Prosopagnosia

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Prosopagnosia 

 

Prosopagnosia
Other names	Face blindness
The fusiform face area, the part of the brain associated with facial recognition
Pronunciation	/ˌprɒsəpæɡˈnoʊziə/
Specialty	Neurology

Prosopagnosia (from Greek prósōpon, meaning "face", and agnōsía, meaning "non-knowledge"), also called face blindness, is a cognitive disorder of face perception in which the ability to recognize familiar faces, including one's own face (self-recognition), is impaired, while other aspects of visual processing (e.g., object discrimination) and intellectual functioning (e.g., decision-making) remain intact. The term originally referred to a condition following acute brain damage (acquired prosopagnosia), but a congenital or developmental form of the disorder also exists, with a prevalence rate of 2.5%. The specific brain area usually associated with prosopagnosia is the fusiform gyrus, which activates specifically in response to faces. The functionality of the fusiform gyrus allows most people to recognize faces in more detail than they do similarly complex inanimate objects. For those with prosopagnosia, the new method for recognizing faces depends on the less sensitive object-recognition system. The right hemisphere fusiform gyrus is more often involved in familiar face recognition than the left. It remains unclear whether the fusiform gyrus is only specific for the recognition of human faces or if it is also involved in highly trained visual stimuli.

Acquired prosopagnosia results from occipito-temporal lobe damage and is most often found in adults. This is further subdivided into apperceptive and associative prosopagnosia. In congenital prosopagnosia, the individual never adequately develops the ability to recognize faces.

Though there have been several attempts at remediation, no therapies have demonstrated lasting real-world improvements across a group of prosopagnosics. Prosopagnosics often learn to use "piecemeal" or "feature-by-feature" recognition strategies. This may involve secondary clues such as clothing, gait, hair color, skin color, body shape, and voice. Because the face seems to function as an important identifying feature in memory, it can also be difficult for people with this condition to keep track of information about people, and socialize normally with others. Prosopagnosia has also been associated with other disorders that are associated with nearby brain areas: left hemianopsia (loss of vision from left side of space, associated with damage to the right occipital lobe), achromatopsia (a deficit in color perception often associated with unilateral or bilateral lesions in the temporo-occipital junction) and topographical disorientation (a loss of environmental familiarity and difficulties in using landmarks, associated with lesions in the posterior part of the parahippocampal gyrus and anterior part of the lingual gyrus of the right hemisphere).

The opposite of prosopagnosia is the skill of superior face recognition ability. People with this ability are called "super recognizers".

Types

Apperceptive

Apperceptive prosopagnosia has typically been used to describe cases of acquired prosopagnosia with some of the earliest processes in the face perception system. The brain areas thought to play a critical role in apperceptive prosopagnosia are right occipital temporal regions. People with this disorder cannot make any sense of faces and are unable to make same–different judgments when they are presented with pictures of different faces. They are unable to recognize both familiar and unfamiliar faces. In addition, apperceptive sub-types of prosopagnosia struggle recognizing facial emotion. However, they may be able to recognize people based on non-face clues such as their clothing, hairstyle, skin color, or voice. Apperceptive prosopagnosia is believed to be associated with impaired fusiform gyrus. It is interesting that experiments on the formation of new face detectors in adults on face-like stimuli (learning to distinguish the faces of cats) indicate that such new detectors are formed not in the fusiform, but in the lingual gyrus.

Associative

Associative prosopagnosia has typically been used to describe cases of acquired prosopagnosia with spared perceptual processes but impaired links between early face perception processes and the semantic information we hold about people in our memories. Right anterior temporal regions may also play a critical role in associative prosopagnosia. People with this form of the disorder may be able to tell whether photos of people's faces are the same or different and derive the age and sex from a face (suggesting they can make sense of some face information) but may not be able to subsequently identify the person or provide any information about them such as their name, occupation, or when they were last encountered. Associative prosopagnosia is thought to be due to impaired functioning of the parahippocampal gyrus.

Developmental

Developmental prosopagnosia (DP), also called congenital prosopagnosia (CP), is a face-recognition deficit that is lifelong, manifesting in early childhood, and that cannot be attributed to acquired brain damage. While developmental prosopagnosia begins early in life, many people do not realize that they have DP until later in their adult lives. A number of studies have found functional deficits in DP both on the basis of EEG measures and fMRI. It has been suggested that a genetic factor is responsible for the condition. The term "hereditary prosopagnosia" was introduced if DP affected more than one family member, essentially accenting the possible genetic contribution of this condition. To examine this possible genetic factor, 689 randomly selected students were administered a survey in which seventeen developmental prosopagnosics were quantifiably identified. Family members of fourteen of the DP individuals were interviewed to determine prosopagnosia-like characteristics, and in all fourteen families, at least one other affected family member was found.

In 2005, a study led by Ingo Kennerknecht showed support for the proposed congenital disorder form of prosopagnosia. This study provides epidemiological evidence that congenital prosopagnosia is a frequently occurring cognitive disorder that often runs in families. The analysis of pedigree trees formed within the study also indicates that the segregation pattern of hereditary prosopagnosia (HPA) is fully compatible with autosomal dominant inheritance. This mode of inheritance explains why HPA is so common among certain families (Kennerknecht et al. 2006).

Cause

Prosopagnosia can be caused by lesions in various parts of the inferior occipital areas (occipital face area), fusiform gyrus (fusiform face area), and the anterior temporal cortex. Positron emission tomography (PET) and fMRI scans have shown that, in individuals without prosopagnosia, these areas are activated specifically in response to face stimuli. The inferior occipital areas are mainly involved in the early stages of face perception and the anterior temporal structures integrate specific information about the face, voice, and name of a familiar person.

Acquired prosopagnosia can develop as the result of several neurologically damaging causes. Vascular causes of prosopagnosia include posterior cerebral artery infarcts (PCAIs) and hemorrhages in the infero-medial part of the temporo-occipital area. These can be either bilateral or unilateral, but if they are unilateral, they are almost always in the right hemisphere. Recent studies have confirmed that right hemisphere damage to the specific temporo-occipital areas mentioned above is sufficient to induce prosopagnosia. MRI scans of patients with prosopagnosia showed lesions isolated to the right hemisphere, while fMRI scans showed that the left hemisphere was functioning normally. Unilateral left temporo-occipital lesions result in object agnosia, but spare face recognition processes, although a few cases have been documented where left unilateral damage resulted in prosopagnosia. It has been suggested that these face recognition impairments caused by left hemisphere damage are due to a semantic defect blocking retrieval processes that are involved in obtaining person-specific semantic information from the visual modality.

Other less common etiologies include carbon monoxide poisoning, temporal lobectomy, encephalitis, neoplasm, right temporal lobe atrophy, injury, Parkinson's disease, Alzheimer's disease, and autism spectrum disorder.

Diagnosis

There are few neuropsychological assessments that can definitively diagnose prosopagnosia. One commonly used test is the famous faces tests, where individuals are asked to recognize the faces of famous persons. However, this test is difficult to standardize. The Benton Facial Recognition Test (BFRT) is another test used by neuropsychologists to assess face recognition skills. Individuals are presented with a target face above six test faces and are asked to identify which test face matches the target face. The images are cropped to eliminate hair and clothes, as many people with prosopagnosia use hair and clothing cues to recognize faces. Both male and female faces are used during the test. For the first six items only one test face matches the target face; during the next seven items, three of the test faces match the target faces and the poses are different. The reliability of the BFRT was questioned when a study conducted by Duchaine and Nakayama showed that the average score for 11 self-reported prosopagnosics was within the normal range.

The test may be useful for identifying patients with apperceptive prosopagnosia, since this is mainly a matching test and they are unable to recognize both familiar and unfamiliar faces. They would be unable to pass the test. It would not be useful in diagnosing patients with associative prosopagnosia since they are able to match faces.

The Cambridge Face Memory Test (CFMT) was developed by Duchaine and Nakayama to better diagnose people with prosopagnosia. This test initially presents individuals with three images each of six different target faces. They are then presented with many three-image series, which contain one image of a target face and two distracters. Duchaine and Nakayama showed that the CFMT is more accurate and efficient than previous tests in diagnosing patients with prosopagnosia. Their study compared the two tests and 75% of patients were diagnosed by the CFMT, while only 25% of patients were diagnosed by the BFRT. However, similar to the BFRT, patients are being asked to essentially match unfamiliar faces, as they are seen only briefly at the start of the test. The test is not currently widely used and will need further testing before it can be considered reliable.

The 20-item Prosopagnosia Index (PI20) is a freely available and validated self-report questionnaire that can be used alongside computer-based face recognition tests to help identify individuals with prosopagnosia. It has been validated using objective measures of face perception ability including famous face recognition tests and the Cambridge Face Memory Test. Less than 1.5% of the general population score above 65 on the PI20 and less than 65% on the CFMT.

Treatment

There are no widely accepted treatments.

Prognosis

Management strategies for acquired prosopagnosia, such as a person who has difficulty recognizing people's faces after a stroke, generally have a low rate of success. Acquired prosopagnosia sometimes spontaneously resolves on its own.

History

Selective inabilities to recognize faces were documented as early as the 19th century, and included case studies by Hughlings Jackson and Charcot. However, it was not named until the term prosopagnosia was first used in 1947 by Joachim Bodamer [de], a German neurologist. He described three cases, including a 24-year-old man who suffered a bullet wound to the head and lost his ability to recognize his friends, family, and even his own face. However, he was able to recognize and identify them through other sensory modalities such as auditory, tactile, and even other visual stimuli patterns (such as gait and other physical mannerisms). Bodamer gave his paper the title Die Prosop-Agnosie, derived from Classical Greek πρόσωπον (prósōpon) meaning "face" and αγνωσία (agnōsía) meaning "non-knowledge". In October 1996, Bill Choisser began popularizing the term face blindness for this condition; the earliest-known use of the term is in an 1899 medical paper.

