Friday, March 01, 2013

Special education in Minnesota - The MinnPost series on costs and funding

In the 1960s Minnesota education was a mess. It was funded entirely by property taxes; those who had the least need got the most funding, those with the greatest need got the least. [1] The disparities were egregious. Then, in 1971, came the "Minnesota Miracle". Education was increasingly funded through state taxes.
 
This worked very well for Minnesota, until, in 2002, Minnesotans elected GOP governor Tim Pawlenty and a Republican legislature. They reduced state funding and shifted overall funding back to property taxes; this benefitted their base and harmed the state.
 
Now, 11 years later, education in Minnesota is struggling. Not surprisingly, the effects are being felt most strongly in the funding of special needs education. MinnPost, a digital only nonprofit [2], has put a series together on the topic:
The Star Tribune has a also published a related article: Rising special ed cases are huge cost to Minnesota schools.
 
There's a lot of material in the articles. A few key takeaways, with the caveat that the articles are sometimes more anecdote than science:
  • Some of the cost increases may be related to the education and support of students who, as recently as 10 years ago, might have been institutionalized. As we've learned more about educating special needs students, we're also handling more difficult challenges.
  • There are three regional school districts that focus on special needs education, including New Hope's North Education Center in District 287. They serve about 3,600 students, of which 2,000 were referred in from a home district which pays the bill.
  • The average MN student costs $11K/year to educate, the average special ed student costs about $20K/year to educate [2], and the students in the North Education Center supposedly cost $70K/year. [3]
  • A "large" percentage of St Paul's severe EBD students are African-American and only 30% are ever in a regular classroom [4]. There is significant pressure to at least partly mainstream these students.
  • St Paul's special education district spent @98 million on special education, but only received $62 million in state funding. In other words, special education services are an underfunded state mandate [8]. The remaining $36 million came from other educational programs; the term "cross subsidy" is sometimes used to describe this funds transfer [5].
  • Obsolete rules mandating particular adaptive technologies waste money; iPads are much less expensive and much more desirable. [6] 
  • The sequester will cut $7 million in Title I funds [7] and 9.2 million in federal special ed funding.
  • The special-ed population has risen from 13-15% of the state's student body over the past 10 years. [9]
It's challenging to interpret these articles because, as my footnotes attest, there's a lot of missing data. My sense is that the overall demand is stable or slightly up, but that we are educating children who once received little education. Most of all, we are living with the damage done by Tim Pawlenty and his GOP legislature, and their reversal of the "Minnesota Miracle" educational funding system. That damage has been compounded by the Great Recession, demographic trends, and a shift from public to private/charter schools.
 
On the bright side, we are emerging from the Great Recession, the GOP are out of power for the moment, and the Accountable Care Act's mental health funding may allow schools to offload some of their services to the healthcare sector. From our experience, there are ways to improve the quality of special care education while also reducing the costs -- though they may require some 'no-child-left-behind' reforms. We can certainly change laws that mandate use of expensive and obsolete technologies.
 
There are issues here, but they aren't insurmountable.
 
- fn -
 
[1] American public education is often funded through taxes on property. Most nations think this is insane, and a major contributor to America's socioeconomic distress. Most nations are correct.
[2] We donate.
[3] We have two children in special ed. #1 is in a modified track, # in an adapted track. It would be interesting to see where the extra 10K goes; I suspect it's partly for speech and occupational therapy. There's also a lot of administrative overhead in managing special ed students.
[4] How large? No data. 
[5] The 2007-2008 budget was 630 million. Assuming it's now about 660 million, the cross-subsidy would be very roughly a 7% "tax" on other programs but in some articles this is described as 20%. The descriptions of what is meant by "cross subsidy" are not always clear.
[6] I've read that elsewhere. The rules require the devices be single purpose, that rules out modern adaptive devices.
[7] Poverty focused funding, but that includes many special ed students.
[8] Unfunded mandates are a common political vice.
[9] We don't know how much of this arose because of shifts of students out of public schools to private schools, or if this number counts charter schools. Given "wealthy flight" in MN over the past decade this might be little true change.

Saturday, February 16, 2013

Title IX for disabled student sports?

