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Response to Intervention

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Running head: RESPONSE TO INTERVENTION AND SOCIAL CONSTRUCTION

Response to Intervention and the Social Construction of Impairment: "It Ain't Nothing `Til We Call It." Deborah S. Hamilton University of Illinois at Chicago

Response to Intervention Abstract When the U.S. Congress authorized the 2004 Individuals with Disabilities Education Improvement Act (IDEIA), it contained provisions for local educational agencies to implement Response to Intervention (RTI) is a diagnostic tool for Specific Learning Disabilities. RTI's arrival on the educational scene brings life to some weighty and longstanding flaws in the domain of educational and psychological diagnostics. Impairment is an unstable category imbued by the prevailing social climate and can be constructed utilizing the same mechanisms that support the construction of disability. Little is known about the causes, proper diagnosis, and effective treatment of learning disabilities. There is growing suspicion that psychological and educational labels are

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neither objective nor substantive. Changes in thinking that led up to the incorporation of RTI into special education law have served to disclose cracks in the façade of special education. The lesson of RTI is that any of our settled practices can be challenged, disputed, and changed and that the field of special education is capable of theorizing impairment. There is much that local practitioners can accomplish by monitoring the path that this reform takes within local educational agencies. RTI represents a subtle shift in thinking but, in its default mode, reverts easily to a model that situates disability squarely in the lap of the individual. RTI in its most mature form will emphasize the professionalism of the interveners rather than the pathology of the responders. In its purest and best formulation, RTI can foment significant discussions regarding the social construction of impairment. It can serve as a stimulus for discourse that has long been lacking in the field of special education regarding the nature of objectivity and our complicit role in naming impairment.

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Response to Intervention and the Social Construction of Impairment: "It Ain't Nothing `Til We Call It."

Introduction Literary theorist Stanley Fish tells an oft-repeated story about baseball umpire Bill Klem. After missing a pitch, a baseball player waited an unusually long time to hear whether the pitch was a ball or a strike. Impatiently, he asked Klem: "Well, is it a ball or a strike?" Klem responded: "Sonny, it ain't nothing `til I call it." Fish uses this story to reinforce his belief in the interpretive nature of the data that surrounds us. Even the hard physics of something a simplistic as a baseball traveling through space and time can be softened, molded, and changed by social and, in this case, individual interpretations. The notion that data can be theory-laden is at the heart of current changes in special education law. When the U.S. Congress reauthorized IDEA in 2004 the resulting law, Individuals with Disabilities Education Improvement Act (IDEIA), contained provisions for changes to the way that individuals are assigned the label Specific Learning Disability." Since the inception of learning disabilities as a category of disability, school districts have been diagnostically "calling it" for students with learning disabilities by comparing the results of I.Q. tests with the results of achievement tests. Local educational agencies are no longer bound by psychometric methods of notating discrepancies between achievement and intellectual ability but may decide instead to "use a process that determines if the

Response to Intervention child responds to scientific, research-based intervention" (IDEIA, 2004). Proponents of this substitution have presented sufficient rationale for supplanting the discrepancy model. The learning disability category is the single largest special education category, containing more than half of all special education students (U.S. Department of

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Education, 2001), a statistic that has led to concerns that students are being overidentified for this category. Other concerns range from the instability of learning disability (LD) percentages among U.S. states (U.S. Department of Education, 2001), the overall increase in the numbers of students identified with learning disabilities over time (McBride, Dumont, & Willis, 2004; Smith, 2004), the link between the LD label and low socioeconomic status (Blair & Scott, 2002), the efficacy of achievement testing as a measure of ability (Salvia & Ysseldyke, 2004; Sattler, 2001), and the treatment time lost while waiting for students to demonstrate a discrepancy in test scores (Elliott & Fuchs, 1997). Response to intervention (RTI) is a diagnostic tool that focuses on providing intensive and specific instruction to students prior to special education labeling. Although it is too early to determine how RTI will be implemented in local educational agencies, its arrival on the educational scene brings life to some weighty and longstanding flaws in the domain of educational and psychological diagnostics. Impairments that are outwardly marked on the body are diagnosed by professionals with more empirical confidence than are educational and psychological impairments that are hidden in the recesses of the mind or found on the pages of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Labels that have fallen in and out of vogue over time (Learning Disorders, Attention Deficit Disorders, Hyperactivity, Homosexuality, Asperger's Syndrome, and Autism) give rise to the perception that the labeling process is