A case of a prosopagnosia is "Dr P." in Oliver Sacks' 1985 book The Man Who Mistook His Wife for a Hat, though this is more properly considered to be one of a more general visual agnosia. Although Dr P. could not recognize his wife from her face, he was able to recognize her by her voice. His recognition of pictures of his family and friends appeared to be based on highly specific features, such as his brother's square jaw and big teeth. Oliver Sacks himself suffered from prosopagnosia, but did not know it for much of his life.

The study of prosopagnosia has been crucial in the development of theories of face perception. Because prosopagnosia is not a unitary disorder (i.e., different people may show different types and levels of impairment), it has been argued that face perception involves a number of stages, each of which can cause qualitative differences in impairment that different persons with prosopagnosia may exhibit.

This sort of evidence has been crucial in supporting the theory that there may be a specific face perception system in the brain. Most researchers agree that the facial perception process is holistic rather than featural, as it is for perception of most objects. A holistic perception of the face does not involve any explicit representation of local features (i.e., eyes, nose, mouth, etc.), but rather considers the face as a whole. Because the prototypical face has a specific spatial layout (eyes are always located above nose, and nose located above mouth), it is beneficial to use a holistic approach to recognize individual/specific faces from a group of similar layouts. This holistic processing of the face is exactly what is damaged in prosopagnosics. They are able to recognize the specific spatial layout and characteristics of facial features, but they are unable to process them as one entire face. This is counterintuitive to many people, as not everyone believes faces are "special" or perceived in a different way from other objects in the rest of the world. Though evidence suggests that other visual objects are processed in a holistic manner (e.g., dogs in dog experts), the size of these effects are smaller and are less consistently demonstrated than with faces. In a study conducted by Diamond and Carey, they showed this to be true by performing tests on dog-show judges. They showed pictures of dogs to the judges and to a control group and they then inverted those same pictures and showed them again. The dog-show judges had greater difficulty in recognizing the dogs once inverted compared to the control group; the inversion effect, the increased difficulty in recognizing a picture once inverted, was shown to be in effect. It was previously believed that the inversion effect was associated only with faces, but this study shows that it may apply to any category of expertise.

It has also been argued that prosopagnosia may be a general impairment in understanding how individual perceptual components make up the structure or gestalt of an object. Psychologist Martha Farah has been particularly associated with this view.

Children

Developmental prosopagnosia can be a difficult thing for a child to both understand and cope with. Many adults with developmental prosopagnosia report that for a long time they had no idea that they had a deficit in face processing, unaware that others could distinguish people solely on facial differences.

Prosopagnosia in children may be overlooked; they may just appear to be very shy or slightly odd due to their inability to recognize faces. They may also have a hard time making friends, as they may not recognize their classmates. They often make friends with children who have very clear, distinguishing features.

Children with prosopagnosia may also have difficulties following the plots of television shows and movies, as they have trouble recognizing the different characters. They tend to gravitate towards cartoons, in which characters have simple but well-defined characteristics, and tend to wear the same clothes, may be strikingly different colours or even different species. Prosopagnosiac children even have a hard time telling family members apart, or recognizing people out of context (e.g., the teacher in a grocery store). Some have difficulty recognising themselves in group photographs.

Additionally, children with prosopagnosia can have a difficult time at school, as many school professionals are not well versed in prosopagnosia, if they are aware of the disorder at all. Recently, a database of children's faces and test for child face perception has been developed, which may offer professionals a way to evaluate if a child has prosopagnosia.

 

Learning disability

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Learning_disability 

Learning disability
Other names	Learning difficulties, Developmental academic disorder, Nonverbal learning disorder, Developmental disorder of scholastic skills, unspecified, Knowledge acquisition disability NOS, Learning disability NOS, Learning disorder NOS
People at a Learning Disabilities Month event
Specialty	Psychiatry, Neurology

Learning disability, learning disorder, or learning difficulty (British English) is a condition in the brain that causes difficulties comprehending or processing information and can be caused by several different factors. Given the "difficulty learning in a typical manner", this does not exclude the ability to learn in a different manner. Therefore, some people can be more accurately described as having a "learning difference", thus avoiding any misconception of being disabled with a lack of ability to learn and possible negative stereotyping. In the United Kingdom, the term "learning disability" generally refers to an intellectual disability, while difficulties such as dyslexia and dyspraxia are usually referred to as "learning difficulties".

While learning disability and learning disorder are often used interchangeably, they differ in many ways. Disorder refers to significant learning problems in an academic area. These problems, however, are not enough to warrant an official diagnosis. Learning disability, on the other hand, is an official clinical diagnosis, whereby the individual meets certain criteria, as determined by a professional (such as a psychologist, psychiatrist, speech language pathologist, or pediatrician). The difference is in degree, frequency, and intensity of reported symptoms and problems, and thus the two should not be confused. When the term "learning disorder" is used, it describes a group of disorders characterized by inadequate development of specific academic, language, and speech skills. Types of learning disorders include reading (dyslexia), arithmetic (dyscalculia) and writing (dysgraphia).

The unknown factor is the disorder that affects the brain's ability to receive and process information. This disorder can make it problematic for a person to learn as quickly or in the same way as someone who is not affected by a learning disability. People with a learning disability have trouble performing specific types of skills or completing tasks if left to figure things out by themselves or if taught in conventional ways.

Individuals with learning disabilities can face unique challenges that are often pervasive throughout the lifespan. Depending on the type and severity of the disability, interventions, and current technologies may be used to help the individual learn strategies that will foster future success. Some interventions can be quite simplistic, while others are intricate and complex. Current technologies may require student training to be effective classroom supports. Teachers, parents, and schools can create plans together that tailor intervention and accommodations to aid the individuals in successfully becoming independent learners. A multi-disciplinary team frequently helps to design the intervention and to coordinate the execution of the intervention with teachers and parents. This team frequently includes school psychologists, special educators, speech therapists (pathologists), occupational therapists, psychologists, ESL teachers, literacy coaches, and/or reading specialists.

Definition

Representatives of organizations committed to the education and welfare of individuals with learning disabilities are known as National Joint Committee on Learning Disabilities (NJCLD). The NJCLD used the term 'learning disability' to indicate a discrepancy between a child's apparent capacity to learn and his or her level of achievement. Several difficulties existed, however, with the NJCLD standard of defining learning disability. One such difficulty was its belief of central nervous system dysfunction as a basis of understanding and diagnosing learning disability. This conflicted with the fact that many individuals who experienced central nervous system dysfunction, such as those with cerebral palsy, did not experience disabilities in learning. On the other hand, those individuals who experienced multiple handicapping conditions along with learning disability frequently received inappropriate assessment, planning, and instruction. The NJCLD notes that it is possible for learning disability to occur simultaneously with other handicapping conditions, however, the two should not be directly linked together or confused.

In the 1980s, NJCLD, therefore, defined the term learning disability as:

a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities. These disorders are intrinsic to the individual and presumed to be due to Central Nervous System Dysfunction. Even though a learning disability may occur concomitantly with other handicapping conditions (e.g. sensory impairment, intellectual disability, social and emotional disturbance) or environmental influences (e.g. cultural differences, insufficient/inappropriate instruction, psychogenic factors) it is not the direct result of those conditions or influences.

The 2002 LD Roundtable produced the following definition:

Concept of LD: Strong converging evidence supports the validity of the concept of specific learning disabilities (SLD). This evidence is particularly impressive because it converges across different indicators and methodologies. The central concept of SLD involves disorders of learning and cognition that are intrinsic to the individual. SLD are specific in the sense that these disorders each significantly affect a relatively narrow range of academic and performance outcomes. SLD may occur in combination with other disabling conditions, but they are not due primarily to other conditions, such as intellectual disability, behavioral disturbance, lack of opportunities to learn, or primary sensory deficits.

The issue of defining learning disabilities has generated significant and ongoing controversy. The term "learning disability" does not exist in DSM-IV, but it has been added to the DSM-5. The DSM-5 does not limit learning disorders to a particular diagnosis such as reading, mathematics, or written expression. Instead, it is a single diagnosis criterion describing drawbacks in general academic skills and includes detailed specifiers for the areas of reading, mathematics, and written expression.

United States and Canada

In the United States and Canada, the terms learning disability and learning disorder (LD) refer to a group of disorders that affect a broad range of academic and functional skills including the ability to speak, listen, read, write, spell, reason, organize information, and do math. People with learning disabilities generally have intelligence that is average or higher.

Legislation in the United States

The Section 504 of the Rehabilitation Act 1973, effective May 1977, guarantees certain rights to people with disabilities, especially in the cases of education and work, such being in schools, colleges and university settings.

The Individuals with Disabilities Education Act, formerly known as the Education for All Handicapped Children Act, is a United States federal law that governs how states and public agencies provide early intervention, special education and related services to children with disabilities. It addresses the educational needs of children with disabilities from birth to the age of 21. Considered as a civil rights law, states are not required to participate.

Canada

In Canada, the first association in support of children with learning disabilities was founded in 1962 by a group of concerned parents. Originally called the Association for Children with Learning Disabilities, the Learning Disabilities Association of Canada – LDAC was created to provide awareness and services for individuals with learning disabilities, their families, at work, and the community. Since education is largely the responsibility of each province and territory in Canada, provinces and territories have jurisdiction over the education of individuals with learning disabilities, which allows the development of policies and support programs that reflect the unique multicultural, linguistic, and socioeconomic conditions of its area.

United Kingdom

In the UK, terms such as specific learning difficulty (SpLD), developmental dyslexia, developmental coordination disorder and dyscalculia are used to cover the range of learning difficulties referred to in the United States as "learning disabilities". In the UK, the term "learning disability" refers to a range of developmental disabilities or conditions that are almost invariably associated with more severe generalized cognitive impairment. The Lancet defines 'learning disability' as a "significant general impairment in intellectual functioning acquired during childhood", and states that roughly one in 50 British adults have one.

