luana Greulich Adventist Education and Students With ......Luana Greulich, Ph.D., serves as...

luana Greulich

G U E S T E D I T O R I A L

ducating students with disabilities is still relativelynew in the United States. Mandatory education ofstudents with disabilities did not occur until theinception of the Individuals with Disabilities Ed-

ucational Act (IDEA) in 1975, which included Public Law94-142 requiring “free and appropriate education” forstudents with disabilities.1 IDEA was revised in 2004 tocall for more inclusive education for students with dis-abilities in the educational setting.2 As a result, more U.S.public school students with disabilities are being edu-cated in the regular classroom than in self-contained orresource rooms, shifting the responsibility of educatingstudents with disabilities to the classroom teacher withsupport from a special-education teacher.3

Although laws regulating the educa-tion of students with disabilities in theUnited States do not apply to all privateeducational institutions, this does notmean that students in private institu-tions cannot receive services. These serv-ices vary depending upon the agreementbetween the local school system and theprivate institution.

So how does this uneven access to re-sources affect students with disabilitiesattending Adventist schools? There is nosimple answer since the diversity of the Adventist educa-tional system also includes significant variation in the serv-ices provided to students with disabilities. The Adventisteducational system in the U.S. consists of numerous small,rural one-teacher multigrade schools as well as largerschools with multiple teachers. In other countries, ourschools may have up to 80 students in one class with oneteacher. Some of the larger Adventist schools may employa special-education teacher, while other schools may accessresources provided by the local public school system, orthere may be no special-education services provided. In2001, James Tucker addressed the need for special educa-tion to become a viable part of the Adventist educationalsystem. Little has changed, confirming Tucker’s conclusionthat although this topic has been researched and debatedfor many years, there are still no consistent outcomeswithin our educational system. However, one problem can-not be ignored: In the Adventist system and public schoolsystem, teachers need more training to successfully assist

students with disabilities.4 Many Adventist educators con-firm that they are already serving students with disabilitiesin their classrooms, and recognize that they need moreguidance and training. Some of our universities and con-ference educational departments are presently providingtraining through resources, classes, and programs to helpeducators learn how to assist students with disabilities.

One resource for Adventist educators is this special issueon teaching students with disabilities. The articles addressthe most common disabilities as well as the areas in whichstudents with disabilities struggle the most. The authorswere chosen because of their expertise and currently servein a variety of roles: education researchers, college pro -fessors specializing in counseling and education, and

pro fessionals who serve students withdisabilities (student-services personnel,education administrators, and schoolpsychologists). This issue provides infor-mation, strategies, and resources to assistAdventist educators in working with stu-dents with disabilities. The topics in thisissue are as follows: “Why Advent ist Ed-ucation Should Be Special” (Austin C.Archer), “Understanding Autistic Chil-dren in the Classroom” (Sheryl Gregoryand Donna Jeffery), “Handling Common

Emotionally Based Behavior Problems” (Ronald D. Cof-fen), “Special-needs Children and Mental Health” (NancyCarbonell), “Effective Early Reading Instruction” (Steph -anie Al Otaiba), “Response to Intervention for Math”(Matthew K. Burns), and “Accommodating Students WithDisabilities at the College Level” (Carletta Witzel, LuanaGreulich, and James R. Jeffery). Although this issue cannotcover everything related to working with students with dis-abilities, it provides a good starting point. Further infor-mation can be obtained by consulting the “Sources for Ad-ditional Information” in some of the articles, readingmaterials that the authors have published elsewhere, andby conducing topic searches.

The field of special education is constantly changingand evolving. Since 2004, there have been significantchanges that affect society such as a dramatic increase inthe number of children diagnosed with autism,5 a move-ment toward inclusive education in secular school systems,and in the United States, the implementation of the Com-

http:// jae.adventist.org The Journal of Adventist Education • December 2015/January 2016 3

Adventist Education andStudents With Disabilities

Continued on page 46

E

46 The Journal of Adventist Education • December 2015/January 2016 http:// jae.adventist.org

encing academic difficulties. Her areas ofresearch interest include disability lawand academic support.

Luana Greulich,Ph.D., serves as As-sociate Professorand Coordinator ofthe Special Educa-tion Program atAndrews Univer-sity. Dr. Greulich

earned her doctorate in special educationfrom Florida State University in Talla-hassee. While at FSU, she worked at theFlorida Center for Reading Research. Herteaching experiences include being an el-ementary teacher, special-educationteacher, and university professor. Dr.Greulich is a member of the MichiganEducator Preparation Institute and theMichigan Autism Council.

2. Cynthia G. Simpson and Vicky G. Spencer,College Success for Students With Learning Disabil-ities (Waco, Texas: Prufrock Press, 2009), p. 112.

3. Chris Wise Tiedemann, College Success—forStudents With Physical Disabilities (Waco, Texas:Prufrock Press, Inc., 2012), p. 129.

4. Christy Oslund, Supporting College and Uni-versity Students With Invisible Disabilities: A Guidefor Faculty and Staff Working With Students WithAutism, AD/HD, Language Processing Disorders,Anxiety, and Mental Illness (London and Philadel-phia: Jessica Kingsley Publishers, 2014), p. 28.

5. Ibid., p. 43.6. Ibid., p. 87.7. Norman Coombs, Making Online Teaching

Accessible: Inclusive Course Design for Students WithDisabilities (San Francisco: John Wiley & Sons,2010), p. 24.

8. Ibid., p. 23.9. Jane E. Jarrow, “When Faculty Are Too Ac-

commodating!” Social Security Administration:http://www.janejarrow.com/public_library/inservice-material/factooacc.html.

10. Ellen G. White, Counsels to Parents, Teach-ers, and Students (Mountain View, Calif.: PacificPress Publ. Assn., 1913), p. 229.

mon Core State Standards. As guest editor for this issue, I wouldlike to call for more topics in special education in publicationslike THE JOURNAL OF ADVENTIST EDUCATION.

Our goal for this issue is to help teachers learn about re-sources they can successfully use in their classrooms to assiststudents with disabilities. Our teachers need more resourcesto help them ensure that every student enrolled in our schoolsnot only obtains a good spiritual foundation, but also a strongacademic foundation. May the words of Jesus in Luke 9:48 res-onate as we strive to meet this need: “‘Whoever receives thischild in my name receives me, and whoever receives me re-ceives him who sent me. For he who is least among you all isthe one who is great’” (ESV).6

Luana Greulich, Ph.D., serves as Associate Professor and Coor-dinator of the Special Education Program at Andrews Universityin Berrien Springs, Michigan. Dr. Greulich earned her doctoratein special education from Florida State University in Tallahassee.While at FSU, she worked at the Florida Center for Reading Re-search. Her teaching experiences include being an elementaryteacher, special-education teacher, and university professor. Herpassion is teaching and research, and she has authored and pre-sented papers on reading, behavior, Response to Intervention, andwriting. She is currently a member of the Michigan EducatorPreparation Institute and the Michigan Autism Council. In thepast three years, she has enhanced the Special Education Programat Andrews University and is currently pursuing avenues to do

research in the surrounding public school systems. The JAE edi-torial staff express heartfelt appreciation for the many hours Dr.Greulich devoted to selecting topics, obtaining peer reviewers, pro-viding input on article content, as well as her prompt responsesto the editor’s questions during the planning and production ofthis issue.

NOTES AND REFERENCES1. Barbara D. Bateman, “Law and the Conceptual Foundations of Special Ed-

ucation Practice.” In Jean B. Crockett, Mike M. Gerber, and Timothy J. Landrum,eds., Achieving the Radical Reform of Special Education: Essays in Honor of JamesM. Kauffman (Mahwah, N.J.: Erlbaum, 2007), pp. 95-114; Barbara D. Bateman,“Individual Education Programs for Children With Disabilities.” In James M.Kauffman and Daniel P. Hallahan, eds., Handbook of Special Education (New York:Routledge, 2011); Dixie Snow Huefner, Getting Comfortable With Special EducationLaw: A Framework for Working With Children With Disabilities (2nd ed.) (Nor-wood, Mass.: Christopher Gordon, 2006); United States Office of Education, “As-sistance for States for Education for Handicapped Children: Procedures for Eval-uating Specific Learning Disabilities,” Federal Register 42 (1977):G1082-G1085.

2., Individuals With Disabilities Education Improvement Act of 2004, H. R.1350, 108th Congress (2004).

3. National Center for Educational Statistics, Children and Youth With Dis-abilities, http://nces.ed.gov/programs/coe/indicator_cgg.asp.

4. James A. Tucker, “Pedagogical Applications of the Seventh-day AdventistPhilosophy of Education,” Journal of Research on Christian Education 10 (2001):169-185.

5. National Center for Education Statistics, ibid.; Autism Society, Facts andStatistics, http://www.autism-society.org/what-is/facts-and-statistics/.

6. Scripture quotations marked ESV are from The Holy Bible, English Stan-dard Version, copyright © 2001 by Crossway Bibles, a division of Good NewsPublishers. Used by permission. All rights reserved.

James Jeffery,Ph.D., served asthe Dean of theSchool of Educa-tion at AndrewsUniversity from2003-2015 and re-cently retired. His

background in education includes beinga high school principal, a school superin-tendent, department chair, and professorof leadership and educational adminis-tration. Dr. Jeffery’s research interests arein school governance and leadership, andonline teaching and learning.

NOTES AND REFERENCES1. “ABC’s of Accommodation,” Education Life

(October 30, 2012): http://www.nytimes.com / 2012/11/04/education/edlife/guide-to-accommodations-for-college-students-with-disabilities. html?_r=0; National Center for Educational Sta-tistics, “Students With Disabilities”: https://nces. ed.gov/ fastfacts/display.asp?id=60. Websites inthe endnotes were accessed in May 2015.

Guest Editorial Continued from page 3

Why Adventist EducationShould Be Special


Seventh-day Adventist educa-tion is not ordinary educa-tion. When Ellen White de-scribed education as “theharmonious development of

the physical, the mental, and the spiri-tual powers,”1 she laid the basis for theessential wholism of Adventist educa-tion. At the level of the individual, Ad-ventist education is special because itinsists that education is incomplete if itis merely academic or vocational, or in-deed, only spiritual. True educationmust encompass the entire individual.It must develop the whole person.

Yet, at a systemic level, Adventist ed-ucation would be seriously lacking ifwe stopped at developing the wholeperson for it is possible to educate a se-

lect few in a wholistic manner and feelsatisfied that we have met the test. Oneof the best things about Adventist edu-cation is that it has historically beenegalitarian. It has avoided elitism.Churches and schools have provided away for those who have modest meansto receive an Adventist education.

In his first letter to the Corinthians,Paul2 described the church as a bodywith different parts serving differentfunctions, but all making up Christ’sbody. I would suggest that wholism inAdventist education must not only in-volve the whole person; it must also in-volve the whole Body of Christ. ThatBody includes the rich and the poor; italso includes those with disabilities aswell as those without.

In order to find out how we aredoing in special education, I conducted

two informal surveys, one in 2008 anda follow-up in 2014. I asked my studentassistant to contact all the union con-ferences in the United States in order tofind out whether they employed spe-cial-education teachers, and if not, howthey dealt with special-needs childrenwithin Adventist schools.3 Of the 911schools for which we received informa-tion (2008), only 26 had a designatedspecial-education teacher. In the fall of2014, of the 659 schools for which wereceived a report, 41 had access to spe-cial-education services provided by achurch employee.4 Some conferencesprovided special-educational servicesby assigning one trained educator toserve many schools. In other cases,

B Y A U S T I N C . A R C H E R

a polemic With Some practical Suggestions

schools made do with the expertise oradditional training provided by theirregular teachers. But in the overwhelm-ing majority of cases, special-educationservices were simply not provided, andthe schools depended on local publicresources to meet their needs.

There is a real problem in the provi-sion of special-education services inAdventist schools in the United States.Based on our initial (2008) inquiry, lessthan two percent of Adventist elemen-tary schools in the U.S., and less thanthree percent of all our schools (inclu-sive of junior high and high schools),provided direct special services to our

children.5 The more recent surveyyielded more optimistic numbers. Still,only six percent of schools reported ac-cess to Adventist special-educationservices in 2014. If one assumes thatAdventist schools in the U.S. are betterendowed in this area than elsewhere,especially in developing societies, hardquestions must be raised regardinghow well we provide for students withspecial needs worldwide.

Putting the facts so starkly, however,is not intended to indict our system.Underneath this bleak reality are themany ways in which these schools showthat they are aware of the needs of their

students with special needs, and areemploying various strategies to meetthose needs. So the responses we re-ceived provide hints for solving thisproblem. A few suggestions are listedbelow. Some of these better fit the U.S.educational environment, but mostcan be adapted to a variety of systemsaround the world.

1. Make Use of the public System. U.S. law requires that facilities be

made available in the public educationsystem for all children with disabilities,including those enrolled in parochialand private schools.6 Since public

5http:// jae.adventist.org The Journal of Adventist Education • December 2015/January 2016

we value our students as

being of equal worth, we must

consider including all of them, with

and without disabilities, in every

aspect of the learning experience.

school districts are generally betterstaffed with school psychologists andspecial-education teachers than ourconferences, we can benefit from usingthese facilities. Many Adventist schoolsystems report that they have addressedthe need in this way. However, there isa reason why we as a church chose todevelop our own system, even thoughour students have a right to free publiceducation. If Christian education istruly to be wholistic, it is far from idealto subdivide our educational offeringsinto parts—the part that can be deliv-ered by the state and the part that weare able to deliver ourselves. If we arecommitted to Christian education,then we must do it wholistically. Thatmeans although the use of the publicsystem may be a helpful stopgap, it isonly that. Ideally, Adventist educationmust be available to all of the church’schildren, regardless of ability or eco-nomic status. In order to do so, wemust have Christian personnel in ourschools who are trained to provide spe-cial education.

2. Use our Trained personnel. My informal 2008 survey suggested

that only six percent of our U.S.schools have access to trained person-nel functioning as such. This suggests aserious problem of unmet need. Thereis a reason for this. Hiring specializedpersonnel is seen as a luxury that ourmostly small schools cannot afford dueto limited resources. In multigradeschools, many of which lack a full-timeprincipal, each person has heavy re-sponsibilities, and it is unrealistic toexpect one to be a specialist. It is notsurprising, then, that the lack of spe-cial-education personnel is most evi-dent at the elementary level, since inthe North American Division, most ofthe schools are small, with only one ortwo teachers.

The Adventist educational system inthe United States is fortunate to have anumber of teachers with substantialtraining in special education who func-

tion as regular teachers in classrooms.These teachers can be sought out andused as consultants in the schools inwhich they serve. Our survey foundsome schools in which this is alreadybeing done. It may serve to enhancetheir profile and effectiveness if theseteachers are provided with incentivesthat recognize their specialized skillsand responsibilities. Such incentivesmight include financial enhancements,flexibility in scheduling, or subsidies tofacilitate further professional develop-ment.

3. provide “circuit Riders.”Some conferences reported ap-

pointing special-education teachers toserve a collection of schools within ageographical area. This is another wayour limited trained personnel can beused in areas with many small schools.The number of circuit riders neededcould be calculated using a formulabased on the number of students en-rolled in Adventist schools within aparticular area. Such teachers mightwork from an office in one of thoseschools or at the conference office.They could receive travel reimburse-ment to allow for movement amongthe schools within the assigned “dis-trict” and a mandate to serve all thespecial-needs students within that par-ticular area. They could also providein-service training to classroom teach-ers on how best to meet the needs ofthese special students. One danger ofthis approach is the likelihood of such

teachers being over-extended, whichwould reduce their effectiveness.

4. Embrace Inclusion as a Working policy.

A popular special-education text de-fines Inclusion as “the process of bring-ing all, or nearly all, children with ex-ceptionalities into the general classroomfor their education, with special educa-tional support.”7 If we value our stu-dents as being of equal worth, we mustconsider including all of them, with andwithout disabilities, in every aspect ofthe learning experience. A serious com-mitment to educating all studentsequally will require us to considerwhether this can best be done by plac-ing students with special needs in thesame settings as other students. Al-though it is not the purpose of this arti-cle to make a case for Inclusion as a pol-icy directive, several lines of research8

suggest that it may be a worthwhile ap-proach. Indeed, it seems like a goodmatch for our church school system,where specialized personnel are in shortsupply. However, this approach does noteliminate the need for specialized per-sonnel. Because it is a statutory require-ment in American public schools(though the term is not used explicitlyin the law), most teachers in the U.S.system are already oriented to this prac-tice. Church schools in other countriesshould seriously consider this approach.Yet, any adoption of Inclusion should be


done only after careful consideration ofthe research, rather than as a hastilychosen option of convenience. Imple-menting this approach would require acomprehensive change in orientationand training among all the teachers inany school that adopts it.

5. Focus on and Expand Training.Whether your school decides to use

the conventional approach or the In-clusion approach to special education,both beginning and in-service teacherswill need more training than they gen-erally receive in the area of teachingchildren with special needs. Currently,certification requirements for mostU.S. states demand only cursory theo-retical training about exceptional chil-dren. Yet, if Adventist teachers mustcontinue to function in an environ-ment with few specialist resources, theywill require more extensive training.Unfortunately, recent trends in our Ad-ventist colleges and universities inNorth America are not encouraging,with only one school offering an un-dergraduate degree in special educa-tion, and no teacher-education pro-gram requiring more than a minimumexposure to special needs or Inclusioneducation. A possible course of actionmight be to require that all teacherswho have not taken such courses beprovided with in-service training andsubsidies for coursework relating to theeducation of students with disabilities.

6. change our orientation.Probably the greatest need is for

every educator in the Adventist system,from the classroom teacher to the su-perintendent, to re-evaluate the way wethink about special education. Is it aluxury that we can leave to the vagariesof budgets, an extra that we can lop offwhen times get difficult? Or is it an es-sential element that is central to whatwe do because we value all our studentsequally, whether their abilities allowthem easily to be taught, or whetherthey require special attention or specialaccommodations in order to succeed?Are some of our children more deserv-ing of a complete Adventist education

Austin C. Archer,Ph.D., is a Professorof Psychology andEducation at WallaWalla University inCollege Place, Wash -ington. His currentresearch interests in-

clude cognition, memory, and construc-tivist learning theory, and he has publishedarticles in various journals, including TheJournal of Educational Research and theJournal of Research in Christian Educa-tion. Dr. Archer currently teaches graduatecourses in Advanced Human Development,Qualitative Research, Psychology of Learn-ing, and Counseling Diverse Populations.

NOTES AND REFERENCES1. Ellen G. White, Education (Mountain View,

Calif.: Pacific Press Publ. Assn., 1903), p. 13.2. 1 Corinthians 12:12-27. 3. I wish to acknowledge student assistants

Keri Wilson, who gathered the initial informa-tion, and Zhu Min, who helped with the more re-cent inquiry.

4. Because this was an informal inquiry, a morecareful and detailed evaluation needs to be made.

5. According to our inquiries of 756 elemen-tary and 35 junior high programs, 14 had special-education teachers. Of 120 secondary schools, 12had special-education teachers.

6. The specific provision is found in TITLE I/B/612/a/10 of the U.S. Individuals with Disabili-ties Education Act (IDEA) 2004, which can be ac-cessed at this source: http://idea.ed.gov/.

7. Samuel Kirk, James Gallagher, Mary RuthColeman, and Nick Anastasiow, Educating Excep-tional Children (Belmont, Calif.: Wadsworth,2012), 13th ed., p. 41. See also “What Is Inclu-sion,” Florida State University Center for Preven-tion & Early Intervention Policy (2002): http:// www.cpeip.fsu.edu/resourcefiles/resourcefile_18.pdf. Accessed September 2, 2015.

8. Various studies suggest that Inclusion ap-proaches may be superior to conventional specialeducation (Kenneth A. Kavale and Gene V. Glass,“The Efficacy of Special Education Interventionsand Practices: A Compendium of Meta-AnalysisFindings,” Focus on Exceptional Children 15:4[1982]:1-14; Conrad Carlberg and KennethKavale, “The Efficacy of Special Versus RegularClass Placement for Exceptional Children: AMeta-Analysis,” Journal of Special Education 14:3[1980]:295-309), as well as being cost effective(James Q. Affleck, et al., “Integrated ClassroomVersus Resource Model: Academic Viability andEffectiveness,” Exceptional Children 54:6 [1988]:339-348).

9. Matthew 25:31-40.10. Mark 12:31.


experience than others? If, as I believe,the answer is “No,” then every educatormust do whatever it takes to ensurethat no special-needs child is left with-out an appropriate Adventist educa-tion.

In Jesus’ parable of the sheep andthe goats9 in the last judgment, thebasis for judgment is how well we asHis followers have met the needs of theleast among us. If Adventist educationis going to be truly Christian, we can-not ignore the increasing number ofstudents who come to us with physical,cognitive, and emotional disabilities.We must take them and provide as ade-quately for their educational needs aswe do for the rest of our students. Wecannot turn them away or merely turnthem over to the public system or aChristian school operated by anotherdenomination. Doing so could sendthe message that Adventist education isnot for them, too.

There is no evidence that childrenfrom Adventist homes are any more orless vulnerable to the whole range of is-sues associated with physical, intellec-tual, or learning disabilities. Conse-quently, there is no less of a demandfor these needs to be met in Adventistschools than in other schools. More-over, many Adventist schools serveconstituencies that go beyond the nar-row confines of the children from Ad-ventist homes. The mandate of Jesus tolove our neighbor as ourselves10 obli-gates us to care for all the students thatmight enroll in Adventist schools. Thisarticle, then, is in some ways a polemic.It is a call to re-examine our commit-ment to Adventist education as ameans for all children who attend Ad-ventist schools to achieve the harmo-nious development of all their powers.It is a plea for Adventist education topay much more attention than we havepreviously to those students who arethe “least of these.”

This article has been peer reviewed.