Response to Intervention more variable than static, more theoretical than empirical, and more at the whim of "the caller" than at the materiality of "the called". Nowhere is this so apparent as in the field of special education and the label of learning disabled. Deborah Gallagher (2004) questions this state of affairs by asking: "How is it that students are identified daily as having a learning disability when no one really knows what a learning disability is?" (p. 11). Professionals have been hard-pressed even to calculate the statistical prevalence of

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learning disabilities and estimates vary wildly, ranging from 1 percent to 30 of the school population (Lerner, 2000). Through inadequate teaching, impatience while students are reaching predetermined and possibly artificial benchmarks, lack of an understanding of minority differences, and overzealous labeling practices we have created a situation in which it is acceptable for educational professionals to call impairment into existence. In a very real way "it ain't nothing `til we call it." The Hard Kernel of Impairment In the exercise of disability theorizing it has been useful to separate the physicality of impairment from the social constructs of disability. Structuralism, essentialism, and modern evolutionary thought together conspired to mire minorities in their bodies and thereby reduced societal culpability when biology indeed became the destiny of women, racial minorities, and disabled individuals. This thinking ensured that the early intellectuals who theorized sex, skin color, and impairment would minimize biology and choose instead to emphasize the social construction of gender, race, and disability. Bell Hooks (1995) embraces a critique of essentialism for African-Americans by noting that "abandoning essentialist notions would be a serious challenge to racism" (p.122). Disability studies theorists kept adherence to this formula, choosing to de-

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emphasize pain, inconvenience, and the individual bodily experience of impairment. In a rare departure from this formula, David Mitchell (2002, p. 17) refers to the "hard kernel" or "recalcitrant corporeal matter" of impairment as depicted in literature to serve as "reminders of the real physical limits that weigh down transcendent ideals of the truthseeking disciplines". Michael Bérubé (2002) mirrors Mitchell's thoughts: . . . whenever we get too blithe about the possibility that social constructions can be constructed otherwise, too complacent in our belief that we can change a socially constructed world by the end of next week, we need to remember . . . that there's a there there, that the biological materiality of the body is susceptible to a finite (and sometimes severely delimited) number of constructions. (p. 341) Many disability studies scholars are reluctant to discuss the corporeal physical limits of disability in favor of emphasizing the social limits imposed by our culture but nonetheless the biological fact of impairment is rarely under dispute in those same circles. Poststructuralist thinkers give pause to the dichotomies that have proved to be so useful in minority group thinking by insisting that there is no such thing as feminine nature. Judith Butler (1999), building on the work of Michel Foucault, disputes not only the cultural conventions of gender but also the status of sex as a natural category. Butler writes: Originally intended to dispute the biology-is-destiny formulation, the distinction between sex and gender serves the argument that whatever biological intractability sex appears to have, gender is culturally constructed: hence, gender is neither the causal result of sex nor as seemingly fixed as sex . . . if the immutable character of sex is contested, perhaps this construct called sex is as

Response to Intervention culturally constructed as gender; indeed, perhaps it was always already gender, with the consequence that the distinction between sex and gender turns out to be no distinction at all. (pp. 9-10) Just as the stability of sex as the biological portion of a set of binary categories can be called into question, so can the existence of impairment. In truth, impairment is an unstable category imbued by the prevailing social climate. Lessons from cultural

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anthropology have taught us that even physical traits that are limiting in one social setting can be advantageous another. Physical height is valued in most cultures but in Ghana tall men have formed a support group, The Tall Men's Club of Ghana, because their physical trait is not favored or supported by society (Perry & Perry, 2003). Individuals who are albino are stigmatized in most of the world but among the Kuna people in Panama albinism is a highly desired state (the Kuna have the highest incidence of albinism in the world); albino individuals are afforded a unique niche in society and are not segregated from it (Howe, 1998). In Central Borneo among the Punan Bah the birth of twins is a source of shame and adult twins do not exist in that culture (Nicolaisen, 1995) but in much of the rest of the world the birth of twins is cause for celebration. Ingstad & Whyte (1995) express the variability of impairment categories succinctly while challenging universalist assumptions about what is normal: What is significant for our purposes at the moment is that the cultural conceptualization of humanity is variable; the anomalies that may be seen as inhuman differ greatly from one society to another, and they do not correspond directly to biomedical definitions of impairment. (p. 11)

