10 S – T

Saphris® (see anti-psychotic medications) 

Savant (savantism)

Refers to an individual who possesses outstanding (but narrow) knowledge, skills, or capabilities. These capabilities may be exemplified by knowledge of math, arcane topics (e.g., airline schedules), or musical or artistic capabilities. Especially in cases of autism spectrum disorder (ASD) with savantism, the individual suffers impairments on other dimensions, such as adaptive functioning and socialization. Such impairments stand in stark contrast to his/her savant capabilities. Savantism occurs disproportionately among individuals with ASD (at rates estimated from approximately 10% to 30%), depending on the degree of exceptional talent required for a designation (Dubischar-Krivec, Bolte, Braun, Poustka, Birbaumer & Neumann, 2014). Savant-like characteristics, however, are not a diagnostic criterion for ASD. See DSM-5 page 50, for the diagnostic criteria for ASD.

Scaffolding

This concerns a group of procedures teachers or others (e.g., aides, support staff, tutors) use to support and guide student learning. The idea is that scaffolding enables students to execute skills that they are not yet able to demonstrate independently. The scaffold typical buttresses a knowledge or skill deficit that would otherwise constrain the execution of a task. For example, a student with limited general knowledge is assigned to read a passage about the American Civil War and would later need to answer questions about what she had read. Her teacher, however, provides scaffolding because he knows that she lacks some background facts needed to make sense of the reading assignment. This might consist of a refresher about the 1861 map of the United States. It might also involve clarification of 1861 attitudes about slavery/emancipation held by residents of Union and Confederate states. The nature, complexity, and life-span of scaffolds vary greatly. In general, the idea is that, like physical scaffolds used in building construction, instructional scaffolds are removed or trimmed down when no longer needed.

For more details see the following link from Peabody College at Vanderbilt University: https://iris.peabody.vanderbilt.edu/module/sca/cresource/q1/p01/.

Schedules of reinforcement

Reinforcement (events that occur after an operant behavior and change its probability) can be characterized in various ways. These are important for school psychologists who are attempting to understand and change students’ overt behavior. Specifically, schedules of reinforcement help determine how readily new behaviors are acquired and old ones extinguished. For example, continuous reinforcement (instances in which behavior is reinforced each time it is emitted) helps assure that new behaviors are learned as rapidly as possible. In contrast, intermittent reinforcement (instances in which behavior is reinforced only some of the times when it is emitted) typically leads to slower acquisition but greater resistance to extinction.

Thus, when school psychologists plan behavioral intervention plans (BIPs), the continuous reinforcement vs. intermittent reinforcement distinction matters. This is especially the case when undesirable behavior, such as tantrums, have a history of reinforcement via teacher attention. Attempts to extinguish tantrums by ignoring work only as long as complete (or nearly complete) inattention follows each tantrum. Otherwise, the attempt to extinguish the behavior is actually a type of intermittent reinforcement, perhaps inadvertently inoculating the behavior from easy extinction. The table below includes sub-distinctions of continuous and intermittent reinforcement. Standard textbooks on behavior modification, such as Kazdin (2011), offer considerably more details on this topic.

Schema

The basic building block of knowledge, according to the theory of Jean Piaget. During progressive stages of child development, schema become more complex, differentiated, as well as less tied to the senses and motor actions and more characterized by abstraction and high-level cognition.

School connectedness

School connectedness is often considered to comprise several interrelated elements: interpersonal attachments, attachment to the school, as well as a positive attitude toward school. This follows from the expectation, or belief, held by students that adults in the school community (e.g., teachers, administrators) care about them individually and are concerned about their learning. A document entitled the Wingspread Declaration suggests that several factors contribute to school connectedness:

• expression of high academic expectations coupled with support for learning
• positive relationships between adults at school and students
• student safety that encompasses both physical and emotional dimensions

Connectedness is arguably important to develop because of its association with student motivation and an array of desirable outcomes, such as academic success, graduation rates, and regular attendance.

See the following link with further details on this topic prepared by Robert W. Blum http://www.ascd.org/publications/educational-leadership/apr05/vol62/num07/A-Case-for-School-Connectedness.aspx

Section 504 definition

School psychologists are often involved in Section 504 determinations. To be protected under Section 504, “a student must be determined to:

1. have a physical or mental impairment that substantially limits one or more major life activities; or
2. have a record of such an impairment; or
3. be regarded as having such an impairment.”

Section 504 requires that school districts provide a free appropriate public education (FAPE) for all qualified students in their jurisdictions (i.e., all students with a physical or mental impairment that substantially limits one or more major life activities). It is common for students with ADHD, as on example, to have 504 accommodation plans to assure that they receive FAPE.