I've had concerns with my #1's school, but some very dedicated teachers have provided him with adapted floor hockey and adapted soccer activities. For him this time is more valuable than most of his coursework.

The exercise is good -- adapted floor hockey is more work than I'd naively expected. The social activity is more important though. He's able to work and play with his peers. 

It wasn't easy for his teachers and the schools to put these programs together. They have to work around the fuzzy boundaries of "CI" and "PI", a divide that predates autism spectrum disorder. His teammates are technically "PI" (physically impaired) but most have some degree of "CI" (cognitive impairment) as well. In his case the CI is significant and the PI a bit of a stretch -- but "pure" CI opportunities are very limited.

For #2 son, who has "high functioning" autism, there are no school sport options. Whereas #1 has a relatively easy time joining adapted or mainstream sports teams, #2 would need some inventiveness. (He does quite a few sports -- but on his own terms.)

For both of my boys, and for special needs students in general, there may be some good news on sports access....

Education Dept. Clarifies Law on Disabled Students’ Access to Sports - NYTimes.com

The Education Department’s Office for Civil Rights clarified legal obligations Friday for school districts in providing access to sports for students with disabilities....

... The guidance concerns Section 504 of the Rehabilitation Act of 1973, a law that deals with the rights of disabled people who participate in activities that receive federal dollars.

A school district ‘is required to provide a qualified student with a disability an opportunity to benefit from the school district’s program equal to that of students without disabilities,’ according to the Education Department.

Advocates for disabled athletes, some of whom have pressed legal claims against state athletic associations in recent years, praised the clarification of rules and said that as a result, participation for disabled athletes could rise.

‘This is a landmark moment for students with disabilities,’ Terri Lakowski, chief executive of Active Policy Solutions, a Washington-based advocacy group, said. ‘It will do for kids with disabilities what Title IX did for women. This level of clarity has been missing for years.’

At least 12 states have passed laws in recent years requiring schools to include disabled students in sports and other extracurricular programs, and the Education Department’s guidance is considered a complement to those laws.

‘Taking them together with the state laws means more opportunities for disabled athletes,’ Lakowski said. According to the department, a district’s legal obligation to comply ‘supersedes any rule of any association, organization, club or league that would render a student ineligible to participate, or limit the eligibility of a student to participate’ based on disability...

That sounds encouraging. But ..

... No student with a disability is guaranteed a spot on an athletic team for which other students must try out, according to the Education Department. But districts must ‘afford qualified students with disabilities an equal opportunity for participation in extracurricular athletics in an integrated manner to the maximum extent appropriate to the needs of the student.’ ...

That sounds like it's meaningless.

I think it's premature to call this "Title IX" for disabled sports access, even if we remember that it took a lot of lawsuits to make Title IX more than words. I'll go with "encouraging" for now, but we need to watch where this goes. It may make a difference if litigation is needed.

Tuesday, December 25, 2012

Minneapolis and Loppet Foundation/Courage Center launch Adaptive Cross-Country Ski program

#1 and #2 have both become quite good XC skiers. It took some ingenuity to get there [1]. Now there's a new option to make winter more fun... (emphases mine):

Minneapolis Park & Recreation Board - Cross-Country Skiing:

... Adaptive Cross-Country Ski Program

The Minneapolis Park and Recreation Board is teaming up with the Loppet Foundation and Courage Center to offer an Adaptive Cross Country Ski Program for individuals with visual impairments, physical and/or developmental disabilities.

Athletes will be paired one-on-one with instructors trained by Courage Center, with sessions culminating with the Luminary Loppet candlelit ski, part of the City of Lakes Loppet Cross-Country Ski Festival.

... Five Thursday Sessions: Jan. 3, 10, 17, 24, 31, 6:30-8 p.m. (meet at the Wirth Par 3 building) Cost: $95, includes equipment, trail passes, coaching, and registration fee for the Luminary Loppet (with transportation to and from the event).

The authors omitted directions on how to sign up for this (oops), but see the update below..

