The Seven-Year-Old Who Can’t Sit Still

The team should consider specific learning disability in basic reading skills or reading fluency, other health impairment (OHI) for ADHD, and-depending on state law-developmental delay if Andre is still within the age range. It should not start with a category and look for supporting data. SLD requires a pattern of strengths and weaknesses or a processing deficit, underachievement, and exclusion of lack of appropriate instruction. OHI requires a chronic or acute health condition that results in limited strength, vitality, or alertness and adversely affects educational performance. The observation data matter: 5% off task in hands-on science versus 40% during independent writing suggests task-specific attention problems, which could be secondary to reading frustration rather than a primary attention disorder. The family history of reading difficulty and his difficulty with blends and vowel teams point to word-level reading. The team should also consider speech-language if phonological processing is weak, and it should not use emotional disability without evidence of a pattern across settings and time. The request for a one-to-one aide is a service question, not an eligibility question.

Before eligibility, the team needs: (a) Tier 2 intervention fidelity and progress data-what intervention, how many minutes, who delivered it, and 8–12 weeks of probes; (b) comprehensive reading assessment covering phonological awareness, phonics, fluency, vocabulary, and comprehension; (c) processing measures, especially phonological processing and rapid naming; (d) classroom observations in at least two settings and at different times of day; (e) teacher and parent rating scales across settings; (f) developmental and medical history, including medication timing and dose; (g) review of attendance and the quality of core instruction; and (h) exclusionary factors such as cultural, linguistic, and economic factors and lack of instruction. The team should compare Andre to peers and use local norms. If Tier 2 was not delivered with fidelity, the team cannot conclude SLD. It must also ask whether attention problems are better explained by reading frustration or by ADHD. A pediatric diagnosis alone does not establish educational eligibility; the team needs evidence of adverse educational impact and need for specially designed instruction.

Treat the diagnosis and medication as one data source, not as the eligibility decision. OHI requires more than a diagnosis: the team must document limited strength, vitality, or alertness due to a chronic or acute health condition that adversely affects educational performance. Ask the parent for the medication schedule, dose, and observed changes; collect data on days or times when medication is active versus not, but never require medication as a condition of eligibility or services. School staff should not recommend starting or changing medication. If Andre’s attention improves markedly on medication but his reading does not, that pattern supports a reading disability rather than a primary attention disorder. If attention problems persist across settings and tasks and interfere with learning, OHI may be appropriate. The team should guard against overidentifying Black boys and should examine whether the referral reflects bias or a mismatch between instruction and behavior. Either way, the IEP team determines services based on needs-not the teacher’s request for a one-to-one aide.