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Saturday, September 22, 2018

Incentives Floated for Treating People with Developmental Disabilities

From DisabilityScoop

By Courtney Perkes
August 13, 2018

Federal lawmakers are looking to make doctors and other health care services far more available for people with intellectual and developmental disabilities.

Proposed legislation would designate people with intellectual and developmental
isabilities as a "medically underserved population" creating new incentives to
encourage health care providers to treat this population.

A bipartisan bill introduced late last month in Washington would for the first time designate people with intellectual and developmental disabilities as a “medically underserved population” and qualify this group for additional resources under more than two dozen federal programs.

Health care experts say passage of the legislation would increase access to medical and dental care, reduce health disparities and improve specialized training for medical providers.

“It’s exciting to see it starting to get some traction,” Dr. Stephen Sulkes, a developmental-behavioral pediatrician and president of the American Academy of Developmental Medicine and Dentistry, said of the proposal.

“This is going to encourage health care providers to pay attention to this population and learn what it takes to provide appropriate care, to be good listeners, to be understanding and responsive in ways that will enhance care.”

The so-called MUP designation would allow doctors to receive higher payments from Medicare and Medicaid for seeing patients with intellectual and developmental disabilities.

It would also offer repayment of student loans for health professionals who serve this population and provide funding for research on topics affecting this group, according to U.S. Reps. Seth Moulton, D-Mass., and Gregg Harper, R-Miss., who sponsored the bill known as the Healthcare Extension and Accessibility for Developmentally Disabled and Underserved Population, or HEADs Up, Act of 2018.

Research shows that people with intellectual and developmental disabilities have a hard time finding competent providers, have a higher rate of chronic conditions like cardiovascular disease and are less likely to receive routine health screenings, according to a report by the Autistic Self Advocacy Network.

The MUP designation was created to identify groups with too few primary care providers, high infant mortality, high poverty or a high elderly population. Since the 1960s, some groups have been automatically included by law, including migrant workers and people who are homeless. But for others to qualify, they must live in the same neighborhood or geographic area.

“The issue here is that a generation ago, people with IDD were institutionalized,” said Sulkes, a professor at the University of Rochester. “When they were institutionalized, they got all their health care in the institutions.”

So now, with deinstitutionalization, in order for people with disabilities to be included, the law would have to be changed to reflect their widespread presence in communities across the country.

“The only reason that the IDD population has not been designated as a MUP is because they do not live together in a geographic area,” Moulton and Harper wrote in a letter to their Congressional colleagues. “To go back to forced segregation, in order to receive the benefits of being designated a MUP, would be to require the community to undo all of the hard work that has been done.”

Among the benefits of the MUP designation would be training programs and student loan forgiveness for health professionals who choose to focus on caring for patients with intellectual and developmental disabilities.

David Ervin, chief executive for The Resource Exchange, a nonprofit service provider that is collaborating with the University of Colorado to train medical students to better treat patients with intellectual and developmental disabilities, said student loans are a barrier to attracting doctors to the field.

“So many of our folks (with intellectual and developmental disabilities) are on Medicaid or dually eligible and whether we like it or not, that is not a way to repay your medical school loans,” Ervin said. “This gives a pathway.”

Two Schools with High Numbers of Special Education Students Face Budget Cuts

From The Lens

By Marta Jewson
September 20, 2018

Two New Orleans public schools that make a point to serve special education students will have to make budget adjustments if they can’t hit enrollment targets by the beginning of next month, when the state takes a formal enrollment count.

Cypress Academy in Mid-City is 71 students shy of its budgeted enrollment of 265 students, a district official announced this week. That’s about a 25 percent gap.

“We are actively working with our finance team to address the financial ramifications and will be bringing a plan forward for consideration at the October board meeting,” district Chief of Schools Rene Lewis-Carter told Orleans Parish School Board members Tuesday.

Meanwhile, Noble Minds Institute for Whole Child Learning has already amended its budget, including a cut in hours for some employees. The state-authorized charter school had 53 students as of Tuesday. That was 17 short of its original 70-student goal.

“Our short-term goal is to get to 60,” Noble Minds CEO Vera Triplett told her charter board members Wednesday.

“As a result of the lower enrollment we have had to make staffing cuts,” she said. “We just had to respond to our new financial reality.”

Orleans Parish has a unique funding formula that — on top of a base per-pupil amount — provides extra funding depending on the severity of a student’s special education needs. Sometimes that money isn’t enough to cover services for students with particularly intense need.

However, it only applies to direct-run and district-authorized charter schools, not Triplett’s state-authorized charter.

“We just had to respond to our new financial reality.”
—Vera Triplett, Noble Minds Institute for Whole Child Learning

Back at Cypress, parents are a little too familiar with budget shortfalls.

In May, grappling with a projected budget shortfall for the 2018-19 school year, the Mid-City charter school’s board decided to shutter the school. The board announced the decision just three days before the end of the school year, sending many Cypress families into a tailspin. But Cypress parents quickly rallied and demanded answers and action.

After a few harrowing days, the district announced it would step in and run the school. A week later, the district agreed to run the school for two years. That made Cypress the first new traditional school in Orleans Parish since Hurricane Katrina.