See also:

[1] I've never fully documented the Machiavellian program I followed. #3 is neurotypical, and loves to do special things with her mother. So they did an intro class together. #2 (Asperger's) is not a natural skier, but he is fiercely competitive with #2. So we played on that to get  him to outrace her. That left #1, who is a natural athlete -- once we have Mom, #2 and #3 and skijoring dog on board he will naturally go along. It unfolded as planned.
[2] Largest in North America, and we don't think any other country has a larger program.

Update 12/28/2012

Some more information on how to register: contact "Nels Dyste; nels.dyste@CourageCenter.org".

Sunday, December 23, 2012

Special education vs. standards based grading: What are grades for?

We've been struggling with some of #1's 10th grade teachers for about 8 weeks now.

The problem seems to be related to his school's transition to "standards based grading", though I am sure there are other contributing factors. New teachers, for example, don't have much training in adaptation vs. modification, and several of his teachers are relatively new. Experienced teachers learn this over time.

This seems to be a fairly simple problem, so I was initially surprised how slow progress has been.

I was surprised, that is, until I remembered my general rule "Everything in education maps onto health care". When I remembered that rule, I understood. I know secondary education only as a special needs parent and a medical school professor, but I know American health care and medicine very well.

I know how dysfunctional even the best health care systems are, and I know American health care is far from the best. I also know that most physicians only understand a part of what's broken, and that almost none understand why simple things seem not to happen [1]. So I can't blame educators for struggling to understand; like physicians they have too much going on, and the system is broken in too many ways.

If we ever did have a meeting of minds on modification and grading for non-degree students, I'd like it to be based on reviewing and expanding this simple table, a summary of the utility of grades for diplomate and non-diplomate students.

ReasonDiplomateNon-diplomate
Mandate (system) Yes Yes
Work incentive Yes Yes
Teacher evaluation Yes Yes
Guide instruction Yes Yes
Certification Yes No
Streaming Yes No
Post-grad triage Yes No

The last three, to us at least, are the key.

Non-diplomate students grades are not being certified as "high school" graduates. They aren't being streamed for advanced pre-graduation opportunities. They aren't being triaged into community college, state college or elite college tracks or scholarship eligibility.

Once one understands what grades are used for, it should be easy to discuss how to manage grade adaptation. For example, a grade record of all D with the occasional C doesn't fit this framework.

In the meantime, we'll continue the time consuming process of meetings upon meetings. We seem to make progress through meeting-induced exhaustion; it's a process few parents can afford.

See also:

Update 1/13/2013
 
We're not going to win this battle. The lesson is we can work with teacher problems, and we can work with system problems, but we can't work with both system and teacher problems.
 
Update 3/6/2013
 
Contrary to what I thought two months ago, and thanks to L's patience and persistence and hard work at many levels of the school, we actually reached a reasonable detente. This has involved a mixture of arbitrary grade increases, more appropriate grading of his work, and increased flexibility in assignments. I don't think there was ever a dramatic understanding, more gradual acceptance.

- fn -

[1] My personal pick for most obscure and under-appreciated micro level contributor to US health care failure -- the 1990s transition to "CPT E&M" based accounting mechanisms. Just one among many causes, but not one physician in a thousand understands what that did. At a macro level, Baumol's Disease afflicts both health care and education. Another micro-cause - physicians don't understand why their health record software is so bad.

Anthropology of the alien mind

As a neurotypical [1] parent of an atypical mind I often feel like a human anthropologist visiting an alien world. Sometimes I imagine I can understand #1's thinking, and sometimes I know I can't.

I know he has an IQ less than half of what I once had [2], but often he has insights I miss. He solves the world in a different way; usually a much inferior way, but sometimes his methods are better.

He can't explain them though; he can't translate his inner states and reasonings to verbal form, or even to an internal model of himself [3]. He can't tell me why he suddenly won't go to hockey practice because he doesn't know himself.

Perhaps he saw something disturbing on the long and twisty road to the distant arena. Maybe it's a joint practice, and there's someone on another team he wants to avoid. Maybe he's feeling anxious, and he wants to know that his father will enforce the rules and consequences he relies on. Rules he is, as yet, unable to internalize.

When the rules are applied, not for missing a practice, but for breaking a promise [4], he is not angry or sad. He is cheerful. He seems relieved. His guard rails are intact.