Extensive information is available on the U.S. Department of Education website regarding school implementation of Section 504 via the following two links. http://www2.ed.gov/about/offices/list/ocr/504faq.html.

https://www2.ed.gov/about/offices/list/ocr/docs/504-resource-guide-201612.pdf

Seizure (see epilepsy)

Sensitivity (see diagnostic utility statistics)

Sensory processing deficits/sensory-based therapies

Sometimes learning and behavior problems are ascribed to deficits in sensory processing. This inference, however, has been challenged as inaccurate because more recognized explanations exist (e.g., ADHD, autism, or intellectual disability). In fact, the American Academy of Pediatrics (AAP) advocates against use of “sensory processing disorder” as an independent diagnosis.

Parallel considerations are present regarding therapy. Specifically, AAP urges telling families that there is limited data supporting sensory therapies (e.g., use of brushes, swings, and balls). This is especially true when such therapies stand alone, rather than when delivered as part of a comprehensive intervention plan.

School psychologists may want to learn more from the following American Academy of Pediatrics link: https://healthychildren.org/English/news/Pages/AAP-Recommends-Careful-Approach-to-Using-Sensory-Based-Therapies.aspx.

Serotonin selective reuptake inhibitors (SSRIs)

SSRIs are a class of psychiatric medications typically used to treat depression but also employed for social anxiety and obsessive-compulsive disorder (also see anti-depressant medications). SSRIs work by blocking reabsorption into the presynaptic neuron of a neurotransmitter called serotonin. Trade names for SSRIs include Prozac®, Zoloft®, and Praxil®. Beside their therapeutic benefits, there is some evidence that SSRIs are associated with new or worsening thoughts of suicide. The National Institute of Mental Health advocates for adolescent depression to be treated with combined medication and psychotherapy, such as cognitive behavior therapy (CBT).

Facts on the treatment of adolescent depression with SSRIs and CBT are available at this National Institute of Health link: http://www.nimh.nih.gov/funding/clinical-research/practical/tads/questions-and-answers-about-the-nimh-treatment-for-adolescents-with-depression-study-tads.shtml

Seroquel® (see anti-psychotic medications)

Serzone® (see anti-depressant medications)

Shaping (in behavior modification)

Shaping refers to a behavioral technique that involves development of new behavior by successive approximations. Shaping takes place when small steps, each approximating the final desired behavior, are reinforced. Shaping is important for school psychologists to understand because for many students it represents a powerful tool for establishing previously nonexistent behavior, such as social or academic skills.

Sickle cell trait/disease

Some individuals, especially those from families with sub-Saharan African origin, carry a gene variant (i.e., an allele) associated with sickle cell. Although this variant appears to confer protection against malaria in Africa, it is also capable of altering hemoglobin and consequently causing blood-related difficulties. Sickle cell disease per se occurs when two copies of this allele are present (this is an autosomal recessive disorder), but a single copy can result in sickle cell trait and some, but not all, of the problems cited below. Hemoglobin with a sickle cell shape may lead to stroke, accumulation of blood in various joints, and consequently neurological symptoms associated with the former or pain associated with the latter.

The presence of sickle cell disease or trait is important for school psychologist to recognize because affected students may miss class due to pain, doctors’ appointments, or occasional infections. Similarly, it is important for school psychologists to understand that a host of neurological symptoms can arise if a stroke occurs. These may take place in one-quarter to one-third of children affected with sickle cell disease (Schatz & McClellan, 2006). Research suggests that decrements in IQ, nonverbal ability and achievement (especially in math) may accompany “documentable” strokes. Even “suspected” strokes are associated with attention and executive problems (Schatz & McClellan, 2006). More surprising is the presence of executive, memory, and academic difficulties among some children with no history of stroke, perhaps due to insufficient oxygen and glucose delivery. Processing speed may also be slowed, perhaps due to central executive dysfunction (Smith & Schatz, 2016). Thus, it is hardly surprising that more than half (58%) of parents in one study expressed concern about educational problems for their children with sickle cell disease (Mayes, Wolfe-Christensen, Mullins, & Cain, 2011).

For additional information, see the following link from the National Institutes of Health: www.nhlbi.nih.gov/health/health-topics/topics/sca/

Sight vocabulary

Sight vocabulary refers to the subset of words that a reader is able to identify rapidly, reliably, and accurately without needing to resort to phonics-related decoding strategies. Without a grade-level sight vocabulary some students struggle to read passages fluently and this fact, in turn, can constrain reading comprehension. Understandably, many reading experts advocate that every student develop a strong sight vocabulary. Many basal reading programs include drills to help accomplish this. There are lists of high-frequency words that were once routinely taught as sight vocabulary to elementary students. One famous set is entitled the Dolch 220 list. This list is still sometimes encountered as an instruction target for poor readers.

For more information, see the following link from the Iowa Reading Research Center: https://iowareadingresearch.org/blog/teaching-sight-words. 