Acknowledging the school’s high population of students with special education needs, the district transferred its assistant director of exceptional children’s services, Laverne Fleming, to become Cypress’ executive director.

Cypress parent Jeremy Dewberry said parents are continuing to monitor the district’s management of the school.

“The parent group is dedicated to ensuring that our kids are getting the services that they need and that they were promised,” he said Thursday.

Dewberry said parents hadn’t heard anything about enrollment numbers.

“We haven’t heard anything negative or positive indicating that there’s going to be any cuts or any moves or anything of that nature,” he said.

The district did not respond to a request to clarify what parents could expect if the school has to revise its budget.

“At this time, the district is working to finalize its plan for under-enrollment at Cypress,” district spokeswoman Dominique Ellis wrote in an email late Thursday. “Those plans, once finalized, will be presented at the October board meeting.”

Of course, the adjustments may not be necessary if schools hit their enrollment numbers by October 1. That date, and February 1, are “count days” — the dates the state uses to determine student counts for funding purposes.

The district’s decision to halt enrollment at four charter schools that may close at the end of the school year could help the under-enrolled schools meet their targets by lowering competition in the city.

Student Enrollment Drives Revenue

All schools face a delicate budgeting balance each year because they are funded on a per-pupil basis. This is particularly important to independent charter schools, which are operating on a much smaller scale and do not have the financial backing of a traditional school district.

In New Orleans, students rank schools in a central lottery system and no child has an assigned neighborhood school.

A 2015 study found 25 out of 30 school leaders surveyed reported engaging in some kind of marketing strategy in response to competition.

The second most common response to competition was offering unique programming and extra services. That kind of differentiation is an integral part of both Cypress and Noble Minds.

When Cypress opened in 2015, it reserved 20 percent of its seats for students at risk for a reading disability. The school quickly became known for working with students with disabilities. Cypress parents praised the school at parent meetings last spring and challenged the school board to keep it open.

Noble Minds takes a therapeutic approach to education, Triplett said, and offers students a social-emotional classes that teach them how to express and manage their feelings in a healthy, controlled way. Parents have also praised the school’s programming.

Targeting Special Populations

Both schools have a higher than average percentage of students who need special education services. And those services come with a price tag. Many students with special education needs cost more to educate than the schools receive in public funding.

“Make no mistake about it, it’s a much more difficult situation, particularly when you’re dealing with a higher percentage of high-needs students than most schools,” Triplett said.

In May, Cypress parents begged Orleans Parish school district administrators not to let the school close. They said it would reinforce the idea that having a higher than average special education population wasn’t worth the budgetary trouble.

Triplett said things are even tougher for Noble Minds because the state-authorized school does not receive additional special-education money through the Orleans Parish funding formula.

She said the school has focused its cuts on supplies. She also said a number of administrative staff are now working few hours.

“We do need folks to step in and help. We need private foundations and individuals to step in and help,” Triplett said. “People who say this is important to them should know that it costs money, and we do not get enough from the federal [government] or the state to cover these services.”

Triplett said she expected enrollment challenges because it is a new school. It opened in 2017 on the West Bank, then moved to Carrollton this summer.

“We’re small and a lot of people just don’t know we’re here.”
—Vera Triplett, Noble Minds Institute for Whole Child Learning

Noble Minds is not the first school to struggle to fully enroll in early years. When Cypress opened in 2015, the school had to convert two of its kindergarten classes to first grade classes to attract enough students. Noble Minds opened as a kindergarten through second grade school last fall. They added third grade this school year.

At Wednesday’s Noble Mind’s board meeting, board members asked Triplett about marketing and how the school could recruit more students in the next 10 days. She offered an array of ideas, including setting up a table at Walmart.

As part of their professional development, Triplett said Noble Minds staffers will canvas the neighborhood on Friday to raise awareness of the school.

“We’re small and a lot of people just don’t know we’re here.”

Friday, September 21, 2018

Network for Public Education Conference to Feature Groundbreaking Report on Privatization of Education

From the Education Law Prof Blog

September 12, 2018

This summer, the Network for Public Education and the Schott Foundation released on new report on the privatization of public education titled, Grading the States: A Report Card on Our Nation’s Commitment to Public Schools.

The report was the one I had been waiting for. It filled in key facts that have been missing from the public debate and will help move it in a more positive direction. The Network's national conference on October 20 to 21 will feature a panel on the report.

John Jackson, President of Schott, and Tanya Clay House, a long time civil rights advocate and former Obama appointee, will be on the panel along with myself.

Registration for the event is still open HERE.

The panel promises to be an important one. As I argue in Preferencing Educational Choice: The Constitutional Limits, the analysis of charter schools and vouchers needs to be reframed. Toward that end, I identify a handful of categorical ways in which states have actually created statutory preferences for charters and vouchers in relation to traditional public schools.

I explain why a statutory preference for these choice programs contradicts states’ constitutional obligations in regard to education. I also explain how, even if there is no statewide statutory preference, choice programs can have the effect of undermining the delivery of adequate and equitable education opportunities in particular locations.

When they do, the programs violate state education clauses. We just have to examine the facts on a case by case basis.

My research, however, analyzes the issues from a relatively high level of abstraction, highlighting problematic examples in particular states and districts and synthesizing constitutional principles from various states.