Japan

In Japan, acknowledgement and support for students with learning disabilities has been a fairly recent development, and has improved drastically in the last decade. The first definition for learning disability was coined in 1999, and in 2001, the Enrichment Project for the Support System for Students with Learning Disabilities was established. Since then, there have been significant efforts to screen children for learning disabilities, provide follow-up support, and provide networking between schools and specialists.

Effects

The effects of having a learning disability or learning difference are not limited to educational outcomes: individuals with learning disabilities may experience social problems as well. Neuropsychological differences can affect the accurate perception of social cues with peers. Researchers argue persons with learning disabilities not only experience negative effects as a result of their learning distinctions, but also as a result of carrying a stigmatizing label. It has generally been difficult to determine the efficacy of special education services because of data and methodological limitations. Emerging research suggests adolescents with learning disabilities experience poorer academic outcomes even compared to peers who began high school with similar levels of achievement and comparable behaviors. It seems their poorer outcomes may be at least partially due to the lower expectations of their teachers; national data show teachers hold expectations for students labeled with learning disabilities that are inconsistent with their academic potential (as evidenced by test scores and learning behaviors). It has been said that there is a strong connection between children with a learning disability and their educational performance.

Many studies have been done to assess the correlation between learning disability and self-esteem. These studies have shown that an individual's self-esteem is indeed affected by his or her awareness of their learning disability. Students with a positive perception of their academic abilities generally tend to have higher self-esteem than those who do not, regardless of their actual academic achievement. However, studies have also shown that several other factors can influence self-esteem. Skills in non-academic areas, such as athletics and arts, improve self-esteem. Also, a positive perception of one's physical appearance has also been shown to have positive effects of self-esteem. Another important finding is that students with learning disabilities are able to distinguish between academic skill and intellectual capacity. This demonstrates that students who acknowledge their academic limitations but are also aware of their potential to succeed in other intellectual tasks see themselves as intellectually competent individuals, which increases their self-esteem.

Research involving individuals with learning disabilities who exhibit challenging behaviors who are subsequently treated with antipsychotic medications provides little evidence that any benefits outweigh the risk.

Causes

The causes for learning disabilities are not well understood, and sometimes there is no apparent cause for a learning disability. However, some causes of neurological impairments include:

Heredity and genetics

Learning disabilities are often linked through genetics and run in the family. Children who have learning disabilities often have parents who have the same struggles. Children of parents who had less than 12 years of school are more likely to have a reading disability. Some children have spontaneous mutations (i.e. not present in either parent) which can cause developmental disorders including learning disabilities. One study estimated that about one in 300 children had such spontaneous mutations, for example a fault in the CDK13 gene which is associated with learning and communication difficulties in the children affected.

Problems during pregnancy and birth

A learning disability can result from anomalies in the developing brain, illness or injury. Risk factors are fetal exposure to alcohol or drugs and low birth weight (3 pounds or less). These children are more likely to develop a disability in math or reading. Children who are born prematurely, late, have a longer labor than usual, or have trouble receiving oxygen are more likely to develop a learning disability.

Accidents after birth

Learning disabilities can also be caused by head injuries, malnutrition, or by toxic exposure (such as heavy metals or pesticides).

Diagnosis

IQ-achievement discrepancy

Learning disabilities can be identified by psychiatrists, speech language pathologists, school psychologists, clinical psychologists, counseling psychologists, neuropsychologists, speech language pathologists, and other learning disability specialists through a combination of intelligence testing, academic achievement testing, classroom performance, and social interaction and aptitude. Other areas of assessment may include perception, cognition, memory, attention, and language abilities. The resulting information is used to determine whether a child's academic performance is commensurate with his or her cognitive ability. If a child's cognitive ability is much higher than his or her academic performance, the student is often diagnosed with a learning disability. The DSM-IV and many school systems and government programs diagnose learning disabilities in this way (DSM-IV uses the term "disorder" rather than "disability").

Although the discrepancy model has dominated the school system for many years, there has been substantial criticism of this approach among researchers. Recent research has provided little evidence that a discrepancy between formally measured IQ and achievement is a clear indicator of LD. Furthermore, diagnosing on the basis of a discrepancy does not predict the effectiveness of treatment. Low academic achievers who do not have a discrepancy with IQ (i.e. their IQ scores are also low) appear to benefit from treatment just as much as low academic achievers who do have a discrepancy with IQ (i.e. their IQ scores are higher than their academic performance would suggest).

Since 1998 there have been attempts to create a reference index more useful than IQ to generate predicted scores on achievement tests. For example, for a student whose vocabulary and general knowledge scores matches his/her reading comprehension score a teacher could assume that reading comprehension can be supported through work in vocabulary and general knowledge. If the reading comprehension score is lower in the appropriate statistical sense it would be necessary to first rule out things like vision problems

Response to intervention

Much current research has focused on a treatment-oriented diagnostic process known as response to intervention (RTI). Researcher recommendations for implementing such a model include early screening for all students, placing those students who are having difficulty into research-based early intervention programs, rather than waiting until they meet diagnostic criteria. Their performance can be closely monitored to determine whether increasingly intense intervention results in adequate progress. Those who respond will not require further intervention. Those who do not respond adequately to regular classroom instruction (often called "Tier 1 instruction") and a more intensive intervention (often called "Tier 2" intervention) are considered "non-responders." These students can then be referred for further assistance through special education, in which case they are often identified with a learning disability. Some models of RTI include a third tier of intervention before a child is identified as having a learning disability.

A primary benefit of such a model is that it would not be necessary to wait for a child to be sufficiently far behind to qualify for assistance. This may enable more children to receive assistance before experiencing significant failure, which may, in turn, result in fewer children who need intensive and expensive special education services. In the United States, the 2004 reauthorization of the Individuals with Disabilities Education Act permitted states and school districts to use RTI as a method of identifying students with learning disabilities. RTI is now the primary means of identification of learning disabilities in Florida.

The process does not take into account children's individual neuropsychological factors such as phonological awareness and memory, that can inform design instruction. By not taking into account specific cognitive processes, RTI fails to inform educators about a students' relative strengths and weaknesses Second, RTI by design takes considerably longer than established techniques, often many months to find an appropriate tier of intervention. Third, it requires a strong intervention program before students can be identified with a learning disability. Lastly, RTI is considered a regular education initiative and consists of members of general education teachers, in conjunction with other qualified professionals. Occupational therapists (OT's) in particular can support students in the educational setting by helping children in academic and non-academic areas of school including the classroom, recess and meal time. They can provide strategies, therapeutic interventions, suggestions for adaptive equipment, and environmental modifications. OT's can work closely with the child's teacher and parents to facilitate educational goals specific to each child under an RTI and/or IEP.

Latino English language learners

Demographers in the United States report that there has been a significant increase in immigrant children in the United States over the past two decades. This information is vital because it has been and will continue to affect both students and how educators approach teaching methods. Various teaching strategies are more successful for students that are linguistic or culturally diverse versus traditional methods of teaching used for students whose first language is English. It is then also true that the proper way to diagnose a learning disability in English language learners (ELL) differs. In the United States, there has been a growing need to develop the knowledge and skills necessary to provide effective school psychological services, specifically for those professionals who work with immigrant populations.

Currently, there are no standardized guidelines for the process of diagnosing English language learners (ELL) with specific learning disabilities (SLD). This is a problem since many students will fall through the cracks as educators are unable to clearly assess if a student's delay is due to a language barrier or true learning disability. With an unclear diagnosis, many students will suffer because they will not be provided with the tools they need to succeed in the public education school system. For example, in many occasions teachers have suggested retention or have taken no action at all when they lack experience working with English language learners. Students were commonly pushed toward testing, based on an assumption that their poor academic performance or behavioral difficulties indicated a need for special education. Linguistically responsive psychologist understand that second language acquisition is a process and they understand how to support ELLs' growth in language and academically. When ELLs are referred for a psychoeducational assessment, it is difficult to isolate and disentangle what are the effects of the language acquisition process, from poor quality educational services, from what may be academic difficulties that result from processing disorders, attention problems, and learning disabilities. Additionally not having trained staff and faculty becomes more of an issue when staff is unaware of numerous types of psychological factors that immigrant children in the U.S dealing could be potentially dealing with. These factors that include acculturation, fear and/or worry of deportation, separation from social supports such as parents, language barriers, disruptions in learning experiences, stigmatization, economic challenge, and risk factors associated with poverty. In the United States, there are no set policies mandating that all districts employ bilingual school psychologist, nor are schools equipped with specific tools and resources to assist immigrant children and families. Many school districts do not have the proper personnel that is able to communicate with this population.

Spanish-speaking ELL

A well trained bilingual school psychologist will be able to administer and interpret assessment all psychological testing tool. Also, an emphasis is placed on informal assessment measures such as language samples, observations, interviews, and rating scales as well as curriculum-based measurement to complement information gathered from formal assessments. A compilation of these tests is used to assess whether an ELL student has a learning disability or merely is academically delayed because of language barriers or environmental factors. It is very unfortunate that many schools do not have school psychologist with the proper training nor access to appropriate tools. Also, many school districts frown upon taking the appropriate steps to diagnosing ELL students.

Assessment

Many normed assessments can be used in evaluating skills in the primary academic domains: reading, including word recognition, fluency, and comprehension; mathematics, including computation and problem solving; and written expression, including handwriting, spelling and composition.

The most commonly used comprehensive achievement tests include the Woodcock-Johnson IV (WJ IV), Wechsler Individual Achievement Test II (WIAT II), the Wide Range Achievement Test III (WRAT III), and the Stanford Achievement Test–10th edition. These tests include measures of many academic domains that are reliable in identifying areas of difficulty.

