High School Graduation Among Students with Disabilities

Participation and Performance of Students with Disabilities\
in State Assessment Systems

Challenges To Providing Secondary Education and Transition Services for
Youth with Disabilities

Outcomes for Students with Problem Behaviors in School: Issues,
Predictors, and Practices

Results Experienced by Children and Families Entering Early Intervention

High School Graduation Among Students with Disabilities

The Office of Special Education Programs (OSEP) establishes goals,
objectives, and performance indicators in accordance with the Government
Performance and Results Act (GPRA) to measure progress in improving
results for students with disabilities. One of the objectives included
in the U.S. Department of Education's 2001 Annual Plan is that secondary
students with disabilities will receive the support they need to
complete high school prepared for postsecondary education or employment
(U.S. Department of Education, 2000). The percentages of students with
disabilities who graduate from high school with a standard diploma and
who drop out of high school are important indicators of progress toward
this objective. Accordingly, this module reports graduation and dropout
information for students with disabilities for the 1998-99 school year
and examines trends in graduation and dropout rates over the past few
years. In addition, the module discusses graduation and dropout rates by
disability category and by race/ethnicity.

# Graduation and Dropout Rates for Students with Disabilities

According to the National Center for Education Statistics (NCES, 2000),
high school graduation, completion, and dropout rates may be calculated
in a number of different ways. OSEP is particularly interested in the
rate at which students with disabilities graduate from high school with
a standard diploma.

One method of calculating graduation rates is to divide the number of
students age 14 and older who graduated with a standard diploma by the
number of students 14 and older who are known to have left school (i.e.,
graduated with a standard diploma, received a certificate of completion,
reached the maximum age for services, died, or dropped out). This is the
formula OSEP uses to establish performance indicators under GPRA.

Graduation rates for students with disabilities age 14 and older have
climbed steadily since 1993-94, as illustrated in figure I-1. At the
same time, the dropout rate among these students has declined.

In 1993-94, the dropout rate was 34.5 percent. By 1998-99, that rate had
reached a 6-year low of 28.9 percent. This rate was somewhat better than
OSEP's target dropout rate of 31 percent (U.S. Department of Education,
2000). Dropout rates are presented in figure I-2.

Figure I-1

Percentage of Students Age 14 and Older Graduating with a Standard
Diploma, 1993-94 to 1998-99

![](media/image1.wmf){width="5.492361111111111in"
height="3.7555555555555555in"}

Note: Graduation rates were calculated by dividing the number of
students 14 and older who graduated with a diploma by the number of
students 14 and older who graduated with a diploma, received a
certificate, reached the maximum age for services, died, and dropped
out.

Source: U.S. Department of Education, Office of Special Education
Programs, Data Analysis System (DANS).

# Graduation and Dropout Rates by Disability

Graduation rates for students age 14 and older with disabilities varied
by disability category. Students with visual impairments graduated at
the highest rate (75.1 percent), followed by students with traumatic
brain injury (70.3 percent) and students with hearing impairments (69.4
percent).

Students in five disability categories graduated at rates lower than the
57.4 percent observed for all students with disabilities. Graduation was
least likely among students 14 and older who had mental retardation
(41.7 percent) and emotional disturbance (41.9 percent). Table I-1
presents graduation rates for students age 14 and older in all 12
disability categories.

Figure I-2

Special Education Dropout Rates, 1993-94 to 1998-99

![](media/image2.wmf){width="5.492361111111111in"
height="3.7555555555555555in"}

Note: Dropout rates were calculated by dividing the number of students
14 and older who dropped out by the number of students 14 and older who
graduated with a diploma, received a certificate, reached the maximum
age for services, and dropped out.

Source: U.S. Department of Education, Office of Special Education
Programs, Data Analysis System (DANS).

Dropout rates for students age 14 and older also varied by disability
category. Dropout rates were lowest for students with autism (9.5
percent), deaf-blindness (11.5 percent), and visual impairments (11.8
percent). The highest dropout rate occurred among students with
emotional disturbance: half of the students in that disability category
dropped out of school in 1998-99. Dropout rates for the different
disability categories are presented in table I-1.

# Graduation and Dropout Rates by Race/Ethnicity

The *Twenty-second Annual Report to Congress* included, for the first
time, data on the racial/ethnic composition of the special education
population. This section of the module looks at graduation rates by
race/ethnicity. Because the race/ethnicity data collection is so new,
the data reported here should be interpreted cautiously. Analysis in the
next 2 to 3 years will present a clearer picture of this variable.

Table I-1

Number and Percentage of Students Age 14 and Older with Disabilities

Graduating with a Standard Diploma or Dropping Out, 1998-99

  ------------------------- ----------- ------------ ----------- ------------
                            Graduated                Dropped Out 
                            with a                               
                            Standard                             
                            Diploma                              

  Disability Category       Number      Percentage   Number      Percentage

  Specific learning         100,738     63.3         43,156      27.1
  disabilities                                                   

  Speech/language           4,260       64.8         1,644       25.0
  impairments                                                    

  Mental retardation        16,086      41.7         9,628       24.9

  Emotional disturbance     13,735      41.9         16,583      50.6

  Multiple disabilities     2,075       47.0         788         17.8

  Hearing impairments       2,610       69.4         533         14.2

  Orthopedic impairments    1,830       63.4         421         14.6

  Other health impairments  5,706       66.8         1,940       22.7

  Visual impairments        1,172       75.1         184         11.8

  Autism                    418         47.1         84          9.5

  Deaf-blindness            52          54.2         11          11.5

  Traumatic brain injury    790         70.3         169         15.0

  All disabilities          149,472     57.4         75,141      28.9
  ------------------------- ----------- ------------ ----------- ------------

Note: The percentages in this table were calculated by dividing the
number of students age 14 and older who graduated with a standard
diploma or dropped out by the number of students age 14 and older who
are known to have left school (i.e., graduated with a standard diploma,
received a certificate of completion, reached the maximum age for
services, died, or dropped out.)

Source: U.S. Department of Education, Office of Special Education
Programs, Data Analysis System (DANS).

Graduation rates for students with disabilities ages 14 through 21
varied by racial/ethnic group, ranging from 63.4 percent among white
students to 43.5 percent among black students. Graduation rates for each
racial/ethnic group are reported in table I-2. Dropout rates also varied
by racial/ethnic group. Asian/Pacific Islander students had the lowest
dropout rate, with a figure of 18.8 percent. They were followed by white
students, with a dropout rate of 26.9 percent, Hispanic students, with a
dropout rate of 32.3 percent, and black students, with a dropout rate of
33.7 percent. The highest dropout rate occurred among American
Indian/Alaska Native students, at 44.0 percent.

Table I-2

Number and Percentage of Students Age 14 and Older with Disabilities
Graduating with a Standard Diploma by Race/Ethnicity, 1998-99

  ---------------------------- ----------- ------------ ---------- ------------
                               Graduated                Dropped    
                               with a                   Out        
                               Standard                            
                               Diploma                             

  Race/Ethnicity               Number      Percentage   Number     Percentage

  American Indian/Alaska       1,544       47.9         1,420      44.0
  Native                                                           

  Asian/Pacific Islander       2,033       56.6         675        18.8

  Black                        19,653      43.5         15,251     33.7

  Hispanic                     13,150      52.9         8,029      32.3

  White                        100,900     63.4         42,820     26.9
  ---------------------------- ----------- ------------ ---------- ------------

> Notes: The percentages in this table were calculated by dividing the
> number of students ages 14 through 21 in each racial/ethnic group who
> graduated with a standard diploma or dropped out by the number of
> students ages 14 through 21 in that racial/ethnic group who are known
> to have left school (i.e., graduated with a standard diploma, received
> a certificate of completion, reached the maximum age for services,
> died, or dropped out).
>
> New York, North Carolina, Washington, and the District of Columbia
> have not yet reported 1998-99 exiting data by race/ethnicity and are
> thus not included in this table.
>
> Source: U.S. Department of Education, Office of Special Education
> Programs, Data Analysis System (DANS).

# Summary

Since 1993-94, the high school graduation rate for students with
disabilities has steadily increased, while the percentage of students
dropping out of school has declined. Graduation and dropout rates varied
by disability category, with students with visual impairments, traumatic
brain injury, and hearing impairments graduating at the highest rates.
Graduation and dropout rates also varied by racial/ethnic group. White
students graduated at the highest rate, and Asian/Pacific Islander
students had the lowest dropout rate.

# References

National Center for Education Statistics. (NCES). (2000). *A recommended
approach to providing high school dropout and completion rates at the
state level.* (NCES 2000-305). Washington, DC: U.S. Department of
Education.

U.S. Department of Education. (2000). *U.S. Department of Education's
1999 performance report and 2001 annual plan.* Washington, DC: Author.
Retrieved\
December 14, 2000, from the World Wide Web:
http://www.ed.gov/pubs/AnnualPlan2001/index.html

Participation and Performance of Students with Disabilities in State
Assessment Systems

# Participation

In 1999, the National Center on Educational Outcomes (NCEO) asked State
directors of special education to provide their most recent frequency
data on the participation of students with disabilities in State
assessments (Thompson & Thurlow, 1999). In the past, most States were
able to provide only estimates of the participation of students with
disabilities in State assessments. In 1997, prior to the reauthorization
of the Individuals with Disabilities Education Act (IDEA), 15 States
provided actual participation numbers (Erickson & Thurlow, 1997). In
1999, 23 States provided these data.

Although the Federal requirement is for States to report the number of
students with disabilities participating in State and district
assessments, participation rates (reported as percentages) are useful
for policymakers evaluating the inclusiveness of assessment programs.
Using State-provided numbers of students participating in assessments
and child count data, NCEO calculated participation rates for specific
administrations of State tests (Thompson & Thurlow, 1999). These
estimated rates are contained in table I-3. Rates of participation
varied from less than one-fourth of students with disabilities to all
students with disabilities.

There are several factors that State directors of special education
believe may work against the full participation of students with
disabilities in large-scale assessment programs, especially in States
where accountability systems have significant consequences for students
or schools (Thompson & Thurlow, 1999). The top three factors are:

-   High stakes (i.e., sanctions or rewards) attached to school or
    district performance;

-   Lack of exposure to the curriculum or content included in tests; and

-   The perception of teachers, parents, and others that large-scale
    testing is irrelevant to the educational success of students with
    disabilities.

Table I-3

Percentage of Students Receiving Special Education Services Who
Participated in State Assessments

  ------------------- ---------------- ----------------- -----------------
  State               Elementary       Middle School     High School
                      Grades\          Grades\           Grades\
                      (K-5)            (6-8)             (9-12)

  1                   44%              43%               27%

  2                   81               73                51

  3                   52               63                53

  4                   51               79                78

  5                   62               66                56

  6                   100              100               100

  7                   95               95                \-\--\*

  8                   96               93                91

  9                   84               89                \-\--\*

  10                  65               70                51

  11                  83               88                93

  12                  88               90                \-\--\*

  13                  62               59                46

  14                  80               78                61

  15                  48               56                32

  16                  94               91                91

  17                  58               74                67

  18                  74               72                70

  19                  39               42                41

  20                  90               85                50

  21                  92               94                \-\--\*

  22                  89               \-\--\*           \-\--\*

  23                  23               15                26
  ------------------- ---------------- ----------------- -----------------

\* No test administered at this level.

