The Dangers of Misdiagnosing Learning Disability Essay

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Educational Diagnosis

The ethical dilemma of diagnosing a learner with a disability when there are other alternatives for support

Resnik (2011) defines ethics as "norms for conduct that distinguish between acceptable and unacceptable behavior." As in research, participants have data source rights, so too in teaching/education do students, parents/guardians, teachers and staff have legal rights that should be observed and respected in the course of ethical adherence. These rights include all Constitutional rights, as Bonauto (2008) points out. Thus, students have the right to attend school in safety, without facing harassment or discrimination, and have the right to equal access under the Equal Access Act, which is a further identification of the student's right of protection against discrimination. Teachers also possess the right of non-discrimination and enjoy the right to free speech. Teachers also have something called "academic freedom" according to Hosford v. School Committee of Sandwich, which vied that "a 'no-nonsense' special needs teacher who had been terminated for a class discussion regarding the meaning and use of certain vulgar terms" should be re-instated, considering the students had brought up the terms themselves and her discussion of them was "factual" rather than "provocative" (Bonauto, 2008, p. 17).

Parents likewise have the same rights when it comes to how their children are treated in schools, what they are exposed to, and what the parent judges to be appropriate. Neglecting or dismissing a parent's concern can be a costly mistake for any teacher, staff member or school administrator (Dewey, 2013).

At the same time, making a diagnosis regarding special needs, learning disability or behavioral disability can leave a child with a stigma that may be carried from one state or school to the next, even if the same diagnostics do not apply in that state or school -- and this is a major ethical dilemma that should be considered before making a diagnosis of disability. A wrong diagnosis moreover can negatively impact both the life of the child and the life of the parent/guardian or caretaker. Likewise assessing disorders/disabilities is not easy or always even possible. As Wohr and Scattoni (2013) note, autism for example "is a behaviorally defined disorder" (p. 5). This means that it is only identified as a result of behavior exhibited by the student and observation by the diagnostician, who, it should go without saying, is fallible. After all, as Ollendick and Cerny (2010) observe, the method used to define behavior/disability and to assess treatments are so numerous that one could easily short-change a student if an improper rigor is used: for example, rating scales can be utilized as well as observation methods, IQ tests and the examination of "the social-cultural-physical environment" in which the child lives -- but none guarantees an absolutely accurate assessment (Ollendick, Cerny, 2010, p. 33). Indeed, language differences or "inadequate instruction" may just as easily explain why some students exhibit behaviors that have in the past been interpreted as symptoms of learning disability (Colorado Department of Education, 2011, p. 5).

Moreover, common errors made in the administration, scoring, and interpretation of tests depends upon adherence to reliable practices and guides. The concepts of reliability and validity are situated within the framework of the tests themselves, which serves to affect the field of testing by supporting it with data culled from participants. These tests are formed using principles such as standardization, objectivity, test norms, reliability and validity. In terms of reliability, tests are meant to have shown to have provided the same findings following several takings (Schultz, 2010) -- but not every assessor agrees with their reliability or their validity. And The fundamental questions regarding testing refer to the interpretive scores that these tests give, which may be open to interpretation, based on personal history, context, curve, etc. (Gregory, 2013). Because these interpretations can also be based on the type of framework utilized for coding the responses, the questions regarding the reliability and validity of these tests can be controversial or disputed if certain criteria are not met or followed precisely. In effect, testing requires a high degree of human element in the distribution of the test and the interpretation so there is always some possibility that a fallacy can be committed. Thus, the extent to which testing for disabilities is effective may be taken a hundred different ways.

Another of the ethical considerations to make when diagnosing a learner with a disability is the matter of consent. Diagnosticians should not take it upon themselves to perform a diagnostics test without first gaining consent from an informed guardian/parent.

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Gaining informed consent is a fairly common practice that alleviates the diagnostician of any possibility of overreach or conducting an assessment that parent or guardian might feel to be detrimental for the child, and it also helps to preserve the student's rights (Bournot-Trites, Belanger, 2005). At the same time, one way to better improve the odds of gaining consent is to engage the community in order to exchange in a two-way flow ideas about what it is the diagnostician does and why (Okello et al., 2013).

Other ethical problems that may occur are related to race, cultural or ethnic bias: as Reschly (1996) has reported, a disproportionate number of African-American students have been labeled with some form of learning disability or "diagnosed with mild mental retardation" and this may be more the result of "poverty, cultural bias, and inherent differences" between the students and the teachers -- though the phenomenon had not been fully or adequately understood at the time of Reschly's study (p. 41). Today, bias is much more acknowledged by researchers who have studied the phenomenon more closely in the twenty years that have passed since Reschly's assessment. As Richardson and Norris (2010) show, it is not uncommon to see disparities in care/treatment among racial groups as a result of bias.

Attending to these ethical concerns, especially when there are other means of support available to assist the struggling child at school, may help to alleviate the conditions that a misdiagnosis could cause. Consideration should be given to the student's background, his or her social and economic condition at home, his own academic history and the possible reasons for a lack of development that may point to external rather than internal causes, etc. In other words, it may behoove both student and teacher (as well as parent) to attempt to locate the problems demonstrated by the student in other areas that may have impacted the student along the way rather than focusing instead on a disability that may not have anything to do with the student's brain function or behavioral mechanisms on a biological level.

Part 2: The fact that disabilities, particularly mild disabilities, are a social construct

The fact that disabilities, particularly mild disabilities, are a social construct, is identified by various researchers such as Morgan (2006) who identify these social constructions as "psychic prisons": these occur when "favored ways of thinking and acting become traps that confine individuals within socially constructed worlds and prevent the emergence of other worlds" (Morgan, 2006, p. 211). When this occurs, a psychic prison has been manifested. This prison is similar to Plato's allegory of the cave in that those trapped within the organizational culture cannot see the world outside it and therefore are not in a position to break free from the cultural chains that keep them from reaching forward and climbing upward towards a better and brighter understanding of themselves, their potential, and a more enlightened workplace environment.

As Liu (2010) notes, it is the main purpose of the "authentizotic" method of Kets de Vries to "bring the person back into the organization" (p. 192). This is essentially the basis of a transformational leadership development, in which individuals/stakeholders (whether students, teachers, staff or parents/guardians) within the school are recognized as human beings (rather than as problems that need to be addressed or fixed) and are thus both assisted and challenged to better themselves (rather than labeled as having a learning disability as the parent of a child who has said disability). Avoiding such terms and the possibility of stigma and/or negative repercussion of an inappropriate or misdiagnosis is in line with what the goal of a "healthy" organization should be (Vries, 1999, p. 275). But in a psychic prison, an organization or school does not recognize or see the importance of its own life force (because it unfortunately views itself in terms of the social construction, identifying persons by labels rather than as persons). When an organization or school places the individual needs above the needs of the organization/school (such as a teacher's need to feel in control, a staff member's need to see administrative efficiency, a parent's need to see that a student is properly being assessed and/or understood), it breaks free from the psychic prison, and transforms itself, functionally speaking, into the type of paradigm promoted by Plato when he sends his philosopher out of the cave and up the mountain of truth. In short, diagnosticians should see students as.....

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