�

Understanding AutisticChildren in the Classroom


B Y S H E R Y L G R E G O R Y a n d D O N N A J E F F E R Y

Peter1 sits on the floor in the hallway, book bag open and papers in disarray.The bell rings, indicating that he should go to his classroom; however, he

remains seated on the floor, talking intently to himself and oblivious to histeacher’s initial prompt to hurry. It will take three attempts to get him to re-spond. He is one of Ms. Brighton’s brightest students. If he has an interest in atopic, he can recite impressive amounts of information, and he possesses an in-credible memory for details. Teachers are drawn to him, yet although he is gen-erally delightful, it is difficult to connect with him because of the lack of reci-procity—he is unable to sustain a conversation.

Fourteen-year-old Emma likes math but refuses to study any other subject. Herparents have homeschooled her for two years, frustrated with her constant

behavior problems at school. They are very concerned that she will not earn ahigh school diploma. Emma is fascinated with recipes and owns several bindersfilled with her favorites; yet, according to her mother, she doesn’t like to cook.

eter, Emma, Maria, and Sam exhibit behaviors that stu-dents with an autism spectrum disorder (ASD) maydisplay in a classroom. Many of these children strugglewith specific conditions that cause them to react andbehave in ways that teachers don’t always understand.

Sometimes teachers are able to find strategies or interventionsthat successfully accommodate students with this disorder; butoften these children are simply disciplined with detentions,time-outs, and similar measures. In this short article, all teach-ers, especially those in Adventist, Christ-centered classrooms,are encouraged to become more familiar with the special needsof students with an autism spectrum disorder, the challengesthat such children face, and strategies for creating a productivelearning environment for them.

Most educators are familiar with the term autism. However,this condition was not officially recognized in the United Statesuntil 1990 in the Individuals with Disabilities Education Act(IDEA). The root of the word autism comes from the Greekword autos meaning “self.” So, “autism” implies that a personhas an isolated self.2 Researchers in the United States started

using this term in the 1940s in reference to children with socialand emotional difficulties. Around the same time, Hans As-perger, a German pediatrician, described a similar group ofcharacteristics that has been referred to as Asperger’s Syn-drome.3

a Brief descriptionUntil recently, three types of autistic disorders were recog-

nized separately: autistic disorder, Asperger’s syndrome, andpervasive developmental disorder—not otherwise specified.However, in the 2013 edition of the Diagnostic and StatisticalManual of Mental Disorders (DSM-V), autism spectrum disor-der (ASD) is the only term used to describe autistic behaviorand its variations. According to this most recent definition, achief characteristic of ASD is persistent deficits in social com-munication and interaction. The affected individual also dis-plays a notable restricted, repetitive pattern of behaviors, inter-ests, and/or activities. The person with ASD often exhibitsdifficulties with or unusual reactions to sensory input such astouch, smell, sound, and visual stimuli. ASD is a lifelong con-


P

Maria is in the 2nd grade. When her teacher says “Good morning, Maria!” sheresponds with a blank stare, struggling to process the words and deter-

mine how to respond. She constantly lines up her pencils and keeps things injust the right order. When the fire alarm sounds, she covers her ears and screamsbecause she was not anticipating it, and the loud noise is overwhelming for her.Although Maria generally plays alone at recess, when she does play with otherchildren, she does not engage in meaningful interaction unless she is in charge.

Seventeen-year-old Sam is very set in his ways. He completes assignmentsand earns fairly good grades in most subjects, yet has difficulty communi-

cating. He avoids eye contact and turns sideways in his chair when spoken todirectly. His mother explains to his teachers that there are routines Sam mustfollow every day: He must put his coat on a certain way, his clothes must be of aspecial texture and fit, and his food preferences are limited. Changes to his rou-tine bring loud and often inappropriate protests. When he arrives home fromschool, Sam checks through the house to ensure all is in order.

dition that develops in early childhood, although it may not bediagnosed until school age or later.4

Each child with ASD has a unique set of strengths and weak-nesses, and each will vary widely in the amount and severity ofhis or her symptoms. Although there is no known cure for ASD,children with less severe symptoms may live normal or near-normal lives. Most, however, will experience problems with lan-guage or socialization throughout their lifetimes.5

Cognitive development may be uneven in children withASD. Some children readily process information visually, yetstruggle with processing information verbally. Most childrenwill be slow to learn new information, and some will exhibit

intellectual impairments. Others will have normal to above-av-erage intelligence.6

Perhaps the most challenging aspect of ASD is the child’sdifficulty communicating and interacting with others. Somechildren may have no ability to speak, while others may expe-rience differing levels of verbal ability, usually related to theproper use of semantic and pragmatic language. Children withASD may speak in a professorial tone or in a nonfluent manner.

Socially, children with autism often experience difficulty in-teracting in an age-appropriate manner. Initiating conversa-tions and understanding another person’s perspective can bechallenging for them. Children with ASD may not be able to


Evaluation/diagnosisAs symptoms of ASD are typically noticeable

by age 3, concerned parents of young childrengenerally first seek the advice of their pediatri-cians, who in turn may refer the child to a teamof professionals trained in identifying this dis-order. As a result, many children with ASD willenter elementary school with a diagnosis al-ready in place; however, it is estimated that onlyhalf of children with this disorder are diagnosedbefore kindergarten.12 Sometimes the teachermay be the professional who first observes spe-cific social interaction difficulties of an undiag-nosed school-aged child. It is important to re-member that ASD is a complex disorder andhaving a few of these characteristics is insuffi-cient to constitute a diagnosis. It is necessary toidentify this disorder only if the cluster of diffi-culties is preventing the child from being suc-cessful in school. Some typical indicators thatteachers may observe include the following: re-sistance to change; impairment in social inter-actions and communication; restricted range ofinterests; poor concentration; poor motor co-

ordination; sensory problems; and emotional vulnerability.13

Authentic, knowledgeable, and empathetic communicationbetween the parent and the teacher is an important first stepin addressing the child’s needs. A teacher may observe certainbehaviors demonstrated by the child, or a parent may volunteerinformation about their child’s behavior patterns and seek ad-vice from the teacher. It is important for the teacher to discussobservations with the child’s parent, especially if the child hasnot been referred to or evaluated by a professional.

Each of our Adventist schools should have a plan to accom-modate and educate students with special needs. If it becomesapparent that a child needs additional support, the teacher andparent should meet together with the principal and discuss howthe school could best meet these needs. This support may in-clude accessing resources from the local public school district.In the United States, the local public special-education depart-ment will provide an evaluation at no cost to the school or par-ent. Seek agreement for this evaluation with the parent andyour administration, remembering that the parents must al-ways give their signed permission to evaluate.

Due to the complex nature of ASD, a comprehensive eval-uation should be conducted by a team of professionals. In-clude a speech and language pathologist because symptomsoften appear in the form of delayed speech and the awkwarduse of language. Lack of coordination and limited motor skillsmay require a screening by an occupational or physical ther-apist. A school psychologist, experienced in identifying thisdisorder, will administer or oversee the additional compo-nents of the assessment, beginning with the child’s detaileddevelopmental history. This evaluation typically includes cog-nitive, achievement, and socialization measures, as well as vi-


erhaps the most challenging

aspect of aSd is the child’s diffi-

culty communicating and interacting

with others. Some children may

have no ability to speak, while others

may experience differing levels of

verbal ability, usually related to the

proper use of semantic and prag-

matic language.

pick up on social and non-verbal clues, including decipheringthe tone of voice, joking, and facial expressions. They may notrespond to their name, prefer to play alone, and be unaware ofthe feelings of others.7 They may have a tough time with achange in routine and stopping/starting activities. In stressfulor exciting situations, these children may engage in repetitiveactions like rocking, spinning, or hand-flapping, which providesome comfort for them. These behaviors can be hard for otherchildren to understand8 and result in their being subjected toteasing and ostracism.

causesContinuing research is being conducted to determine the

cause of ASD. Most scientists now believe the cause of ASD’sspectrum of impairments is most likely a combination of ge-netics and environmental factors. Researchers have identifieda number of gene markers, and identical twin studies stronglysuggest a genetic factor.9 Early brain development in the wombmay also be a contributor, but findings are only emerging atthis point. Infection, injury, or effects of environmental toxinsin the womb or early infancy are also areas that are being ex-plored. Studies have disputed any relation to vaccines.10

prevalence Due to the changes in the definition and criteria of autism

and related conditions, reports of prevalence have variedwidely. The U.S. Centers for Disease Control (CDC) has re-cently estimated that 1 in 68 American children are diagnosedwith ASD. The CDC further reported that ASD occurs in allracial, ethnic, and socioeconomic groups and is five times morecommon in boys than girls (1 in 42 boys; 1 in 189 girls).11

P

sion and hearing screenings. Direct observa-tion of the child will be a very important partof the evaluation along with interviews withthe parent and teacher. They may be asked tocomplete behavior rating scales regarding thestudent’s behavior both in the classroom andduring less-structured times like play andmealtime.14

In the United States, comprehensive evalu-ations by a private agency may be expensive, soworking with insurance or through the localschool district’s special-education departmentmay be helpful. Based on the evaluated needs,the student diagnosed with ASD may be eligi-ble for local special-education services thattypically will include psychological services,along with speech, occupational, physical, and behavioral ther-apy. In addition, it is important to note that services providedto private schools by the local public school district may differfrom state to state or from school system to school system basedon availability of resources.

Once a child has been evaluated by a multidisciplinaryteam and determined to be eligible by the case conferencecommittee (which must include the parent, teacher, adminis-trator, and a certified professional who is able to effectivelyexplain the results of the evaluation), a plan for learning willbe established. Teachers and parents should work together toimplement the recommended education plan. A recordshould be maintained and reviewed periodically for how wellthe interventions and strategies are working. If there is a lackof appropriate progress, then additional help may be soughtfrom the available resources provided by the local school dis-trict, such as an autism consultant, behavior specialist, and aspecial-education teacher.

StrategiesThe teacher must understand that daily integrating compas-

sion and God’s love is the best and only way to really care ef-fectively for all children, especially for a child with ASD. Thesechildren are often very difficult to teach. Although there is noknown cure for ASD, with appropriate intervention, many chil-dren will achieve progress when evidence-based classroomstrategies are used. Each child with ASD will benefit from anindividualized approach. Here are a few suggestions:

Communication• Begin by giving instructions in a concrete manner, moving

to more abstract ideas as the child’s understanding progresses.For example, when asking a student to match items in one col-umn with corresponding items in another column, use precisenouns and active verbs. Instead of just saying “Match theitems,” first say “Draw a line to connect the items in columnone with matching items in column two.” Then, model or showthe student how this is done. Conclude by having the studentreplicate the task.

• Slow down the pace of instruction, and give the studentadequate time to process the information.

• Consider allowing the student to use illustrations or pic-tures at times as an alternative to verbal response.

• Practice patience as it may be very difficult for the childwith ASD to express thoughts verbally.

• Avoid using too many nonverbal cues, idioms (“Hold yourhorses!”), and sarcasm.

Organization• Structure the learning environment to minimize distrac-

tions and organize the work. Having clear physical and visualboundaries may help the child to understand where each learn-ing area begins and ends.

• Determine by observation, or home reports from parentsor others associated with the child, any type of sound/visual/ol-factory/tactile stimulants that may be distressing for the stu-dent, and minimize them.

• Establish a regular classroom routine, and provide age-ap-propriate schedules and visual cues to help the child experiencepredictability. Give advance notice if the routine will bechanged, and express understanding for possible upset whenthis happens.

Social/Emotional Skills• Teach social skills directly. Use pictorial social cards or de-

velop social stories for situations where the child needs specificreminders.

• Practice role playing, individually or with the whole class,to teach appropriate social skills.

• Because children with ASD often lack in the ability to readnonverbal cues, protect them from teasing and bullying. Createa classroom climate where peers are accountable for one an-other.

Behavior Management• Try to identify situations that may trigger meltdowns and

blowups. Teach the student how to successfully manage thosesituations or avoid them.


he teacher must understand that

daily integrating compassion and

God’s love is the best and only way to

really care effectively for all children,

especially for a child with aSd.

T

• Make sure classroom behavior expectations are clear andconsistent. Create an environment that reduces stress, anxiety,and frustration, which will help reduce the occurrence of chal-lenging behaviors.

• Allow breaks from difficult tasks, interspersing them withpreferred activities.

• Consult a behavioral specialist or a local autism specialistfor further ideas for managing difficult behaviors. (A list of in-ternational organizations has been included in the resource sec-tion of this article.)

Home Involvement• Involve parents by working collaboratively and sharing in-

formation. • Use daily logs as a helpful communication tool between

home and school.Teaching a student with ASD can be extremely challenging

and rewarding. Seek wisdom and direction from experiencedcolleagues, and pursue opportunities to collaborate with otherprofessionals. There is an abundance of research articles, books,and credible information available on the Internet today aboutautism spectrum disorder. Educators are encouraged to learnmore about ASD and become advocates for their students. Betheir friend, and watch them grow to reach their potential. LetGod use you to be His hands and arms to surround them withHis love. Teach them to know Jesus, who is their Best Friendand understands their strengths and weaknesses, and the de-sires of their heart. Who can say what extraordinary achieve-ment is in their future?


Sheryl Gregory, Ph.D., an experienced teacher and school psy-chologist, has served in the Adventist and public school systems atvarious levels. She coordinated the school psychology program at

�

Andrews University, and served as a professor of psychology atSouthern Adventist University.

Donna Jeffery, Ed.S., is a school psychologist in South Bend, In-diana. Prior to that, she taught in Adventist elementary and sec-ondary schools in Canada for more than 20 years.

NOTES AND REFERENCES1. Names are pseudonyms.2. WebMD, “A History of Autism,” http://www.webmd.com/brain/ autism/

history-of-autism. Accessed August 2015. 3. Ibid.4. American Psychiatric Association, Diagnostic and Statistical Manual of

Mental Disorders, Fifth ed. (Arlington, Va.: American Psychiatric Publishing,May 27, 2013), p. 50.

5. Lisa A. Ruble and Natacha Akshoomoff, “Autism Spectrum Disorders:Identification and Diagnosis,” Communique Handout 38:8 (June, 2010):1-4:http://www.nasponline.org/publications/ cq/38/8/ pdf/ V38_ N8_ Autism Spec trum.pdf.

6. Lisa A. Ruble and Trish Gallagher, Autism Spectrum Disorders: Primer forParents and Educators: http://www.nasponline.org/resources/ handouts/autism 204_ blue.pdf.

7. Ibid.8. Daniel H. Geschwind, “Genetics of Autism Spectrum Disorders,” Trends

in Cognitive Sciences 15:9 (September 2011):409-416. 9. “Autism,” Harvard Health Publication Health Topics A-Z: http://www.

health. harvard.edu/topics/autism.10. Centers for Disease Control and Prevention, Data and Statistics

(March 28, 2014): http://www.cdc.gov/ncbddd/autism/data.html; Ruble andAkshoomoff, “Autism Spectrum Disorders: Identification and Diagnosis,” op.cit.

11. “Autism (Autism Spectrum Disorder),” Harvard Health PublicationsHealth Topics A-Z: http://www.health.harvard.edu/childrens-health/autism-autism-spectrum-disorder.

12. Michael D. Powers with Janet Poland, Asperger Syndrome and YourChild: A Parent’s Guide; Unlocking Your Child’s Potential, Reprint edition (NewYork: William Morrow Paperbacks, 2003):40-61.

13. “Building a Legacy: IDEA 2004”: http://idea.ed.gov. 14. Based on one of the author’s personal experiences completing these

evaluations, as prescribed by Indiana and federal law.


autism Speakshttp://www.autismspeaks.org

International autism organizationshttp://www.autismspeaks.org/what-autism/��world-autism-awareness-day/international�-��autism-organizations

autism Societyhttp://www.autism-society.org

national association of School psychologistshttp://www.nasponline.org

autism Spectrum disorders: aSd consultationToolkit

http://www.asdconsultationtoolkit.com1001 Great Ideas for Teaching and Raising childrenWith autism or asperger’s, 2nd Edition

by�Veronica�Zysk�and�Ellen�Notbohm�(Arlington,�Texas:�Future�Horizons,�2010).

H E l p F U l R E S o U R c E S

Effective Early ReadingInstruction

A

D

B

C


ombating the cycle of illiteracyand poverty is a major globalissue, particularly in develop-ing countries, where far toomany children (and adults)

cannot read and write at a basic level.Data from the World Bank confirmsthat in many developing countries,fewer than 50 percent of individualsmore than 15 years old can read.1

Within this group, there are those whohave special needs. This issue is not anew problem for educators currentlyteaching in developing countries, andthe high rate of illiteracy underminesthe economic and educational goals ofthe populace. The primary purposes of

this article are to provide backgroundknowledge about language and readingdevelopment; describe new assessmenttools; share practical guidance for devel-oping early reading standards to reducereading problems; and suggest ways toreview, revise, or design early literacyand special-education curriculum re-sources that align with standards andassessments. Research shows that earlyliteracy intervention is a powerful ap-proach to preventing reading problemsand is more effective than trying to re-mediate persistent reading problems.2

Understanding language andEarly literacy Skill development

Understanding language and read-ing development is critical for special-

education practitioners and generalclassroom teachers. Reading disabilitiesare the most common disabilities, andthey are caused by deficits in phonemicawareness, letter-sound correspon-dence, and a lack of automatic and flu-ent reading.3

Reading and writing are relativelynew in human history. Louisa Moats4

in her resource for language teachersexplains that both cuneiform and hi-eroglyphics developed around 4000B.C., but there is evidence that oral lan-guage existed earlier. Indeed, many lan-guages around the world do not have awritten form. She describes how alpha-betic languages (those which assignsymbols to sounds) developed from

B Y S T E P H A N I E A L O T A I B A

aligning Standards, curriculum, and assessment for

Special Education

C

these non-alphabetic early writtenforms that represented syllables, unitsof meaning, and sounds. The Phoeni-cians created a syllabic set of symbolsto represent consonant-vowel and con-sonant sounds. Although the Greeksembraced these symbols around 1000B.C., they further assigned a symbol toeach sound. In turn, to represent Latin,the Romans refined the Greek alpha-betic system, and it spread around theworld.

The easiest alphabetic systems, whichhave exactly one symbol for each sound,are called transparent systems. Thiscontrasts to opaque systems like Eng-lish, in which words are spelled by rep-resenting sounds (phonemes) and sylla-bles, but also representing small units ofmeaning (morphemes).5

Understanding how reading andwriting develop is essential for provid-ing effective early reading instructionto prevent and remediate reading dis-

abilities. There are many theories, butthe Simple View of Reading6 is a help-ful, foundational resource for educa-tors. The Simple View regards readingdevelopment as the product of stu-dents’ ability to understand the code oftheir own language and understand themeaning of words. The importance ofcode and meaning skills has been testedacross a number of languages (alpha-betic and non-alphabetic), and under-standing this area has been useful to


many professionals who work withspecial-education teachers and parents.

Code-focused SkillsIf children cannot read a passage, it

may be because they lack the ability tosound out the word or because they donot know its meaning. In most lan-guages, meaning skills include back-ground knowledge, oral language (in-cluding vocabulary and grammar),and listening comprehension. Code-focused skills differ somewhat by typeof language. Within the English lan-guage, the task of “understanding thecode” relies on skills such as phonolog-ical awareness, alphabetic awareness,sounding out words, and recognizingirregular words by sight. Phonologicalawareness7 refers to the ability to hearand manipulate spoken sounds in themind and out loud. An initial strategymight be to break words into large

chunks; for example, hotdog can bebroken into hot and dog. A next step isto break or segment and blend words atthe onset (or first sound) and the rimelevel (the vowel and sounds thereafter);in other words, /c/ /at/ is cat. An evenmore complex manipulation is to recog-nize that bat said backwards is tab or thatpast without the /t/ is pronounced pass.

To learn to read English, studentsneed to be able to blend and segmentindividual sounds in speech (e.g., dogcan be segmented into three sounds:/d/ /o/ /g/, and those three sounds canalso be blended together to form theword dog). Furthermore, the word linksto an image of an animal that says“woof.” Similarly, to decode a word, astudent must know the sounds that let-ters make and eventually acquire theability to apply a knowledge of phonicsand syllable patterns to read words(and sentences and texts) fluently.8

However, many words in English (e.g.,

the) do not follow the regular phoneticpatterns (See Table 1).

Variations in Code StructureOf course, not all languages have the

same structure or follow the same codepatterns as English.9 For example, somealphabetic languages like Spanish andArabic are much more transparentthan English, meaning that each soundis represented by a single symbol. InArabic, many words are divided into aroot and an ending. So Mom is pro-nounced “Om,” and that is the root.The ending sound “ee” means my.Thus, Om-ee is the pronunciation for“my mom.” Thus, blending soundsmight involve blending bigger chunksof meaning than in English.

In other non-alphabetic languages,like Chinese, words are composed ofcharacters and in turn, the characters


are composed of radicals. These radi-cals are units of meaning; some are se-mantic or morphological, but othersare phonetic (representing sounds). Inthe Korean language, units are logo-graphic, which means that symbols orcharacters may represent a unit ofmeaning. So reading involves combin-ing these units.10

Using Knowledge about Readingdevelopment

Because reading with comprehen-sion requires students to decode andread simple, familiar words, it makessense to use assessment tools to learn(1) what individual students know andneed to learn and (2) how many chil-dren within a school or educationalsystem can read at grade level. Early in-tervention is vital. Therefore, since2006, the U.S. Agency for InternationalDevelopment and the World Bank haveworked with developing nations to cre-ate a simple tool to help countries,schools, teachers, and parents under-stand how well children in primaryschool can recognize letters, read sim-ple words and sentences, read passages,and comprehend what they are read-ing. This assessment tool, the EarlyGrade Reading Assessment (EGRA),11

is a 15-minute individually adminis-tered series of tasks.

