The summary below is based on an actual case example from the TOD authors Nancy Mather, PhD, Sherry Bell, PhD, Steve McCallum, PhD, and Barbara Wendling, MA. We’ve changed the personally identifiable information to protect the privacy of the student and his family.  

Background 

Ryan Garcia is six years old. He’s curious, funny, active, and social. He’s had abundant exposure to all sorts of activities and experiences: summer camps, Sunday school, parks & recreation programs, and library story hours. He’s also had ample explicit instruction in phonemic awareness and phonics in preschool programs he’s attended since the age of two. That’s why his parents referred him for dyslexia evaluation: Despite good instruction and a love of stories read aloud to him, Ryan struggles to read and write. Whether he’s reading in class or at home, he fatigues and becomes frustrated easily. What he writes is hard to understand. 

Our Testing Strategy

Based on his background and TOD-Screener results, we administered these assessments in two separate sessions, each one lasting around an hour. 

• Tests of Dyslexia-Early (TOD-E)
• TOD Parent/Caregiver and Teacher Rating Scales
• Written Language and Math tests from the Woodcock Johnson IV Tests of Achievement (WJ IV ACH) 

We chose this approach because we wanted a clear picture of his linguistic abilities and his reading and writing skills, in addition to his dyslexia risk. We also wanted to be able to compare them to his abilities in other areas. 

Ryan’s Index Scores

In the TOD-E, all tests except Picture Vocabulary contribute to the Early Dyslexia Diagnostic Index (EDDI). When we analyzed Ryan’s performance, we saw significant differences in scores from test to test. For example, Ryan had an Average score on segmentation and rhyming tests but had a Well Below Average score on the rapid naming test. Because of the discrepancy, we took extra care with interpreting his performance. Overall, Ryan’s EDDI score was 75, which is in the Well Below Average range, telling us that he has a Very High Probability of dyslexia. 

When we reviewed Ryan’s scores on the five tests that make up the Early Reading and Spelling Index (ERSI), we noted a total score of 74, in the Well Below Average range. Again, we saw some variability in how he performed from one test to another within that index.

Ryan’s scores on the three tests included in the Early Linguistic Processing Index (ELPI) were in the Below Average range. He had higher scores in rhyming and early segmenting (Average) and lower scores on early rapid number and letter naming (Well Below Average).

When we compare Ryan’s scores on the tests most sensitive to dyslexia (EDDI) to his results on the Picture Vocabulary test, which measures his receptive vocabulary, we were struck by the difference. It clearly indicated dyslexia.  

Ryan’s Composite Scores

The TOD-E gave us insights into four sets of skills and abilities: Early Sight Word Acquisition, Early Phonics, Early Basic Reading Skills, and Early Phonological Awareness. On tests that involved Early Sight Word Acquisition, his combined score of 67 indicated he was Significantly Below Average on both tests.  The combined score for two Early Phonics Knowledge tests was 86—that’s considered Below Average—but scores differed between the two tests.

On the two tests that measure Early Basic Reading Skills, Ryan’s standard score was 79, in the Well Below Average range. Once again, there was a notable difference between his ability to recognize sight words and his knowledge of letters and sounds. Finally, on the two tests that track Early Phonological Awareness, Ryan’s total score was 92, in the Average range. His rhyming and early segmenting abilities were about equally developed.  

Ryan’s Written Language and Math Abilities

To get a different perspective on Ryan’s writing and spelling skills, we used the WJ IV ACH spelling and writing samples. His standard score on this measure was 89—Below Average. On two math measures, Calculation and Applied Problems, however, his scores were Above Average. He understood basic math facts and could solve problems—even though he sometimes reversed or transposed numbers.

TOD-E Teacher and Parent/Caregiver Rating Scales

Ms. Eston, Ryan’s teacher, reported that his oral language and reasoning were more advanced than many of his classmates. She considered his rhyming, blending, and segmenting abilities typical for a first grader. And she pointed out that he has a hard time telling the difference between some look-alike letters, as well as difficulty with spelling some high-frequency words.

Her other observation was that Ryan never chooses to read on his own, even though he likes listening to other people read stories. Taken together, her responses gave a T-score of 71—which correlates to a Very High Risk of dyslexia.

Ryan’s parents reported that his father had trouble with reading. They also said Ryan had speech and language services when he was in pre-K and kindergarten. They see his current oral language and reasoning abilities as more advanced than his peers’. Even so, they said, he has trouble with spelling and with learning the names of letters. He sometimes mixes up look-alike letters. Like Ryan’s teacher, the Garcias noticed that Ryan avoids reading and writing. In fact, he has to work extra hard to carry out the fine motor aspects of writing, tracing, and cutting. 

The Garcias’ rating scale responses produced a T-score of 77, which is characterized as a Very High Risk of dyslexia. 

Recommended Interventions

Based on his background, his TOD and WJ IV ACH assessment response patterns, and what our team has observed, our diagnostic impression is that Ryan has a specific learning disability in reading (dyslexia) and in written language (dysgraphia). 

Using the TOD Interventions companion guide and our clinical experience, we recommend the following interventions: 

At School  

1. His school team should consider Ryan’s eligibility for SLD services, especially systematic interventions to address his difficulty with reading and spelling. 
2. While his reading and writing skills are improving, Ryan’s teachers will need to adjust the level of difficulty in his classwork and homework. 
3. We recommend allowing Ryan to use the digital program Read, Write, and Type as an alternative to regular homework. Learning opportunities such as oral reports and project-based learning are a preferable way for Ryan to show what he knows. It’s also a good idea to build on areas where he’s already strong, such as vocabulary and math learning opportunities. 

At Home 

1. To grow, Ryan needs specialized instruction from a teacher trained to work with attention and reading difficulties. One option might be intensive private tutoring, especially during the summer. We’d recommend one hour, three times a week.  
2. To minimize frustration, Ryan’s homework time should be broken into short periods of around 10-15 minutes, followed by a rewarding activity break. For homework periods that last longer, periodic tokens or rewards will help him stay motivated. 
3. Keep reading books to Ryan—especially on topics he loves. That will grow his vocabulary and his interest in reading. 

First Steps  

1. Ryan needs an intensive synthetic phonics program to teach him letter-sound relationships. He needs immediate instruction to build his recognition of common letter patterns and spelling rules, as well as his ability to break words into syllables.  
2. To develop his early literacy skill, try a program such as Road to the Code. 
3. Ryan also needs a systematic spelling program. We’ve used Scholastic Success with Spelling (Grade 1) with success.  
4. One-minute speed drills will help Ryan get faster and more accurate pronouncing sight words and irregular words. It’s important to use the drills and track his performance daily. 
5. Decodable texts will help develop Ryan’s phonics skills.  
6. Don’t penalize Ryan when he reverses or transposes numbers in math. Remind him to check larger numbers using place value.  

Outcomes

The TOD-S and TOD-E gave us the information we needed to identify the probability that Ryan has dyslexia. The indexes and composites were useful as diagnostic indicators, but perhaps just as important, they showed us where to focus our instruction and intervention recommendations.  

The rating scales provided us with much needed context and helped us identify risk factors in Ryan’s background. Using the interventions guide, we were able to provide specific guidance to his teachers and family. Later in the school year, we’ll be able to work with his teachers to monitor progress with growth scores.  

This case example provides information based on the Tests of Dyslexia (TOD), published by WPS. The original case example appears in Chapter 3 of the TOD Manual.

Related to this TOD Case Example: 

• The WPS Guide to Dyslexia Assessment 
• TOD FAQs 
• Dyslexia Assessment Tool Kit 
• How Schools Can Use the TOD to Transform Dyslexia Education 

Every dyslexia evaluation takes patience and skill. That’s especially true when the person you’re assessing is still learning how to speak, read, and write in English. How do you know whether an apparent difficulty is related to learning a new language, having a language condition, or having a learning disability? The complexity can lead to over- or under-identification of dyslexia in multilingual learners. 

Here's a short list of questions you can explore, followed by evidence-based guidance, to make the assessment process clearer and more accurate:

1. What is the student’s family reading history?  

Dyslexia has a strong genetic link, so it’s important to find out whether anyone in the student’s immediate family has a similar history in academics or reading. It may be helpful to work with an interpreter if family members are also English learners.

2. How much quality instruction has this student received in each language? 

To be sure that any difficulties aren’t owing to a lack of exposure, you’ll need to find out as much as possible about the instruction received in the first language (L1) as well as the second (L2). If a student had trouble learning to read in L1, too, a dyslexia evaluation may be warranted—even if the nature of the difficulties is different between languages.

3. How do sounds map to letters in the student’s primary language?  

In some languages, certain sounds reliably map to certain letters. That’s known as a transparent language or shallow orthography. English orthography is considered deep or opaque because some letters can have multiple sounds. If a student has trouble learning to read a language with a shallow orthography, it may be more indicative of a learning disability.