I am training for First Contact.

[1] More or less: What if we could see the diversity of minds?
[2] As I age we may yet converge!
[3] Arguably neither can "we", cognitive research has shown many of the mental-state stories we tell ourselves are false. They are often post-hoc explanations with little relationship to how we think.
[4] Hockey is important for many reasons, but most of all as a safe lab in which to learn the rules of adult life and of employment. 

Sunday, December 16, 2012

Special needs and psychosis: living with uncertainty

A NYT story of psychosis following developmental delay recalls Andrew's story (emphases mine)...

Providing Comfort When a Cure Is Out of Reach - Tara Ebrahimi - NYTimes.com

... Although Takkin had been found to have development delay and fairly severe A.D.H.D. at a young age, he had managed to lead a “normal” life well into his teenage years. He stayed in the school system for as long as he could, participating in work and life-skills programs. He was doing data entry at the airport and held a steady part-time job as a greeter at Trader Joe’s.

His situation was complex, as is often the case for people who fall into the gray space between severe intellectual disability and borderline development delay. He knew he was different from others in their early 20s, recognized that he didn’t really have any friends and that he would never go to college as his two older siblings had. He wanted nothing more than to get his driver’s license. But he was happy at times, especially when he was socializing.

Then he had the dental surgeries, and it was as if a switch in him had been flipped. After a series of root-canal procedures and teeth extractions, he woke up from his final round of procedures and anesthesia, and was never the same...

... we began seeking psychiatric help for what eventually would be referred to as Takkin’s “psychosis” and “delusional thinking.”...

... he was already in the social services system, which in our state consisted of a labyrinthine series of hoops and hurdles and bureaucratic insanity that not even the most educated and competent can easily navigate...

... I came up with a plan of action. And then another when the first plan failed. And another when the second plan failed...

... I drove to the emergency room, where we waited eight hours for him to be admitted to the psychiatric ward...

... it was time for Takkin to leave the psychiatric ward for an outpatient home ... I called a dozen times a day and could never get a response on the status of his anticipated stay, so he never went....

... he was released from the psychiatric ward into my custody, I was unable to reach his case manager at the hospital despite my constant phone calls, e-mails and voice messages, which were alternately kind, threatening and pleading...

Tara tells a story of psychosis developing after low IQ/ADHD cognitive disorder, Andrew's story tells of psychosis developing after Asperger's/autism. Adam's story may add to this tragic set. We have no idea how often this happens; that's just one of the failures of modern mental health research [1].

Tara also describes the disaster of American mental health care. That story has been told before. Recently some have suggested taxing bullets to drive a renaissance in mental health care. We could hardly do worse than we do now.

For us these stories are  personal. Our #1 son resembles the young Takkin. He lives in the "gray space", -- he has severe ADHD, cognitive disabilities, and the usual range of essential but near meaningless diagnostic labels. Will he, like Takkin and Andrew, develop a psychotic disorder over the next seven years? Does he, in a sense, have only a few relatively good years left?

We look at him, and we see features of an unnamed syndrome that continues to play out. We see uncoordinated growth, as though his cells were a mosaic of developmental clocks. Small feet, short legs, persistent  mandibular growth after maxillary has stopped. He too will need dental surgery.

There is something we cannot name that is ongoing. We assume the same process will continue to affect his brain development over at least the next decade.

How do we live with this? How do other parents of children with short lifespans or degenerative neurologic disorders live?

We live in the moment and in the past. We take photographs of good times. We spend our time and our money to have good experiences for him now, because his future is grimmer than most. Not hopeless, but not particularly hopeful.

We don't spend our time looking for a fix or a cure. We are decades from being able to fix this type of problem. Maybe centuries. Better to spend the time we have building memories.

Being the best we can be.

- fn -

[1] While we known almost nothing of natural history or epidemiology of psychosis with developmental disorders, we have hints like this preprint.

Emphases mine, the research community suspects that our definitions of "autism" and "schizophrenia" are at best incomplete, at worst completely misleading. This knowledge has not made its way into the general psychiatric community.