Significance (statistical versus clinical)

Statistical significance has a specific meaning, which is commonly misunderstood by the lay public and sometimes forgotten by school psychologists. Statistical significance simply indicates that an association between variables (e.g., the difference between an experimental and a control group) was unlikely to have arisen by mere chance (i.e., is statistically improbable). Unfortunately, consumers of psychological research might assume that statistical significance implies that important practical differences have been detected. In other words, it’s easy to think, incorrectly, that “significance” in the statistical sense connotes “significance” in the everyday sense.

Although seeming counterintuitive, statistically significant findings are sometimes practically trivial. For example, the difference in reading proficiency between individuals in an experimental and a control group might be quite slight (and devoid of real importance) even if these differences are statistically significant (not due to chance). To address the issue of clinical or practical significance, consumers of psychological research are generally advised to attend to indicators of “effect size” (quantitative measures of the strength of an association). This tells them, for instance, how large mean differences are between experimental and control groups (e.g., Cohen’s d) or how much of the variance in a dependent variable is explained by an independent variable (e.g., eta squared). Also see the entry for effect size.

Skill versus performance deficit

Skill deficits referred lack of attainment of particular, tangible proficiencies. These may pertain to, for example, computational arithmetic or oral reading skills. Skills are viewed as the product of direct instruction. It can be important for school psychologists to distinguish skill deficits from performance deficits. Students with performance deficits actually possess skills but (sometimes, perhaps often) fail to express them. This situation seems to be common among students with attention, motivation, or psychiatric problems. When academic problems are present, part of the problem solving and consultation process is to distinguish whether the problem is principally one of skill or performance. Obviously, different courses of action are necessary in each instance. Thorough collection of background information, work samples, and straightforward assessment of skills helps untangle these two competing possibilities.

SNRI (Serotonin Norepinephrine Reuptake Inhibitor; see anti-depressant medications)

Social maladjustment clause

Some writers have argued that the mention of “socially maladjusted” in the IDEA definition of emotional disability (ED) has a meaning that helps determine whether ED is  present. Specifically, it is sometimes contended that documentation of social maladjustment is sufficient to rule out eligibility for ED. Careful reading of the ED definition, however, makes this conclusion dubious. Here is the critical phrase, which appears at the end of the definition, “The term does not apply to children who are socially maladjusted, unless it is determined that they have a serious emotional disability.” Other scholars have argued that there are logical and empirical limits in school psychologists’ ability to make reliable judgments about whether social maladjustment is or isn’t present and that even if present social maladjustment does not preclude ED designation (Olympia et al., 2004). Consequently, school psychologists and multidisciplinary teams may choose to use circumspection regarding this confusing clause. See entry for emotional disability, which provides a verbatim definition.

Specific language impairment

Students with specific language impairments are regularly encountered by school psychologists because the condition is so common among those referred for psychoeducational evaluations. These children are exemplified, for example, by deficient WISC-5 Verbal Comprehension Index scores (or other psychometric indicators of language development) coupled with delayed acquisition of linguistic milestones. Language-intensive school tasks, such as reading comprehension and certain content subjects (e.g., English, social studies) often prove to be difficult (Wodrich & Schmitt, 2006). Social shortcomings are common. Research suggests high rates of psychiatric comorbidity (Beitchman et al., 2001).

When school psychologists are involved, students with specific language impairment often qualify for specific learning disabilities designation with basic reading, reading comprehension, oral expression, and listening comprehension typically being areas that are impacted. Early on, the students may be identified as having speech language impairment and receive services from a speech language pathologist. Note: Specific language impairment should not be confused with speech or language impairment (an IDEA category), which shares the same “SLI” abbreviation, and for which there may be overlap.

Additional information is provided at the following National Institute of Health link: https://www.nidcd.nih.gov/health/specific-language-impairment.

Specific learning disability (federal) definition

The following is the IDEA definition of a specific learning disability. “…. A disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, or do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, and developmental dyslexia. The term does not include learning problems that are primarily the result of visual, hearing, or motor disabilities, mental retardation, emotional disturbance, or of environmental, cultural or economic disadvantage.”

To add clarity to this definition and to assist teams in identifying students with SLD, three broad approaches have emerged. Most school psychology training programs devote considerable didactic coverage plus extensive clinical supervision to assure students understand these three approaches and can apply one or more of them in practice. Each state, however, creates its own regulations. Thus, each state may require, permit, or prohibit one or more of the three approaches (Maki, Floyd & Roberson, 2015), which are summarized here:

• Ability/achievement discrepancy: SLD is conceptualized as unexpected academic underachievement. The identification process concentrates on documenting low achievement (especially on individually administered tests) compared to IQ scores.
• Pattern of strengths and weaknesses (PSW): an alternative to ability/achievement discrepancy in which SLD is conceptualized as a processing disorder documented by severe discrepancies among a student’s cognitive strengths and weaknesses that match academic deficits.
• Response to Intervention (RTI): an alternative to ability/achievement discrepancy in which SLD is conceptualized as persistent failure to succeed even when a student is provided targeted and increasingly intensive interventions.