The NPE/Schott report drills down into the facts deeper than anyone before. It offers a systematic examination of charter and voucher laws in each state. As a result, it clearly shows the extent to which each state’s laws represent a decommitment to public education.

The report is the “yin” to the National Alliance for Public Charter Schools’ “yang.” Each year, the National Alliance for Public Charter Schools (NAPCS) releases a report detailing charter school laws, with the frame of reference being the extent to which states have law that promote the expansion of charters. The report normatively assumes that charter schools are good and state laws that overly restrict them are bad.

So. the states that it labels as having excellent charter laws will probably fair poorly on the Network for Public Education (NEP)/Schott Foundation report. For instance, NAPCS ranks Indiana as the top state for charters, but NEP and Schott rank Indiana in the 40s.

But that is what makes this report so important. Because there hasn’t been any systemic to response to NAPCS’s reports, it has been able to skew the conversation. This new report brings balance.

Here are some key paragraphs from the executive summary:

"Public schools remain a source of pride and hope, helping to level the playing field for children from incredibly diverse racial, ethnic, religious and socioeconomic groups. Even amid concerns and often unsubstantiated criticism, Americans continue to view public schools as a defining hub for their communities. In the spring of 2001, a national poll found that Americans ranked public schools as “the most important public institution in the community” by at least a five-to-one margin over hospitals, churches and other institutions.

Nonetheless, within the past two decades, there has been a fervent push by those interested in privatization who seek to de-prioritize the importance of public schools and effectively undermine their functionality. Ignoring these attacks, most parents and citizens understand that public schools provide a critical service to American society by educating the majority of students with a base level of accountability while protecting their civil rights in the classroom.

Moreover, a recent poll conducted in October of 2017 found that among all registered voters, only 40 percent supported vouchers while 55 percent are opposed. This number further decreases to 23 percent with opposition at 70 percent when voters were asked to consider support if it meant less money for public schools.

With the ongoing debate on the relevance and benefit of public schools versus private schools, the historical context of this debate must be understood. The commitment to a free education for American children has its roots in the 17th century and has evolved along with the laws of the nation to include a free and appropriate public education (FAPE) for all children. Those of privilege have always understood that education is the cornerstone to success and inclusion in society.

Yet the reality is that disadvantaged groups including African Americans, Latinos, Native Americans, women, the poor, those with disabilities and others have always had to fight for inclusion. For many generations, structural racism inherent in American society maintained a segregated system for African Americans and people of color. From passage of Massachusetts’s first compulsory education law to present day, historically disenfranchised communities have fought for the right to receive a free education.

The public education system was developed to serve all children and can continue to do so with the appropriate support from the federal, state and local levels. Public schools offer a rich opportunity for all children to learn from their peers of other racial, ethnic, religious or other identities. Private schools, including charters, were not created to serve all children. Although parents always have a right to send their children to private schools at their own expense, they are not and never can be the model for educating of all this nation’s children, nor should they be supported by public dollars."

The report evaluated education privatization based on the following, assigning numerical values to each:
  • Types and Extent of Privatization
  • Civil Rights Protections
  • Accountability, Regulations and Oversight
  • Transparency
  • Other Factors (charter schools)

It found that:

"Overall grades were assigned based on the extent of privatized school choice in the form of vouchers, neo-vouchers and charter schools, as well as the quality of the state’s laws that promoted accountability, oversight, transparency and civil rights. The states with the best overall grades for resisting school privatization are predominantly rural states with a strong commitment to community public schools and an aversion to public dollars leaving already cash-strapped rural schools[, although]... rural state support for public education is not a universal pattern.

There are 22 states with grades between a C and a B+. Six states and the District of Columbia received a grade of D or D+ and 17 received a grade of F.

In addition to giving each state an overall grade, we assigned grades for voucher and charter policies as well. There are 22 states that earned an A+ for resisting attempts to give public funds in the form of vouchers and/or neo-vouchers to their public schools.

The six states with an A+ for their charter laws are Montana, Nebraska, North Dakota, South Dakota, Vermont and West Virginia. However, there were also 37 states plus the District of Columbia that received a Grade of F based on their charter laws — states that embrace for-profit charter management, weak accountability and other factors that make their charter schools less accountable to the public."

For more detailed findings, see HERE.

We’ve So Overscheduled Our Kids That Doctors are Now Prescribing Playtime

From The Washington Post

By Katherine Marsh
September 14, 2018

We idiotically insist that all of their activities be purposeful and structured.

Last month, I picked up my children from their first day back in American elementary school after three years at a French school in Belgium. They both looked glum. “Did you make any friends?” I asked hopefully.

“What’s the point?” my 7-year-old daughter said. “Recess is too short.”

In Brussels, they had 50 minutes of recess plus a 20-minute mid-morning break. In Washington, they have 30 minutes of recess total. The school district here guarantees just 20 minutes, and some American schools offer just 15 minutes, which is the amount of time it takes most children just to get out the door.

In Belgium, regardless of the weather, recess was always outdoors. In the District, if it’s too hot, too cold or too rainy, the children have indoor recess — which, at our school, Lafayette Elementary, is held in the classroom because of a lack of available gym space.