4. How do the student’s reading skills compare to peers with similar backgrounds?

To explore whether a student’s difficulties might be something other than language learning, you may want to look at how other students with similar language histories perform. Of course, reading abilities are highly individual—but if a student is progressing at a rate that’s different from others who were introduced to English at roughly the same time, and who speak the same primary language, it may be time for a closer look.

5. What does the pattern of errors look like?

It can be helpful to know what kinds of errors are common among ELs who speak different languages. If certain sounds and spellings are usually difficult for people with a certain L1 to master, those errors may be related to language learning rather than dyslexia.

6. What is the most appropriate assessment, given the needs of this student?  

As you’re deciding whether a particular reading or dyslexia test is appropriate for your student, look carefully at these traits:

• Does the normative sample include people with similar backgrounds? 
• Is the test available in the student’s primary language? 
• Do any test items show cultural or linguistic bias? 
• Would any accommodation or modification you’re considering affect test validity?

If you’re using a test published by WPS, our Assessment Consultants can help you select the best option for your student. We can also help you understand how to administer it for the most accurate results. 

7. What are the student’s language abilities like?

Children with dyslexia often have a history of language delays in early childhood—and both receptive and expressive language difficulties can be lasting (Price et al., 2022). For a complete picture of a child’s abilities and needs, assessing language is a key part of a dyslexia evaluation.

8. How well-developed is the student’s phonological awareness?  

Research indicates that phonological awareness is problematic for students with dyslexia—whether they have learned one language or more than one. In one study, Italian researchers found that children with reading difficulties didn’t perform as well on phonological awareness tasks as good readers—no matter how much exposure to Italian (L2) they had (Taha et al., 2022).

9. How well does the student read words?

Dyslexia can affect all aspects of reading, whether a student is naming individual letters or trying to comprehend a complex text. Even so, trouble with word reading is consistently associated with dyslexia risk in multilingual learners. In one study involving ELs in 3rd grade, researchers concluded, “Our results revealed that the differences between ELs with typical reading skills and reading difficulties were most apparent, based on effect size differences, on measures of word reading” (Miciak et al., 2022).

10. Who should be on this student’s evaluation team? 

Because so many factors are involved, it’s especially important to hear from parents, caregivers, teachers, SLPs, school psychologists, and other professionals—especially those with expertise in the student’s language and culture. Relying on a standardized assessment alone isn’t likely to give you the most accurate “read” on the student’s abilities. What you learn from an assessment needs context.

Key Messages

When students are learning a second language, their ability to read and write in that language can sometimes look like a reading disability. To understand whether these difficulties are evidence of dyslexia—or are the natural progression of language learning—takes a careful and collaborative assessment approach. 

Knowing about someone’s background and educational exposure is key. Choosing the right tests and understanding how to interpret them is also vital. Looking at performance over time, using a variety of artifacts, and hearing from a wide range of experts can also lead to a more accurate diagnosis.  

Learn more: 

• The WPS Guide to Dyslexia Assessment 
• Dyslexia Assessment Tool Kit 
• Video: Challenges of Dyslexia Assessment with Nancy Mather, PhD 

A total meltdown on a school bus is not unheard of. Temperature, noise, the feeling of being too close to too many people—all of it can boil over, especially if you are a person with sensory sensitivities and a history of trauma. That was the case on a warm day in central Kentucky. The bus was packed. The transportation schedule was tight. There was no time or space for a kid to melt down. 

But someone did. 

Instead of shouting commands in a big, scary voice—the bus driver quietly contacted the school. Then he doubled back to the parking lot, where the counselor was already waiting. She stepped on board and whispered to the student, “You are not in trouble. Walk with me.” Within minutes, the student was lying in cool grass—his own calming strategy—and the bus was on its way.

“That day, nobody got hurt. Everybody got home safely. And that child’s dignity was preserved,” says Amy Riley, M.Ed., the counselor who stepped onto the school bus to help the upset student. “I wish I could tell that story to every bus driver out there.”

The driver’s humane and effective response was owing to the trauma sensitivity training he had received as part of his job. Riley and her school’s leaders had facilitated trauma training for all staff at their grade 3-5 school. 

The strategies that Riley and her team use are holistic: They involve the whole school, not just the classroom. Here are five steps to make safer and calmer learning environments for kids with trauma histories.  

Step One: Recognizing the Need 

The need for specialized training became clear when the school experienced an unprecedented number of suicide threat assessments—52 in a single school year.  

“We’ve always dealt with suicide threats, but they were rare,” Riley says. “After COVID, our team noticed that the number of students who expressed suicidal ideation or a desire to self-harm was through the roof.  We screened every child who said those words and found that the majority had actual intent and planning behind them. And most of those positive screenings were kids who had experienced significant trauma.” 

Step Two: Forming a Trauma Team  

The state of Kentucky requires all schools to have a trauma team. At Riley’s school, that team is comprised of an administrator, school mental health professionals, a nurse, and select teachers. The team meets regularly to discuss student needs and training opportunities. Some of the steps they’ve taken to lower the impacts of trauma include: 

• Organizing wrap-around services for identified students 
• Tracking student progress monthly 
• Pairing students with teachers who can act as a support (The team is especially attentive to “outlier” students who don’t seem to have a connection with any adult in the school building)
• Providing a “handle with care” notice to everyone who has contact with a child with trauma history
• Creating community connections, such as a program with firefighters and first responders who can inform the school when a student may have been affected by an adverse event
• Writing 504 or IEP plans to accommodate students with trauma based on emotional disturbance, which is one of the 13 categories of disability under the Individuals with Disabilities Education Act (IDEA) 

Step Three: Putting Tier 1 Interventions in Place 

Tier 1 interventions apply to everyone, and they’re meant to be protective and preventative.  

For example, the state of Kentucky requires all staff to have training in trauma-informed educational practices; however, not all schools include cafeteria staff, custodians, and bus drivers. Riley’s does. 

During training, staff learned what happens in the brain during and after a traumatic event. They learned how trauma can change behavior and learning abilities. As part of training, Riley read aloud a list of the specific adverse events students at the school were experiencing.

“You could have heard a pin drop,” she said. “Once our staff understood the trauma our students were going through, they were eager to implement these practices.”

What do some of those practices look like? In classrooms, teachers 

• use children’s names every day; 
• maintain predictable routines; 
• dim the glare of overhead lights; and 
• speak softly—no raised voices, ever. 

Because professionals in every department received training, trauma sensitivity and education has expanded throughout the school. 

• Information on emotion regulation is displayed in bathroom stalls, where children can see it. 
• In the pick-up/drop-off line, staff greet children by name each day. 
• Calming music plays in the cafeteria serving line and in hallways—places where noisy transitions can add stress.
• In the gym, coaches teach progressive muscle relaxation.
• When it’s time for an assembly, seating choice, headphones, and alternate locations are available for students who need them.
• Restorative circles, natural consequences, and positive reinforcement are replacing punitive discipline policies.
• Administrators and educators remind students and families of available services and support when the anniversary of a natural disaster or school violence episode approaches.

Riley is particularly moved when she considers the changes in the cafeteria—a place many students feel overwhelmed. 

“A few years ago, we had a real issue with our cafeteria monitors raising their voices,” she recalls. “They didn’t understand another way to discipline children, and it caused friction between parents and staff. Students just didn’t want to go into there.” After training, that changed.

“It was a mindset shift,” she says. Voices softened. And because they’d been included in professional development, the cafeteria staff's value and importance were reinforced.

“We had an autistic student who had experienced trauma and high poverty. For whatever reason, she was terrified of a specific food the cafeteria often served,” Riley says. “The cafeteria staff went beyond the extra mile in accommodating her. Not only did they offer her an alternative, they knew when her class was coming in. Someone would watch for her so they could be sure there was none of that specific food anywhere in view. And we did not have a problem all year because of those ladies.” 

It can look like coddling or weakness, Riley says, unless you understand what’s really going on.  

Step Four: Including Families in Your Planning 

Awareness of trauma extends to families. Special care is taken when communicating with parents and caregivers, many of whom have had traumatic experiences themselves—some of which were related to school.

“Some of our parents live in poverty and feel very marginalized by the system and by government,” Riley explains. “When we would call them, they’d be very on-edge. Part of what we did was to make sure that parents had positive communication from us. We tried to bring them into school for events, and at times when things were not bad.

“We start conversations by saying, ‘Your child is not in trouble. We’re here to help, not to judge.’ That’s especially true of calls about self-harm. It’s important for me to follow up with families later, so they know I’m not just going on about my life while they’re sitting in an emergency room somewhere.” 

Taking a more sensitive approach with parents can’t make up for harmful experiences in the past. But it can help. “I saw walls come down,” Riley says. “It wasn’t with every family. But I saw more involvement and had more communication. And that did trickle into the classroom.” 

Step Five: Helping Escalated Kids

Preventative measures are important, but they don’t guarantee a crisis-free environment. To help students cope when emotional dysregulation happens, Riley’s team first educated students in the language they could use to describe what they were thinking and feeling. Students learned how to ask for help. They thought about and wrote down things they could do to calm themselves in upsetting moments.