In the reading domain, there are also specialized tests that can be used to obtain details about specific reading deficits. Assessments that measure multiple domains of reading include Gray's Diagnostic Reading Tests–2nd edition (GDRT II) and the Stanford Diagnostic Reading Assessment. Assessments that measure reading subskills include the Gray Oral Reading Test IV – Fourth Edition (GORT IV), Gray Silent Reading Test, Comprehensive Test of Phonological Processing (CTOPP), Tests of Oral Reading and Comprehension Skills (TORCS), Test of Reading Comprehension 3 (TORC-3), Test of Word Reading Efficiency (TOWRE), and the Test of Reading Fluency. A more comprehensive list of reading assessments may be obtained from the Southwest Educational Development Laboratory.

The purpose of assessment is to determine what is needed for intervention, which also requires consideration of contextual variables and whether there are comorbid disorders that must also be identified and treated, such as behavioral issues or language delays. These contextual variables are often assessed using parent and teacher questionnaire forms that rate the students' behaviors and compares them to standardized norms.

However, caution should be made when suspecting the person with a learning disability may also have dementia, especially as people with Down's syndrome may have the neuroanatomical profile but not the associated clinical signs and symptoms. Examination can be carried out of executive functioning as well as social and cognitive abilities but may need adaptation of standardized tests to take account of special needs.

Types

Learning disabilities can be categorized by either the type of information processing affected by the disability or by the specific difficulties caused by a processing deficit.

By stage of information processing

Learning disabilities fall into broad categories based on the four stages of information processing used in learning: input, integration, storage, and output. Many learning disabilities are a compilation of a few types of abnormalities occurring at the same time, as well as with social difficulties and emotional or behavioral disorders.

Input

This is the information perceived through the senses, such as visual and auditory perception. Difficulties with visual perception can cause problems with recognizing the shape, position, or size of items seen. There can be problems with sequencing, which can relate to deficits with processing time intervals or temporal perception. Difficulties with auditory perception can make it difficult to screen out competing sounds in order to focus on one of them, such as the sound of the teacher's voice in a classroom setting. Some children appear to be unable to process tactile input. For example, they may seem insensitive to pain or dislike being touched.

Integration

This is the stage during which perceived input is interpreted, categorized, placed in a sequence, or related to previous learning. Students with problems in these areas may be unable to tell a story in the correct sequence, unable to memorize sequences of information such as the days of the week, able to understand a new concept but be unable to generalize it to other areas of learning, or able to learn facts but be unable to put the facts together to see the "big picture." A poor vocabulary may contribute to problems with comprehension.

Storage

Problems with memory can occur with short-term or working memory, or with long-term memory. Most memory difficulties occur with one's short-term memory, which can make it difficult to learn new material without more repetitions than usual. Difficulties with visual memory can impede learning to spell.

Output

Information comes out of the brain either through words, that is, language output, or through muscle activity, such as gesturing, writing or drawing. Difficulties with language output can create problems with spoken language. Such difficulties include answering a question on demand, in which one must retrieve information from storage, organize our thoughts, and put the thoughts into words before we speak. It can also cause trouble with written language for the same reasons. Difficulties with motor abilities can cause problems with gross and fine motor skills. People with gross motor difficulties may be clumsy, that is, they may be prone to stumbling, falling, or bumping into things. They may also have trouble running, climbing, or learning to ride a bicycle. People with fine motor difficulties may have trouble with handwriting, buttoning shirts, or tying shoelaces.

By function impaired

Deficits in any area of information processing can manifest in a variety of specific learning disabilities. It is possible for an individual to have more than one of these difficulties. This is referred to as comorbidity or co-occurrence of learning disabilities. In the UK, the term dual diagnosis is often used to refer to co-occurrence of learning difficulties.

Reading disorder (ICD-10 and DSM-IV codes: F81.0/315.00)

Reading disorder is the most common learning disability. Of all students with specific learning disabilities, 70–80% have deficits in reading. The term "Developmental Dyslexia" is often used as a synonym for reading disability; however, many researchers assert that there are different types of reading disabilities, of which dyslexia is one. A reading disability can affect any part of the reading process, including difficulty with accurate or fluent word recognition, or both, word decoding, reading rate, prosody (oral reading with expression), and reading comprehension. Before the term "dyslexia" came to prominence, this learning disability used to be known as "word blindness."

Common indicators of reading disability include difficulty with phonemic awareness—the ability to break up words into their component sounds, and difficulty with matching letter combinations to specific sounds (sound-symbol correspondence).

Disorder of written expression (ICD-10 and DSM-IV-TR codes 315.2)

Further information: Disorder of written expression

The DSM-IV-TR criteria for a disorder of written expression is writing skills (as measured by a standardized test or functional assessment) that fall substantially below those expected based on the individual's chronological age, measured intelligence, and age-appropriate education, (Criterion A). This difficulty must also cause significant impairment to academic achievement and tasks that require composition of written text (Criterion B), and if a sensory deficit is present, the difficulties with writing skills must exceed those typically associated with the sensory deficit, (Criterion C).

Individuals with a diagnosis of a disorder of written expression typically have a combination of difficulties in their abilities with written expression as evidenced by grammatical and punctuation errors within sentences, poor paragraph organization, multiple spelling errors, and excessively poor penmanship. A disorder in spelling or handwriting without other difficulties of written expression do not generally qualify for this diagnosis. If poor handwriting is due to an impairment in the individuals' motor coordination, a diagnosis of developmental coordination disorder should be considered.

By a number of organizations, the term "dysgraphia" has been used as an overarching term for all disorders of written expression.

Math disability (ICD-10 and DSM-IV codes F81.2-3/315.1)

Further information: Dyscalculia

Sometimes called dyscalculia, a math disability involves difficulties such as learning math concepts (such as quantity, place value, and time), difficulty memorizing math facts, difficulty organizing numbers, and understanding how problems are organized on the page. Dyscalculics are often referred to as having poor "number sense".

Non ICD-10/DSM

• Nonverbal learning disability: Nonverbal learning disabilities often manifest in motor clumsiness, poor visual-spatial skills, problematic social relationships, difficulty with mathematics, and poor organizational skills. These individuals often have specific strengths in the verbal domains, including early speech, large vocabulary, early reading and spelling skills, excellent rote memory and auditory retention, and eloquent self-expression.
• Disorders of speaking and listening: Difficulties that often co-occur with learning disabilities include difficulty with memory, social skills and executive functions (such as organizational skills and time management).

Management

Spell checkers are one tool for managing learning disabilities.

Interventions include:

• Mastery model:
  • Learners work at their own level of mastery.
  • Practice
  • Gain fundamental skills before moving onto the next level
    • Note: this approach is most likely to be used with adult learners or outside the mainstream school system.
• Direct instruction:
  • Emphasizes carefully planned lessons for small learning increments
  • Scripted lesson plans
  • Rapid-paced interaction between teacher and students
  • Correcting mistakes immediately
  • Achievement-based grouping
  • Frequent progress assessments
• Classroom adjustments:
  • Special seating assignments
  • Alternative or modified assignments
  • Modified testing procedures
  • Quiet environment
• Special equipment:
  • Word processors with spell checkers and dictionaries
  • Text-to-speech and speech-to-text programs
  • Talking calculators
  • Books on tape
  • Computer-based activities
• Classroom assistants:
  • Note-takers
  • Readers
  • Proofreaders
  • Scribes
• Special education:
  • Prescribed hours in a resource room
  • Placement in a resource room
  • Enrollment in a special school or a separate classroom in a regular school for learning disabled students
  • Individual education plan (IEP)
  • Educational therapy

Sternberg has argued that early remediation can greatly reduce the number of children meeting diagnostic criteria for learning disabilities. He has also suggested that the focus on learning disabilities and the provision of accommodations in school fails to acknowledge that people have a range of strengths and weaknesses, and places undue emphasis on academic success by insisting that people should receive additional support in this arena but not in music or sports. Other research has pinpointed the use of resource rooms as an important—yet often politicized component of educating students with learning disabilities.

Society and culture

School laws

Schools in the United States have a legal obligation to new arrivals to the country, including undocumented students. The landmark Supreme Court ruling Plyler v. Doe (1982) grants all children, no matter their legal status, the right to a free education. This ruling suggests that as a country we acknowledge that we have a population of students with specific needs that differ from those of native speakers. Additionally specifically in regards to ELL's the supreme court ruling Lau v. Nichols (1974) stated that equal treatment in school did not mean equal educational opportunity. Thus if a school teaches a lesson in a language that students do not understand then they are effectively worthless. This ruling is also supported by English language development services provided in schools, but these rulings do not require the individuals that teach and provide services to have any specific training nor is licensing different from a typical teacher or services provider.

Critique of the medical model

Learning disability theory is founded in the medical model of disability, in that disability is perceived as an individual deficit that is biological in origin. Researchers working within a social model of disability assert that there are social or structural causes of disability or the assignation of the label of disability, and even that disability is entirely socially constructed. Since the turn of the 19th century, education in the United States has been geared toward producing citizens who can effectively contribute to a capitalistic society, with a cultural premium on efficiency and science. More agrarian cultures, for example, do not even use learning ability as a measure of adult adequacy, whereas the diagnosis of learning disabilities is prevalent in Western capitalistic societies because of the high value placed on speed, literacy, and numeracy in both the labor force and school system.

Culture

There are three patterns that are well known in regards to mainstream students and minority labels in the United States:

• "A higher percentage of minority children than of white children are assigned to special education";
• "within special education, white children are assigned to less restrictive programs than are their minority counterparts";
• "the data — driven by inconsistent methods of diagnosis, treatment, and funding — make the overall system difficult to describe or change”.

In the present day, it has been reported that white districts have more children from minority backgrounds enrolled in special education than they do majority students. “It was also suggested that districts with a higher percentage of minority faculty had fewer minority students placed in special education suggesting that 'minority students are treated differently in predominantly white districts than in predominantly minority districts'".

