Evidence, Ethics, and the Law

1. Evidence, Ethics, and the Law Ronnie Detrich Wing Institute

2. The Law • No Child Left Behind (NCLB) requires that interventions used to improve educational performance are based on scientific research. • In NCLB there are over 100 references to scientific research. • Individuals with Disabilities Education Improvement Act [IDEIA] (2004) requires interventions that are scientifically based instructional practices.

3. The Law • Specific requirements of IDEIA include: • Pre-service and professional development for all who work with students with disabilities to ensure such personnel have the skills and knowledge necessary to improve the academic achievement and functional performance of children with disabilities, including the use of scientifically based instructional practices, to the maximum extent possible.

4. The Law • Specific requirements of IDEIA  Scientifically based early reading programs, positive behavioral interventions and supports, and early intervention services to reduce the need to label children as disabled in order to address the learning and behavioral needs of such children; • In determining if a child has a specific learning disability, a local education agency may use a process that determines if a child responds to a scientific, research-based intervention as part of the evaluation procedures.

5. The Law • Specific requirements of IDEIA: • The IEP shall include a statement of the special education and related services and supplementary aids and services, based on peer-reviewed research to the extent practicable,to be provided to the child, or on behalf of the child, and a statement of the program modifications or supports for school personnel that will be provided for the child.

6. Federal Intent • Clearly, the intent of Congress, the U.S. Department of Education, and Office of Special Education Programs is to rely on interventions that have a scientific basis. • A problem is that the definition of evidence is not clearly specified. • The broad federal definition allows many different types of evidence. • There is some controversy within the field about what the standards for evidence should be.

7. Ethics • First rule of ethical conduct is do no harm. • What constitutes harm? • How can we know if we are causing harm? • Does failing to have impact constitute harm?

8. Ethics • How can we minimize risk of harm? • The assumption is that interventions with a scientific basis will increase probability of benefit for students. • Is using programs with scientific basis sufficient to meet legal and ethical requirements?

9. Ethics • Most national psychological and educational organizations have ethical standards requiring science based practices to address problems. • American Psychological Association Ethical Standard 2.04: • Psychologists’ work is based on the established scientific and professional knowledge of the discipline.

10. Ethics • National Association of School Psychologists • Standard III F 4. • School psychology faculty members and clinical or field supervisors uphold recognized standards of the profession by providing training related to high quality, responsible, and research-based school psychology services. • Standard IV C 1b. • Decision-making related to assessment and subsequent interventions is primarily data-based.

11. Ethics • National Association of School Psychologists • Standard IV 4. • School psychologists use assessment techniques, counseling and therapy procedures, consultation techniques, and other direct and indirect service methods that the profession considers to be responsible, research-based practice. • Standard IV 6. • School psychologists develop interventions that are appropriate to the presenting problems and are consistent with the data collected. They modify or terminate the treatment plan when the data indicate the plan is not achieving the desired goals.

12. Ethics • Behavior Analysis Certification Board • Standard 2.09a • The behavior analyst always has the responsibility to recommend scientifically supported, most effective treatment procedures. Effective treatment procedures have been validated as having both long-term and short-term benefits to clients and society. • Standard 2.09b • Clients have a right to effective treatment (i.e., based on the research literature and adapted to the individual client.

13. Ethics • Behavior Analysis Certification Board • Standard 4.04 • The behavior analyst collects data or asks the client, client-surrogate, or designated other to collect data needed to assess progress within the program. • Standard 4.05 • The behavior analyst modifies the program on the basis of data.

14. Ethics • Primary organizations responsible for services for children mandate use of practices based on scientific research as part of ethical behavior. • Data-based decision making is mandated in ethical guidelines.

15. One Other Ethical Consideration • Special education services are largely funded through public dollars (taxpayers dollars). • There is an implicit assumption that the money will be spent for the public good. • A fiduciary responsibility exists when one person or organization is charged with managing another person’s money.

16. One Other Ethical Consideration • The primary responsibility of a fiduciary is to act solely for the benefit of the other party. • Being a fiduciary carries the weight of ethical conduct. • Those of us charged with providing special education services have a fiduciary responsibility to assure that the taxpayers are receiving the greatest possible return on their investment.

17. How Do We Meet Our Fiduciary Responsibility? • Interventions that have an evidence base are more likely to produce positive effects for students. • Our fiduciary responsibility requires that we use the intervention that has a higher probability of success, i.e. evidence-based intervention.

18. How Do We Meet Our Fiduciary Responsibility? • It is unknown what impact non-evidence-based interventions are likely to have. • Using a non-evidence-based intervention when there are evidence-based interventions available constitutes unethical practice. • If we want to use a non-evidence based intervention then it should be considered research and all of the safe-guards afforded research participants and their families should be in place. • Conducting research with tax-dollars provided for education may constitute a violation of our fiduciary responsibility.

19. The Evidence • There are many interventions that are promising but most of these intervention are evaluated under laboratory conditions by highly skilled researchers (efficacy research). • Far fewer interventions have been evaluated under typical conditions found in public school settings (effectiveness research). • Very few of these interventions have been evaluated to determine if they meet standards to be considered evidence-based.

20. The Evidence • Even if an intervention is established as evidence-based, it does not mean that it is guaranteed to work for all students. • An evidence-based problem solving approach requires that we collect data about the impact of our interventions on each individual student (practice-based evidence).

21. The Evidence • Earlier in this talk ethical questions were raised: • What constitutes harm? • How can we know if we are causing harm? • Does failing to have impact constitute harm? • An evidence-based problem solving approach provides a means for addressing these questions.

22. The Evidence • If the function of education is to teach skills that are relevant for a student then failing to teach skills constitutes harm. • We can know if we are causing harm by monitoringprogress on the skills we are teaching. • If progress is not occurring then we are obligated to change interventions until there is progress. • The unethical conduct is failing to monitor performance and failing to change interventions if there is no progress.

23. The Evidence • An evidence-based approach to problem solving requires not only that we collect data to evaluate the impact of an intervention but that we actually look at the data on a regular basis. • The Response to Intervention (RTI) approach is an example of a systemic evidence-based approach to providing education for all students.

24. RTI Model • Starts with an evidence-base of effective academic and behavioral interventions. • Interventions are applied universally within a population (i.e., entire school, classroom). • If a student is not benefiting from these interventions, as determined by systematic progress monitoring, then the student receives additional evidence-based support while monitoring continues. • Process continues until student is progressing.

25. RTI as Ethics-based Intervention • Starts from a base of established evidence-based practices. • Consistent with ethical statements of professional organizations. • At the heart of RTI is progress monitoring. • Consistent with emphasis on data-based decision making ethical requirements of professional organizations.

26. RTI: From Evidence-based Practice to Practice-based Evidence • RTI is an example of starting with evidence-based practices and completing the process with practice-based evidence. • To be successful requires a system that works together. • Responsibility cannot fall on teachers alone.