The school also made these resources available to all students: 

• Classrooms are equipped with calming boxes—small plastic bins with squeeze balls, fidget toys, and prompts for deep-breathing and cognitive restructuring exercises. The bins also contained a timer. A student feeling stressed can go to the calming zone in the classroom, sign out the calming box, set the timer for five minutes, and use the tools in the box. The child can self-regulate and stay in the classroom without missing instructional time.  
• The school has created a sensory room, equipped with a small tent, white noise machine, low lighting, and other calming tools. A teacher can escort any emotionally escalated child to this space. 
• For children who become over-stimulated and are in danger of hurting themselves or someone else, the school has made available an empty room with white walls and nothing on the floor. For some children, the absence of sensory stimulation is a good way to calm down. In both the sensory room and the empty space, students are supervised, often by a special education teacher. They’re also taught calming strategies. 
• Outside and throughout the building, there are growing things, open spaces, and animals for students to access. (Riley’s advice regarding animals is simple but imperative: “You need a plan for your service dogs,” she says.) 

Key Messages 

Trauma-informed practices are increasingly common in classrooms, but they can be broadened so that every part of the school day is easier for all students, especially those who have experienced adverse events. For that to happen, everyone who interacts with students should be trained in trauma-informed educational practices.

The results are worth the time and effort: After this school prioritized schoolwide trauma training, suicide threat assessments dropped from 52 to 14.

Getting “buy-in” for these systemic changes need not be difficult, Riley notes, even among initiative-weary faculty. That’s because most are already aware of student distress. “They are the ones seeing students getting carried off to hospitals. They are the ones seeing the plans written in their notebooks. They know. They know it is a big deal,” she says. 

Who is school for? 

It’s for everyone – or at least it should be. A free appropriate public education (FAPE) is a right of all children in the United States, but as parents, students, and education professionals know, there are many obstacles to equity – especially for students with learning differences and disabilities. 

To this point, on July 24, 2023, the Department of Education published updated guidance to “ensure and strengthen the rights and protections guaranteed to children with disabilities and their families…” In part, this updated policy guidance and accompanying Dear Colleague letter, address problems like the lack of early intervention services that were exacerbated by at-home schooling during the pandemic. The letter reports, in part, that “OSEP [Office of Special Education Programs] has determined that many States have, over the past 15 years, not consistently met IDEA’s requirements.”  

This likely comes as no surprise to parents and educators working with school systems that are underfunded and understaffed.  

These shortfalls are also at the center of a recent lawsuit in the state of Rhode Island. The ACLU there alleges that the Rhode Island State DOE is “not meeting its obligations under federal law to provide early intervention services to children between the ages of 3 and 5 who have sensory, emotional, physical, cognitive or language disabilities.” 

Surprisingly, Rhode Island agreed, and said that the root cause of this issue was widespread staffing shortages affecting many school districts across the nation. 

Equity is an issue that follows students to college. Once a student enrolls in college, if there is a burden of accommodation, it falls on them alone. There is no IEP system mandated across colleges and universities in the United States. Pedagogical scholars even debate whether autistic students should share college classrooms with allistic students despite many successful, prolific autistic scholars.  

With a shortage of special education professionals, assessment experts, and teachers in general, the state of education is struggling to meet the needs of children. As this problem continues to grow, all stakeholders suffer: overworked educators and administrators, worried parents, and of course, the student at the heart of an evaluation.  

WPS is taking action for positive change with our inaugural scholarship contest. The WPS Neurodiversity and Student Diversity Scholarships aim to encourage college students of all ages – undergraduate or graduate, two- or four-year institutions – to pursue studies in the following fields: 

• Clinician 
• Educator 
• Special Educator
• School Psychologist
• Occupational Therapist
• Speech Language Pathologist
• School Administrator 

These two $2,500 scholarships are for students with an identified neurodiversity, like autism, ADHD, or dyslexia; or students who represent a diversity in race, gender/sexual identification, religion, socioeconomic status, and other diverse traits. 

Learn more about the WPS Scholarships here. 

Science shows that early intervention matters, and that children respond positively to people with whom they personally identify. From birth, through school years, into college, and even in a person’s professional life, neurodiversity and diversity can be obstacles to success. They can also be incredible, positive assets in understanding and facilitating growth and education with the right supports and tools.  

It is early morning, and the students and families of Kāneʻohe Elementary are gathered, virtually and in person, for piko—a ceremony opening the school day. Together, students recite an oli, a chant composed by cultural practitioner and head custodian, Wali Camvel. The teachers respond with an oli welcoming students to the campus. It concludes: 

Eia i nā leo o ke aloha 

Here are the voices of aloha 

Ka mohala Ko’olau, i nā ulupua 

The blossoms of the Ko’olau, the growing children 

E ho'okipa e, e ho'okipa e 

Welcome, welcome 

This practice is one of many that Principal Derek Minakami and his team have introduced as part of a larger program of place-based social–emotional learning (SEL). School leaders are weaving the values and practices of Aloha into the school’s culture. 

“When we do piko in the morning, it’s a means of getting everyone on the same page,” Minakami explains. “We’re doing the same thing and hearing the same message. This year, our theme is he kaula pa’a—the strong, firm rope. Piko is another way we are that strong, firm rope because we are joining together.” 

First Steps Toward a New Approach

Integrating Aloha into the school’s SEL and academic curricula arose from the need to address student trauma. 

“Generally, our school doesn’t have a huge behavior or discipline problem. We’ve had kids who have fought, or vaped, or even used alcohol on campus—but it’s rare occasions,” Minakami says. “But we were seeing students who were facing tragic circumstances. We had one student who was expressing suicidal ideations in the first grade. One in the third grade lost both her parents in separate instances in the same year. When counselors were in contact with our families, there was just an outpouring and a cry for help.”

A first attempt at SEL didn’t go as planned. “We did an off-the-shelf SEL program, but we were having a hard time implementing it. It just wasn’t resonating with our students,” he says.

Then school leaders embarked on a Design Thinking course in which, Minakami says, they asked, “How do we strengthen SEL for our students? How do we provide that connection, so they understand this is not something disconnected from our lives, but has been practiced by their kupuna, their ancestors, so their family is aware of it? Aloha had become lost a bit in modern culture. We find ourselves having to reteach it. So we decided to design our SEL program around that.” 

How Aloha Shapes Everyday SEL

For many years, the language, culture, and ancestral knowledge of Hawaiian people were excluded from formal education in public schools. But school leaders in many communities have begun looking to their heritage to build resilience and well-being in students, and to strengthen the school’s connection with the families they serve. Their goal is to foster a deep inclusion that is based, Minakami says, on “reverence, not reference.” This requires that values be integrated intentionally. 

In addition to piko, the principal hosts a weekly Aloha Focus blog in which he shares stories that illustrate how Aloha values make a difference in day-to-day life.  School leaders provide teachers with daily prompts and reflection questions to help them relate these values to the day’s academic lessons. When students design and carry out project-based learning, the projects are often informed by Aloha values. And school leaders incorporate Aloha instruction as they work with students to resolve conflicts and address behavioral issues that inevitably crop up.  

SEL in the Soil

One of the most important aspects of Aloha is a connection to ‘Āina, land. When Western missionaries and traders arrived generations ago, they took Hawaiian land and suppressed Hawaiian histories, language, and traditions. The loss of land, identity, and connection to ancestral wisdom has had lasting psychological and physical effects (Keli‘iholokai et al, 2020).

At Kāneʻohe Elementary, students regularly tend to trails, gardens, and beautification projects on campus. Some have opportunities to cultivate food in partnership with a local farm.

“What we want kids to understand is that they have a kuleana, a responsibility, to be caretakers of the land,” Minakami says. “When we think about the fires that have consumed different parts of Maui, it underscores that when we don’t take care of the land, there can be severe consequences. We want students to focus on that symbiotic relationship between the land and themselves. The two are intertwined.”

A strong bond with ‘Āina is “imperative” to Hawaiian health, well-being, and resilience. In research published in the Journal of Environmental Research and Public Health, study participants told researchers, “The health of the land is the health of the people” (Antonio et al., 2023). In another study involving Hawaiian teens who had experienced the effects of historical trauma, students called land “a pathway to healing.” They told researchers that working in the soil changed how they saw themselves and how they behaved with each other (Riley et al., 2022).

Minakami has seen similar changes. “I think when students develop a sense of agency—and their families, too—over their fate, seeing that they can heal the land and find healing from the land, when they participate in planting, in showing Akahai to this place, then there is a measure of healing.”

Does that mean there are no more trauma symptoms, emotional difficulties, or behavior issues at Kāneʻohe Elementary? No. It means a new sense of hope has sprouted.

“Hope is essential to recovering from trauma,” Minakami points out. “If we hope and look ahead at where we can go, and realize that we have power to get there, then we can move beyond trauma.”  