Educators have only recently started to look into the effects of culture on learning disabilities. If a teacher ignores a student's culturally diverse background, the student will suffer in the class. “The cultural repertoires of students from cultural learning disorder backgrounds have an impact on their learning, school progress, and behavior in the classroom”. These students may then act out and not excel in the classroom and will, therefore, be misdiagnosed: “Overall, the data indicates that there is a persistent concern regarding the misdiagnosis and inappropriate placement of students from diverse backgrounds in special education classes since the 1975”.

Social roots of learning disabilities in the U.S.

Learning disabilities have a disproportionate identification of racial and ethnic minorities and students who have low socioeconomic status (SES). While some attribute the disproportionate identification of racial/ethnic minorities to racist practices or cultural misunderstanding, others have argued that racial/ethnic minorities are overidentified because of their lower status. Similarities were noted between the behaviors of “brain-injured” and lower class students as early as the 1960s. The distinction between race/ethnicity and SES is important to the extent that these considerations contribute to the provision of services to children in need. While many studies have considered only one characteristic of the student at a time, or used district- or school-level data to examine this issue, more recent studies have used large national student-level datasets and sophisticated methodology to find that the disproportionate identification of African American students with learning disabilities can be attributed to their average lower SES, while the disproportionate identification of Latino youth seems to be attributable to difficulties in distinguishing between linguistic proficiency and learning ability. Although the contributing factors are complicated and interrelated, it is possible to discern which factors really drive disproportionate identification by considering a multitude of student characteristics simultaneously. For instance, if high SES minorities have rates of identification that are similar to the rates among high SES Whites, and low SES minorities have rates of identification that are similar to the rates among low SES Whites, we can know that the seemingly higher rates of identification among minorities result from their greater likelihood to have low SES. Summarily, because the risk of identification for White students who have low SES is similar to that of Black students who have low SES, future research and policy reform should focus on identifying the shared qualities or experiences of low SES youth that lead to their disproportionate identification, rather than focusing exclusively on racial/ethnic minorities. It remains to be determined why lower SES youth are at higher risk of incidence, or possibly just of identification, with learning disabilities.

Learning disabilities in adulthood

A common misconception about those with learning disabilities is that they outgrow it as they enter adulthood. This is often not the case and most adults with learning disabilities still require resources and care to help manage their disability. One resource available is the Adult Basic Education (ABE) programs, at the state level. ABE programs are allotted certain amounts of funds per state in order to provide resources for adults with learning disabilities. This includes resources to help them learn basic life skills in order to provide for themselves. ABE programs also provide help for adults who lack a high school diploma or an equivalent. These programs teach skills to help adults get into the workforce or into a further level of education. There is a certain pathway that these adults and instructors should follow in order to ensure these adults have the abilities needed to succeed in life. Some ABE programs offer GED preparation programs to support adults through the process to get a GED.  It is important to note that ABE programs do not always have the expected outcome on things like employment. Participants in ABE programs are given tools to help them succeed and get a job but, employment is dependent on more than just a guarantee of a job post-ABE. Employment varies based on the level of growth a participant experiences in an ABE program, the personality and behavior of the participant, and the job market they are entering into following completion of an ABE program. 

Another program to assist adults with disabilities are federal programs called "home and community based services" (HCBS). Medicaid funds these programs for many people through a fee waiver system, however, there are still lots of people on a stand-by list. These programs are primarily used for adults with Autism Spectrum Disorders.  HCBS programs offer service more dedicated to caring for the adult, not so much providing resources for them to transition into the workforce. Some services provided are: therapy, social skills training, support groups, and counseling. 

Contrast with other conditions

People with an IQ lower than 70 are usually characterized as having an intellectual disability and are not included under most definitions of learning disabilities because their difficulty in learning are considered to be related directly to their overall low intelligence.

Attention-deficit hyperactivity disorder (ADHD) is often studied in connection with learning disabilities, but it is not actually included in the standard definitions of learning disabilities. An individual with ADHD may struggle with learning, but he or she can often learn adequately once successfully treated for the ADHD. A person can have ADHD but not learning disabilities or have learning disabilities without having ADHD. The conditions can co-occur.

People diagnosed with ADHD sometimes have impaired learning. Some of the struggles people with ADHD have might include lack of motivation, high levels of anxiety, and the inability to process information. There are studies that suggest people with ADHD generally have a positive attitude toward academics and, with developed study skills, can perform just as well as individuals without learning disabilities. Also, using alternate sources of gathering information, such as websites, study groups, and learning centers, can help a person with ADHD be academically successful.

Some research is beginning to make a case for ADHD being included in the definition of LDs since it is being shown to have a strong effect on "executive functions" required for learning. This has not as yet affected any official definitions. Though, historically, ADHD was not clearly distinguished from other disabilities related to learning. Scientific research continues to explore the traits, struggles, and learning styles of those with ADHD.

Individuals with Disabilities Education Act

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Individuals_with_Disabilities_Education_Act 

 

Individuals with Disabilities Education Act

Long title	Individuals with Disabilities Education Act
Acronyms (colloquial)	IDEA
Enacted by	the 101st United States Congress
Citations
Public law	Pub.L. 101-476
Statutes at Large	104 Stat. 1142
Codification
Acts amended	Education for All Handicapped Children Act
Titles amended	20
U.S.C. sections amended	1400 et seq.
Legislative history
Introduced in the Senate as S.1824 by Tom Harkin (D–IA) on October 31, 1989 Committee consideration by Committee on Labor and Human Resources Passed the Senate on November 16, 1989 (voice vote) Passed the House on June 18, 1990 (without objection) Reported by the joint conference committee on October 1, 1990; agreed to by the Senate on October 2, 1990 (voice vote) and by the House on October 15, 1990 (voice vote) Signed into law by President George H.W. Bush on October 30, 1990
Major amendments
No Child Left Behind Act Individuals with Disabilities Education Improvement Act of 2004, P.L. 108-446
United States Supreme Court cases
Board of Ed. of the Hendrick Hudson Central School Dist. v. Rowley, 458 U.S. 176 (1982) Cedar Rapids Community School Dist. v. Garret F., 526 U.S. 66 (1999) Schaffer v. Weast, 546 U.S. 49 (2005) Arlington Central School Dist. Bd. of Ed. v. Murphy, 548 U.S. 291 (2006) Winkelman v. Parma City School Dist., 550 U.S. 516 (2007) Forest Grove School Dist. v. T.A., 557 U.S. 230 (2009) Endrew F. v. Douglas County School Dist. RE–1, No. 15-827, 580 U.S. ___ (2017)

The Individuals with Disabilities Education Act (IDEA) is a piece of American legislation that ensures students with a disability are provided with Free Appropriate Public Education (FAPE) that is tailored to their individual needs. IDEA was previously known as the Education for All Handicapped Children Act (EHA) from 1975 to 1990. In 1990, the United States Congress reauthorized EHA and changed the title to IDEA. Overall, the goal of IDEA is to provide children with disabilities the same opportunity for education as those students who do not have a disability.

IDEA is composed of four parts, the main two being part A and part B. Part A covers the general provisions of the law; Part B covers assistance for education of all children with disabilities; Part C covers infants and toddlers with disabilities, including children from birth to age three; and Part D consists of the national support programs administered at the federal level. Each part of the law has remained largely the same since the original enactment in 1975.

In practice, IDEA is composed of six main elements that illuminate its main points. These six elements are: Individualized Education Program (IEP); Free and Appropriate Public Education (FAPE); Least Restrictive Environment (LRE); Appropriate Evaluation; Parent and Teacher Participation; and Procedural Safeguards. To go along with those six main elements, there are also a few other important components that tie into IDEA: Confidentiality of Information, Transition Services, and Discipline. Throughout the years of IDEA's being reauthorized, these components have become key concepts when learning about IDEA.

Background and historical context

Historical context

In 1954, the established educational format in the United States of segregating black and white students into separate schools was declared unconstitutional by the United States Supreme Court in Brown v. Board of Education of Topeka. This declaration caused a great deal of unrest in the political sphere and marked a gateway moment in the Civil Rights Movement. Education was an important aspect of the Civil Rights Movement.

The 1960s and early 1970s were marked by strife in the United States, from the assassination of John F. Kennedy in 1963 to the Vietnam war ongoing from 1955 until 1975. On top of those events, the Civil Rights Movement was in full force in the United States. From schools being integrated to the Montgomery Bus Boycott, from Greensboro sit-ins to marches on Washington, equal rights for all was a prevalent ideal. President John F. Kennedy showed interest in cognitive impairment studies and President Lyndon Johnson used Federal funds to increase research on "at-risk" youth. Early intervention programs for children living in low socioeconomic situations, such as the Head Start Program, began showing up around the country. Education was soon at the forefront of many political agendas.

As of the early 1970s, U.S. public schools accommodated 1 out of 5 children with disabilities. Until that time, many states had laws that explicitly excluded children with certain types of disabilities from attending public school, including children who were blind, deaf, and children labeled "emotionally disturbed" or "mentally retarded." At the time, 3.5 million disabled children attended school but were "warehoused" in segregated facilities and received little or no effective instruction. More than 1 million children had no access to the public school system, with many of them living at state institutions where they received limited or no educational or rehabilitation services. About 75% of deaf or blind children attended state institutions.

Education for Handicapped Children (1975)

Main article: Education for All Handicapped Children Act

The first legislation to provide relief was the Rehabilitation Act of 1973.

Congress then enacted the Education for All Handicapped Children Act in 1975 to alleviate the financial burden created by litigation pursuant to the Rehabilitation Act. Public schools were required to evaluate handicapped children and create an educational plan with parent input so as to emulate as closely as possible the educational experience of non-disabled students. Students should be placed in the least restrictive environment, one that allows the maximum possible opportunity to interact with non-impaired students. Separate schooling may occur only when the nature or severity of the disability is such that instructional goals cannot be achieved in the regular classroom. Finally, the law contains a due-process clause that guarantees an impartial hearing to resolve conflicts between the parents of disabled children and the school system.