Later that week, my 10-year-old son reported watching a short film at school about how the kids of my generation “didn’t have video games and had to play board games.” The point, he explained, was that kids should get off screens and play together (never mind the irony of teaching this message through a screen).

Last month, the American Academy of Pediatrics released a report detailing the developmental importance of play and suggesting that doctors write “prescriptions” for it during early-childhood checkups.

Calls for increased playtime have been out there before — including in previous AAP reports and from nonprofit groups like KaBoom and the U.S. Play Coalition — but the idea of “prescribing play” made headlines, showing up in a range of media from the New York Times to People magazine.

[We’re bad at judging risk to kids, but we’re great at judging parents]

This is an important cause, but after I spent three years in Europe, the fact that child development experts had to “prescribe” play to get society to listen struck me as ridiculous, much like using a movie to promote screen-free time.

To justify children’s natural behavior to parents and teachers, it apparently has to be presented as a data point. Play can’t be just what children do or what they enjoy — it has to serve a purpose.

There is nothing wrong with having a sense of purpose when it comes to parenting or teaching children, especially in comparison with the more neglectful practices of the past. But increasingly in America, there is a sense that every moment of a child’s life must be purposeful.

As a children’s book writer, I spend a lot of time thinking about the unique ways children process the world; in life, as in literature, moments of growth and discovery are more likely to take place in the absence of adults, not when they micromanage.

This tyranny of purpose also exhausts parents and teachers: Instead of letting children play for an extra half-hour in a state of semi-supervised chaos, we supervise them while they do something educational.

But because no one has that level of constant energy, we end up relying on screen-based activities billed as educational, even when our instincts tell us they are not. Does anyone really think a 6-year-old should be playing math games on an iPad instead of running around outside?

[Forget about free-range kids. Children in America still aren’t safe enough.]

This relentless emphasis on purpose flows from a heightened sense of competition. At a party in Belgium, I met a French mom who had lived for several years in the Washington area. She recalled with disdain the American kindergartners who bragged about their reading skills but seemed at a loss about what to do on a playdate.

Several years ago, I met an Italian parent at my son’s American elementary school who noted a similar sense of academic purpose in even very young children. He offered a theory: Anxiety over the next generation’s economic prospects and fear of losing a foothold in the meritocracy put parents under pressure to invest in their children’s skills earlier as a competitive advantage.

But by always driving children to be purposeful, are we giving them a better future or a worse one? One way to gauge this is to look at our own sense of satisfaction as parents. An ocean of ink has been spilled on the topic of how stressful parenthood has become, in large part because we don’t allow ourselves to stop parenting.

We are being driven mad by purposefulness, including guilt that we can’t be there, and be on, for our children every minute of the day. It may well be more honest — and more beneficial to children — to teach them that we all need downtime.

[We had the solution to America’s child-care crisis 78 years ago]

Play also does not need to be justified as educational, which is what tech marketers do to sellgames that might teach a little math or basic programming, but are essentially babysitting for teachers and parents and screen time for kids.

It’s fine to play these games — contrary to the film my son saw in class, I spent plenty of my childhood zoning out to Pac-Man on my Atari — but let’s stop pretending that we’re enriching our children rather than giving them and ourselves a rest. By more honestly treating these games as entertainment rather than edification, we’re also teaching kids to be savvier consumers.

No one wants his or her child to become a purposeless adult. But part of the joy of childhood is doing things because they anchor you to the moment, not because they will reap future benefits or rewards. There is a sense of mindfulness children feel when they play that so many of us long for as adults.

This is why the AAP report is so important — and why we need to implement its philosophy by trusting ourselves as parents and teachers, not by following doctor’s orders. True play is freedom from purpose, and no doctor can prescribe that.

Katherine Marsh is a children’s author and the former managing editor of The New Republic. Her most recent novel is Nowhere Boy.”

Childhood Trauma Linked to Impaired Social Cognition Later in Life for Patients with Major Psychiatric Disorders

From Elsevier
via ScienceDaily

September 12, 2018

A new report published in European Psychiatry identified a significant association between childhood adversity and impaired social cognitive functioning among adults diagnosed with major psychiatric disorders.

Through a comprehensive review of all research conducted to date, the investigators established that a traumatic early social environment frequently leads to social cognitive problems and greater illness severity for individuals with schizophrenia, bipolar disorder, borderline personality disorder, major depressive disorder, or post-traumatic stress disorder.

"Early childhood neglect, abuse, and/or trauma puts patients at greater risk for developing cognitive impairments that will later affect social perception and interaction, a core aspect of disability in major psychiatric disorders," explained Lead Investigator Gary Donohoe, M.PsychSc, D.ClinPsych, Ph.D., of the Centre for Neuroimaging and Cognitive Genomics at the National University of Ireland in Galway.

Deficits in social cognitive function are a hallmark feature of major psychiatric disorders resulting in impaired social and occupational functioning, specifically with regard to emotion recognition and regulation, theory of mind (the ability to attribute mental states to oneself and others), attributional style, and social perception.

Traumatic childhood experiences -- such as emotional and physical abuse and neglect, early loss of caregivers, and insecure attachment styles -- are frequently reported in as high as 85 percent of patients with various psychiatric disorders.

