Evidence, Ethics, and the Law

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Evidence, Ethics, and the Law

• Ronnie Detrich
• Wing Institute

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The Law

• No Child Left Behind (NCLB) requires that
  interventions used to improve educational
  performance are based on scientific research.
• In NCLB there are over 100 references to
  scientific research.
• Individuals with Disabilities Education
  Improvement Act IDEIA (2004) requires
  interventions that are scientifically based
  instructional practices.

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The Law

• Specific requirements of IDEIA include
• Pre-service and professional development for all
  who work with students with disabilities to
  ensure such personnel have the skills and
  knowledge necessary to improve the academic
  achievement and functional performance of
  children with disabilities, including the use of
  scientifically based instructional practices, to
  the maximum extent possible.

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The Law

• Specific requirements of IDEIA
• ? Scientifically based early reading programs,
  positive behavioral interventions and supports,
  and early intervention services to reduce the
  need to label children as disabled in order to
  address the learning and behavioral needs of such
  children
• In determining if a child has a specific
  learning disability, a local education agency may
  use a process that determines if a child responds
  to a scientific, research-based intervention as
  part of the evaluation procedures.

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The Law

• Specific requirements of IDEIA
• The IEP shall include a statement of the special
  education and related services and supplementary
  aids and services, based on peer-reviewed
  research to the extent practicable, to be
  provided to the child, or on behalf of the child,
  and a statement of the program modifications or
  supports for school personnel that will be
  provided for the child.

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Federal Intent

• Clearly, the intent of Congress, the U.S.
  Department of Education, and Office of Special
  Education Programs is to rely on interventions
  that have a scientific basis.
• A problem is that the definition of evidence is
  not clearly specified.
• The broad federal definition allows many
  different types of evidence.
• There is some controversy within the field about
  what the standards for evidence should be.

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Ethics

• First rule of ethical conduct is do no harm.
• What constitutes harm?
• How can we know if we are causing harm?
• Does failing to have impact constitute harm?

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Ethics

• How can we minimize risk of harm?
• The assumption is that interventions with a
  scientific basis will increase probability of
  benefit for students.
• Is using programs with scientific basis
  sufficient to meet legal and ethical
  requirements?

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Ethics

• Most national psychological and educational
  organizations have ethical standards requiring
  science based practices to address problems.
• American Psychological Association Ethical
  Standard 2.04
• Psychologists work is based on the established
  scientific and professional knowledge of the
  discipline.

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Ethics

• National Association of School Psychologists
• Standard III F 4.
• School psychology faculty members and clinical or
  field supervisors uphold recognized standards of
  the profession by providing training related to
  high quality, responsible, and research-based
  school psychology services.
• Standard IV C 1b.
• Decision-making related to assessment and
  subsequent interventions is primarily data-based.

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Ethics

• National Association of School Psychologists
• Standard IV 4.
• School psychologists use assessment techniques,
  counseling and therapy procedures, consultation
  techniques, and other direct and indirect service
  methods that the profession considers to be
  responsible, research-based practice.
• Standard IV 6.
• School psychologists develop interventions that
  are appropriate to the presenting problems and
  are consistent with the data collected. They
  modify or terminate the treatment plan when the
  data indicate the plan is not achieving the
  desired goals.

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Ethics

• Behavior Analysis Certification Board
• Standard 2.09a
• The behavior analyst always has the
  responsibility to recommend scientifically
  supported, most effective treatment procedures.
  Effective treatment procedures have been
  validated as having both long-term and short-term
  benefits to clients and society.
• Standard 2.09b
• Clients have a right to effective treatment
  (i.e., based on the research literature and
  adapted to the individual client.

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Ethics

• Behavior Analysis Certification Board
• Standard 4.04
• The behavior analyst collects data or asks the
  client, client-surrogate, or designated other to
  collect data needed to assess progress within the
  program.
• Standard 4.05
• The behavior analyst modifies the program on the
  basis of data.