The act also required that school districts provide administrative procedures so that parents of disabled children could dispute decisions made about their children's education. Once the administrative efforts were exhausted, parents were then authorized to seek judicial review of the administration's decision.

IDEA (1990)

In 1990, the Individuals with Disabilities Education Act replaced the EHA in order to place more focus on the individual, as opposed to a condition that individual may have. The IDEA also had many improvements on the EHA, such as promoting research and technology development, details on transition programs for students post-high school and programs that educate children in their neighborhood schools, as opposed to separate schools.

By 2003 only 25% of deaf or blind children were educated at state institutions.

As of 2006, more than 6 million children in the U.S. receive special education services through IDEA.

Six pillars of IDEA

Individualized Education Program (IEP)

Main article: Individualized Education Program

The IDEA requires that public schools create an Individualized Education Program (IEP) for each student who is found to be eligible under both the federal and state eligibility/disability standards. The IEP describes the student's present levels of academic achievement and functional performance, and how the student's disabilities affect or would affect the child's involvement in the general education curriculum. The IEP also specifies the services to be provided and how often, and it specifies accommodations and modifications to be provided for the student.

The U.S. Supreme Court has described the IEP as "the centerpiece of the statute's education delivery system for disabled children". Honig v. Doe, 484 U.S. 305, 311 (1988) The IEP is the "basis for the handicapped child's entitlement to an individualized and appropriate education" and the school system must design the IEP "to meet the unique needs of each child with a disability." Phillip C. v. Jefferson County Bd. of Educ., 701 F. 3d 691, 694 (11th Cir. 2012), citing Doe v. Ala. State Dep't of Educ., 915 F.2d 651, 654 (11th Cir. 1990) and Winkelman v. Parma City Sch. Dist., 550 U.S. 516, 524 (2007). An IEP must be designed to meet the unique educational needs of that child in the Least Restrictive Environment appropriate to the needs of that child.

When a child qualifies for services, an IEP team is convened to design an education plan. In addition to the child's parents, the IEP team must include at least:

• one of the child's regular education teachers (if applicable);
• a special education teacher;
• someone who can interpret the educational implications of the child's evaluation, such as a school psychologist;
• any related service personnel deemed appropriate or necessary; and
• an administrator or CSE (Committee of Special Education) representative who has adequate knowledge of the availability of services in the district and the authority to commit those services on behalf of the child.

Parents are considered to be equal members of the IEP team along with the school staff. Based on the full educational evaluation results, this team collaborates to write for the individual child an IEP that will provide a free, appropriate public education.

Free Appropriate Public Education (FAPE)

Main article: Free Appropriate Public Education (FAPE)

Guaranteed by the IDEA, Free Appropriate Public Education (FAPE) is defined as "special education and related services that:

• A) are provided at the public's expense, under public supervision and direction, and without charge;
• B) meet the standards of the State educational agency;
• C) include an appropriate preschool, elementary, or secondary school education in the State involved; and
• D) are provided in conformity with the individualized education program under section 614(d). (Pub. L. No. 94-142, § 602(9))"

To provide FAPE, schools must provide students with an "education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment, and independent living."

The IDEA includes requirements that schools provide each disabled student an education that:

• is designed to meet the unique needs of that one student;
• provides "access to the general curriculum to meet the challenging expectations established for all children" (that is, it meets the approximate grade-level standards of the state educational agency.)
• is provided in accordance with the Individualized Education Plan (IEP) as defined in 1414(d)(3).
• results in educational benefit to the child.

Least restrictive environment (LRE)

Main article: Least restrictive environment

The U.S. Department of Education, 2005a regulations implementing IDEA requires that "to the maximum extent appropriate, children with disabilities including children in public or private institutions or care facilities, are educated with children who are nondisabled." The regulations further state that "special classes, separate schooling or other removals of children with disabilities from regular educational environment occurs only if the nature or severity of the disability is such that education in regular classes with the use of supplementary aids and services cannot be achieved satisfactorily." In other words, the Least Restrictive Environment (LRE) is the environment most like that of typical children in which the child with a disability can succeed academically (as measured by the specific goals in the student's IEP).

The court in Daniel R. R. v. State Board of Education, relying on Roncker, developed a two-part test for determining whether the LRE requirement is met:

1. Can an appropriate education in the general education classroom with the use of supplementary aids and services be achieved satisfactorily?
2. If a student is placed in a more restrictive setting, is the student "integrated" to the "maximum extent appropriate"? (Standard in AL, DE, GA, FL, LA, MS, NJ, PA, TX).

Appropriate evaluation

Children become eligible to receive special education and related services through an evaluation process. If the evaluation is not appropriately conducted or does not monitor the information that is needed to determine placement, it is not appropriate. The goal of IDEA's regulations for evaluation is to help minimize the number of misidentifications; to provide a variety of assessment tools and strategies; to prohibit the use of any single evaluation as the sole criterion of whether a student is placed in special education services; and to provide protections against evaluation measures that are racially or culturally discriminatory. Overall, the goal of appropriate evaluation is for students who need help to receive appropriate assistance and to help them reach the goals set by their respective IEP teams.

Parent and teacher participation

A good family-professional partnership is key for a student to receive the education necessary for success. Parents and teachers need to be willing to communicate and work together to determine the best ways of working with and providing information for a student. Both the family and the teacher work together on the IEP team to determine goals, the LRE, and to discuss other important considerations for each individual student. Throughout the whole IEP and special education process, parents and families should be updated and kept informed of any decisions made about their specific student. Parents should also be able to provide valuable input about their child to determine placement and other educational goals.

Procedural safeguard

Parents, as well as teachers, are able to challenge any decisions that they feel are inappropriate for the student. IDEA includes a set of procedural safeguards designed to protect the rights of children with disabilities and their families, and to ensure that children with disabilities receive a FAPE.

IDEA guarantees to parents the following access to information:

• Access to their child's educational records;
• Parent participation in all IEP team meetings regarding identification, placement, and educational decisions;
• Prior written notice (Anytime anything will be changed in a student's IEP, their parents must be notified first.);
• Procedural safeguards written notice;
• Understandable language (Translators must be provided when needed.);
• Informed consent (Before any evaluations or services are provided, the student's parents must be informed and agree in writing before the school can move forward.); and
• Right to request independent educational evaluations at public expense,

For parents who disagree with the school's decisions, IDEA outlines the following dispute resolution guidelines:

• "Stay Put" rights (If parents disagree with the school's decision, the student can stay put while the parents and school go through dispute resolution.)
• Mediation (This is an alternative to due-process hearings.)
• Due process hearings (If a parent has a dispute with the school about their student's special education placement or teaching, a process called due process is used to resolve issues; both parties are then able to tell their sides of the story in a court-like setting.)
• Civil litigation (If due-process results are not to the liking of the parent or the school, a civil lawsuit can be filed)

Other important issues

Litigation and costs

Several U.S. Supreme Court cases have outlined how litigation works under the IDEA. Parents have independent enforceable rights under the IDEA and may appear pro se on behalf of their children. Winkelman v. Parma City School District, 550 U.S. 516. Under the IDEA, the party that requests a hearing has the burden of proof in such an action. Schaffer v. Weast, 546 U.S. 49. Prevailing parents may not recover expert witness fees as part of the costs under 20 U.S.C.§ 1415(i)(3)(B). Arlington Central School Dist. Bd. of Ed. v. Murphy, 548 U.S. 291.

Confidentiality of information

Throughout the entire IEP process, the school must protect the confidentiality of the student. Some schools may think that providing a teacher with the IEP is a violation of the student's confidentiality, but the Family Educational Rights and Privacy Act States that "if the disclosure is to other school officials, including teachers, within the educational institution or local education agency who have been determined by the agency or institution to have legitimate educational interests", the school does not need written consent from a parent. For more information about confidentiality, see the Family Educational Rights and Privacy Act of 1974 (FERPA).

Transition services

At the age of 16, students are required to be invited to IEP meetings to discuss transition services with the IEP team. Transition services can be started earlier if the IEP team deems it necessary, but the student must be invited to the meeting or appropriate measures must be taken to account for student preference. Transition services coordinate the transition between school and post-school activities, such as secondary education, vocational training, employment, independent living, etc. These transitional decisions should be based on the student's strengths/weaknesses, preferences, and the skills possessed by the individual. Once a decision has been made on the transition service, a plan should be formed to allow the student to be able to fully reach this goal. In order for this to happen, objectives, instruction needed, and other skills should be assessed and taken into account to prepare the individual for this transition.

Discipline of a child with a disability

Pursuant to IDEA, when disciplining a child with a disability, one must take that disability into consideration to determine the appropriateness of the disciplinary actions. For example, if a child with Autism is sensitive to loud noises, and she runs out of a room filled with loud noises due to sensory overload, appropriate disciplinary measure for that behavior (running out of the room) must take into account the child's disability, such as avoiding punishments that involve loud noises. Moreover, an assessment should be made as to whether appropriate accommodations were in place to meet the needs of the child. According to the United States Department of Education, in cases of children with disabilities who have been suspended for 10 or more days for each school year (including partial days), the local education agency (LEA) must hold a manifestation determination hearing within 10 school days of any decision to change the placement of a child resulting from a violation of code of student conduct. The Stay Put law states that a child shall not be moved from their current placement or interim services into an alternative placement if the infraction was deemed to cause danger to other students. The LEA, the parent, and relevant members of the individualized education program (IEP) team (as determined by the parent and LEA) shall review all relevant information in the student's file, including the child's IEP, any teacher observations, and any relevant information provided by the parents to determine whether the conduct in question was:

• caused by, or had a direct and substantial relationship to, the child's disability; or
• the direct result of the LEA's failure to implement the IEP.

