The Educator's Diagnostic Manual of Disabilities and Disorders (EDM)

Authors

Dr. George Giuliani J.D., Psy.D., FSICPP

Dr. Roger Pierangelo  PhD., FSICPP


"This work offers educators a manual that finally puts them on a level professional playing field with members of other disciplines such as psychiatry, psychology, and other diagnostic-related professions. Long have educators needed such a manual, which allows their views and clinical insights to be offered in a forum that can be recognized uniformly and with parallel integrity to other professions. I believe this manual will become the standard used to clarify the complicated nature of IDEA and other diagnostic and educational ruling conflicts among professionals of different disciplines."

Mark H. Yeager, Ph.D., FAAIDD, Board of Directors, American Association on Intellectual and Developmental Disabilities


Overview and Purpose of the Educator’s Diagnostic Manual of Disabilities and Disorders (EDM)

The purpose of the EDM is to provide all professionals working in the field of special education, college students preparing to work with children with special needs, administrators, college professors, parents, and students with disabilities with the information necessary to adequately determine the most comprehensive, detailed, and precise diagnoses of disabilities or disorders seen in infants, toddlers, children, and adolescents, particularly in the educational environment.

Rationale for the Publication of the EDM

Up to now, the sole responsibility for interpreting the specific disabilities associated with the classifications under Individuals with Disabilities Education Improvement Act of 2004 was at the discretion of the district committee responsible for classification and placement. However, simple word definitions are open to interpretation and potentially significant subjectivity. Since many of the specific disorders contained under an IDEA category are not provided, there was a very strong need to objectify this process. The EDM provides specific descriptions of the areas of concern, as well as the levels to which the disability (or disabilities) adversely affects the academic performance of their child.

Individualized Education Programs (IEPs) and the EDM

Under IDEA, every child who is classified as “child with a disability” in special education receives an Individualized Education Program (IEP). An IEP is a written statement for a child with a disability that is developed, reviewed, and revised in a meeting in accordance with certain requirements of law and regulations. These requirements and the entire IEP process are discussed in this section.

Two general purposes of the IEP are (1) to establish measurable annual goals, including benchmarks or short-term objectives, for the child; and (2) to state the special education and related services and supplementary aids and services that the public agency will provide to, or on behalf of, the child. The regulations state that the State Education Agency (SEA) must ensure that each public agency develops and implements an IEP for each child with a disability served by that agency (Section 300.341).

The IEP is developed by a team whose members meet, review the assessment information available about a child, and design an educational program to address a child's educational needs that result from his or her disability. The child's IEP must be reviewed at least annually thereafter to determine whether the annual goals are being achieved and must be revised as appropriate [Section 300.343(c)].

On this IEP, the actual IDEA classification of the child is noted. For example, on a child’s IEP it could state that the classification is: Specific Learning Disability; or Emotional Disturbance; or Speech and Language Impairment, or Autism, etc. Unfortunately, all too often teachers, parents, professionals and students themselves had little or no idea of what specific type or types of disability the child has with respect to his or her classification on the IEP. For example, a child with a reading disability (Dyslexia), math learning disability (Dyscalculia), writing disability (Dysgraphia) and the child with a visual processing disorder might all be classified as students with Specific Learning Disabilities. In these students’ IEP’s, the diagnoses would be Specific Learning Disabilities not the specific types. So, nowhere on the IEP would it state “the child has a specific learning disability in reading (dyslexia); or the child has a specific learning disability in mathematics (dyscalculia). It would just be a general classification of “Specific Learning Disability.” Furthermore, for numerous types of disabilities, there are “subtypes.” For example, there are over 10 different types of dyslexia. Which one(s) does this child have? On the IEP, there would be no statement of that whatsoever. A teacher reading these students’ IEP’s would have no clear idea of an exact diagnosis, let alone the specific subtypes that would facilitate the educational direction best suited for these children.

