Using the Conners 3 and Conners CBRS: Identification and Intervention © E.P.Sparrow, 2007

Using the Conners 3 and Conners CBRS: Identification and Intervention

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Overview of Workshop

• Clinical context: Knowledge and identification

– Important issues in school-aged youth

– Focus on ADHD

• Introduction to the Conners 3rd Ed. (Conners 3)

• Introduction to the Conners Comprehensive Behavior Rating Scales (Conners CBRS)

• Clinical context: Intervention planning

• Special topic: Individuals With Disabilities Education Act (IDEA) 2004 and Conners scales

• Application of skills: Case studies © E

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Prevalence

• Retrospective study: 74% of adults with mental disorders have a history of a childhood diagnosis.

• Longitudinal study (youth ages 9-16 years in NC)

– At any time, 1 in 6 youth has a psychiatric disorder.

– At least 1 in 3 youth has one or more psychiatric disorders by age 16 years.

• 2002 U.S. survey (youth ages 6-14 years)

– 7% have difficulty doing regular schoolwork.

– 2% have difficulty getting along with others.

• In the 2005-2006 school year, 14% of students received services under IDEA.

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Prevalence(% of total enrollment)

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– Specific learning disability (LD) = 6% (increase from 2% in 1976)– Speech/language = 3% (steady)– Mental retardation (MR) = 1% (decrease from 2% in 1976)– Emotional disturbance (ED) = 1% (steady)– Hearing impairment = <1% (steady)– Orthopedic impairment = <1% (steady)– Other health impairment (OHI) = 1% (slight increase from 0.3%

in 1976)– Visual impairment = <1% (steady)– Multiple disabilities = <1% (steady)– Deaf-blindness = <1% (steady)– Autism and traumatic brain injury (TBI) = <1% (slight increase from 0.1

to 0.4)– Developmental delay = <1% (slight increase from 0.1 to 0.6)

All disabilities = 14% of total enrollment (increase from 8% in 1976)

Clinical Context: Common Issues

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• Academic/Cognitive– Subject-specific difficulties– Inattention– Executive deficits

• Behavioral– Aggressive or oppositional behaviors– Hyperactive or impulsive behaviors

• Emotional– Irritability, worrying, separation fears, perfectionism– General distress, symptoms of depression, physical

symptoms• Social

– Social skills, lack of social interests, social isolation

Clinical Context: Rare But Critical

• Severe conduct problems and risk for violent behaviors

• Self-mutilation

• Suicide

• Exposure to extremely stressful event(s)

• Substance abuse/dependence

Key = Identify and intervene

(the earlier the better)

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Clinical Context: DSM-IV

In the public schools, you are faced with a dilemma:

• Often you are the first to recognize emerging symptoms of an undiagnosed disorder

• Must discuss and review past diagnoses

• May question outside diagnoses at times

• But, in most states, you cannot assign a DSM diagnosis.

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Clinical Context: DSM-IV (cont.)

• Attention-deficit/hyperactivity disorder (ADHD)

• Disruptive behavior disorders: Conduct disorder (CD), oppositional defiant disorder (ODD)

• Mood disorders: Major depressive disorder, bipolar disorder

• Anxiety disorders: Generalized anxiety disorder (GAD), separation anxiety disorder (SAD), social phobia, obsessive-compulsive disorder (OCD)

• Pervasive developmental disorders (PDDs): Asperger’s disorder, PDD not otherwise specified (PDD-NOS), high functioning autism

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DSM-IV Building Blocks

• ADHD has three types

– Predominantly inattentive type

– Predominantly hyperactive-impulsive type

– Combined type

• Major depressive episode and manic episode are two building blocks for mood disorders

– Major depressive episode without any mania is the foundation for major depressive disorder.

– Major depressive episode and manic episode are the building blocks for one type of bipolar disorder.

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Prevalence ofDSM-IV Disorders

• ADHD

• Disruptive behavior disorders

– CD

– ODD

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Prevalence ofDSM-IV Disorders (cont.)

