Psychology
in
rhe
Schools
1982,
19,
319-327
INTERCLINICIAN AGREEMENT AND BIAS IN SCHOOL PSYCHOLOGISTS’
DIAGNOSTIC AND TREATMENT RECOMMENDATIONS
FOR
A
LEARNING DISABLED CHILD’
ROGER
E.
FRAME,* HARVEY
F.
CLARIZIO,
ANDREW
c.
PORTER,
AND
JOHN
R.
VINSONHALER
Michigan State University
Interclinician agreement was measured among 24 practicing school psychologists who
assessed a simulated learning disability case
of
a fourth-grade girl. The data were
analyzed with both an unprompted report written by each subject (recall), and a
checklist
of
descriptive statements about the case (recognition). Interclinician agree-
ment was found to be moderately high for diagnoses, and somewhat less for prescrip-
tions. Interpretation bias due to the child’s race (black, white),
SES
(low, high) and
achievement level of the child’s school (low, high) was not observed
on
most
diagnostic statements. Only 17
of
the 744 possible diagnostic main effects and 2-way
interactions were significant at
p<.OI,
while 7 such differences would be expected
purely by change.
No
statements about intelligence, classroom behavior,
or
social
relationships were statistically significant. However, the simulated low
SES
black
child did tend to be classified as “not eligible
for
special education” much more often
than did the white
or
upper class black on both the written reports
and
on
the
checklist, while the upper SES child was labelled learning disabled more frequently
than was the low SES child on the recognized checklist. Other main effects and in-
teractions also were noted
in
some statements about developmental history,
arithmetic achievement, perceptual-motor integration, and excessive dependence.
Public Law
94-142
authorizes an estimated annual expenditure of
$2.32
billion in
1981
and
$3.16
billion in
1982
to implement special education services (Children’s
Defense Fund, Note
1).
The placement decisions that determine who will receive these
services are highly influenced by the school psychologists’ diagnostic’ and treatment
recommendations (Yoshida, Fenton, Maxwell, 8c Kaufman,
1978).
Yet, at the same time
that psychological services have been mandated in the schools, there is growing concern
that many recommendations are unjustified, inaccurate, and/or biased (Cassel,
1973;
McDermott,
1980;
Samuda,
1975;
Weiderholt,
1974).
This sentiment also is reflected in
several judicial decisions (Diane, Note
2;
Guadalupe, Note
3;
Hobson, Note
4;
Larry
P.,
Note
5).
This study investigated: (a) the general level of interclinician agreement on diagnosis
and prescription when school psychologists could choose their assessment tools
for
a
simulated learning disability case, and (b) whether any interpretation bias was apparent
in
their diagnostic and prescriptive statements. Because diagnostic agreement may not
translate into prescriptive agreement, these two aspects were analyzed separately.
METHOD
Subjects
Twenty-four practicing school psychologists from
1
1
counties in southern Michigan
served as subjects. They represented seven local districts and eight intermediate school
districts, and were fairly evenly distributed across rural, small town, suburban, and urban
‘This research was supported by Michigan State University grant #79-9.
2N~~ with Collier County Public Schools, Naples, Florida.
Requests
for
reprints should be sent to Harvey Clarizio, 456 Erickson Hall, Mi4igan State University,
East Lansing, MI 48824.
319