Where to Start with Place-Based SEL 

If you’re not sure where to begin designing and implementing place-based SEL where you are, here are some questions to consider:  

• When designing curriculum, you might ask: Whose stories are we missing? Who does not see themselves in the school and curriculum? Looking at the secondary and tertiary demographics of your school can reveal hidden populations whose voices and identities may have been overlooked. 
• When working with place-based and project-based learning, you might ask: How can students have a voice in the projects they do? How can faculty have agency in designing projects?  
• You might also ask: How can stories of place support other subjects? Minakami cites the story of Pele the fire goddess and her sisters. “Their journey supports the science of volcanos,” he says. “Science and storytelling arrive at the same destination. That’s the genius in ancestral knowledge.” 

Key Messages

When SEL practices are grounded in a specific place—when they grow out of a culture that belongs to students and teachers—they can 

• extend a feeling of belonging to those whose stories aren’t normally told; 
• help students see themselves in the curriculum;  
• build resilience to enable students to cope with adverse events; and 
• re-connect staff and students to the natural world. 

In short, place-based SEL can be the strong, firm rope that connects people to each other, to cultural resilience resources—and to the land on which everyone depends. 

WPS acknowledges and honors the foundational teachings of Auntie Pilahi Paki and Gholdy Muhammad in shaping this approach to learning. 

In an autism evaluation, practitioners set out to gather as much information as possible about how someone behaves in different settings. But how humans behave can vary widely from culture to culture.

How do you know if your assessment results reflect the characteristics of autism or a difference related to someone’s background? And how can you be sure that aspects of a person’s identity aren’t subtly affecting how autism characteristics show up? 

Regilda Romero, PhD is Clinical Assistant Professor at the University of Florida’s Center for Autism and Related Disabilities. In her work, cultural considerations are an important part of autism evaluations. 

“Given the demographic shifts in the United States, there is a growing need to implement culturally informed autism assessments,” she explains. “While there are tons of diagnostic approaches available, autism assessments using a cultural lens are essential because of the strong relationship between social cognition, behavior, and culture.”

Romero recommends making your autism evaluations more culturally adaptive by working within a cross-cultural framework. 

What’s a cross-cultural assessment framework? 

A cross-cultural framework is a set of questions you can ask to make sure you’re considering every aspect of someone’s identity and lived experience. Lots of different models have been developed over the years. Some are more extensive than others, but they all cue you to consider the whole person in context.

“Cultural sensitivity in assessments, in general, is important because context matters. When I say that context matters, I am thinking about a host of multicultural factors that may be affecting the presenting problems. While we still must look at the DSM-5-TR in terms of the ASD criteria, the manner in which we view some of these symptoms may be influenced by their context,” Romero says.

Conscious use of a framework can be helpful no matter how long you’ve been practicing, but they may be especially useful early on. 

“In retrospect, I probably did not have a clear understanding of the impact of culture on assessment until I was a practicum student in San Francisco, California,” Romero recalls. “I had a first-grade Filipino patient who was referred for testing to evaluate the possibility of a learning disability. As expected, the patient’s first language was Tagalog.

“Since there were no language measures in Tagalog, I had to test limits during some of the verbal/language measures. Fortunately, I spoke Tagalog and was able to test limits using the patient’s first language. If the assessment did not include consideration of cultural and language factors, this patient would probably have been misdiagnosed as having a learning disability or intellectual disability.” 

For that reason, it's especially important to be guided by a cross-cultural framework if the test you’re using was developed by researchers from another culture.  

Which frameworks can be used in autism assessment? 

Cross-cultural frameworks can usually be applied to a variety of neuropsychological tests, including autism assessments. Here are two commonly used frameworks to consider: 

ECLECTIC Model

Developed by Daryl Fujii, the ECLECTIC framework prompts practitioners to learn about specific aspects of a person’s background early in a neuropsychological evaluation, before assessments take place (Fujii, 2018). These areas are: 

• Education and literacy 
• Culture and acculturation (which can influence the relevance of test items and the speed of test-taking) 
• Language (especially proficiency in the language of the test) 
• Economics 
• Communication (including idioms people use to communicate distress)
• Testing situation (including what a person may need to feel comfortable and motivated)
• Intelligence conceptualization
• Context of immigration (which may predict stress levels or mental health difficulties)

Researchers who used the ECLECTIC framework to guide their autism evaluations said it “results in more accurate findings and more individualized planning for the patient” (Bordes Edgar et al., 2022).  

ADDRESSING Model

Similarly, the ADDRESSING framework, developed by Pamela Hays, PhD, calls on the practitioner to consider nine elements of a person’s identity when planning assessments and interventions. This framework typically addresses whether someone is a member of a culturally dominant or minoritized group. Identity areas include:

• Age (including generational roles and responsibilities) 
• Disability (whether cognitive, physical, or psychiatric) 
• Religion and spiritual orientation 
• Ethnic and racial identities 
• Socioeconomic status (including family income, education, and occupations)
• Sexual orientation
• Indigenous heritage
• National origin (including immigrant status)
• Gender 

As with the ECLECTIC framework, the practitioner asks questions of the individual and the family to learn more about the whole person. It can also be useful for you, as the practitioner, to use the framework to identify your own cultural influences, perspectives, and potential biases. 

Which autistic behaviors are most sensitive to cultural difference?

The broad diagnostic criteria of autism are defined consistently across cultures and regions. Even so, subtle cultural differences exist in

• how autism behaviors are expressed;  
• how autistic behaviors are perceived or interpreted; 
• how much difficulty autism causes in day-to-day functioning; and 
• when, how, and where caregivers seek help (deLeeuw et al., 2020).

“Multicultural assessments are imperative in the diagnostic process as there are specific cultural factors that should be considered, such as societal perception of disabilities, cultural values, and acculturation level,” says Romero.

The list of examples below isn’t exhaustive, but it’s a good starting place for further exploration: 

• For many Chinese children, avoiding eye contact with adults is considered a mark of social respect. Some researchers have suggested that it might be more appropriate to look for atypical eye contact rather than a lack of eye contact (Hus & Segal, 2021). “To make the eye contact issue even more complicated, we must be aware that there are autistic individuals who make a concerted effort to modulate their eye contact. As such, we should not automatically assume someone is not autistic because of eye contact,” Romero points out. 

• In Ethiopia, social greetings are a matter of tradition. Greeting someone in a formal way might be considered a positive social skill, rather than a scripted or ritualized behavior or a communication deficit. In fact, when Ethiopian parents seek an autism diagnosis, social interactions are much less likely to have sparked their concern than other behaviors (Zeleke et al., 2018).

• On rating scales used to identify autism, two items (“Enjoys social occasions” and does not understand “the point of a joke”) do not predict autism as accurately among people in India as they do for those in some other locations (Carruthers et al., 2018).

• Test items that measure a person’s response to uncertainty and spontaneity don’t always predict autism well with people in Japan, studies show (Carruthers et al., 2018).

• Pointing and other communicative gestures aren’t universally carried out with the hands. In some regions, people “point” by raising, lowering, or tilting the head or face. Researchers have described these gestures as “effortful movements…produced with the apparent intention of directing attention…” (Cooperrider & Slotta, 2018).

• Imaginative or fantasy play is less common in some parts of the world than it is in the West (deLeeuw et al., 2020).

“We also must be mindful of different communication styles,” notes Romero. “There are cultures that use high-context communication, such as nonverbal gestures, body language, tones, and overall context, while others use low-context communication such as direct, specific, explicit communication.”

When it comes to unwritten rules and social norms, Romero encourages practitioners to ask, “Whose norms are we talking about?”  

What You Can Do

Adopting a cultural framework is a good place to start. In addition, you may also want to consider these strategies:  

• To increase your own understanding and boost buy-in from families, you may want to work with local partners and experts (Hoekstra et al., 2018). In some communities, partnering with faith leaders can be effective (Kang-Yi et al., 2018).

• When possible, use a care coordinator who speaks the family language. A coordinator can be a primary point of contact for the family, helping them to access care, ask and answer questions, and make community connections (Sakai et al., 2019).

• Learn what you can about the family’s perspective on autism. In some cultures, stigma can affect whether parents seek or accept a diagnosis. For example, in some Korean American communities, church leaders and childcare workers said discomfort, denial, and shame led some parents to avoid the topic of autism. For some, the stigma is rooted in the idea that a parent’s mental illness, bad genes, or “abusive caretaking” cause autism (Kang-Yi et al., 2018).

• Consider each family’s resources and support networks when planning interventions. Some caregivers may want extended family members to help with interventions so the child’s therapeutic environment is consistent. But that’s not always easy to accomplish. Educating, communicating with, and training a wider family network could help. Connecting people with support groups outside the family may be a good option for people without extended families or whose families are resistant (DuBay et al., 2018).

It’s also vital, Romero advises, to be attentive. “I believe that it is truly crucial that we listen,” she says. “As practitioners, we need to listen, acknowledge, and respect people’s lived experiences. As an allistic person, I make sure that I provide space and advocacy for autistic voices. We can claim to be experts in the DSM-5-TR and evidence-based assessments, but I believe that the best practice is the practice that begins with cultural humility.”  