This tool is particularly helpful be-cause its multiple versions can be usednot only to screen students who are

below a benchmark, but also to moni-tor progress while students are receiv-ing intervention. The tool is adaptableto a range of learning environments—from large schools to small schools—because it is individually administered,and there are a variety of tasks, so thatteachers in multigrade classrooms canbetter understand what grade leveltexts match a student’s skill level, groupchildren appropriately for instruction,and monitor whether students aremaking progress as readers. For moreinformation, see https://www.eddataglobal.org/reading/index.cfm. Coun-tries have received assistance to developtheir own versions of the EGRA so thatthe set of words in the various tests aresimple and common in each languageand cultural context. Because manycountries have multiple languagegroups, efforts have been made to de-velop bilingual (and multilingual) ver-sions of this tool. Many Non-Govern-mental Organizations (NGOs) such asSave the Children and CARE have sup-ported efforts to pilot these tools. Put-ting EGRA or similar tools into thehands of systems, schools, teachers, andparents is a goal of many internationalorganizations. The Website listed aboveprovides links to briefs, the actual as-sessments, and training workshops.

Using Knowledge about Readingdevelopment and assessment todevelop Grade-level Standards

Standards represent end-of-gradeliteracy goals for each of the importantareas of reading development. In theUnited States, more than 40 states haveadopted the Common Core Standards.However, other countries may havetheir own grade-level achievementstandards.12 EGRA data can be used asa benchmark goal for the end of theyear; then teachers can monitor read-ing progress toward that goal for allstudents, including those with specialneeds. Here is an example:

By the end of Grade 1, the pupilwill:Demonstrate relations between spokenwords and sounds (Phonological Aware-ness).

• When presented with a word (orpicture), the pupil will say the firstsound.

• When presented with a word (orpicture), the pupil will blend thesounds to make a word (or will seg-ment the sounds into parts).Demonstrate that spoken sounds are rep-resented by letters (or characters or sym-bols) (Phonics).

• Given a letter (or character), thepupil will name the sound.

• Given a word (for example, dog),the student will sound it out and cor-rectly read the word.

• Given a word (for example, see-ing), the student will recognize the rootsee and understand that adding anending (morpheme) such as ing createsa new word, seeing.Read familiar grade-level words in a listor in a passage or text (Fluency).

• When shown an EGRA word list,the pupil will read ___ words in oneminute.

• When shown an EGRA passage,the pupil will read ___ words in oneminute.

• For non-reading pupils: Listen to afamiliar story, and answer ___ out of___ questions correctly. For beginningreaders: Read an EGRA passage, andanswer ___ out of ___ questions cor-rectly (Comprehension).


VC it CVC dog

VCC ask CVCC lamp

CVC cup CVCC dust

CCVC crib CVCe cake

CCVC spent CCCVC scrap

CCCVCC shrink

Table 1. Regular phonetic patterns in EnglishKey: C = Consonant V = Vowel

Using Knowledge about Readingdevelopment to Make curriculumdecisions

It can be a huge undertaking to de-cide what instructional materials are ap-propriate and sequence them accordingto students’ reading development needs.It is even more difficult to start with noresources to teach students with a vari-ety of mother tongues. That challenge isvery real in many developing countries,which also have the fewest resources(trained teachers, curricular materials,books, printing presses, and writing ma-terials). Teachers can think of the stan-dards as a guideline or roadmap of thesequence of grade-level benchmarks orskills; then assessments like EGRA canreveal how many students are reachingthat benchmark.

If reading curricula exist, teacherscan start with a review of what is avail-able—what is adequate, what could berevised, and what needs to be created. Ifrelevant curricular materials do notexist, then step by step, the teacher willneed to purchase or create them. As dis-cussed earlier, according to the SimpleView,13 code-focused curricula areneeded to teach the alphabet, to teachdecoding (how to sound out regularwords) and identifying common words,and to practice reading these words insimple sentences. These materials shouldbe carefully sequenced to match thestandards or roadmap of skills, movingfrom easiest to most difficult. For exam-ple, in Year 1, many children probablycannot read a complex story to them-selves. Rather, they need to practice andreview these smaller building blocks ofreading in order to develop the ability torecognize letter sounds and names, readsimple common words, combine thosewords to create short sentences, and toeventually read fluently with expressionand understanding. Curricular adapta-tions might include teaching to mastery,monitoring progress to determinegrowth, or increasing intensity. The boxin the next column provides a list of freeonline resources to which teachers mayrefer as examples. Information about

teams of researchers currently workingto create curricula and assessments indifferent orthographies is provided onpage 19.

Meaning-focused materials, accord-ing to the Simple View,14 can teach orallanguage and reading comprehension.Thus, these may differ and could beread aloud to students to teach vocabu-lary and listening skills, and the con-cept that stories have a structure (be-ginning, middle, and end) and aresomewhat predictable (most have char-acters, and may contain a problem anda solution). In addition, a variety ofbooks are probably being used as con-tent-area resources (national history,science, or health, for example). Oncechildren can comprehend sentencesand short texts, they can read thesetexts to themselves or to younger orless-able peers. Adaptations might in-clude having children listen to recordedbooks or read easier content than ap-pears in grade-level text, or groupingstudents into small groups to increasethe intensity of instruction.

conclusionEarly reading intervention, sup-

ported by data from assessments, canprevent most reading problems and re-duce the number of students who will

require special-education services.General classroom teachers interestedin special education can use standardsand available curriculum resources tocreate effective interventions for theirclasses. Learning about language andreading development will provide abackground; however, the examples ofassessment tools, practical guidance fordeveloping early-literacy reading stan-dards, and information about ways toalign, review, revise, or design curricu-lum and assessment provide teacherswith practical tools to help childrenwith special reading needs. The links tomaterials in English shown in the boxabove are free and accessible online.

The reading research teams listed onpage 19 are actively assisting teachersand special educators around theworld, and working to develop readingmaterials in several other languages.Early intervention can be effective;teachers have the power to create anddevelop resources that can effectivelymake a difference for struggling readersin their classrooms.


�


• The Florida Center for Reading Research (http://www.fcrr.org).This link directs the teacher to an array of simple downloadable materialsin English that can be adapted or used as models to create practice andinstructional materials (e.g., flashcards of sight words, card games forrhyming activities).

• Starfall Books (http://www.Starfall.com). This link provides simple,decodable books in English that can be translated or adapted if the pic-tures are identical or similar enough to objects in the language of instruc-tion (and in the mother tongue of the student).

• The Text Project (http://textproject.org/products/beginningreads/).This Website links to simple decodable books in English for beginningreaders as well as many books for 3rd- to 5th-graders for summer read-ing. These books can be translated or adapted if the pictures are identicalor similar enough to objects in the language of instruction (and in themother tongue of the student).

Resources to Guide creation and Revision of Materials

Stephanie AlOtaiba, Ph.D., is aProfessor and Cen-tennial Chair in theSimmons School ofEducation at South-ern Methodist Uni-versity in Dallas,

Texas. She earned her doctorate inHuman Development from Peabody Col-lege of Vanderbilt University in Nashville,Tennessee, and worked at the FloridaCenter of Reading Research at FloridaState University in Tallahassee, Florida.Dr. Al Otaiba taught and worked as aspecial educator for 13 years in the UnitedArab Emirates and is credited with morethan 100 published articles and chapters.Her research interests include early liter-acy interventions for students with or atrisk for disabilities, Response to Interven-tion, and teacher training.

NOTES AND REFERENCES1. United Nations Educational, Scientific, and

Cultural Organization (UNESCO) Institute forStatistics, The Adult Literacy Rate: http://data. worldbank.org/indicator/SE.ADT.LITR.ZS. Re-trieved April 17, 2012.

2. National Institute of Child Health andHuman Development (NICHHD) Report of theNational Reading Panel. Teaching Students toRead: An Evidence-based Assessment of the Scien-tific Research Literature on Reading and Its Impli-cations for Reading Instruction (NIH PublicationNo. 00-4754) (Washington, D.C.: U.S. Govern-ment Printing Office, 2000).

3. Ibid.4. Louisa C. Moats, Speech to Print: Language

Essentials for Teachers (Baltimore, Md.: Paul H.Brookes, 2010).

5. Ibid.6. Philip B. Gough and William E. Tunmer,

“Decoding, Reading, and Reading Disability,” Re-medial and Special Education 7:1 (1986):6-10.

7. NICHHD, Report of the National ReadingPanel, op. cit.


with special educators throughout Oman. In addition, he has de-veloped teacher-training materials to guide interventions.

A team from the Yung-Ling Research Center for Reading In-struction of National Taitung University in Taiwan has producedmaterials and core readers in Mandarin that were carefullyconstructed to help Aboriginal students whose first language isnot Mandarin to learn to read. Contacts: Drs. Shu-Li Chen([email protected]) and Shih-Jay Tzeng (jay.tzeng@ gmail. com).

Dr. Nadia Jameel Taibah ([email protected]) is an As-sistant Professor of Special Education and Head of Scientific Com-mittee/Childhood Center: Applied Research, Training, and Services(CCARTS) Childhood Studies at King Abdulaziz University (KAU) inJeddah, Saudi Arabia. She has developed similar activities usedby the Florida Center for Reading Research in standard Arabic.

Dr. Mahmoud Eman is an Associate Professor in Special Edu-cation at the Sultan Qaboos University in Oman who has devel-oped curriculum-based measures for reading and piloted them

Reading Research Teams

8. Ibid.9. Moats, Speech to Print: Language Essentials

for Teachers, op. cit.10. Young Suk Kim, “The Relationship Be-

tween Home Literacy Practices and Developmen-tal Trajectories of Emergent Literacy and Con-ventional Literacy Skills for Korean Children,”Reading and Writing 22:1 (2009):57-84: http:// dx. doi.org/10.1007/s11145-007-9103-9.

11. The Early Grade Reading Assessment: Ap-plications and Interventions to Improve Basic Lit-eracy, Amber Gove and Anna Wetterberg, eds.:http://www.rti.org/pubs/bk-0007-1109-wetterberg.pdf; The Early Grade Reading Barometer:http://www.eddataglobal.org. Retrieved May 27,2015.

12. In my work with the World Bank, I wasasked to help explicitly link reading standards toitems assessed on the EGRA so that teacherswould know how to plan instructional goals.

13. Gough and Tunmer, “Decoding, Reading,and Reading Disability,” op. cit.

14. Ibid.

Early literacy intervention: Phonological awareness—the abilityto hear sounds in words (for example: to hear the rhyme, to blendat an onset-rime level, to say the words in a sentence).

Phonemic awareness: The ability to hear, blend, segment, andmanipulate individual sounds or phonemes in words.

Letter-sound correspondence: Understanding that letters repre-sent sounds, and sounds are represented by letters.

Fluency: The ability to read automatically and with prosody.

Alphabetic systems: Languages that are represented by letters.

Transparent vs. opaque languages: Languages that have clearsound-letter spellings vs. languages in which there are severalways to spell a sound.

Phonemes: The smallest units of sound in speech.

Morphemes: The smallest units of meaning.

Meaning skills: Vocabulary, language, and comprehension.

Code-focused skills: Phonological awareness, phonics.

*Terms compiled and defined by author.

common literacy Terms*

Response toIntervention for Math

2 +2=

Using data to design and Monitor

Interventions


n 2013, only 42 percent of 4th-grade students and 34 per-cent of 8th-grade students in the United States scored at orabove the proficiency standard on the National Assessmentof Educational Progress in math,1 and approximately 30percent of the 4th-grade students and 20 percent of 8th-

grade students who completed the Trends in InternationalMathematics and Science Study2 demonstrated proficientmath skills.

Math proficiency requires both procedural fluency and con-ceptual understanding.3 Procedural fluency is the understandingof the rules and steps that make it possible to solve a math prob-lem as well as the ability to use them quickly enough to computeresults; while conceptual understanding is the knowledge of theunderlying relationships that make the procedure work.4 Re-searchers have found that many students have adequate con-ceptual understanding but struggle to recall basic math factsquickly enough to apply the information within a procedure.5

Furthermore, remedial instruction that focused on math factfluency improved students’ recall of math facts, computational

fluency, and performance on different types of math problems,6

but had less of an effect for students who lacked a basic under-standing of the underlying concepts.7 Thus, the procedural andconceptual knowledge dichotomy could be useful for determin-ing what type of math intervention specific students need.

What Is Response to Intervention (RTI)?Response to Intervention (RTI) is a systematic process to

analyze student outcome data in order to determine appropri-ate interventions for students before considering whether theyhave a disability. Once it is determined that a learning disabilityexists, special-education professionals use RTI outcome data tocontinue providing intensive instructional support to studentswho need it. As a result, RTI approaches work well for studentswho lack academic preparation and are at risk, as well as thosewho are diagnosed with learning disabilities.

Several practices are associated with RTI, including provid-ing high-quality instruction, changing instruction by fre-quently monitoring student progress, and making important

B Y M A T T H E W K . B U R N S

I

educational decisions based on student response to the changedinstruction or intervention.8 The main components of RTI are(1) quality core instruction, (2) universal screening, (3) mon-itoring progress of students identified with difficulties, (4) im-plementation of increasingly intensive interventions based onstudent need, and (5) use of resulting data collected to makeinstructional and resource allocation decisions.

As shown in Table 1 (and discussed elsewhere in detail inBurns and Gibbons, and VanDerHeyden and Burns9), RTI ismost effectively delivered within a three-tiered model of inter-vention. Tier 1 consists of quality core instruction and universalscreening three times each year; Tier 2 generally involves small-group interventions that target broad academic deficits; whileTier 3 interventions are usually intensive approaches designedfor and delivered to individual students. Thus, as student needsand difficulties become more intense, the required interven-tions will need to become more intense (i.e., require more re-sources and involve more analysis to identify them).

Essentially, an RTI system revolves around attempting to an-swer the three analysis questions presented in Table 1. Thus,measurement becomes more frequent and more precise withineach tier.10 Assessments for Tier 1 decisions are conducted three

times each year but may be required daily or at least once ortwice each week for Tier 3. Second, progressing through thetiers, measurement becomes more precise. For Tier 1, generaloutcome measures (GOMs) involve gross measures of overallmath proficiency. However, decisions at Tiers 2 and 3 are basedon data from much more specific subskill measures such asmastery of specific math facts or concepts (e.g., single-digitmultiplication; division of double-digit numbers by a single-digit number without remainders; multi-digit addition andsubtraction; time, money, and word problems). Both of thesetwo progressions (frequency and precision) occur because thespecificity of problem solving increases as students progressthrough the tiers. Essentially, an effective RTI model attemptsto answer three questions:

• The primary problem analysis for Tier 1: Is the problem spe-cific to the student or the system? (Is it a class-wide problem?)

• The Tier 2 problem analysis question: What is the categoryof the problem?

• And finally, Tier 3 attempts to determine the following:What is the causal variable?

The term “causal variable” can be confusing. As used here,the term refers to the environmental variable (e.g., amount of


repetition, focus of the intervention, and approximation to howinformation will be applied) teachers can manipulate and thatis most closely related to the problem. To illustrate, let’s use thisframework to discuss an RTI model for math.

Tier 1 – Class-wide ProblemThe definition of quality mathematics instruction has gen-

erated considerable debate, and describing the characteristicsof core instruction are beyond the scope of this article. Researchhas highlighted the need to begin RTI decision making by firstidentifying class-wide problems as an indicator of the qualityof core instruction.11 If a class-wide problem exists, then it maybe more efficient to conduct the intervention for the entire classthan to pull students out and perform interventions at the se-lected level (Tier 2). For example, consider a 3rd-grade class-room with 25 students, 14 of whom score below the expectedlevel of performance on standardized tests or other forms ofassessment and thus require intervention. It would be imprac-tical to provide small-group intervention for 14 of 25 students.Thus, data from the assessment should be used to identify class-wide problems and compare data.

dataData used for Tier 1 decisions within an RTI framework

should be global in nature or associated with an entire cur-riculum because their low-level analyses only examine stu-dents’ overall proficiency. Thus, most measures used withinTier 1 are considered general outcome measures that assessproficiency of global outcomes.12 Below, I will discuss twocommon approaches for performing Tier 1 assessments.

Curriculum-based measurement. Many schools use cur-riculum-based measurement (CBM) to screen for math per-formance because it is easy to use, free to create, and hasstrong evidence for reliability and validity.13When using theCBM approach, teachers provide the students with a seriesof math computation problems, provide four minutes forthem to complete the problems, then record the number ofcorrect responses per minute. Thus, data from a math CBMconsist of digits correct per minute (DCPM). (To explainthe DCPM metric would exceed the scope of this article.Readers are encouraged to consult Hosp, Hosp, and Howell’sbook on curriculum-based measurement14 or the Websitesin Table 2.)

Math CBM either samples a single skill (e.g., single-digit


Table 1. problem analyses and data Within Three Response to Intervention Tiers

Tier Primary Problem Data Used Intervention FocusAnalysis Question

Is there a class-wide problem?

What is the category of the problem?

What is the causal variable?

Tier 1

Tier 2

Tier 3

Class-wide interventionsfor procedural fluency

Procedural fluency ofspecific math objectives

Intense procedural fluency or conceptual understand-ing of specific objectives

General outcome measure (GOM) (e.g., curricu-lum-based measurement or group-administeredstandardized math test) three times each year

Designing Interventions:• GOM to screen• Subskill mastery measures (SMM) (e.g., curriculum-based assessment for instruc-tional design [CBA-ID] of specific objectives)

Monitoring Progress:• Weekly GOM and SMM

Designing Interventions:• GOM to screen• SMM of specific objectives• Conceptual understanding assessment

Monitoring Progress:• At least weekly GOM and SMM

multiplication, three-digit subtraction with regrouping, etc.)or involves a multi-skill probe (i.e., combination of problemsfrom the grade-level curriculum). A multi-skill probe allowspractitioners to craft an assessment that samples all of theyearly objectives for a given grade, which may more effectivelyhighlight students’ progress over time. Moreover, multi-skilled measures correlate better with outcome measures ofmath performance than do single-skill probes.15 Thus, CBMmulti-skilled probes can be often used as efficient indicatorsof general math skills within Tier 1 and thus are administeredthree times each year as a universal screening tool. Classroomteachers will require much more detailed data than these todrive daily instruction, but math CBM data can adequatelyscreen students to determine which ones need additional sup-port and to identify a class-wide problem.

Group tests. Although CBM math assessments can pro-duce useful screening data, many teachers are also interestedin assessments of math concepts and applications, which canalso be reliably measured.16 Thus, some schools conduct uni-versal screenings three times each year using highly reliablegroup-administered commercial measures such as the Meas-ures of Academic Progress17 or Star Math.18 With commer-cially prepared math screeners, the data tend to link better toinstruction than CBM math,19 and Star Math has predictedstate test scores among 3rd- and 4th-grade students betterthan did math CBM data.20 Moreover, both Measures of Aca-demic Progress and Star Math are computer-adaptive tests,which ensure efficient measurement with psychometricallysound data because groups of students can complete the testsin a matter of 15 to 30 minutes, and the tests can be instanta-neously scored and reported.

Readers in countries other than the United States are en-couraged to examine measures created with the EdData II proj-

ect.21 Some measures are available free on the Website, andmost have convincing evidence for reliability and validity.

criteriaTo interpret screening data, the teacher must first identify

or rule out class-wide problems. To do this, he or she must ex-amine the score for every student and calculate the class me-dian. The median is used because averages can be dispropor-tionally affected by outlying data for small data sets (e.g., lessthan 30 data points), and this measure is not susceptible toskewing by outliers. The class median is then interpreted bycomparing the score to a national standard. Class medians thatfall at or below the 25th percentile on the national norm (thelowest end of the average range) suggest a class-wide problem.22

However, the criterion used to identify a class-wide problem isa local policy decision. Choosing the 50th percentile as the cut-off point for intervention obviously rep resents a more ambi-tious standard that may be more appropriate for some schools.Criteria for various decisions are included in Table 3. Scorespresented for screening decisions represent the 25th percentileon a national norm for multi-skilled CBM for math.

InterventionIf the teacher identifies a class-wide problem, it may be more

efficient to bring the intervention to the class than to pull stu-dents out for intervention at the selected level (Tier 2). Van-DerHeyden and Burns23 implemented a peer-assisted learningstrategy to teach math facts in schools with a class-wide prob-lem (see http:// www. gosbr.net/math/ for a protocol). The class-room intervention led to such a dramatic improvement in stu-dent skills that the class-wide problem was no longer evidentafter a few weeks, and student scores increased significantlywithin the school year and across cohorts.24


Area Group Address

RTI Overview RTI International http://www.rti.org/

National RTI Center http://www.rti4success.org/

Math curriculum-based Vanderbilt University https://my.vanderbilt.edu/ special education induction/ measurement files/2013/07/IA.Math-CBM.pdf

National Center on Student http://www.studentprogress.org/ Progress Monitoring

Intervention Central http://www.interventioncentral.org/curriculum-based-measurements-reading-math-assesment-tests

Interventions Evidence-based Intervention Network http://ebi.missouri.edu/ iSTEEP http://gosbr.net/

Table 2. Website Resources for Response to Intervention (RTI)

Class-wide interventionsgenerally require approximately10 to 15 minutes per day. Stu-dents form heterogeneouspairs, practice single-skill com-putation for two minutes withworksheets or flashcards, afterwhich they score each other’swork and provide feedback onits accuracy.25 Students are thenassessed each week, and the in-tervention continues until theclass median exceeds the crite-rion.

