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Friday, May 6, 2016

Saving the IEP Meeting When Conflict Arises

From Smart Kids with LD

By Ann McCarthy
April 25, 2016


As parents of a child with learning disabilities, it’s important to realize that conflict is likely to occur at IEP meetings; how you handle it is what matters. When dealt with appropriately, dissension can lead to positive outcomes for your child.

Following are three strategies to help keep you and your child’s IEP team on track when conflicts arise:
  • Control the emotional temperature in the room: Plan for the moment when conflict has rendered you or an IEP team member too emotional to be productive. Call a five-minute break so that everyone can collect their thoughts. Strong emotions come with having a child with special needs, but try to keep them out of the meeting room.
  • Have a Plan B: With the goals you hope to achieve in mind, come to the meeting with alternative solutions that will enable you to reach those goals. Is there another reading program that would work? Is there an option that the school district is proposing that you should consider? Determine the breadth of your “wiggle room” before you walk into a meeting.

Here are examples of how to handle some common disagreements in an IEP meeting:

School: “We are required to try strategies via Response to Intervention before we consider an evaluation for special education.”

Parent: “I’m glad you brought that up. This is a common misunderstanding, and here is a memo from the U.S. Department of Education that states the opposite. I’ll give you a moment to look it over before we talk about what John’s evaluation will include.”

School: “We cannot agree to five hours of speech/language support weekly until we get approval from the special education administrator. We’ll get back to you.”

Parent: “My understanding is that at every IEP meeting there must be a representative from the district who is knowledgeable about the availability of resources in the district. If that person is not present, can you get them on the phone now?

School: “Here are the evaluation reports. We are sorry we couldn’t get them to you before the meeting. We can use this time to review all four documents and plan for next year.”

Parent: “I can’t discuss how to use the results when I am only now seeing the information for the first time. Let’s review the reports today, and schedule a second meeting to plan for next year.”

.....................................................................

Ann McCarthy is a former special education advocate.

Thursday, May 5, 2016

May 27th: “Stronger Together” - 6th Annual PPAL Conference and Celebration

Sponsored by PPAL
The Mass. Family Voice for Children’s Mental Health

May 3, 2016
Workshop:

Let’s Discuss Neuropsychological Testing
Evaluating Complex Emotional and Behavioral Conditions

Presenter:

Jessica Geragosian, Psy.D.


Other Conference Workshops: 

Child Requiring Assistance
Psychiatric Diagnosis in Children and Adolescents

Minority of Mind: Living with Schizophrenia
Cultural Perspectives on Mental Health:
Providers, Parents and Community
The Heroin Epidemic in MA

A Father’s Role in Family Culture and Mental Health
Your Body, Mind and Emotion

What Makes an Animal More than Just a Pet?

Beyond PTSD:
Innovative Solutions for Complex Conditions
Youth Engagement is a Must

or Call 617-542-7860

Our Presenter

Dr. Jessica Geragosian completed postgraduate training in pediatric neuropsychology at the Massachusetts General Hospital for Children at North Shore Medical Center, where a focus of her work was on neurodevelopmental assessment of young children with developmental challenges. In the hospital, school and clinic settings, she has had diverse clinical experience working with children and adolescents presenting with a wide range of cognitive, learning, social and psychological challenges. 

She has conducted research on Mild Traumatic Brain Injury, focusing on the social and psychological consequences for adolescents. She has provided wide-ranging school-based services, including assessment, consultation and therapy.

She enjoys working collaboratively with families and other professionals to address the needs of children with developmental delays and autism spectrum disorders.

When:  8:30am - 3:00pm Friday, May 27, 2016

Where: Best Western Royal Plaza Hotel and Banquet Space
                   181 Boston Post Rd, Marlborough, MA

Admission: Professional, $40; Parent, $15; Youth, $10

Tuesday, May 3, 2016

What Should an Evaluation for Autism Look Like?

From the Child Mind Institute

By Rachel Ehmke
April 25, 2016

From finding the right clinician to diagnostic tools and parent interviews, there are many steps.


Autism is a diagnosis that covers a spectrum of children with a wide range of skills and impairments. Because of this, the disorder can look very different from child to child. Many experts who diagnose and treat children with autism like to say, “If you’ve seen one child with autism, you’ve seen one child with autism.”

The diversity of autism spectrum disorder (ASD) can make it difficult to correctly diagnose. Sometimes autistic children are mistakenly diagnosed with a different disorder, like ADHD, or are told that nothing is wrong. Other times kids are diagnosed as autistic when they actually aren’t.

