Making Equitable Eligibility
Decisions for Emotional Disabilit
y
Racial Equity Workgroup Baltimore County Public Schools
Outcomes
1. Gain knowledge and discuss the eligibility criteria for Emotional
Disability through an equity lens.
2. Increase familiarity with the ED Guidance Document to support use of
best practices related to equitable eligibility decisions.
3. Analyze a scenario in which a student is suspected to qualify for special
education services as a student with an Emotional Disability (ED).
4. Reflect on the decision-making process (including biases) that guided
eligibility determination regarding Emotional Disability.
Opening Question
What are our roles and/or contributions
to making equitable eligibility decisions
Concepts to Consider
Implicit Bias• Attitudes and stereotypes that affect our understanding, actions and decisions in an unconscious manner
• Based on one’s upbringing, heritage, possible fear of the unfamiliar, and repeated exposure to the way certain groups are represented in the media and popular culture
Stereotypes
• Widely held beliefs that people have certain characteristics because of their membership in a group (based on gender, race, physical appearance, etc).
Trauma
• Response to a deeply distressing or disturbing event that overwhelms an individual’s ability to cope, causes feelings of helplessness, diminishes their sense of self and their ability to feel the full range of emotions and experiences.
How Did We Get Here?
•
Maryland by the Numbers
53% 37% 5% 4%
Maryland Schools
(2000)
White African American Hispanic Asian/Pacific Islander 43% 36% 12% 6% 4%Maryland Schools
(2010)
White African American Hispanic Asian American Two or More Races 36% 33% 19% 7% 4.80%Maryland Schools
(2019)
White African American Hispanic Asian American Two or More RacesHow Did We Get Here?
• National Disproportionality
How Did We Get Here?
Students Identified with an Emotional Disability
NATIONAL
MARYLAND
Total Students
5.1%
5.53%
African American
6.8%
7.25%
Emotional Disability: Educational Identification vs.
DSM-V Diagnosis
Commonly Identified DSM-5 Conditions
Attention Deficit
Hyperactivity
Disorder
Generalized
Anxiety
Disorder
Disruptive Mood
Dysregulation
Disorder
Major Depressive
Disorder
Oppositional
Defiance
Disorder
Obsessive-Compulsive
Disorder
Post-traumatic
Stress Disorder
Overview of Internalizing and externalizing disorders/definitions
Internalizing
• Internalizing Disorders – conditions that generally result in a sense of emotional despair and social isolation
•Associated with overcontrolled behaviors that are considered to be inner-directed
•Types of Internalizing Disorders:
Depression, anxiety, somatic problems
Externalizing
• Externalizing Disorders – related to acting-out or disruptive behaviors
•Associated with undercontrolled
behaviors which often result in excessive deviant behavior such as aggressiveness and impulsivity
•Types of Externalizing Disorder: conduct disorder, ADHD, and various other
manifestations of antisocial-aggressive behavior
Racial Implications of ED Assessment
White students tend to be diagnosed with internalizing
behaviors at a much higher rate than students of color,
including in a national sample (Gage, 2013; Mizock & Hawkins 2011)
Black students are much more likely to be diagnosed
with Conduct Disorder and Oppositional Defiant Disorder (Fadus et al.,
2020).
Comorbid conditions and internalizing disorders are less likely to be included as diagnoses for Black students (Mizock and Hawkins, 2011).
IDEA and MSDE Code of Maryland Regulations
(COMAR)
Provides a current definition and requirements for identification
“Identification”, not diagnosis
This concept has no meaning outside the field of education.
COMAR and
IDEA criteria
The educational definition of ED consists of
three major components:
1. ED as a condition;
2. ED as a set of three limiting criteria,
all of which must be met prior to
classification; and
3. ED as a set of five characteristics,
one of which must be met prior to
classification.
Each component of the definition requires
careful consideration before determining that
a student has ED.
ED as a
condition
Not necessary to establish the existence of a
psychiatric disorder under the DSM-V criteria
in order to identify a student with ED
However, an MSDE guidance document about ED (2011) states that the DSM-V should be used as a guide to determine the existence of a condition and for defining
the clinical range
ED refers to a condition manifested by a
syndrome of behaviors that are significantly
different from responses or behaviors that
would be expected of the student’s cultural
Emotional Disability as a condition
PRESENCE OF A CONDITION
Student has a valid DSM-V diagnosis.