• Mood disorders

– Major depressive disorder

– Bipolar disorder

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• Anxiety disorders

– GAD

– SAD

– Social phobia

– OCD

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• PDDs

– Autistic disorder

– Asperger’s disorder

– PDD-NOS

– High functioning autism

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What is ADHD?

• Attention-deficit/hyperactivity disorder (ADHD)is the current term used by the DSM-IV (andDSM-IV-TR)

• Past DSM terms include:

– ADD+H, ADD-H

– Hyperactive

– Hyperkinetic disorder

– Minimal brain damage

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What is ADHD? (cont.)

• DSM-IV diagnosis begins with:

– Inattention (9 criteria) and/or

– Hyperactivity/Impulsivity (9 criteria)

• Symptoms must occur “often.”

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• DSM-IV diagnosis of ADHD

– Symptoms that occur “often”

• 6 of 9 for inattentive type

• 6 of 9 for hyperactive-impulsive type

– Meet criteria for both inattentive and hyperactive-impulsive subtypes to qualify for combined type

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• DSM-IV-TR requires symptoms of inattention, hyperactivity, and/or impulsivity that are:

– Present in early childhood (evidence before age 7 years)

– Persistent over time (at least 6 months)

– Inconsistent with developmental level

– Pervasive across settings (at least two settings)

– Impairing in everyday life

– Not better accounted for by another diagnosis (differential diagnosis) ©

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Differential Diagnosis of ADHD

What possible diagnoses would you consider for the following referral?

– 12-year-old girl

– “Seems spacey, daydreams a lot”

– “Doesn’t follow directions”

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ADHD and Related Disorders

• ADHD has high rates of comorbidity.

• Commonly co-occurring diagnoses include:

– Disruptive behavior disorders

– Anxiety disorders

– Mood disorders

– Learning disorders

– Tic disorders

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• Associated features

– Executive deficits, including variability in performance

– Social functioning deficits

– Lowered self-esteem

– Sensory integration deficits

– Increased use of medical resources

– Positive traits and strengths

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Conners 3: History

• 1960s: Normed behavior rating scale developed by Dr. Keith Conners

• 1989: More extensive normative sample collected; Conners Rating Scales (CRS) were made available to public

• 1997: CRS was revised (CRS-R)—items added, sophisticated statistical analyses performed, new normative data collected

• 2008: Release of the Conners 3

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Conners 3: Key Features

• Covers ADHD and associated features• Includes two commonly co-occurring disruptive

behavior disorders, ODD and CD• Links to DSM-IV-TR and IDEA 2004• Multi-informant (parent, teacher, youth)• Full-length and short form options• Available in English and Spanish• Easy administration, scoring, and profiling of

results• Excellent reliability and validity

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Conners 3: What Is New?

• Updated, large normative sample, representative of U.S. population

• Scales for DSM-IV symptoms of ODD and CD

• Executive Functioning scale

• Validity scales

• Severe conduct critical items

• Screener items for anxiety and depression

• Impairment items

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Conners 3: What Is Different?

• Revised the CRS-R based on recent research and statistical findings

• Increased similarities across parent, teacher, and youth self-report forms

• Modified age range

• Simplified language of DSM-IV-TR items

• Created a companion rating scale, the Conners CBRS, to provide broader coverage of common childhood disorders and problems

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Conners 3: Technical Details

• Normative sample:– Large

• 1,200 youth rated by parents and teachers• 1,000 youth self-reports• Stratified by age (year) and gender

– Diverse (based on the U.S. Census)• Stratified by race/ethnicity• Represented all socio-economic status

(SES) groups• Represented all geographic regions

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Conners 3: Technical Details (cont.)

• Normative sample: Large and diverse

• Reliability

– Internal reliability (consistency) is good.

– Test-retest reliability is good.

• Validity

– Factorial validity is solid.

– Convergent and divergent validity are good, supporting construct validity.

– Discriminant (predictive) validity is good.

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Conners 3: Technical Details (cont.)


• Reliability is good.

• Validity is good.

• Age and gender effects:

– Significant changes over the course of development

– Significant differences between males and females

– T scores take age and gender into account

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Conners 3: Content

• Content scales

• DSM-IV scales and symptoms

• Index scores

• Critical items

• Screener items

• Validity scales


• Additional questions

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Conners 3: Content (cont.)

