DMR Eligibility Decision by H.O. Hudgins, January 11, 2009

DMR Eligibility Decision by H.O. Hudgins, January 11, 2009

Outcome: Ineligible

Keyword: Flynn effect

Hearing Officer: Marcia Hudgins

Counsel present for Appellant: Yes – Deborah Filler

Counsel present for DMR: Yes – Kim LaDue

Appellant present: No

Hearing Officer decision: January 11, 2009

Commissioner letter: January 30, 2009

The appellant is a 20 year old man.  He has been evaluated for mental illness and to determine his functioning level a number of times.  He has been diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD), pervasive developmental disorder not otherwise specified (PDD-NOS), Multiple Complex Developmental Disorder, a specific phobia of water, depression, significant language and learning difficulties and possibly attachment disorder. He has difficulty with a number of tasks, such as planning, language, academics and social skills.

When the appellant was 11 years old, he was evaluated using the Wechsler Intelligence Scale for Children – Third Edition (WISC-III) for the purposes of placing him in the appropriate school.  His test results were in the average range.  It was at this time that he received the ADHD and depression diagnoses.  The doctor did not offer a diagnosis of mental retardation.

Two years later, he received another evaluation because he seemed unstable, insecure and depressed.    He received a much lower score on his second WISC-III, which the doctor who evaluated him attributed to social and emotional concerns and language-based difficulties.  The same doctor tested him again two years later, at which point he tested slightly better but still received another below average IQ score.  She did not offer a diagnosis of mental retardation after either test.  When the appellant was 18 years old, he same doctor evaluated him once more, using the Wechsler Adult Intelligence – Third Edition (WAIS-III) test this time.  The appellant was on medication at the time and reported feeling “spacey” and “lazy.”  His score had declined again, and he was more easily overwhelmed and disorganized by complex information during the test.  A diagnosis of mental retardation was still not suggested.

In the mean time, throughout his childhood the applicant saw a number of doctors and received a variety of diagnoses.  When he was 16, he was enrolled at the Pathway School.  The school determined after the admissions process that he had borderline intelligence, and was functioning at elementary school levels with regards to academics.  When he was 18, he began to display a number of odd behaviors and was hospitalized at Somerville Hospital.  Even after he was no longer hospitalized, some of these odd behaviors continued.

The appellant applied for DMR services, but was denied because he was not found to have significant sub-average intelligence.  On appeal, one of the appellant’s witnesses, Dr. James Leffert, testified that the appellant’s IQ scores should be interpreted in light of the Flynn Effect, which is the tendency of people to do better on IQ tests from year to year.  This would possibly make the appellant’s IQ scores even lower, which would make him eligible for DMR services.  Dr. Leffert was of the opinion that the appellant’s low IQ scores were not a result of his other mental illnesses.  Dr. Leffert also testified that PDD, one of the appellant’s diagnoses, often overlaps with mental retardation, and that mental retardation was an appropriate diagnosis.  The doctor who had evaluated him multiple times testified to say that she agreed with this assessment.

Dr. Radine Perry testified as an expert witness on behalf of DMR.  She testified that the appellant’s low performances on his evaluations were due to his other mental illnesses.  She also testified that the IQ scores he received on these tests were within the normal range, and that the Flynn effect should not be applied to the WAIS-III test.  For these reasons, she said that the appellant was not qualified to receive DMR services.

The Hearing Officer found that the appellant had not proved by a preponderance of the evidence that he met the criteria for DMR services.  Although the Hearing Officer held that he had significant adaptive behavior deficits, she did  not find that he had significant sub-average intellectual functioning.  She concluded that the low IQ scores were likely a result of the psychiatric and behavioral problems he struggled with during adolescence, and that she was not qualified to determine whether the Flynn Effect should be used to interpret the appellant’s IQ scores.  Because the appellant never received IQ scores below 70, she determined that he did not meet DMR criteria for receiving services.