Key Messages

Autism is an essential part of a person’s identity—and so is culture. To identify autism in someone whose background is different from your own, it’s vital to look carefully at areas where differences of culture could influence autistic traits. It’s also important to explore how people view autism, the diagnostic process, and intervention options. Using a cultural framework can raise your cultural awareness and help you minimize bias in your autism evaluations.

Learn More: The WPS In-Depth Guide to Autism Assessment

Trauma-informed practices continue to gain traction among health and education professionals as we collectively move through pandemic recovery. With so many of us coping with traumas like fallout from the opioid addiction crisis, intensifying climate-related natural disasters, ongoing racialized conflict, and ubiquitous episodes of school violence, a trauma-informed approach not only makes sense, it can be a necessity.

Yet for many practitioners, knowing that care should be trauma-informed and knowing how to provide it are two different things. That’s especially true when it comes to specialized tasks like assessments and evaluations.

Rachel Archambault, MA, CCC-SLP is the Speech-Language Pathology Program Specialist for Broward County Public Schools in south Florida. Her experience with trauma-informed care began as she, her colleagues, and their students coped and adapted following a shooting in their school—Marjory Stoneman Douglas Highschool in Parkland.

Since that time, she has used a highly rated podcast, Speech Science, and her website, The PTSD SLP, to advocate for the use of trauma adaptations in education. Archambault was recently named an Innovator by the American Speech Language Hearing Association for her work in the field.

Here are a few of her recommendations for making assessment experiences better for those who are recovering from trauma. 

1. Be straightforward about what to expect in the assessment process.   

To recover, people who have experienced trauma need to be able to build trust in others—especially authority figures. They also need processes to be transparent. Practically speaking, that means evaluators need to be clear about what students and patients can expect to happen during an assessment.  

“Standardized tests are often very lengthy,” Archambault explains. “We know what the research says about the timespan for concentration in students of different ages. When tests are very long, it’s daunting.” 

It can be tempting to say something like, “Just one more subtest to get through” when there are more. “You might be thinking, ‘Oh, we can just power through.’ But that’s not transparent and doesn’t foster trust. What ends up happening is that the child thinks, ‘Okay, I can do it for another few minutes,’ but when the subtest ends and you’re flipping over and there’s another test, you have lost trust.”  

2. Offer choices during the assessment process where possible.

Another core principle of trauma-informed care is offering choices, which can help create a sense of autonomy. That’s important for people who may have experienced traumatizing events where they felt they had no power or control.

“When we’re testing ESE [Exceptional Student Education] students to determine their eligibility for services, there may be multiple diagnoses involved,” Archambault says. “It’s fair to say to the person you’re testing, ‘Would you like me to pull you again in two hours or would you like to do another subtest now?’”

In some places, choices around scheduling standardized tests aren’t always possible. There simply isn’t time. “In schools, we don’t always have that kind of flexibility. In places where there are no caseload caps…we can’t always offer those kinds of choices because the systems above us aren’t as trauma-informed as we would like,” she says. 

Some practitioners offer a choice of which subtest to perform first, or which writing implement to use, or when to take breaks.  

3. Consider movement breaks, especially if students are fading or dysregulated. 

Multiple studies have shown that physical movement helps children and teens regulate their own emotions (Vasilopoulos et al., 2021). Some studies even link a brisk ten-minute walk to improvement in fatigue-related mood problems (Edwards et al., 2018). When walks take place outdoors in natural environments, they help reduce the symptoms of anxiety and depression (Grassini, 2022). 

“A lap around my garden area can help with emotional regulation,” Archambault confirms. “Movement is regulating. Moving around and jumping around are helpful for regaining focus.” 

4. Foster a sense of safety with private, appropriately furnished spaces. 

“When I’m thinking about safety, I think about how my room looks,” she notes. “I make sure my room is as private as possible, especially in a high school, where it can be embarrassing to be in speech. Middle schoolers have also told me they didn’t want to be seen in the speech room. It’s sometimes seen as a baby room because of the way it’s decorated.”

To avoid causing embarrassment or reluctance, it’s a good idea to be sure other students cannot see inside the speech room, for example, through a window.

“I ask my students what would make them feel better and safer in the room,” she says.  “For some kids, that’s the ability to charge their phone and keep it in eyesight.” Zero-tolerance phone policies aren’t aligned with trauma-informed practice, she notes.

She also makes it a habit to eliminate language and imagery linked to violence. Sentences like, “Shoot me a text” can be upsetting to students who have experienced domestic violence or terrorism. 

“We’re not going to know all the things that could upset the student in front of us because we’re not trauma detectives. But we can change our language in advance, just in case,” she says. “I am direct and I avoid figurative language during an evaluation.” 

5. Validate students’ feelings during the process. 

When a student does express frustration with the process or reluctance to participate, it’s important not to take those comments personally. “Be honest and open rather than being dismissive,” encourages Archambault. 

Another way to validate feelings is to pay attention to signals from the student. “We need to notice students who are fading during a test,” she says. “They’re starting to get things wrong, or they may begin giving very quick answers because they want to get out of there. The test is too long for them.”

When you see fatigue creeping in, validate that student’s experience by checking in with them.  

6. Model self-advocacy skills to increase empowerment. 

Not every person who experiences trauma will be equipped or supported in recovering from it (Delker et al., 2020). One way to help students build resilience is to encourage self-advocacy during the testing process. 

“Instead of expecting a student to know that they can ask for a break, I can model that by saying, ‘Do you think you might need to take a break between these test sections? Do you want water? Do you need to use the bathroom?’ They may not know that they can ask an authority figure for a break,” she says, “but that’s a life skill they’re going to need.”  

7. Look for places where test items and other features could be problematic. 

Being familiar with the assessments you plan to give can help you ensure that the tests themselves don’t re-traumatize or upset students. It’s also important to know as much as possible about your student’s culture, gender, and other identities. Some tests, for example, offer just two gender options. Knowing that in advance gives you an opportunity to prepare.

“In one test I use, there’s a test question about hurricanes. Well, I’m from Florida. I know that, chances are, someone has been affected by a hurricane,” Archambault explains. “Also, some tests expect answers that don’t take into consideration the use of African American English. When the test isn’t modeled after the answers I could receive, I have to report the test with a narrative to explain the situation.”  

8. Expand narratives to document what you observe. 

One place where you can account for individual differences, including the possible effects of trauma, is in your report-writing. If you think a test score may not accurately capture all the factors involved, you can document what you think is noteworthy. Those notes can inform your collaboration with others who work with the student in question.  

“My narrative sections are usually huge, because I am taking care to describe the behaviors I’m seeing. I may notice that someone’s eyes are continuously looking around the room. Or that this student was dysregulated or appeared hypervigilant,” Archambault says. “I may discuss that at an IEP meeting, where I can collaborate with the social worker. She can look into the record to see if trauma might be a good explanation, or whether it could be ADHD or PTSD. It’s asking, ‘What else could this be?’ It’s changing our mindset from ‘What’s wrong with you?’ to ‘What happened to you?’” 

9. Know how to tell if you’re dysregulated—and what works for you to cope with it. 

Finally, it’s important to recognize your own stress and trauma history.  Educators and clinicians are as likely as students to experience adverse events. When you factor in job pressures and second-hand stress from working with traumatized students, it’s possible you could benefit from implementing trauma-informed practices as much as your students can.

“A dysregulated adult cannot regulate a dysregulated child,” Archambault says. “You can’t. We all need to work on being able to identify when we’re triggered, because learning is not going to happen when you’re on edge. We need to know what happens when we’re dysregulated or stressed.”

You may also want to plan some interventions for yourself when you do feel overwhelmed during an evaluation. You might try one or some of the following actions:

• Ask a colleague to cover for you while you step outside for a moment 
• Find a quiet ‘fidget’ that distracts or calms you (Archambault presses her rounded fingernails firmly into her palms to give herself “tactile feedback”) 
• Practice breathing exercises 
• Drink water or wash your hands

“I have learned, through years of therapy, to advocate for myself. If I need a second, if a loud noise bothers me, I will tag a coworker and ask for time to go to the restroom,” she says.  

Key Messages

Professional caseloads and productivity pressures can make it feel as though there isn’t enough time to provide trauma-informed care, especially in tightly scheduled standardized test situations. “You go in, you test, and you leave. You might even lose pay because of your productivity,” says Archambault.

Still, many professional associations view trauma-sensitive care as best practice and an ethical obligation. While these 9 strategies aren’t comprehensive, they’re a good starting place. And they may inspire you to seek extra training in this increasingly important approach—for your own benefit, as well as your students’. 

West Seaford Elementary had a big problem. About a quarter of its students were missing school more than 10% of the time. The problem of chronic absence was so significant that staff and student morale (to say nothing of academic performance) was slumping.

When Principal Laura Schneider, Ed.D., took the helm, she and her team decided to work on the attendance problem like they’d work on a learning problem—using multi-tiered systems of support (MTSS) to prevent absences from getting out of hand in the first place.  