Using IDEA as the frame of reference, the categories chosen for the EDM are all defined under this Federal Law [Section 300.7(a)(1)]. The disorders discussed in the EDM represent the various types and subtypes under each of these disability categories that may apply to children with disabilities ages birth through 21 years of age. Now, utilizing the coding system in EDM, students can receive much more specific and exact diagnoses to have stated on their IEP’s. Ultimately, this aids professionals in establishing appropriate remediation, accommodations, and teaching techniques for each child with a disability.

The Importance of the EDM

In schools today, after a comprehensive assessment is completed for a child with a suspected there is no common and agreed upon diagnostic manual book that all professionals turn to when making a determination of whether the child meets the criteria for a specific disability as defined by IDEA. This goes against all common sense, as there should be some standard and guide by which educators make decisions regarding the educational decisions for a child.

Mental health professionals are provided with the Diagnostic and Statistical Manual (DSM-IV-TR), medical professionals have a variety of manuals that provide specific information on all types of medical conditions that they can use as references sources, and lawyers have their reference guides as well.

The Educator’s Diagnostic Manual of Disabilities and Disorders (EDM) represents the very first manual created specifically for the field of special education that provides definitions, symptoms, characteristics, types, and subtypes for almost all disabilities and disorders that professionals and/or parents need to understand within educational settings.

Using the EDM

The EDM provides necessary guidelines, information, and examples for a variety of situations that commonly occur in education. For example, suppose that a:
A child in a classroom has been diagnosed with a disability that a teacher, special educator or administrators knows very little or nothing about in terms of symptoms, characteristics, etc. The EDM can provide a quick reference to that disability and its important features.

A special education professional is speaking with a parent of a child who has a certain disorder listed on his/her IEP and you need some immediate reference material. The EDM will provide you with the specific type of disorder which will then make it easier to gather more detailed information on it.

A parent of a child diagnosed with a certain disorder is in need of further information or a list of organizations for support groups. The EDM provides lists of organizations for every IDEA category.

A special education professional is attending a Child Study Team Meeting for a child with a specific disability and/or disorder and needs to present information specific to it. The EDM provides this information for every IDEA category.

A child study team determines that a student meets the criteria for a disability as defined by IDEA. Although the team knows that the student has a disability, it is unsure of the specific type of disability (e.g., they know the student has a speech and language impairment but is it a phonological processing disorder, articulation disorder, speech fluency problem, etc). The EDM provides the team with numerous types of disorders under IDEA from which to choose in order to make the most specific and detailed diagnosis for the student.

The Practical Value of the EDM

The EDM is a practical complete reference guide that is written in an easy-to-read format. It will provide all professionals in the field of education with specific details on over 1,500 different disabilities and disorders as seen every day in the field of education.

This book will also provide a valuable reference source for Child Study Teams, Multidisciplinary Teams, School Based Support Teams, and Committees on Special Education, IEP Committees, federal, state and local agencies, private and public special education schools, administrators, professors, college students and parents of children with special needs. EDM is a must have reference source for parents and professional involved with children with special needs.

The Development of EDM

In 1975, Congress passed the most important federal law for children with disabilities, the Education for All Handicapped Children Act (EHA), Public Law (P.L.) 94–142. This law has been amended many times since its original enactment, each time after lengthy debate and consideration. Today, the current federal law is known as The Individuals with Disabilities Education Improvement Act of 2004 (P.L. 108–446; herein cited as IDEA).

Under P.L. 94–142, eligible children and youth with disabilities were guaranteed certain procedural and educational rights. One of the most important rights was to a free appropriate public education (FAPE) (Section 300.13) designed to meet the unique educational needs of each child.

Under P.L. 94–142 (and still today under IDEA), every child identified as a student with a disability must be afforded an individualized education program (Sections 300.340–300.350). With the development of the Individual Education Program came the responsibility for district committees involved in special education to find the appropriate classifications for each child from the various categories provided in the law. This public agency must ensure that it has met the law’s requirements regarding eligibility decisions (as specified at Sections 300.534–300.535). Today, we have 13 categories under the law for students, ages 6–21 years.