Which of these approaches is best represents among the most hotly debated aspects of school psychology (e.g., see Hale et al., 2010), although it is argued that logically the approaches are more complementary than contradictory (Wodrich, Spencer & Daley, 2006). Note: RTI is also an important general education prevention and intervention approach (see response to intervention entry). Also see the following link: https://sites.ed.gov/idea/regs/b/a/300.8/c. 

Specificity (see diagnostic utility statistics)

Speech or language impairment (federal) definition

The following is the IDEA definition of a speech or language impairment. “Speech or language impairment means a communication disorder such as stuttering, impaired articulation, a language impairment, or voice impairment that adversely affects a child’s educational performance.” Note: A speech or language impairment is not to be confused with a specific language impairment, which shares the same “SLI” abbreviation, and for which there may be overlap.

Also see the following link: https://sites.ed.gov/idea/regs/b/a/300.8/c.

Splinter skills

This refers to islands of well-developed skills, generally assumed to be non-cognitive in nature, that exist in the presence of broader cognitive delays. Splinter skills are exemplified by adequate, or even advanced, motor speed or rote memory development seen in a student with low overall IQ.  The presence of splinter skills can prove confusing to school psychologists when they make inferences about cognitive capability. In general, isolated skills, especially if they are not applicable across an array of school situations, are not used to anchor general cognitive capability. That is, splinter skills would not typically be used in calculating ability/achievement discrepancies. WISC-5 scores like the General Ability Index may sometimes be used in lieu of full scale IQ (also see savant). Additional information is available in Wodrich and Schmitt (2006).

SSRI (Serotonin Specific Reuptake Inhibitor; see anti-depressant medications).

Standards for Educational and Psychological Testing

This is an essential guide that was prepared jointly by the American Educational Research Association, the American Psychological Association, and the National Council on Measurement in Education. This comprehensive document, available in paperback and e-book options, provides essential information about the uses of psychological testing including: requirements for reliability and validity, norms, scoring, interpretation, and fairness, and testing of individuals from diverse linguistic backgrounds. Consequently, it is an important source of information and guidance for school psychologists who use psychometric tests as part of their practice.

The Standards are now available for downloading free of charge: https://www.testingstandards.net/uploads/7/6/6/4/76643089/standards_2014edition.pdf.

State/trait distinction

Psychological states concern dimensions that are subject to change (e.g., anxiety level). Traits, in contrast, are conceptualized as enduring characteristics (e.g., sociopathy). This is an important distinction for school psychologists as the former might be a target for change via intervention, whereas the latter typically are not targets for change. Moreover, school psychologists might be able to measure changes (improvements) in psychological states by repeated assessments (e.g., pre-post rating scale score changes).

Stelazine® (see anti-psychotic medications)

Stereotype threat

This notion from social psychology concerns the situation in which members of a group (e.g., women, Latinos) are at risk of confirming a pre-existing stereotype about themselves. The idea is that existence of the stereotype (e.g., women are less mathematically capable) compromises actual performance in the way that the stereotype would imply. That is, the girls-are-less-capable-in-math stereotype could set up a situation in which girls actually do less well in math than their male counterparts. This might happen when girls attentive to this stereotype avoid enrolling in advanced math classes or second guess their solutions to math problems in the classes in which they actually are enrolled. For school psychologists, awareness of widely endorsed stereotypes is an important first step in mitigating the potential negative effect of any stereotype threat.

For more information, see the following link from the American Psychological Association: http://www.apa.org/research/action/stereotype.aspx.

Stereotypies

This term denotes repetitive, abnormal movements that include a ritualistic quality (e.g., hand flapping, spinning). Stereotypies are important for school psychologists to recognize because they sometimes occur among children with autism but are rare among individuals without autism. See DSM-5, pages 50 and 77.

Stimulants and other ADHD medications

Strabismus

This denotes misalignment of the eyes, sometimes referred to as being “cross-eyed” or having a “wandering eye.” The condition is important for school psychologists because it is fairly common, requires management by a vision care specialist, and might contribute to a student’s presenting problem (e.g., inability to perform well academically). Other terms such as, “extropia” (eyes diverge), “estropia” (eyes are crossed), or “hypertropia” (eyes are vertically misaligned) might also be seen in students’ health records.

The following link from Stanford University might be helpful: http://www.stanfordchildrens.org/en/topic/default?id=crossed-eyes-strabismus-90-P02109

Strategy training (such as for students with ADHD)

As implied by its name, strategy training refers to explicitly taught and highly-practiced strategies that fit a particular academic situation (Daily & Birchwood, 2010). It seems that strategy training is best suited for students in middle school and higher grades. At this level, strategy training might be applied to student-specific challenges such as tackling homework or effective notetaking during class. Although intuitively plausible, strategy training has not yet been subjected to rigorous research. For school psychologists, it probably makes the most sense to use strategy training on a case-by-case basis during consultation when careful progress monitoring is part of the consultation process.