Response to Intervention It is a nascent thought among disability scholars that impairment can be socially constructed utilizing the same mechanisms that support the construction of disability. Lennard Davis (2002) illuminates the shaky ground of impairment:

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Is anorexia or ADD an impairment or a disability? Particularly with illnesses that did not exist in the past, the plethora of syndromes and conditions that have sprouted in the hearts and minds of physicians and patients--conditions like attention deficit disorder, fugue states, pseudoneurotic schizophrenia, or borderline psychosis--we have to question the clear line drawn between the socially constructed `disability' and the preexistent and somatic `impairment.' Ian Hacking, in Mad Travelers: Reflections on the Reality of Transient Mental Illnesses, points out that fidgety children were not considered to have impairments until ADD began. Is the impairment bred into the bone, or can it be a creation of a medical--technological--pharmaceutical complex? (p. 23) The reluctance by most disability scholars to theorize impairment is, in part, due to trust in the biomedical nomenclature of impairment. Shelley Tremain (2004) notes in her treatise on impairment: Because much of the past work in disability studies has assumed a realist ontology, impairment has for the most part circulated in disability discourse as some objective, transhistorical and transcultural entity which biomedicine accurately represents. Foucault's historical approach could enable us to show, however, that this allegedly `real' entity is in fact an historically contingent effect of modern power. (p. 34)

Response to Intervention Is there a there there? If physical impairments can be deconstructed by cross-cultural comparisons and/or theoretical endeavors, then psychological and educational impairments might benefit from a similar arrangement. Professionals who interface with the human mind might well ask themselves the question that Michael Bérubé answered for individuals with physical impairments: Is there a there there? Thomas Szasz (1970) has long asserted that mental illness is a myth. In Study Guide to DSM-IV-TR, the author acknowledges that "the problem of fuzzy boundaries becomes even more relevant when clinicians try to determine where normal behavior, thought, and mood end and their abnormal variants begin" (Fauman, 2002, p. 6). In the fuzzy math of special education labeling little is known about the causes, proper diagnosis, and effective treatment of learning disabilities. Deborah Gallagher (2004) opens up the possibility that learning disabilities can be socially constructed by noting that: "what is at the root of all the difficulty in defining and identifying learning disabilities is the confusions between discovery and construction" (p. 10). Even more appalling is the current state of affairs in which more is known about the connection between socioeconomic factors (race, gender, poverty) and the increased risk of L.D. overidentification than is currently being openly discussed. There is growing suspicion that psychological and educational labels are neither objective nor substantive. Thomas & Loxley, 2001) unravel part of the history of special education that is bound up by normed testing: . . . words like `intelligence' have been taken as without-problems descriptors of God-given phenomena which were taken manifestly to exist. Psychologists and

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Response to Intervention educators have seen it as their duty merely to seek out, reveal and measure such phenomena rather than explicate them or problematize them. (p. 23)

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Changes in thinking that led up to the incorporation of RTI into special education law have served to disclose cracks in the façade of special education. It is imperative that these chinks in the armor are allowed to stay exposed and that others are discovered. Response to intervention is not an unchallengeable new premise upon which we can rest. No model for diagnosis, whether old or new, will be innocent or immutable. However, the lesson of RTI is that any of our settled practices can be challenged, disputed, and changed and that the field of special education is capable of theorizing impairment. The question to ask ourselves concerning the measurement of learning disabilities is this: how are we causing the effect that we are attempting to measure? Or, in the words of Berger & Luckmann (1966, p. 18), "how is it possible that subjective meanings become objective facticities?" We must make ourselves fully aware of Heisenberg's Uncertainty Principle and then pose this query: how does our perspective influence what we see? If the proponents of RTI are correct, then intensive research-based instruction will alleviate the need to label some students with the LD impairment. Following this line of reasoning, and still assuming that the proponents of RTI are correct, some LD impairments are currently being created by inadequate instruction. If this is true, then the categories of disability and impairment are conflated as they are each being actively socially constructed. No doubt this conflation will be unwelcome on many levels. First, for impaired persons who experience tangible impairments that truly exist, the notion that impairment might be socially constructed dismisses the hard kernel of truth regarding pain, fatigue,