Expression of autism spectrum and schizophreni... [Schizophr Res. 2012] - PubMed - NCBI

Copy number variants (CNVs) associated with neuropsychiatric disorders are increasingly being identified. While the initial reports were relatively specific, i.e. implicating vulnerability for a particular neuropsychiatric disorder, subsequent studies suggested that most of these CNVs can increase the risk for more than one neuropsychiatric disorder. Possibly, the different neuropsychiatric phenotypes associated with a single genetic variant are really distinct phenomena, indicating pleiotropy. Alternatively, seemingly different disorders could represent the same phenotype observed at different developmental stages or the same underlying pathogenesis with different phenotypic expressions.

... ASD and schizophrenia associated with 22q11.2DS should be regarded as two unrelated, distinct phenotypic manifestations, consistent with true neuropsychiatric pleiotropy...

In this particular small study with a particular autism-spectrum-related genotype, the incidence of psychosis resembled the general population.

I have created an RSS Feed to track research on the relationship between developmental disorders and psychosis.

Tuesday, December 11, 2012

Minnesota's state mandated child abuse: standardized testing of special needs students.

This is madness. I have a post pending about the struggles we've had with grading and our non-degree-candidate #1 son; this news story hits on a related topic:

When tests tell teachers nothing: Special needs not met by standardized tests | Twin Cities Daily Planet

...  teacher Rachel Peulen spends two to three weeks administering a test that she knows will tell her next to nothing about her students.

On most days, Peulen’s middle schoolers each work on activities designed to meet their particular needs. One student works on remembering classmates’ names. Another practices recognizing flashcards inscribed with simple words. Her most advanced students do simple arithmetic...

... But over three weeks, Peulen takes each student out of the classroom for up to an hour-and-a-half, so she can ask them to compare fractions, find the slope of a line and identify the main idea of a story. With no additional staff to assist her, paraprofessionals take over the class...

These tests are the equivalent of scoring a paraplegic on their long jump ability.

I hope Nolan Murphy was misquoted here, because he doesn't come across very well...

Minneapolis Public schools’ lead teacher for developmental and cognitive disabilities programs, Nolan Murphy, said some good has come out of testing students with disabilities: more than ever, special education teachers are aligning their lessons with those of their grade-level general education peers.

It's worse than madness, it's pointless cruelty. As a physician I'm legally mandated to report suspected child abuse. So where do I report the State of Minnesota?

Friday, November 30, 2012

Asperger's syndrome and depression

Adolescence is a time for new adventures -- such as depression. It's not clear whether depression is more common in person's with Asperger's syndrome, but since depression is associated with stressful life events it would be surprising if it were not associated with high-function autism spectrum disorder.

As of Nov 2012 there is no useful academic research on the management of depression in the context of autism syndromes at any age. There's no  We do wonder sometimes where all the NIH autism syndrome money is going.

I found two somewhat useful references:

Physicians used to be taught that there was a clear line between "pathological" depression and the "normal dysphoria" of life in an often difficult world. I was never convinced by that argument. I'm not sure there's even a very sharp line between non-psychotic and psychotic depression -- though that transition is relatively clear. That line is probably even harder to spot in persons with stressful disabilities such as Asperger's. The focus then is on decreasing ability to perform activities of daily living, such as school work. The fear, of course, is suicide.

It's not hard to find semi-scholarly articles claiming that suicide rates are increased with Asperger's syndrome, but even there we see caveats (emphases mine):

... An increased risk of suicide is observed in persons with Asperger syndrome, with risks possibly rising in proportion to the number and severity of comorbid maladies...

In other words we don't know. My own suspicion is that we'll find:

  • cognitive-behavioral therapy is useful
  • decrease academic stress
  • cautious use of antidepressants -- notoriously tricky in adolescents. May prefer to avoid SSRIs.

Tuesday, October 30, 2012

Special education vs. standards based grading: I think we have a problem

Number one reads and writes at a 3rd-4th grade level. Lately, at age 15, his handwriting has become fairly legible.

We're proud of him. I didn't think he'd learn to read or write at all. it has been a long road with a lot of help from teachers, aides and, yeah, his parents.

