Diagnosis diagnosed by Galen Alessi

This is the unedited section of Galen Alessi's classic article, "Diagnosis diagnosed: A systemic reaction" that describes his study of school psychologists blaming the child:

On the completely different theme of values, I agree with Joel Meyers that a dramatic shift in conceptual models is needed in school psychology diagnostic systems. And, I agree that what is required is a switch from an individual to a systemic (ecological) perspective. Perhaps the most important, recent discovery in school psychology in the past 50 years has been that every school pupil interacts daily with teachers, peers, a basal curriculum, parents, and school administrators. Some school psychologists now are suggesting that these factors may contribute to (and perhaps even be the source of) many pupils' school problems. But such school psychologists are only a tiny minority (cf. rump group?), and considered to be egregious radicals by their individually centered colleagues. What makes school psychologists hold so tenaciously to an individually centered conception of behavior? Could it be that giving up this schema would change the professional role in fundamental ways that neither the schools nor school psychologists are prepared to accept?

The major part of the school psychology role involves case studies to determine the sources of learning and behavior problems in school. Not only are school psychologists experts in tracking down factors contributing to such problems, but they also are bound by professional ethics to report the results objectively as they are determined. Parents trust school psychologists not to adopt assessment practices that are inherently biased in ways that could hinder, rather than help, their children. But school psychologists with an individually centered perspective may have adopted naturally, and with the best intentions, inherently biased assessment models.

When a child has difficulty learning or behaving at school, the source of the problem usually can be traced to one or more of five broad areas. First, the child may be misplaced in the curriculum, or the curriculum may contain faulty teaching routines (cf. Becker, 1986; Carnine & Silbert, 1979; Engelmann & Carnine, 1982; Silbert, Carnine, & Stein, 1981). Second, the teacher may not be implementing effective teaching and/or behavior management practices (Becker, 1986; Heller, Holtzman, & Messick, 1982; Paine, Radicchi, Rosellini, Deutchman, & Darch, 1983; Sprick, 1985). Third, the principal and other school administrators may not be implementing effective school management practices (Brookover et aI., 1982). Fourth, the parents may not be providing the home-based support necessary for effective learning. Fifth, and finally, the child may have physical and/or psychological problems that may be contributing to the learning problems.

With several groups of school psychologists (about 50 each), in different areas of the country, I have replicated the following informal survey that highlights the crucial problem with current individually centered diagnostic practices. First, the psychologists were asked whether all agreed that each of the just-mentioned, five factors may play a primary role in a given school learning or behavior problem. They almost always agreed. Next, they were asked for the number of cases each had examined in the past year to determine the source of learning problems. The answer was usually about 120. Using 100 as a round number, multiplied by the group size of 50, yields about 5,000 cases studied by the group in the past year.

At the next step, the group was asked for the number of psychological reports written that concluded that the referred problem was due primarily to curriculum factors. The answer was usually none. All cases out of 5,000 examined confirmed that their schools somehow had been fortunate enough to have adopted only the most effective basal curricula.

When asked for the number of reports that concluded that the referred problem was due primarily to inappropriate teaching practices, the answer also was none. All cases out of 5,000 examined proved that their districts had been fortunate enough to have hired only the most skilled, dedicated, and best prepared teachers in the land.

When asked how many reports concluded that the referred problem was due primarily to school administrative factors, the answer again was none. All cases out of 5,000 examined demonstrated that their districts had hired and retained only the nation's very best and brightest school administrators.

When asked how many reports concluded that parent and home factors were primarily responsible for the referred problem, the answer ranged from 500 to 1,000 (10% to 20%). These positive findings indicated that we were finally getting close to the source of educational problems in their schools. Some children just don't have parents who are smart, competent, or properly motivated to help their children do well in school.

Finally, I asked how many reports concluded that child factors were primarily responsible for the referred problem. The answer was 100%. These 5,000 positive findings uncovered the true weak link in the educational process in these districts: the children themselves. If only these districts had better functioning children with a few more supportive parents, there would be no educational difficulties.