Spoiler alert:  It’s working.

At a time when many other schools are still struggling to revive pre-COVID attendance numbers, West Seaford has gone from a chronic absence rate near 22% to just 9%. That’s far below the 33% national rate for the 2021-22 school year.

The numbers are impressive, and so is the shift in school culture. School counselor Jordan Forston describes it this way: “The kids are happier and more focused when they’re not worried about catching up on missed work, when they know what’s going to be happening every day. And teachers know they can trust the tiered system, where there are multiple people involved in tracking what’s going on with our kids.”

The culture change aligns with educational research that links attendance to a sense of connectedness and engagement among students (Mooney et al., 2023). Multi-tiered systems of support are associated with greater self-efficacy in teachers, which can improve their well-being and lessen burnout (Nichols et al., 2020).

How does MTSS prevent chronic absence?   

Just as is true of academic MTSS plans, initial attendance interventions apply to all students. They include instructional and screening components. 

Tier 1 Attendance Interventions 

Tier 1 interventions at West Seaford focus on an intensive communication plan. Roughly 97% of families are connected to the school through ClassDojo, which enables teachers to message parents when a child is late. “That one gentle push can sometimes keep late from becoming absent,” Principal Schneider says.  

The school also educates families about the risks associated with absence, sometimes using resources from advocacy groups like Attendance Works. At times of the school year when absences tend to be more likely, the school may reach out to families proactively or schedule a spirit week to encourage steady attendance. Attendance scores are posted around the school and discussed at parent-teacher conferences and workshops.

“We can’t expect families to just ‘get’ why attendance is important,” Fortson explains. “We work hard to make sure families understand why we have high expectations, that we’re going to be checking on attendance, and that we’re going to help them however we can.”   

West Seaford’s attendance team monitors absences every two weeks from the start of the school year.  The team is comprised of the principal, assistant principal, school counselor, special education coordinator, and reading specialist, along with a school nurse, attendance secretary, social worker, and family crisis therapist when available. Teachers aren’t usually on the team because it meets during school hours.

“At our first meeting, we look at absences in the school as a whole,” Schneider says. “At the next meetings, we look at student subgroups and grade levels we know are more vulnerable to chronic absence. We look at individual student data to see who falls into the low, moderate, high, or extreme absence levels. Low or moderate is less than 10% of school days up to that point; so, if we were at 100 days, anyone with 10 or more absences would be a tier 2 or tier 3 student. We implement supports according to the tier, unless we call home and find out that the supports in that tier are inappropriate for the child.” 

Tier 2 Attendance Interventions 

Tier 2 supports include personalized outreach to families to ask what obstacles might be present and what strategies could help. They can also include motivators such as setting attendance goals with a student, having them track their attendance on a calendar, and earning incentives for meeting their goals.

Tier 3 Attendance Interventions 

In tier 3, the school and family co-create an individual attendance plan for the student, complete with 3 parent commitments and 3 school commitments. The plan sometimes identifies a short list of people who can be available to help with transportation to school.

“This has helped us all to focus on our relationships with our families,” Schneider says. “There have been times when the counselor and I have helped with transportation from the nearby apartment complex which allows us to talk to families who might be less likely to visit the school building.” 

Strong bonds with neighborhood families haven’t always been easy to form. Forston says, “We have families who have had a lot of experience with broken schools. They may have been overlooked. It may have felt like the school did not care or didn’t want to get to know them.  We have to build that trust, so they realize their kids are safe when they come here.”  

Fortson recounts the story of a young student who shared with her teacher that when she got home from school, her mom was not there.

“Her mom spoke only Creole,” Forston says. “One of our teachers speaks Creole, so she reached out to mom and discovered that she was expecting a baby, and there was a problem with the pregnancy.” A neighbor had watched the student while her mom sought treatment.

The baby would need to be delivered at a special facility in another state. The family would need to stay nearby at the Ronald McDonald House for around two months after the birth.

“Knowing in advance helped us make a plan. We got the family a Chromebook and uploaded the student’s lessons. She and her teacher worked together daily, sending video messages back and forth. And she wasn’t marked absent a single day,” Forston says. Providers at the Ronald McDonald House called to say how impressed they were with the school’s involvement. 

Aware the family had experienced job and housing loss because of the baby’s health, the school helped the family arrange new housing and had a van waiting to bring her to back school. They provided her with clothing, shoes, and school supplies. When she stepped through the door, she said, “This is the best day ever, because I am back in school.” 

How did school culture change for everyone at West Seaford? 

That student’s story is one of many at West Seaford. Using MTSS to prevent chronic absence has helped to re-shape how it feels to be part of the school.

It’s fostered a sense of belonging for students.  

“Kids like structure, so if they miss a couple of days, they may feel less of a sense of belonging,” Schneider points out. “If they’re not sure of new procedures or new learning, they can be ‘off’ emotionally, as well. And when people are absent chronically, it can affect friendships between kids.” 

It’s strengthened relationships with families.

“When a kid is not here, we’re on it,” Forston says. “Teachers have a conversation with the family right away, and that can be when we find out the reason behind the absence. Maybe the parent says, ‘We lost our house last night,’ or ‘I worked a double and was exhausted.’ If you’re in a school and you’re not tracking chronic absence from day one, by the time you notice, it may be too late to set up services to help the family.” 

It's made life a little easier for teachers. 

“If kids aren’t coming to school every day, a teacher has to keep re-teaching over and over, which affects the flow of tier 1 instruction for the whole class,” Schneider says. “In our experience, teachers quickly realized that what may have seemed like an additional burden at first [reaching out to families about absences] paid dividends in the end because they didn’t have to do as much re-teaching and their kids excelled in reading. Our oral reading fluency for grade 1 shot up 186%, which is important because oral reading fluency is a predictor of reading proficiency in upper grades. That’s why oral reading fluency was one of our school goals. Teachers saw that a simple phone call or text was so meaningful to the parents. They saw a direct link between student achievement and kids coming to school.” 

Key Messages

School leaders have long recognized that chronic absence jeopardizes learning, graduation rates, and outcomes later in life. What many now understand is that it can also jeopardize the way it feels to be in school day to day—for everyone. 

Establishing MTSS to boost attendance has had a powerful influence on school culture and achievement at West Seaford. Perhaps the school counselor says it best: “You can have a really cool positive behavior incentive system, you can track all the right behaviors, you can buy the best curriculum and paint the school any color you want. But if the kids aren’t there, what is the point?” 

Learn more:  

• How to Communicate with Families to Build Connection, Engagement, and Trust 
• How to Assess the 5 Components of Reading This Year 

The debate around what’s “normal” is never ending, and it’s often harmful to marginalized groups and persons. But in academic studies, and especially in education, the practice of age and grade norming is essential to help students and parents measure ability and progress in testing. Norming typically involves collecting data from a large and diverse sample of individuals who are similar to the population for which the test is intended, and then using statistical methods to establish “norms” based on this sample. Like the discussion around the term “normal,” norming can also fall subject to bias when the testing sample doesn’t have enough diversity.

Standardized tests are fixed by nature: everything from IQ tests to the SAT. To produce meaningful results from standardized tests, researchers, assessors, and graders use norming in K-12 schools, colleges, and even workplaces. If you have ever taken an entrance exam or personality test, your results have most likely been compared to a normative sample. For example, standardized tests like the SAT or ACT use grade norming to compare the performance of test-takers to other students in their same grade level. Similarly, classroom assessments and assignments may be graded using age- or grade-normed rubrics or criteria that are specific to the expectations for a particular grade level.

In a 2023 article titled, “Reducing the Bias of Norm Scores in Non-Representative Samples: Weighting as an Adjunct to Continuous Norming Methods,” published in the journal Assessments (ASM), WPS Chief Operating Officer, David Herzberg, joined authors Sebastian Gary, Alexandra Lenhard, and Wolfgang Lenhard to explore statistically reliable ways to reduce bias in norming. The authors used a method called raking—commonly used in the social sciences but rarely applied to the results of psychometric tests.

Raking simply applies “weights” or multipliers to test scores from a sample group. This process adjusts the distribution of scores in the sample so that it approximates the distribution of scores from a demographically representative sample. What demographic variables do researchers consider in this process? The demographics include gender, race, age, education level, and regionality.

Take the example of gender – in the general U.S. population, males and females are represented in approximately equal proportions. If a test sample had 40 boys and 60 girls, and test performance differed between the two genders, the distribution of scores could be skewed. With raking, sample differences in gender are adjusted to approximate the general population. (Interestingly enough, the statistical term ‘raking’ was inspired by the tool used to smooth over the surface of a garden.)

In this paper, raking is used in combination with continuous norming methods to improve the accuracy of normed test scores derived from non-demographically representative samples. The authors created a simulation using sample data, then used raking to adjust for education, ethnicity, and region. The authors found they could successfully reduce bias in norm scores and improve their accuracy by using a combination of methods.