Strattera® (see stimulants and other ADHD medications) 

Structure (used to diminish problematic behavior)

“Structure” is often encouraged as a remedy for problematic behavior, especially among young children and those with ADHD. In fact, parents and those without behavioral training are often quick to talk about the need for structure as if it were a panacea. Accordingly, it makes sense to specify exactly what is meant by structure.

A first (simple) notion of structure is the establishment of routines coupled with the expectation that routines are followed. The idea here is that if students become accustomed to doing the same activities in the same order every day that eventually they will simply do so without need for thought or external guidance. A corollary to this conceptualization of structure is that as students build up habit strength for acceptable actions that problems will shrink. Examples might be a morning routine for a first grade class that involves entering the classroom, placing coats in a designated spot, followed by moving directly to one’s desk, then followed by the entire classroom quietly waiting for the teacher’s direction about what comes next. With structure, students would come to anticipate what follows each preceding step. To support this, a menu of activities might always be posted.

A second conceptualization of structure is more behaviorally-oriented. During situations in which one (or several) students risk inappropriate behavior adults (teacher, parents) intervene with structure. This notion of structure commonly involves explicit teacher-to-student directions. To maximize effectiveness, a student might be told, for example, what precisely is expected in the near term, which actions are acceptable, which actions are unacceptable and the consequences she can expect for following either the acceptable or the unacceptable option. Details might include a student with problematic behavior who is told before leaving the classroom for the cafeteria that she is expected to keep hands to herself, follow immediately behind the student in front of her, use an inside voice, and stop to wait when reaching the cafeteria door. To add structure, she is then told if she follows these directives, she will maintain her position in the lunchroom line. On the other hand, if she violates these directives, she will be subject to immediate removal from her current lunch-line position and peremptory placed at the very end of the line.

As school psychologists will recognize, both of these meanings of structure may suggest ways to help students with limited executive function and poor planning ability. It is also noteworthy that using either style of structure would be unnecessarily stifling to older students or students without executive dysfunction. For many students, however, the habitual conceptualization of structure (the first meaning of structure) seems less effective than providing clear, in-advance directions about what is expected coupled with well-defined contingencies (the second meaning of structure). Serving as consultants, school psychologists might aid teachers and parents considering use of either (or both) notions of structure.

Sublexical

Refers to parts of a word rather than a word as a whole. In reading instruction, the term is sometimes used in indicate focus on phonemes (and their association with letters or groups of letters) rather than reading by identification of whole words.

Successive approximations (see shaping) 

Sugar (as cause of hyperactive behavior)

Excessive sugar consumption is believed by many parents and teachers to cause temporary hyperactivity (witness, for example, parents’ comments at birthday parties as the consumptions of sweets and wild behavior both rise). Yet there appears to be limited support for any such association. A comprehensive review of the empirical research from way back in 1986 still appears to hold true: “Most studies have failed to find any effects associated with sugar ingestion, and the few studies that have found effects have been as likely to find sugar improving behavior as making it worse.” (Milich, Wolraich, & Lindgren, 1986, p. 493).

T-score

A type of standard score with a mean of 50 and a standard deviation of 10.

Tarasoff v. California Board of Regents

This is an important legal decision establishing that mental health professionals, presumably including school psychologists, have a duty to protect persons who are being threatened with physical harm. Confidentiality as might exist between a professional and a client is waived under certain circumstances, such as threats to harm another. Under these circumstances there is a requirement to warn the threatened individual, the police, or to take some alternative action to assure protection. There is, however, state-to-state variability in the adoption of Tarasoff’s requirements. Unfortunately, implementing the requirements of Tarasoff can prove complex and potentially confusing (Bersoff, 2013; Felthous, 2006). Consequently, many school psychologists seek advice from senior colleagues and legal counsel when elements of Tarasoff might be at issue for a student. The provisions of the Tarasoff case are sometimes referred to simply as “duty to warn.”

