Educational Accommodations for Youth with Behavioral Challenges

Educating youth with Emotional and Behavioral Disorders (EBD) or with Attention-Deficit/Hyperactivity Disorder (ADHD) costs school districts three times as much/$5,007 more, respectively, than educating students without EBD or ADHD. Much of this cost is related to provision of services, including accommodations, modifications, and interventions, mandated by federal law. The goal is for all students to demonstrate proficiency on core academic standards. Thus, these costs would seem justified if these services were improving student outcomes. However, youth with EBD and ADHD are suspended more often than typical peers, score below “proficient” on high stakes assessments, and leave high school prior to graduation.

The lack of guidance on selecting services has resulted in confusion regarding what constitutes an accommodation, modification, or intervention and the purposes of these, as well as in an overreliance on strategies without evidence of effectiveness. Strategies deemed to be accommodations are most frequently selected by educators for youth with EBD/ADHD. The Individuals with Disabilities Education Improvement Act (2004) and No Child Left Behind (2001) encourage educators to consider scientific evidence when selecting interventions, but there are no such recommendations regarding accommodations. Educators are thus left to select strategies from long lists (149 are recommended) of potential accommodations that may or may not meet the definition of an accommodation and may or may not have positive consequences for students.

To address this lack of guidance, we conducted a comprehensive literature review in an attempt to determine which strategies recommended for students with EBD/ADHD meet the definition of an accommodation and have empirical evidence of effectiveness. Based on the literature, we established definitions of accommodation, modification, and intervention, and reviewed empirical studies of 68 that could function as an accommodation. Our goal was to determine which satisfied the following four criteria of an accommodation: (a) a change in school practices, (b) hold the student to the same standard as students without disabilities (i.e., grade level academic content standard), (c) mediates the impact of the disability on the student’s access to the general education curriculum, and (d) provides a differential boost for those with EBD/ADHD relative to those without.

We found only 18 peer-reviewed studies of 12 strategies with a small total sample of 362 students. No studies were found of the remaining 56 strategies. Some evidence suggested that nine strategies improved student performance and that two might level the playing field between youth with and without EBD/ADHD. However, there was insufficient evidence to say that any of the reviewed potential accommodations met the definition for accommodation or could be considered evidence-based. This lack of evidence was due to insufficient quantity and quality of scientific study. In addition, preliminary evidence suggested that providing extended time, the most frequently used strategy, does not provide a differential boost for youth with ADHD and may result in more harm than benefit.

These results are disappointing and confirm that although educators may be regularly selecting accommodations for youth with EBD/ADHD, neither policy makers nor researchers are providing sufficient guidance for this to be an effective or efficient process. Therefore, we recommend the following for policy makers, researchers, and educators:

• First, we encourage policy-makers to address the confusion in federal mandates around accommodation, modification, and intervention. Provide definitions and descriptions of the intended use and purpose of each and encourage selection of accommodations with empirical support.
   
• Second, as educators are mandated to consider accommodation, modification, and intervention by federal law, we recommend that policy-makers encourage funding for research in this area and that researchers conduct rigorous studies to address numerous unaddressed questions.
   
• Third, we encourage educators to implement interventions to build student competencies prior to or in conjunction with selecting accommodations and policy makers to consider adopting a model that provides guidance on selection of accommodations, modifications, and interventions that follows a logical path to increasing student competency as outlined in the Life Course Model developed by Evans and colleagues (2014).

The full study (gated) can be found in Harrison, J.R., Bunford, N., Evans, S.W. and Owens, J. S. (2013). Educational Accommodations for Students with Behavioral Challenges: A Systematic Review of the Literature. Review of Education Research, 83(4), 551-597. doi: 10.3102/0034654313497517. More on the Life Course Model can be found in Evans, S. W., Owens, J. S., Mautone, J. A., DuPaul, G. J., & Power, T. J. (2014). Toward a comprehensive, Life Course Model of care for youth with ADHD. In M. Weist, N. Lever, C. Bradshaw, & J. Owens (Eds.), Handbook of School Mental Health (2^nd ed, pp. 413-426). New York: Springer.