A Case Study: Carter Carter was initially referred for possible special education services in a first-grade compensatory classroom at Browning Elementary School. The compensatory class, a district Tier Il intervention, served students who had not reached the criterion score for first-grade placement on the district readiness test. This classroom had only 15 students and was served by a teacher and a full-time aide. Carter was referred by his mother, who had many concerns about her son. She noted that his progress seemed slow, that he not only had problems with academics but had a lot of trouble paying attention, was impulsive, and had poor motor control. Carter's teacher concurred with the mother's concerns. Carter was having very little success in the classroom and was constantly in motion. This bad become a problem even in this developmentally appropriate, alternative first-grade program. He was easily distracted and had trouble delaying gratification. He was impatient and gave up easily. He was easily discouraged, and he complained that he did not have any friends. His teacher reported that Carter voiced fears that were "unusual" for this age group. Carter was the younger of two children. He had been a large baby (10 pounds at birth), and the pregnancy had been complicated by high blood pressure and toxemia. However, no adverse effects were noted after the birth. His mother described Carter as a clumsy child, with repeated falls and bumps. Normal developmental milestones were somewhat delayed. He did not crawl until he was 8 months old or walk until he was 2. Speech development was interrupted by a loss of hearing at 18 months due to ear infections. The speech and language evaluation, done at the time of referral, confirmed difficulty with some sound frequencies, and it confirmed deficits in speech and communication skills. Carter was taking Ritalin twice a day, prescribed by his pediatrician for attention and hyperactivity problems (ADHD). Even so, Carter's mother described him as a creative, sensitive, and generally happy child. At age 6½, Carter was evaluated by the school psychologist, who noted that Carter was able to concentrate more easily on tasks that involved manipulation of objects but was very distracted in auditory tasks. He needed encouragement and reinforcement to sustain effort during the testing. The results indicated the following: WISC-IV (measure of intellectual functioning): Full Scale IQ: 105 Composite scores: Verbal Comprehension 102 Perceptual Reasoning 109 Working Memory 95 Processing Speed 110 Carter also achieved a standard score of I 05 (63rd percentile) on the Peabody Picture Vocabulary Test, a measure of receptive language ability, which indicated age-appropriate receptive language skills consistent with the WISC-IV results. Carter was given two measures of academic achievement: Diagnostic Achievement Battery -3 Reading: 109 Math: 94 Wide Range Achievement Test (WRAT-4) Subtest Standard Score Re.

1. A Case Study: Carter
Carter was initially referred for possible special education
services in a first-grade compensatory classroom at Browning
Elementary School. The compensatory class, a district Tier Il
intervention, served students who had not reached the criterion
score for first-grade placement on the district readiness test.
This classroom had only 15 students and was served by a
teacher and a full-time aide.
Carter was referred by his mother, who had many concerns
about her son. She noted that his progress seemed slow, that he
not only had problems with academics but had a lot of trouble
paying attention, was impulsive, and had poor motor control.
Carter's teacher concurred with the mother's concerns. Carter
was having very little success in the classroom and was
constantly in motion. This bad become a problem even in this
developmentally appropriate, alternative first-grade program.
He was easily distracted and had trouble delaying gratification.
He was impatient and gave up easily. He was easily
discouraged, and he complained that he did not have any
friends. His teacher reported that Carter voiced fears that were
"unusual" for this age group.
Carter was the younger of two children. He had been a large
baby (10 pounds at birth), and the pregnancy had been
complicated by high blood pressure and toxemia. However, no
adverse effects were noted after the birth. His mother described
Carter as a clumsy child, with repeated falls and bumps. Normal
developmental milestones were somewhat delayed. He did not
crawl until he was 8 months old or walk until he was 2. Speech
development was interrupted by a loss of hearing at 18 months
due to ear infections.
The speech and language evaluation, done at the time of

2. referral, confirmed difficulty with some sound frequencies, and
it confirmed deficits in speech and communication skills. Carter
was taking Ritalin twice a day, prescribed by his pediatrician
for attention and hyperactivity problems (ADHD). Even so,
Carter's mother described him as a creative, sensitive, and
generally happy child.
At age 6½, Carter was evaluated by the school psychologist,
who noted that Carter was able to concentrate more easily on
tasks that involved manipulation of objects but was very
distracted in auditory tasks. He needed encouragement and
reinforcement to sustain effort during the testing. The results
indicated the following:
WISC-IV (measure of intellectual functioning):
Full Scale IQ: 105
Composite scores:
Verbal Comprehension
102
Perceptual Reasoning
109
Working Memory
95
Processing Speed
110
Carter also achieved a standard score of I 05 (63rd percentile)
on the Peabody Picture Vocabulary Test, a measure of receptive
language ability, which indicated age-appropriate receptive
language skills consistent with the WISC-IV results.
Carter was given two measures of academic achievement:
Diagnostic Achievement Battery -3
Reading: 109
Math: 94