> Note: Because there were multiple tests in some States and multiple
> grades in others, total numbers are not available.
>
> Source: Thompson & Thurlow, 1999.

An analysis of data from the National Assessment of Educational Progress
(NAEP) suggested that the provision of accommodations also affects the
participation rate of students with disabilities. NAEP participation
rates were higher in grades 4 and 8 (but not grade 12) when
accommodations were provided (U.S. Department of Education, 1999). Since
accommodations are included in students' IEPs, fewer students will
participate in assessments if the terms guiding the use of
accommodations for specific assessments are in conflict with students'
IEPs. For example, if a student's IEP specifies multiple breaks during
testing but a particular assessment's guidelines say to break only at
specific times, that student is less likely to participate in the
assessment.

# Performance

NCEO analyzes State education reports to determine what types of
information are provided on students with disabilities. Previous
analyses had shown that few States (11 in the first analysis and 13
States in the second analysis) reported test-based results for students
with disabilities. For the most recent analysis, 170 reports were
collected from State accountability offices and State special education
offices between March 1999 and August 1999. This analysis found that
only 14 States included participation data, and only 17 States included
performance data for students with disabilities in State assessments
(Thurlow, Nelson, Teelucksingh, & Ysseldyke, 2000).

According to public reports, participation rates in State assessments
varied from 33 percent to 97 percent of students with disabilities.
Performance levels also varied widely, with the differences between
rates of students with disabilities who met State standards and all
students ranging from 20 percent to 50 percent. Table I-4 summarizes the
performance data obtained from State reports.

There were increases in the reporting of performance data for students
with disabilities but not to the extent that might be expected given the
timelines in the IDEA Amendments of 1997. Of the 41 States that provide
information other than financial data on students with disabilities, 17
States disaggregated performance data for students with disabilities on
statewide assessments. A handful of States included information in their
State accountability documents on how students with disabilities perform
over time and whether their performance improves from year to year
(Thurlow et al., 2000).

For the 17 States that presented information on statewide assessments,
the most frequently reported content areas were reading (17 States) and
mathematics (17 States). Eleven States reported science data, 10
reported writing data, and 6 reported social studies data. Sixteen
States reported on students with disabilities in three or more content
areas.

# *Reading Achievement*

In the 17 States with disaggregated performance data, between 5 percent
and 87 percent of students with disabilities who were tested met
performance standards in reading. The differences in passing rates for
all students and students with disabilities ranged from 12 to 49
percentage points. In grade 8, the grade for which the most States
reported data, the differences in passing rates for all students and
students

Table I-4

Summary of Reports on Educational Results on Students with Disabilities

+-----------------------------------------------------------------------+
| **Educational Results**                                               |
|                                                                       |
| -   Seventeen States disaggregated performance data as specified in   |
|     IDEA for students with disabilities (CT, DE, MD, MA, MN, MS, NV,  |
|     NH, NY, NC, RI, SC, SD, TX, VT, VA, WV)                           |
|                                                                       |
| ```{=html}                                                            |
| <!-- -->                                                              |
| ```                                                                   |
| -   Of 74 reports that did not include data on students with          |
|     disabilities, over 50 included performance data on regular        |
|     education students                                                |
|                                                                       |
| ```{=html}                                                            |
| <!-- -->                                                              |
| ```                                                                   |
| -   The most frequently reported content areas for assessment are     |
|     reading (17 States) and mathematics (17 States)                   |
|                                                                       |
| ```{=html}                                                            |
| <!-- -->                                                              |
| ```                                                                   |
| -   Sixteen States tested and reported on students with disabilities  |
|     in three or more content areas                                    |
|                                                                       |
| ```{=html}                                                            |
| <!-- -->                                                              |
| ```                                                                   |
| -   While 20 States reported graduation exam results for regular      |
|     education, only 35 percent\                                       |
|     (7 States: MD, MN, MS, NY, SC, TX, VA) reported these results for |
|     students with disabilities                                        |
|                                                                       |
| ```{=html}                                                            |
| <!-- -->                                                              |
| ```                                                                   |
| -   It is important to keep in mind participation factors (e.g.,      |
|     percentage of students with disabilities actually being tested)   |
|     when examining the performance results of students with           |
|     disabilities. Higher proficiency rates may also be a result of    |
|     increased exclusion of student scores or lower standards          |
|                                                                       |
| ```{=html}                                                            |
| <!-- -->                                                              |
| ```                                                                   |
| -   The differences in proficiency rates between all students and     |
|     students with disabilities on 8th grade State assessments ranged  |
|     from:                                                             |
|                                                                       |
|     -   23 to 47 percent in reading                                   |
|                                                                       |
|     -   19 to 42 percent in math                                      |
|                                                                       |
|     -   25 to 44 percent in writing                                   |
|                                                                       |
| ```{=html}                                                            |
| <!-- -->                                                              |
| ```                                                                   |
| -   New York, Rhode Island, and Texas presented unique data on        |
|     students with disabilities in the domain of Academic and          |
|     Functional Literacy:                                              |
|                                                                       |
|     -   NY: Test scores on Occupational Education Proficiency         |
|         examinations                                                  |
|                                                                       |
|     -   RI: Test scores on health content area in statewide           |
|         assessment                                                    |
|                                                                       |
|     -   TX: Test scores on college entrance exam (TASP)               |
|                                                                       |
| ```{=html}                                                            |
| <!-- -->                                                              |
| ```                                                                   |
| -   Kansas continued to report data in the domain of personal and     |
|     social well-being (number of violent acts toward staff and        |
|     students)                                                         |
+-----------------------------------------------------------------------+

Source: Thurlow et al., 2000.

Figure I-3

Differences on Criterion-Referenced Mathematics Tests Between 8^th^
Grade Students with and Without Disabilities in 10 States

![](media/image3.wmf)

Source: Thurlow et al., 2000.

with disabilities in reading performance ranged from 23 to 47 percentage
points, using criterion-referenced measures.

## *Mathematics Achievement*

Mathematics performance was similarly variable. Overall, 3 percent to 74
percent of students with disabilities met mathematics performance
standards in the 17 States with disaggregated performance data. The
differences in passing rates of students with disabilities and all
students ranged from 13 to 42 percentage points (see figure\
I-3). For 8^th^ graders taking criterion-referenced mathematics exams,
the differences in passing rates ranged from 19 to 42 percentage points.

These results are consistent in direction with results from the NAEP
assessment of mathematics skills in 1996 (U.S. Department of Education,
1999). In the 1996 NAEP, students with disabilities scored between the
9^th^ and 18^th^ percentile, varying by grade and subsample. Across
grades and subsamples, the NAEP mathematics scores of white students
with disabilities were higher than those of minority students with
disabilities.

Using a large longitudinal database, NCEO examined the effect of
transitions between regular education and special education across
grades on performance trends for the special education population. The
study also examined the effect of changes in assessment exemption rates
across grades for students with disabilities. NCEO found that the
highest achieving special education students left special education to
return to regular education and that the lowest performing regular
education students who had been referred to and found eligible for
special education entered special education (Bielinski & Ysseldyke,
2000). The result of this movement between regular and special education
was a substantial increase in the performance gap over time between
regular education and special education students across grades. The
study also revealed that the reduction in assessment exemption rates
from testing that has occurred over timeand that is reflected in this
study primarily in the higher gradesadded to the size of the gap.

When the same special education students were tracked over time,
however, the performance gap decreased slightly (Bielinski & Ysseldyke,
2000). These findings have significant implications for the States as
they begin to publicly report disaggregated data on students with
disabilities (such as those shown in figure I-3), particularly if
attempts are made to track performance across time. Failure to document
and account for changes in students' special education status and
previous assessment exemption rates could result in misinterpretations
about the effectiveness of special education services. Restricting the
group of students for longitudinal analysis to those who received
special education services during the first year of analysis and
following their performance regardless of whether they continued to
receive special education services will provide a more accurate
indication of progress over time. Thus, States should consider ways to
report on both the performance of all students with disabilities and the
longitudinal performance of clearly defined targeted groups of students
receiving special education services.

# Change in Participation Rates and Performance Levels of Students with Disabilities 

NCEO's 2001 Survey of State Directors of Special Education (Thompson,
Thurlow, & Boys, 2001) asked directors whether the most recent test
participation rates of students with disabilities on their State
assessments had changed from previous years. Similarly, directors were
asked whether the most recent test performance levels of students with
disabilities on their State assessments had changed (see figures I-4 and
I-5).

Figure I-4

Change in Test Participation Rates of Students with Disabilities Over
Previous Testing Years

![](media/image4.wmf){width="5.4944444444444445in"
height="3.8006944444444444in"}

Source: Thompson et al., 2001.

The assessment participation rates of students with disabilities have
increased in over half of the States and remained the same in another 25
percent of States. Only one State reported participation rates that are
lower than in previous years. Nine States reported that they were in
their first year of testing and did not have comparison data from
previous years. State directors of special education attributed an
*increase* in participation rates primary to these factors:

-   IDEA regulations requiring participation in statewide assessments;

-   Requirements of State accountability programs;

-   Alternate assessment participants being exempt in previous years;
    and

-   Increased flexibility in test accommodations.

Figure I-5

Changes in Test Performance Levels of Students with Disabilities Over
Previous Testing Years

![](media/image5.wmf){width="5.4944444444444445in"
height="3.952777777777778in"}

Source: Thompson et al., 2001.

State directors of special education reported that the assessment
performance levels of students with disabilities have increased in about
a quarter of the States and remained the same in another 32 percent of
the States. Four States reported lower performance levels than in
previous years. The director in one of these States commented, "The
lower levels of performance may be the result of increased participation
of students who previously received an alternative form of assessment as
determined by their IEP teams." Over a third of the State directors
reported that either their States have not yet disaggregated performance
data for students with disabilities or that this is their first year of
testing, and they do not have data from previous years to use for
comparison purposes.

Table I-5

Status of Alternate Assessments Across States

+--------------------------------------------------------+-------------+
|                                                        | Number and  |
|                                                        | Percent of  |
|                                                        | States      |
+--------------------------------------------------------+-------------+
| **Alternate assessment content**                       | 19 (38%)    |
|                                                        |             |
| > State standards (may be expanded)                    | 15 (30%)    |
| >                                                      |             |
| > Functional skills linked back to State standards     | 8 (16%)     |
| >                                                      |             |
| > State standards plus functional skills               | 4 (8%)      |
|                                                        |             |
| Functional skills only, no link to State standards     | 4 (8%)      |
|                                                        |             |
| > Other                                                |             |
+--------------------------------------------------------+-------------+
| **Performance descriptors**                            | 13 (34%)    |
|                                                        |             |
| > Same as general assessment (e.g., basic, proficient, | 17 (45%)    |
| > advanced)                                            |             |
| >                                                      | 8 (21%)     |
| > Different from general assessment (e.g.,             |             |
| > independent, emergent)                               |             |
| >                                                      |             |
| > Our State has not made a decision about this yet     |             |
+--------------------------------------------------------+-------------+
| **Inclusion in State reports**                         | 8 (16%)     |
|                                                        |             |
| > Student counted as assessment participant, and       | 20 (40%)    |
| > actual score is aggregated with scores of all other  |             |
| > assessment participants                              | 6 (12%)     |
| >                                                      |             |
| > Student counted as assessment participant, but       | 16 (32%)    |
| > actual score is reported separately                  |             |
| >                                                      |             |
| > Other                                                |             |
| >                                                      |             |
| > Our State has not made a decision about this yet     |             |
+--------------------------------------------------------+-------------+

Source: Thompson et al., 2001.