These findings are relevant to gain a better understanding the mechanisms between a traumatic early social environment and subsequent social cognitive problems and increased illness severity for a range of major psychiatric disorders in adulthood.

The first three years of life are a very sensitive period for the development of attachment relationships, and exposure to traumatic events during this time has irreversible effects on subsequent cognitive, social, and emotional development. The link between childhood adversity and insecure attachment is supported by a number of previous studies.

Once a dysfunctional attachment pattern is formed in childhood, it tends to persist later in life and can cause misperceptions of others' intentions and beliefs. Heightened threat vigilance can distract abuse victims from processing peripheral cognitive and social information, and the lack of stable, positive role models can interfere with their ability to recognize and respond to emotional cues.

"Better understanding of the connection should lead to more effective interventions and treatments."

The investigators hope that the study will guide future public health efforts to develop clinical interventions that reduce the consequences of childhood adversity.

"With a better understanding of the connections between early trauma and later deficits, mental health clinicians may be able to develop strategic interventions that ameliorate patients' disabilities and improve their quality of life. The fact that these deficits are not generally improved by antipsychotic medication makes social cognition an important treatment target and the development of a causal working model of the deficits of crucial importance," noted Prof. Donohoe.

The study, funded by the European Research Council and Science Foundation Ireland, involved a systematic review of the published literature to provide a comprehensive picture of current research. This included the assessment of more than 2,650 published papers on the topic that were identified using the PubMed and PsycINFO databases. Of these, 25 research articles were found to meet the study's strict criteria and were included in the review.

The investigators recommend additional research to model the relationship between early adversity and genetic risk that contributes to social cognitive development. Understanding the mechanisms by which neurocognitive and biological factors come into play is also an important subject for future study.

Journal Reference
  • Karolina I. Rokita, Maria R. Dauvermann, Gary Donohoe. Early life experiences and social cognition in major psychiatric disorders: A systematic review. European Psychiatry, 2018; 53: 123 DOI: 10.1016/j.eurpsy.2018.06.006

Thursday, September 20, 2018

Twice-Exceptional Kids: Both Gifted and Challenged

From the Child Mind Institute

By Beth Arky
September 19, 2018

2e kids, as they’re called, have a unique set of issues that need addressing.

Some children are highly gifted in areas such as math, writing or music. Then there are those with challenges that affect learning: They could have ADHD, dyslexia or dyscalculia, or perhaps they’re autistic or have sensory processing issues.

But there are also kids who fit both categories. They’re called twice-exceptional, or 2e, which means that they have exceptional ability and disability. They are gifted in some way but they also face learning or developmental challenges.

Children who are both gifted and challenged can be tough to understand. Gifted kids can use their strengths to compensate for the special need, and in the process mask their learning problems. Or the special needs can mask the giftedness. In some cases, neither the disability nor the giftedness is recognized.

Once 2e kids are identified, it can still be difficult to get the supports these children need in school. If they’re in a gifted program, they may be floundering in a certain area. If they’re placed in a special-ed program, it may not challenge them, and they may be frustrated and restless. In either case, anxiety, depression, a lack of self-esteem and emotional dysregulation can result, leading to behavior problems.

Why 2e Kids are Overlooked

One reason twice-exceptional kids are in danger of slipping through the cracks is that their schools are set up to help kids meet grade-level academic skills, and they may be on grade level, despite their challenges.

“Let’s take bright kids who have a reading disability,” says Adam S. Zamora, Psy.D., a neuropsychologist at the Child Mind Institute. “When they’re reading, there are words that they don’t know how to decode but they use inferential reasoning and their overall cognitive capacity to kind of figure out what the missing word might be. These kids might go under the radar.”

They may eventually be diagnosed with a learning disability if they hit a wall when they reach later grades and expectations rise, or they may never receive the diagnosis and support they need.

Then there’s the case of a 2e child who may have issues that overshadow his giftedness.

This was the case at first with Jenn Choi’s son, Logan, now 14. His special needs (ADHD and then dyslexia) were identified after he was asked to leave his first preschool for his “behaviors,” which included not being able to sit in circle time.

But it wasn’t until Logan was turning 5 and had his first neuropsychological assessment that his parents realized his potential, when he scored in a very superior range in visual-spatial thinking, including perception, analysis and synthesis. This can translate into excellence in math, science and engineering.

“It was a big surprise to us that he was really smart,” Choi says. And it wasn’t until first grade, when he attended an afterschool program at the Quad Mahattan, created for twice-exceptional kids, that she learned the term. Choi now offers a listserve for 2e parents in New York City.

Emotional and Behavioral Issues

Not having both talents and disability identified can have emotional and behavioral consequences for children.

“They know that they’re capable of more and yet something is holding them back, and they can’t really figure out why,” says Dr. Laura Phillips, Psy.D., a neuropsychologist at the Child Mind Institute.“That’s why you often see a lot of frustration and anxiety and even behavioral dysregulation in a lot of these kids.”

They may come off as lazy because they’re clearly bright but performing poorly in some areas. They may get a lot of criticism from parents and teachers: “You’re just not trying on this math!” Their self-esteem suffers and they may experience depression.