Now, as a non-diplomate Setting II student with modifications, he's straining his brain to label mitochondria and endoplasmic reticulum while answering questions about demographic transitions. It's probably not the best use of his time, but he seems to enjoy the work and it's good practice for his reading and writing skills, and even for his very (very) short term IQ 60 verbal memory. We're proud of that too. 'A' work by our standards.

Not by the current standards of his mainstream teachers though. He's getting C- or Fail grades -- despite his IEP. At least one teacher feels this is appropriate since he's "minimally meeting expectations".

Yes, we have a problem.

It's not a new problem. It amazes me how many of his teachers have been unable to read an IEP, and how many seem to lack any low IQ experience. Usually this responds to some education and orientation, but things have been getting worse over the past two years. I think part of the problem is that his school is moving to a recent educational fashion: 'standards based grading'...

Educational Leadership:Expecting Excellence:Seven Reasons for Standards-Based Grading Patricia L. Scriffiny

... standards-based grading, which involves measuring students' proficiency on well-defined course objectives (Tomlinson & McTighe, 2006). Although many districts adopt standards-based grading in addition to traditional grades, standards-based grading can and should replace traditional point-based grades....

... 

An A means the student has completed proficient work on all course objectives and advanced work on some objectives.
A B means the student has completed proficient work on all course objectives.
A C means the student has completed proficient work on the most important objectives, although not on all objectives. The student can continue to the next course.
A D means the student has completed proficient work on at least one-half of the course objectives but is missing some important objectives and is at significant risk of failing the next course in the sequence. The student should repeat the course if it is a prerequisite for another course.
An F means the student has completed proficient work on fewer than one-half of the course objectives and cannot successfully complete the next course in sequence....

...

Students who struggle can continue to retest and use alternate assessments until they show proficiency, and they are not penalized for needing extended time. I guide students with special needs to modify their work and, if needed, develop different ways of demonstrating that they've met their proficiency goals. Their working styles can be easily accommodated in this system because modified assignments and assessments require no special adjustments in the grade book. The grade book simply shows where they are in meeting the standards, without reference to how they are demonstrating their learning or what modifications needed to be made....

I wonder what Ms. Scriffiny means by 'meeting the standards'. Does she mean the unadjusted course objectives, or does she mean adjusted standards? Her meaning is unclear, and that is the crux of the question. Other articles I've found on 'standards based grading' suggest that grades for non-diplomate Setting II students are problematic.

This really isn't a complex problem. There are two ways to think about this, and they both lead to the same outcomes.

One approach is to adjust the goals, and then grade on the adjusted goals. This is an excellent approach, though it requires some thought and help to formulate goals and modifications. That can be a problem

There's also a budget approach. Start by asking what purpose grades serve for both mainstream (diplomate) students and corporate executives. They motivate work, they measure teacher or manager quality [1], and they are used to stream students and employees along different paths including promotion, lateral moves (from physics to biology for example), and termination. 

In that context a fixed standard makes sense. But number one is not going to graduate from High School. He is not going to go Michigan State University (his current dream). He is probably not going to have unsubsidized employment. He will probably never live independently. There is no point in streaming him, because he is not in the water. He was beached at birth. For him grades serve only two purposes - they can incent him or they can demoralize him

At the moment, his teachers seem to working on the second mission. Our job is to try to change that, working with both teachers and school leadership. Failing that, our job is to find him a better learning environment.

[1] Alas, both corporations and classrooms are prone to the stack-ranking disease.

See also:

Update: A valued advisor of mine suggests this language be added to the IEP. It says to the teacher, "STOP.... you can't grade the way you normally do."

The case manager may reduce course assignments in number, length, content or weight. Alternative assignments need to be arranged between case manager and teacher.

Grading Modification:

Grading may be based on a student’s personal effort in consideration of the student’s own skills/strengths and disability. Casemanager will help determine appropriate grading. Factors such as attendance, class participation, or other appropriate measures should be used to determine a grade if necessary.
Student should not be graded based on meeting the course requirements set for non-disabled peers. Instead, grading should be based on ...