# Alternate Assessment

Alternate assessments are designed for students with disabilities who
are unable to participate in general State or district assessments. As
shown in table I-5, the NCEO Survey of State Directors of Special
Education found that most States link alternate assessment content to
State standards, but they do so in different ways (Thompson et al.,
2001). Nineteen States (38 percent) started with State standards,
expanding them to be inclusive of all students. Fifteen States (30
percent) began with functional skills that were then linked back to
standards. Eight States (16 percent) supplemented their standards with
functional skills that are not directly linked to standards, and four
States (8 percent) based their alternate assessments on a set of
functional skills, with no link to State standards.

Thirteen States (34 percent) reported that they use the same performance
descriptors for their alternate assessment as for the general
assessment, making aggregation possible. Seventeen other States (45
percent) said they select performance descriptors for their alternate
assessments that differ from those used for the general assessments. At
least eight States (21 percent) have not yet decided on performance
descriptors.

About a third of the States (*n*=16) have not decided how alternate
assessment performance will be included in their State reports. Of those
that have, eight States (16 percent) have decided that the scores of
alternate assessment participants will be aggregated with the scores of
other assessment participants. In 20 States (40 percent), alternate
assessment scores will be reported separately.

# Difficulties in Reporting Data for Students with Disabilities

Differences in data collection and management systems may contribute to
difficulties in reporting data for students with disabilities. Many
States collect data at different points in time, through different
offices, and for different purposes. In their study of performance and
participation rates of students with disabilities in Oregon's State
assessment, Almond, Tindal, & Stieber (1997) discovered that joining two
extant databases was difficult because the two systems did not share a
common student identifier. The researchers pointed to the historical and
legal conditions under which these two databases were created and how
those precedents may have interfered with the eventual merging of the
two systems. The researchers also noted assessment difficulties for
assessments conducted at particular grade levels. Such assessments
generally rely on age-to-grade designations and thus may exclude
students from nongraded programs, those who started school late, or
those who repeat a grade. States may need to retool their data
collection and management systems to ensure that all students with
disabilities are included in performance reporting. Additional
challenges in reporting these data include:

-   Information systems that do not identify students with disabilities
    in State assessment procedures;

-   Inaccuracy in marking answer documents by students, staff members,
    or proctors;

-   State policies that exclude students with disabilities who receive
    any type of accommodation or those who use "nonstandard"
    accommodations;

-   Lack of standardized procedures for calculating participation rates;

-   Use of information on the number of students who were absent from
    the assessment;

-   Data aggregation at the school or district level but not at the
    State level;

-   State reports that do not explicitly describe the population sample
    or disaggregate the data of students with disabilities; and

```{=html}
<!-- -->
```
-   Policies that allow for the collection but no public reporting of
    data on students with disabilities.

# Summary

The IDEA Amendments of 1997 required that students with disabilities be
included in large-scale assessments and provided for the use of
accommodations or alternate assessments where necessary. The amendments
also stipulated that State educational agencies must report on the
performance of students with disabilities with the same frequency and in
the same detail as they report on the performance of nondisabled
students. Recent research indicates that the participation of students
with disabilities in state- and districtwide assessments still varies
considerably across States. Similar variations are seen in States'
reporting of assessment results for students with disabilities. Although
barriers to increasing assessment participation, performance, and
reporting still remain, NCEO studies have found that the States are
making progress toward meeting the requirements set forth in the IDEA
Amendments of 1997. Research has also suggested methodologies that will
enhance States' abilities to accurately monitor performance trends over
time.

# References

Almond, P., Tindal, G., & Stieber, S. (1997). *Linking inclusion to
conclusions: An empirical study of participation of students with
disabilities in statewide testing programs.* Minneapolis: University of
Minnesota, National Center on Educational Outcomes.

Bielinski, J., & Ysseldyke, J. (2000). *Interpreting trends in the
performance of special education students* (Technical Report 27).
Minneapolis: University of Minnesota, National Center on Educational
Outcomes.

Erickson, R., & Thurlow, M. (1997). *1997 state special education
outcomes: A report on state activities during educational reform*.
Minneapolis: University of Minnesota, National Center on Educational
Outcomes.

Thompson, S., & Thurlow, M. (1999). *1999 state special education
outcomes: A report on state activities at the end of the century*.
Minneapolis: University of Minnesota, National Center on Educational
Outcomes.

Thompson, S., & Thurlow, M. (2000). *State alternate assessments: Status
as IDEA alternate assessment requirements take effect* (Synthesis Report
35). Minneapolis: University of Minnesota, National Center on
Educational Outcomes.

Thompson, S., Thurlow, M., & Boys, C. (2001). *2001 State special
education outcomes: A report on state activities at the beginning of a
new decade.* Minneapolis: University of Minnesota, National Center on
Educational Outcomes.

Thurlow, M.L., House, A., Boys, C., Scott, D., & Ysseldyke, J. (2000).
*State participation and accommodation policies for students with
disabilities: 1999 update.* (Synthesis Report 33). Minneapolis:
University of Minnesota, National Center on Educational Outcomes.

Thurlow, M., Nelson, J.R., Teelucksingh, E., & Ysseldyke, J. (2000).
*Where's Waldo? A third search for students with disabilities in state
accountability reports* (Technical Report 25). Minneapolis: University
of Minnesota, National Center on Educational Outcomes.

U.S. Department of Education. (1999). *Twenty-first annual report to
Congress on the implementation of the Individuals with Disabilities
Education Act*. Washington, DC: Author.

Challenges To Providing Secondary Education and Transition Services for
Youth with Disabilities[^1]

Beginning in the mid-1980s, the U.S. Department of Education's Office of
Special Education and Rehabilitative Services (OSERS) has emphasized the
importance of improving transition services nationally. The Federal
Government has assumed a crucial role in stimulating State and local
efforts to improve transition services through a variety of policy,
research model demonstration, and technical assistance efforts. Specific
language on transition was included in the Individuals with Disabilities
Education Act (IDEA) Amendments of 1990 and again in the IDEA Amendments
of 1997. From this Federal legislation, regulations were established
requiring State and local educational agencies specifically to address
the school and postschool transition service needs of students with
disabilities. These needs would be met through interagency agreements
and coordinated planning among special education staff, parents,
students, regular education, and public service agencies.

With the reauthorization of IDEA in 1997, significant new requirements
were put into place to ensure students greater access to the general
curriculum and state- and districtwide assessment programs. The IDEA
Amendments of 1997 also expanded previous transition requirements by
requiring that the individualized education program (IEP) include, at
age 14 or earlier, a statement of transition service needs that focus on
the student's courses of study (such as participation in
advanced-placement courses or vocational education programs). The IEP
must also include, beginning at age 16 or younger, a statement of needed
transition services and interagency responsibilities or any needed
linkages.

The current challenge is to integrate and align these transition
requirements with other IDEA requirements that give students with
disabilities greater access to the general curriculum and state- and
districtwide assessment programs. Several recent studies indicate that
the implementation of transition service requirements has been too slow,
with many States failing to achieve minimal levels of compliance
(Hasazi, Furney, & DeStefano, 1999; Johnson & Sharpe, 2000; National
Council on Disability, 2000). Areas of greatest noncompliance include
having appropriate participants in IEP meetings, providing adequate
notice of meetings, and providing a statement of needed services in
students' IEPs. These problems have been complicated further by State
and local standards-based assessment systems that either fail to include
students with disabilities or provide inadequate accommodations that
support their participation.

Students with disabilities also experience difficulties in meeting State
and local graduation requirements, and concerns are mounting about the
relationship between students' academic experiences and the development
of postschool transition plans that address how students will access
postsecondary education, employment, and community living opportunities
(Guy, Shin, Lee, & Thurlow, 1999; Johnson, Sharpe, & Stodden, 2000;
Policy Information Clearinghouse, 1997; Stodden & Dowrick, 2000a).
Limited levels of service coordination and collaboration among schools
and local service agencies create difficulties for students with
disabilities and families in accessing postschool education or work
results. Strategies are desperately needed to help State and local
educational agencies and community service agencies address the
transition service requirements as students access the general
curriculum and meet State standards and graduation requirements. This
module will discuss the challenges involved in providing services to
this population and some strategies for meeting those challenges.

# Challenges Affecting Secondary Education and Transition Services

### *Challenge 1: Ensure Students with Disabilities Access to the Full Range of Curricular Options and Learning Experiences*

The IDEA Amendments of 1997 provide many students with disabilities new
opportunities to participate in and benefit from a wide array of general
courses and learning experiences. A major goal of accessing the general
curriculum is to prepare students to earn a standard diploma and help
prepare them for adult life (Policy Information Clearinghouse, 1997;
U.S. Department of Education, 1999). Although the general curriculum
contains both academic (e.g., math, science) and nonacademic (e.g.,
career education, arts, citizenship) domains, student performance is
assessed primarily in academics. As a result, it is not uncommon for
portions of the general curriculum as well as transition goals to
receive limited or no attention (Hasazi et al., 1999; Warren, 1997).
Efforts must be undertaken to ensure that students with disabilities
remain on a full "curriculum" track with learning expectations that
guide the instruction of regular education students. IEP teams must work
to ensure that high expectations are maintained and students are
afforded opportunities to develop skills through a wide range of
curricular options, including vocational education, service learning,
community work experience, and adult living skills (Hasazi et al., 1999;
Johnson et al., 2000). Therefore, secondary education and transition
models are also needed that integrate academic, career, work-based,
service learning, and other learning experiences.

Access to the general curriculum requires more than common standards,
the integration of academic and applied learning, and universal
design.[^2] It also depends on other factors, such as the knowledge and
skill levels of educators (Boudah, Schumaker, & Deshler, 1997; Carnine,
1995; Kameenui & Carnine, 1994; Tralli, Colombo, Deshler, & Schumaker,
1999), use of appropriate accommodations during instruction and testing
(Elliott & Thurlow, 2000; Thurlow, Elliott, & Ysseldke, 1998; Thurlow,
House, Boys, Scott, & Ysseldyke, 2000), collaboration between regular
education and special education personnel in designing educational
programs for students with disabilities (Knight, 1998; Lenz & Scanlon,
1998), and the support and vision of educational leadership.

There is also a critical need to develop assessment, curriculum, and
instructional strategies that are relevant to all students (including
those who have significant learning needs), allowing them to
successfully achieve State and local standards, as well as to develop
other essential adult life skills through vocational education, training
in adult living skills, and community participation. Strategies such as
universal design offer another approach to ensuring that students with
disabilities access the full range of learning opportunities in the
secondary education curriculum (Jorgensen, 1997; Orkis & McLane, 1998;
Rose & Meyer, 1996).

To ensure that students with disabilities access the full range of
general curricular options and learning experiences, there is a need to:

-   **Promote high expectations for student achievement and learning.**
    High expectations must be maintained for students with disabilities
    across the full range of academic and nonacademic courses and
    programs available within middle schools and high schools
    nationally. This is consistent with the Bush Administration's
    blueprint for education reform, No Child Left Behind, that makes
    schools accountable for ensuring that all students meet high
    academic standards. In order to maintain high academic standards,
    instructional strategies that promote differential teaching,
    universal design, integrated academic and applied learning, and
    other practices will need to be broadly adopted.