Or they seem oppositional to teachers and parents. “Frustrated by their difficulties, they act out in infinite ways, and they get mischaracterized or misunderstood as being oppositional,” Dr. Phillips says.

Giftedness Can Lead to Misdiagnosis

Children who are gifted may have behaviors that look like ADHD or autism.

“One of the things we know about gifted children almost universally is that they are intense,” says psychologist James T. Webb, who specializes in them. “If they’re into dinosaurs, they eat, drink, live dinosaurs. If they’re into math and factors, they love it. If they’re into power struggles or sibling rivalry, it’s equally as intense.”

This intensity can make sitting in a regular classroom very frustrating. “The research indicates that for most gifted children, from one fourth to one half the regular classroom time is spent waiting for others to catch up,” Webb notes. “If you’re sitting there and your mind is intensely churning, you’re likely to be seen as being off task, fidgety, interrupting others, classic behaviors that are ADHD-like.”

It’s also easy to misdiagnose gifted kids as being on the autism spectrum. There’s that intensity in interests. Also, “gifted children as a group just seem to be quirkier than other kids,” Dr. Webb says.

Gifted kids can also be oversensitive to stimuli, making them avoid bright lights, noise and crowds. The combination of over-excitability and intellectual advancement can make them a bad match for their noisy and boisterous peers. “They just don’t play well with others,” he says. “They try to structure their world in a rigid way. They have difficulty with being redirected to new tasks. All of these are behaviors are ones you often see on the spectrum.”

Of course a child can also be 2e — both gifted and have ADHD or autism.

How to Identify 2e Children

First, Dr. Webb emphasizes, parents and teachers need to be familiar with the concept of twice exceptionality. “One of the big myths about gifted children is that they will be equally gifted in all areas, or very close to that,” he says.

“There really is no universally agreed upon definition of ‘gifted’ — even with respect to general intellectual ability,” Dr. Phillips says, “as giftedness in its truest definition is not limited to intellectual potential, but instead can refer to extraordinary capabilities in creative thinking, specific academic areas, psychomotor functioning, or visual/performing arts.”

She says she and most school placement decisions use a Standard Score in IQ testing of 130 as the cut-off for gifted intelligence, which would place the child in the top 2 percent of the population.

Experts suggest that when a teacher sees a child who does just okay in some areas, but in one or two areas is a prodigy — or does exceptionally well in all areas except one, where she is lagging — the child should be referred for testing.

The optimal way to pick up on twice exceptionality is through a neuropsychological evaluation.

“Neuropsych evaluations are really the best way to understand a student’s full profile of cognitive and academic strengths and weaknesses, and to individualize a curriculum, which really is what these kids need,” Dr. Phillips explains. “They might be three grade levels ahead in math, but they might need extra support in reading.”

The Challenge of Educating the 2e Child

According to a survey spearheaded by Choi of 503 parents with 2e kids, 254 of whom attend New York City public schools, their biggest challenge is being forced to choose between cultivating the child’s intellectual ability and helping with their special-education needs; they are not usually offered at the same time.

One way to try to get the individualized teaching 2e kids need is by being placed in an Integrated Co-Teaching (ICT) class, with one general-education teacher and one special-needs teacher. But if 2e kids are performing at grade level, it can make it difficult to persuade schools that they should provide remediation or accommodations through an Individualized Education Program or a 504 Plan.

Choi says the survey showed parents are told that children in a gifted and talented program can’t have an IEP, which is not true. The survey also showed that only 5 percent of the 2e kids had a gifted and talented placement in an ICT classroom.

Should kids be moved to older classrooms for the subjects where they excel? Dr. Phillips says it can be tricky because they don’t have the maturity level to handle the homework and social demands. In some cases, parents may opt for private schools, with smaller classes and/or curriculum tailored to a particular student’s strengths and weaknesses.

Instead of placing kids in older classes, Dr. Phillips recommends that parents provide a lot of enrichment outside school. One such resource: the Davidson Institute, including its Davidson Young Scholars Program for 2e students. Also, some museums provide weekend programming for gifted students.

How Support Can Help

Getting support can help twice-exceptional children reach their full potential, both in terms of academics and on the emotional front.

When 2e kids are identified and supported, Dr. Zamora says, they can do better in school and have higher self-esteem. “If parents are well informed about what’s going on with the kid, if the teachers really understand that this is a bright kid who just has these one or two areas of weakness, it can affect the way the teachers talk to the kid, the way they teach the kid,” he says.

Another way to help 2e kids, adds Dr. Phillips, is to let them know it will get easier.

“When I work with any sort of learning disability, I tell parents the years from kindergarten through 12th grade are going to be the hardest years in their kids’ lives” because they are required to take all the core subjects. But when they head off to college, they can select the courses in their areas of strength. “After that, they can choose careers that are suited to their strengths again and really shine there as well.”

As for Logan, he attended three private schools between kindergarten and the middle of seventh grade, partially for behavioral issues but also because the curriculum wasn’t challenging enough for him. Eventually he settled into a gifted and talented program in a public school, which has been a better fit. This month, he started at a competitive public high school.

Even with the changes, Choi says she feels all of Logan’s needs haven’t been met. She says his gifts put him on an engineering path, something that won’t be addressed in school. Instead, she says, “We are going to have to figure it out as we go along.”