Student has symptoms related to an emotional condition, across settings or raters, as evidenced by:
• interviews,
• observations, and
ED as a Set of 3 Limiting Criteria
“Over a long
period of time”
“To a marked
degree”
“Adversely
affects a child’s
educational
3 Limiting Criteria:
“Over a long time”
•
Generally accepted in practice to
mean that the student has a history of
affective and/or behavioral symptoms
or characteristics.
• For at least 6 months, “however, when the
severity of certain symptoms or
characteristics (e.g., clinical depression or psychosis) results in extreme impairment of the student, the time period may be
3 Limiting Criteria:
“To a marked degree”
The frequency, duration, and intensity (as measured by structured/systematic observations, interviews, developmental history, and clinically significant rating scales) are atypical for student's age/developmental level.
The symptoms occur across more than one setting (e.g., home, school, math, reading, writing, recess, specials, lunch).
Additional Considerations for Marked Degree includes: Student has been hospitalized for suicidal ideation, self-injurious behaviors/ thoughts, or homicidal behaviors /thoughts.
3 Limiting Criteria:
“Adversely affects a child’s educational performance”
Is there an adverse effect on the student’s educational performance?
Poor academic performance as compared to state academic standards, poor report card grades, poor performance on standardized tests, low benchmark data, etc.
Poor task engagement such as poor in-class participation and limited work completion.
Poor interpersonal skills - difficulty with peer and adult social interactions which seriously interfere with his/her learning and (or) the learning of others.
Poor school attendance (e.g., student stays at home when not in school, generally a good student when in school).
Loss of Instructional time due to disciplinary consequences - (e.g. a history of classroom removals, exclusions, detentions, and (or) suspensions.)
Limited response to interventions (e.g., behavior charts, counseling, student intervention plan, reading intervention, math intervention, writing intervention, etc.
Previous assessments ascribing to an adverse effect (e.g., outside psychological evaluation or previous formal assessments).
ED as
Characteristics
An inability to learn which cannot be explained by intellectual, sensory, or health factors
An inability to build or maintain satisfactory
interpersonal relationships with peers and teachers
Inappropriate types of behavior or feelings under normal circumstances
A general pervasive mood of unhappiness or depression
A tendency to develop physical symptoms or fears associated with personal or school problems
ED as Characteristics
An inability to learn which cannot be explained by intellectual, sensory, or health factors
An inability to build or maintain satisfactory
interpersonal relationships with peers and teachers Inappropriate types of behavior or feelings under normal circumstances
A general pervasive mood of unhappiness or depression
A tendency to develop physical symptoms or fears associated with personal or school problems
How could a
trauma-focused
lens and/or our
own biases play a
role in our
interpretations of
any one of these
criteria?
Consider the Following for Characteristic #3
*Must be evidenced by at least one of the following:
Reminder: “Normal” = expected and routine for that student in the given situation.
Student demonstrates excessive manifestation or expression of negative or harmful behaviors that occur persistently and
interfere with the student’s capacity to learn or disrupt the learning environment so that other students’learning is negatively affected.
Behaviors may include but are not be limited to:
overreaction to environmental stimuli, obsessive or compulsive behaviors, or bizarre verbalizations.
Student demonstrates chronic, disruptive behaviors; extreme reactions to everyday occurrences, self-injurious behaviors,
extreme behavioral manifestations of delusions, hallucinations, distorted thoughts, and extreme behavioral and emotional shifts ranging from manic (being extremely outgoing and joyful, i.e., singing, constantly laughing, etc.) to extremely withdrawn and sad (i.e., constantly crying and not communicating with others).
The student is unsafe to self and/or others.
Student demonstrates internalizing behaviors in the school setting that interfere with the student’s learning such as: perseveration, self-deprecating statements, pretending to be sick (somatic symptoms), school refusal and/or skipping classes, sulking, acting grouchy, getting into trouble at school (e.g., low level behaviors such as failure to follow rules like taking hoods off, removing earbuds, etc.), the student may demonstrate excessive worry, feelings of nervousness or uneasiness, chronic fatigue, the student may express feeling misunderstood, as well as isolating or secluding themselves from others (withdrawal).