That’s why it’s important for parents to know what the components of an autism diagnosis should be: What kinds of information should a clinician who’s evaluating your child be considering? How can you know whether your clinician is following best practices in doing an assessment?


Social Communication Issues

Problems in social communication and social interaction are often what are flagged as possible signs of autism, and that’s one source of confusion. “There are a lot of things that can cause social problems,” points out Dr. Susan Epstein, a neuropsychologist at the Child Mind Institute.

“There are subtle language disorders that can masquerade as autism. Or other disorders, particularly when they appear in clusters — ADHD, learning disorders, depression.”

If a child is having trouble with formulating phrases or sentences, for example, that can create a situation that might at first glance look like a sign of autism, but could have other causes. “The child has trouble communicating, which causes problems with peers, so the child might become withdrawn. It looks like they’re having social problems, and they are, but it’s of a different nature,” explains Dr. Epstein.

Arriving at the right diagnosis requires gathering and interpreting a lot of information about the child. Dr. Epstein, who specializes in evaluating autism spectrum disorder, recommends that children should receive an assessment that goes beyond screening and diagnostic tools to get the fullest possible picture of what is going on before making a diagnosis.

Screening

There are a variety of screeners that pediatricians or other practitioners might employ as a first step to learning if a child might have autism, before beginning a formal evaluation. Some are questionnaires that parents fill out and others are assessments done by clinicians. The Modified Checklist for Autism in Toddlers, or M-CHAT, is one questionnaire that is used to identify red flags. The M-CHAT asks questions about behaviors that might indicate autism, but Dr. Epstein warns that the test purposefully “casts a very broad net,” so it often flags children who may or may not be autistic.

Similar scales include the Childhood Autism Rating Scale and the Ages and Stages Questionnaire, which is more of a basic developmental screener.

The Screening Tool for Autism in Toddlers and Young Children, or STAT, is another screener that probes for autism symptom behaviors in more detail than the other screeners mentioned, but is still intended to be used as a tool to catch children who are candidates for further evaluation. Screener results alone should never be considered a diagnosis.

Diagnostic Instruments

If a screener indicates that a child may have autism spectrum disorder, the child should receive a comprehensive evaluation from someone trained in diagnosing autism.

This evaluation will often begin with a diagnostic instrument such as the Autism Diagnostic Observation Schedule, or the ADOS-2. The ADOS is a test with different modules to accommodate a range of children. There is a version for toddlers that is play-based. For kids older than thirty months, there are modules that include more conversation, according to the child’s language level.

This isn’t the kind of test where there are right answers. The purpose of the ADOS is to evaluate the social skills and repetitive behaviors the child displays during the test. This means the evaluator is paying attention to things like if the child asks for help when he needs it, gives other people a chance to speak, and follows along with changes of subject.

The Communication and Symbolic Behavior Scales (CSBS) is another good diagnostic instrument for toddlers and young children. This play-based instrument is also backed by research, but is used less than the ADOS, which covers a broader age range.

Problems with Interpretation

Dr. Epstein notes that even with these tools it is important to be working with a mental health professional who has experience diagnosing people on the autism spectrum. “You want to be working with someone who understands the subtleties,” she says.

“For example, a person who has real expertise will be able to distinguish if a child has poor eye contact because the child is shy, versus if there is poor eye contact in the way we expect to see it in an autism spectrum disorder.”

A recent study underscores the difficulty in distinguishing between autism and other disorders, like ADHD, using even gold-standard tools like ADOS. Looking at school age kids with high verbal functioning, the study found that found that 21% of children with ADHD—but not autism—met diagnostic criteria for autism when given the ADOS.

“The minute that we diagnose blindly based on score, we’re going to misplace a lot of kids into categories,” lead researcher Somer Bishop, assistant professor of psychiatry at the University of California, San Francisco, tells Spectrum, an online journal on autism research. “These instruments were designed to assist in clinical decision-making, but they are not a replacement for a clinical brain.”

Adds Catherine Lord, director of the Center for Autism and the Developing Brain at New York-Presbyterian Hospital, who developed the ADOS, it’s important to consider the motivation for the behavior. A child with ADHD might avoid an adult’s gaze because he thinks he has done something wrong, she tells Spectrum, rather than because of a social deficit. Or, a child’s face might be unexpressive because she is bored or distracted, not because she is less expressive in general.

Interviews

Screeners and diagnostic tools are ways of gathering information, but they have to be considered in the context of other information from a range of adults who know the child. A full evaluation should also include a thorough interview with the child’s parents that covers general development and current concerns. The interview will also closely investigate ASD-related symptoms. To gather more information, parents might be asked to fill out special questionnaires as well.