Rethinking What Gifted Education Means, and Whom It Should Serve

From The New York Times

By Dana Goldstein
September 13, 2018

Sweeping changes to gifted education in Montgomery County, Md., are meant
to address educational inequality early in the pipeline, as young as second grade.

SILVER SPRING, Md. — It was a searing summer day before the start of the school year, but Julianni and Giselle Wyche, 10-year-old twins, were in a classroom, engineering mini rockets, writing in journals and learning words like “fluctuate” and “cognizant.”

The sisters were among 1,000 children chosen for an enrichment course intended in part to prepare them for accelerated and gifted programs in Montgomery County, Md. All of the students were from schools that serve large numbers of low-income families.

“It’s one of my favorite parts of summer,” Julianni said.

The program is one element in a suite of sweeping changes meant to address a decades-old problem in these Washington suburbs, and one that is troubling educators across the nation: the underrepresentation of black, Hispanic and low-income children in selective academic settings.

[Quiz: Try your hand at some test questions used to screen students for gifted programs.]

Amid deepening debate over the issue, sometimes referred to as “the excellence gap,” school officials across the country and at all educational levels are wrestling with possible remedies. Montgomery County is one of several districts that is successfully diversifying its gifted programs, in part by overhauling the admissions process and rethinking the fundamental mission of such programs.

This 160,000-student school system, one of the nation’s highest performing and most diverse, has provided a potential model — but not without creating anxiety and skepticism among some parents who feel their children have been hurt by the changes.

By far the biggest shift is in how children are admitted to the 13 elementary magnet schools perceived as the most intellectually elite in the county. In the past, parents had to apply for their children to attend, limiting spots to those in the know. This year, for the first time, every third grader in the county — some 12,000 students — was automatically considered for admission, with 715 winning a spot.

The district now gives less weight to the Cognitive Abilities Test, a common assessment for admission to gifted programs, and more to class performance. Parents can no longer submit private evaluations attesting that their children are gifted — statements that can be secured by paying hundreds of dollars to a psychologist.

Teacher recommendations, too, now play a smaller role. (Research has found educators are less likely to recommend low-income students of color, even when their performance is identical to middle-class and white peers.)

The county also changed its paradigm about whom the special schools should serve: not the students with the highest abilities across the county, but rather, those students who are outliers at their neighborhood schools, with fewer than 20 peers with similar abilities.

Jack Smith, the system’s superintendent, sees the changes as part of a broader integration strategy. “If you’re a student in poverty and you go to school with a critical mass of students who are not in poverty, you have a different experience,” he said. “It’s desirable to level out the amount of poverty in a school. It’s not always possible.”

Last year, Montgomery County rechristened its elementary magnet schools for the “highly gifted” as Centers for Enriched Studies. The idea was to label the program, not the students.

The reforms got results. More students from every demographic group were selected for the 13 special schools this year, because the number of seats increased. But the overall makeup of the pool changed.

In 2016, 23 percent of students in the county’s elementary school magnet programs for the highly gifted were black and Hispanic, in a district where half the students belong to those groups. This year, 31 percent of the students selected for the Centers for Enriched Studies were black or Hispanic. A fifth came from low-income families, nearly double the percentage who were accepted two years ago.

The white share of the accepted population increased, too, by 3 percentage points. But the Asian share of the population admitted to the special schools dropped 8 points.

The changes have left some parents, mostly Asian and white and living in the county’s more affluent areas, anxious. They worry their children will be excluded from selective programs, or that the level of instruction at the magnet schools will fall as students are accepted from lower-performing elementary schools. They argue that a more holistic admissions process, with less attention paid to test scores, is one that is, ultimately, less transparent.

Their concerns echo those of a group suing Harvard University, saying that the college’s admissions policies discriminate against Asian-American applicants. They also echo complaints from some parents in New York City who are resisting Mayor Bill de Blasio’s proposal to change admissions to the city’s most elite high schools, in order to admit more black and Hispanic students.

Unlike many other school diversity efforts, the reforms in Montgomery County are meant to address educational inequality early, for students as young as second grade. Parents here, like those in many other districts, compete in an arms race of real estate acquisition, school visits, test preparation and application-writing to gain access to the most coveted schools. But only some parents know the rules of the game, or have time to play.

Students in a summer enrichment program in Montgomery County that is
meant in part to prepare them for accelerated and gifted programs.
Credit: Emma Howells for The New York Times

“The goal is to try and snatch a few seats,” said Lang Lin, chair of the gifted child committee of the Montgomery County P.T.A. “But over all, the problem is the number of seats is just too little.”

The reforms here were driven by a consultant’s report, published two years ago, that detailed a history of exclusion and low expectations for black and Hispanic children in this progressive county. Many of the district’s selective academic programs were founded in the 1970s and 1980s, with the explicit goal of keeping white families in the public school system.

By the 1990s, black and Latino community groups were protesting the district, arguing that their children were being left to stagnate in general education classrooms while white students filled rooms reserved for gifted, honors and Advanced Placement programs. School buildings appeared to be racially integrated, but many classrooms remained segregated.