VanDerHeyden and col-leagues26 have consistently dem - onstrated the effectiveness ofidentifying and remediatingclass-wide problems in math.Intervention protocols that uti-lize peer tutoring to deliver fact-fluency interventions have beenshown to be effective in im-proving student achievement.27

The second question withinan RTI framework involvesidentifying the category of theproblem. Because math is ex-tremely objectives-based, ob-jectives can be used as cate-gories to identify interventiontargets. For example, a studentmay be struggling with single-digit multiplication, or solvingword problems, or addition offractions with like denomina-tors. Practitioners can assessstudent skills in specific mathobjectives to determine the ap-propriate starting point for in-tervention. Once the target is identified, students can begrouped (e.g., students who require intervention in single-skillmultiplication in one group, and students who struggle withtriple-digit subtraction with regrouping in a different group,etc.). The data, criteria, and interventions to use for this processare described below.

dataData used for Tier 2 decisions are more specific than mere

measures of general math proficiency. The following section

provides information about how to use curriculum-based as-sessment for instructional design and technology-enhanced ap-proaches to assess individual skills.

Curriculum-based assessment for instructional design. Thelevel of problem analysis increases in complexity as childrenprogress through the three tiers, which indicates that decisionsmade in Tiers 2 and 3 depend on more specific subskill masterymeasures (SMMS)28 such as curriculum-based assessment forinstructional design (CBA-ID).29 CBA-ID measures only oneobjective at a time (e.g., single-skill multiplication), but the as-


Table 3. criteria for Math assessments in digits correct per Minute

Grade Instructional Level1 Screening2 Proficiency3 Rate of Growth4

2 Fall .40 per week Realistic

First 14 to 31 7 Winter 17 .65 per week Ambitious

10 Spring .30 per week 50th percentile


Second 14 to 31 16 Winter 17 .50 per week Ambitious



Third 14 to 31 18 Winter 17 .35 per week Ambitious



Fourth 24 to 49 32 Winter 29 .75 per week Ambitious



Fifth 24 to 49 28 Winter 29 .50 per week Ambitious


REFERENCES1. Matthew K. Burns and Melissa Coolong-Chaffin, “Response-to-Intervention: Role for and Effect on School

Psychology,” School Psychology Forum 1:1 (2006):3-15.2. Aimsweb, Measures/Norms (Eden Prairie, Minn.: Edformation, 2006).3. Amanda M. VanDerHeyden and Matthew K. Burns, “Examination of the Utility of Various Measures of Math-

ematics Proficiency,” Assessment for Effective Intervention 33 (2008):215-224.4. Lynn S. Fuchs, et al., “Formative Evaluation of Academic Progress: How Much Growth Can We Expect?”

School Psychology Review 22 (1993):27 -48; Aimsweb, Measures/Norms, op. cit.

Tier 2 – Categoryof the Problem

sessment is conducted similarly for CBM. Students receive asheet with computation problems representing one skill (e.g.,single-digit multiplication) and have two to four minutes tocomplete as many problems as possible. Once again, the dataare obtained by computing digits correct per minute. However,in Tier 2, the data are compared to a criterion for an instruc-tional level, which will be discussed below. Thus, CBA-ID is notidentical to CBM, even though they have much in common be-cause the data are interpreted somewhat differently and arebased on only one type of skill.

Although constructing CBA-ID probes is largely a straight-forward process, skill sequencing is important. Many free Web-sites offer help in creating single-skill probes including www.mathfactcafe.com, www.aplusmath.com, and www.interventioncentral.com. After creating the probes, the sequence of theskills within the curriculum will determine the order of theprobes. Since many curricula do not have a research-basedskills sequence, practitioners will need to rely on the sequencein which skills are actually taught.

Technology-enhanced assessment. Although formativeevaluation is a critical component of effective instruction andintervention, a truly formative and comprehensive assessment-to-intervention system is difficult to implement.30 Technology-enhanced assessment can make continuous assessment moremanageable31 and help ensure more systematic diagnostic as-sessment and monitoring of student progress.32

Accelerated Math33 and Monitoring Basic Skills Progress(MBSP)34 are two potentially useful technology-enhanced mathassessments. Accelerated Math assesses specific objectives, pro-vides targeted practice of deficit skills until mastery, and in-cludes regular review of mastered objectives for skill mainte-nance. Accelerated Math also provides an automated feedbackloop, and the data generated can be used to target interven-tions. The MBSP is a somewhat similar approach that includesmeasures of Basic Math Computation, and Basic Math Con-cepts and Applications. The MBSP involves students complet-ing assessments that are instantaneously scored and includedin graphs of student progress, class-wide reports, and instruc-tional recommendations.

criteriaData are used for two purposes within Tier 2: (1) to deter-

mine which intervention to use; and (2) to determine if the in-tervention is working. The criteria for selecting interventionsand monitoring progress are discussed below.

Selecting interventions. CBA-ID data are usually inter-preted with instructional-level criteria. Burns, VanDerHeyden,and Jiban35 empirically derived math criteria to which SMMscould be compared. The results of this study found instruc-tional-level criteria of 14 to 31 DCPM for 2nd- and 3rd-graders, and 24 to 49 DCPM for 4th- and 5th-graders, whichare included in Table 3. Scores below the lowest end of the in-structional level range fall within the frustration level, suggest-ing that the skill is too difficult for the child, while those thatexceed the highest score of the instructional level range fall

within the mastery (or independent) category. Thus, practi-tioners should administer single-skill probes until the task thatrepresents an instructional level is identified for students inTier 2 using the criteria derived by Burns and colleagues36 forstudents through the 5th grade.

Monitor progress. Frequent monitoring of student progressis a hallmark of an effective RTI model. The more frequentlydata are collected, the more quickly decisions can be made.First, practitioners should evaluate the skill level. Although the25th percentile can serve as an appropriate score to identify astudent as struggling in math, it is too low a criterion to use asan indicator of proficiency. Some practitioners may use the50th percentile, which may be appropriate. Likewise, the in-structional-level criteria derived by Burns and colleagues37 maybe useful for designing interventions, but higher criteria maybe needed to determine proficiency. VanDerHeyden andBurns38 empirically determined the score necessary at variousgrade levels to determine proficiency, i.e., the one that will leadto mastery of subsequent skills and may be appropriate targetsfor proficiency with CBA-ID data.

After determining if the student has reached a level of pro-ficiency, the teacher should assess his or her rate of growth.There are four possible decisions: (1) the student has reachedproficiency, and intervention is no longer needed; (2) the stu-dent is making adequate progress but has not yet achieved pro-ficiency, and the intervention should continue; (3) the studentis not making adequate progress, has not yet reached profi-ciency, and a change is needed within the tier; and (4) the stu-dent is not making adequate growth, has not reached profi-ciency, and a change in tier is needed (e.g., from Tier 2 to Tier3). As can be seen from the list of possible decisions, rate ofgrowth is an important indicator within an RTI framework.

Using both level and growth to judge student progress re-sults in better decisions than using just one of these measures.39

Multiple methods can be employed to examine growth includ-ing normative approaches such as using the 50th percentilerank in rate of improvement on a national norming.40 The rateof growth (in increased digits correct per minute per week ofintervention) that represents the 50th percentile for each gradeis included in Table 3. Fuchs, et. al.,41 presented math growthrates for realistic and ambitious goals that may also be useful,to judge the growth of individual students, and which are alsoincluded in Table 3.

InterventionFewer commercially prepared small-group interventions exist

for math than for reading, but research has identified potentialtargets and approaches. Math interventions should include ex-plicit instruction that involves models for solving a problem typeusing an array of examples, extensive practice in use of newlylearned strategies and skills, opportunities to think aloud, andextensive feedback.42 Fluent computation is also an importantgoal for math and could be a target for small-group interven-tions since students who struggle in math often have trouble re-calling basic facts43 and lack the skills required to solve more ad-


vanced problems.44 Moreover, providing additional practice withbasic or component skills (e.g., single-digit multiplication) ledto increased performance of the more advanced skills.45

Several commercially prepared interventions can be used toenhance students’ fluency in basic math skills while also provid-ing an array of problem examples, extensive practice in use ofnewly learned skills, and in-depth feedback. Technology-baseddrills, practice, and tutorials can improve student performancein specific areas, but research relating to this has been inconsis-tent.46 Math Facts in a Flash (MFF)47 is a computer-deliveredmath intervention that improved classroom-level math compu-tation skills48 among students receiving a Tier 2 intervention formath.49 A relatively large number of students can participate inMFF simultaneously because it is delivered via computer. Thus,MFF offers a potential small-group Tier 2 intervention for math.However, previous research used other approaches to help stu-dents practice math fluency while providing an array of problem

examples and extensive feedback such as flashcards with studentdyads and paper-and-pencil assessment.50 Several easy-to-usegroup math-intervention protocols developed from research byAmanda VanDerHeyden are available free of charge at www. gosbr.net/math.

Tier 3 – Causal VariableThe primary problem-analysis question for Tier 3 addresses

the causal variable; that is, the variable teachers can controlwhich is most closely related to the problem. Extensive dataanalysis exists for Tier 3 decisions, which will be discussedbelow.

dataAs with Tier 2, data for Tier 3 are needed to monitor student

progress and to analyze student difficulties. The framework for


monitoring progress at Tier 3 is essentially identical to Tier 2but is conducted with greater frequency. Teachers monitor stu-dent progress at least once each week, assessing both subskillmastery and general outcome measures. Students receiving aTier 2 intervention are assessed using a general outcome meas-ure (e.g., multi-skilled CBM Math, Star Math) every otherweek, but those receiving a Tier 3 intervention need to be mon-itored weekly or even more frequently. This ensures that in-structional changes can be made promptly, as contrasted withless-frequent assessment.

Children receiving Tier 3 interventions receive much morecomplex problem analysis than for those at Tier 2 becausegeneral measures alone provide insufficient data for instruc-tional planning. Rivera and Bryant51 present both active andpassive means to assess the procedures students used to com-plete the task.

The passive approach examines error patterns by examiningsamples of completed tasks. For example, a child may completea subtraction problem with regrouping by simply subtractingthe smaller number from the larger regardless of where it isplaced in the problem.

Passive approaches are often sufficient for classroomteachers to identify common errors that suggest which po-tential skills or procedures need to be retaught, but a morein-depth approach will probably be necessary for a studentreceiving a Tier 3 intervention. Thus, teachers may conductone of two active assessments to target intervention efforts:(1) Provide the student an example of the target problem andask him or her to “think out loud” while completing it. Thiswill allow the student to verbally articulate what errors arebeing made52; (2) If the error is not articulated, then the stu-dent should be provided with a second example of the prob-lem type, asked to assume the role of teacher, and explain tothe instructor how to complete the task. One of these ap-proaches will likely identify the specific procedural errorbeing made, which can then be directly and explicitly reme-diated.

Although procedural information is important for analyz-ing math difficulties at Tier 3, creating interventions for chil-dren with more severe difficulties will likely require additionalstrategies beyond mere procedural indicators. Simple discrim-ination tasks can be used to assess students’ conceptual un-derstanding of mathematical concepts by asking them tojudge whether items are correctly completed.53 For example,a student could be provided a series of items, each of whichcontains three examples of the same mathematical equation,and asked to circle the correct one. Building on research byBeatty and Moss,54 Burns55 developed a math measure con-taining two equations for each item and a picture cue (e.g.,two dice) that matched one of the equations. Students wereinstructed to circle which of the two equations matched thepicture. The data were used to determine whether the studentsunderstood the concept of single-digit multiplication, and theappropriate intervention (i.e., conceptual versus procedural)produced positive effects.

criteriaData used to monitor student progress at Tier 3 should be

compared to the same criteria used in Tiers 1 and 2. For exam-ple, general outcome measures should be compared to re-search-based benchmarks for proficiency,56 and subskill mas-tery data should be compared to empirically derived criteriafor an instructional level.57

InterventionAlthough there are fewer interventions for math than for

reading, meta-analytic research has identified important com-ponents of an effective intervention. First, intensive interven-tions within Tier 3 should use principles of explicit instructionin teaching both math concepts and procedures.58

However, the same study found a negligible effect for con-ceptual math interventions and reported that these interven-tions “present a complex puzzle of findings, open to multipleinterpretations.”59 One explanation for the complex findingsrelating to conceptual interventions could be that many stu-dents who struggle with math understand the underlying con-cept but require additional intervention for the procedure,60

and differentiating between the two provides a useful interven-tion heuristic.61

Effective computation interventions include practice withmodeling and various strategies for providing high repetition withthe task.62 For example, Incremental Rehearsal (IR)63 has consis-tently proved effective in providing high repetition of basic mathfacts.64 Readers are referred to http://www.interventioncentral. org/academic-interventions/math-facts/math-computation-promote-mastery-math-facts-through-incremental-re for additionalinformation on using IR with math facts. However, there aremany good sources for conceptual interventions as well.65

conclusionAlthough RTI procedures for reading remediation are well

articulated, math research has been considerably less promi-nent over the past decade.66 Some aspects of the RTI frame-work cut across reading and math, such as first examiningclass-wide problems, delivering quality core instruction,screening all students, closely monitoring student progress,and implementing increasingly intensive interventions basedon student need. However, different assessment data areneeded for reading than for math, and the problem analysisapproach at Tiers 2 and 3 could be qualitatively different (e.g.,category of the problem based on objectives and assessing con-ceptual understanding within Tier 3 decisions). The ap-proaches to intervention suggested in this article provideschools with a place to begin implementing Response to In-tervention; however, this area continues to be one that requiresmore research as schools pay close attention to math instruc-tion and math outcomes.


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Matthew K. Burns, Ph.D., is the AssociateDean for Research for the College of Educa-tion and a Professor of School Psychology atthe University of Missouri in Columbia,Missouri. He earned his Ph.D. in Leadershipfrom Andrews University in Berrien Springs,Michigan. Dr. Burns has published morethan 150 articles and book chapters in na-

tional publications, and has co-authored or co-edited 12 books. Asone of the leading researchers regarding the use of assessment datato determine individual or small-group interventions, he has pub-lished extensively on Response to Intervention, academic interven-tions, and facilitating problem-solving teams. In addition, Dr.Burns was also a practicing school psychologist and special-edu-cation administrator, and served on the faculty of the Universityof Minnesota for 10 years and Central Michigan University forfive years.

NOTES AND REFERENCES1. National Center for Education Statistics, The Nation’s Report Card: Math-

ematics 2013 (Washington, D.C.: U.S. Department of Education, Institute ofEducation Sciences, 2013).

2. National Center for Education Statistics, Trends in International Mathe-matics and Science Study (TIMSS): https://nces.ed.gov/timss/.

3. Jeremy Kilpatrick, Jane Swafford, and Bradford Findell, eds., Adding ItUp: Helping Children Learn Mathematics (Washington, D.C.: National AcademyPress. 2001).

4. James Hiebert and Patricia Lefevre, “Conceptual and Procedural Knowl-edge in Mathematics: An Introductory Analysis.” In J. Hiebert, ed., Conceptualand Procedural Knowledge: The Case of Mathematics (Hillsdale, N.J.: Erlbaum,1986), pp. 1-28.

5. David C. Geary, et al., “Cognitive Mechanisms Underlying AchievementDeficits in Children With Mathematical Learning Disability,” Child Develop-ment 78:4 (July/August 2007):1343-1359; Laurie B. Hanich, et al., “PerformanceAcross Different Areas of Mathematical Cognition in Children With LearningDifficulties,” Journal of Educational Psychology 93:3 (2001):615-626.

6. Matthew K. Burns, “Using Incremental Rehearsal to Practice Multipli-cation Facts With Children Identified as Learning Disabled in MathematicsComputation,” Education and Treatment of Children 28 (2005):237-249; RobinS. Codding, Jillian R. Archer, and James Connell, “A Systematic Replication andExtension of Using Incremental Rehearsal to Improve Multiplication Skills: AnInvestigation of Generalization,” Journal of Behavioral Education 19:1 (March2010):93-105; Christopher H. Skinner, Danielle N. Pappas, and Kai A. Davis,“Enhancing Academic Engagement: Providing Opportunities for Respondingand Influencing Students to Choose to Respond,” Psychology in the Schools 42:4(April 2005):389-403.

7. Matthew K. Burns, “Matching Math Interventions to Students’ SkillDeficits,” Assessment for Effective Intervention 36:4 (August 2011):210-218.

8. George Batsche, et al., Response to Intervention: Policy Considerations andImplementation (Alexandria, Va.: National Association of State Directors ofSpecial Education, 2005).

9. Matthew K. Burns and Kimberly Gibbons, Implementing Response-to-Intervention in Elementary and Secondary Schools: Procedures to Assure Scien-tific-based Practices (New York: Routledge, 2012), 2nd ed.; Amanda M. Van-DerHeyden and Matthew K. Burns, Essentials of Response to Intervention (NewYork: Wiley, 2010).

10. Burns and Gibbons, ibid.11. Amanda M. VanDerHeyden and Matthew K. Burns, “Using Curricu-

lum-based Assessment and Curriculum-based Measurement to Guide Elemen-tary Mathematics Instruction: Effect on Individual and Group Accountability

Scores,” Assessment for Effective Intervention 30:3 (2005):15-29.12. Lynn S. Fuchs and Stanley L. Deno, “Paradigmatic Distinctions Between

Instructionally Relevant Measurement Models,” Exceptional Children 57:6(May 1991):488-500.

13. Theodore J. Christ, et al., “Implications of Recent Research: Curricu-lum-based Measurement of Math Computation,” Assessment for Effective In-tervention 33:4 (September 2008):198-205.

14. Michelle K. Hosp, John L. Hosp, and Kenneth W. Howell, The ABCs ofCBM: A Practical Guide to Curriculum-based Measurement (New York: Guil-ford, 2007).

15. Amanda M. VanDerHeyden and Matthew K. Burns, “Examination ofthe Utility of Various Measures of Mathematics Proficiency,” Assessment for Ef-fective Intervention 33:4 (September 2008):215-224.

16. Milena A. Keller-Margulis, Edward S. Shapiro, and John M. Hintze,“Long-term Diagnostic Accuracy of Curriculum-based Measures in Readingand Mathematics,” School Psychology Review 37:3 (2008):374-390.

17. Northwest Evaluation Association, Measures of Academic Progress forMath (Portland, Ore.: Northwest Evaluation Association, 2003).

18. National Center on Response to Intervention, Star Math (WisconsinRapids, Wisc.: Renaissance Learning, 2011): http://www.renaissance.com/Products/Star-Assessments/Star-Math.

19. Edward S. Shapiro, New Thinking in Response to Intervention: A Com-parison of Computer-adaptive Tests and Curriculum-based Measurement WithinRTI (Wisconsin Rapids, Wisc.: Renaissance Learning, 2012).

20. Edward S. Shapiro and S. N. Gebhardt, “Comparing Computer-adaptiveand Curriculum-based Measurement Methods of Assessment,” School Psychol-ogy Review 41:3 (2012):295-305.

21. https://www.eddataglobal.org/math/.22. Burns and Gibbons, Implementing Response-to-Intervention in Elementary

and Secondary Schools: Procedures to Assure Scientific-based Practices, op. cit.23. VanDerHeyden and Burns, “Using Curriculum-based Assessment and

Curriculum-based Measurement to Guide Elementary Mathematics Instruc-tion: Effect on Individual and Group Accountability Scores,” op. cit.

24. Ibid.25. Matthew K. Burns, T. Chris Riley-Tillman, and Amanda M. VanDer-

Heyden, Advanced RTI Applications: Intervention Design and Implementation(New York: Guilford, 2012).

26. VanDerHeyden and Burns, “Using Curriculum-based Assessment andCurriculum-based Measurement to Guide Elementary Mathematics Instruc-tion: Effect on Individual and Group Accountability Scores,” op. cit.; A. M. Van-DerHeyden, J. C. Witt, and D. Gilbertson, “A Multi-year Evaluation of the Ef-fects of a Response to Intervention Model on Identification of Children forSpecial Education,” Journal of School Psychology 45 (2007):225-256; A. M. Van-DerHeyden, J. C. Witt, and G. Naquin, “Development and Validation of aProcess for Screening Referrals to Special Education,” School Psychology Review32 (2003):204-227.

27. Robin S. Codding, et al., “Examining a Class-wide Application of Cover,Copy-Compare With and Without Goal Setting to Enhance Mathematics Flu-ency,” School Psychology Quarterly 24 (2009):173-185; VanDerHeyden andBurns, “Using Curriculum-based Assessment and Curriculum-based Measure-ment to Guide Elementary Mathematics Instruction: Effect on Individual andGroup Accountability Scores,” op. cit.

28. Matthew K. Burns and Melissa Coolong-Chaffin, “Response to Inter-vention: The Role for and Effect on School Psychology,” School PsychologyForum 1:1 (2006):3-15.

29. Edward E. Gickling and S. Havertape, Curriculum-based Assessment(Minneapolis, Minn.: School Psychology Inservice Training Network, 1981).

30. Dylan Willam, “Formative Assessment: Getting the Focus Right,” Edu-cational Assessment 11:3-4 (2006):283-289.

31. Jeffrey C. Wayman, “Involving Teachers in Data-driven Decision Mak-ing: Using Computer Data Systems to Support Teacher Inquiry and Reflection,”Journal of Education for Students Placed at Risk 10:3 (2005):295-308.

32. James E. Ysseldyke and Scott McLeod, “Using Technology to EnhanceRTI Progress Monitoring.” In S. Jimerson, M. Burns, and A. VanDerHeyden,eds., Response to Intervention (New York: Springer, 2007), pp. 396-407.


33. Accelerated Math, https://www.renaissance.com/products/accelerated-math (Wisconsin Rapids, Wisc.: Renaissance Learning, 1999).

34. Lynn S. Fuchs, Carol L. Hamlett, and Douglas Fuchs, Monitoring BasicSkills Progress—Basic Math Computation (Austin, Tex.: Pro-Ed, 1998) (2nd ed.,Blackline Masters).

35. Matthew K. Burns, Amanda M. VanDerHeyden, and Cynthia Jiban, “As-sessing the Instructional Level for Mathematics: A Comparison of Methods,”School Psychology Review 35:3 (September 2006):401-418.

