March-April 2006 Selected Content
Taking Charge - Larry and Susan Kaseman
Why Children Are Not for Screening
Your newborn undergoes routine screening before leaving the hospital. A letter arrives saying that preschool screening is required by law and announcing the date your four year old should report. A health care provider begins asking non-medical questions such as "Where does your baby sleep?" "Does your two and a half year old cling to you more than you expect?" "Do they seem too friendly with strangers?" and "About how many close friends does your 15 year old have?" A recent U.S. Supreme Court decision favors school districts over parents in controversies over special education. It's all part of the increase in screening of children and challenges to parents' rights.
Widespread assessments are a recent phenomenon. In 1972, only one state required standardized testing of public school students. But by 1989, all 50 did. Today assessments are no longer confined to schools. Children are assessed from birth on. The federal Individuals with Disabilities Education Act (IDEA) is used to justify many screenings, even though the law only requires that officials make screenings available; it does not require that parents have their children screened. However, officials eager to expand the reach of schools and increase their budgets have used preschool screening to enlarge IDEA even though it is a program supposedly designed for children with serious disabilities. In addition, screenings are being conducted by many professionals, including health care providers, social workers, teachers, physicians, and counselors. Drug companies and others are pushing for increased mental health screening. (See our column in the Jan/Feb 2005 issue of HEM or online at http://www.homeedmag.com/HEM/221/jftch.html.) Children who supposedly do not do well on screenings are subjected to more extensive evaluations by a multidisciplinary team of "experts" to determine whether they need special education or other treatment.
But do screenings help children develop in healthy ways? Or do they cause more problems than they solve? This column will explore the risks of screening, the benefits of choosing alternatives to screening, and ways to minimize the damage screening can do.//
Problems with Screening
Reports from screenings are often misleading and inaccurate. Inaccuracies arise from several sources. Any test or assessment inevitably reflects the values, background, and experience of its creators. Members of ethnic minorities and people who have chosen values different from the dominant culture are unfairly handicapped when assessed by mainstream standards. Is it really fair or accurate to say that children who don't do well on tests biased in favor of white middle-class boys are abnormal?
Most people do not do their best in stressful situations. Young children who are appropriately shy around strangers and in unfamiliar settings often fail to perform tasks during preschool screening that they frequently do at home, leading assessors to underestimate their abilities.
To make matters worse, inaccurate assessments can become self-fulfilling prophecies when children conclude they are "dumb."
Many evaluators are biased, sometimes unintentionally. They focus on finding problems, not on identifying the few children who need and would benefit from available help and encouraging the rest of the families to continue what they are doing. Evaluators' training, mindset, and worldview tend to be dominated by the notion that many, many children need the help that their profession can offer. In addition, evaluators' prestige, salary, and job security depend on their finding new clients.
Screening can result in legal difficulties. Parents who allow screening surrender a great deal of control. It is often harder to prevent additional screening once a child has been screened. Schools and other agencies may claim the initial screening shows that formal evaluations are necessary as a follow-up to the screening. Labels such as "learning disabled" (LD) and "attention deficit hyperactivity disorder" (ADHD) give schools legal authority they don't have if children have not been labeled. School officials can report families to social services. For example, if children appear to do poorly on part of a preschool screening, social services may be notified that the children's home needs to be investigated.
Even parents who really want to have their children screened should seriously consider whether the information from public school screening is worth the risk of legal difficulty. It is less risky to pay for a private assessment and consider the expense a relatively small price to pay for maintaining privacy and control of their lives and minimizing the risk of intervention by the state. However, parents must select private evaluators carefully to ensure that they will not submit results of the screening to the state, as some evaluators now do. And, of course, the basic risks of screening, such as inaccurate results and loss of confidence, apply to private assessments as well as public ones.
Screening undermines children's confidence. It is a search for weaknesses, not strengths, and a vote of no confidence. To enable assessors to rank and label children, screenings include questions and tasks that few if any children will be able to handle in the time allowed. This increases some children's sense that "something must be wrong with me," that they have failed or at least done poorly.
Screening undermines parents' confidence in their children, themselves, and their ability to raise children. It says that parents are not competent and that "experts" are needed to assess children and tell parents what to do. In addition, parents know more about their children than people conducting screenings do. When parents are intimidated by screenings and give up on their own ideas and observations, we lose a very valuable resource for helping children grow and learn.
Screening interferes with children's learning and development. Each of us learns best at our own pace, quickly in some areas, more slowly in others. Learning happens much more easily and effectively when we discover things for ourselves instead of trying to follow a teacher's explanations that may not make sense or that we aren't ready to understand. But screening imposes arbitrary, one-size-fits-all standards that really don't fit anyone. Attempts to correct supposed deficiencies often make the situation worse. Supporters of screening often argue that "early detection" is necessary so problems can be corrected promptly. This leads to children being diagnosed with "problems" they would have outgrown given more time.