Although this paper had very promising findings, there is no substitute for real diversity in a test sample. The authors noted that further research is needed to fully evaluate the effectiveness of raking and other weighting techniques in the norming of psychometric tests.

In the future, raking can be a useful tool for adjusting for lack of representativeness in normative samples, but there’s also a possibility it may introduce error into the raw-to-norm-score relationships if not used carefully. The authors also noted that it is important to consider joint distributions of demographic variables in developing norms, as these variables may interact with one another in their effects on test scores. Future research should explore alternative methods for developing norms that consider complex interactions among demographic variables.

What does it feel like to be in school?  

That question is on the minds of many educators as a new school year opens amid record mental health needs and nationwide teacher shortages. How people feel when they are in school is partly a reflection of a school’s culture— which may be why school leaders are increasingly focused on making it healthier.

One place to start is by changing how a school welcomes students with visible and invisible disabilities.  While it may not be surprising that inclusion programs benefit students with disabilities, it turns out that these programs can also have a powerful effect on entire school cultures. They can help everyone feel more welcome.

The Just Say Hi! program run by the Cerebral Palsy Foundation is an excellent example. In many ways, it’s serving as a model for transforming school culture through disability inclusion. Piloted in 2016 in New York City’s public schools, the program includes 84+ cross-curricular Pre-K–12 lesson plans, professional development, family engagement resources, learning adaptations, inclusive media/mentor texts, and more.

Debbie Fink, the organization’s Vice President of Education and Inclusion, empathizes with school leaders working to shift school cultures right now. “None of them signed up to deal with a pandemic or the fear of school shootings,” she says. “Just Say Hi isn’t an antidote to that. But it is a response to it. It amplifies empathy, respect, and inclusion among students and adults in the school community. It’s trying, through education, to elevate a sense of belonging for kids with disabilities.” 

The program’s name—Just Say Hi!—is the starting place for personal connection. Fink says, “People don’t always know how to interact, so the natural instinct is to avoid interaction, or to deal with the discomfort by ridiculing or bullying or using behaviors that have no place or space in an environment that is aiming to feel welcoming and safe for all.”  

Just Say Hi! teaches disability inclusion through these six scaffolded modules:   

• What Is Disability? 
• Disability History & Laws 
• Making Connections 
• Power of Language 
• Breaking Down Stereotypes 
• Welcoming Communities

Here’s what schools can learn about effective disability inclusion programs based on the Just Say Hi model.   

Be intentional.   

The Centers for Disease Control and Prevention (CDC) says disability inclusion is “more than simply encouraging people; it requires making sure that adequate policies and practices are in effect in a community or organization” (CDC, 2020). When disability inclusion is intentional, people with disabilities may become more engaged, take better advantage of available resources and relationships, and enjoy more day-to-day activities, the CDC notes.  

That’s important, Fink shares, because students with disabilities can often feel misunderstood and ignored, leading to greater isolation. “There’s physical safety and then there’s emotional safety,” she points out. “Kids with disabilities tend to have much more experience with feeling unsafe.”  

Partner with disability communities.

The design and content of a disability inclusion program should be developed by and with people who have disabilities. “Every element of our curriculum has been done in partnership with the disability community,” Fink says.

The components of the program, including individual lessons, were written by educators and counselors, many of whom have different types of disabilities and other intersectional identities. The materials can be accessed in many ways. For example, in pre-K through grade 8, every lesson features a video American Sign Language (ASL) word bank, so students can be exposed to and experience seeing and using ASL, helping to break down stereotypes. The ASL word bank was reviewed by a deaf professor at Gallaudet University, a leader in deaf education in the U.S.  

Prepare educators and staff.

Increasingly, students with diagnosed and undiagnosed disabilities are included in general education classes. That means educators need more training in how to adapt their lessons and learning environments so everyone has access and feels included.

A group of researchers studying resistance to disability inclusion initiatives identified several sources of discomfort among teachers (Lyra et al., 2023):

• Some felt anxious and uncertain about their ability to teach students with disabilities. 
• Some worried that creating inclusive learning environments would mean a work overload. 
• Some were resistant to change, especially increased collaboration.

For these reasons and others, it’s important for any disability inclusion program to provide ample opportunities for educators and staff to learn and grow.

“We tend to presume competence on the part of educators,” Fink explains, “when most general education teachers have not received training or upskilling on how to deal appropriately with students who have varied disabilities. That’s why professional development is paramount. It’s a must for their own ability to reach and teach every student: Educators need to presume competence among all students.”  

Weave inclusion throughout the whole curriculum. 

The lesson plans, adaptations, and other resources in Just Say Hi are cross-curricular. The 84+ lesson plans are intentionally designed for use in language arts, STEM, history, social studies, counseling, and arts classrooms.

The Just Say Hi Adaptations for Learning help teachers make other lessons, assessments, and materials more accessible and inclusive for all students. The cross-curricular functionality ensures that disability inclusion shows up in every course. It also ensures that no single educator or counselor is responsible for all six modular lessons.  

“The scaffolded lessons are based on the principles of universal design for learning: intentionally designed to be accessible for all students,” Fink notes. “It’s not meant for one teacher to do all six lessons. It’s spread out by subject. The total class time it takes is approximately 3-4.5 hours annually; 5 hours for high school. It’s not a heavy investment of time. It’s a dense, content-rich curriculum.” 

School leaders can also decide exactly how they want to roll out the curriculum—over a week, a month, a season, or the school year. Flexibility is important because lots of educators are dealing with “initiative fatigue”—too many mandates competing for limited time and resources.

“There are lots of options for how to use the program,” says Fink. “It’s adaptable based on individual school calendars.”  

Find out more about the disabilities in your school.

However school leaders decide to address disability inclusion, a good starting place is with an assessment of disability needs and barriers within the school. At the 2023 National Association of Elementary School Principals conference, Fink and her colleagues encouraged school leaders to consider questions like these:

• How many of our students have IEPs or 504 plans? 
• How many of our faculty and staff have visible or invisible disabilities? 
• How many of our staff and students have diagnosed or undiagnosed mental health issues?

A close look at the answers can illustrate the importance of intentional disability inclusion. The answers may also help school leaders motivate even more people to participate.  

Look for the ripple effects. 

Studies have shown that when students with special educational needs (SEN) experience inclusive teaching, their academic self-concept improves, as does their sense of social inclusion and school well-being (Alnahdi et al., 2022).

In one study, students with and without special educational needs participated in inclusive interactive groups in general education settings. Researchers predicted that the groups would benefit students with disabilities; what they discovered was that the inclusive activities benefitted everyone academically, socially, and emotionally. Researchers said students in the inclusive, interactive learning environments learned to “respect others, accept differences, and acknowledge different abilities.” New friendships formed, social skills improved, and cognitive abilities grew. One student said the groups made “going to school more meaningful” (Molina Roldán et al., 2021).

Fink echoes these findings. “We’ve seen students feeling comfortable engaging with each other,” she says, “and we’ve seen educators feeling comfortable engaging with students, even those who aren’t necessarily theirs—in the halls, cafeterias, playgrounds, and throughout the school.”  

Key Messages    

School leaders across the nation are looking for ways to raise teacher morale, restore student motivation, and reimagine their school cultures. Disability inclusion programs like Just Say Hi can make a big difference.

It’s important that disability inclusion programs be developed and delivered in concert with people who have disabilities. It’s also vital that they prioritize professional development, provide creative learning across the curriculum, and be flexible enough to make the process easy for overworked educators.  

Maybe that’s a tall order—but it’s one worth filling if it can change how people feel when they’re in school.   

Read more: 

• How WPS is Building Greater Diversity, Equity, and Inclusion 
• Are Your Evaluations Equitable for People with Disabilities? 

High school graduation should be a time to celebrate: A young person, brimming with promise, is ready to embark. But what if the student isn’t ready—not for college or career or lifelong partnership? What if hearing loss has kept them from acquiring enough language to keep up with ever-increasing academic and social demands? 

“We see this all the time,” says Peter Isquith, PhD, Senior Attending Neuropsychologist at Boston Children’s Hospital. “Imagine the outcomes if you don’t have the ability to think in language or talk in language. What job are you going to do? What relationships are you going to have? The effects can be quite devastating. It sounds extreme, but it’s not unusual.” 

Isquith and his colleagues evaluate dozens of deaf/hard of hearing (D/HH) students every year, conducting research and consulting with providers across the nation.  

“One of the things that happens is that kids with hearing loss of all stripes will end up in an elementary school. They may have a team working with them that includes speech and language pathologist, teacher of the deaf, educational audiologist, and others. Nobody notices just how much information they’re missing,” he says. “The gaps may be filled in by an aide and everything looks okay. Then right around the 5th grade, someone notices that the child can’t read, write, communicate, or socialize as expected. And then we’re in big trouble, because the child is outside the critical window for language development.” 

 Students like these have been immersed in education systems, yet, Isquith explains, “[t]he systems and providers have historically made the decision to give them language exposure but not necessarily language access.” 