-   **Make systematic and appropriate use of assessment and
    instructional accommodations.** Regular education and special
    education teachers need information and skills on how to
    appropriately use accommodations in assessment and instructional
    situations. Improved teacher preparation at the preservice and
    continuing education levels, promotion of collaborative teaching
    models, and other strategies are needed to address this issue. State
    and local agencies are also grappling with inconsistent policies,
    procedures, and practices on the use of accommodations.
    Consequently, accommodations are many times viewed as unacceptable
    in meeting State or local district testing conditions, often
    over-used in the hope of "boosting" student performance, and
    commonly considered too expensive and difficult to implement. The
    latter factor often results in students' not receiving appropriate
    accommodations.

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-   **Ensure that students have access to the full range of secondary
    education curricula and programs.** Students' IEPs must focus on the
    broadest range of curriculum and programs that support students with
    disabilities in successfully meeting State academic and related
    standards as well as developing essential adult skills. In addition
    to the academic focus of the general curriculum, high school
    curricular options must also include community-based work
    experience, vocational education, dropout prevention and re-entry
    programs, independent living skills programs, Tech Prep programs,
    and service learning opportunities.

### *Challenge 2: Make High School Graduation Decisions Based on Meaningful Indicators of Students' Learning and Skills and Clarify the Implications of Different Diploma Options for Students with Disabilities* 

Requirements that States set for graduation can range from Carnegie unit
requirements (a certain number of course credits earned in specific
areas), successfully passing a competency test, high school exit exams,
or a series of benchmark exams (Thurlow, Ysseldyke, & Anderson, 1995).
States may also require a combination of these. Diversity in graduation
requirements is complicated further by an increasingly diverse set of
possible diploma options within individual States. In addition to the
standard high school diploma, some States offer special education
diplomas, certificates of completion, occupational diplomas, and others.
Many States have implemented multiple strategies to improve the passing
rates of students with disabilities on State exit exams and in meeting
other requirements for graduation. Strategies have included grade-level
retention; providing special instruction during the school day, after
school, on weekends, and during the summer; and supporting teachers in
using a variety of instructional strategies.

State and local educational agencies also need to examine the
implications of developing and granting alternative diploma options for
students with disabilities. The question here is whether receiving less
than a standard high school diploma may limit a student's access to
future postsecondary education and employment opportunities. Currently,
most States offer and grant alternative diplomas in addition to the
standard high school diploma (Guy et al., 1999). State and local
educational agencies need to thoroughly discuss the "meaning" and
"rigor" of these alternative diplomas with, at a minimum, postsecondary
education program representatives and employers. Consensus must be
reached on their use for postsecondary education admissions and in
making hiring decisions.

### *Challenge 3: Ensure Students Access to and Full Participation in Postsecondary Education, Employment, and Independent Living Opportunities* 

Young adults with disabilities still face significant difficulties in
securing jobs, accessing postsecondary education, living independently,
and fully participating in their communities. With the passage of recent
Federal legislation (Americans with Disabilities Act, P.L. 101-336; and
the IDEA Amendments of 1997; P.L. 105-17) has come an expanding social
awareness of accessibility and disability issues surrounding youth with
disabilities seeking access to postsecondary education, life-long
learning, and employment (Benz, Doren, & Yovanoff, 1998; Horn &
Berktold, 1999).

The National Center for the Study of Postsecondary Educational Supports
(NCSPES), a Rehabilitation, Research and Training Center funded by the
National Institute on Disability and Rehabilitation Research, U.S.
Department of Education, at the University of Hawaii at Manoa, has
conducted an extensive program of research focused upon the access,
participation, and success of youth with disabilities in postsecondary
education and subsequent employment. Based on this research, NCSPES has
framed issues concerning students with disabilities and postsecondary
education within the following four areas of intervention:

(1) Include opportunities for students to understand themselves and
    their disability in relation to needed services and supports, with a
    focus on advocating for those needs in different postschool
    educational and employment settings (NCSPES, 2000a);

(2) Develop effective models of assistance and support that are
    personally responsive, flexible, and individualized, as well as
    coordinated with instruction and integrated with the overall life
    support needs of the student (NCSPES, 2000b; Stodden & Dowrick,
    2000a);

(3) Coordinate and manage postsecondary education supports and services
    with those provided by other community service agencies (health,
    mental health, human services, transportation, others) required by
    many students with disabilities to successfully participate in and
    complete their postsecondary education programs (NCSPES, 2000a;
    Stodden & Dowrick, 2000b); and

> \(4\) Ensure that the educational supports required by students during
> their postsecondary education program experiences transfer to eventual
> employment settings (NCSPES, 2000a; Thomas, 2000).

Another pressing societal challenge concerns the overall unemployment
rate among adults with disabilities in the United States. Although
employment has improved somewhat over the past 14-year period for people
who say they are able to work, employment is still an area with the
widest gulf between all people with disabilities and the rest of the
population. Currently, only 32 percent of persons with disabilities,
ages 18-64, work full- or part-time, compared to 81 percent of the
nondisabled populationa 49 percent gap (National Organization on
Disabilities, 2000). Further results from this study also note that
employment prospects for 18- to 29-year-olds are the most promising.
Among this cohort, 50 percent of those with disabilities who are able to
work are working, compared to 72 percent of their nondisabled
counterparts.

It is well understood that preparation for the transition from high
school to postsecondary education, employment, and independent living
must begin early, or at least by age 14. It is at this age that
students' IEP teams must engage in discussions regarding the types of
coursework students will need, to the extent appropriate for each
individual student, to be able to enroll in postsecondary education
programs; the types of learning options and experiences students will
need to develop basic work skills for employment; and the skills
students will need for independent living.

Specific types and levels of accommodations and supports a student will
need to overcome barriers to participation in these postschool
environments must also be identified. President Bush's *New Freedom
Initiative* is intended to help Americans with disabilities by
increasing their access to assistive and universally designed
technologies that remove barriers to participation in postsecondary
education, employment, and community life. Increased access to assistive
technologies, funding for low-interest loan programs to purchase these
technologies, and better coordination among agencies in prioritizing the
immediate needs of young adults with disabilities for assistive
technology needs in communities nationwide are part of this initiative.

Prior to the student's graduation from high school, it is the
responsibility of the student's IEP team to identify and engage the
responsible agencies, resources, and accommodations required for the
student to successfully achieve positive adult life outcomes. State
vocational rehabilitation programs have, for example, served as a major
resource in the preparation of some transition-age youth for employment.
A recent longitudinal study of State vocational rehabilitation programs
reported that transition-age youth currently represent 13.5 percent of
all vocational rehabilitation clients, or approximately 135,391 persons
nationally (Hayward & Schmidt-Davis, 2000). This study also reported
that receipt of specific vocational rehabilitation services, including
education or training services, physical or mental restoration services,
and diagnostic or evaluation services, were strongly associated with
achieving a positive employment outcome and to entering competitive
employment. Overall, nearly two-thirds (63 percent) of transition-age
youth who were vocational rehabilitation clients achieved an employment
outcome as a result of the services they received (Hayward &
Schmidt-Davis, 2000). Prior to a student's graduation from high school,
all agencies responsible need to:

-   **Ensure that community service agency participation systematically
    occurs in the development of postschool transition plans.**
    Strategies such as formalizing agency responsibilities through
    interagency agreements or memorandums of understanding and
    formalizing follow-up procedures and actions when agencies are
    unable to attend should be considered.

-   **Engage in integrated service planning.** The IEP should be
    coordinated with the individualized service plans required under
    other Federal and State programs (including Title I of the
    Rehabilitation Act of 1973, Title XIX of the Social Security Act
    \[Medicaid\], Title XVI of the Social Security Act \[Supplemental
    Security Income (SSI)\], and other Federal programs).

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-   **Provide information to parents and students on essential health
    and income maintenance programs.** Information on the SSI program,
    including information on basic program eligibility, 18-year-old
    benefit redeterminations, appeals processes, and use of the SSI work
    incentives in promoting employment outcomes must be readily
    accessible to professionals, parents, and students with
    disabilities.

-   **Promote collaborative employer engagement.** Increased secondary
    and postsecondary work-based learning opportunities, and ultimately
    jobs, are predicated on available and willing employers. Vehicles
    are needed that build on existing cooperative education programs in
    high schools, such as intermediary linking entities, that convene
    and connect schools, service agencies, and employers so as to
    maximize the important learning adjuncts that workplaces represent.

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-   **Establish partnerships with workforce development entities.** The
    participation of youth and young adults with disabilities, family
    members, and special education and rehabilitation professionals in
    State and local workforce development initiatives should be
    promoted. This is critically important to ensure that initiatives
    such as the Workforce Investment Act's youth employment programs are
    fully accessible to individuals with disabilities as they pursue
    postsecondary education and employment opportunities.

### *Challenge 4: Support Student and Family Participation* 

The importance of student participation has been reinforced by emerging
practices in public schools emphasizing the core values of
self-determination, personal choice, and shared responsibility. OSEP has
played a major role in advancing a wide range of self-determination
strategies through sponsored research and demonstration projects. A
recent national study that surveyed local special education directors
and supervisors found that the majority (82 percent) of students over
the age of 14 with disabilities frequently or almost always participate
in their IEP meetings (Johnson & Sharpe, 2000). This study, however, did
not address the question of how well prepared these young people are to
participate in and ultimately lead discussions concerning their school
and postschool goals.

Parent participation in IEP meetings has been required since the
inception of IDEA in 1975. A large part of the discussion in the
literature centers around the role of parents as participants in the
development of their child's IEP. The IDEA Amendments of 1990 and the
1997 amendments have also required that State and local educational
agencies notify parents and encourage their participation when the
purpose of the meeting is the consideration of transition services.
While existing policies have strongly encouraged parent participation,
it is less clear how successful these strategies have been in creating
meaningful and valued roles for parents. Because of the critical role
that parents play in assisting their children in making the transition
from school to adult life, additional attention must be given to
establishing strategies and methods needed to actively engage them in
discussions and decisions concerning school and postschool options.
Special attention is being given to increased funding for effective
training and outreach strategies for parents from diverse multicultural
backgrounds and those living in poverty. To improve student and parent
participation, there is a need to:

-   **Support students in the development of decisionmaking,
    communication, and self-advocacy skills necessary to assume a
    leadership role in their transition/IEP meetings.** Strategies may
    include offering classes specifically designed to enhance decision
    making, efforts to promote self-determination and goal setting
    throughout the curriculum, and sending information home to assist
    parents in preparing their child for participation. Students' goals
    for self-determination must also be clearly stated within IEPs.

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-   **Ensure that parents and students have the information they need to
    participate in the IEP and transition planning process.** Parents
    also need information on the juvenile justice system, appropriate
    strategies and programs for serving youth with emotional and
    behavioral disabilities, information on community service programs
    and their availability, and many other issues.

