Advocacy in the news

Two unfortunate but interesting cases in the news about LD/ADHD advocacy.

LD leads to death?

The first is a group out of the UK that has released a report about the deaths of Learning Disabled individuals in hospital care. Here is a quote:

"An independent inquiry is being launched into the deaths of six people with learning disabilities ... the deaths were avoidable and pointed to "widespread ignorance" within the health service."

Now here is a break down of three cases presented as examples:

• 43-year-old Martin, went without food for 26 days while in hospital following a stroke. That left him too weak to undergo surgery and he died on December 21 2005.
• Cancer patient, Emma, 26, was told by doctors in 2004 she had a 50/50 chance of survival but they did not treat her as they believed she would not co-operate with treatment
• Mark, 30, died eight weeks after being admitted to hospital with a broken leg.

Clearly unfortunate cases. I have to admit though that I really wonder what they are referring to when they mention Learning Disability. I have never evaluated a person (or worked with) a person with an LD who would of died of these incidents (maybe the first one if the stroke was severe enough. I have certainly seen hospitals starve people before). Perhaps these could happen in very severe cases of MR, but LD? How the heck did they allow someone to die of a broken leg. Thankfully there is an inquiry. Read more by CLICKING HERE.

ADD Student Denied LSAT Accommodations

A really interesting case out of the states was reported on today about an ADD student that was denied extra time on the LSAT (law school entrance) exams after a court reviewed his case. In a nutshell they acknowledged that students with learning disabilities do often qualify for extra time and accommodations on high stakes exams but that this particular gentleman did not because his IQ of 110 (75th percentile) was not significantly discrepant from his previous LSAT results (unaccommodated) of 46th percentile. They noted that he scored about where you would expect an average student to score. An interesting statement and thought but there is some HUGE errors in that statement and makes me really wonder about the lawyers and psychologists involved:

1. Just eyeballing it that is pretty darn close to a significant discrepancy
2. There was a comment that his processing speed was significantly lower than his other abilities and was the reason for the need for extra time. This means his FSIQ was probably an underestimate of his actual comprehension and reasoning abilities. Had they used his VCI/POI score (or whichever if they used something other than WAIS) they probably would of found he was well above Average (since he technically already is High Average)
3. I've seen the LSAT and it is extremely heavy in reading content and is multiple choice. An ADHD-Inattentive subtype is clearly at a disadvantage
4. The old adage that you cannot achieve higher scores then your ability score is clearly been thrown out the window. Students who implement appropriate strategies and skilled /directed problem solving techniques can clearly preform higher then expected.

I do wonder about one thing. They say he fell at the 46th percentile nationally. Is that compared to a norm group representing the entire population or just college students who took the LSAT. If that is the case he is probably way above the 46th percentile when compared to a random peer group and therefor operating no where near a discrepancy. You can read the full article by CLICKING HERE

What should we do?

So how do we resolve this? We get rid of these stupid LSAT, GRE, MCAT and other large scale entrance exams that have been continually proven not to do anything but otherwise thin the herd. They have been routinely shown not to correlate to grad school success and one study even showed them being negatively correlated.

They should at the least get rid of power tests of these domains and move towards content tests that are based on criteria that identify individuals who would be good for identifying specific traits related to success in a field.

A question on accommodations with high stake testing

I must admit that I am actually torn on the idea of accommodations of high stake testing. On licensing exams where individuals may be placed in environments in which they need to make high speed decisions on medications (dosage) or procedures do we want to bypass this high speed element for individuals who may face these types of challenges?

I'm going to say yes they should. Some of the most talented, knowledgeable, and qualified individuals I have met in Psychology, nursing, and in other fields have been those who have specific learning difficulties like working memory. They are also individuals who are aware of their strengths and weaknesses and put strategies in place to compensate for them. Maybe these individuals are even better prepared because they are aware of the challenges and put steps in place to avoid them. I have certainly heard of cases of individuals without these problems performing medical errors or cutting off the wrong limbs.

I also think that the concerns were influenced by the large array of low functioning individuals we come across in our lives. In reality they are never going to make it into these types of environments in the first place if they are not able to accommodate their daily life challenges. So is this really an issue at all?