• Content scales

– Executive Functioning (not on self-report)

– Learning Problems

– Aggression

– Hyperactivity/Impulsivity

– Peer Relations (called Family Relations on self-report)

– Inattention

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• Content scales• DSM-IV content: ADHD, ODD, and CD

– Full-length form only– DSM-IV symptom counts: Absolute levels

• Each DSM-IV symptom is represented.• You can count these to see if the student

has enough symptoms of that disorder to consider a diagnosis.

• Guidance is given for determining whether a symptom is likely indicated, may be indicated, or not indicated.

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• Content scales

• DSM-IV content: ADHD, ODD, and CD

– DSM-IV symptom counts: Absolute levels

– DSM-IV scales: Relative levels of symptoms

• T scores compare the student to peers.

• Helps determine if symptoms are atypical for particular age and gender.

• High score means more symptoms than typically seen.

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• Content scales

• DSM-IV scales and symptoms: ADHD, ODD,and CD

• Index scores: Full-length form only

– Conners 3 ADHD Index (Conners 3AI)

– Conners 3 Global Index (Conners 3GI)

• Not available for self-report

• Two subscales

–Conners 3GI Emotional Lability

–Conners 3GI Restless-Impulsive © E

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• Content scales


• Index scores: Conners 3AI and Conners 3GI

• Critical items: Severe conduct

– Full-length form only

– Severe misconduct that requires immediate follow-up

– Behaviors that may predict future violence or harm to others ©

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• Content scales


• Index scores: Conners 3AI and Conners 3GI

• Critical items: Severe conduct

• Screener items: Full-length form only

– Anxiety

– Depression

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• Content scales• DSM-IV scales and symptoms: ADHD, ODD,

and CD• Index scores: Conners 3AI and Conners 3GI• Critical items: Severe conduct• Screener items: Anxiety and depression• Validity scales

– Positive Impression Index (PI)– Negative Impression Index (NI)– Inconsistency Index (IncX): Full-length

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and CD• Index scores: Conners 3AI and Conners 3GI• Critical items: Severe conduct• Screener items: Anxiety and depression• Validity scales: PI, NI, and IncX• Impairment items: Full-length form only

– Academic– Home (parent and self-report only)– Social


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and CD• Index scores: Conners 3AI and Conners 3GI• Critical items: Severe conduct• Screener items: Anxiety and depression• Validity scales: PI, NI, and IncX• Impairment items: Academic, home, and social• Additional questions

– Other concerns– Strengths or skills

Conners 3: Administration

• When is the Conners 3 appropriate to use?

– Initial evaluation

– Re-evaluation

– Screening

– When indicated by Conners CBRS results

– Research studies

• Determine whether a child or adolescent should be included in the research study

• Measure effectiveness of treatment

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Conners 3: Administration (cont.)

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• When is the Conners 3 appropriate to use?• Who can complete the Conners 3?

– Parents– Teachers– Youth (8 to 18 years old)

• Rater requirements:– Must have known student for at least 1 month– Cognitive/reading level of at least 5th grade for

parents and teachers; at least 3rd grade for youth– Motivated



• Who can complete the Conners 3?

• How do I know which form to use?

– Full-length form

– Short form

– Conners 3AI

– Conners 3GI (not available for self-report)

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• What do I tell the rater?

– General description of the Conners 3

– Reason he/she is being asked to complete it

– Instructions to complete it

– Thank you for your information

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• Is there anything I need to tell the administrator?

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Conners 3: Scoring

• Ways to score:

– Hand score

– Computer score

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Conners 3: Interpretation

1. Assess validity of the Conners 3 ratings.

2. Interpret scale scores.

3. Examine the overall profile.

4. Consider item-level responses.

5. Integrate results.

6. Report results.

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Common Threats to Validity

• Response bias

• Random responding

• Impulsive or careless responding

• Comprehension errors

• Missing items

• Inappropriate use of normative data

• Human error

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Conners 3: Interpretation (cont.)