“What we wanted was for the school system to be very open and transparent about how they tracked kids,” said Ana Sol GutiĆ©rrez, a former school board member who led some of the activist efforts and is now a Maryland state legislator. “We never quite got them to own up to the fact that there was a tracking mechanism.”

By 2016, the district had new leadership and “more of a sense of urgency” to address disparities, said Michael Durso, president of the Montgomery County Board of Education and a former principal in the district.

Still, “some people behind the scenes wondered, ‘Well, why would one open this can of worms?’” Mr. Durso remembered. “It was promising to be contentious.”

The district started with a pilot program in the southeastern section of the county, yielding especially controversial results at the middle school level. Few magnet seats were added for middle-school students, while the candidate pool, because of the new policy of screening all students for admission, expanded nearly tenfold to 8,000 children.

Mr. Lin, an engineering manager who immigrated from China two decades ago, said his 11-year-old daughter had earned good grades in an elementary school for enriched studies, but was effectively de-selected this spring. She was not invited to continue in the magnet program into middle school.

About 1,000 children were chosen for the enrichment program. All of the
students were from schools that serve large numbers of low-income families.
Credit: Emma Howells for The New York Times

“If the admission criteria hadn’t changed, she would have been in a magnet for sure,” Mr. Lin said.

District officials do not deny that some students who would have been chosen for the elite middle schools in the past were not selected this year. It has been “the hardest change,” said Lori-Christina Webb, an executive in the district’s central office who is a driving force behind the reforms.

Asian-American students were hit especially hard. At two middle-school magnet programs in the pilot region, the number of black, Hispanic and white students admitted grew modestly, but there were 18 fewer seats for Asian students.

According to the district, evaluators do not see children’s names, race or language status as they determine admission. They do, however, see information about the family’s socioeconomic status and the child’s gender.

The changes for Asian students were “expected,” according to a district spokesman, because universal screening brought the demographics of admitted students closer in line to the overall demographics of the county.

Among Asian-Americans, the changes “are really very stressful within the community,” Mr. Lin said.

The middle-school reforms will roll out countywide this year. Ms. Webb said the district would meet the needs of children like Mr. Lin’s daughter at local middle schools, in new accelerated classes reserved for high-performing students. “There is an element of prestige associated with going to a magnet program, but that can’t be a driver for the district,” she said.

But Mr. Lin worries the new courses at neighborhood middle schools won’t be as challenging as classes at the magnets. That concern is shared by Michelle Gluck, president of the Gifted and Talented Association of Montgomery County, and a lawyer for a local university. She has two children who have attended the county’s magnet schools and other accelerated programs.

“Gifted education does have a bad racial history in this country,” Ms. Gluck said. She said she supports changes meant to address that history, especially the universal screening process.

Still, she is concerned that the curriculum at the magnet schools will be “pitched lower,” she said, as the admissions standards change.

“For those of us who live with and raise and deal with these highly gifted students, we also want these classrooms to be offering what they need,” she said. If challenging instruction is not available, she added, she and other parents might enroll their children in private school.

The parents of Giselle, left, and her twin Julianni Wyche were thrilled
with their daughters’ inclusion in the enrichment program.
Credit: Emma Howells for The New York Times

Kimberly Petrola, a fourth-grade teacher at Fox Chapel Elementary School in Germantown, one of the Centers for Enriched Studies, acknowledged that instruction had changed since the school became part of the pilot program last year, ahead of the rest of the county.

With a more diverse student body, not every child performed above grade level, Ms. Petrola said. She said she and other teachers used ability grouping to teach at different levels. For example, for a unit in which students read an author’s autobiography and fiction side by side, to look for consistent themes, some groups were assigned authors who wrote at a more challenging reading level.

Ms. Petrola said that while some teachers were apprehensive about the changes, she supported them.

“The process identified a lot more of the underachieving gifted,” she said. “It’s good for the community to see that the gifted students are not just the typical students that you think of when you think of gifted and talented. Anybody from any diverse background can be gifted.”

Some experts say diversifying selective academic programs is not enough to address inequality in education. In fact, they argue that such programs should not exist at all. They point to research showing that low-performing students learn more when they attend classes alongside higher-performing peers, while the test scores of high performers do not suffer.

“Race is a very scary thing, and when people are liberal, they try to figure out how to have diversity in a way that still feels safe and still feels protective of their own children’s privilege,” said Jeannie Oakes, an emeritus professor of education at the University of California, Los Angeles. “It’s this sense of, ‘Well, if we can find the good ones, it would be good to have diversity in these programs.’”

For those children not selected, she added, “low expectations really put a ceiling on what we can achieve.”

In Montgomery County, some were quick to defend selective academic programs and the districts’ reforms. The parents of the twins in the summer enrichment program, Catherine and Rashawn Wyche, who are Hispanic and black, moved to the area six years ago, in part because of the bilingual and accelerated programs in the schools.

Ms. Wyche works in information technology and Mr. Wyche is an engineer. They were thrilled with their daughters’ inclusion in the enrichment program. They want their children in gifted programs during the regular school year, too, they said — but not as demographic tokens.

“We want them to be proud of their heritage, and be where they feel comfortable,” Ms. Wyche said. She hoped her daughters would realize that other smart kids “look like me. We can excel together.”