As an addendum, I offered informal data collected in local Individual Educational Planning Committee (IEPC) meetings that suggest that family factors are invoked most often when the parent does not attend the meeting or if the parent is involved in a way deemed inappropriate by the school staff. Otherwise, child factors alone seem to carry the explanatory burden for school learning and behavior problems.

One does not need complex statistical analyses to know that these results are significant beyond the .0000001 level. The set of all cases studied by these school psychologists comprises a needs assessment for their districts. And, the results indicate clearly no need to improve curricula, teaching practices, nor school administrative practices and management. The only needs involve somehow improving the stock of children enrolled in the system, and some of their parents. But, it is equally unclear how school psychologists can help resolve this kind of problem. School psychologists seem to define school problems in ways that cannot be resolved.

At this time, of course, many psychologists raise their hands to protest that all five areas are indeed responsible for problems in cases they have studied, but that informal school policy (or "school culture") dictates that conclusions be restricted to child and family factors. Many feel that they could lose their jobs were they to invoke school-related factors. Certainly, they claim, their professional lives would be made very uncomfortable. Others note that not all evaluations determine that serious problems exist. But the fact remains that no school psychologist in the group had determined that any existing problems were due to school-related factors.

School psychologists, however, appear to have come by their child-as-the-problem biases quite honestly. The bias trail leads back to graduate training programs. Graduate core requirements in school psychology programs usually focus on child factors to the virtual exclusion of school-related factors. Workshop and paper presentations at school psychology conferences share the same restricted focus. Articles in the leading journals focus on child factors.

Textbooks also stipulate the child-as-the-problem bias. An informal survey of a few widely adopted texts on diagnosing reading problems yields the following results. Sources are not referenced out of respect for the authors, but the reader can find similar results by quickly surveying texts off the shelf. The first text devotes 4 pages (7% of total coverage) to school factors related to reading problems, 2 (3%) pages to home factors, and the remaining 55 pages (90%) to child factors. The second text devotes 1 page (4% of total coverage) to school factors related to reading problems, 0 (end p. 149) pages to home factors, and 22 pages (96%) to child factors. A third text devotes 0 pages to school factors related to reading problems, 0 pages to home factors, and 250 pages (100%) to child factors. A fourth text devotes 10 pages (4% of total coverage) to school factors related to reading problems, 9 pages (3%) to home factors, and 237 pages (93%) to child factors. The classic book on reading disability edited by Money (1962) does not include chapters addressing school or home factors related to reading problems. All chapters focus on child factors.

There are isolated and recent exceptions to this long-standing bias. Carnine and Silbert's (1979) reading text devotes almost no space to the discussions of child factors (other than pres kills) and close to 100% of coverage to school-related factors (teaching and instructional management). The Silbert, Carnine, and Stein (1981) mathematics text follows this same general formula.

The widely adopted textbooks, however, also may have come by the childas-the-problem bias honestly. Texts cannot review school factors unless researchers select those kinds of factors to study. Perhaps the proportions of pages included in these texts represent fairly the amount of research available in each respective area.

A comprehensive review by Arter and Jenkins (1979) of process models for explaining and treating learning problems indicates how extensively the childas-the-problem bias pervades our research and practice. The continued wide use of such process models, in spite of clear evidence that they not only are invalid but also ineffective, indicates the persistence with which such biases are held. Coles (1978) presented an extensive review of the research on learning disabilities. He noted with some surprise that of the approximately 1,000 studies reviewed, not one examined the relation between school factors and learning disabilities. Most studies examined child factors, some home factors, and a few both child and home factors. Coles suggested that such an extensive research literature focusing on child and home factors, to the exclusion of school factors, could be interpreted as pointing to some kind of conspiracy by researchers against examining school factors as they relate to school learning problems.

Educational researchers, however, also may have come by the child-as-the-problem bias honestly. Perhaps school administrators (or teacher unions) are reluctant to permit researchers to study school factors as they relate to learning and behavior problems. Perhaps researchers are only approved for projects that focus on child and home factors. Reports from school psychologists in the informal surveys just cited seem to support this interpretation.