• PI

• NI

• IncX

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• Content scales

• DSM-IV scales and symptom counts

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DSM-IV symptom counts and T scores: Agreement between symptom count and T score

• Both scores high: This diagnosis should be given strong consideration.

• Both scores low: It is unlikely that the diagnosis is currently present (although criteria may have been met in the past).

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Resolving DSM-IV Discrepancies

• Symptom count high, T score low Although the absolute DSM-IV-TR symptomatic criteria may have been met, the current presentation is not atypical for this age and gender. The assessor should give careful consideration as to whether the symptoms are present in excess of developmental expectations (an important requirement of DSM-IV-TR diagnosis).

• Symptom count low, T score high Although the current presentation is atypical for the youth’s age and gender, there are not sufficient symptoms reported to meet DSM-IV-TR symptomatic criteria for this disorder. The assessor may wish to consider alternate explanations for why the T scores could be elevated in the absence of this diagnosis (e.g., another diagnosis may be producing these types of concerns in this particular setting).

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• Relative elevations of T scores


• Conners 3AI

• Conners 3GI

• Conners 3GI Emotional Lability

• Conners 3GI Restless-Impulsive

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• Items from elevated scales (content and DSM)

• Screener items (anxiety and depression)

• Critical items (severe conduct)


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• Within a single rater’s Conners 3 responses,

• Across multiple Conners 3 raters, and

• With other sources of information.

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DSM-IV and Conners 3

• DSM-IV diagnosis of ADHD

• DSM-IV diagnosis of ODD

• DSM-IV diagnosis of CD

• Indicators of possible:

– Anxiety disorder(s)

– Mood disorder(s)

– Learning disorders

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6. Report results.

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• Individual interpretation strategy

• Other contexts for interpretation

– Change over time (e.g., treatment monitoring)

– Screening a group of individuals

– Evaluating an intervention program

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Conners 3: Summary

• History

• Key features

• What’s new and different

• Technical details

• Content

• Administration and scoring

• Interpretation and reporting

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Conners CBRS: History

• Dr. Conners and the MHS team saw the need for a comprehensive rating scale:

– Guided by clinical experience and research

– Supported by solid psychometrics and statistical analyses

– Useful to professionals who work with children and adolescents for:

• Identification of needs/disabilities

• Intervention planning and monitoring

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Conners CBRS: Key Features

• Comprehensive behavior rating scales

– Behavioral, emotional, social, and academic issues

– Violence potential, severe conduct, self harm

– DSM-IV-TR diagnoses

• Used to describe youth ages 6-18 years old

• Multi-informant (parent, teacher, youth)

• Available in English and Spanish

• Easy administration, scoring, and interpretation

• Excellent reliability and validity

• Linked to DSM-IV and IDEA 2004

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Conners CBRS: Technical Details

• Normative sample: Co-normed with Conners 3

• Reliability

– Internal reliability (consistency) is good.

– Test-retest reliability is good.

• Validity

– Factorial validity is solid.

– Convergent & divergent validity are good, supporting construct validity.

– Discriminant (predictive) validity is good.

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Conners CBRS: Technical Details (cont.)


• Reliability is good.

• Validity is good.

• Age and gender effects:

– Significant changes over the course of development

– Significant differences between males and females

– T scores take age and gender into account

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Conners CBRS: Content

• Content scales


• Critical items

• Other clinical indicators

• Clinical index score

• Validity scales



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Conners CBRS: Content (cont.)

• Content scales

– Emotional Distress

– Aggressive Behaviors

– Academic Difficulties

– Hyperactivity/Impulsivity

– Separation Fears

– Social Problems (not on self-report)

– Perfectionistic and Compulsive Behaviors(not on self-report)

– Violence Potential

– Physical Symptoms

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• Content scales

• DSM-IV content

– ADHD

– Disruptive behavior disorders: ODD, CD

– Mood disorder building blocks: Major depressive episode and manic episode

– Anxiety disorders: GAD, SAD, social phobia, OCD

– Pervasive developmental disorders (not on self-report): Autistic disorder, Asperger’s disorder

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• Content scales

• DSM-IV content

– DSM-IV symptom counts: Absolute levels

• Each DSM-IV symptom is represented.