36. Ibid. 37. Ibid. 38. VanDerHeyden and Burns, “Examination of the Utility of Various

Measures of Mathematics Proficiency,” op. cit. 39. Lynn S. Fuchs, “Assessing Intervention Responsiveness: Conceptual and

Technical Issues,” Learning Disabilities: Research & Practice 18:3 (August2003):172-186.

40. Aimsweb, Measures/Norms (Eden Prairie, Minn.: Edformation, 2006).41. Lynn S. Fuchs, et al., “Formative Evaluation of Academic Progress: How

Much Growth Can We Expect?” School Psychology Review 22:1 (1993):27-48.42. National Mathematics Advisory Panel, Foundations for Success: Final

Report of the National Mathematics Advisory Panel (Washington, D.C.: U.S. De-partment of Education, 2008).

43. David Geary, et al., “Cognitive Mechanisms Underlying AchievementDeficits in Children With Mathematical Learning Disability,” op. cit.; Hanich,et al., “Performance Across Different Areas of Mathematical Cognition in Chil-dren With Learning Difficulties,” op. cit.

44. D. E. Houchins, M. E. Shippen, and M. M. Flores, “Math Assessmentand Instruction for Students At-risk.” In R. Colarusso and C. O’Rourke, eds.,Special Education for All Teachers (Dubuque, Iowa: Kendall/Hunt Publishing,2004), 3rd ed.

45. Jessica Singer�Dudek and R. Douglas Greer, “A Long-term Analysis ofthe Relationship Between Fluency and the Training and Maintenance of Com-plex Math Skills,” The Psychological Record 55 (2005):361-376.

46. National Mathematics Advisory Panel, Foundations for Success: FinalReport of the National Mathematics Advisory Panel, op.cit.

47. Accelerated Math Fluency (Wisconsin Rapids,Wisc.: Renaissance Learning, 2003): http://www.renaissance.com/Products/Accelerated-Math-Fluency.

48. James E. Ysseldyke, et al., “Effects of a LearningInformation System on Mathematics Achievement andClassroom Structure,” Journal of Educational Research96:3 (January/February 2003):163-173.

49. Matthew K. Burns, Rebecca Kanive, and MeganDeGrande, “Effect of a Computer-delivered Math FactIntervention as a Supplemental Intervention for Mathin Third and Fourth Grades,” Remedial and Special Ed-ucation 33:3 (May/June 2012):184-191.

50. VanDerHeyden and Burns, “Using Curriculum-based Assessment and Curriculum-based Measure-ment to Guide Elementary Mathematics Instruction:Effect on Individual and Group Accountability Scores,”op. cit.

51. Diane M. Rivera and Brian R. Bryant, “Mathe-matics Instruction for Students With Special Needs,”Intervention in School & Clinic 28:2 (November 1992):71-86.

52. Ibid.53. Katherine H. Canobi, “Individual Differences in

Children’s Addition and Subtraction Knowledge,” Cog-nitive Development 19:1 (January-March 2004):81-93; K.H. Canobi, R. A. Reeve, and P. E. Pattison, “Patterns ofKnowledge in Children’s Addition,” Developmental Psy-chology 39:3 (May 2003):521-534.

54. Ruth Beatty and Joan Moss, “Teaching the Mean-ing of the Equal Sign to Children With Learning Disabil-


ities: Moving From Concrete to Abstractions.” In W. G. Martin, M. E. Strutchens,and P. C. Elliott, eds., The Learning of Mathematics: Sixty-ninth Yearbook (Reston,Va.: National Council of Teachers of Mathematics, 2007), pp. 27-42.

55. Burns, “Matching Math Interventions to Students’ Skill Deficits,” op. cit.56. See, for example, VanDerHeyden and Burns, “Examination of the Utility

of Various Measures of Mathematics Proficiency,” op. cit.57. Burns, VanDerHeyden, and Jiban, “Assessing the Instructional Level for

Mathematics: A Comparison of Methods,” op. cit.58. Scott Baker, Russell Gersten, and Dae-Sik Lee, “A Synthesis of Empirical

Research on Teaching Mathematics to Low-achieving Students,” The Elemen-tary School Journal 103:1 (September 2002):51-73.

59. Ibid., p. 66.60. Russell Gersten, Nancy C. Jordan, and Jonathan R. Flojo, “Early Identi-

fication and Intervention for Students With Difficulties in Mathematics,” Jour-nal of Learning Disabilities 38:4 (July-August 2005):293-304.

61. Burns, “Matching Math Interventions to Students’ Skill Deficits,” op. cit.62. Robin Codding, Matthew Burns, and Garcia Lukito, “Meta-analysis of

Mathematic Computation Fluency Interventions: A Component Analysis,” Learn-ing Disability Research & Practice 26:1 (February 2011):36-47.

63. J. A. Tucker, Basic Flashcard Technique When Vocabulary Is the Goal.Un-published teaching materials, School of Education, University of Tennessee atChattanooga (Chattanooga, Tenn., 1988).

64. Burns, “Using Incremental Rehearsal to Practice Multiplication FactsWith Children Identified as Learning Disabled in Mathematics Computation,”op. cit.; __________, “Matching Math Interventions to Students’ Skill Deficits,”op. cit.; Codding, Archer, and Connell, “A Systematic Replication and Extensionof Using Incremental Rehearsal to Improve Multiplication Skills: An Investi-gation of Generalization,” op. cit.

65. See, for example, John A. VanDeWalle, Karen S. Karp, and Jennifer M.Bay-Williams, Elementary and Middle School Mathematics: Teaching Develop-mentally (Boston: Allyn & Bacon, 2010), 7th ed.

66. National Mathematics Advisory Panel, Foundations for Success: FinalReport of the National Mathematics Advisory Panel, op. cit.

Help students excel — with CIRCLE. Access Adventist resources online anytime, anywhere.

Special-needs Childrenand Mental Health


B randon1 is in 4th grade. Heoften interrupts other stu-

dents, rarely follows instruc-tions, and almost never workscalmly at his desk. He seldomturns in any of his classwork,and his assignments are oftenfound crushed inside the backof his desk. Papers, pencils, andother objects he collects can befound littering the 5-footperimeter around his desk.What is going on with Brandon?How can he be helped?

B Y N A N C Y C A R B O N E L L

J ake, a 9th grader, signed upfor the volleyball intramural

games, but his mood suddenlychanged one month into theschool year, and he has missedsix of the nine games in the pastthree weeks. Lately, he seemssad and sluggish. Various teach-ers have heard him say, “I wish Icould stop everything” or “I’m sostupid” in class or in the halls. Heeats alone in the cafeteria andseems uncommonly burdened.Almost every day, after arrivinghome from school, he stays in hisroom, and his mom reports thathe isn’t sleeping well. His parentsand teachers are concernedabout his wellbeing. What mightbe happening with Jake? Howcan he be helped?

C armen is a 3rd grader. Shehas difficulty reading. She

cannot sound out words andoften will make up words basedon the first letter and/or the con-text. Although the teacher hasplaced her with a parent-volun-teer who is willing to give herspecial tutoring in this area, Car-men frequently misses the ses-sions. According to her mother,she often complains of stom-achaches and cries when she hasto leave for school. Sometimesthe “fight” over going to school isso intense that Carmen’s motherdecides to keep her home for theday, stating that this at leastseems to help the stomachache.What might be going on with Car-men? How can she be helped?

What do these stories have incommon? They are repre-sentative of many studentswho experience learningdifficulties while at the

same time struggling with mental oremotional issues. Special-needs teacherssee children like Brandon, Carmen, andJake in their classrooms every day. It isestimated that in the U.S., 37 percent ofchildren with special needs also needmental-health care.2 That is approxi-mately one in every three special-needsstudents! This is particularly challengingfor teachers whose training did not in-clude how to deal with children experi-encing mental-health issues.3

Helping children with mental-healthissues dovetails well with the philosophyof Seventh-day Adventist education,which emphasizes the balanced devel-opment of the whole person.4 Ellen G.White wrote: “A comprehensive educa-tion is needed—an education that willdemand from parents and teachers suchthought and effort as mere instructionin the sciences does not require. Some-thing more is called for than the cultureof the intellect. Education is not com-plete unless the body, the mind, and theheart are equally educated.”5 Acknowl-edging the psychological wellbeing ofeach child and ensuring his or herwholistic development to the fullest po-tential God desires are aspects Christianeducators dare not ignore.

Research shows that although teach-ers are not always comfortable with therole of gatekeeper, they realize that it istheir responsibility to be aware andsupportive of students with mental-health needs. This has often led themto recognize that they must initiateneeded interventions.6 Clearly, moreattention and training are needed toeducate teachers on how better to as-sess and access the appropriate mental-health care children need.

This article will identify and reviewthree mental-health disorders commonlyfound among children: Attention Deficit/Hyperactivity Disorder (ADHD), Sepa-ration Anxiety Disorder (SAD), andMajor Depression Disorder (MDD). Itwill discuss the findings of what causes

each disorder, the diagnosis frequentlygiven, and treatment options available.The article will also review and discusssymptoms that would warrant teacherreferral of such students for mental-health care.

attention deficit/Hyperactivitydisorder

Attention Deficit/HyperactivityDisorder (ADHD) is one of the mostprevalent disorders among school-agedchildren. ADHD affects three to sevenpercent of school-age children in theUnited States and is more prevalentamong boys.7 Symptoms are often ap-parent by 3 to 6 years of age8 but be-come prominent once a child reachesschool age. The danger lies not only inthe affected child’s inability to do wellacademically, but also in his or her dif-ficulty in developing healthy social in-teractions with peers. Brandon’s storydescribes well what ADHD looks likein a school setting. Although much re-search is still being conducted to deter-mine what factors may be tied toADHD (such as mother’s use of to-bacco and alcohol during pregnancy,exposure to toxins [i.e.. lead], low birthweight, premature delivery, and braininjury), studies suggest that geneticsalso play a part.9 Children diagnosedwith ADHD typically have a parent,sibling. or close relative with ADHD.

Children with ADHD may exhibitthe following behaviors:

• inattention;• inability to follow instructions;• incessant talking;• easily distracted from schoolwork or play;

• chronic forgetfulness;• inability to stay seated;• obliviousness to what is happeningaround them;

• impulsivity, acting and speaking without thinking;

• trouble taking turns; • interrupting others. While all children may engage in one

or more of these actions from time totime, those with ADHD engage in such

behaviors frequently or at excessive lev-els. Such behavior occurs over an ex-tended period of time and in varied set-tings, such as home, school, and church.

Children with ADHD are particu-larly challenging in the classroom.Teachers may feel impatient and an-noyed about repeating instructions orreminding wanderers to return to theirseats. Unfortunately, these behaviorscan lead to teacher/child interactionsthat are predominately negative andpunitive. Actions that further alienatethe child (making him or her sit in thehallway for extended periods of time),or taking away certain privileges thatmost children need and enjoy (recess,free-time activities, etc.) only con-tribute to the child’s conviction that“My teacher hates me!”

ADHD traits may also lead to troublewith classmates—being bullish at play,breaking things, loud and impulsive be-havior, inability to “play fair” with class-mates, etc. Thus, school is often perceivedas a hostile place by children with ADHD.

diagnosis of adHdA child showing such ADHD symp-

toms needs to be referred to a mental-health professional (the family physi-cian or the school’s health professional).These persons will collect observationalinformation from various adults in thechild’s life such as teachers, parents, andcaretakers, and also from the child’sfamily history, using questionnaires thatassess ADHD behaviors.10

Interventions for adHd Although ADHD can’t be cured and

often continues into adulthood, it canbe managed successfully, and somesymptoms may actually decrease withage.11 A number of therapies (e.g., cog-nitive, occupational, biofeedback,herbal, vitamins, food supplements)have been used in ADHD manage-ment, although no evidence-basedstudies exist to prove their effective-ness.12 The best course is to consult atrained mental-health provider who isable to work with and monitor thechild, parents, and teacher.13

Behavioral therapy and cognitive-


behavioral therapy have been found tobe successful in dealing with both be-havior and thought patterns that resultin ADHD behavior.14 The counselor/ psy chologist teaches the child variousskills—interacting with others, problemsolving, and self-monitoring—to culti-vate the desired behavior and minimizeimpulsive and inattentive behaviors. Thecounselor often includes parents in thetreatment process so that the family be-comes aware of ADHD issues and learnsto address the symptoms effectively.

affirmation Is preferable toSanctions

In the classroom, teachers can helpADHD children through preventativeclassroom modifications, particularly inspecial-education classes since thosetend to have fewer children and utilizeone-on-one teaching approaches. Thesestrategies might include sitting the childclose to the teacher’s desk and awayfrom windows, doors, and other obvi-ous distractions (class pets, pencilsharpeners, etc.), or allowing the childto take breaks as needed, and perhapsstructuring the break so the child isasked to be the teacher’s helper to takemessages to the office or turn in thelunch count. Children love helping inthis way. Some children with ADHDalso concentrate better if they are al-lowed to have outlets for their excess en-ergy in order to stay on task. For exam-ple, being allowed to pace in the backwhile thinking or keeping their handsmoving by squeezing “stress balls” asthey work on an assignment.

It is important for teachers to estab-lish and enforce clear and consistentclassroom rules and redirect the ADHDchild’s energy toward a goal or taskwhen he or she gets off task and tofocus on the child’s successes in theclassroom rather than the problems heor she “causes.” Research15 has revealedthat ADHD children are best motivatedby rewards and affirmations. Openlypraising the child for the good job doneand positively reinforcing with a tokenor star on a chart provide affirmation,and constitute powerful tools for teach-

ers. The teacher can also affirm thechild by asking him or her to hand outhomework, collect assignments, or as-sist in decorating a bulletin board. Posi-tive moments help build self-esteem,help motivate on-task behavior, andfoster a good relationship between theteacher and the child.

Strengthening the parent-teacher re-lationship is also critical to resolvingstudents’ school problems.16 Whenteachers have ongoing positive com-munication with parents, home andschool can work together to help chil-dren complete academic tasks consis-tently and successfully. Teachers cansupport parents by providing teacher-student contracts that allow the studentto complete unfinished work at home,send home daily or weekly reports onhow the child is doing, and the assign-ments that still need to be completed.

Clinical practice guidelines17 involv-ing diagnosis, evaluation, and treatmentof ADHD in children and adolescentsrecommend that medication be usedonly when behavioral interventions are

not available or when significant roomfor improvement exists following effec-tive implementation of behavioral inter-ventions. Pharmacological interventionshave been shown to increase the brain’sproduction of certain neurotransmittersthat activate the parts of the brain deal-ing with impulsivity and attentiveness. Itis imperative that parents and physicianswork together to monitor medicationsand their side effects, and obtain peri-odic assessment of their effectiveness.

Separation anxiety disorder The second mental-health disorder

commonly experienced by school-agedchildren is Separation Anxiety Disorder(SAD). Children with SAD often refuseto go to school or to sleep alone. Theyfear being away from key parental figuresin the home, have nightmares about sep-aration, and complain of physical symp-toms in anticipation of separation. Car-men’s story at the beginning of thisarticle describes well what separationanxiety disorder might look like. In suchcases, the child’s anxiety leads to exces-


sive worry and stress beyond what isnormal for the child’s age group. It isnatural for many children younger thanage 5 or 6 to feel anxious when separatedfrom their caregiver. However, whenschool-aged children (7 years and up)feel such severe anxiety that they nolonger want to go to school or visitfriends, or insist on sleeping with theirparents rather than in their own room,there is cause for concern. In fact, the keyfeatures of this disorder are the non-age-appropriate and excessive nature of thesymptoms.18 In such situations, the anxi-ety can become so extreme that it im-pedes the child’s desire to engage in newexperiences and to discover and learnnew things—experiences important increating self-efficacy in most children.

Children with SAD tend to:• feel that family members are in

danger when separated from them;• exhibit extreme over-attachment

to parent(s);• shadow parents at home;• fear sleeping in a dark room alone;• experience physical symptoms

(headaches, stomachaches, dizziness)when anticipating separation;

• whine about going to school, to afriend’s house, or a birthday party;

• dislike saying good-bye to parents.SAD is often inaccurately referred to

as “school phobia.” In reality, the anxietyactually occurs at the thought of beingseparated from parents or caregivers.Such children would never leave theircaregiver’s side if they did not have to.Consequently, they may miss many daysof school, which affects their ability tokeep up with school work, and also keepsthem disconnected and isolated frompeers and age-appropriate experiences.19

To make things worse, parents com-monly will try to protect such childrenby allowing them to stay home if theystart complaining of stomachaches orheadaches as the time to leave for schooldraws near. Without intending to do so,such parents actually reinforce the be-havior that induces anxiety!

About four percent of children andadolescents have this disorder.20 Thechances for overcoming separation anxi-ety are best when it is diagnosed and dealt

with in the early stages. If untreated, anxi-ety tends to create and blossom into moreanxiety, thus hindering good manage-ment or recovery.21 The teacher’s role be-comes even more important to the child’swellbeing because the parents themselvesmay be contributing to the problem bynot knowing how to respond appropri-ately. Although the connection betweenchildhood and adult anxiety is not yetclearly understood, evidence suggests thatvulnerability to adult anxiety may mani-fest itself in childhood.22 Learning how todeal with anxiety early in childhood isthus advisable and necessary.

diagnosis of Separation anxietydisorder

Research shows that a high percent-age of children with SAD have a parentwho also experienced separation anxietyin childhood, which suggests that SADmay have a genetic component.23 Thisshould be taken into account when ateacher shares his or her concerns withthe parent so that the child can be prop-erly diagnosed either by a mental-healthprofessional or a physician. A diagnosisis usually made after collecting observa-tional information from interviews withvarious adults in the child’s life, such asteachers, parents, and caregivers.

Interventions for Separationanxiety disorder

The teacher’s main role in the inter-vention process is one of informing theparents regarding his or her observa-tions and connecting them and theirchild with a competent mental-healthprovider. The sooner the child receivescounseling intervention, the better.Studies show that cognitive-behavioraltherapy and family interventions appearto be most effective for children aged 7to 10, while the cognitive-behavioral ap-proach alone is just as helpful for thoseaged 11 to 14.24 The early treatment al-lows the child to learn to manage anxi-ety in more productive ways beforemaladaptive patterns become too en-trenched.

As mentioned earlier, some studiessuggest that families of children with

SAD tend to contribute to their chil-dren’s anxiety issues by being excessivelyconcerned and over-protective.25 Hence,the importance of involving parents inthe intervention process cannot be over-stated. By including the parents in theprocess, they not only learn to better un-derstand how and why their child is in-teracting with their world in this way,but it will also guide parents on how tocalm down and support their child in away that facilitates success in his or herlife. Parents can learn to help their childmaster appropriate anxiety-managingskills and can assist the child in identify-ing the signs of an anxiety episode be-fore it spins out of control.

Another helpful method is bibliother-apy,26 a treatment approach used by psy-chotherapists, which includes carefullyselected books and journaling to helptreat depression. The therapist may pro-vide parents and teachers with helpfulbooks that provide management skillsand strategies for supporting the child athome and at school, such as Helping YourAnxious Child: A Step-by-Step Guide.27 Itshould be noted, however, that althoughbooks and other information sourcesmay help in dealing with children withSAD, these are no substitute for profes-sional mental-health care.28

Major depressive disorderWhile separation anxiety is often

seen in younger children, Major De-pressive Disorder (MDD) is often trig-gered as children move into puberty.Chronic feelings of sadness and worth-lessness seem to permeate everythingthe young person does and often robhim or her of the capacity for happi-ness and joy. The disorder is so perva-sive that it can interfere with all aspectsof an adolescent’s life, causing him orher to skip school, experience difficultyin socializing with friends, and in se-vere cases, triggering suicidal thoughts.The major signs to look for are:

• changes in mood, either more irri-table or more despondent;

• marked, involuntary changes inweight;

• highly critical of self; feelings ofworthlessness;


• depression lasting weeks ormonths;

• unusual sadness and reduced in-terest in activities once enjoyed (hang-ing out with friends, participating insports, etc.);

• thoughts or attempts of suicide;• changes in sleep patterns;• fatigue and sluggishness; • indecisiveness that significantly in-

terferes with day-to-day activities. Although many factors may be re-

sponsible for childhood and adolescentdepression, genetics play a key role.Behavioral scientists have found thathumans inherit varying levels of vul-nerability to depression that cause in-dividuals to respond differently to vari-ous stressors in the environment.29

Children whose close relatives sufferfrom depression are more likely to bevictims. (This is not to say that thosewithout any family history are immunefrom becoming depressed.)

Depression may also be triggered bytraumatic events, such as being attackedby a dog, losing a loved one, ending arelationship, or being the victim of sex-ual abuse. It can also occur in thosewho have no family history or havenever experienced trauma. Depressiveepisodes can often be resolved with ef-fective counseling, so finding a mental-health professional who specializes inworking with children with this disor-der is the most effective approach.

Interventions for depressionThe U.S. Centers for Disease Control

and Prevention (CDC) reported that in a2009 sampling of 16,410 high schoolyouth, 26.1 percent felt sad and hopelessenough to stop their normal activities;13.8 percent reported they seriously hadcontemplated suicide during the previ-ous year; 10.9 percent had actually devel-oped a suicide plan; and 6.3 percent hadattempted suicide one or more times.30

Depression is a serious matter, but oftenby the time the symptoms are recog-nized, the life of the person affected maybe at risk. The suffering and dysfunctioncaused by mood disorder can harm the

child in many ways—developmentally,socially, and academically. Further, de-pressed youngsters are more at risk thanthe general population to develop alco-hol and legal/illegal substance dependen-cies and to become suicide risks.31

In cases of mild depression, counsel-ing is generally sufficient. For more dif-ficult cases, psychotherapy and medica-tion may be needed. For example,cognitive-behavioral therapy, duringwhich the counselor teaches young peo-ple how their thoughts can affect theirfeelings and behavior and how to re-place dysfunctional messages with morerational ones, has been found helpful.Interpersonal therapy seeks to jump-start recovery by focusing on the child’sparents, family, and friends in order toassess the positive and negative impacton one another’s lives, while encourag-ing the children to seek out friends andactivities they once enjoyed.