General Information about Disabilities that Qualify Infants, Toddlers, Children, and Youth for Services under the Individuals with Disabilities Education Improvement Act of 2004 (IDEA).

Every year, under the federal law known as the Individuals with Disabilities Education Improvement Act of 2004 (P.L. 108–446: herein cited as IDEA), millions of children with disabilities receive special services designed to meet their unique needs. For infants and toddlers with disabilities birth through two and their families, special services are provided through an early intervention system (Part C of IDEA 2004). For school-aged children and youth (aged 3 through 21), special education and related services are provided through the school system. Related services are defined in the regulations as transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education (Section 300.24). These services can be very important in helping children and youth with disabilities develop, learn, and succeed in school and other settings.

The major purposes of the IDEA are:
  • to ensure that all children with disabilities have available to them a "free appropriate public education" that emphasizes special education and related services designed to meet their unique needs and prepare them for employment and independent living
  • to ensure that the rights of children and youth with disabilities and their parents are protected
  • to assist States, localities, educational service agencies, and Federal agencies to provide for the education of all children with disabilities
  • to assess and ensure the effectiveness of efforts to educate children with disabilities. (Section 300.1)

Eligibility for Services

Under the IDEA, states are responsible for meeting the special needs of eligible children with disabilities. Before a child with a disability can receive special education and related services for the first time, a full and individual initial evaluation of the child, also known as a preplacement evaluation, must be conducted (Section 300.531). Informed parent consent must be obtained before this evaluation may be conducted [Section 300.505(a)(1)(i)].

The law requires that a child be assessed in all areas related to his or her suspected disability. This includes, where appropriate, evaluating a child's:

  • health
  • vision
  • hearing
  • social and emotional status
  • general intelligence
  • academic performance
  • communicative status, and motor abilities. [Section 300.532(g)]

To accomplish this, a variety of assessment tools and strategies must be used to gather relevant functional and developmental information about a child. The ultimate purpose of the initial evaluation is to gather information that may assist in determining:

  • whether or not the child is a "child with a disability" [Section 300.7 (a)(1)]
  • the content of your child's IEP, if he or she is found eligible for special education and related services. [Section 300.532(b)]

To this end, then, the evaluation must be sufficiently comprehensive to identify all of the child's education and related services needs, whether or not those needs are commonly linked to the disability category in which he or she is thought to have a disability [Section 300.532(h)].

Infants and Toddlers, Birth Through Two

Under the IDEA, “infants and toddlers with disabilities“ are defined as children from birth through age two who need early intervention services because they are experiencing developmental delays, as measured by appropriate diagnostic instruments and procedures, in one or more of the following areas:

  • cognitive development
  • physical development, including vision and hearing
  • communication development
  • social or emotional development
  • adaptive development
  • have a diagnosed physical or mental condition that has a high probability of resulting in developmental delay.

The term may also include, if a state chooses, children from birth through age two who are at risk of having substantial developmental delays if early intervention services are not provided.” (34 Code of Federal Regulations §303.16)

Children Aged 3 Through 9

For children aged 3 through 9, a "child with a disability" may include, at the discretion of the State and the local educational agency (LEA) and subject to certain conditions (enumerated at Section 300.313), a child who is experiencing developmental delays, as defined by the State and as measured by appropriate diagnostic instruments and procedures, in one or more of the following areas:

  • physical development
  • cognitive development
  • communication development
  • social or emotional development
  • adaptive development...

..and who, because of the developmental delays, needs special education and related services [Section 300.7(b)].