### *Challenge 5: Improve Collaboration and System Linkages at All Levels*

The effective use of interagency collaboration and cooperation to
address transition needs of youths with disabilities has been difficult
to achieve due to widely varying factors, including: (1) lack of shared
information on students across agencies, making it virtually impossible
to develop integrated service plans that support individuals in
achieving school and postschool results (Johnson et al., 2000); (2) lack
of follow-up data on program recipients that could be used to improve
service effectiveness (Johnson, McGrew, Bloomberg, Bruininks, & Lin,
1997; Stodden & Boone, 1987); (3) lack of adequate attention in IEPs to
health insurance, transportation, and other aspects of adult living; (4)
lack of systematic transition planning with those agencies that would
assume responsibility for postschool service needs (Hasazi et al., 1999;
Johnson & Sharpe, 2000); (5) ineffectual interagency agreements (Guy &
Schriner, 1997); (6) difficulties in anticipating needed postschool
services; and (7) inefficient and ineffective management practices for
establishing interagency teams (Johnson et al., 1987). Despite these
problems, interagency collaboration and coordination of services must
continue as a major strategy in addressing the needs of youths with
disabilities.

A wide range of collaborative approaches and models has been part of the
ongoing effort to improve transition services and postschool outcomes
for youth with disabilities and families for more than two decades.
OSEP's State and Local Implementation of IDEA (SLIIDEA) study (2001)
identified strategies by States to improve the coordination of services.
The study found, for example, that States have relied extensively on the
development of interagency agreements to provide services that support
students with disabilities as they transition from school to adult life.
The study found that 89 percent of the States have written agreements
with vocational rehabilitation, 56 percent with mental health agencies,
and 51 percent with agencies responsible for employment and training
(U.S. Department of Education, 2001). States have also funded transition
coordinators whose primary responsibility is assisting districts to help
students transition from school to postsecondary education, employment,
and community living. Currently, 46 States report employing one or more
transition coordinators (U.S. Department of Education, 2001). To improve
collaboration at all levels, there is a need to:

-   **Promote regular education and special education collaboration.**
    This would include collaborative models of instruction, student
    assessment, and IEP and transition planning between regular
    education and special education to promote positive school outcomes.

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-   **Promote collaborative staff development programs.** A variety of
    multidisciplinary and interdisciplinary approaches such as
    cross-training, train-the-trainer, team-building, and others
    involving collaborative relationships between State and local
    agencies, school-district personnel, institutions of higher
    education, parent centers, and consumer and advocacy organizations
    must be promoted.

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-   **Establish cross-agency evaluation and accountability systems.**
    This would include evaluations of school and postschool employment,
    independent living, and related outcomes of former special education
    students.

-   **Develop innovative interagency financing strategies.** Fiscal
    disincentives should be removed and waiver options provided to
    promote cost-sharing and resource-pooling among agencies in making
    available needed transition services and supports for students with
    disabilities.

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U.S. Department of Education. (2001). *State and local implementation of
IDEA*. Washington, DC: Abt Associates.

Warren, S. (April 1997). *Building school-based capacity to sustain
change in special education practices*. Paper presented at the annual
meeting of the American Education Research Association, San Diego, CA.

Outcomes for Students with Problem Behaviors in School: Issues,
Predictors, and Practices

The purpose of this module is to review issues, practices, progress, and
challenges regarding problem behaviors. Although the module addresses
behavior issues across all disability groups, as well as children
without disabilities, the research foundation regarding behavior issues
stems largely from the work with students with emotional and behavioral
disorders. The module begins with a review of what we know about this
population and the academic and life outcomes for students with some of
the most challenging problem behaviorsthose whose behavior interferes
with their ability to learn or to maintain satisfactory relationships or
is disruptive to the learning environment. These difficulties may be
termed academic and social failure.

Students who exhibit behavior disorders in school continue to be one of
the most problematic issues for both teachers and administrators
(Furlong, Morrison, & Dear, 1994). As a consequence of their behaviors,
these students spend less time engaged in instruction and often disrupt
the learning environment for both themselves and their peers. The
prognosis for success in school and in life for these students is
frighteningly poor. This prognosis creates the need to develop effective
and efficient prevention and intervention practices. Unfortunately,
while inclusion is a goal for these students, research indicates that
simply placing them in regular education environments with appropriate
peer models is not sufficient to facilitate academic or behavioral
success (Gable, McLaughlin, Sindelar, & Kilgore, 1993). For many of
these students, placement in the regular education environment without
appropriate supports may lead to more academic and social failure than
does placement in more restrictive settings (Friedman, Cancelli, &
Yoshida, 1988; Rich & Ross, 1989).

This module looks at trends and outcomes among students with problem
behaviors, focusing on the school's role. A review of the research will
lead to a discussion of the predictors of students who exhibit problem
behaviors in school. Although these students often come to school
predisposed to failure, a comprehensive analysis of these predictors is
key to developing effective school-based prevention strategies. Finally,
the module presents a brief summary of effective prevention practices.

# Students with Problem Behavior: Outcomes

This section presents a review of student outcomes in regard to problem
behaviors. Throughout the 1997 reauthorization of the Individuals with
Disabilities Education Act (IDEA), discussions on behavior and
discipline were constant and somewhat contentious. Through these
debates, it became obvious that there was a lack of the data that are
needed to make informed decisions. Several data collection efforts are
currently in place to provide information on behavioral issues,
including national studies on the implementation of the behavior-related
provisions of IDEA and State-reported data on suspensions and
expulsions.

## *School Outcomes*

In 1998-99, OSEP began collecting data from States on children with
disabilities who were removed from their educational placement for
disciplinary reasons. These data were required as part of a
comprehensive effort to address discipline issues in the 1997
reauthorization of IDEA. States reported the number of children with
disabilities who were (1) unilaterally removed to interim alternative
education settings following drug or weapon offenses, (2) removed based
on hearing officer determinations regarding likely injury to themselves
or others, or (3) suspended/\
expelled for more than 10 days in a school year. States also reported on
the acts precipitating these removals. Data were reported by
race/ethnicity and by disability category. In 1999-2000, OSEP funded a
study of issues associated with the validity of the State-reported
discipline data and found many threats to the validity of the data. As a
result, OSEP has initiated revisions to the collection.

In order to provide a more complete understanding of the importance of
addressing problem behaviors early and comprehensively, the following
sections of the module review the literature to provide a synthesis of
current views on typical outcomes for students with problem
behaviors.[^3]

### *Academic and Social Failure*

While academic failures are directly related to curricular expectations,
social failures involve a lack of success in meeting expectations for
interacting in a school environment. Academic and social failures are
reciprocally and inextricably related (Kauffman, 2001; Maguin & Loeber,
1996). The most obvious connection is seen in students with difficult
behaviors who often suffer from associated academic deficits. However,
the connection is equally sound in the opposite direction in that
academic deficits are among the most powerful predictors of social
failures and problem behaviors (Maguin & Loeber, 1996; Morrison &
D'Incau 1997; Rylance, 1997; Wu, Pink, Crain, & Moles, 1982). In some
sense, there appears to be evidence of characteristics of what might be
termed "social learning disabilities" in many of these students. These
students tend to have few friends and significantly impaired abilities
to relate to peers (Kauffman, 2001). Regardless of the reasons, Marcus
(1996) reports that delinquent adolescents' friendships are
characterized by greater conflict, poorer attachment quality, lesser
ability to repair relationships, cognitive distortions, and poorer
social-cognitive problem solving.

### *Life-Long Challenges* 

The longer academic or social failure persists for these students, the
less likely it is that they will be successful in their educational
experiences or in their lives following separation from school (Walker,
Colvin, & Ramsey, 1995). About 50 percent of students identified under
IDEA as having emotional and behavioral disorders drop out of school
(Wagner, Newman, D'Amico, Jay, Butler-Nalin, & Marder, 1991). Once they
leave school, these students lack the social skills necessary to be
successfully employed; they consequently suffer from low employment
levels (Bullis, Nishioka-Evans, Fredricks, & Davis, 1993; Carson,
Sitlington, & Frank, 1995) and poor work histories (Bullis &
Gaylord-Ross, 1991). Over the course of their lives, students with
emotional and behavioral disorders typically hold multiple short-term
jobs rather than long-term employment (Wagner, D'Amico, Marder, Newman,
& Blackorby, 1992) and, consequently, earn less than students from any
other disability category (Frank & Sitlington, 1997).

The poor prognosis for students with academic and social failures,
regardless of whether they have been served under IDEA, extends beyond
employment. Within 3 years of leaving school, 70 percent of these
students will be arrested (Jay & Padilla, 1987), continuing a pattern of
failure that becomes extremely difficult to correct. If there is one
characteristic that separates juvenile offenders from any other child
who exhibits problematic behavior, it is perhaps the extraordinarily
poor prognosis of successful rehabilitation, particularly for those who
have been incarcerated (Scott, Nelson, Liaupsin, Jolivette, Christle, &
Riney, in press). Continuing life problems include involvement with
social services and the corrections system (Duncan, Forness, &
Hartsough, 1995) and drug abuse (Wagner, Blackorby, Cameto, & Newman,
1993). These outcomes represent only a partial list of identified
negative outcomes that are associated with students whose behavior
problems result in academic and social failure.

# Students with Problem Behavior: Predictable Failure

When we can predict the academic and social failures of students with
behavior problems, we then have much of the information necessary to
prevent more serious academic and social problems from developing over
time. However, unraveling the complex array of home, community, and
school factors associated with any student quickly becomes too unwieldy
a task to undertake on a large scale. But research has identified
significant predictors of which students with behavior problems will
experience academic and social failure. The purpose of prediction is not
to place or remove blame; it is helpful only if it assists in
alleviating the problem. Prediction has two clear benefits. First, we
must understand the reasons for failure if we are to effectively develop
prevention and intervention strategies that are likely to provide these
students with their best chances for success. Second, we must determine
how to best use our existing resources and where additional resources
will be needed to create successful programs. Regardless of the nature
or source of identified predictors, this review maintains a focus on the
school's role in creating and facilitating environments that predict
success for students predisposed to or currently exhibiting academic and
social failure.

## *Poverty and Predictable Early Academic Deficits*

The single greatest predictor of academic and social failure in
America's schools is poverty (Illinois State Board of Education, 2001;
Rylance, 1997). Multiple regression analyses of statewide data in
Illinois and Kentucky demonstrate that approximately 70 percent of the
variance in standardized achievement scores can be accounted for by
nothing more than income level (Illinois State Board of Education, 2001;
Nelson, Scott, Liaupsin, Christle, & Riney, 2001). Further analysis in
Illinois reveals that the cumulative effects of multiple other variables
do not significantly add to the predictability of student success or
failure (see table I-6).

There is strong evidence regarding the issues associated with poverty
that tend to predict student failure. Students from a background of
poverty typically come to school with significantly less exposure to
print materials (Adams, 1988) and with less vocabulary and less practice
at following complex sets of directions (Hart & Risley, 1995). These
students then experience academic and social failures from the first day
of school and at a higher rate than their peers (Coleman & Vaughn,
2000). These failures begin a pattern within which students experience
more negative interaction and punishment while at the same time
receiving less academic time with teachers. This becomes a vicious
circle as students escalate problem behaviors in order to avoid aversive
classroom experiences; the result is more punishment and eventual
exclusion. This is an especially tragic pattern in light of the fact
that there is ample evidence to suggest that increased academic engaged
time and effective instructional practices can promote both academic and
social success with these students (Nelson, Johnson, &
Marchand-Martella, 1996; Scott, Nelson, & Liaupsin, in press; Tarver &
Jung, 1995).

