States, is being used as part of the process in identifying learning disabilities.

Students who do not respond to effective interventions are likely to have biologically-based

learning disabilities and likely to be diagnosed with a learning disability.

A child who demonstrates ‘gaps’ in their understanding and is not achieving age

appropriate expectations does not necessarily mean they have a learning disability. A student

profile may reveal a history of poor attendance, an unsupported home environment, and a high

number of school moves and is not meeting learning outcomes, but when given the correct

interventions that student may be able to reach age appropriate expectations.

It is critical that assessment is a systematic process that includes the four pillars of

assessment; norm-referenced tests (standardized tests), interviews, observations, informal

assessment and testing should be fair and culture-free. Look at developmental factors, medical

history; use the rule out process. What is the current level of functioning, interview

teachers/observations and parent information. Ask parents what kind of a reader their child is.

Just using cognitive and achievement testing is not enough to give a representation of the whole

child.

I recently put in a referral for psycho educational assessment for a student in grade ten.

Academically, this student has had ongoing challenges since early elementary and has received

Learning Assistance as well as adapted courses and one to one support. In spite of this, he has

found school to be very difficult and often stays home from school as a result. Unfortunately this

backfires by the student falling behind and then becoming overwhelmed by the expectations.

When attending, the student is generally focused and puts forth a good effort which at times pays

off, but more often the effort does not result in success. The referral question queried whether the


student had a learning disability which interfered with him working to his potential or whether

the history of absenteeism was contributing to the ‘gaps’ in his education and was enough to

interfere with his potential academic achievement.

Results of this assessment revealed academic difficulties are likely resulting from a

combination of factors including, anxiety, depression, attention, frequent absences and learning

disabilities in reading comprehension and math reasoning. If assessment had only included a

cognitive and achievement test, there would not have been a complete diagnosis, and all of the

student’s needs would not have been identified. It was critical the four pillars of assessment were

used.

One area that research is unclear is whether processing speed and deficits in working

memory would fit in the learning disabilities category. When referring to the DSM-V TR criteria,

the question would be asked if the deficit is interfering with academic achievement or activities

of daily living that require reading, mathematical, or writing skills.

Like Learning Disabilities, Autism is another disorder which persists throughout

childhood and adulthood. As stated in Mash and Barkley (2003), Autistic Disorder is a lifelong

developmental disability that affects the functioning of the brain. The brains of individuals with

autism spectrum disorders appear to have structural and functional differences. A high

percentage of children with Autism Spectrum Disorders do not develop functional speech.

The DSM-IV TR classifies autism spectrum disorders as a disorder within a broader

group of Pervasive Developmental Disorders (PDD). PDD is an umbrella term for disorders that

involve impairment in reciprocal social interaction skills and communication skills, and the

presence of stereotypical behaviours, interests and activities. The PDD category includes the


following disorders: Autistic Disorder, Asperger’s Disorder, Rett’s Disorder, Childhood

Disintegrative Disorder (CDD) and Pervasive Developmental Disorder Not Otherwise Specified

(PDD-NOS). These disorders have common features; however there are differences in

symptoms, age of onset, developmental patterns and levels of cognitive functioning.

From my experience, Autistic Disorder, Asperger’s Disorder and Pervasive

Developmental Disorder Not Otherwise Specified are the three disorders with a higher profile in

the school system.

One of the wishes I often hear from parents of children with autism spectrum disorders is

that they just want their child to be happy and have some friends of their own. The child with an

autism spectrum disorder often fails miserably when trying to make friends as a direct result of

deficits in basic social skills (e.g. turn taking and initiating conversation). Where most children

learn these basic skills simply by exposure to social situations, children with Autism Spectrum

Disorder often need to be taught these skills explicitly. People often take for granted how much

we use our understanding of other people’s thoughts and feelings to guide our social interactions.

Social stories, facilitating reciprocal interactions, peer mentors, direct teaching of

recognizing and understanding the feelings and thoughts of self and others, role playing,

structured play and videotaped self-modeling are strategies that I have found to be successful

when working with a student with a diagnosis on the Autism spectrum.

Children with autism often engage in abnormal ritualistic behaviours; these can be

behaviours that are characterized by repetitive motor movements; hand flapping, spinning or

rocking (often referred to as stimming, or self-stimulating behaviour), and more complex

behaviours that are characterized by insistence on following elaborate routines (e.g. rearranging


or ordering of toys, food preference and instance on following the same sequence of events

during everyday activities) and circumscribed interests which usually involve memorization of

facts about a specific top (e.g. trains, space, weather) . Mash and Barkley suggest the repetitive

movements occur more in younger and lower-functioning children with autism while the more

complex repetitive behaviours are observed in children with less severe levels of retardation in

children with autism. Some children with autism spectrum disorders have normal levels of

intelligence, often referred to as high-functioning autism spectrum disorder, while those children

with low levels of intelligence are referred to as low-functioning autism spectrum disorders.

