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IS DISABILITY IN THE EYE OF THE RATER? CONSIDERATIONS FOR ADHD ASSESSMENT AND IMPLICATIONS BEYOND DIAGNOSTIC IDENTIFICATION. Charles Barrett, PhD, NCSP California Association of School Psychologists Spring Institute March 2019. #itsalwaysabouthechildren. @_charlesbarrett. @charlesabarrett.
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IS DISABILITY IN THE EYE OF THE RATER? CONSIDERATIONS FOR ADHD ASSESSMENT AND IMPLICATIONS BEYOND DIAGNOSTIC IDENTIFICATION Charles Barrett, PhD, NCSP California Association of School Psychologists Spring Institute March 2019
#itsalwaysabouthechildren @_charlesbarrett @charlesabarrett
NASP AND SOCIAL JUSTICE • Social Justice is one of five NASP Strategic Goals • Workforce Shortages • Leadership Development • NASP Practice Model • Mental/Behavioral Health Providers • In September 2017, a definition for school psychologists was adopted by the Board of Directors and Leadership Assembly
SOCIAL JUSTICE: A DEFINITION • Social justice is both a process and a goal that requires action. • School psychologists work to ensure the protection of the educational rights, opportunities, and well-being of all children, especially those whose voices have been muted, identities obscured, or needs ignored. • Social justice requires promoting non-discriminatory practices and the empowerment of families and communities. • School psychologists enact social justice through culturally-responsive professional practice and advocacy to create schools, communities, and systems that ensure equity and fairness for all children.
Ensure that all children and youth are valued and that their rights and opportunities are protected in schools and communities.
SOCIAL JUSTICE TASK FORCE: 2016-2018 • Elizabeth A’Vant • Charles Barrett • Khadijah Cyril • Sycarah Fisher • Nikole Hollins-Simms • Niekema Hudson • Emily Klein • Angela Mann • Shereen Naser • Daphne Perry • Rosalyn Pitts • Sherrie Proctor • Tara Raines • Tracey Scherr • David Shriberg • Amanda Sullivan
SOCIAL JUSTICE TASK FORCE: 2016-2018 • Privilege • Understanding Race and Privilege • Talking about Race and Privilege: Lesson Plan for Middle and High School Students • Understanding Race and Privilege: Lesson Plan and Activity Guide for Professionals • Implicit Bias • Implicit Bias: A Foundation for School Psychologists • Implicit Bias, Part 2: Addressing Disproportionality in Discipline: A Prospective Look at Culturally Responsive Positive Behavior Intervention and Supports • Intersectionality • Intersectionality and School Psychology: Implications for Practice • Intersectionality Infographic
Social Justice Committee: 2018 • Charles Barrett • Sherrie Proctor • Carlos Calderon • Adrianna Crossing • Danielle Guttman-Lapin • Tiombe Kendrick • Leandra Parris • Sheila Desai, Staff Liaison • Celeste Malone, Strategic Liaison
Social Justice Committee: 2018 • Engage members around social justice and related issues using NASP resources such as publications, presentations, and social media • Develop social justice resources to support members in increasing their awareness, knowledge, and skills regarding social justice issues that are relevant to children, families, schools, and communities • Provide consultation to NASP committees engaging in social justice work • Build NASP leaders’ and delegates’ capacity to support the organization in integrating social justice as a strategic goal • Expand the available pool of NASP members prepared to offer social justice related support to school psychologists, school systems, state associations, and other stakeholders
Social Justice Committee: 2019-2020 • The Social Justice Committee will focus on the justice implications of poverty throughout 2019-2020 • This examination will include an interdisciplinary analysis—sociology, social work, economics, public policy, and other fields • Historically, school psychology research has not focused on the impact of poverty, specifically, on adverse outcomes for children, families, schools, and communities
NASP EXPOSURE PROJECT • We need every school psychology graduate student, faculty member, and practitioner to present to high school students and/or undergraduates at least once each semester • https://tinyurl.com/NASP-ExposureProject • https://tinyurl.com/NASP-EP-Tracking
IS DISABILITY IN THE EYE OF THE RATER? CONSIDERATIONS FOR ADHD ASSESSMENT AND IMPLICATIONS BEYOND DIAGNOSTIC IDENTIFICATION
Agenda • Study Rationale • Behavior Rating Scales • Rater Ethnicity • Socioeconomic Status • Direct Observations • Acculturation • Critical Gaps in the Literature • Research Questions and Hypotheses • Methods • Results • Discussion
Rationale: Behavior Rating Scales • ADHD is one of the most common conditions impacting school-age children • Approximately 3 to 5 percent have been diagnosed with this condition • Behavior rating scales are often used in the assessment process because they: • Are acceptable to use • Have been developed using large normative samples • Are feasible for respondents to complete quickly • Provide national comparison data for children of similar age and gender • Generally have strong psychometric properties