Details on the case can be found at the following link from Stanford University: https://scocal.stanford.edu/opinion/tarasoff-v-regents-university-california-30278

Tenex® (see stimulants and other ADHD medications)

Tests of Variables of Attention-TOVA (see continuous performance tests)

Theory of mind

A developmental skill that is routinely mastered during the course of psychological growth that may be absent, or impaired, among children with autism (see Baron-Cohen, Leslie & Frith, 1985). Theory of mind involves the ability to recognize that others possess a mind of their own (including their own knowledge, perceptions, and attitudes) that logically is distinct from everyone else’s. A child with autism, however, may fail to recognize that classmates lack interest in a bottlecap collection that he/she adores. Similarly, a child with autism may act as if a classmate experienced the pleasant taste of chocolate milk he just consumed for lunch even though the classmate drank water, not milk, with her meal. According to this theory, children with autism fail to act “mentalistically.” They are sometimes said to be “mind blind.” It is important for school psychologists to recognize that impaired theory of mind may help explain behavior seen among children with autism. Moreover, theory of mind tests are sometimes included in psychometric test batteries (e.g., NEPSY-II; Korkman, Kirk & Kemp, 2007). However, limited research is available to confirm the diagnostic utility of theory of mind measures as adjuncts to autism diagnostic tools.

See the following link from Simply Psychology for more details: https://www.simplypsychology.org/theory-of-mind.html

Thorazine® (see anti-psychotic medications)

Threat assessment

In the context of schools, threat assessment refers to evaluation of real or potential threats made by a student. Understandably, such threats take various forms from explicit and clear indications of wanting to harm one or more persons to vague and implied indications suggesting this possibility. School psychologists are frequently involved as part of a team to assess such threats. Typically, a school policy exists, and team members have received advanced training to enable policy implementation.

More details are available at the following NASP link: https://www.nasponline.org/resources-and-publications/resources/school-safety-and-crisis/threat-assessment-at-school/threat-assessment-for-school-administrators-and-crisis-teams.

Thought disorder

A term that refers to impaired ability to generate logical statements and explanations. In adults, this is seen as a hallmark of schizophrenia or another psychotic disorder. Among children, however, it can be difficult for practitioners to make a confident determination that a thought disorder is present. For instance, apparent circumstantiality (explanations that are overly detailed and digress so much that the flow of thinking may be difficult to follow) might simply reflect severe language impairment and/or cognitive immaturity.

Threats to internal and external validity (when interpreting psychological research)

Most school psychologists are concerned with interpreting, rather than conducting, research. Their challenge is to stay abreast of research and make judgments about the validity of studies that they have read or heard about. Skepticism is a valuable professional trait in contemporary times. Today’s parents and teachers are apt to cite claims of treatment efficacy for one condition or another that they have learned about from the internet. Of course, many of these claims may be untrue. Two concepts, internal and external validity, can be especially helpful when school psychologists scrutinize research.

Threats to internal validity relate to independent variables and their apparent effect on dependent variables. For example, a group of poor readers participates in a novel summer reading program and is found to improve an entire grade level in three months. One might infer that the novel reading program caused the reported skill boost. However, there are a host of threats to internal validity that prompt uncertainty. Perhaps some, or all, of the gain is due to maturation (as brain’s mature so does their ability to perform most tasks).  Or perhaps higher post-test scores arise simply because of practice effects associated with taking the same reading test (the study’s dependent variable) twice. Researchers can handle many threats to internal validity by use of experimental and control groups (and by related practices, such as careful, random assignment of individuals to each group). Classic texts on internal and external validity, such as Campbell and Stanley (1966), describe a host of other threats to internal validity. Although dated, this concise guide remains extremely valuable today for anyone interested in learning to think critically about the research she encounters.

External validity concerns the extent to which results from a particular study can be applied more broadly. The threat is that a specific study’s conclusions are of limited relevance to the setting where a particular school psychologist works. For example, even if it is concluded that the reading intervention (mentioned above) was truly responsible for the reading gains described, questions remain about applicability in new settings. Perhaps especially skilled teachers implemented the reading program in this study (e.g., teachers in the study might have averaged many years of experience in reading instruction) but no such teachers are available in the school psychologist’s venue. Similarly, participants in one study’s site may have cognitive or demographic characteristics dissimilar from those in another site. Perhaps the novel program actually works, but not for all students.

By remembering the importance of internal and external validity, school psychologists hope to become better, more vigilant, consumers of research.

Tics/Tourette’s disorder

Tics are defined as recurrent, sudden, rapid, non-rhythmic movements or vocalizations. They may be repeated many times and are quite stereotyped. Movement around the eyes, nose, and mouth are quite common manifestations. DSM-5 provide specific facts about various sub-delineation of tics, with Tourette disorder representing the most severe variation. Tics are sometimes exacerbated by situational stress (e.g., needing to stand up and speak in front of classmates). For many students, tics’ frequency and severity declines at adolescents. Before then, a waxing and waning course is common.

It is important for school psychologists to recognize the tics are quite common (found in perhaps as many as 7% of school-age children) and can be easily overlooked. This fact suggests that tics are often so subtle that their existence may go unnoticed by the child herself as well as by classmates. An important fact regarding tics is the high rate of comorbidity with conditions such as ADHD, OCD, (Lewin et al., 2011) and learning problems (sometimes involving writing). Guidelines for diagnosis exist, but the diagnostic task rarely falls on school psychologists. See DSM-5, page 81.