The Autism Diagnostic Interview, Revised (or ADI-R) is one such interview, and is often paired with the ADOS. However the ADI-R takes two hours to provide, making it difficult to use in clinical assessments, Dr. Epstein notes. An interview based on the ADI-R or a parent checklist, such as the Social Communication Questionnaire, can also be effective if it is led by a clinician trained in diagnosing autism.

Dr. Epstein explains that it is important to include early developmental information during the interview, because there are many circumstances where symptoms are more obvious earlier, say at around four years of age, but diminish as the child grows.

“If you aren’t attending to that early development and you have an eight or ten year old, for example, you’re going to risk really missing out,” she warns. Having that information about early development can help the provider make a more accurate diagnosis.

If the child is of school age, it is also helpful if the practitioner can speak to the child’s teacher to get their point of view, too. A school visit to observe the child would be “absolutely ideal,” says Dr. Epstein, but not always possible. A conversation with the teacher, or having the teacher fill out a questionnaire, will give the person doing the evaluation some insight into what the teacher is seeing firsthand at school, which may be different from what parents are seeing at home.

Cognitive Testing

An assessment should also include some amount of cognitive testing. One reason for this is that cognitive testing gives the person doing the assessment another chance to examine the child’s behavior, but this time under different circumstances. The ADOS is a socially loaded test that is also less structured, which might be difficult for some kids.

Dr. Epstein explains that some kids will do better during a more structured cognitive test when they are answering specific questions. “Or, maybe they will get upset during the cognitive testing if they don’t know the answer to a particular question, and they might have a tantrum,” says Dr. Epstein. All of this information is helpful for the person doing the evaluation.

The cognitive testing is also important because you want to learn more about how the child thinks — for example you want to learn more about how the child organizes and plans, or solves problems. Beyond helping the evaluator in making an accurate diagnosis, Dr. Epstein explains,

“If you don’t know their strengths and weaknesses, you can’t really contribute meaningfully to building an educational program for them at school. You want to be able to say, ‘He can do this; he can’t do that; this is what he needs to be able to do that.’”

Working with a Specialist

Screeners are often given by pediatricians, but if there are red flags that indicate further evaluation would be appropriate, it is best to work with someone who has both experience and expertise in diagnosing children on the autism spectrum.

“You’re not going to go to a doctor for a heart transplant who’s done two or three, right?” says Dr. Epstein. “It’s the same with autism. You want someone who’s seen hundreds of kids with all different stripes – typical children, intellectually disabled children, autistic children — and knows what to look for.” Academic and medical centers are often good places to find experienced diagnosticians.

Parents can ask some questions to try to gauge a potential provider’s experience. For example:
  • What’s your training and experience?
  • Have you had specific training in assessment of people on the spectrum? How much?
  • What do you plan to do as part of this assessment?
  • Will you be contacting my child’s teacher or pediatrician?

Try to find a practitioner who is able to answer your questions readily and makes you feel comfortable. A clinician who takes your concerns seriously and is experienced in assessing autism spectrum disorder is essential to getting an accurate diagnosis.

Friday, April 29, 2016

Part II - Gatekeeping 101: Response To Intervention

From Parents Have the Power
to make Special Education Work

By Carson Graves and Judith Canty Graves
April 3, 2016



An article in a Massachusetts newspaper in 2013, entitled: “[Superintendent] Looking to Curb Sped Referrals,” (1) highlights a growing trend of school districts actively discouraging the referral of students for special education evaluations.

The article quotes a local school district superintendent as calling special education referrals “a resource zapper,” and requesting that instead, parents ask their child’s classroom teacher to decide if any concerns they might have about possible disabilities are valid. If the teacher agrees with the parents, then the teacher can refer the parent’s concern to a panel of “teachers and special education staffers.”

This panel then has the option to refer the child to a program commonly known as “Response to Intervention” or RTI. According to the superintendent, “... all I’m asking is for parents to work closer with the classroom teacher and keep a dialogue open, and wait for the teacher to go through the RTI process.”

To many parents, this may sound perfectly reasonable. Special education services cost money, so why shouldn’t the school district be able to decide what conditions to place on admission to it? The answer lies in the purpose for which RTI is being used and how it is implemented.

What is RTI?

RTI is loosely defined in the regulations that accompany the 2004 reauthorization of IDEA (2) with the goal of screening all students early in their school career to identify any who are struggling and, through increasing levels of intervention, prevent the need for more costly special education services later.

By applying the screening process universally, it represents an effort to make IDEA, which addresses the unique needs of individual students, more closely conform with No Child Left Behind (NCLB), which attempts to raise standards for all students uniformly.

