Fletcher Jack M, Francis David J, Morris Robin D, Lyon G Reid
Department of Pediatrics and the Center for Academic and Reading Skills, University of Texas Health Science Center at Houston, 77030, USA.
J Clin Child Adolesc Psychol. 2005 Sep;34(3):506-22. doi: 10.1207/s15374424jccp3403_7.
The reliability and validity of 4 approaches to the assessment of children and adolescents with learning disabilities (LD) are reviewed, including models based on (a) aptitude-achievement discrepancies, (b) low achievement, (c) intra-individual differences, and (d) response to intervention (RTI). We identify serious psychometric problems that affect the reliability of models based on aptitude-achievement discrepancies and low achievement. There are also significant validity problems for models based on aptitude-achievement discrepancies and intra-individual differences. Models that incorporate RTI have considerable potential for addressing both the reliability and validity issues but cannot represent the sole criterion for LD identification. We suggest that models incorporating both low achievement and RTI concepts have the strongest evidence base and the most direct relation to treatment. The assessment of children for LD must reflect a stronger underlying classification that takes into account relations with other childhood disorders as well as the reliability and validity of the underlying classification and resultant assessment and identification system. The implications of this type of model for clinical assessments of children for whom LD is a concern are discussed.
本文综述了评估学习障碍（LD）儿童和青少年的四种方法的可靠性和有效性，包括基于以下方面的模型：（a）能力-成就差异，（b）低成就，（c）个体内差异，以及（d）干预反应（RTI）。我们发现了严重的心理测量问题，这些问题影响了基于能力-成就差异和低成就的模型的可靠性。基于能力-成就差异和个体内差异的模型也存在显著的有效性问题。纳入RTI的模型在解决可靠性和有效性问题方面具有相当大的潜力，但不能作为LD识别的唯一标准。我们建议，结合低成就和RTI概念的模型有最有力的证据基础，且与治疗有最直接的关系。对LD儿童的评估必须反映一个更强有力的潜在分类，该分类要考虑到与其他儿童期疾病的关系，以及潜在分类、最终评估和识别系统的可靠性和有效性。本文还讨论了这种类型的模型对关注LD的儿童进行临床评估的意义。