3. Wide Range Achievement Test (WRAT-4)
Subtest
Standard Score
Reading Composite
112
Word reading
113
Sentence comprehension
110
Spelling
108
Math computation
103
From the evaluation, the multidisciplinary team concluded that
Carter was a student of average intelligence who showed no
significant strengths and weaknesses. Based on state guidelines,
he did not qualify for special education at that time.
Carter went on to second grade, continuing on the Ritalin for
his medically diagnosed ADHD. His classroom teacher was very
sensitive to Carter's needs and monitored the effects of his
medication carefully. Carter continued to show signs of
problematic socialization behaviors. He had significant trouble
getting along with others, often picking on other children. In
third grade, he moved to another school, where he still received
all of his education in the regular classroom program. He
returned to Browning Elementary School in fourth grade, where
he seemed to be in constant trouble. He was still on Ritalin,
receiving the highest dose possible. His mother had sought help
and advice from other doctors and agencies, and she was in the
process of getting him evaluated by a major regional child
evaluation clinic. Carter's behavior at home continued to cause
serious problems. He exhibited a lot of unwarranted fears and
was obsessed by violence. He could not seem to complete any

4. tasks given to him. For the first time, his math skills fell below
grade level. In January of that year, the school support team
placed him in the resource room under the new eligibility of
"other health impaired" because of his ADHD. He was also
receiving counseling at the community mental health clinic.
Carter's problems with attention were causing him difficulties,
specifically during transitions, such as from lunch to recess and
from recess back to class. Right before lunch, when his morning
medication would wear off and before the noon dose would take
effect, he was unable to concentrate and do work and was
consistently disruptive in the regular classroom. It was
suggested that his resource room services could include having
lunch with the resource teacher and spending recess in the
resource room. This was done for about 4 months, during which
careful anecdotal records were kept on his behavior to
determine what would be the best placement for Carter. His
mother requested that he be reevaluated. He was also scheduled
for a brain scan and other diagnostic testing outside of school.
During this period, Carter was being weaned off the Ritalin
because he had to be completely off it for the planned brain
scan to be accurate. As he came off the Ritalin, his attention
quickly diminished. By the time he was completely off the drug,
he could not sustain attention for more than 1 or 2 minutes at a
time, even on things that he enjoyed, such as computer games.
He was unable to do any academic work at that time.
Problem behaviors toward his classmates, teachers, and other
people were still very evident. Those behaviors didn't change
whether he was on the Ritalin or not. His reevaluation by the
school psychologist included additional tests to try to uncover
the real source of Carter's problems. The reevaluation and the
behavioral records helped clarify the nature and extent of his
problems. His new fear of crowds caused him to resist going to
the lunchroom and to prefer solitude. He made up stories and

5. talked extensively about violence. He would jump from one
thing to another in conversation, not seeming to know whether
he was telling true or made-up stories. He seemed not to be able
to tell what was real from what was not real. By April of that
year, the full team met with his mother to determine how to best
meet Carter's needs. He had not made any progress during this
school year, and the entire experience had been very frustrating
for him, his mother, and his teachers.
Everyone at the meeting was aware that Carter had attention-
deficit/hyperactivity disorder. When the team met, the school
psychologist reported that the results of the evaluation indicated
that Carter's school problems stemmed primarily from his
emotional problems, not from the ADHD. The ADHD was a
contributing factor, but the primary disability appeared to be the
emotional or behavioral disorder. Even when he was on Ritalin,
the abnormal behavior continued. The mother and the classroom
teacher concurred in this. They saw a special class placement as
being the least restrictive environment for Carter at that time, a
placement that it was hoped would allow him to resume
academic learning and to work on his emotional issues and
problem behaviors. However, the teacher of the class for
students with emotional or behavioral disorders disagreed,
saying that the ADHD was the root problem.
The committee took all the evidence and decided that the
emotional problems were the central issue. Those concerns were
always there: on or off the Ritalin: therefore, they felt that his
emotional problems were the primary cause of his lack of
academic success. Carter had never had a successful year since
he started school. and because of his past history, it was the
committee’s sincere hope that intensive work in the self-
contained classroom environment would help him finally begin
to make progress.

6. Learners with Mild Disabilities: A Characteristics Approach,
Enhanced Pearson 5th Edition By Eileen B. Raymond Published
by Pearson, p. 147 – 149.
Copyright © 2017 ISBN-10: 0-13-382711-9; ISBN-13: 978-0-
13-382711-8
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