• You can count these to see if the student has enough symptoms of that disorder to consider a diagnosis.

– DSM-IV scales: Relative levels of symptoms

• T scores compare the student to peers.

• Helps determine if symptoms are atypical for particular age and gender.

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• Content scales


• Critical items

– Severe conduct

• Severe misconduct that requires immediate follow-up

• Behaviors that may predict future violence or harm to others

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• Content scales


• Critical items: Severe conduct and self harm


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-Bullying -Enuresis/Encopresis

-Pica -Panic attack

-Posttraumatic stress disorder (PTSD)

-Substance use

-Specific phobia

-PDD -Trichotillomania

-Tics


• Content scales




• Clinical index score (Conners CI)

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• Content scales




• Clinical index score

• Validity scales

– Positive Impression Index (PI)

– Negative Impression Index (NI)

– Inconsistency Index (IncX)

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• Content scales• DSM-IV scales and symptoms• Critical items: Severe conduct and self harm• Other clinical indicators• Clinical index score • Validity scales: PI, NI, and IncX• Impairment items

– Academic– Home (parent and self-report only)– Social


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• Content scales• DSM-IV scales and symptoms• Critical items: Severe conduct and self harm• Other clinical indicators• Clinical index score • Validity scales: PI, NI, and IncX• Impairment Items: Academic, home, and social• Additional questions

– Other concerns– Strengths or skills

Conners CBRS: Administration

• When should I use the Conners CBRS?

– Initial evaluation

– Re-evaluation

– Screening

– When indicated by the Conners 3 results

– Research studies

• Determine whether a child or adolescent should be included in the research study

• Measure effectiveness of treatment

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Conners CBRS: Administration (cont.)


• Who can complete the Conners CBRS?

– Parents

– Teachers

– Youth (8 to 18 years old)

• Rater requirements:

– Must have known student for at least 1 month

– Cognitive/reading level of at least 5th grade for parents and teachers; at least 3rd grade for youth

– Motivated

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– Full-length form (Conners CBRS)

– Clinical index (Conners CI)

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– General description of the Conners CBRS

– Reason he/she is being asked to complete it

– Instructions to complete it

– Thank you for your information

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• Is there anything I need to tell the administrator?

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Conners CBRS: Scoring

• Ways to score:

– Computer score

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Conners CBRS: Interpretation

1. Assess validity of the Conners CBRS ratings.





6. Report results.

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Common Threats to Validity

• Response bias

• Random responding

• Impulsive or careless responding

• Comprehension errors

• Missing items

• Inappropriate use of normative data

• Human error

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Conners CBRS: Interpretation (cont.)


• PI

• NI

• IncX

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• Content scales and subscales

• DSM-IV scales and symptom counts

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DSM-IV symptom counts and T scores: Agreement between symptom count and T score

• Both scores high: This diagnosis should be given strong consideration.

• Both scores low: It is unlikely that the diagnosis is currently present (although criteria may have been met in the past).

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Resolving DSM-IV Discrepancies

• Symptom count high, T score lowAlthough the absolute DSM-IV-TR symptomatic criteria may have been met, the current presentation is not atypical for this age and gender. The assessor should give careful consideration as to whether the symptoms are present in excess of developmental expectations (an important requirement of DSM-IV-TR diagnosis).

• Symptom count low, T score highAlthough the current presentation is atypical for the youth’s age and gender, there are not sufficient symptoms reported to meet DSM-IV-TR symptomatic criteria for this disorder. The assessor may wish to consider alternate explanations for why the T scores could be elevated in the absence of this diagnosis (e.g., another diagnosis may be producing these types of concerns in this particular setting).

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• Relative elevations of T scores


• Conners CI

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• Items from elevated scales (content and DSM)

• Clinical indicators

• Critical items (severe conduct, self harm)


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• Within a single rater’s Conners CBRS responses,

• Across multiple Conners CBRS raters, and

• With other sources of information.

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6. Report results.