If the LEA, the parent, and relevant members of the IEP team make the determination that the conduct was a manifestation of the child's disability, the IEP team shall:

• conduct a functional behavioral assessment and implement a behavioral intervention plan for such child, provided that the LEA had not conducted such assessment prior to such determination before the behavior that resulted in a change in placement described in Section 615(k)(1)(C) or (G);
• in the situation where a behavioral intervention plan has been developed, review the behavioral intervention plan if the child already has such a behavioral intervention plan, and modify it, as necessary, to address the behavior; and
• except as provided in Section 615(k)(1)(G), return the child to the placement from which the child was removed, unless the parent and the LEA agree to a change of placement as part of the modification of the behavior intervention plan.

If it is determined that a student's behavior is a manifestation of their disability, then he or she may not be suspended or expelled. However, under IDEA 2004, if a student "brings a weapon to school or a school function; or knowingly possess, uses, or sells illegal drugs or controlled substances at school or a school function"; or causes "serious bodily injury upon another person," he or she may be placed in an interim alternate educational setting (IAES) for up to 45 school days. This placement allows the student to continue receiving educational services while the IEP team has time to determine the appropriate placement and the appropriate course of action including reviewing the FBA and the BIP.

Prohibition on mandatory medication

Due to allegations that school officials coerced parents into administering medication such as Ritalin to their child, an amendment to the IDEA was added called prohibition on mandatory medication. Schools may not require parents to obtain a controlled substance as a condition of:

• attending school
• receiving an evaluation or reevaluation
• receiving special education services

Alignment with No Child Left Behind

The reauthorization of IDEA in 2004 revised the statute to align with the requirements of the No Child Left Behind Act (NCLB). NCLB allows financial incentives to states who improve their special education services and services for all students. States who do not improve must refund these incentives to the federal government, allow parents choice of schools for their children, and abide by other provisions. Some states are still reluctant to educate students who are eligible for services under IDEA and seek remedies through the courts. However, IDEA and NCLB are still the laws of the land to date.

In looking to align NCLB and the 2004 reauthorization of IDEA, there are a few key areas of alignment: requirement of highly qualified teachers; an establishment of goals for students with disabilities; and assessment levels for these students. The alignment of NCLB and IDEA requires that all special education teachers be highly qualified. While the standards for being highly qualified may differ between state or school district, the minimum requirements are that a teacher hold a bachelor's degree from a four-year college, be certified and licensed to teach by the state and have taken the necessary tests to indicate competency in one's subject area, although special education teachers are often exempt from such testing. These requirements for highly qualified teachers do not always exist for private schools, elementary or secondary. Next, goals and assessments must be provided to align with students' educational needs. A state is allowed to develop alternate or modified assessments for students in special education programs, but benchmarks and progress must still be met on these tests that indicate adequate yearly progress (AYP). In addition, these goals and assessments must be aligned similarly to students enrolled in general education. Finally, in order to make AYP, schools may additionally require that schools meet state standards of student retention in terms of dropout rates and graduate rates for their special education students.

Early intervention

The Education for All Handicapped Children Act of 1975 started the course of action for early intervention programs. In this Act, public schools that received federal funding were required to provide equal access to education for children with disabilities. Services for infants and toddlers were not included in the Act until the reauthorization in 1986.

On September 6, 2011, the US Department of Education updated the IDEA to include specific interventions for children of ages 2 and under who have disabilities. This section of the IDEA is entitled Part C and serves children with developmental delays or children who have conditions that may lead to future developmental delays. Part C is a $436-million initiative that will be administered at the state level.

On September 28, 2011, the Department of Education published an article in the Federal Register detailing the updates that have been made to Part C of the IDEA. The regulations are effective on October 28, 2011. Major changes in the regulations are detailed below:

• The definition of multidisciplinary has been revised to respect aspects of an updated individualized family service plan (IFSP) team.
• Native language is the language normally used by the parents of the child for any child who is deemed limited English proficient.
• A state's application must include how the State plans to follow the payor-of-last-resort requirements in Section 303.511
• A state's application must distinguish between pre-referral, referral, and post-referral IFSP activities such as screening, evaluations, assessments, IFSP development, etc.
• Such an application must specify that early identification information be provided in the native languages of various population groups in the State.
• A state must report to the public the performance of each Early Intervention System program in relation to the State's Annual Performance Report.

More specific details on Early Intervention requirements are found below.

Part C of IDEA

Individualized Family Service Plan (IFSP)

An Individualized Family Service Plan (IFSP) is a strengths-based plan of care for the infant/toddler having a developmental delay or disability. The plan is based on a child and family assessment of strengths and needs as well as the results of multidisciplinary evaluations administered by qualified professionals meeting their state's certification guidelines. The IFSP is similar to an IEP in that it addresses specific services; who will provide them and when/where, how often, etc.; is monitored and updated frequently. Unlike an IEP, however, the IFSP addresses the needs of not only the child but also the family to meet their family goals and specified outcomes as relates to assisting in their child's development. All infants and toddlers receiving early intervention services under Part C of IDEA are required to have an IFSP in order to receive services. Part C of IDEA is the program that awards grants to every state in the United States to provide early intervention services to children from birth to age 3 who have disabilities and to their families. Part C of IDEA also allows states to define "developmental delay" (either as a standard deviation or a percent delay in chronological months) for eligibility. States provide early intervention services to the children who have medically diagnosed disabilities as well as children who exhibit developmental delays. Some states opt to expand services to "at risk" infants and toddlers and define in state statutes what constitutes a child at risk for developmental delay. In order to receive funding, participating states must provide early intervention to every eligible child and the respective family, regardless of pay source. Lastly, services from Part C are not necessarily free – early intervention programs, as the payor of last resort, make use of public and private insurance, community resources, and some states implement a "sliding scale" of fees for services not covered by public or private insurance.

Goals for an IFSP

The goal of an IFSP is to assist the family in meeting their child's developmental needs in order for the infant or toddler (birth to age three) to increase functional abilities, gain independence and mobility, and be an active participant in his/her family and community. Another goal of early intervention in general is to improve a child's functional abilities, particularly in the domains of communication, cognitive ability, and social/emotional well-being in preparation for preschool and later kindergarten so that extensive special education services will not be necessary for the child's academic success. Once an infant/toddler is determined eligible (each state setting its own eligibility requirements), the family identifies whom they would like to participate as part of the IFSP team. The Individuals with Disabilities Education Act (IDEA) Part C requires that the IFSP team consist of the family and at least two early intervention professionals from different disciplines (one being the service coordinator) – consistent with CFR §303.343(a)(1)(iv). However, the family may choose to include other members on the team such as the child's pediatrician, an early- intervention service provider who may be working with the child, a parent advocate or trusted friend/family member.

The IFSP team works with the family to create a "service plan" to address the deficits of the infant or toddler and to assist the family in meeting their goals for their child's (and family's) development. The team uses information that the family provides as well as the results of at least two evaluations, all available medical records, and the informed clinical opinion of the professionals serving on the IFSP team. An initial IFSP is then created with the family. An IFSP will outline the following:

1. the child's current levels of physical, cognitive, communication, social or emotional, and adaptive development;
2. the family's resources, priorities, and concerns to help in their child's development;
3. the desired end result for the child and for the family (goals/outcomes), as well as the steps needed to achieve said end result (objectives). The plan will be monitored and evaluated quarterly to gauge progress. If the family chooses to revise the goals or the plan, they include updates as revised additions to the plan.
4. the early intervention services for the child and the family, including how often and the method of how the child and the family will receive the services, the different environments in which the services will be provided and justification for services not provided in the "natural environment" as defined by IDEA (the location where a child without a disability would spend most of his/her time). For example, the family might have requested to receive services for the child at a day-care center or in their home.
5. the date the services will begin and their anticipated duration.
6. the identification of the service coordinator from the profession most immediately relevant to the infant's or toddler's family's needs, the person who will be responsible for the implementation and coordination of the plan with the other agencies and persons.
7. For toddlers approaching the third birthday, the IFSP will include a transition plan outlining the steps, activities, and services needed to support the transition of the toddler with a disability to preschool or other appropriate services.

In summary, a key to an effective IFSP is to include outcomes that "address the entire family's well-being and not only outcomes designed to benefit the child's development." For this reason, the IFSP will inherently have goals that are designed for the family as well as for the child. The service coordinator will help the early-intervention team of service providers write objectives that meet the family's priorities and concerns.

Differences between IFSP and IEP

When writing the IFSP for a child, the IFSP can (but will not always) outline services that are not one of the seventeen mandated early-intervention services under Part C of the IDEA. For example, a parent may need counseling services to overcome debilitating depression in order to better care for the infant or toddler, and these services will be written into the family's plan. The IEP (Individualized Education Plan) cannot include services to meet "family goals" but must focus solely on what the child needs to achieve academic success in an educational setting (whether the class or activity is academic or extra-curricular in nature).

The Individualized Family Service Plan is different compared to an Individual Education Plan in other key ways:

1. Eligibility for early intervention (birth to three) under Part C of IDEA is set by each state individually and is often different from eligibility for special education (3–21) under Part B of IDEA.
2. The IFSP will have goals and outcomes for the family and for the infant's/toddler's development.
3. Goals on the IFSP may be in non-academic areas of development such as mobility, self-care, and social/emotional well-being. The IEP has goals and outcomes for the child only and related entirely to his/her ability to adapt to and progress in an educational setting.
4. The IFSP includes services to help a family in natural environment settings (not just in daycare/preschool) but at home, in the community, etc. Services and activities on the IFSP could be tailored to include "nap time," "infant swimming lessons at the YMCA," "church outings," etc. The IEP provides services solely on what happens in a pre-school or K-5 school environment or school-sponsored field trip/activity
5. The IFSP team involves a service coordinator who assists the family in developing and implementing the IFSP. The IEP team also involves the family, but the school district generally does not provide a professional who represents them and provides case management/service coordination. The family will have to communicate with the special education department's designee.