Furthermore, practice guidelines exist for interventions, which are outlined in the accompanying link. http://www.jaacap.com/article/S0890-8567(13)00695-3/pdf.

Timeout

Timeout refers to removal from access to positive reinforcement contingent upon a particular behavior. For example, a student is removed from the playground (assuming this represents positive reinforcement) contingent upon teasing another student. This procedure aims to decrease the frequency of a particular behavior (teasing).

For better or worse, the idea of timeout has now made its way into popular culture. Sometimes, however, the concept is misunderstood and misapplied. The central idea is actually timeout from positive reinforcement. This presupposes that a child occupies a highly reinforcing environment before he/she is contingently removed for misbehavior. School psychologists, of course, recognize that many classroom environments provide limited ongoing reinforcement, at least for some students. Consequently, removing a student from tedious seatwork for violating a rule (e.g., talking with a classmate) is unlikely to reduce the rate of violating that rule. Conversely, a brief period of isolation from playground activities contingent on breaking a playground rule might stand a better chance of working. Because timeout’s effectiveness usually depends on reduction of stimulation, and accordingly attention from others, ignoring is often required to make the procedure work. This proves difficult for many teachers and parents who often want to attend to the student before or after the behavior, thus mitigating the impact of timeout. That is to say, a heart-felt discussion of the need to follow rules generally and the nature of the misbehavior the just lead to timeout may be counterproductive. Often a functional behavior analysis (FBA) is helpful if timeout is to be used effectively.

Titration (of medication)

This refers to the practice of adjusting medicine to a proper (therapeutic) level. The notion of titration is important for school psychologists because, for example, stimulant medications used to treat ADHD often require adjustment. Because individual reactions are so varied, as are side effects, monitoring of attention, work completion, and behavior may be needed to optimize titration. The same is true regarding side effects.

Tofranil (see anti-depressant medications)

TORCH syndrome

This acronym refers to various infections of a developing fetus or newborn that result in a host of related symptoms (e.g., fever, rash, jaundice). The infectious agents are listed below:

(T) toxoplasmosis

(O) other agents

(R) rubella

(C) cytomegalovirus

(H) herpes simplex

If affected from birth (congenitally) children with any of these infections encounter a risk of developmental problems. The following link provides more information:

https://rarediseases.org/rare-diseases/torch-syndrome/.

TOVA (see continuous performance tests)

Toxoplasmosis (see TORCH)

Tracking (related to rule following)

The notion of tracking in the context of school-age children refers to ongoing compliance with a previously stated (or already known) rule. This is an important concept for school psychologists because failures of tracking are common among young children and those with ADHD. A student who shouts out an answer in class may either have failed to track the rule to wait until called on or alternatively intentionally flaunted that rule.

Ongoing (day-to-day, minute-to-minute) rule following is probably more complex than it appears. This is because for a student to comport his behavior with classroom (or playground or home) rules requires orchestration of many mental and behavioral components. These include retention of the applicable rule in long-term memory, searching for and retrieving the rule from memory when needed, holding the rule in working memory, rendering judgments about when the rule should be applied in overt actions, and then actually executing the behavior dictated by the rule. Not surprisingly, this often proves tremendously difficult. Helping distinguish tracking problems from compliance problems is often eye opening. It seems to be a common error to judge that rule breaking is almost always intentional and that it may represent opposition to authority. In many such instances, however, the problem may actually be failure of “tracking.”

Note: Russell Barkley has included the idea of internalization of rules (and keeping track of them) as a core failure in youth with ADHD. This is an element of executive dysfunction (see the following link from Dr. Barkley’s website for more information):

http://www.russellbarkley.org/factsheets/ADHD_EF_and_SR.pdf).

Trapped (related to behavioral programming)

Trapped in the context of applied behavior analysis refers to the eventual replacement of extrinsic reinforcers with natural reinforcers. For example, a behavior intervention plan  (BIP) might target homework completion by permitting access to video-game time (positive reinforcement) contingent on nightly completion of assigned work. Over time, however, greater homework completion may elicit naturally occurring teacher and parent praise, and the student may experience an enhanced sense of self-efficacy. As a consequence, the desired behavior change (i.e., greater homework completion) may become “trapped.” If this is the case, continued homework completion might no longer require extrinsic reinforcers (or at least to the same degree). Obviously, trapped behavior is a happy occurrence because few teachers or parents can (or will) engage in behavioral programming indefinitely. Thus, school psychologists may want to consider ways to facilitate trapping when they help devise BIPs.