If after interviewing the child and par-ent(s), a mental-health professional sus-pects that the cause of depression has agenetic component, the child will mostlikely be referred to a child psychiatrist ormedical doctor to receive further evalua-tion and treatment. The medications thatseem most effective are those that in-crease the supply of certain neurotrans-mitters, such as serotonin, epinephrine,and dopamine. The use of medicationsfor a child with depression is never aneasy decision. Experts, however, believethat the benefits outweigh the risks sinceuntreated depression is a serious threat toteen health and happiness.32

If a student displays symptoms of de-pression, take time to talk with him orher and show an interest in his or her life.If a child or adolescent expresses self-in-juring or suicidal thoughts, speak directlyto him or her about such thoughts. Somefear that such a direct approach may leadto harmful effects; but in fact, it allowscaregivers to assess the seriousness of thedepression and how far it has progressed.

In the United States, if an educatorsuspects that a child is dangerous to selfor others, the law requires him or herto contact the parents, guardians, orschool counselor, and do everythingpossible to keep the student safe. Every

school should have a clear protocol tofollow in such situations, which spellsout the steps teachers and staff shouldfollow when they encounter a poten-tially suicidal student. In the U.S., ifsuch an emergency occurs and the childappears to be suicidal, call the NationalSuicide Prevention Lifeline (1-800-273-TALK [8255]), 1-800-SUICIDE (1-800-784-2433), or 911. For internationalresources, visit the International Asso -ciation for Suicide Prevention Websiteat http://www.iasp. info/resources/ Crisis_ Centres.

conclusionFor the first time since 1960, when

the U.S. Government began collectingdata on the types of disabilities experi-enced by children, the top five disabilitiesaffecting youth are mental-health chal-lenges rather than physical problems.33

The challenges facing families, teachers,and administrators are greater than ever.In today’s world, almost 40 percent of allstudents with special needs will also havea coexisting mental-health disorder!

Because of the large amount of timechildren and young adults spend eachday in the school setting, it often be-comes the responsibility of the classroomteacher to make an initial identificationof which children have mental-healthneeds that require special assistance.While teachers are key players in guidingthe parents and child on how and whereto go to obtain effective assessments andinterventions for such mental-healthconcerns, they will need the support oftheir school administrators and continu-ing-education courses to obtain appro-priate training. Two great resource booksare The Educator’s Guide to MentalHealth Issues in the Classroom by FrankKline and Larry Silver, and Teaching KidsWith Mental Health and Learning Disor-ders in the Regular Classroom by MylesCooley.34 These are must-reads for alleducators who work with children. Theauthors provide information on the vari-ous mental-health and learning prob-lems found among children in the class-rooms and give practical suggestions onhow to address them.


It is also imperative that administra-tors and teachers work together to iden-tify nearby mental-health providers whocan become a part of their team as theywork to help these students. Havinggood referral services to turn to for con-sultation or assessment is crucial. Whilethe challenges are great, we also havemore knowledge and resources than everbefore to face them head on.


Nancy Carbonell,Ph.D., is a Professorin the Departmentof Graduate Psy-chology and Coun-seling at AndrewsUniversity, BerrienSprings, Michigan.

A licensed psychologist, Dr. Carbonellalso maintains a part-time private prac-tice in the Berrien Springs area. She haspublished in the areas of family life, racerelations, and the power of self-talk. Herresearch interests include understandingdiversity, the effect of values and beliefson multicultural relations, and the ethi-cal training of counselors.

NOTES AND REFERENCES1. Names used are pseudonyms.2. Amanda P. Spears, “The Healthy People 2010

Outcomes for the Care of Children With SpecialHealth Care Needs: An Effective National Policyfor Meeting Mental Health Care Needs?” Maternal& Child Health Journal 14:3 (2010): 401-411.

3. Jenny Cvinar, Educating Private SchoolTeachers About Issues of Mental Health: A ProgramDevelopment. Psy.D. dissertation, The ChicagoSchool of Professional Psychology (2010).

4. General Conference of Seventh-day Ad -ventists, General Conference Policy Manual(2003), “Seventh-day Adventist Philosophy ofEducation—Departmental Policies” (2003): FE05, FE 10.

5. Ellen G. White, The Ministry of Healing(Mountain View, Calif.: Pacific Press Publ. Assn.,1942), p. 398.

6. Robert Roeser and Carol Midgley, “Teach-ers’ Views of Issues Involving Students’ MentalHealth Issues,” The Elementary School Journal 98(1997):115-133: http://www.jstor.org/stable/ 1002138?seq=1#page_scan_tab_contents. Unless

�

otherwise indicated, all Websites in the endnoteswere accessed in September 2015.

7. U.S. Centers for Disease Control and Pre-vention (CDC), “Youth Risk Behavior Surveil-lance: 2009,” Mortality Weekly Report 56:35(2010):905-908.

8. American Psychiatric Association (APA),Diagnostic and Statistical Manual of Mental Dis-orders (DSM-IV-TR) (2013).

9. Alessandro Serretti and Chiara Fabbri,“Shared Genetics Among Major Psychiatric Dis-orders,” The Lancet 381:9875 (2013):1339-1341.

10. C. Keith Conners, The Conners RatingScales—Revised (North Tonowanda, N.Y.: Multi-Health Systems, 1997); Marc S. Atkins, William E.Pelham, and Mark H. Licht, “The Differential Va-lidity of Teacher Ratings of Inattention/Overac-tivity and Aggression,” Journal of Abnormal ChildPsychology 17:4 (1989):423-435.

11. CDC, Mortality Weekly Report, op. cit.12. Russell A. Barkley, Attention Deficit Hy-

peractivity Disorder: A Handbook for Diagnosisand Treatment (New York: Guilford Press, 2014).

13. Estrella Rajwan, Anil Chacko, and MosheMoeller, “Nonpharmacological Interventions forPreschool ADHD: State of the Evidence and Impli-cations for Practice,” Professional Psychology: Re-search and Practice 43:5 (2012):520-526.

14. Steven W. Evans, Julie Sarno Owens, andNora Bunford, “Evidence-based PsychosocialTreatments for Children and Adolescents With At-tention-Deficit/Hyperactivity Disorder,” Journal ofClinical Child & Adolescent Psychology 43:4 (2014):527-551. DOI: 10.1080/15374416.2013. 850700.

15. Caryn L. Carlson and Leanne Tamm, “Re-sponsiveness of Children With Attention Deficit-Hyperactivity Disorder to Reward and ResponseCost: Differential Impact on Performance andMotivation,” Journal of Consulting and ClinicalPsychology 68:1 (February 2000):73-83.

16. Susan M. Sheridan and Thomas R. Kra-tochwill, Conjoint Behavioral Consultation: Pro-moting Family-School Connections and Interven-tions (New York: Springer, 2008).

17. American Academy of Pediatrics, “ADHD:Clinical Practice Guidelines for the Diagnosis,Evaluation and Treatment of Attention Deficit/Hyperactivity Disorder in Children and Adoles-cents,” Pediatrics 128:5 (2011):1007-1022.

18. Nikole J. Cronk, et al., “Risk for Separa-tion Anxiety Disorder Among Girls: Paternal Ab-sence, Socioeconomic Disadvantage, and GeneticVulnerability,” The Journal of Abnormal Psychol-ogy 113:2 (May 2004):237 -247.

19. Cyd C. Strauss, et al., “Peer Social Statusof Children With Anxiety Disorders,” Journal ofConsulting and Clinical Psychology 56:1 (February1988):137-141.

20. APA, Diagnostic and Statistical Manual ofMental Disorders, op. cit.

21. Martin B. Keller, et al., “Chronic Courseof Anxiety Disorders in Children and Adoles-cents,” Journal of the American Academy of Child


and Adolescent Psychiatry 31:4 (1992):595-599.22. Peter M. Lewinsohn, “Separation Anxiety

Disorder in Childhood as a Risk Factor for Fu-ture Mental Illness,” Journal of the AmericanAcademy of Child and Adolescent Psychiatry 47:5(2008):548-555.

23. Paula M. Barrett, Mark R. Dadds, andRonald M. Rapee, “Family Treatment of ChildhoodAnxiety: A Controlled Trial,” Journal of Consultingand Clinical Psychology 64:2 (April 1996):333-342;Vanessa Elise Cobham, The Role of Parental Anxietyin the Aetiology and Treatment of Childhood Anxi-ety, Ph.D. dissertation, University of Queensland(1997); Muniya S. Khanna and Philip C. Kendall,“Exploring the Role of Parent Training in the Treat-ment of Childhood Anxiety,” Journal of Consultingand Clinical Psychology 77:5 (2009):981-986.

24. Barrett, Dadds, and Rapee, “Family Treat-ment of Childhood Anxiety,” ibid.

25. Ibid. See also Cobham, The Role ofParental Anxiety in the Aetiology and Treatment ofChildhood Anxiety, op. cit.; and Khanna andKendall, “Exploring the Role of Parent Trainingin the Treatment of Childhood Anxiety,” op. cit.

26. American Library Association, “Biblio -theraphy,” http://www.ala.org/tools/bibliotherapy.

27. Ronald M. Rapee, et al., Helping YourAnxious Child, 2nd ed. (Oakland, Calif.: NewHarbinger Publications, Inc., 2008).

28. Ronald M. Rapee, Maree J. Abbott, and HeidiJ. Lyneham, “Bibliotherapy for Children With Anxi-ety Disorders Using Written Materials for Parents: ARandomized Controlled Trial,” Journal of Consultingand Clinical Psychology 74:3 (2006):436-444.28;Michael Shanahan and Scott M. Hofer, “Social Con-text in Gene-Environment Interactions: Retrospectand Prospect,” Journals of Gerontology Series B: Psy-chological Sciences and Social Sciences, Vol. 60, Sup-plement 1 (March 2005):65-76.

29. CDC, “Youth Risk Behavior Surveil-lance—United States, 2009” (2010): http://www. cdc. gov/mmwr/pdf/ss/ss5905.pdf.

30. Ibid.31. Jeffery A. Bridge, et al., “Clinical Response

and Risk for Reported Suicidal Ideation and Sui-cide Attempts in Pediatric Antidepressant Treat-ment: A Meta-analysis of Randomized Con-trolled Trials,” Journal of the American MedicalAssociation (JAMA) 297:15 (2007):1683-1696.

32. International Association for Suicide Pre-vention Resources: Crisis Centers: http://www. iasp.info/resources/Crisis_Centres.

33. Anita Slomski, “Chronic Mental HealthIssues in Children Now Loom Larger Than Phys-ical Problems,” Journal of the American MedicalAssociation (JAMA) 308:3 (2012):223-225.

34. Frank M. Kline and Larry B. Silver, eds.,The Educator’s Guide to Mental Health Issues inthe Classroom (Baltimore, Md.: Paul H. BrookesPubl. Co., 2004); and Myles L. Cooley, TeachingKids With Mental Health & Learning Disorders inthe Regular Classroom: How to Recognize, Under-stand, and Help Challenged (and Challenging)Students Succeed (Minneapolis, Minn.: Free SpiritPublishing, Inc., 2007). Both books are availablefrom Amazon.com.

Handling Common EmotionallyBased Behavior Problems


den1 moves constantly. His time on task is measuredin seconds. Although he can describe the correct be-havior for a situation, he rarely performs the appro-priate behavior when he should do so.

Olivia delights in arguing minor points untiladults give up, and often raises her voice to get her way. Duringdisagreements, she brings up issues from the past that she per-ceives as unfair as if they applied to the current debate. Whenteachers redirect her behavior, she counter-attacks (e.g., whenasked to clean her desk, she counters that the teacher alwaysbosses her around).

Andy refuses to engage in new activities, declaring that hewon’t be able to do them correctly. He avoids groups and con-versations with others. When his behavior is redirected (whichis rare), he becomes tearful. Instead of playing at recess, he sitsmournfully on the ground watching the other children becausehe thinks he might accidentally break the rules of the games.

The Individuals with Disabilities Education Act (IDEA), afederal law in the United States, classifies these symptomsunder the heading of emotional disturbance. The term refers toa chronic condition that adversely affects the child’s educationalperformance and results in one or more of the following: (1)significant difficulties with learning, (2) problems negotiatingrelationships, (3) inappropriate behavior or feelings for thecontext, (4) feeling unhappy most of the time, or (5) becomingsick or fearful about typical home or school problems.2

In American public schools, individualized education plansidentify how school staff will help children with emotional dif-ficulties learn skills to cope with, manage, or resolve the diffi-

culties. Recognizing that these are children of God, teachers inAdventist schools have a higher calling than a federal mandateto serve them. This article will (1) identify essential character-istics of attention deficit/hyperactivity disorder, oppositionaldefiant disorder, and generalized anxiety disorder; (2) offer in-terventions teachers can use to address each condition; and (3)describe behaviors and symptoms that require referral.

attention deficit/Hyperactivity disorder (adHd)About five percent of children worldwide have ADHD.3 Aden

exhibits essential characteristics of ADHD: excessive, driven ac-tivity; attention easily distracted by noise, movement, or othersensory stimuli; and a tendency to do the first thing that comesto mind without thought of consequences or whether an alter-native action would be more appropriate.4 Because humanshave innate needs for competence and control, children withADHD are often frustrated with their own limited self-control,which leaves them feeling incompetent and helpless.

Children with ADHD do not initially possess the needed levelof internal self-control to consistently respond appropriately toothers and situations; therefore, interventions for ADHD are de-signed to improve their self-regulation. Initial interventions suchas point charts use adult-imposed external controls that even-tually become internalized. Having the child self-monitor his orher level of activity and then linking various (lower) levels toprivileges that are naturally attractive to the child can often behelpful because self-awareness creates the possibility of self-con-trol. The most successful interventions use just two or three spe-cific target behaviors for the child to monitor, such as (1) stay in

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his or her seat, (2) hands on the assigned work, and (3) eyes onthe assigned work (which is both an activity issue and an atten-tion issue). Self-monitoring can be done by the child using ateacher-made chart. With an external prompt (from the teacheror a timer), the student places a checkmark for every five-minuteperiod during which the target behavior was present the wholetime. Over time, the student will begin to self-monitor his or herown behavior. (Here is a link to a sample chart and additionaldetails: http://www.andrews.edu/~coffen/self-monitoring-chart.doc.) Five-minute intervals can be accomplished withcount-down timers (on watches or kitchen timers) that repeatintervals of time, pre-recorded CDs with beeps every five min-utes (see http:// www.andrews.edu/~coffen/audiotimer.htm formore information), software programs, or devices like theWatchMinder II (http://watchminder.com). At the end of eachclass period, the teacher records a star for each non-overlappinggroup of three checks.

At home, each star is associated with a small amount of aprivilege. Because parental involvement is associated with bet-ter child behavior, parental implementation of privileges athome has the added benefit of increasing parental involvementwith the child’s school life. Teachers and parents can help thechild notice the good feelings experienced when he or she ex-ercises self-control and note how he or she got that to happen,which helps develop self-regulation. When the child gets 80 to90 percent of the possible checkmarks, the external motivationcan be gradually discontinued by extending the time periodsfrom five-minute to six- or 10-minute intervals, or by replacingone target behavior with a different one.5

Self-monitoring can also help improve children’s attentionspan.Another option for enhancing attention is to break tasksinto segments. Since success is one of the best motivators, seg-menting a task provides multiple success experiences that canmotivate the child to focus on the task. For example, the teachercan ask the child to predict how long it will take him or her tocorrectly solve the first five of 20 math problems, and then thenext five, and so on until all 20 have been completed. Beatingthe clock can be motivating because it creates a sense of com-petence, control, and success.6

Breaking a longer assignment, such as writing a paper, intovery specific steps can also be helpful. For example, the teachercould print out the steps and have the child check off each oneas it is accomplished: (1) Pick a topic; (2) Create an outline; (3)Generate a title; and (4) Write a first sentence that tells some-thing interesting about the topic, etc.7

Related to breaking a task into segments is narrowing thechild’s field of vision to focus on a specific component of thetask. Children with ADHD become overwhelmed when facinga page full of problems because they do not see it as a series oftasks, but as something they have to do all at once. However,by covering up (with blank paper or card stock) all but the cur-rent row or the current problem, the child regulates his or herown attention and feels less overwhelmed by having a smallsection on which to focus. Similarly, when reading, the childcan move his or her finger under the words as they are read,

which focuses attention and also makes productive and focuseduse of the child’s tendency to move.8

One of the most powerful methods for reducing impulsivityis positive practice. Children with ADHD struggle to quicklyidentify an appropriate behavior because of their underdevel-oped short-term planning skills. But teaching self-regulationalso involves planning for the long term. Positive practice is along-term plan for promoting appropriate behaviors at thepoint they are required. Habitual behaviors “slip out” withoutconscious thought because they are over-practiced. Impulsiveinappropriate behaviors (typically social blunders) indicate anarea where the appropriate behavior is not yet habitual. If achild is simply punished (scolded, put in time out, denied priv-ileges), only the inappropriate behavior has been practiced. Forpunishment to achieve the desired goal, the next time the childthinks about doing the inappropriate behavior, he or she mustinhibit the behavior long enough to think, “The last time I didX, I got punished and I didn’t like that, so I’ll do W, Y, or Z thistime.” Children with ADHD are not good at inhibiting a re-sponse or at instantly identifying alternatives. Thus, what “slipsout” is the most-practiced behavior—and up to this point, thathas been the inappropriate behavior. So, positive practice re-quires using role play to help the child to perform the “correct”behavior more frequently than the “incorrect” behavior.

Briefly, the steps for positive practice are as follows: 1. When the child engages in an inappropriate behavior,

move him or her out of the situation. When the child’s emo-tions have calmed, implement a “cooling-off” period (positivepractice will notwork when a child is angry, and anger is a likelyresponse to being pulled aside).

2. Ask the child what he or she could have done differentlythat would have made things go better. It builds competencewhen a child can think of ideas himself or herself, but a young-ster with ADHD may need adult help to brainstorm at leastthree ideas (more is better).

3. Next, the adult role plays each part in the initial situationexcept the child’s role. The child must choose a better solutionto act out than the ones used in the past.

4. When the child uses an appropriate behavior, the adultrole plays a positive outcome and offers praise for using a moreconstructive solution.

5. The role play is done three times so that the appropriate be-havior is practiced more times than the inappropriate behavior,thus increasing the chances that the positive behavior will “slipout” in the future. Another option for positive practice: Teacherscreate common social scenarios and practice positive responsesbefore the problem arises. This can be done with the whole classas a part of the curriculum, such as presenting problem scenariosand having children try out different social responses in roleplays.9 (See http://www.andrews.edu/~coffen/ pos-practice.pdffor more details.)

A few final points: Do not take away recess (research showsthat physical activity, like recess, is associated with increasedon-task behaviors).10 Move closer to the child, or drop thechild’s name into your lecture to restore attention (“As I was

http:// jae.adventist.org The Journal of Adventist Education • December 2015/January 2016


saying to Aden earlier…”). Remind the class about your behav-ioral expectations before the start of an activity, and privatelycommend or note the compliance of the child with ADHDshortly after the activity begins.11

oppositional defiant disorder (odd)An estimated three percent of children worldwide have

ODD.12 Unlike ADHD, ODD may not occur in both home andschool settings.

Olivia exhibits essential characteristics of ODD: active defi-ance of and noncompliance with authority; frequent argu-ments, tantrums, and hostility; habitual anger and aggression;deliberately annoying others, holding grudges, and denying re-sponsibility.13

Children with ODD often do not view their behaviors asproblematic.14 They have a very high tolerance for hostility,yelling, shame, insults, crying, and threats, and seem to enjoycreating a negative environment. When directed to do some-thing, they escalate their negative behavior. If the adult has alower tolerance for negativity than the child, the adult willwithdraw his or her demands of the child and withdraw fromthe situation to decrease his or her feelings of discomfort. How-ever, giving in increases the child’s use of negative behaviors inthe future since they “worked” in the past.

Unlike children with ADHD who need help developing con-trol, children with ODD need a “control vacation.” These childrentry to manage the world as if they were adults rather than accept-ing the appropriate levels of control and boundaries that actuallyhelp children feel safe. Paradoxically, as grownups enforce fewerand fewer boundaries because of the effort required, childrenwith ODD feel as though adults are taking less and less care ofthem, so children with ODD escalate their attempts at adult-likecontrol, causing further clashes with authority.15

Therefore, the essential features of interventions for ODDare to provide the child with as much appropriate control andchoice as possible while preventing him or her from coercivelycontrolling things in the adult domain. For example, appropri-ate control offers choices about how to complete homework(e.g., at Olivia’s desk or at the work table; by herself or with agroup; at home or at school), but not whether to complete it.

In contrast, with coercive control, the child escalates his orher negative behavior (tantrums) in attempting to escape a re-quest. The escalation works only when both the child and theadult seek to maximize immediate gains by turning off theother’s aversive behavior as quickly as possible—the child seeksto dismiss the adult’s command, and the adult seeks to end thechild’s tantrum. To prevent such power struggles, teachers needto identify effective negative sanctions in advance over whichthey have complete control (this may require collaboration withparents to implement sanctions at home, e.g., loss of five min-utes of TV or video-game time or loss of five minutes of play-time with friends). Sanctions that require child compliance inorder to be effective (e.g., sitting on the sidelines during recess,which requires the child to obey this restriction; saying “Sorry,”which requires the child to repeat the required phrase) typically

are ineffective and may generate additional arguments. After thechild has been informed of the sanctions, the teacher shouldmake only one request before applying the sanction (e.g., lossof a privilege for five minutes) and should continue applyingthe sanction (e.g., every two minutes) until the child complies.No deals should be made to delay or lessen the request or sanc-tion since that would mean the child’s arguing and noncompli-ance effectively reduced the requirements and thus promotedadditional arguments and noncompliance.16

Since these children react to adult demands with actions thatthey believe will produce the maximum payoffs, sanctionsshould typically be combined with predetermined and desir-able outcomes for appropriate responses (compliance). Anypositive outcome (reinforcement) for the child that resultsfrom oppositional behaviors must be eliminated, while positiveoutcomes for prosocial behavior must increase, thus reducingthe child’s perception of the “value” of exerting control.