Table I-6

Percentage of Successful Predictions for ITBS Scores Below the Mean in
Illinois

  ------------------------------------------------------------ ------------
  Predictors                                                   Successful
                                                               Prediction

  Poverty rate                                                 71 percent

  Poverty rate + mobility rate                                 73 percent

  Poverty rate + mobility rate, attendance rate, race, teacher 77 percent
  race, and highest teacher degree-masters                     

  Poverty rate + mobility rate, attendance rate, limited       78 percent
  English proficiency rate, average teacher salary, average    
  teacher experience, truancy rate, race, teacher race,        
  funding per pupil, school enrollment, average class size,    
  highest teacher degree-bachelors, and highest teacher        
  degree-masters                                               
  ------------------------------------------------------------ ------------

Source: Adapted from table presented on the Illinois State Board of
Education web site.

Research indicates that there are no easy answers for low-income
students with a history of early academic and social failure. Simply
providing effective instruction in key deficit areas is a necessity,
although it is apparently insufficient to facilitate continuing success
(Hart & Risley, 1995). Students with problem behaviors require effective
instruction, supportive/encouraging environments, and continuous
feedback on an ongoing basis. That is, preventative support cannot be
delivered via a "hit and run" model. Instead, support for students with
these challenges must be incorporated into the system and follow
students throughout their school career. The longer a student goes
without support, at any level, the less likely it is that the student
will experience success. Thus, research indicates that there is little
room for error in promoting success with all childrenbut especially
those who are at-risk for academic and social failure.

# Practices Affecting Student Outcomes

The following practices have been successful in both preventing student
failures and in providing effective supports for intervening with
students who are already experiencing failure. These practices can be
characterized in three stages: (1) primary preventioncreating school
environments that minimize conditions that predict failure and provide
effective instruction and prompting for success across all students; (2)
secondary preventionidentifying students exhibiting initial failures
despite primary prevention efforts and providing them with more
individualized strategies to prevent failures from progressing; and (3)
tertiary prevention\
identifying students with the most chronic and pervasive academic and
social failures and providing intensive and collaborative
school/community-based strategies to prevent these failures from
resulting in school drop-out and the negative life outcomes typically
associated with it (i.e., incarceration, social welfare involvement,
drug abuse, etc.).

## *Positive Behavioral Support*

Systems of positive behavioral support provide schools with a framework
within which to predict student failures and to create strategies and
expectations across all personnel in an effort to prevent failures. Such
practices have been successful in decreasing a variety of student
failures, thereby facilitating increased student success rates (Lewis &
Sugai, 1999; Scott, 2001; Sugai, Sprague, Horner, & Walker, 2000). To be
successful, positive behavioral supports must be implemented as a system
wherein all personnel take equal responsibility for planning,
implementation, and evaluation of student progress (Scott & Nelson,
1999a; Jolivette, Barton-Arwood, & Scott, 2000).

Positive behavioral support is a schoolwide approach to adopting and
sustaining the use of effective practices to prevention designed to
enhance the capacity of schools to educate all students, especially
students with problem behaviors resulting in academic and social failure
(Sugai et al., 2000). For students with problem behavior, positive
behavioral supports help to prevent many of the predictable behavior
problems that typically begin a pattern of escalating academic and
social failures. This approach has been advocated in the *2000 Report of
the Surgeon General's Conference on Children's Mental Health* as a
cost-effective method of prevention. This report recommends that
positive behavior support emphasize "primary prevention methods that
recognize the unique differences of all children and youth, but should
include selective individual student supports for those who have more
intense and long-term needs" (p.7).

For students with problem behavior, positive behavioral supports help to
prevent many of the predictable behavior problems that typically begin a
pattern of escalating problems. However, regardless of the fidelity and
implementation of schoolwide support systems, many students with problem
behaviors will continue to exhibit behavior problems and experience
academic and social failure. These students will require more intensive
and individualized interventions (Sugai & Horner, 1999). Sugai and
Horner (1999) suggest that, within a system of support, the level and
intensity of support are dictated by the level and complexity of the
behavior problem. Efficiency is then realized by preventing problems
across all students so that more intensive needs may be identified
earlier and more resources may be applied in developing individualized
interventions.

Because students with problem behaviors often experience a high degree
of academic and social failure in their lives, effective schools provide
multiple opportunities for success and facilitate success by
communicating high expectations, providing effective instruction, and
developing environments that encourage, prompt, and acknowledge success.
Students with a background of failure are easily discouraged and must be
set up to succeed on a frequent and predictable basis (Scott et al., in
press).

## *Effective Instruction and Collaborative Practices*

Meta-analyses of over 800 studies have examined effective practice for
students with problem behaviors (Gottfredson & Gottfredson, 1996;
Lipsky, 1991). The largest effects were found for social skills
instruction, behaviorally based interventions (i.e., encouragement and
consistent responses to positive and negative behavior), and academic
instruction. What these three practices have in common is that they are
based on the delivery of effective instruction. For both academic and
social problems, meta-analyses have identified practices in which
instruction includes clear expectations and how to meet them,
encouragement and facilitation of success, and consistent
acknowledgment/feedback for both positive and negative behavior.

As previously discussed, students with problem behaviors require
effective instruction that engages them in learning and facilitates
frequent success. Evidence clearly indicates that academic success is
associated with a decrease in problem behavior and involvement with the
judicial system (Gottfredson & Gottfredson, 1996; Lipsky, 1991; Maguin &
Loeber, 1996). However, while effective instruction has historically
been conceived of as mainly an academic issue, students with problem
behaviors require effective instruction across the curriculum and into
students' extracurricular lives. In the social realm, research indicates
a need for programs that include social skills, peer mediation and
conflict resolution, and transition planning (Jolivette, Stichter,
Nelson, Scott, & Liaupsin, 2000; Peck, Sasso, & Jolivette, 1997).

Effective interventions will likely require schools to look beyond their
traditional role with these students. For example, Neel, Meadows,
Levine, and Edgar (1988) described vocational training as the means for
identifying, teaching, and reinforcing appropriate and specific job
skills within a variety of work environments. This definition implies
collaboration between the school and community in developing coordinated
experiences and expectations. The array of problems faced by many
students requires interventions that are beyond the scope of the school.
Although intervention plans may be initiated by the school, the plans
themselves and effective implementation of them will require a
collaborative effort between the school, family, and community.

### *Wraparound Planning*

One positive trend for students with behavior problems has been the move
toward integrated and collaborative assessment and intervention.
Wraparound planning typically has been conceptualized as a family- and
student-centered, multidisciplinary planning process specifically
designed for students whose history of problem behaviors warrants the
most intensive interventions. However, wraparound planning has also been
applied for students with more mild behavioral problems and as early
intervention for students identified as at-risk for emotional and
behavioral disabilities (Eber, Smith, Sugai, & Scott, 2001; Eber, 1999).
Wraparound planning involves all stakeholders, including parents, school
personnel, the student, and a variety of associated professionals from
the community (e.g., vocational counselors, physical therapists, mental
health, and medical professionals). Services commonly used by
individuals with emotional and behavioral disabilities include
counseling; financial counseling; job training, mentoring, and coaching;
and health services (Karp, 1996).

### *School Responses* 

A survey conducted during the 1996-97 school year found that more than
75 percent of all schools reported having zero tolerance policies for
various student offenses (U.S. Departments of Education and Justice,
1999). In addition, there has been an increase in the presence of law
enforcement officers and metal detectors in public schools (U.S.
Departments of Education and Justice, 1999). However, evidence suggests
that such measures have been ineffective, or even counterproductive, in
preventing school violence (Hyman & Perone, 1998; Mayer & Leone, 1999).
Schools continue to exclude students with problem behaviors as a
first-level response, often without implementing active instructional
strategies for future problem prevention.

### *Functional Behavioral Assessment* 

The 1997 amendments to the Individuals with Disabilities Education Act
(IDEA) mandate the development of behavior intervention plans based on
functional behavioral assessment for those students with disabilities
who exhibit behaviors that constitute a pattern of misbehavior or
require a change in placement (P.L. No. 105-17, §615(k)(1)(B)(i)).
Functional behavior assessment has been defined as "a process for
gathering information that can be used to maximize the effectiveness and
efficiency of behavioral support" (O'Neill et al., 1997, p. 3). Simply,
functional behavior assessment is a systematic method of assessing the
purpose or "function" of a student's behavior in relation to its context
(i.e., surrounding environment) so that appropriate interventions can be
designed to meet the unique needs of

Table I-7

Steps for Conducting a Functional Behavioral Assessment and Implementing
a Behavioral Intervention Plan

  ------------------------------ ----------------------------------------
  Steps                          Procedures

  Step 1: Define the Problem     Create a concrete definition of the
  Behavior                       problem behavior and the conditions
                                 under which it typically occurs.

  Step 2: Gather Information     Use interviews, questionnaires, record
  Regarding Environment and      reviews, and direct observations to
  Behavior                       determine what environmental events tend
                                 to precede and follow behavior.

  Step 3: Hypothesize Function   Use collected information to hypothesize
  of Behavior                    the function or purpose the behavior
                                 serves for the student.

  Step 4: Develop a Behavioral   Determine and teach an appropriate
  Intervention Plan              behavior that serves the same function
                                 for the student. Arrange the environment
                                 to prompt desired behavior and develop
                                 plans for providing consequences for
                                 both desired and undesired behavior.

  Step 5: Monitor Behavior To    When monitoring indicates that the
  Verify Hypothesis and Validate intervention is successful, the
  Intervention                   functional behavioral assessment is
                                 completed. When intervention is
                                 unsuccessful, return to Step 2 and
                                 continue gathering data toward a more
                                 valid hypothesis.
  ------------------------------ ----------------------------------------

individual students. The great benefit of functional assessment is the
ability to assist in developing proactive (i.e., preventative),
positive, and individualized behavior intervention plans for students
with challenging behaviors. The basic steps for conducting a functional
behavior assessment and implementing a behavioral intervention plan are
presented in table I-7. The mandating of functional behavior assessment
has resulted in the need to train large numbers of personnel in the
process of creating behavior intervention plans based on the function of
student problem behavior. However, the structure and cost of traditional
professional development models make such large-scale training efforts
difficult (Scott & Nelson, 1999b; Sailor et al., 2000).

Traditionally, students with problem behaviors have been placed in
exclusionary environments (i.e., resource room, self-contained room,
non-school placement). As more students identified with behavioral
disabilities are being included in the general environment, questions
have arisen regarding the appropriateness of traditional methods of
functional behavioral assessment. Recent literature, however, provides
support for the efficacy of functional behavioral assessment for most
problem students in public school classrooms (Ellingson, Miltenberger,
Stricker, Galensky, & Garlinghouse, 2000; Heckaman, Conroy, Fox, &
Chait, 2000).

Examples of systems and procedures for conducting functional behavioral
assessment and implementing behavioral intervention plans in public
schools have increasingly demonstrated positive outcomes for students
with problem behavior (e.g., Scott, DeSimone, Fowler, & Webb, 2000;
Sugai, Lewis-Palmer, & Hagan, 1998). These student successes have been
facilitated by functional behavioral assessment processes that involve
collaborative decisionmaking and planning across a range of
professionals and stakeholders (Eber, Smith, Sugai, & Scott, 2001;
Jolivette, Barton-Arwood, & Scott, 2000). To bring systems together in
creating effective and efficient plans, the functional behavioral
assessment must be a part of typical systemic procedures for assessing
problem behaviors at any level (Sugai, Horner, & Sprague, 1999). In a
1998 research synthesis funded by OSEP, behavioral intervention plans
that were based on a prior functional behavioral assessment were more
likely to result in positive behavior change.