Recently, however, educational researchers have produced very valuable data on school factors and learning (cf. Becker, 1986; Brookover et aI., 1982; Carnine 1978; Heller, Holtzman, & Messick, 1982). As this body of research grows, school psychologists will increasingly face the burden of deciding whether they work for the schools or for the children, in cases where the interests clash.

We end with a discussion of the ethical burdens on school psychologists to be forthright and honest when reporting their findings. Are we really helping children by concluding that children alone are responsible for educational problems? Are we helping the school system at the expense of the children? How do we balance the rights of those who pay for our services against the rights of those who receive our services, when interests clash? Is the role of the school psychologist to label children to help schools avoid improving faulty educational practices, or to help schools improve faulty educational practices to avoid labeling children?

In this social context, I think Joel Meyers's proposed model will benefit school psychology if the ecological and systemic aspects are embraced. I think it will be transformed into "old wine in new bottles" if emphasis is refocused exclusively on the individually centered aspects (e.g., cognitive factors).


REFERENCES
Alessi, G. J., & Kaye, 1. G. (1983). Behavioral assessment for school psychologists. Stratford, CT: National Association of School Psychologists Publications.
Arter, 1., & Jenkins, 1. (1979). Differential diagnosis-prescriptive teaching: A critical appraisal. Review of Educational Research, 49, 517-555.
Ashlock, R. (1986). Error patterns in computation: A semi-programmed approach (4th ed.). Columbus, OH: Merrill.
Becker, W. (1986). Applied psychology for teachers: A behavioral cognitive approach. Chicago, IL: Science Research Associates.
Brookover, W., Beamer, L., Efthim, H., Hathaway, D., Lezotte, L., Miller, S., Passalacqua, J., & Tornatzky, L. (1982). Creating effective schools: An inservice program for enhancing school learning climate and achievement. Holmes Beach, FL: Learning Publications.
Carnine, D. (1978). Analysis of achievement data on six cohorts of low-income children from 20 school districts in the University of Oregon Direct Instruction Model: Appendix A, formative research studies on direct instruction. Eugene, OR: University of Oregon Follow Through Project.
Carnine, D., & Silbert, 1. (1979). Direct instruction reading. Columbus, OH: Merrill.
Coles, G. (1978). The learning disabilities test battery: Empirical and social issues. Harvard Educational Review, 48, 313-340.
Engelmann, S., & Carnine, D. (1982). Theory of instruction: Principles and applications. New York: Irvington.
Heller, K., Holtzman, W., & Messick, S. (Eds.). (1982). Placing children in special education: A strategy for equity. Washington, DC: National Academy Press.
Money, J. (1962). Reading disability: Progress and research needs in dyslexia. Baltimore, MD: Johns Hopkins University Press.
Monteiro, M., & Heiry, T. (1983). A direct instruction supervision model. Direct Instruction News, 2, 8-9.
Paine, S., Radicchi, 1., Rosellini, L., Deutchman, L., & Darch, C. (1983). Structuring your classroom for academic success. Champaign, IL: Research Press.
Silbert, J., Carnine, D., & Stein, M. (1981). Direct instruction mathematics. Columbus, OH: Merrill.
Sprick, R. (1985). Discipline in the secondary classroom: A problem-by-problem survival guide. West Nyack, NY: Center for Applied Research in Education.
Ysseldyke, 1., & Christenson, S. (1987). TIES: The Instructional Environment Scale. Austin, TX: PRO:ED.

Received April 9, 1987 Final Acceptance April 13, 1987

Requests for reprints should be sent to Galen Alessi, Western Michigan University, Department of Psychology, Kalamazoo, MI 49008.
PROFESSIONAL SCHOOL PSYCHOLOGY, 3(2),145-151 Copyright @ 1988, Lawrence Erlbaum Associates, Inc. pp. 148 – 151

Siegfried Engelmann on Galen Alessi (short)
Siegfried Engelmann on Galen Alessi (longer)
Engelmann on inputs versus outputs
Mothers from Hell 2