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Ethics

• Primary organizations responsible for services
  for children mandate use of practices based on
  scientific research as part of ethical behavior.
• Data-based decision making is mandated in ethical
  guidelines.

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One Other Ethical Consideration

• Special education services are largely funded
  through public dollars (taxpayers dollars).
• There is an implicit assumption that the money
  will be spent for the public good.
• A fiduciary responsibility exists when one person
  or organization is charged with managing another
  persons money.

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One Other Ethical Consideration

• The primary responsibility of a fiduciary is to
  act solely for the benefit of the other party.
• Being a fiduciary carries the weight of ethical
  conduct.
• Those of us charged with providing special
  education services have a fiduciary
  responsibility to assure that the taxpayers are
  receiving the greatest possible return on their
  investment.

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How Do We Meet Our Fiduciary Responsibility?

• Interventions that have an evidence base are more
  likely to produce positive effects for students.
• Our fiduciary responsibility requires that we use
  the intervention that has a higher probability of
  success, i.e. evidence-based intervention.

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How Do We Meet Our Fiduciary Responsibility?

• It is unknown what impact non-evidence-based
  interventions are likely to have.
• Using a non-evidence-based intervention when
  there are evidence-based interventions available
  constitutes unethical practice.
• If we want to use a non-evidence based
  intervention then it should be considered
  research and all of the safe-guards afforded
  research participants and their families should
  be in place.
• Conducting research with tax-dollars provided
  for education may constitute a violation of our
  fiduciary responsibility.

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The Evidence

• There are many interventions that are promising
  but most of these intervention are evaluated
  under laboratory conditions by highly skilled
  researchers (efficacy research).
• Far fewer interventions have been evaluated under
  typical conditions found in public school
  settings (effectiveness research).
• Very few of these interventions have been
  evaluated to determine if they meet standards to
  be considered evidence-based.

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The Evidence

• Even if an intervention is established as
  evidence-based, it does not mean that it is
  guaranteed to work for all students.
• An evidence-based problem solving approach
  requires that we collect data about the impact of
  our interventions on each individual student
  (practice-based evidence).

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The Evidence

• Earlier in this talk ethical questions were
  raised
• What constitutes harm?
• How can we know if we are causing harm?
• Does failing to have impact constitute harm?
• An evidence-based problem solving approach
  provides a means for addressing these questions.

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The Evidence

• If the function of education is to teach skills
  that are relevant for a student then failing to
  teach skills constitutes harm.
• We can know if we are causing harm by monitoring
  progress on the skills we are teaching.
• If progress is not occurring then we are
  obligated to change interventions until there is
  progress.
• The unethical conduct is failing to monitor
  performance and failing to change interventions
  if there is no progress.

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The Evidence

• An evidence-based approach to problem solving
  requires not only that we collect data to
  evaluate the impact of an intervention but that
  we actually look at the data on a regular basis.
• The Response to Intervention (RTI) approach is an
  example of a systemic evidence-based approach to
  providing education for all students.

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RTI Model

• Starts with an evidence-base of effective
  academic and behavioral interventions.
• Interventions are applied universally within a
  population (i.e., entire school, classroom).
• If a student is not benefiting from these
  interventions, as determined by systematic
  progress monitoring, then the student receives
  additional evidence-based support while
  monitoring continues.
• Process continues until student is progressing.

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RTI as Ethics-based Intervention

• Starts from a base of established evidence-based
  practices.
• Consistent with ethical statements of
  professional organizations.
• At the heart of RTI is progress monitoring.
• Consistent with emphasis on data-based decision
  making ethical requirements of professional
  organizations.

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RTI From Evidence-based Practice to
Practice-based Evidence

• RTI is an example of starting with evidence-based
  practices and completing the process with
  practice-based evidence.
• To be successful requires a system that works
  together.
• Responsibility cannot fall on teachers alone.