This level of cooperation among a diverse group of professionals
represents a fundamental change in the ownership of problem studentsa
shift from the expert model to the collaborative model. Such systemic
changes are difficult for schools to undertake, regardless of the topic
or students involved. When focusing on such a group of students whose
behaviors are seen as among the most problematic issues facing school
personnel, the challenge of changing systems becomes ever larger (Scott,
Nelson, & Zabala, in press). Still, current evidence suggests that such
processes and collaborative systems are related to positive student
outcomes.

# Summary

Students with problem behaviors present challenges to schools; in turn,
schools tend to react in ways that often set the context for further
problem behaviors and eventual school exclusion. Such students typically
experience poor social and academic outcomes in school, leading to poor
employment outcomes, involvement with the social services system, and
incarceration. Research on school achievement points to poverty as the
leading predictor of both academic and social failure. Students from a
background of poverty are less prepared to enter school on both academic
and social grounds and typically experience failure very early in life.

Practices that increase positive outcomes for students with problem
behaviors are those such as social skills instruction, behaviorally
based interventions, and academic instruction that provide systems-level
support calculated to prevent predictable failures. Individualized
interventions based on functional behavioral assessment and involving a
range of stakeholders from both the school and community have been found
to increase positive outcomes for these students. Although not
implemented on a large scale, interventions and collaborative ownership
of problem behaviors that are evidenced in the positive behavioral
support model and the functional behavioral assessment and wraparound
procedures that have been implemented systematically give reason for
optimism. In general, this trend would seem to be a turning point in the
effort to prevent student failure. The components of a successful model
are known and well-validated. The question of success will revolve
around the ability of systems to adopt and share the responsibilities
for change.

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TResults Experienced by Children and Families Entering Early
Intervention

he emphasis in education and other social programs has recently shifted
from a focus on documenting what was provided to describing what was
achieved. For infants and toddlers with special needs, the desired
results of intervention services are challenging to conceptualize.
Acquisition of school-age skills such as reading and mathematics skills
are clearly not appropriate outcomes for this age group. Similarly,
broad goals of community participation or membership in groups have
limited applicability to children under 3 years of age. What then are
the desired results of early intervention services?

A priority addressed by the National Early Intervention Longitudinal
Study (NEILS) is to examine the outcomes experienced by children and
families in early intervention. Some of the purposes of Part C deal
specifically with child and family outcomes and provide guidance as to
the results expected from early intervention. Part C was enacted in part
because of the "urgent and substantial need:

\(1\) to enhance the development of infants and toddlers with
disabilities and to minimize their potential for developmental delay;

\(2\) to reduce the educational costs to our society, including our
Nation's schools, by minimizing the need for special education and
related services when infants and toddlers with disabilities reach
school age;

\(3\) to minimize the likelihood of institutionalization of individuals
with disabilities and maximize the potential for their independently
living in society;

(4) to enhance the capacity of families to meet the special needs of
    their infants and toddlers with disabilities" (§631(a)).

Drawing upon the stated purpose of the legislation, the conceptual
framework for NEILS identified three distinct outcome areas that the
study would assess: (1) short-term outcomes for children (enhancing
development), (2) long-term outcomes for children (minimizing the need
for future services, minimizing the likelihood of institutionalization),
and (3) outcomes for families (enhancing the capacity of families).
These three outcome areas are discussed in greater depth in the pages
that follow.

NEILS is a longitudinal study following children from four birth years.
These children received their first early intervention service between
September 1997 and November 1998. The oldest children in the sample
started kindergarten in 2000-01 and thus exited early intervention in
1998. The youngest will exit the early intervention service system in
mid-2001 and will probably begin kindergarten in 2003-04. Because of the
age distribution in the sample, it will be another year before
short-term child outcomes are completely analyzed and a little longer
before the first set of long-term child outcomes is ready for
dissemination. The framework for looking at child outcomes is presented
along with some preliminary data on the children's status at program
entry.

# Short-Term Outcomes for Children

Short-term outcomes refer to those that occur after a limited period of
time in early intervention. NEILS is interviewing families annually
until the child's third birthday. The short-term outcome areas being
tracked are physical health; developmental milestone attainments in
motor, communication, cognition, and independence; social skills and
relationships with peers and adults; behavior and engagement;
participation or interaction with typically developing peers; and the
need for ongoing services.

The data presented in this report are baseline data against which
short-term outcome data will be compared at subsequent time points. Many
of the findings on status at entry to early intervention were already
presented elsewhere in this report in the section on characteristics of
children and families in early intervention. The data on physical health
indicated that although many parents of children entering early
intervention reported their child's health to be very good or excellent,
these proportions were substantially smaller than those reported for the
general child population under 5 (61 percent vs. 82 percent). Behavioral
data suggested that more than half (56 percent) of the children entering
early intervention had no trouble playing with other children, and 39
percent were not at all aggressive with other children. In this section,
we will focus on the attainment of developmental milestones by
describing the developmental status of children when they begin
services.

Attaining age-appropriate developmental competencies is an important
outcome for all infants and toddlers. It is significant for children
under 3 because it facilitates interaction with the environment, which
forms the foundation of individual child development. The developmental
accomplishments of infancy and toddlerhood are also important because
they lay the groundwork for the next level of developmental skills
children must master as they move through the preschool years and then
enter elementary school. For example, communication and mobility are
important developmental tasks for young children. Acquiring beginning
communication skills allows the child to more effectively communicate
his or her needs. Similarly, becoming mobile provides access to a much
broader range of environments and objects to explore and enjoy. On the
other hand, the child without adequate communication skills is limited
in his or her ability to interact with caregivers and others in his or
her social world and is possibly frustrated by this limitation. A child
who is not mobile is restricted to where he or she is placed and reliant
on what others bring for the child to explore.

NEILS examined developmental attainments by asking parents to report on
a set of child behavior and skills in several domains. For each item,
the parent was to report whether the child "does it well," "does it but
not well," or "doesn't do it at all." The specific milestones were
selected because they were assumed to have face validity as markers of
developmental attainment, to be universal in expression with minimal
cultural/socioeconomic bias, and to be observable in everyday
activities.

The status of children upon entry into early intervention on a select
set of the milestones is shown in table I-8. The nationally
representative data are grouped by domain and reported separately for
children who were less than 12 months of age at the time of the first
interview, between 12 and 24 months of age, and older than 24 months of
age. In interpreting these data, it is important to remember that the
three age groups of entry into early intervention reflect three
fundamentally different groups of children with regard to the nature of
their disability or delay. (See discussion of characteristics of
children entering early intervention in Chapter II.) Children who began
early intervention and whose families were interviewed when the child
was less than 12 months of age are not just younger than the other two
age groups. Children who begin early intervention at less than 12 months
of age are much more likely to have a diagnosed condition or a risk
condition such as low birth weight. Children older than 12 months,
especially those older than 24 months, are much more likely to have a
communication-related disability or delay.

The findings for children who were less than 12 months old at the time
of the interview show that very few of the children in this group have
mastered sitting, crawling, or walking. To some extent, this might be
expected because the age range includes children as young as several
weeks old.

Within the group of children whose families were interviewed when they
were between 12 and 24 months, some have mastered the motor milestones.
For example, 41 percent were reported as able to walk well. Nearly all
children in the general population can walk by 17 months of age. Many of
the youngest children in this middle age group entering early
intervention would not therefore be expected to walk yet. Overall, the
data on the motor milestones are consistent with other NEILS

Table I-8

Milestone Attainment in Different Domains by Age Group at Entry to Early
Intervention Services

+----------------------------------------+---------+---------+---------+
|                                        | Per     |         |         |
|                                        | centage |         |         |
|                                        | of      |         |         |
|                                        | C       |         |         |
|                                        | hildren |         |         |
|                                        | R       |         |         |
|                                        | eported |         |         |
|                                        | Able To |         |         |
|                                        | Do      |         |         |
|                                        | Mi      |         |         |
|                                        | lestone |         |         |
|                                        | Well    |         |         |
+----------------------------------------+---------+---------+---------+
|                                        | Age at  |         |         |
|                                        | First   |         |         |
|                                        | In      |         |         |
|                                        | terview |         |         |
+----------------------------------------+---------+---------+---------+
|                                        | \<12    | 12 to   | 24 to   |
|                                        | Months  | 24      | 32      |
|                                        |         | Months  | Months  |
+----------------------------------------+---------+---------+---------+
| ##### **Motor**                        |         |         |         |
+----------------------------------------+---------+---------+---------+
| Grasp objects and let go of them (10)  | 52      | NA      | NA      |
+----------------------------------------+---------+---------+---------+
| Crawl, scoot, or creep (11)            | 17      | NA      | NA      |
+----------------------------------------+---------+---------+---------+
| Sit up (11)                            | 15      | NA      | NA      |
+----------------------------------------+---------+---------+---------+
| Pick up small objects with finger and  | 18      | 75      | 87      |
| thumb (12)                             |         |         |         |
+----------------------------------------+---------+---------+---------+
| Hold a crayon or pencil (16)           | 2       | 41      | 72      |
+----------------------------------------+---------+---------+---------+
| Walk without holding on (17)           | 0       | 54      | 90      |
+----------------------------------------+---------+---------+---------+
| Walk quickly or run (25)               | NA      | 42      | 81      |
+----------------------------------------+---------+---------+---------+
| Take paper off candy to unwrap (25)    | NA      | 17      | 50      |
+----------------------------------------+---------+---------+---------+
| ##### **Communication**                |         |         |         |
+----------------------------------------+---------+---------+---------+
| Babbles (3)                            | 64      | NA      | NA      |
+----------------------------------------+---------+---------+---------+
| Says "mama" or "dada" (12)             | 13      | 58      | 77      |
+----------------------------------------+---------+---------+---------+
| Responds to simple gestures like       | 19      | 70      | 88      |
| someone waving\                        |         |         |         |
| "bye-bye" (17)                         |         |         |         |
+----------------------------------------+---------+---------+---------+
| Repeats or imitates a word (18)        | 4       | 22      | 30      |
+----------------------------------------+---------+---------+---------+
| Follows a 2-step verbal direction (24) | NA      | 37      | 65      |
+----------------------------------------+---------+---------+---------+
| Says 2 or 3 words in a sentence (25)   | NA      | 5       | 17      |
+----------------------------------------+---------+---------+---------+
| ##### **Self-Help**                    |         |         |         |
+----------------------------------------+---------+---------+---------+
| Eats bite size pieces with fingers     | 11      | NA      | NA      |
| (11)                                   |         |         |         |
+----------------------------------------+---------+---------+---------+
| Lifts a cup and drinks from it (18)    | 5       | 65      | 88      |
+----------------------------------------+---------+---------+---------+
| Takes off socks without help (23)      | NA      | 65      | 78      |
+----------------------------------------+---------+---------+---------+
| Washes and dries hands thoroughly (28) | NA      | NA      | 36      |
+----------------------------------------+---------+---------+---------+
| ##### **Cognition**                    |         |         |         |
+----------------------------------------+---------+---------+---------+
| Looks for object out of sight (7)      | 26      | NA      | NA      |
+----------------------------------------+---------+---------+---------+
| Laughs in response to peek-a-boo (8)   | 49      | NA      | NA      |
+----------------------------------------+---------+---------+---------+
| Explores objects by shaking and        | 39      | NA      | NA      |
| banging (11)                           |         |         |         |
+----------------------------------------+---------+---------+---------+
| Puts things into and takes them out of | 5       | NA      | NA      |
| things (12)                            |         |         |         |
+----------------------------------------+---------+---------+---------+
| Does simple pretending in play like    | 1       | 29      | 64      |
| feeding a doll (18)                    |         |         |         |
+----------------------------------------+---------+---------+---------+
| Shows that knows two body parts (28)   | NA      | 40      | 77      |
+----------------------------------------+---------+---------+---------+
| Refers to things as "mine" (30)        | NA      | 21      | 51      |
+----------------------------------------+---------+---------+---------+
| Gives his or her first name (35)       | NA      | 6       | 14      |
+----------------------------------------+---------+---------+---------+

Note: The number in parenthesis after the milestone is the age in months
by which almost all children in the general population (approximately 90
percent) have attained this milestone. Some milestones are too advanced
or too young for some age groups and were "not asked" (NA) for these
children.

