Aptos psychologist: How to cut entitlement programs such as Social Security Disability

by Cameorn Jackson
Time that Social Security Disability got a razor hair cut? Yes. And time to lighten the load for taxpayers.

The federal government hit the Replace function and Mental Retardation (MR) became Intellectual Disability (ID). Per the WSJ article 11-30-2010 no change in services occurs. The hurtful label goes.

Is this a superficial face lift for Mental Retardation? Does the underlying structure remain the same but the pain associated with the label continues? Perhaps less pain. But confusion continues.

Confusion exists and continues because words used in one context – education — mean something quite different in another — the medical setting.

In the educational setting, Mental Retardation is a catch-all category to provide special educational services for various students who “donâ€t fit” That includes behavior problems and a wide variety of other behaviors.

In contrast, in the medical setting (doctors, psychiatrists, psychologists) Mental Retardation means that certain criteria are met. Those criteria are specified in the Diagnostic and Statistical Manual (DSM-IV) or what will be in DSM-V in 2013. For a medical diagnosis of MR or IT must meet the criteria set out in 317.0 Mental Retardation or a gradation of it.

It is not correct to think of educational MR like a banana and medical MR like a apple and that both are in the category of fruit. Education MR and medical MR are not – and were not — similar in kind or degree. They are simply different entities.

What happens far too often is the student labeled as MR by the schools later slides in to a MR diagnosis and receives social security disability .

How does this happen? Schools often give students leaving high school an exit IQ test. Who knows why but the test often given is the adult version of the Wechsler. And, lo and behold, special education students categorized as MR who have not been held accountable to meet certain standards for moving along in various skills typically perform in the Deficient range. Based on a Deficient score social security deems the person MR and pays social security disability.

What to do about this? Itâ€s time that social security disability got a hair cut. Think of it akin to a razor cut, one that thins out appropriately. Using sense and caution, it is time to separate out those persons who truly are low functioning in most areas of life because of low cognitive IQ abilities.

How to do this? Change the federal law that defines Individual Education Plans (IEP). Require that all students who have an IEP to provide a copy which will be reviewed by local professionals trained in assessment. It is better to use local community standards rather than federal one-size-fits-all standards. By screening IEPs every three years by the time the student turns 18 it will be quite clear whether he or she meets a medical diagnosis of MR alias IT. The defining characteristic of MR alias IT is consistently low functioning abilities — as a result of low cognitive IQ abilities. So, around age 16 students with IEPs should be assessed as to their overall functional abilities

Interestingly, the young man Eddie Belasco discussed in the WSJ article (WSJ, 11-2—2010, A6) may well not meet a diagnosis of MR or IT. Most persons with a medical diagnosis of MR or IT do not graduate from high school; Eddie graduated from a catholic high school. Unlike most persons with MR or IT Eddie has a job, he is saving for his own apartment and he is about to be engaged.

Yes it is good to remove hurtful labels. We used to refer to low IQ and low functioning persons as “idiots” and “morons”. Saying that they were “retarded” was supposed to be a step up. My guess is that because intellectual deficiency has 9 syllables and mental retardation only 6, that it is harder to say it in a pejorative manner. “You ID!” just does not have the ring that “You retard!” had. Unless people think that “You ID!” stands for “You idiot!” If so, we have come full circle.

It is commonly thought that I.Q. is the ceiling and that students can achieve up to their ceiling. However, I have met a number of students with Deficient I.Q. (standard scores lower than 70) who achieve in academics in the high 70’s and low 80’s — a full standard deviation above their IQ scores. How is this possible? Home environment. For example, a child with Deficient IQ raised in a positive way with several brothers and sisters gets pulled upward by them. I.Q scores are just one facet of functioning.

Yes, it is time to trim social security disability. And let’s start with appropriately thinning out those who receive money under mental retardation alias intellectual disability.
written by Cameron Jackson