IDEA-04 “permits” (not “requires”) schools to employ “scientific, research-based” techniques to help struggling students discovered in the screening process.

These techniques are applied in increasing levels of support, known as “tiers.” The progress of each student is monitored; if the initial tier of intervention isn’t working, the student is then referred to the next, more intense, tier.

IDEA doesn’t specify how many tiers a school must use (three tiers seem to be the most common), the criteria for deciding whether a tier is working or not, nor how long a student must stay in one tier before moving to another. All of these details are left to the individual states and school districts.

In other words, RTI is not the same as, nor a substitute for, special education. RTI does not provide for evaluations by qualified professionals to identify specific learning disabilities, and a student in RTI does not have an IEP to specify learning goals or the accommodations and modifications needed to achieve those goals.

Although some schools may employ these techniques, there is no requirement to do so. Most important, there is no legal mandate for a school to provide agreed upon services, accommodations, or program modifications, as there is when a student is on an IEP.

In fact, the US Department of Education makes it clear that a student in special education is also eligible to receive RTI services along with special education services. (3) Schools, however, appear to regard RTI as a substitute for special education that is less involved, and of course, less expensive.

So, What’s the Problem?

Early screening of and intervention for all “at-risk” students regardless of the presence of a documented learning disability is a laudable and potentially cost effective way to improve public education. The problem arises when the reality doesn’t match the intention.

In the article mentioned above, the first thing to note is that the school isn’t screening all students as the RTI model is designed to do. The only students who are considered for the RTI program are those who are able to pass through at least three gates:
  • First, the parents must express concerns about their child to the school.
  • Next, the classroom teacher, who may not have any training in special education, must agree that the parent’s concerns are valid.
  • Only then does a child reach gate number three, the panel of “teachers and special education staffers” who are the ones to decide if there is any need for services, all without any formal evaluation of the student for learning disabilities.

By contrast, IDEA has very specific criteria for determining eligibility for special education and who is qualified to make the determination. (4) Once parents request an initial eligibility evaluation and give their written consent for the necessary testing, the school has 60 calendar days (by federal law, state laws may vary) to perform evaluations in all areas of suspected disabilities. These evaluations must be performed by qualified and knowledgeable professionals.

There is no provision in IDEA for multiple layers of screening by people who may not have the training or qualifications to recognize or evaluate learning disabilities.

RTI as Gatekeeping

The inescapable conclusion is that the superintendent quoted in the article is attempting to use RTI in a manner for which it was not intended. Instead of an early screening tool for all students to identify the at-risk ones before they fall too far behind, he wants to use it as an alternative to performing special education evaluations only for those students whose parents have raised concerns and then are able to pass through two levels of “gatekeeping.”

This circumvents IDEA’s mandate that schools perform evaluations in all areas of suspected disability by qualified and knowledgeable professionals.

What is surprising is how clearly the superintendent admits this. When he calls the law’s evaluation requirements “a resource zapper,” he really means that his problem is the budget, as these resources cost money.

Rather than provide services according to need as the law requires, he is telling the community for which he serves as the head of public education that his goal is to protect the budget by not even attempting to identify the need, and therefore denying students in his care the public education that it is his job to provide.

The worst part of this admission, however, is the knowledge that the superintendent is not simply doing this out of ignorance of the law. For years, the Department of Education has warned schools not to use RTI to deny or even delay special education evaluations.

In a memo sent to all state special education directors in 2011, the Office of Special Education Programs (OSEP) wrote that, “... the use of RTI strategies cannot be used to delay or deny the provision of a full and individual evaluation… to a child suspected of having a disability…” (5)

This memo followed a 2006 memo that stated quite clearly: “An RTI process does not replace the need for a comprehensive evaluation.” (6)

How can it be possible that the superintendent is not aware of this widely publicized policy at the same time he is promoting RTI as an alternative to special education evaluations?

Unfortunately, this school superintendent is far from alone. Other school districts are adopting this policy and many are announcing it publicly. A more recent article from another town’s newspaper begins with a headline that announces that the district’s special education program is to be “culled” of excess students, as if the students were a herd of over-reproducing deer.

The article contains extensive quotes from both the district’s director of special education and a school committee member, explaining that students “must” be referred to a screening program that includes RTI before they can be referred to special education, a clear violation of the law. (7)

It is not clear from the article how the school administration was planning to remove students already in special education. That is a process that can only be done through extensive evaluations with objective data to prove that a previously identified learning disability no longer exists.

It is possible to have sympathy for those administrators and public officials who might have good intentions but who are caught in the dilemma of trying to balance available resources and the needs of students.