Inappropriate types of behavior or feelings under normal
circumstances
ED Guidance Document
This is an internal document that has been created based on the guidance of The Role of the School Psychologist in the Identification of Emotional Disability Guidance and Technical Assistance for School Psychologists In Assessment, Identification, Service Provision, and Progress Monitoring of Students with Emotional Disability (MSDE, 2013).
The purpose of the ED Guidance document is to assist school psychologists as they review data and summarize evidence that does/does not support qualification for
ED Guidance Document
• The role of the school psychologist in determining eligibility for special
education services is to establish the presence of a condition through the psychological assessment and
document in the psychological report. In addition, the school
psychologist collaborates with the
school-based IEP team to ensure there is sufficient data to determine
Scenarios
Lila
12 years old
6th grade (Middle School)
Section I: Data Review
The psychologist thoroughly reviewed the following data points:
All possible attempts should be made to collect data points from section one.
Record Review (e.g., medical history, educational history, school and attendance history, previous evaluations)
Observations (e.g., across multiple settings)
Interviews (e.g., in-depth student, parent, and teachers/staff)
Rating Scales (e.g., standardized student, parent, and teacher/staff)
✓
✓
✓
✓
Section II: Emotional Condition
Choose one or more to document the presence of a condition:
Yes
No
Student has a valid DSM-V diagnosis.
Student has symptoms related to an emotional condition, across
settings or raters, as evidenced by interviews, observations, and
clinical rating scales with scores in the clinically significant range.
✓
Section III: Characteristics
Characteristic #1 - Inability to learn that cannot be explained by
intellectual, sensory, or health factors.
Yes
No
Intellectual Factors Evidence of general cognitive functioning below 70.
Sensory Factors
Evidence of sensory needs such as hearing, vision,
sensory processing disorder, etc.
Health Factors
Evidence of medical conditions and/or acute health
problems such as Attention Deficit Hyperactivity
Disorder (ADHD), Autism, seizures, Traumatic Brain
Injury, lead poisoning, asthma, diabetes, sickle cell
anemia, side effects of medications, etc.
✓
✓
✓
Section III: Characteristics
Consider the following for Characteristic #1:
Yes
No
Cognitive weaknesses in some areas exist but are not the primary
cause of lack of achievement or academic progress.
Failure on tests, classroom assignments, or homework, despite
evidence of a
student’s
ability to succeed.
Inability or refusal to complete work, pronounced difficulty
beginning tasks, or the appearance of intellectual limitations,
when adequate cognitive skills have been documented.
✓
✓
✓
Section III: Characteristics
Consider the Following for:
An inability to build or maintain
satisfactory interpersonal relationships with peers.
Yes
No
Difficulty sustaining peer relationships (e.g., has no friends, socially
isolated).
Difficulty learning with peers while working in a group.
Difficulty developing friendships with peers (not due to immaturity
or cognitive impairment).
Difficulty building or maintaining peer relationships across multiple
settings.
✓
✓
✓
✓
Section III: Characteristics
Consider the Following for:
An inability to build or maintain
satisfactory interpersonal relationships with adults.
Yes
No
Difficulty establishing and maintaining enough of a relationship with
most teachers to learn from them within the classroom.
Difficulty sustaining adult relationships.
Difficulty naming a trusted adult.
Difficulty building or maintaining adult relationships across multiple
settings.
✓
✓
✓
✓
Section III: Characteristics
Consider the Following for Characteristic #3:
Yes No
Student demonstrates significant manifestation or expression of negative or harmful behaviors that occur persistently and interfere with the student’s capacity to learn or disrupt the learning environment. Such behaviors are deemed inappropriate as they are not expected in the school setting. Behaviors may include but are not limited to overreaction to environmental stimuli, obsessive or compulsive behaviors, or bizarre verbalizations.
