Attention-Deficit Proposal Spurs Spec.-Ed. Protests
WASHINGTON--A Congressional attempt to prod schools to provide special-education services to children with attention-deficit disorders has unleashed a torrent of protests from an unusually wide array of educators, special-education groups, and mental-health professionals.
The move comes in the form of a provision in a House report on legislation to reauthorize the Education of the Handicapped Act. The controversial language, virtually unnoticed by the general education community until the House passed the bill in June, could change the federal definition of an eligible special-education category to specifically include the disorder.
More than 18 state education departments and national associations--including some that normally are staunch advocates on behalf of handicapped children--have launched a lobbying campaign to block the change. And the ensuing controversy threatens to delay final passage of the federal special-education law, which has been pending in the Congress for more than 14 months and must be reauthorized soon in order to be funded.
The advocates say they fear expanding the federal definition would lead to an explosion in the numbers of children receiving special-education services. And many of those children, they contend, could be labeled inappropriately.
"It's almost like turning on a switch," said Kevin Dwyer, a lobbyist for the National Association of School Psychologists, one of the groups protesting the change. "It's going to create a lot of easy ways to diagnose kids who are a pain in the neck in the classroom and people don't want to look at thoroughly."
Attention-deficit disorder, a rela recent term in the psychiatrist's lexicon, affects an estimated 3 percent to 5 percent of all school-age children. The condition is often characterized by impulsivity and an inability to concentrate or pick up on social cues.
As one mother described her son, "He was the one who rolled around kicking the other kids at story time."
"In art," said the mother, Mary Fowler Cox, "he was the one who threw his art project on the floor." She said her son also would forget to do his homework, or do it and then lose it in his desk, and seemed unable to follow instructions.
Ms. Cox and other parents and advocates who work on behalf of these children contend that many of them are not currently getting the help they need in school because the federal special-education law makes no provision for them.
The House report attempts to address that concern by listing the disorder under the eligible category known as "other health-impaired." While the bill itself does not list the disorder, the report language is important because families suing school districts for not providing services to their children may cite such language in their lawsuits.
An earlier, Senate-approved version of the measure places the disorder under the category "minimal brain dysfunction"--a tougher standard requiring such children to also be learning-disabled before they could qualify for services.
House and Senate staff members have been holding meetings through the summer with some of the groups involved in an effort to reconcile the two versions.
Led by the National School Boards Association, the groups opposing the change include associations representing school administrators, principals, and state superintendents of education; state departments of education in California, Utah, Washington State, and New York; the National Mental Health Association; and the Council for Exceptional Children, which generally advocates on behalf of children with disabilities. The U.S. Education Department also opposed the change in hearings earlier this year.
The opponents contend that, because attention-deficit disorder is often coupled with a learning disability, many such children are already enrolled in special-education classes.
And they claim others, who may not have an additional disability, can get the help they need under another federal law, the Rehabilitation Act of 1973, which prohibits agencies receiving federal funds from discriminating against the disabled.
"It's not that we're opposed to kids being served," said Edward Kealy, a lobbyist for the National School Boards Association. "What we think is a problem in specifically lisiting ADD is that it would change the criteria in a basic way that would extend a weaker criteria for what it means to be handicapped."
But parents and researchers who have lobbied on behalf of children with the disorder disagree. They point to recent research indicating that only between 10 percent and 25 percent of children with attention-deficit disorders also have a learning disability.
Some of those without a concurrent disability may still be getting special education, but under an inappropriate label, such as learning-disabled or seriously emotionally disturbed, said Harvey C. Parker, executive director of Children with Attention Deficit Disorders, a national support group. He said the rest simply never get any special-education help at all--often because schools refuse to provide it.
According to Mr. Parker's group, the condition qualifies a child for services under only one state department of education.
"The most discouraging aspect of ADD is that, when you finally find out what's wrong and go to the school, they say 'tough,"' said Laney Hester, a Maryland businessman whose son has attention-deficit disorder but no learning disability. He was able to get services for his son only after filing a complaint under the federal rehabilitation law.
"The real problem," said Ms. Cox, "is that the pie has been cut."
"The people who are opposing this change are afraid of the numbers,'' she charged.
No one knows how many additional children would qualify for special-education services under the proposed revision. Education groups fear services would be expanded, in part, because of what one lobbyist called the "loosey goosey" nature of existing clinical criteria for diagnosing attention-deficit disorder.
"The fear is that this will cause lots of children to be identifed who aren't all that different from children in the regular education classes," Mr. Kealy said. And, as has been the case with many other disability categories, a disproportionate share of those children may be members of minority groups.
The American Psychiatric Association in 1987 issued 14 criteria for identifying children with the disorder. A child who consistently exhibits at least eight of those symptoms over a long period of time is consido have the disorder.
According to the criteria, such a child "often fidgets with hands or feet or squirms in seat, has difficulty remaining seated when required to do so, has difficulty awaiting turns in games, often blurts answers to questions before they have been completed, and has difficulty following instructions," among other characteristics.
Moreover, the education groups point out, language in the House report specifies that services for children with the disorder should be "substantially different" from many existing special-education programs. In the case of some children, that could mean providing an aide to remind them to take their medication or do their homework. Other students, however, might require smaller classes or comprehensive behavior-modification programs.
"Where are these services going to come from?" Mr. Kealy asked. "Who's going to train the teachers?"
"We feel this will dilute services for currently eligible kids," he said.
Responding to those concerns, some parents, researchers, and advocates point out that the APA's definition may actually be more restrictive than it appears.
"We're talking about only the most extreme cases, the top 5 percent of children who have those symptoms," Mr. Parker said. He said clinicians also use sophisticated rating scales upon which to base those judgments.
Moreover, more restrictive clinical criteria are currently being developed for the psychiatric association by researchers in that field. Advocates said any definition drawn up by the Congress would probably have even tighter criteria.