The Problem of Language Deprivation  

Language deprivation—the term for denying people adequate access to language—is in the national headlines. The U.S. Supreme Court recently ruled that a case brought by a deaf student, Miguel Perez, could proceed against the Sturgis Public School District in Michigan. The school system denied Perez a diploma after advancing him year after year. Perez and his parents say the school system didn’t support him well enough and misrepresented his progress.

Perez v. Sturgis highlights a growing trend: More and more D/HH students are present in mainstream classrooms without adequate support. “When they lack language,” Isquith says, “it’s an emergency.”

To address the emergency, every student’s progress needs to be assessed early enough to make a difference. But not every practitioner is equipped to conduct such complex evaluations.  When a D/HH student needs an evaluation, how should you decide whether to assess, consult, or refer the student to an expert?  

A Matter of Fairness    

The decision about who should assess a D/HH student comes down to two variables: access and competence. The student must be able to understand how to do the test, and the evaluator must know how to choose the right assessment, deliver it appropriately, and interpret the results accurately. 

Some D/HH students whose hearing loss was identified early, and who had hearing technology early, have a firm language foundation. They may need minimal accommodations for standardized test-taking. For example, they may need a quiet environment and appropriate sound access rather than an evaluation from a signing psychologist. Other students may need more support or different assessment options.  

“Access means I have to make my communication accessible, whether it’s through a cochlear implant, a functional hearing aid, signing, or spoken words combined with sign support. Does the language work for the child?” Isquith asks.  

Hearing technology has advanced, but hearing aids and cochlear implants are not always sufficient. Learning environments need to adjust to the language needs of the child, instead of a student trying to learn in an unsuitable modality. Without access and competence, the process won’t be fair and the results aren’t likely to be reliable.  

To illustrate, Isquith points to some of the problems that arose during the COVID-19 pandemic.  

“There were masks, so there was no speech reading. And there was a plexiglass wall,” he recalls. “I reviewed an evaluation where the person was missing all kinds of information and making lots of mistakes, which were interpreted, sadly, as a dementia, when in fact it was a hearing issue.” 

The Necessary Knowledge   

There’s some question about whether it’s ever appropriate for a person who doesn’t have the language skills and training to give an assessment to a D/HH student. Experts in the field do not all agree. Isquith encourages practitioners to “approach assessment carefully.” 

To assess a D/HH student, Isquith says it’s essential to have foundational knowledge in these areas: 

• The type of hearing loss your student has, along with information about what caused it, how severe it is, what kinds of sounds are accessible, when the hearing loss happened, when it was identified, and what kinds of interventions have been tried 
• Your student’s access to language, including how old they were when they were first exposed to language, which languages they’ve used at home and school, and how good their language access has been in those environments
• Your student’s education, including information about early intervention and preschool, academic performance, and their ability to communicate and socialize
• Your student’s other health conditions, disabilities, delays, or mental health difficulties
• Clinical knowledge of hearing loss types and their potential impacts on language acquisition, cognitive abilities, learning, executive function, and social-emotional development
• Technical knowledge of hearing aids, cochlear implants, and other devices that can improve access to language
• Risk factors for hearing loss
• Language and communication systems, including those used in your student’s parent-child communication 
• Factors associated with resilience  

It’s important to take stock of your background knowledge and the current language functioning of the child before you plan an assessment. Then, he says, “you can decide if you are comfortable seeing a child or not.” 

The Necessary Competencies 

In addition to background knowledge, questions like these can help you decide whether you have the necessary skills to assess a D/HH student: 

• Is conducting this assessment within your professional scope of practice? 
• Can you communicate in a language the student can access? 
• How much training in cross-cultural assessment do you have?
• What other racial, ethnic, religious, or economic identities could intersect with learning differences and hearing loss?
• Do you know which test measures and assessment methods are appropriate for the student?
• Can you appropriately adapt assessments to meet the student’s needs? 

The NASP position statement further states that those serving D/HH students are “responsible for confirming that the samples and validity studies for any assessment they use are aligned with the student’s background” (NASP, 2020). 

“That’s a pretty heavy responsibility,” Isquith says.  

Consulting, Referring, and Working with Interpreters 

If you don’t yet have the background knowledge or skills to assess a D/HH student on your own, it’s important to consult with or refer to a professional who does. Your state school for the deaf is a good resource to help you locate an expert who may be able to consult with you or do the evaluation. 

“Using an interpreter is possible, but it’s hard. It takes some work,” Isquith points out. “You have to work with the interpreter to find out exactly what they’re doing. You’ll need to tell them in advance, ‘This is what I want you to do and here are the potential problems.’” 

When working with an interpreter, you’ll need to 

• avoid most verbal measures, since they will be hard to interpret; 
• review security and confidentiality processes; 
• ask for both a word-for-word interpretation and cultural meaning interpretation; and 
• de-brief thoroughly after the assessment. 

Isquith also recommends carefully documenting the steps you take during consultation. And whether you assess, consult, or refer—be prepared for a more comprehensive evaluation.

“We should assess more than we would for a typically hearing child,” recommends Isquith. “For example, I routinely give two estimates of cognitive ability, just to make sure I have some agreement. Even though things seem to be going well in some areas, such as spatial reasoning or motor speed, we should double check. We shouldn’t fall prey to looking only where the light is brightest.”

To make sure an evaluation is as complete as possible, it’s important to work with a team of practitioners with varied expertise. The reason for taking such a careful and thorough approach, he says, is that “it’s too easy to make a mistake that will be costly for the child or the family or for you, in the end.” 

Key Messages  

As the number of D/HH students in mainstream classrooms increases, more and more school-based professionals will be involved in making assessment decisions. Taking stock of your own background knowledge and competencies can help you determine whether to assess, consult, or refer the student in your care.

“We need to be thinking about meeting the needs of all students,” Isquith emphasizes. “In the last 30+ years working with the Deaf and Hard of Hearing Program at Boston Children’s Hospital where we have this very unique team, we’ve gone from the majority of kids as signers to the majority of kids as talkers, through the advent of advanced hearing technologies such as cochlear implants. A lot of these kids are not being seen by specialists…but there are still special considerations that we need to think about for assessment.”

Educators and clinicians must make sure D/HH students are carefully, competently assessed early enough to prevent language deprivation. Doing so will mean that more students can spend their school years building skills and friendships. And more students can leave school ready for all the possibilities on the other side of the graduation stage.  

• Learn more about the Language Equality and Acquisition for Deaf Kids (LEAD-K) legislation being studied and adopted across the U.S. 
• Explore learning opportunities through the Laurent Clerc National Deaf Education Center at Gallaudet University.  
• Find out more about the services offered by the Boston Children’s Hospital Deaf and Hard of Hearing Program. 

Autism Diagnosis Later in Life: What Does it Mean?

Researchers at the University of Bath surveyed 303 autistic adults to find out which factors had the greatest impacts on their quality of life. They looked at education, employment, household income, relationship status, independent living, sex, ethnicity, mental health, age at diagnosis, and autistic traits. For many of the study’s participants, learning about their autism as an adult has less of an impact than some other factors (Leung et al., 2023).   

Strongest Predictor of Quality of Life  

In this study, having more autistic traits had the biggest impact on well-being and quality of life (QoL). Researchers used the Ritvo Autism and Asperger Diagnostic Scale-14 (RAADS-14) to measure the number of autistic traits each participant experienced, both as children and as adults. Those with more autistic traits reported a lower QoL, whether they received an autism diagnosis in childhood or adulthood. 

Factors Linked to Better QoL   

Researchers in this study looked at several quality-of-life domains. Study participants who reported a higher psychological quality of life were older, had fewer autistic traits, and had no co-occurring mental health conditions. Greater physical quality of life was associated with: 

• Being employed independently 
• Being White 
• Having fewer autism traits 
• Not experiencing other mental health conditions 

Higher social quality of life was linked to:  

• Being female 
• Being in a relationship 
• Having fewer characteristics of autism 

Overall, sex, mental health, relationship status, and autistic traits influenced well-being to a greater degree than a person’s age at diagnosis.  

It’s important to note that other studies have come to conflicting conclusions about the relative impacts of these same factors (Mason et al., 2018). Some studies, for example, highlight the powerful sense of relief and regret autistic people sometimes feel when a diagnosis happens later in life (Ghanouni et al., 2023). 

Key Messages 

Autism experts have long said that early identification and intervention improve long-term outcomes for many people. That’s especially true when an autism diagnosis helps people get the support and services they need to feel good about themselves in school, in relationships, and at work (Oredipe et al., 2023).

For those who learn they’re autistic in adulthood, age at diagnosis may not be as important to well-being and quality of life as other factors. Studies like this one can help researchers, practitioners, and autistic people understand more about how to move forward when autism is identified in adulthood. 

Articles Related to Autism Diagnosis Later in Life:

• Autism is Cross-Cultural. Shouldn’t Your Assessments Be, Too?
• Lived Experiences: Autistic Girls and Women
• How Does Autism Present Across the Lifespan?