Student demonstrates chronic, disruptive behaviors including, but not limited to extreme reactions to everyday occurrences, self-injurious behaviors, the presence of delusions, hallucinations, distorted thoughts, and extreme behavioral and emotional shifts, manic behaviors (being extremely outgoing and joyful, i.e., singing, constantly laughing, etc.), withdrawal and sadness (i.e., constantly crying and not communicating with others).
✓
Section III: Characteristics
Consider the Following for Characteristic #3:
Yes
No
The student has demonstrated unsafe behaviors toward self and/or others.
Student demonstrates internalizing behaviors in the school setting that interfere with the student’s learning such as perseveration, self-deprecating statements, somatic complaints, school refusal and/or skipping classes, sulking, acting grouchy, getting into trouble at school (e.g., low level behaviors such as failure to follow rules like taking hoods off, removing earbuds, etc.). The student may demonstrate excessive worry, feelings of nervousness or uneasiness, chronic fatigue, the student may express feeling misunderstood, as well as isolating or secluding themselves from others.
✓
Section III: Characteristics
Consider the following for Characteristic #4:
Yes
No
Mood of Unhappiness - A pattern of behavior that may include
feelings of sadness, tearfulness, irritable mood, exaggerated
frustration over minor matters, withdrawal, helplessness,
worthlessness, and/or loss of energy or fatigue.
Depression - A sustained pattern of behavior that is more than just
a
“mood
of unhappiness.
”
While a DSM-V diagnosis is not
required, depression is a condition that may be diagnosed from
the DSM-V.
✓
Section III: Characteristics
Consider the following for Characteristic #5:
Yes No
Student has frequent visits to the nurse, bathroom, counselor’s office, other support room, etc.
Student demonstrates significant anxiety, panic attacks, severe phobic reactions, expression of physical symptoms (fatigue, fidgeting, headaches, nausea, numbness in hands and feet, muscle tension/aches, difficulty breathing, trembling, irritability, agitation, sweating, restlessness, and insomnia). Additional social anxiety (fear surrounding humiliation, rejection, and/or public performance), school avoidance, and/or perfectionism may be present.
Student demonstrates encopresis, trichotillomania, eating disorders, etc.
Student complains of experiencing stress related symptoms (i.e., ulcers, headaches, etc.).
✓
✓
✓
✓
Section IV: Limiting Criteria
To a Marked Degree
Yes No
Frequency, duration, and intensity (as measured by structured/systematic observations, interviews, developmental history, and clinically significant rating scales) are atypical for student's age/developmental level.
Symptoms occur across more than one setting (e.g., home, school, math, reading, writing, recess, specials, lunch, bus, before/after care).
****An additional ‘look for’ in terms of marked degree includes: History of hospitalization for suicidal ideation, self-injurious behaviors/ thoughts, or homicidal behaviors /thoughts. ****
Over a Long Period of Time Yes No
Symptoms have been present for six consecutive months (not necessarily 6
months from a formal diagnosis).
✓
✓
✓
Adverse impact on the student’s educational
performance.
Poor academic performance as compared to state academic standards, poor report card grades, poor performance on standardized tests, and/or low benchmark data, etc.
Poor task engagement such as limited in-class participation and limited work completion Poor interpersonal skills - difficulty with peer and adult social interactions which seriously interfere with his/her learning and (or) the learning of others.
Poor school attendance (e.g., student stays at home when not in school, generally a good student when in school).
Loss of instructional time due to disciplinary consequences - (e.g. a history of classroom removals, exclusions, detentions, and/or suspensions).
Limited response to interventions (e.g., behavior charts, counseling, student intervention plan, reading intervention, math intervention, writing intervention, etc.). Previous assessments that provide documentation of an adverse impact (e.g., outside psychological evaluation or previous formal assessments).
No
No
No
Yes
Yes
No
Yes
Eligibility Decision
Based on the data presented... Would Lila be eligible for specialeducation services as a student with an Emotional Disability?
Scenarios
(Debrief)
1. What biases came up as you discussed this
scenario (e.g., thoughts about another student, racial biases, thoughts about the impact of this
student’s behavior in the building)
2. What questions about equity did you ask yourself as you worked through the scenario?
3. How difficult was it for you to use the document to guide your decision-making?
4. How would/could you resolve debates amongst the IEP team about the decision?