Sunday, October 21, 2012

Adaptation versus Modification: Critical code words in understanding K12 special education. (plus Settings)

Every discipline has its own special language, and special education is no exception. Common words, like 'accommodation', 'adaptation' and 'modification' can take on special meanings. After years of using these words, it may be surprising to learn that not everyone knows what they mean.

Certainly I was surprised to learn, after years of being a special education parent, that for some teachers there's a significant difference between 'adaptation' and 'modification' in special needs education, whereas for others the terms are synonymous. There appear to be local usage variations and it's not clear that regular education teachers, especially novice teachers, understand the distinctions as well as special education teachers.

From what I read the term accommodation is consistently used for relatively modest changes to education and examination. A student may have additional time to do an exam, or may hear questions rather than read them.

The term modification is usually used to refer to significant changes to a curriculum or testing process. My rewrite of a standard 9th text in World History to a 4th grade reading level would be considered a substantial modification. I believe in some locations the words "change in rubric" is used to mean modification.

The term adaptation is sometimes used as a synonym for 'accommodation', sometimes as a synonym for 'modification' and sometimes for something between the two. The meanings appear to be regional, but this British Columbia school district description matches what I hear from a Minneapolis Special Education teacher ...

Adapted and modified education programs

Adapted Program

This is a program that retains the learning outcomes of the prescribed (regular) curriculum but adaptations are provided so that student can participate in the program. Examples of adaptations include assigning a 'buddy' for note-taking, assigning fewer examples for practice, extending time for assignments and tests. Students on adapted programs are assessed using the provincial curriculum standards set out by the Ministry of Education.

Modified Program

This is a program in which the learning outcomes are substantially modified from the prescribed curriculum and specifically selected to meet the student's needs. Examples of modifications include the student being taught the same information as other students, but at a different level of complexity; or given a reduced assignment (e.g., fewer questions to answer); or the student uses a lower-level reading textbook. A student on a modified program is assessed in relation to the goals and objectives established in the student's IEP.A student's program could include some courses that are modified and others that are adapted.

Another BC document makes clear the practical distinction between adaptation and modification:

Although decisions about modifications to a student’s courses or subjects may take place in grades earlier than Grade 10, a formal decision that an overall program is modified does not need to occur until Grade 10.  The decision to provide modifications, particularly at the secondary school level, will result in students earning a School Completion Certificate upon leaving school rather than credits toward graduation ... 

As a parent of one special needs child who will not graduate from high school, and another who should graduate from college, I love the clarity of the Canadian (BC specifically) distinctions. Adapted means regular diploma, modified means no diploma. 

Knowing this, it's possible to squint hard at a No Child Left Behind document on adaptation vs. modification and spy the political subtext. There are big racial achievement gaps in American schools (Koreans do best), and the there's considerable pressure to do 'adaptations' rather than 'modifications' so more kids get diplomas and go to college. This may explain why some school districts appear to be emphasizing adaptations, and why there appears to be no money, and no market, for adapted modified textbooks. Without adapted modified textbooks, and with cuts to special education resources who can do modifications, we have the situation of my son's utterly incomprehensible college-level human geography text and his impossible biology exams.

Mainstream teachers don't have the time, and perhaps not the training, to do modifications, and it's absurd to think that a shrinking number of special education teachers can generate a unique modified textbook and curriculum for every student. Of course there's no reason someone like me couldn't do modified textbooks to be distributed nationwide, but that appears to be quite inconceivable.

See also

Update 10/22/2012: 

In the US the "Settings" concept is an important complement to the model of adaptation (diploma) and modification (no diploma). There are Levels of "settings":

  • Setting I: less than 20% of time in special education setting
  • Setting II: 20-60% of day in special education setting
  • Setting III: more than 60% of day in special education setting

I suspect Setting I is consistent with Adaptations and a diploma, Setting III means modifications and no diploma and Setting II could go either way.

In the case of my #1 son he's currently in Setting II but might do well in Setting III. At this time, however, he strongly prefers Setting II. I suspect that our school has a limited capacity for Setting III, so Setting II is the only thing we've been offered. That could work well if there were resources to provide modifications for Setting II, and if mainstream teachers were keen to use those resources. Instead we've found our mainstream teachers claim to be completely unaware of how to do modifications; sometimes those claims are credible.