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• Individual interpretation strategy

• Other contexts for interpretation

– Change over time (e.g., treatment monitoring)

– Screening a group of individuals

– Evaluating an intervention program

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Conners CBRS: Summary

• History

• Key features

• Technical details

• Content

• Administration and scoring

• Interpretation and reporting

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Conners: Interventions

Labeling a problem does not usually solve the problem, unless it leads to a plan for change.

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Intervention: Guidelines

1. Identify and prioritize treatment targets. Include current level of functioning.

2. Create specific, measurable, meaningful treatment goals.

3. Develop individualized strategies to reach these goals.

4. Track progress. Regularly review and revise targets, goals, and strategies.

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Strategies for Intervention

• Medical• Behavioral• Cognitive and cognitive-behavioral• Psychosocial• Academic

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Strategies for Intervention (cont.)

• Behavioral therapies

– Target a specific behavior

– Specific interventions

– Modify environment

– Goal is to change the behavior

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• Cognitive and cognitive-behavioral

– Addresses how people think about things or perceive things

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• Psychosocial

– Involves how people interact with others

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• Psychosocial

• Academic

– Modified general instruction

– Small-group or individual instruction

– Specialized instruction techniques

– Specific skill instruction

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• Who can implement these strategies?

– School staff (teachers, aides, assistants, therapists, coaches, bus monitors)

– Parent(s) or other family member(s)

– Community member(s)

– Student

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• Where can these strategies be used?

– School setting

– Home setting

– Community setting

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• What are some ideas for strategies?

• How can I help this student reach the goals?

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– Academic• Practical• Instructional• Testing• Assignments

– Social– Emotional– Behavioral

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Intervention Ideas

• Examples of academic recommendations

– Seating

– Task directions

– Organization

– Testing

– Progress monitoring

– Purpose of a task

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Intervention Ideas (cont.)

• Academic

• Examples of social recommendations

– Social motivation

– Social awareness

– Social skills instruction

– Application of social skills

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• Academic

• Social

• Examples of emotional recommendations

– Recognizing emotions in others

– Regulating extreme emotions

– Expressing emotions appropriately

– Self-help sessions

– Accepting mistakes

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• Academic• Social• Emotional• Examples of behavioral recommendations

– Prompt before a situation– Cue for the appropriate behavior– Catch the student being good– Give the student acceptable choices– Time-outs and self-help sessions– Supportive structure

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• General recommendation ideas

• Using Conners 3 and Conners CBRS data,

– Consider profile elevations.

– Review individual items with high ratings.

– Establish baseline before beginning treatment.

– Monitor progress over course of treatment.

– Evaluate need for continuation, modification, or termination of intervention services.

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Intervention: Summary

• Think about context/setting.

• Be specific in your goals. Prioritize.

• Increase external structure and support.

• Reinforce appropriate behaviors.

• Respond immediately.

• Think about how this skill fits into life, and make a recommendation that will go far.

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Conners CBRS and Educational Law

• Individuals with Disabilities Education Improvement Act, also known as

– IDEA 2004

– Assistance to States for the Education of Children with Disabilities

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Conners and IDEA 2004

• The Conners 3 and Conners CBRS help you with IDEA 2004.– Evaluation procedures– Overidentification and disproportionality– Educational needs– Eligibility for special education and related

services– Individualized education plan (IEP)

development, review, and revision– Positive behavioral interventions– Response to intervention (RTI) ©

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Evaluation Procedures

• Use assessment tools that are not racially or culturally discriminatory: Representative normative sample of the Conners tools reduces racial and cultural bias.

• Select assessment materials in the child’s native language: Conners tools are available in English and Spanish versions.

• Assess specific areas of educational need: Conners tools provide scores for specific concerns that directly impact education.

• Do not determine an appropriate educational program based on a single procedure: Conners tools are designed to be used with multiple informants across multiple settings within the context of a multimodal evaluation.

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Overidentification and Disproportionality

The federal government has mandated that we must work together to reduce disproportionate representation of racial and ethnic groups in special education and related services, to the extent that the representation is the result of inappropriate identification.