Response to Intervention pacing, embarrassment, adaptation, and modification. Second, the elimination of

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impairment as an uncontested category destroys the basis upon which disability identity rests and serves as a measure of cultural erasure. Third, educators who are in the business of providing instruction will be placed in the unhappy position of acknowledging their failure to provide efficacious service and their role in causing impairment instead of alleviating it. Fourth, demonstrating the possibility of a constructed category of impairment in education and/or psychology opens up doubt regarding the existence of other categories of educational and psychological impairments. Fifth, collapsing the categories of impairment and disability leaves fertile ground once more for the growth of essentialism, determinism, and/or structuralism. Developing a social model of impairment necessitates examining schools with fresh eyes. Local educational agencies in the U,S. are more than just microcosms of society. Schools have distinct cultures that vary from community to community and from state to state. It is useful to apply cultural relativism, as gleaned from cultural anthropology, to school climates. Education enjoys viewing itself in a more absolute fashion but in the process the reality of unique school culture is denied and, more dangerously, unexamined. Schools are social communities that craft their own realities, their own truths, and therefore their own local spin on impairment. Charles Lemert (2005) describes the role of the social community in the production of truth: When it comes to the meaning of social things, reality and its corollary, truth, are in fact arbitrary in the rigorously sociological sense: They are conventions of the social community, thus real so long as the community agrees to uphold them, and

Response to Intervention something other than real whenever the community loses its ability to exercise authority over the truth of social things. (p. 64) Conclusion For special education professionals who are attempting to practice while

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simultaneously integrating disability studies theory into their everyday decision-making, issues surrounding diagnosis, labeling, and treatment can be difficult to navigate since they are traditionally guided by medical model thinking. Professionals with no intellectual interest in curing are daily placed into the curing role. Michel Foucault (1965), in Madness and Civilization, pinpoints the source of our discomfort by stating that "interest in cure and in exclusion coincide" (p. 10). Practitioners who find this link a repugnant one walk a fine line between theory and practice. Susan Gabel (2005) articulates this best: One methodological dilemma for educators is the problem of deciding how to balance the need for improvement of function (often the school's concern) with the refusal to pathologize and the reticence to `cure' difference (two concerns of social interpretations). (p. 9) Practioners who wish to bring lasting and significant changes to their school settings have to ask themselves two questions: "How can I reform a system of which I am a part?" and "Am I ready to reform the hand that feeds me?" Professionals who want to bring change into their profession need not only the skills to implement change but also the resolve and courage to apply those skills.

Response to Intervention In the case of an external, federally imposed, and optional change such as RTI there is much that local practitioners can accomplish by monitoring the path that this

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reform takes within local educational agencies. RTI represents a subtle shift in thinking but, in its default mode, reverts easily to a model that situates disability squarely in the lap of the individual. Brown-Chidsey & Steege (2005) note that RTI is premised on progress and that "when empirically validated interventions are used, it is expected that most students' school progress will be appropriate" (p. 9). When the interveners have intervened their hardest and the responders are not responding, the deficit model can find its way back into the schools again. Special education literature is replete with references to the resistance of the individual to instruction. Students have been labeled "inactive learners" and have been presumed to lack motivation, attention, the ability to generalize, the ability to process information, and the ability to problem-solve. Care must be exercised to prevent students from being perceived as resistors in their own treatment. RTI in its most mature form will emphasize the professionalism of the interveners rather than the pathology of the responders. In its purest and best formulation, RTI can foment significant discussions regarding the social construction of impairment. It can serve as a stimulus for discourse that has long been lacking in the field of special education regarding the nature of objectivity and our complicit role in naming impairment.