Dealing With the "Risks" of Refusing to Have Your Children Screened
Some parents may say, "What if we don't have our children screened and we miss a problem that could have been corrected? If the kids are normal, the screening will confirm this, right?" Wrong. The likelihood that screening will turn up a serious but previously unidentified problem is slim and has to be weighed against the much greater chance that the screening will damage a child's natural development. Parents know a lot about their children, especially when they take responsibility for their children and don't turn them over to experts. Screenings, on the other hand, can be inaccurate and often claim to identify "problems" that children would naturally outgrow given more time.
Alternatives to Screening
Parents who want to do the best they can for their children, including protecting them from the risks of screening, can do a lot to understand, support, and encourage their children's development without subjecting them to screening. Among the possibilities:
• Many parents spend a lot of time with their children, simply because they love them and enjoy being with them. In the process, parents learn a great deal about their children's strengths, talents, interests, and abilities. They provide a supportive environment that makes learning easier.
• Parents learn a lot from talking with other parents, observing children from other families, and reading carefully selected books.
Focusing on "doing," on activity and hand-on experiences rather than on "teaching" gives children opportunities to learn more easily and at their own pace. (See John Holt's Learning All the Time, listed in Resources below.)
• Parents who suspect a problem with hearing, vision, etc., take their children to a specialist. Dealing with specialists can still cause difficulties, but it's usually less risky than taking children to a general screening.
• Many parents who are concerned about some aspect of their children's development choose to solve the problem themselves rather than turning to screenings. Parents can identify and focus on the child's strengths, whether physical skills, mechanical ability, creativity, academics, ability to work with people, or whatever. They can apply the "tincture of time" and give children the opportunity to outgrow a problem. They can keep informal records or journals to show their children's progress. By noting when specific problems arise, they can see if a difficulty is connected to a particular time of day, food, stress, etc. They can share their concerns with supportive, experienced parents whose principles and beliefs are similar to their own. They can consult books and websites for more information, fresh perspectives, and support. They can consult alternative health care providers. Such approaches are almost always more effective than turning children over to "experts" for screening. They also strengthen the family.
How We Can Minimize the Damage That Screening Does
• We can know our rights. Screenings are almost always voluntary, and we can avoid some of them by not taking our children to be screened, even when we get letters telling us when to report for preschool and other screenings. However, we have to be alert to prevent our children from being informally screened by health care providers, public school officials, and others. We can insist on being with our children during medical procedures (unless there is a compelling medical reason why we cannot be present) and encounters with school officials and social service workers, and stop them if they start asking inappropriate questions. Sometimes we can put our refusal to have our children screened in writing.
• When an official claims that a screening or other assessment is required by law, we can insist on seeing a copy of the statute(s) that the official is referring to. (We can also refuse to provide vital data about our children, such as their social security numbers, unless officials can show us statutes that require that we give them such information.) We can educate officials who are uninformed or misinformed and think that screenings or other assessments are required when actually they are not.
• We can refuse to allow evaluations of our children that would then give school officials the authority to decide if they need special education. Many children have had negative experiences in special education programs; many parents want to avoid it. Permitting evaluations reduces our authority and increases school officials' authority. To make matters worse, in November, 2005, the U. S. Supreme Court ruled that when parents and school officials disagree on whether a child's Individualized Education Program (IEP) is appropriate for that child or is working well, the parents and not the school district bear the burden of proof and must show that the IEP needs to be changed.
If we refuse to consent to an evaluation, school officials may apply pressure, including threatening to initiate a hearing. We can respond by asking officials to show us the statute that requires that parents agree to evaluations and by citing books and case histories that question the validity of diagnostic techniques, labels, and treatments associated with special education. (See Resources below for helpful books.)
• If our children have been evaluated and are being governed by an IEP that we realize is not what they need or is harmful to them, we can withdraw our children from public school and enroll them in a private school, including a homeschool.
• We can inform other parents about their rights and the problems with preschool screening and other assessments of children. Many people assume preschool screening is both required and safe. We can tell them it is voluntary and risky. The more people who question and refuse to participate in preschool screening, and the more people who know their rights and act on them, the greater the likelihood that we will maintain the rights we now have.
Screenings are risky. They are sometimes inaccurate, undermine parents' and children's confidence, can get families into legal difficulties and cause other problems. Generally speaking, children learn and develop better when they are supported by loving parents who take responsibility for them and spend time with them than when they are turned over to screenings that can cause problems and that very seldom identify real problems that parents haven't already recognized.
• Armstrong, Thomas. In Their Own Way: Discovering and Encouraging Your Child's Personal Learning Style. Criticisms of special education by a former teacher of "learning disabled" children. Outstanding suggestions for helping children learn.
• Cole, Gerald. The Learning Mystique. Somewhat challenging reading but extremely helpful information for bolstering parents' confidence and countering "experts."
• Granger, Lori and Bill Granger. The Magic Feather. One family's story. Easy-to-read, very moving information on the risks of screening and special education.
• Holt, John. Learning All the Time. Excellent information about how children learn and how adults can help them.
© 2006, Larry and Susan Kaseman