The use of a modified reward system similar to the self-monitoring system described above for ADHD may be helpful.Typically, the teacher should be the one to monitor the targetbehaviors, at least initially (self-monitoring may be useful later;see the sidebar on daily report cards). Target behaviors shouldbe positively stated (e.g., “Complied with directions the firsttime asked”). As the child complies more consistently, thelength of time between monitoring points can be extended toonly once or twice per class period, with privileges adjusted tomake success more likely. It is often advisable for the teacher toinclude a penalty for specific inappropriate behaviors on themonitoring chart, which should be per occurrence rather thanper time period. For example, “Argued about directions” couldbe included on the chart, with the loss of one point each timeit occurs (regardless of the amount of time between occur-rences), or with the requirement of performing positive prac-tice (the child should have the option of recovering the lostpoint if he or she performs the practice without complaining).

Privileges and costs implemented at home, based on themonitoring chart, could include increased time in a preferredactivity, decreased requirements of less-desirable chores, in-creased privileges, etc. Non-tangible rewards such as attentionand praise for compliance should be offered (privately for olderstudents) with the goal that children will learn to praise them-selves and thus begin to self-regulate their behavior without ex-ternal rewards.17

An alternative explanation for defiant behavior is that childrensimply have not learned the correct social, cultural, and cognitiveskills necessary for smooth social interactions. To address thisproblem, a teacher could incorporate social-skills training intothe curriculum (e.g., during social studies or language arts).Some children lack fundamental social skills like the use of eyecontact, smiling, respecting physical space, voice volume and in-flection, appropriate content for conversations, and ignoringprovocations. Children may also need help with advanced skills,such as reading social cues, starting/ending conversations, giv-ing/receiving compliments, asking/answering questions, express-ing emotions, en tering a group or conversation, disagreeing with

others, setting limits on others, anticipating what others arethinking/feeling, and developing empathy. Several helpful social-skills training programs exist that can be incorporated into thecurriculum, even at the earliest grade levels (K or Pre-K) and be-fore problems are apparent, including Skillstreaming (by Gold-stein and Mc Ginnis: http://w ww. skill streaming. com) and PATHS(by Kusché and Greenberg: http://www. channing-bete. com/ preven tion programs/paths/ paths. html).18

Children who have not learned appropriate problem-solvingskills will need for them to be taught directly. That is, when adultsrequest the child to perform an action that the child views as in-terfering with his or her personal goals, if the child cannot iden-tify ways to both comply with the request and meet his or her

own goals, then the child is likely toexperience strong negative emo-tions. On the other hand, if thechild can identify alternative waysto accomplish his or her goal, neg-ative emotions decrease, and com-pliance is more likely.

The teacher can teach the fol-lowing steps for problem-solving:(1) Identify the problem; (2)Brainstorm lots of possible solu-tions (even crazy ones!); (3) Rateeach solution on a scale of 1 to 10;(4) Pick the best one, and try it;and (5) If it works, congratulateyourself; if it doesn’t work, pick thenext best solution and try it. Aclass activity illustrating how tocomplete each step will be helpfulfor all students and can be usedwhenever these kinds of difficul-ties arise. A more-detailed exampleof the problem-solving process isavailable at http:// www.andrews. edu/~coffen/problem- solving- steps. pdf.19

The most effective response tocoercive behavior by children withODD is to respond with non-hos-tile, matter-of-fact, non-physicalpunishment. In the process of re-sponding to the child’s coercion, donot let him or her control themood, timing, or content of the in-teraction—that is the adult’s job. Ifyou ask Olivia to clean up her lunchmess and she responds, “You’re somean—you always tell everyonewhat to do!” it is tempting to arguewith her, but that gives her controlover the discussion. Stick to yourcontent, timing, and mood by

calmly (mood) replying, “Right now I expect you to clean up yourlunch (content). If you’d like to stay after school (timing) to talkabout what you can do so I don’t ask you to clean up, that will befine.” If she still refuses to comply, provide appropriate, punish-ment-embedded choices (both choices must be acceptable toyou): “You may choose to clean up your lunch now, or you willbe choosing to clean up your lunch and the rest of the classroomat recess.” Then walk away because if Olivia does not clean upnow, that means she is choosing to clean at recess. Further strug-gles can be handled with the behavior-monitoring plan.20

A few final points: Teachers must be consistent with imple-menting consequences for all children—children with ODD tryto escape limits but are the first to argue about inconsistencies.


Example of daily Report cardsDaily report cards (DRC) can take very little time (less than five minutes per day) and can be effec-

tive in increasing appropriate behaviors.* Here are the basic steps for implementing a DRC system:1. Pick a few specific behaviors to target (no more than five; two or three is best).2. State the behavior that the child should demonstrate (e.g., “Use calm words to say what you

want.”).3. Determine how frequently you will rate the behavior (at least once a day, preferably two or

three times a day to increase the frequency of feedback and chances for success). For example, asystem using three ratings per day would rate all targeted behaviors (a) before lunch and recess, (b)during lunch and recess, and (c) after lunch and recess.

4. Create a simple rating chart that uses the same rating scale for each of the targeted behav-iors. For example, a five-point rating scale might be:

a. 0 = did not demonstrate the behavior at all;b. 1 = demonstrated the behavior very little or only with considerable assistance;c. 2 = demonstrated the behavior about half the time and may have required some assistance;d. 3 = demonstrated the behavior nearly all the time and required very little assistance;e. 4 = demonstrated the behavior all the time and without assistance.

5. In collaboration with parents and student, identify privileges at home that will be associated withthe total points earned on the DRC each day. It is essential, especially early in the implementation ofthe DRC, that the number of points the child is likely to earn will produce success experiences for himor her. The criteria can be gradually raised with consistent performance. An example of a menu of in-centives for three target behaviors using a 0-4 point scale might be as follows:

a. 6-8 pts. = one of the following: 15 minutes of media; 15 minutes with a friend over; 15minutes of playtime with a parent; 25 cents; 15 minutes of cell phone time;

b. 9-11 pts. = one of the following: 30 minutes of media; 30 minutes with a friend over; 20minutes of playtime with a parent; 50 cents; 30 minutes of cell phone time;

c. 12 pts. = one of the following: 60 minutes of media; 60 minutes with a friend over; 30minutes of playtime with a parent; one dollar; 60 minutes of cell phone time.

6. Send home a copy of the DRC each day. Early in the process, follow up with parents to ensurethat the child is receiving the incentives and to troubleshoot any problems.

7. Consider including a weekly and/or monthly reward based on total points over the longer period.The advantage: Even on “bad” days, points that won’t earn a daily incentive will still count toward theweekly/monthly goal and prevent the child from giving up when “bad” days occur. For example, for aweekly reward using three target behaviors and a 0-4 point scale, some options might be:

a. 55-60 pts. = invite a friend to a sleepover;b. 50-54 pts. = choose a fast-food restaurant for a weekend meal;c. 45-49 pts. = choose the menu for one of the major weekend meals.

* Sandra Chafouleas, T. Chris Riley-Tillman, and James McDougal, “Good, Bad, or In-Between: How Doesthe Daily Behavior Report Card Rate?” Psychology in the Schools 39:2 (2002):157-169; George DuPaul,Laura Rutherford, and Shelly Hosterman, “Attention-Deficit/Hyperactivity Disorder.” In Richard Morris andNancy Mather, eds., Evidence-based Interventions for Students with Learning and Behavioral Challenges(New York: Taylor & Francis, 2013), pp. 33-58.


Discipline and reprimandsshould be carried out privately;public confrontation is likely toescalate these children’s acting-out behaviors. Asking childrenwith ODD for solutions can beappropriately empowering forthem and can prevent argu-ments about solutions beingforced on them. If children con-sistently argue when only oneoption is presented (e.g., “Cleannow.”), try offering acceptablechoices first (e.g., “Do you wantto clean now or in two min-utes?”) but do not negotiatefurther. Seek every opportunityto give attention to the child’scompliance.

Be sure parents supportclass rules, or the child will usedivide-and-conquer tactics tojustify misbehavior. Associatethe completion of a commandthat the child is less likely tofollow with one he or she ismore likely to follow (e.g.,“After you clean up your lunch,please get a ball for recess.”). Ifthe child complies with onlypart of the request, praise thataction but restate the expecta-tion or negative sanction. Chil-dren with ODD tend to inter-pret other people’s behaviorsas intentionally hostile—helpthem consider that the actionsmay have been neutral or pos-itive. Webster-Stratton offersteacher-training programs athttp://incredibleyears. com/pro grams/teacher/ to helpteachers promote emotionalregulation, problem solving,and prosocial behaviors amongtheir students—skills thatshould reduce the frequency of oppositional and defiant behav-iors in the classroom.21

anxietyAbout 6.5 percent of youth worldwide have some type of

anxiety disorder, which makes this the most common type ofemotional disorder among youth.22 Anxiety can be either veryspecific (e.g., fear of heights) or very broad (e.g., fear that some-thing bad might happen). Andy exhibits essential characteris-

tics of generalized anxiety disorder (GAD): excessive, difficult-to-control worry about a number of events or activities as wellas social withdrawal. Anxiety is typically accompanied by phys-iological arousal (shaking, rapid heart rate, sweating, muscletension, shallow/rapid breathing) and catastrophic thoughts.23

Like children with ODD, children with anxiety seek escape.Unlike children with ODD, they seek to escape the catastrophethey anticipate. Children with anxiety avoid what they fear be-cause they believe that doing so prevents the catastrophe. But

Peer CoachingPeer coaching (which requires little direct teacher involvement once it is implemented) is an inter-

vention that can help students with poor social skills improve their interactions with peers and in-crease their ability to make friends. Although research on peer coaching is not yet definitive,1 there issome evidence that it can improve social behaviors. Here are the basic steps to implement one ap-proach to peer coaching (the 31-page primary source provides significantly more detail).2

1. Identify which students would make good coaches (those who regularly follow the rules,demonstrate good social skills, and perform well academically).

2. Once a coach has been selected, provide his or her parents with information about what thechild will be expected to do, and obtain informed consent from both the parent and the student whowill do the coaching.

3. Identify which students will benefit from having a peer coach. Candidates include children whohave difficulty making friends due to impulsive social behaviors that lead to rejection, have difficultyidentifying and following through on a goal, have trouble developing a plan for accomplishing a goal,have difficulty sticking with a plan, and are reluctant to try different things when an initial attemptdoes not meet the goal.

4. Meet with the coach and student together to explain the coach’s job—to help the student setgoals for making friends and to support him or her in meeting the goals.

5. Collaboratively identify some “friendship goals” on which the student would like to work (e.g.,join a game in progress, sit with other students at the lunch table, invite someone to play with him orher, start a conversation, etc.) and write them down.

6. For each coached student, create and maintain a notebook containing his or her “friendshipgoals” and progress notes.

7. Develop and describe to the coach and student the daily procedure for coaching (as describedin the steps below).

8. At the beginning of each school day, have the coach and student meet at a designated time andprivate place to identify the “friendship goal” for the day. For example, “Play a group game calmlywithout getting angry when the game doesn’t go in my favor, or it seems that others are cheating.”

9. At the beginning of the period when the student needs to meet the goal (e.g., recess), the coachwill remind the student about the goal.

10. During recess (or other relevant period), the coach will approach the student to offer positivefeedback about the student’s positive actions in attempting to meet the goal.

11. At the end of the period, the coach and student independently rate the student’s success inachieving the goal (1 = did not achieve; 5 = achieved).

12. When the student’s rating is within one point of the coach’s rating, the highest score is used. Ifboth gave the same rating, the score plus an additional point is used. If the ratings are more than onepoint apart, no points are received.

13. Throughout the week, check occasionally with the coach and student to troubleshoot any diffi-culties (remembering that the process is intended to be student mediated).

14. At the end of the week, total the points earned, and allow both the coach and the student tochoose a reward from a list of options (rewards can be provided at school or home). Also, send homea letter at the end of the week informing the parents of both the student and the coach about theirachievement of the week’s goals.

REFERENCES1. Pamela Plumer and Gary Stoner, “The Relative Effects of Classwide Peer Tutoring and Peer Coaching on the

Positive Social Behaviors of Children With ADHD,” Journal of Attention Disorders 9:1 (2005):290-300.2. Peg Dawson and Richard Guare, Coaching the ADHD Student (New York: Multi-Health Systems, 2000).

41

maintaining avoidance means they rarely discover that approach-ing the situation does not produce the catastrophe.24

Therefore, the essential feature of interventions for anxietyis preventing escape so the child learns the catastrophe doesnot occur. These children need support as they gradually ap-proach the things they fear. One approach is to have childrenwith this disorder make a hierarchical list that starts with thethings they fear least and ends with the things they fear most.To motivate children to approach feared things, identify somesmall incentives they can achieve by approaching what they fear(starting with the least-feared thing to create a success experi-ence, and to show the child that the catastrophic thing does nothappen). Refusal to approach a situation should not be re-warded—a child who fears attending school should not be al-lowed to stay home and play video games. Initially, the childmay require an adult’s presence to approach the feared thing,but the teacher/aide should gradually remove his or her pres-ence, such as by physically moving farther and farther away.

As the child achieves success with less-feared items, he orshe can move up to those more feared. Moving up to the nextstep may be accompanied by special celebrations at home (e.g.,a cookie for the easiest level up to a meal at a favorite restaurantfor the highest level).25

Anxiety does not rapidly disappear, so the child will have toapproach feared things in spite of these feelings. Try brain-storming with the child some strategies that can reduce his orher physiological reactions. Examples: Singing aloud or silently(e.g., Veggie Tales’ “God Is Bigger Than the Boogie Man”); deepbreaths (breathe in through nose, out through mouth); positiveself-talk (e.g., “It really is safe. Fear is just trying to trick me.”);imagining how a heroic figure would approach the feared thing(e.g., Jesus, Samson, David); squinting and growling at the scary

thing (scare it!); replace catastrophic thoughts with vivid imagesof happy thoughts (e.g., the sights, sounds, smells, tastes, andsensations of heaven or holiday celebrations); pairing the childwith a close friend during feared activities. Some children ben-efit from writing stories about anxiety-provoking situations ifthey receive adult guidance to ensure that the essays includecoping behaviors and have positive conclusions.26

Final ThoughtsMany effective interventions (e.g., medication for ADHD)

have not been included here for the following reasons: (1) Theyare difficult to implement in a classroom setting, (2) teachersand aides will need special training to apply the strategies suc-cessfully, or (3) professionals must evaluate the multitude offactors influencing emotionally based behavior problems.

Typically, interventions need to be tried for at least two weeksbefore changes are made. For acting-out behaviors (e.g., ADHDand ODD), the intervention will often stop working after twoweeks—but don’t stop the intervention! Instead, add an addi-tional cost on top of the incentive intervention.27 The cost can bediscontinued when the incentive begins “working” again. For ex-ample, if the child claims the privileges don’t matter, don’t stopusing privileges as incentives; instead, implement a greater costschedule for lack of earning points (e.g., one additional chore ifonly four points are earned; two chores for only three points, etc.).

Finally, certain symptoms require immediate referral formental-health services: suicidal ideation (comments about wish-ing one were not alive or about killing one’s self); homicidalideation (any veiled or direct comments about seriously harminganother person); hallucinations (hearing or seeing things thatare not there); serious or repeated aggression; drug use; self-harm (e.g., carving on one’s arms); and abuse or neglect.

http:// jae.adventist.org The Journal of Adventist Education • December 2015/January 2016

1. The Therapy Advisor Website offers information in both English andSpanish and is funded in part by the National Institute of Mental Health. Fromthe home page, select the type of content you wish to view (either “practitionercontent” or “consumer content”) and select the “Child Therapies” option inthe sidebar on the left of the page. Then select the type of disorder in whichyou are interested from the list. Information offered is concise (not overwhelm-ing) but easily understood, and there are links to more detailed information orself-help. Topics covered include a description of the disorder, informationabout the types of therapies that are effective for treatment, and informationabout medication. URL: http://www.therapyadvisor.com.

2. The PsyWeb site offers information about diagnostic symptoms forvarious disorders and some information about treatment of disorders as well.Use the URL listed at the end of this item to get you to the right section ofthe site. From that page, select the disorder you are interested in. A descrip-tion of the disorder and what it looks like is provided in easy-to-understandterms. By following relevant links, information is also available that describesthe various types of available treatments and also commonly prescribedmedications. URL: http://www.psyweb.com/ Mdisord/ jsp/mental.jsp.

3. The Center for Mental Health in Schools at UCLA has produced adocument that is full of useful interventions that are well supported by re-

search. There is much useful information in the PDF document, but you willneed to be willing to sift through a lot of information in order to find interven-tions related to a specific problem your student might be having. However,using the table of contents can get you into the right section; then review thetitle headings carefully to determine if that section will be relevant for the issueat hand. URL: http://smhp.psych.ucla.edu/pdfdocs/ conduct/ conduct.pdf.

If you are willing to click around the Website a bit and willing to spendsome time finding what you want, you can check out the main Website forthe Center for Mental Health in Schools at UCLA too. URL to main Website:smhp.psych.ucla.edu.

4. The LD Online Website has links to articles about specific interven-tions that teachers can implement with detailed information about how todo the interventions. The emphasis of interventions is for students withADHD or a Learning Disability. URL: http://www.ldonline.org.

5. The articles and resources offered at Rick Lavoie’s Website arelargely targeted to children with learning disabilities, but many (if not most)children with behavioral disorders also have a learning disorder. Many of thearticles available at this Website offer specific help that can apply to manychildren with learning problems, whether those problems are behavioral,emotional, or cognitive. URL: http://www.ricklavoie.com/gateindex.html.

Continued on next page

Useful Websites


All children have needs that must and can be met. These phys-ical, psychological, social and spiritual needs are part of our na-ture as created by God—He gave us emotions and needs. He gaveus other people and Himself to meet those needs. Teachers canhelp children find appropriate ways to meet those needs.


Ronald D. Coffen, Ph.D., is a Professor inthe Department of Graduate Psychologyand Counseling at Andrews University inBerrien Springs, Michigan, and Director forthe Andrews Community Counseling Cen-ter. Dr. Coffen specializes in psychotherapyfor children and adolescents, and has apractice in Buchanan, Michigan.

NOTES AND REFERENCES1. Names used in this article are pseudonyms.2. U.S. Department of Education, IDEA 2004: Available at: http://idea.ed. gov/

explore/view/p/,root,regs,300,A,300%252E8,c,4,i,. Accessed November 5, 2009.3. American Psychiatric Association (APA), Diagnostic and Statistical Man-

ual of Mental Disorders, Fourth Edition, Text Revision (Washington, D.C.:American Psychiatric Association, 2000); G. Polanczyk, et al., “The WorldwidePrevalence of ADHD: A Systematic Review and Metaregression Analysis,”American Journal of Psychiatry 164 (2007):942-948.

4. APA, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edi-tion, ibid.

5. Peter Fonagy and Arabella Kurtz, “Disturbance of Conduct.” In Peter Fon-agy, et al., eds., What Works for Whom?: A Critical Review of Treatments for Chil-dren and Adolescents (New York: The Guilford Press, 2005), pp. 106-192; C.Robin Boucher, “Attention-Deficit Disorder With Hyperactivity.” In C. RobinBoucher, Students in Discord: Adolescents With Emotional and Behavioral Disor-ders (Westport, Conn.: Greenwood Press, 1999), pp. 87-105; Fonagy and Kurtz,“Disturbance of Conduct.” In Fonagy, et al., eds., What Works for Whom?: A Crit-ical Review of Treatments for Children and Adolescents, ibid.; Anne Todd, RobertHorner, and George Sugaiodd, “Self-Monitoring and Self-Recruited Praise,” Jour-nal of Positive Behavior Interventions 1:2 (1999), pp. 66-122; William G. Kronen-berger and Robert G. Meyer, “Appendix C: Sample Parent Behavior ModificationTraining Handouts.” In The Child Clinician’s Handbook (Boston: Allyn andBacon, 2001), pp. 535-548; __________, “Attention-Deficit/Hyperactivity Dis-order.” In The Child Clinician’s Handbook, ibid., pp. 40-81.

6. Fonagy and Kurtz, “Disturbance of Conduct.” In Fonagy, et al., eds.,What Works for Whom?: A Critical Review of Treatments for Children and Ado-lescents, op. cit., pp. 106-192; Boucher, “Attention-Deficit Disorder With Hy-peractivity.” In Boucher, Students in Discord: Adolescents With Emotional andBehavioral Disorders, op. cit.

7. Ibid.8. Ibid.9. Fonagy and Kurtz, “Disturbance of Conduct.” In Fonagy, et al., eds., What

Works for Whom?: A Critical Review of Treatments for Children and Adolescents, ibid.10. Sabine Kubesch, et al., “A 30-Minute Physical Education Program

Improves Students’ Executive Attention,” Mind, Brain, and Education 3:4(2009):235-242.

11. Boucher, “Attention-Deficit Disorder With Hyperactivity.” In Boucher,Students in Discord: Adolescents With Emotional and Behavioral Disorders, op.cit.; William G. Kronenberger and Robert G. Meyer, “Attention-Deficit/Hyper-activity Disorder.” In The Child Clinician’s Handbook, op. cit., pp. 40-81; JamesLevin and James Nolan, Principles of Classroom Management: A ProfessionalDecision-making Model (New York: Allyn and Bacon, 2007), 5th ed.