Source: National Early Intervention Longitudinal Study.

data showing motor difficulties are less often a reason for early
intervention services among this middle age group compared to the
younger population.

The predominance of communication difficulties among children who begin
receiving early intervention after 24 months of age is strongly
reflected in the milestone data. Saying "mama" is a milestone mastered
by the general population of children by 12 months of age. Within the
group of children who began early intervention between 12 and 24 months
of age, only 58 percent could say "mama." Similarly, almost all children
in the general population can follow a two-step direction by 24 months.
Only 37 percent of children who were between 12 and 24 months when the
interview was conducted could do this well. These children were
relatively more proficient in the area of self-help, but still only 65
percent could use a cup to drink or take off their socks. Both of these
are usually mastered by 24 months.

The children who were the oldest when they began to receive early
intervention services, those who were between 24 and 32 months at the
time of the interview, were somewhat skilled in the motor and self-help
areas. Even in these areas, some children were having difficulties in
areas typically mastered by much younger children. Only 90 percent were
reported as able to walk well, and only 81 percent could run quickly.
Only half could take the wrapper off a piece of candy, something that
nearly all children can do by 25 months. Most could use a cup and take
off their socks.

The oldest children, those who began early intervention services after
24 months, have mastered milestones in the motor, self-help, and
cognitive areas with one exception. Almost all children can pick up
small things by 12 months of age, so even though only 13 percent of the
oldest group of children beginning early intervention were not able to
do this task well, these children are a year or more behind in acquiring
this skill.

A different picture is presented by the communication milestones. Among
this oldest group of early intervention entrants, the percentage who
could say "mama," a 12-month milestone, was only 77 percent. A task that
almost all children can do by 18 months is repeating a word. Among
children who began early intervention between 24 and 32 months of age,
however, only 30 percent were reported by their caregivers as able to do
this. All of the communication milestones show this oldest group as
having difficulty in this area at the time they began to receive early
intervention services.

These data describe the children at entry to early intervention. The
more interesting question is how children will change over time with
regard to short-term developmental outcomes. Future analyses from NEILS
will examine the attainment of developmental milestones as children
receive services over time and as they get older.

# Long-Term Outcomes for Children 

Long-term outcomes from early intervention are those that occur after
the child has left early intervention services. An important long-term
outcome is prevention of future delays and disabilities. The meaning of
"prevention" varies for different kinds of children. It is important to
understand that the population of children being served in early
intervention programs is extremely heterogeneous with regard to the
nature of their delay, disability, or risk condition. A baby born at 975
grams with multiple physical problems presents a very different set of
needs from a healthy 26-month-old with a delay in communication skills.
Both of these children, as well as children with many other different
conditions and needs, can be eligible for early intervention services.
These variations among children have direct implications for what early
intervention is trying or can reasonably be expected to enhance or
prevent.

In NEILS, several different long-term outcomes for former recipients of
early intervention are being examined, including the need for future
services, physical health, developmental attainments, academic skills,
memberships in groups such as being a member of a sports team, and
interpersonal relationships such as friendships. The need for future
services is being examined at 36 months (what proportion of children are
referred for special education upon exiting early intervention?) and at
kindergarten (what proportion are receiving special education in
kindergarten?). Changes in physical health and developmental attainments
are also being assessed at 36 months and at kindergarten. The academic
skills of reading and mathematics are assessed only at kindergarten, as
is membership in groups. Relationships or friendships are assessed at 36
months and at kindergarten.

# Family Outcomes

Early intervention is a program designed for both children and families.
Family-centered practices are mandated as an integral part of early
intervention services and are expected to permeate all aspects of
service delivery (Bailey, Buysse, Edmondson, & Smith, 1992). To address
the need for an approach that could be applied in evaluating family
outcomes across many families and programs, Bailey et al. (1998)
proposed a general framework for assessing family outcomes. The
framework identifies two general types of family outcomes and
corresponding questions that reflect current values and the outcomes
early intervention could be expected to affect. The two general
categories of outcomes are the family's perception of their early
intervention experience and the impact of services on the family. This
framework was used to develop the family outcome measures in NEILS. The
NEILS data presented here refer only to the family's initial perception
of the early intervention experience. All families were interviewed
within 4 months of beginning early intervention; the majority were
interviewed within 2 months. Additional data on the impact on the family
will be forthcoming as information at later time points becomes
available.

NEILS examined a number of issues related to the families' perceptions
about their entry into early intervention, as well as satisfaction with
initial services. These data are shown in table I-9. The great majority
of families had little difficulty finding out about early intervention
services or getting the services started. The findings with regard to
the individualized family service plan (IFSP) are somewhat surprising in
that one in five families was not aware of the existence of a written
plan. Presumably they had participated in such a process 1 to 2 months
prior to being interviewed. The diagnosis of a disability and the
subsequent entry into a new service system can be an overwhelming
process for families, and it appears that the development of the IFSP
may have not been well explained, was forgotten, or both, for some
families. It is also possible that the development of the plan was not
the family-professional partnership it is envisioned to be, so there was
little for families to remember. This may be related to the substantial
number of premature infants entering the system shortly after birth.

Other aspects of the IFSP process were generally perceived as positive.
Perceptions about who was seen as making decisions varied depending on
the decision. Goals and outcomes were overwhelmingly seen as joint
decisions between families and professionals. The kinds of services to
be provided were seen as joint decisions by two-thirds of the families.
On the other hand, about half the families felt professionals mostly
made the decisions on the amount of services. Most families were
satisfied with their level of involvement in the decisionmaking.

Families were generally pleased with the quality and quantity of the
early intervention services they were receiving. Families were asked to
rate their therapy services as well as their other early intervention
services with regard to both of these dimensions. They were also pleased
with the number of professionals working with the child. Over 90 percent
felt the help and information that had been provided to the family was
excellent or good. These ratings were offered within the first 4 months
of the family's experience with early intervention, but the data clearly
indicate that, for most families, their initial experiences with early
intervention are positive.

Table I-9

Families' Perceptions of Entering Early Intervention, the IFSP Process,

and the Initial Services Provided

  ---------------------------------------------------------- ------------
                                                             Percentage
                                                             of Families

  Entering Early Intervention                                

  Amount of effort required to find out where to go to try   
  to get early intervention services                         

  A lot of effort                                            11

  Some effort                                                14

  Little                                                     25

  No effort                                                  50

  Amount of effort to get services started                   

  A lot of effort                                            9

  Some effort                                                14

  Little                                                     34

  No effort                                                  43

  IFSP Process                                               

  Aware of a written plan that describes goals and services  

  Yes                                                        82

  No                                                         18

  Who came up with the goals or outcomes                     

  Mostly the family                                          7

  Mostly the professionals                                   12

  Family and professional together                           81

  Who decided on the kinds of services                       

  Mostly the family                                          9

  Mostly the professionals                                   27

  Family and professional together                           64

  Who decided on the amount of services                      

  Mostly the family                                          8

  Mostly the professionals                                   49

  Family and professional together                           41

  How family feels about involvement in decisionmaking       

  Wanted to be more involved                                 22

  Involved about the right amount                            77

  Wanted to be less involved                                 1

  Satisfaction with Initial Services                         

  Rating of amount of therapy                                

  More than needed                                           4

  About the right amount                                     76

  Less than needed                                           20

  Quality of therapy services                                

  Excellent                                                  60

  Good                                                       32

  Fair                                                       6

  Poor                                                       \<1

  Table I-9 (cont'd)                                         

                                                             Percentage
                                                             of Families

  Rating of amount of other early intervention services      

  More than needed                                           5

  About the right amount                                     82

  Less than needed                                           13

  Quality of other early intervention services               

  Excellent                                                  52

  Good                                                       45

  Fair                                                       6

  Poor                                                       1

  Rating of number of professionals working with child       

  Too many                                                   2

  About the right number                                     91

  Not enough                                                 7

  Rating of help and information family had received         

  Excellent                                                  56

  Good                                                       36

  Fair                                                       7

  Poor                                                       1
  ---------------------------------------------------------- ------------

Note: Numbers may not sum to 100 due to rounding.

Source: National Early Intervention Longitudinal Study.

# Conclusion

The information collected thus far in NEILS documents a relationship
between\
developmental characteristics, reasons why children are eligible for
services, and the age at which they enter the early intervention service
system. It remains to be seen how long-term child outcomes will relate
to these findings and other child, family, and service provision
characteristics.

Overall, families are satisfied with the services they are provided or
offered at the time their child enters early intervention. Continued
contact with parents will determine if the early intervention service
system is able to maintain this standard of meeting the needs of the
families of young children with disabilities.

# References

Bailey, D.B., Buysse, V., Edmondson, R., & Smith, T.M. (1992). Creating
family-centered services in early intervention: Perceptions of
professionals in four states. *Exceptional Children, 58*, 298-309.

Bailey, D.B., McWilliam, R.A., Darkes, L.A., Hebbeler, K., Simeonsson,
R.J., Spiker, D., & Wagner, M. (1998). Family outcomes in early
intervention: A framework for program evaluation and efficacy research.
*Exceptional Children, 64*, 313-328.

Diamond, A. (2000). Close interrelation of motor development and
cognitive development of the cerebellum and prefrontal cortex. *Child
Development*, 71, 44-56.

[^1]: This module is based, in part, on a synthesis of research funded
    by the U.S. Department of Education, Office of Special Education
    Programs, to the National Center on Secondary Education and
    Transition at the University of Minnesota (H326J000005). The
    National Center on Secondary Education and Transition is supported
    by a cooperative agreement from the Office of Special Education
    Programs, U.S. Department of Education.

[^2]: In terms of learning, universal design means the design of
    instructional materials and activities that allows the learning
    goals to be attainable by individuals with wide differences in their
    abilities. This means, for example, that a curriculum should include
    instructional and assessment alternatives to make it accessible and
    appropriate for individuals with diverse learning styles and
    abilities (Access to the General Education Curriculum,
    www.cast.org/ncac).

[^3]: The module does not include State-reported discipline data, which
    are available in Appendix A of this report.