Defining a Child with a Disability

The regulations for IDEA define a "child with a disability" as including a child (a) who has been evaluated according to IDEA's evaluation requirements (specified at Sections 300.530—300.536 ); (b) who has been determined, through this evaluation, to have one or more of the disabilities listed below; and (c) who, because of the disability, needs special education and related services. The disabilities listed by IDEA are:

  • mental retardation
  • a hearing impairment, including deafness
  • a speech or language impairment
  • a visual impairment, including blindness
  • serious emotional disturbance (hereafter referred to as emotional disturbance)
  • an orthopedic impairment
  • autism
  • traumatic brain injury
  • other health impairment
  • a specific learning disability
  • deaf-blindness
  • multiple disabilities. [Section 300.7 (a)(1)]

Prevalence of Disabilities under IDEA 2004

Number of Students Ages 6–21 Who Receive Special Education Services under the Federal Government’s Disability Categories

Table 1.1

Disability Category # of Children % of Total Section in EDM
Specific Learning Disabilities 2,816,361 47.2%
Speech and Language Impairment 1,118,543 18.8%
Mental Retardation 570,642 9.6%
Emotional Disturbance 482,597 8.1%
Other Health Impairments 449,093 7.5%
Autism 140, 473 2.3%
Multiple Disabilities 131,225 2.2%
Hearing Impairments 71, 118 1.2%
Orthopedic Impairments 67,772 1.1%
Developmental Delay* 65,878 1.1%
Visual Impairments 25,294 0.4%
Traumatic Brain Injury 22,459 0.4%
Deaf-Blindness 1,603 <0.1%
All disabilities 5,963,129 100 %

US Department of Education 2004-Twenty- Individuals with Disabilities Education Act (IDEA) data (Table AA3). Washington, DC: Author. Available at http://wwwIDEAdata.org/PartBdata.asp.

The information presented in The Educator’s Diagnostic Manual is all based on IDEA 2004 classifications. It is important to note that approximately 84% of all children and youth ages 6–21 receiving special education are reported under four disability categories:

1) Specific Learning Disabilities (47.2%)

2) Speech and Language Impairment (18.8%)

3) Mental Retardation (9.6%)

4) Emotional Disturbance (8.1%)

As a result, the order of disability categories in this book was considered by the authors to be more practical if listed by prevalence.

It should be noted that during the 2003–2004 school year 679,212 pre-schoolers (ages 3–5) and 272,082 infants and toddlers (birth to 36 months) were among those receiving special education. Due to the fact that the majority of children classified with a Developmental Delay are under 6 years of age, the above chart is not representative of all children with Developmental Delays. As such, EDM has a separate chapter and separate coding system for Infants, Toddlers, and Preschoolers with Disabilities.

EDM Multilevel Coding System-Overview

The broad categories of IDEA classifications have consistently left a void in a complete and thorough understanding of a child’s overall problem, and the specific details as to the type, level, conditions and severity of the disability. Parents, teachers and schools were often left with a general label that failed to provide any understanding or guidance into the true nature of child’s specific disability.

After speaking to thousands of graduate students, teachers, special educators, and administrators, it became clear that there was a need for a more specific and comprehensive coding system to fill this void in understanding disabilities. A common theme that was consistently addressed as a negative aspect of the present special education system was that there was often confusion about the specific type of disability under which their children was classified. They did not know, guessed at the type or tried to find details on the IEP but were unsuccessful due to the absence of any clear diagnostic explanation. This present policy of a single broad disability category significantly interferes in the ability to find the correct remediation, modifications, accommodations, assistive technology, and management solutions for a specific child.

In response to this concern, the EDM was developed to provide parents, college students, teachers, psychologists, speech and language pathologists, all other professionals, and students with disabilities themselves with a very clear 5- level identification of the disability. The EDM multi-level coding system provides parents and professionals the ability to:

  • Determine the specific IDEA Classification-Level I
  • Determine the Specific Disorder/s for this classification-Level II
  • Identify the Specific Type/s of disorders-Level III
  • Determine the Specific subtype(s) of the disorder-Level IV
  • Determine the degree to which the disability adversely affects the child’s educational performance–Level V

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