As there are no biological markers or medical tests for diagnosing autism, the

collaborative approach using behavioural symptoms and developmental history should be

considered when making a diagnosis on the Autism Spectrum. When administering the Autism

Diagnostic Interview-Revised (ADI-R), the caregivers are asked to describe their child’s current

behaviours and past behaviours, with a focus on the behaviours observed during their children’s

preschool years. This information can be difficult to obtain, as the parental input may not be

accurate or available. Observing the child in the school setting and interviewing teachers and

support workers will provide additional information regarding current behaviours.

“At present, there is only one diagnostic instrument that was specifically developed to

assess symptoms within the context of the child’s developmental level: the Autism Diagnostic

Observation Schedule-Generic (ADOS-G)” (Mash & Barkley, 2003, p 420). Although this test

does provide an opportunity for the examiner to observe social interaction, communication and

imaginative play the parental interview is needed to supplement the information about low-

frequency behaviours that may not have been observed during this interview.


Autism is considered to be a universal disorder with the socioeconomic distribution of

families with autistic children similar to the distribution within the general population. Empirical

research shows autism occurring more frequently in males, and females receiving lower scores

on both verbal and nonverbal measure of intelligence. Although the overall prognosis for

individuals with autism is poor with respect to academic achievement and independent living

skills, early intervention does lead to a better prognosis; with the increased likelihood of

language development and regular classroom placement.

As stated in Mash and Barkley (2003), several elements are common to effective early

intervention programs for children with autism. A high level of family involvement, structure,

routine, skills for successful transitions, a functional approach to problem behaviours, a

curriculum focusing on the areas of attention and compliance, motor imitation, communication

and social skills have all been identified. A behaviour/reinforcement model approach, which is

characterized as having a narrow emphasis on conditioning principles, is often used to reinforce

behaviours that will increase the likelihood of the child’s success in the school. When the school

and home work closely together, the chances of success increase.

An area of concern is that the treatment approaches that are effective in a university-

based research setting may not be readily transferable to a school-based setting. Most schools

will do their best to accommodate the needs of the child with autism, but the lack of resources,

specialists and less than ideal student-to-staff ratio does interfere with the integrity of the

treatment programs. Specialist and consultants are a valuable resource when working with such

high needs kids. In our school district, we usually have the opportunity to confer with a

consultant once or twice a year. Often the consult results can be overwhelming, but it is

imperative to implement strategies that can be done continually to be most effective.


Important strides continue to be made in our understanding and treatment of children

with learning disabilities and autistic disorder. Research is moving towards to examining the

genetic and neurobiological correlates and interventions in both of these disorders helping to

identify stronger treatment programs for children. “Historically, little emphasis has been placed

on understanding which specific types of interventions or combination of interventions are most

efficacious for well-defined groups of children with Learning Disabilities” (Mash & Barkley

2003, p 574).

Diagnostic issues are of critical concern for both of these disorders. The definition of

learning disabilities does not coincide with present research. There is little evidence that supports

the Intelligence-Quotient achievement discrepancy model, and puts children at risk for failure

without the early intervention. When looking at the criteria for a reading disorder, one area that

Mash & Barkley discuss is the terminology of substantially below. The ongoing debate is

defining the word substantially. Deciding what classifies as ‘substantially’ becomes very

subjective.

Although there are several different diagnostic instruments for an autism diagnosis, none

of the diagnostic instruments addresses all of the issues of pervasive developmental disorders.

The DSM-IV-TR assesses whether the onset of symptoms occurred before the age of three. This

information can be difficult to obtain, as the caregiver may not have an accurate memory or be

aware of early development. The diagnostic instruments are unreliable in differentiating among

the pervasive developmental disorders. Although these disorders are distinct from each other, it

is difficult to describe the differences adequately enough to produce a reliable and valid

diagnostic instrument.


One issue is how support children with disabilities into ‘main stream society’. When

assessing for learning disabilities and autistic disorder a multi-disciplinary team approach should

be used. This team approach needs to carry into treatment and program planning. Purposeful

inclusion will be more successful when you have identified the purpose and goals of the

classroom and you provide appropriate interventions that will work with the child’s strengths and

areas of competence.

Autistic Disorders and Learning Disabilities are two childhood disorders that are very

prevalent in our schools. As we try to meet the diverse challenges that students bring we must

employ a variety of assessment and instructional strategies and demonstrate an understanding of

individual learning differences and special needs. Students who may appear less academically

capable in some areas of the curriculum can be quite capable and strong in other learning

objectives and when given the appropriate accommodations will thrive. Working with a team,

from assessment to treatment, who is open to ideas, willing to listen to concerns and problem

solve together is essential to be productive and move forward.


References

BC Ministry of Education. (2009) Retrieved from:http://www.bced.gov.bc.ca/diversity/diversity_framework.pdf

Mash, E.J. & Barkley R.A., (2003). Child Psychopathology. New York, NY: The Guilford Press.

http://www.bced.gov.bc.ca/diversity/diversity_framework.pdf

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