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Conners and Educational Needs

• The Conners tools help you fulfill the requirement to determine the nature and extent of special education and related sevices needed, including academic and behavioral services.

• IDEA 2004 (and commentary in the Federal Register) indicate that needs may include:

– Parent counseling and training

– Facilitation of social-emotional learning

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Conners and Eligibility

• Determine eligibility for special education and related services

• Identify possible IDEA category/categories (or areas of developmental delay) that describe the student’s needs

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Conners and IEPs

• The Conners tools can help you:

– Develop goals for initial IEP,

– Measure progress toward goals during regular review of the IEP, and

– Suggest new or updated goals for IEP revisions.

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Positive Behavioral Intervention

• The Conners tools can help you:

– Identify the need for positive behavioral interventions,

– Establish baselines for the behaviors,

– Suggest targets for intervention plans,

– Monitor progress in behaviors, and

– Support decisions to discontinue or increase positive behavioral supports.

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RTI: A General Model

• High quality, research-based instruction and behavioral supports in general education

• Universal screening of academics and behavior

• Scientific, research-based interventions for individual student difficulties (delivered with appropriate intensity)

• Collaborative approach to develop, implement, and monitor interventions

• Frequent data collection and analysis

− Student RTI

− Consistent implementation of interventions by staff

• High levels of parent involvement

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Tiers of RTI

Source: National Association of State Directors of Special Education (NASDSE)

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RTI and IDEA 2004

• IDEA 2004 mentions RTI in two contexts:– Determination of specific learning disability– Early intervening services (Grades K-12)

• Overarching goal of including RTI in IDEA 2004: “Utilize RTI to address the challenges and potential of NCLB for improving outcomes for all students, including students with disabilities.”

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1 National Association of State Directors of Special Education & Council of Administrators of Special Education. (2006, May). Response to intervention: NASDSE and CASE white paper on RTI. Retrieved May 14, 2009 from http://nasdse.org/Portals/0/Documents/Download%20Publications/RtIAnAdministratorsPerspective1-06.pdf

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RTI and IDEA 2004 (cont.)

• Determination of specific learning disability can be based on the following:

• Student does not meet age- or grade-level standards when provided with learning experiences and instruction appropriate for age (in 1/8 academic areas).

• Student does not make sufficient progress in 1/8 academic areas when using a process based on his or her response to scientific, research-based intervention.

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• Determination of specific learning disability

• Develop and implement early intervening services in Grades K-12, including:

– Professional development for staff to deliver scientifically-based academic and behavioral interventions

– Educational and behavioral evaluations, services, and supports

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• General model of RTI is broader than that represented in IDEA 2004 (not just limited to LD) and includes the concept of universal screening.

• IDEA 2004 references RTI in two ways:

– Determination of specific LD (as an alternative to the discrepancy model).

– Important for early identification of academic and behavioral struggles in students in Grades

K-12, including intervention and monitoring.

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Conners and RTI

• Suggest need for comprehensive evaluation to determine the existence of a specific LD.

• Identify students (Grades K-12) who require academic and/or behavioral supports in order to succeed in the general education setting.

• Clarify targets for interventions.• Provide an objective way to monitor student RTI.• Provide an objective way to identify at-risk

children without bias due to race or ethnicity.

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Conners and RTI (cont.)

• Within the context of IDEA 2004:– Suggest which students need comprehensive

evaluation for a specific LD.– Identify students who need early intervening services.– Develop and monitor early intervening services.

• Within the broader context of the RTI model:– Use in universal screening to identify students who are

at risk for academic, social, emotional, and/or behavioral problems.

– Target symptoms for treatment.– Monitor progress in treatment.– Indicate areas to be addressed in a comprehensive

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Conners and RTI (cont.)

Tier III: Comprehensive evaluation

Tier II: Target and monitor skills/behaviors

Tier I: Universal screening

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Source: National Association of State Directors of Special Education (NASDSE)

Conners and Educational Law

• IDEA 2004; Assistance to States for the Education of Children with Disabilities

• Section 504 of the Rehabilitation Act of 1973

• No Child Left Behind Act of 2001 (NCLB; Elementary and Secondary Education Act [ESEA])

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