Trauma (psychological)

Trauma is defined as exposure to a variety of events or situations (e.g., threatened or actual physical or sexual violence, kidnapping, severely frightening motor vehicle accidents). Psychologically meaningful trauma includes indirect experiences, such as a child who learns about severe trauma of a family member. Attention to the prospect of trauma is important for school psychologists because: (1.) trauma is a precondition for determination of posttraumatic stress disorder (PTSD), and (2.) the symptoms of PTSD, or sub-clinical variations of PTSD, sometimes mimic common conditions, such as anxiety, depression and ADHD. In addition, childhood rates of exposure to trauma appear higher than might be intuited (LaGreca & Danzi, 2020). Consequently, some experts (e.g., Grant et al., 2020) advise that routine inquiries be made about possible exposure to significant life stressors and trauma as part of psychological evaluations. Checklists exist to support school psychologists wishing to investigate these possibilities (also see PTSD).

For more information regarding trauma see the following link: https://www.nctsn.org.

Traumatic brain injury (federal) definition

The IDEA definition of traumatic brain injury (TBI) is as follows: Traumatic brain injury means an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance. Traumatic brain injury applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech. Traumatic brain injury does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.

See the following link: https://sites.ed.gov/idea/regs/b/a/300.8/c

Traumatic brain injury (methods for indexing severity)

It is often helpful to know something about the severity of a student’s head injury. Although characterizing severity is complicated, simplified systems exist and they are often helpful for school psychologists to know about.

The first system is the Glasgow Coma Scale, which is often determined at the scene of an injury. This might be done on-site by a paramedic crew and later (or again) at an emergency room. The Glasgow Coma Scale ranges from 15 to 3. It is derived by rating an injured individual’s presentation on three dimensions: ability to open eyes (e.g., spontaneously, following a verbal command), quality of verbal responses (e.g., indicating proper orientation), and quality of motor responses (e.g., able to follow commands, withdraw from pain). The lower the score the more severe the injury.

A second system is simply an assessment of the duration of any post-injury amnesia. Simply put, this assessment answers the question: Is there an inability to lay down and retrieve new memories and if there is how long from the time of injury does this inability persist (e.g., minutes, hours, or days)?  Of course, injury severity is only a general predictor of post-injury cognitive, information processing, and social-emotional considerations.

For more details about the Glasgow Coma Scale see the following link: https://www.cdc.gov/masstrauma/resources/gcs.pdf.

For more information regarding posttraumatic amnesia, see the following link: http://www.acquiredbraininjury.com/abi_manual/post-traumatic-amnesia.

Trichotillomania

This refers to the manifestation of repetitive hair pulling (resulting in hair loss) that the youngster is unable to control. Trichotillomania can result in disfiguration (partial baldness) and accompanying social stigma. Not surprisingly, it is highly comorbid with obsessive-compulsive disorder. See DSM-5, page 251. (Also see the entry for alopecia).

Tricyclics (see anti-depressant medications)

Trintellix® (see anti-depressant medications)

Tuberous sclerosis complex (TSC)

TSC is a genetic disorder inherited in an autosomal dominant fashion. This means that an affected parent has a 50% chance of passing on the gene mutation to his/her offspring. Most cases of tuberous sclerosis, however, arise from a spontaneous mutation (and many affected individuals never reproduce). Tuberous sclerosis is a neuro-cutaneous disorder characterized by lesions on the skin and in the central nervous system. The disorder is associated with cognitive learning and emotional impairments. Approximately 90% of these children have epilepsy. Students with the condition are likely to require special education, which makes it relevant to school psychologists.

For more information see the following National Institutes of Health link:

https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Tuberous-Sclerosis-Fact-Sheet.

Turner syndrome

Turner syndrome is a genetic condition caused by absence of a second X chromosome, it appears only in girls, nearly all of whom are unable to reproduce.  Short stature is almost a universal feature. The genotype is 45XO. Turner syndrome is an important condition for school psychologists because it is commonly associated with math and visuo-spatial deficits and, less commonly, social problems. Learning disabilities in math are quite common (the average girl with Turner syndrome possesses math skills that would make her an extreme outlier in a distribution of neurotypical girls; Baker & Reiss, 2016). Problems with sense of direction and orientation in space are also common. Although diagnosable social-emotional problems may not appear at elevated rates, these girls may nonetheless risk difficulty with interpersonal relations and activities of daily living. Importantly, Turner syndrome may go undiagnosed until the teen years when affected girls fail to develop secondary sex characteristics.

More information is provided in the following National Institute of Health link: https://ghr.nlm.nih.gov/condition/turner-syndrome as well as a link from the Turner Syndrome Society: www.turnersyndrome.org/.

Twice exceptional

This term refers to a student who meets criteria for giftedness and also experiences a disability of some type. Among the most common examples are a gifted student with a specific learning disability or a gifted student with an emotional disability.

The following document, although prepared for use in the state of Colorado, includes interesting and potentially useful information on this topic for all school psychologists:http://www.cde.state.co.us/sites/default/files/documents/gt/download/pdf/twiceexceptionalresourcehandbook.pdf.