12. G. Canino, et al., “Does the Prevalence of CD and ODD Vary Across

�

Cultures?” Social Psychiatry and Psychiatric Epidemiology 45:7 (2010):695-704.13. APA, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edi-

tion, Text Revision, op. cit.14. William G. Kronenberger and Robert G. Meyer, “Disruptive Behavior

Disorders.” In The Child Clinician’s Handbook, op. cit., pp. 82-125.15. Ibid.; Gerald R. Patterson, John B. Reid, and Thomas J. Dishion, Anti-

social Boys: A Social Interactional Approach (Eugene, Ore.: Castalia Pub. Co.,1997), vol. 4; James Keim, “Oppositional Behavior in Children.” In C. EverettBailey, ed., Children in Therapy: Using the Family as a Resource (New York: W.W. Norton & Company, 2000), pp. 278-307.

16. Kronenberger and Meyer, “Attention-Deficit/Hyperactivity Disorder.”In The Child Clinician’s Handbook, op. cit.; Patterson, Reid, and Dishion, An-tisocial Boys: A Social Interactional Approach, vol. 4, ibid.; Keim, “OppositionalBehavior in Children.” In Bailey, ed., Children in Therapy: Using the Family asa Resource, ibid.; C. Robin Boucher, “Oppositional-Defiant and Conduct Dis-orders.” In Boucher, Students in Discord: Adolescents With Emotional and Be-havioral Disorders, op. cit., pp. 106-126.

17. Fonagy and Kurtz, “Disturbance of Conduct.” In Fonagy, et al., eds.,What Works for Whom?: A Critical Review of Treatments for Children and Ado-lescents, op. cit.; Levin and Nolan, Principles of Classroom Management: AProfessional Decision-making Model, op. cit.; Patterson, Reid, and Dishion, An-tisocial Boys: A Social Interactional Approach, vol. 4, op. cit.; Boucher, “Op -positional-Defiant and Conduct Disorders.” In Boucher, Students in Discord:Adolescents With Emotional and Behavioral Disorders, ibid.

18. Fonagy and Kurtz, “Disturbance of Conduct.” In Fonagy, et al., eds.,What Works for Whom?: A Critical Review of Treatments for Children and Ado-lescents, ibid.; Kronenberger and Meyer, “Disruptive Behavior Disorders.” InThe Child Clinician’s Handbook, op. cit.

19. Ibid.; Boucher, “Oppositional-Defiant and Conduct Disorders.” InBoucher, Students in Discord: Adolescents With Emotional and Behavioral Dis-orders, op. cit.

20. Patterson, Reid, and Dishion, Antisocial Boys: A Social Interactional Ap-proach, vol. 4, op. cit.; Keim, “Oppositional Behavior in Children.” In Bailey,ed., Children in Therapy: Using the Family as a Resource, op. cit.

21. Boucher, “Oppositional-Defiant and Conduct Disorders.” In Boucher,Students in Discord: Adolescents With Emotional and Behavioral Disorders, op.cit.; Steven A. McFadyen-Ketchum and Kenneth A. Dodge, “Problems in SocialRelationships.” In Eric J. Mash and Russell A. Barkley, eds., Treatment of Child-hood Disorders (New York: Guilford Press, 1998), 2nd edition, pp. 338-351.

22. Peter Fonagy, et al., eds., “Anxiety Disorders.” In What Works for Whom?:A Critical Review of Treatments for Children and Adolescents, op. cit., pp. 66-88; Kronenberger and Meyer, “Anxiety Disorders.” In The Child Clinician’sHandbook, op. cit., pp. 206-270; G. V. Polanczyk, et al., “Annual Research Re-view: A Meta�Analysis of the Worldwide Prevalence of Mental Disorders inChildren and Adolescents,” Journal of Child Psychology and Psychiatry 56:3(2015): 345-365. doi:http:// dx. doi. org/10.1111/jcpp.12381.

23. APA, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edi-tion, Text Revision, op. cit.; Fonagy, et al., eds., “Anxiety Disorders.” In WhatWorks for Whom?: A Critical Review of Treatments for Children and Adolescentsop. cit., pp. 66-88; Kronenberger and Meyer, “Anxiety Disorders.” In The ChildClinician’s Handbook op. cit., pp. 206-270.

24. Edmund J. Bourne, The Anxiety and Phobia Workbook (New York: MJFBooks, 1995); C. Robin Boucher, “Overview: Anxiety Disorders.” In Boucher,Students in Discord: Adolescents With Emotional and Behavioral Disorders, op.cit., pp. 182-188.

25. Fonagy, et al., eds., “Anxiety Disorders.” In What Works for Whom?: ACritical Review of Treatments for Children and Adolescents, op. cit., pp. 66-88;Kronenberger and Meyer, “Anxiety Disorders.” In The Child Clinician’s Hand-book, op. cit., pp. 206-270; Bourne, The Anxiety and Phobia Workbook, ibid.;C. Robin Boucher, “School Phobia.” In Boucher, Students in Discord: Adoles-cents With Emotional and Behavioral Disorders, op. cit., pp. 189-200.

26. Fonagy, et al., eds., “Anxiety Disorders.” In What Works for Whom?: ACritical Review of Treatments for Children and Adolescents, op. cit.; Kronen-berger and Meyer, “Anxiety Disorders.” In The Child Clinician’s Handbook, op.cit.; Bourne, The Anxiety and Phobia Workbook, op. cit.; Boucher, “School Pho-bia.” In Boucher, Students in Discord: Adolescents With Emotional and Behav-ioral, op. cit., pp. 189-200.

27. Alan E. Kazdin, The Kazdin Method for Parenting the Defiant Child (NewYork: Houghton Mifflin Company, 2008).


Students who choose to attendSeventh-day Adventist col-leges and universities often doso because they want to expe-rience the unique Christian

worldview that permeates the curricu-lum. Many want more than a schoolwhere religious classes are taught—they expect the entire curriculum to beinfused with Seventh-day Adventistvalues. Students with disabilities whoenroll in Adventist colleges and univer-sities desire these same college experi-ences. Recent figures (2012) released bythe United States government showthat almost 11 percent of undergradu-ates across the nation (almost two mil-lion students) have one or more dis-abilities. Approximately 15 percent ofthese have mobility impairments, sixpercent have hearing impairments, andthree percent are blind or visually im-paired. The largest group of students

with disabilities is those with “hidden”disabilities such as language-processingdisorders (often referred to as dys -lexia), Attention Deficit/HyperactivityDisorder (ADHD), mental illness, andautism.1 Disability service offices mayonly be aware of a fraction of these stu-dents, as many do not choose to iden -t ify themselves in college.

The Role of disabilities Serviceoffices

Most institutions of higher learninghave a designated office where studentscan request accommodations (academicadjustments) for their classes. In smallerschools, this office may be associatedwith another office, such as StudentServices or counseling. Students who re-quire accommodations will need tomeet with the appointed disability serv-ices staff, who will interview the student,examine the student’s documentation ofthe disability, and work with the student

to develop a list of accommodations thatare appropriate for any limitationscaused by his or her disabilities.2

The documentation required mayvary from institution to institution, butusually includes a written assessment,prepared by a licensed special-educa-tion professional, that outlines the spe-cific limitations caused by the student’sdisability. When the applicant does nothave documentation (which is oftenthe case for students from smallerschools), the disability office will do theassessments if appropriate, or refer thestudent to a professional for the re-quired assessment and documents. Incases where the disability is obvious(such as a person who uses a wheel-chair), documentation may not be re-quired. In more remote locationswhere certain assessments are not gen-erally available, the disability staff mayneed to rely on student interviews, fac-

B Y C A R L E T T A W I T Z E L , L U A N A G R E U L I C H , a n d J A M E S R . J E F F E R Y

Accommodating Students With Disabilities

in Higher Education


ulty observations, on-site testing, and acertain amount of trial and error.

notifying Teaching Faculty abouta Student’s disability

Once the documentation has beenevaluated and the disability officer hasdetermined appropriate actions, theprofessors will be notified about the re-quired accommodations, which may in-clude “modifications or adjustments tothe delivery of instruction or other aca-demic features of a course to ensureequal access by a student with a disabil-ity, while not fundamentally altering theacademic program itself.”3 Common ac-commodations include extra time totake tests, quiet testing locations, as-signed note-takers or recorded lectures,electronic textbooks to be read using atext-to-speech computer program, des-ignated interpreters for the deaf andhard of hearing, enlarged text, havingclass locations changed to more accessi-ble places, plus accessible housing, park-ing, and food accommodations.

Often the student will carry a letteror form to each faculty member anddiscuss the best ways to facilitate theaccommodations. For privacy reasons,the specific information in the docu-mentation is usually not given to fac-ulty by the disability office, althoughsome students will freely share infor-mation about themselves.4 Instructorsmay contact the disability office to sug-gest alternate, and sometimes more ef-fective, ways to provide the accommo-dation. For example, when a note -taker is required, the professors mayoffer to provide copies of their ownnotes or slides to the student.

Faculty members should assumethat a student with a disability is as ca-pable as any other student. The pres-ence of a disability does not make astudent more or less intelligent, moti-vated, responsible, or talented thanothers. However, students with a dis-ability may need an alternate way tolearn or show their understanding ofthe class content (accommodation).5

Helping Students Withdisabilities Succeed

There are several actions that facultycan take to facilitate better success forall of their students—students with dis-abilities as well as non-disabled studentswho may be studying in a second lan-guage or may lack sufficient back-ground knowledge of the subject. Thesesuggestions are for postsecondary in-structors, but many are also appropriatefor elementary and secondary teachers.

• Select textbooks early and send yourtextbook information to the bookstore.Students who need electronic texts be-cause of visual impairments or readingdisabilities need to be able to purchasetheir texts early so the disabilities officehas time to obtain the electronic copiesfrom the publishers. When textbookorders are submitted late, the studentsmay not be able to have accessible textswhen classes begin.

• Put a statement in your syllabus de-scribing how a student with a disabilitycan request accommodations. State-ments may vary but should containinformation about how to obtain ac-commodations at your school, the

com mitment of the faculty to accom-modate students, and contact informa-tion for the correct office. Collegesoften provide a uniform statement forall syllabi. This statement may needfurther adaptation in classes that pre -sent special challenges to students withdisabilities, such as labs and pract i -cums.

• Prepare any handouts and onlinematerials in an accessible format.MostWord documents are accessible becausethey can be copied and pasted or modi-fied by making enlargements or apply-ing different fonts. Photocopies andPDFs are not accessible because theyare pictures of documents and cannoteasily be modified. Your copier or scan-ner may have an optical characterrecognition (OCR) program that canbe used to create an accessible formatfor your copied material. Your disabil-ity office, or perhaps your campuspress, may also be able to help. Regularhandouts may still be used in class,with the accessible electronic versionavailable so that a student who needs to

• Learn about disability services. The Association on Higher Education andDisability (http://www.AHEAD.org) is a great resource for U.S. and overseasproviders. The “Learn” section has links to many resources available even tonon-members. See also http://www.disabilitycomplianceforhighereducation .com, which has a large number of articles about disability issues. Visitors to thesite can browse articles before deciding to join the organization.

• Network with other people working in this area. The AHEAD Website haslinks for regional organizations where you can get acquainted with other collegedisability personnel. Most will be extremely helpful, and some will share theirforms and documents to use as models for your own.

• Get your administrators and faculty on board. Help everyone to under-stand the school’s responsibility to provide accommodations and your role inhelping the school to fulfill this commitment.

• Write disability policies for your institution. It helps to look at other institutions’policies before you try to write your own. Ask your school’s legal counsel to reviewyour policies to be sure they align with the laws of your country and state/province.

• Develop necessary procedures, such as interviewing students, collectingdocumentation, and notifying teachers.

• Keep good records. Save student information and communications, arecord of decisions and policies, and any adaptations that were necessary afterimplementation.

Recommendations for Starting a New Disability Office


read the document electronically willbe able to receive the materials at thesame time as the rest of the class.

• Plan and implement several oppor-tunities for students to demonstratelearning. Giving several tests ratherthan only midterm and final exams al-lows students to learn from the testingexperience and tends to reduce anxiety.Projects, labs, and presentations giveadditional opportunities for studentsto earn points and are helpful to thosewho do not show their best under-standing through written tests.6

• If you plan to use videos, try to pur-chase versions that are captioned. Closedcaptions are essential for students whodo not hear well and helpful for ESLstudents. Existing materials can be cap-tioned, but it is much easier and morecost effective to request captioned ma-terials when you purchase the video.7

• If you use an online class-manage-ment system such as Blackboard or Moo-dle, check to make sure all components ofthe class are accessible. Documentsshould be posted in an accessible for-mat. Recorded lectures should be cap-tioned, or a transcript should be pro-vided. Pictures should have writtendescriptions. Timed activities need tobe modified for those students who re-quire extended time. Online discus-sions can be difficult for students withlanguage difficulties, slower processing,or ADHD. Consider an alternate wayfor such students to demonstrate theirlearning processes and conclusions.8

• Present class content in small, well-

organized segments. Allow brief pausesfor students to keep up with note-tak-ing. Check with the students periodi-cally to make sure they understand.Some instructors use an electronicclicker system where students canquickly respond to a question. Othersmay present a problem that requiresthe students to use the informationthat has just been presented.

• Provide clear guidelines (both ver-bally and in writing) so students under-stand what is expected in completed work.Giving instructions as lists is helpful formany students. Rubrics and samples ofexcellent completed work help studentsto understand what is expected.

All of these strategies will be benefi-cial to students with or without a dis-ability. However, college professorsshould be cautious about providing spe-cial arrangements to students with dis-abilities that are not provided to otherstudents unless they have a request fromthe institution’s disability office. Thispolicy helps to provide a unified plan forthe student and protects his or her pri-vacy. It also helps to protect facultymembers from charges of discrimina-tion if one instructor should give feweraccommodations than another.9 Thebest practice is to deliver instruction in away that benefits all students, be readyto make accommodations, and refer allstudents who request special accommo-dations to the disability office.

Faculty and staff at Christian institu-tions have a special mission to present

Jesus to all of their students. Yet, thismore is required: “But it is not enoughthat the teacher possess natural abilityand intellectual culture. These are indis-pensable, but without a spiritual fitnessfor the work he is not prepared to engagein it. He should see in every pupil thehandiwork of God—a candidate for im-mortal honors. He should seek to edu-cate, train, and discipline the youth thateach may reach the high standard of ex-cellence to which God calls him.”10 Cre-ating environments that transform thecollege experience for all students, in-cluding those who need alternate waysto participate in the college experience, isa privilege and a responsibility. Makingaccommodations and simple academicadjustments demonstrate a Christlike at-titude, not just to students who havedisabilities, but to all students who wit-ness these caring actions.


Carletta Witzel,M.A., is the Stu-dent InterventionCoordinator andDisabilities ServiceProvider for An-drews University inBerrien Springs,

Michigan. As a member of the StudentSuccess Office team, she coordinates ac-commodations for students with disabili-ties and helps any student who is experi-

�

• Ramos, Manuel, Vallandingham, Dick. Advising Students WithDisabilities. National Academic Advising Association, 1997.

• “Special Needs—Teacher Resources,” TeacherVision:https://www.teachervision.com/special-education/teacher-resources/6640.html. Accessed May 2015.

• Vance, Mary Lee, Lipsitz, Neal E., and Parks, Kaela. Beyondthe Americans With Disabilities Act: Inclusive Policy and Practicefor Higher Education. National Association of Student PersonnelAdministrators, Inc. (NASPA), 2014.

For additional Reading• Freedman, Sarita. Developing College Skills in Students With

Autism and Asperger’s Syndrome. London and Philadelphia: Jes-sica Kingsley Publishers, 2010.

• Holmes, Jeffrey. Accessible College: A Guide to TransitionStudents With Disabilities From High School to College. Austin,Texas: University of Texas, 2012.

• Larson, Nancy Weidner; and Aase, Susan A. From Screening toAccommodation: Providing Services to Adults With Learning Disabili-ties. Association on Higher Education and Disability (AHEAD), 1997.


encing academic difficulties. Her areas ofresearch interest include disability lawand academic support.

Luana Greulich,Ph.D., serves as As-sociate Professorand Coordinator ofthe Special Educa-tion Program atAndrews Univer-sity. Dr. Greulich

earned her doctorate in special educationfrom Florida State University in Talla-hassee. While at FSU, she worked at theFlorida Center for Reading Research. Herteaching experiences include being an el-ementary teacher, special-educationteacher, and university professor. Dr.Greulich is a member of the MichiganEducator Preparation Institute and theMichigan Autism Council.

2. Cynthia G. Simpson and Vicky G. Spencer,College Success for Students With Learning Disabil-ities (Waco, Texas: Prufrock Press, 2009), p. 112.

3. Chris Wise Tiedemann, College Success—forStudents With Physical Disabilities (Waco, Texas:Prufrock Press, Inc., 2012), p. 129.

4. Christy Oslund, Supporting College and Uni-versity Students With Invisible Disabilities: A Guidefor Faculty and Staff Working With Students WithAutism, AD/HD, Language Processing Disorders,Anxiety, and Mental Illness (London and Philadel-phia: Jessica Kingsley Publishers, 2014), p. 28.

5. Ibid., p. 43.6. Ibid., p. 87.7. Norman Coombs, Making Online Teaching

Accessible: Inclusive Course Design for Students WithDisabilities (San Francisco: John Wiley & Sons,2010), p. 24.

8. Ibid., p. 23.9. Jane E. Jarrow, “When Faculty Are Too Ac-

commodating!” Social Security Administration:http://www.janejarrow.com/public_library/inservice-material/factooacc.html.

10. Ellen G. White, Counsels to Parents, Teach-ers, and Students (Mountain View, Calif.: PacificPress Publ. Assn., 1913), p. 229.

mon Core State Standards. As guest editor for this issue, I wouldlike to call for more topics in special education in publicationslike THE JOURNAL OF ADVENTIST EDUCATION.

Our goal for this issue is to help teachers learn about re-sources they can successfully use in their classrooms to assiststudents with disabilities. Our teachers need more resourcesto help them ensure that every student enrolled in our schoolsnot only obtains a good spiritual foundation, but also a strongacademic foundation. May the words of Jesus in Luke 9:48 res-onate as we strive to meet this need: “‘Whoever receives thischild in my name receives me, and whoever receives me re-ceives him who sent me. For he who is least among you all isthe one who is great’” (ESV).6

Luana Greulich, Ph.D., serves as Associate Professor and Coor-dinator of the Special Education Program at Andrews Universityin Berrien Springs, Michigan. Dr. Greulich earned her doctoratein special education from Florida State University in Tallahassee.While at FSU, she worked at the Florida Center for Reading Re-search. Her teaching experiences include being an elementaryteacher, special-education teacher, and university professor. Herpassion is teaching and research, and she has authored and pre-sented papers on reading, behavior, Response to Intervention, andwriting. She is currently a member of the Michigan EducatorPreparation Institute and the Michigan Autism Council. In thepast three years, she has enhanced the Special Education Programat Andrews University and is currently pursuing avenues to do

research in the surrounding public school systems. The JAE edi-torial staff express heartfelt appreciation for the many hours Dr.Greulich devoted to selecting topics, obtaining peer reviewers, pro-viding input on article content, as well as her prompt responsesto the editor’s questions during the planning and production ofthis issue.

NOTES AND REFERENCES1. Barbara D. Bateman, “Law and the Conceptual Foundations of Special Ed-

ucation Practice.” In Jean B. Crockett, Mike M. Gerber, and Timothy J. Landrum,eds., Achieving the Radical Reform of Special Education: Essays in Honor of JamesM. Kauffman (Mahwah, N.J.: Erlbaum, 2007), pp. 95-114; Barbara D. Bateman,“Individual Education Programs for Children With Disabilities.” In James M.Kauffman and Daniel P. Hallahan, eds., Handbook of Special Education (New York:Routledge, 2011); Dixie Snow Huefner, Getting Comfortable With Special EducationLaw: A Framework for Working With Children With Disabilities (2nd ed.) (Nor-wood, Mass.: Christopher Gordon, 2006); United States Office of Education, “As-sistance for States for Education for Handicapped Children: Procedures for Eval-uating Specific Learning Disabilities,” Federal Register 42 (1977):G1082-G1085.

2., Individuals With Disabilities Education Improvement Act of 2004, H. R.1350, 108th Congress (2004).

3. National Center for Educational Statistics, Children and Youth With Dis-abilities, http://nces.ed.gov/programs/coe/indicator_cgg.asp.

4. James A. Tucker, “Pedagogical Applications of the Seventh-day AdventistPhilosophy of Education,” Journal of Research on Christian Education 10 (2001):169-185.

5. National Center for Education Statistics, ibid.; Autism Society, Facts andStatistics, http://www.autism-society.org/what-is/facts-and-statistics/.

6. Scripture quotations marked ESV are from The Holy Bible, English Stan-dard Version, copyright © 2001 by Crossway Bibles, a division of Good NewsPublishers. Used by permission. All rights reserved.

James Jeffery,Ph.D., served asthe Dean of theSchool of Educa-tion at AndrewsUniversity from2003-2015 and re-cently retired. His

background in education includes beinga high school principal, a school superin-tendent, department chair, and professorof leadership and educational adminis-tration. Dr. Jeffery’s research interests arein school governance and leadership, andonline teaching and learning.

NOTES AND REFERENCES1. “ABC’s of Accommodation,” Education Life

(October 30, 2012): http://www.nytimes.com / 2012/11/04/education/edlife/guide-to-accommodations-for-college-students-with-disabilities. html?_r=0; National Center for Educational Sta-tistics, “Students With Disabilities”: https://nces. ed.gov/ fastfacts/display.asp?id=60. Websites inthe endnotes were accessed in May 2015.

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