Response to Intervention References

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Berger, P.L. & Luckmann, T. (1966). The social construction of reality: A treatise in the sociology of knowledge. New York: Anchor Books. Bérubé, M. (2002). Afterword: If I should live so long. In S.L. Snyder, B.J. Brueggemann, & R. Garland-Thomson (Eds.), Disability studies: Enabling the humanities (pp. 337-343). New York: The Modern Language Association of America. Blair, C., & Scott, K.G. (2002). Proportion of LD placements associated with low socio-economic status: Evidence for a gradient? Journal of Special Education 36, 14-22. Brown-Chidsey, R. & Steege, M.W. (2005). Response to intervention: Principles and strategies for effective practice. New York: The Guilford Press. Butler, J. (1999). Gender Trouble. New York: Routledge. Davis, L.J. (2002). Bending over backwards: Disability, dismodernism & other difficult positions. New York: New York University Press. Elliot, S.N., & Fuchs, L.S. (1997). The utility of curriculum-based measurement and performance assessment as alternatives to traditional intelligences and achievement tests. School Psychology Review, 26, 224-233. Fauman, M.A. (2002). Study guide to DSM-IV-TR. Washington, D.C.: American Psychiatric Publishing, Inc. Foucault, M. (1965). Madness and Civilization: A history of insanity in the age of reason. New York: Random House.

Response to Intervention Gabel, S. (2005). Disability studies in education: Readings in theory and method. New York: Peter Lang Publishing, Inc.

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Gallagher, D. (2004). Entering the conversation: The debate behind the debates in special education. In D.J. Gallagher, L. Heshusius, R.P. Iano, & T.M. Skrtic (Eds.), Challenging Orthodoxy (pp. 3-26). Denver: Love Publishing Company. Hooks, B. (1995). Postmodern blackness. In W.T. Anderson (Ed.), The Truth About The Truth (pp. 117-124). New York: Putnam. Howe, J. (1998). A people who would not kneel: Panama, the United States, and the San Blas Kuna. Washington: Smithsonian Institution Press. Individuals with Disabilities Education Improvement Act. (2004). Public Law 108-446. Ingstad, B. & Whyte, S.R., Eds. (1995). Disability and culture. Berkeley: University of California Press. Lemert, C. (2005). Postmodernism is not what you think: Why globalization threatens modernity (2nd ed.). London: Paradigm Publishers. Lerner, J. (2000). Learning disabilities: Theories, diagnosis, and teaching strategies (8th Ed.). Boston: Houghton Mifflin Company. McBride, G., Dumont, R., & Willis, J.O. (2004). Response to intervention legislation: Have we found a better way or will we be just as confused as we have been for the last ten years? The School Psychologist, 58, 86-91. Mitchell, D.T. (2002). Narrative prosthesis and the materiality of metaphor. In S.L. Snyder, B.J. Brueggemann, & R. Garland-Thomson (Eds.), Disability studies: Enabling the humanities (pp. 15-30). New York: The Modern Language Association of America.

Response to Intervention Niolaisen, I. (1995). Persons and nonpersons: Disability and personhood among the

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Punan Bah of Central Borneo. In B. Ingstad & S.R. Whyte (Eds.), Disability and Culture. Berkeley: University of California Press. Perry, J.A. & Perry, E.K. (2003). Contemporary society: An introduction to social science (10th ed.). Boston: Allyn & Bacon. Salvia, J., & Yesseldyke, J.E. (2004). Assessment in special and inclusive education (9th ed.). Boston: Houghton Mifflin. Sattler, J.M. (2001). Assessment of children: Cognitive applications. San Diego: Jerome M. Sattler, Publisher. Smith, D.S. (2004). Introduction to special education: Teaching in an age of opportunity (5th ed.). Boston: Pearson. Szasz, T. (1970). The manufacture of madness. New York: Harper & Row. Thomas, G. & Loxley, A. (2001). Deconstructing special education and constructing inclusion. Buckingham: Open University Press. Tremain, S. (2004). On the subject of impairment. In M. Corker & T. Shakespeare (Eds.), Disability/postmodernity: Embodying disability theory (pp. 32-47). London: Continuum. U.S. Department of Education (2001). The twenty-third annual report to congress on the implementation of IDEA. Washington, D.C.: U.S. Government Printing Office.

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