Rationale: Rater Ethnicity • Especially when using behavior rating scales in the assessment process, numerous studies have shown that there is a significant interaction between child and rater ethnicity • Clinicians should consider the degree to which data provided from behavior rating scales might be a reflection of rater rather than child characteristics
Rationale: SES • Several studies have shown that SES can impact subsequent behavior ratings • For example, analog studies have showed that children from low SES backgrounds typically received higher ratings of problem behaviors • Few studies, however, have examined how rater or informant SES can impact subsequent child behavior ratings
While many of us may be familiar with these oppressive and discriminatory policies, there are other contributing factors that have significantly impacted the African American experience SLAVERY JIM CROW
1954 1964
IN SCHOOLS WITH HIGH PROPORTIONS OF DISADVANTAGED CHILDREN… • Remediation becomes the norm, and teachers have little time to challenge those exceptional students who can overcome personal, family, and community hardships that typically interfere with learning • In schools with high rates of student mobility, teachers spend more time repeating lessons for newcomers, and have fewer opportunities to adapt instructionto student’s individual strengths and weaknesses • When classrooms fill with students who come to school less ready to learn, teachers must focus more on discipline and less on learning
IN SCHOOLS WITH HIGH PROPORTIONS OF DISADVANTAGED CHILDREN… • Children in impoverished neighborhoods are surrounded by more crime and violence and suffer from greater stress that interferes with learning • Children with less exposure to mainstream society are less familiar with the standard English that’s necessary for their future success • When few parents have strong educations themselves, schools cannot benefit from parental pressure for higher quality curriculum, children have fewer college-educated role models to emulateand have few classroom peers whose own families set higher academic standards
Rationale: Acculturation • The extent to, and the process through which ethnic minorities participate in the cultural traditions, values, beliefs, assumptions, and practices of the dominant White society • Acculturated • Bicultural • Traditional • Although this construct has not been typically applied to Black Americans, it has the potential to help explain between group differences as a function of culture rather than ethnicity
Rationale: Acculturation • When studied in Hispanic children, one study showed that as students’ acculturation level increased, they were more likely to be referred for gifted education • When studied in Hispanic teachers, another study showed that it accounted for all between group differences between Hispanic children receiving higher ADHD ratings compared to their White peers (deRamirez & Shapiro, 2005)
Rationale: Direct Observations • Non-majority (e.g., Black) children have frequently received higher ratings than their White peers using behavior rating scales • Without including direct observation data it is possible that these children are indeed displaying more problem behaviors • The inclusion of direct observation data in natural settings is important to determine if rating scale differences are consistent with observation data
Rationale: Direct Observations • However, several studies have showed inconsistent results between rating scale and direction observation data • Although Black children living in the United States received higher ratings than their Caribbean peers, Caribbean children were observed to display more problem behaviors • Further, although Asian and English children were rated to be equally hyperactive, Asian children were observed to be less hyperactive
ASSESSING PRE-SCHOOL STUDENTS • Participants • 132 current or student teachers attending a national conference • 93.9% female • 66.7% White • 22% Black
In Sum… • The inconsistency between rating scale and direct observation data speaks to the importance of studies that investigate the reasons that could account for these discrepancies • Are there aspects of the assessment process that should be examined more closely? • Should additional attention be placed on rater characteristics and what they bring to the assessment process rather than only focusing on the target child?
Critical Gaps in the Literature • Most ADHD research has… • Been conducted using White children* • Data from these studies are not always helpful when working with non-majority populations • Studies that have included Black participants have generally been qualitative in nature • Been conducted in school settings and used teachers as the informants • Cross-cultural comparisons have typically included White and Hispanic groups • Not published data on the effects of rater SES on subsequent ratings of children’s behavior • Not considered the impact of acculturation on subsequent child behavior ratings