Child Abuse Prevention and Treatment Act

The Keeping Children and Families Safe Act of 2003 (P.L. 108-36) amended CAPTA by requiring that cases of abused and neglected children, or those pre- or post-natally exposed to illegal substances, be referred to early intervention services using IDEA Part C funds. This provision is also reflected in the 2004 revision of IDEA. Specifically, states can apply for grant money from IDEA for specific identification and referral programs.

Abused and neglected children are included under IDEA part C due to the growing body of evidence showing increased risk of developmental delay among children in the child welfare system. In 2013, there were an estimated 679,000 victims of child abuse and neglect. Nearly half (47%) were five years or younger. The results of the 2008 National Survey of Child and Adolescent Well-Being (NSCAW) reported that children in Child Welfare had below average cognitive, behavioral, daily living, language, social-emotional and social skills compared to their peers. Slightly less than half of children five and under showed developmental delay. A social and emotional assessment given to caretakers of these children showed 34.1% had a possible problem, and 27.0% had a possible social/emotional deficit or delay compared to 25% and 15%, respectively, in a standardized population. Neurodevelopmentally, children in the child welfare system have risks similar to those of premature and low-birth-weight infants. Children in this population scored nearly one standard deviation below the mean of the early-cognitive-development tool used for assessment. Language skills fell almost one standard deviation below the norm as well. Overall, 42.6% of children aged one to five years showed a need for developmental support, making them potentially eligible for early intervention services.

In order to track the adherence to the law, the Child Abuse Prevention and Treatment Act Reauthorization Act of 2010 (P.L. 111-320) required that eligible children and those actually referred to EI be reported by each state beginning in 2014. A 2008 survey of 30 participating states by the IDEA Infant and Toddler Coordinators Association showed that 65% of children under three who are abused or neglected are being routinely screened for developmental delays. Fifty percent of respondents did not know whether their referrals for Part C had increased or decreased in the prior year. As noted by many respondents to this survey, the referral system needs more funding and better communication among child welfare personnel.

Relationship between IDEA and Section 504

Section 504 of the Rehabilitation Act of 1973 is another law which assures certain protections to certain students with disabilities. §504 states that:

"No otherwise qualified individual with a disability in the United States . . . shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance . . . .". 29 U.S.C. 794(a).

Recipients of this Federal financial assistance include public school districts, institutions of higher education, and other state and local education agencies. The regulations implementing Section 504 in the context of educational institutions appear at 34 C.F.R. Part 104 D. §504 applies to all programs or activities, including schools, that receive federal financial assistance. See 29 U.S.C. 794(b)(2)(B) (defining "program or activity" to include the operations of "local educational agenc[ies]").

Eligibility under §504 is different from that under IDEA. While IDEA recognizes thirteen categories of disability, §504 defines individuals with disabilities to include any individual with a physical or mental condition which substantially limits at least one major life activity. 29 U.S.C. 705(20). It also includes persons with a history of such a disability and those who are perceived to have a disability. Most, if not all, children eligible under IDEA are also entitled to §504's protections. Regulations promulgated by the Department of Education offer additional guidance regarding the statute's prohibitions in the context of this case. See 34 C.F.R. 104 et seq.

Like IDEA, §504's regulations include "child find" provisions. Thus, public school districts have an affirmative duty to identify and evaluate every qualified handicapped child residing in the recipient's jurisdiction who is not receiving a public education and take appropriate steps to notify handicapped persons and their parents or guardians of the recipient's duties under §504. 34 C.F.R. 104.32.

The Section 504 regulations require a school district to provide a "free appropriate public education" (FAPE) to each qualified student with a disability who is in the school district's jurisdiction, regardless of the nature or severity of the disability. Under Section 504, FAPE consists of the provision of regular or special education and related aids and services designed to meet the student's individual educational needs as adequately as the needs of nondisabled students are met.

Legislative history

1975 — The Education for All Handicapped Children Act (EAHCA) became law. It was renamed the Individuals with Disabilities Education Act (IDEA) in 1990.

1990— IDEA first came into being on October 30, 1990, when the "Education of All Handicapped Children Act" (itself having been introduced in 1975) was renamed "Individuals with Disabilities Education Act." (Pub. L. No. 101-476, 104 Stat. 1142). IDEA received minor amendments in October 1991 (Pub. L. No. 102-119, 105 Stat. 587).

1997— IDEA received significant amendments. The definition of disabled children expanded to include developmentally delayed children between three and nine years of age. It also required parents to attempt to resolve disputes with schools and Local Educational Agencies (LEAs) through mediation, and provided a process for doing so. The amendments authorized additional grants for technology, disabled infants and toddlers, parent training, and professional development. (Pub. L. No. 105-17, 111 Stat. 37).

2004— IDEA was amended by the Individuals With Disabilities Education Improvement Act of 2004, now known as IDEIA. Several provisions aligned IDEA with the No Child Left Behind Act of 2001, signed by President George W. Bush. It authorized fifteen states to implement 3-year IEPs on a trial basis when parents continually agree. Drawing on the report of the President's Commission on Excellence in Special Education, the law revised the requirements for evaluating children with learning disabilities. More concrete provisions relating to discipline of special education students were also added. (Pub. L. No. 108-446, 118 Stat. 2647).

2008— Americans with Disabilities Amendments Act was signed into law in September.

2009— Following a campaign promise for "funding the Individuals with Disabilities Education Act", President Barack Obama signed the American Recovery and Reinvestment Act of 2009 (ARRA), including $12.2 billion in additional funds.

2009— Americans with Disabilities Amendments Act became effective on January 1, 2009

Selected U.S. Supreme Court decisions

Cedar Rapids Community School Dist. v. Garret F.

Main article: Cedar Rapids Community School Dist. v. Garret F.

Cedar Rapids Community School Dist. v. Garret F. 526 U.S. 66 (1999) was a Supreme Court case in which the Court, relying heavily on Irving Independent School Dist. v. Tatro, 468 U. S. 883 (1984), ruled that the related IDEA services provision required public school districts to fund "continuous, one-on-one nursing care for disabled children" such as the ventilator-dependent child in this case, despite arguments from the school district concerning the costs of the services." There is no undue burden exemption. Under the Court's reading of the IDEA's relevant provisions, medical treatments such as suctioning, ventilator checks, catheterization, and others which can be administered by non-physician personnel come within the parameters of the special education law's related services. Disability advocates considered the Court decision to be a "substantial victory for families of children with disabilities." Amendments were made in the Education Flexibility Partnership Act of 1999 to increase IDEA funding as a result of the case.

Forest Grove School District v. T.A.

Main article: Forest Grove School District v. T. A.

The case of Forest Grove School District v. T.A., 129 S.Ct. 2484 (2009) addressed the issue of whether the parents of a student who has never received special education services from a public school district are potentially eligible for reimbursement of private school tuition for that student under the IDEA. The Supreme Court held that parents of disabled children can seek reimbursement for private education expenses regardless whether their child had previously received special-education services from a public school. By a vote of six to three, the Court held that the IDEA authorizes reimbursement whenever a public school fails to make a free appropriate public education (FAPE) available to a disabled child.

Endrew F. v. Douglas County School District

Main article: Endrew F. v. Douglas County School Dist. RE–1

Endrew F. v. Douglas County School District is a Supreme Court case about "the level of educational benefit school districts must provide students with disabilities as defined by IDEA. The case is described by advocates as "the most significant special-education issue to reach the high court in three decades." On March 22, 2017, the Supreme Court ruled 8-0 in favor of students with disabilities saying that meaningful, "appropriately ambitious" progress goes further than what the lower courts had held.

The U.S. Supreme Court heard the "potentially groundbreaking case" brought by a "Douglas County couple who claim that their autistic son was not provided an adequate education in the public school system as required by federal law." Access to public education through IDEA was affirmed in 1982 in Board of Education v. Rowley, but the quality of guaranteed education for students with disabilities under IDEA had not been addressed. This Supreme Court case has the potential to "affect the education of 6.7 million children with disabilities" as the Court "struggles "to decide whether it should require public schools to do more under a federal law that calls for them to provide a free education that addresses the children's needs. There are others who contend that the Endrew case may be applicable to all of the 76 million students enrolled in U.S. public schools due to the 14th Amendment Equal Protection Clause. The right to an equal educational opportunity is one of the most valuable rights you have, says ACLU.org. 

In 2010, Endrew, who was in public school in Douglas County School District RE-1, began to exhibit "severe behavioral issues." The parents removed their child from the public school and enrolled him in a private specialized school for children with autism with an annual tuition of $70,000. The family requested reimbursement for the tuition claiming the Douglas County School District had not fulfilled the requirements of IDEA. They lost their case before the United States District Court for the District of Colorado, and before the Appeals Court. Their argument was that "the federal statute only requires that schools provide students with "some educational benefit.""

Supreme Court Justices Stephen G. Breyer, Samuel Alito, and Anthony M. Kennedy expressed concerns about the implications of implementing IDEA with changes in quality of education standards. Breyer cautioned about potential rising costs of litigation, for example, extraneous lawsuits. Kennedy questioned the financial cost to districts with severely disabled students; Alito considered the burden on poorer school districts.

Only two of the circuit courts had set "meaningful educational benefit" standard. The Supreme Court will decide whether a uniform standard should apply nationally.

Justice Ruth Bader Ginsburg cited the Board of Education v. Rowley (1982) 458 U.S. 176 (1982) in which the Court held that public schools were "not required by law to provide sign language interpreters to deaf students who are otherwise receiving an equal and adequate education."

The parents claimed that schools should provide "substantially equal educational opportunities" and that "[IDEA] does not permit cost to trump what the act otherwise requires. Schools should provide "a level of educational services designed to allow the child to progress from grade to grade in the general curriculum."