But, the gatekeepers who choose to keep their jobs and future pensions by protecting the school budget are not the ones who lose. It is the children with disabilities and the families who are struggling with these disabilities who get lost in the bureaucratic spin cycle.

This is why the state and federal special education laws were written, to give the most vulnerable and least powerful the right to a public education appropriate to their abilities. Parents need to understand these rights and not let those with agendas other than providing an appropriate education take these rights away.

Notes

1. “Kerble looking to curb SPED referrals” by Lynne Hendricks, Newburyport Daily News, January 14, 2013.

2. 34 C.F.R. §§ 300.307, 300.309, and 300.311. The only appearance of the words “response to intervention” occurs in 300.311 (a)(7).

3. “Questions and Answers On Response to Intervention (RTI) and Early Intervening Services (EIS)”

4. 20 U.S.C. § 1414 (a – b)

5. Memorandum dated January 21, 2011 from Melody Musgrove, Ed.D., Director, Office of Special Education Programs to State Directors of Special Education

6. “An RTI process does not replace the need for a comprehensive evaluation” From Zirkel letter.

7. “Dedham Public Schools Special Education Program to be Culled” by Sara Feijo, Dedham Transcript, August 29, 2013.

Tuesday, April 26, 2016

Wiped Out: Early School Start Times and Boston’s Epidemic of Exhausted Students

From WBUR 90.9 FM's Blog "Cognoscenti"
Thinking that matters.

By Deborah J. Bennett
April 20, 2016

Deborah J. Bennett: "Thousands of teens who live nowhere near their
school rise as early as 5:30 in the morning in order
to get to school on time." (Lily Monster/Flickr)

The iPhone trills. It’s 5:15 am. Maybe my children will drink in those last 15 minutes before their official wake time. Or maybe the whole house will be startled awake by the alarm or the dog or the toilet’s flush. If so, that will be 15 precious minutes, lost.

My three children fight for their sleep. They refuse to climb out of bed and search for pants, socks and uniform shirts, to put their lunches in their backpacks, to pack a book for the 45-minute bus ride. They are not sick, but they are tired. Tired of this routine, as thousands of children — and their parents — in the Boston public school system are.

In Boston, the history and unintended consequences of segregated schools haunt both the city and the schools in surprising ways, like stealing children’s sleep. Busing became the key to desegregation, and for more than 40 years, children have traversed this sprawling, historic city in long yellow buses built for streets much wider than ours.

The city’s ensuing traffic issues led to staggered start times in public schools, ranging from 7:15 to 9:20 a.m.

With calls to shrink the sprawling zones that determined school choice, as well as pressure to reduce busing costs, the Boston Public Schools (BPS) developed a kindergarten through sixth-grade “home-based school choice” assignment process in 2013 that uses an algorithm developed by an MIT student.

This system aims to limit the distance children travel to schools, but if they are expected to have pencil in hand by 7:15, children are rising early no matter how long their commute.

Here’s the problem with denying children the sleep they need: they don’t learn as well when they are tired. Grades are not the only thing to suffer — students experience anxiety, depression, poor concentration and behavioral problems.

What’s more, the latest research on teenagers’ sleep patterns suggests that, as puberty begins, their circadian rhythms shift to a “sleep phase delay,” which means they naturally fall asleep as late as 10:00 and 11:00 at night, even as their need for up to nine hours of sleep remains the same.

Deborah J. Bennett: “Grades are not the only thing to suffer.
Students experience anxiety, depression, poor concentration
and behavioral problems.”(Lily Monster/Flickr)

So consider the next step in the BPS schooling ladder: high school. For students who hope to attend one of the city’s three sought-after exam schools, there is no home-based placement algorithm. The start times for these schools, scattered across the city, are all before 8:00 in the morning. That means that thousands of teens who live nowhere near their school rise as early as 5:30 in the morning in order to get to school on time.

Our neighbors’ kids barely have time to grab a cereal bar on their way out the door before they board one or more MBTA buses to get to school, where they toss their backpacks and lunch in a locker before racing to Algebra at 7:20.

While parents at one exam school in Boston tried, unsuccessfully, to have their start time changed, parents and school administrators from middle class suburban districts outside of Boston are having more success in doing so. 
Which leads us to a compelling piece of research that suggests that there is a class and racial divide when it comes to sleep.

As one article puts it, “sleep has its own caste system.” Those who are lower on the socioeconomic scale get less sleep and have lower quality sleep when they get it.

Those who are lower on the socioeconomic scale get less sleep and have lower quality sleep when they get it. The causes? Multiple jobs, longer commutes, stress about paying the bills, and living in loud, unsafe communities where it can be hard to find that cool, quiet, dark cocoon that researchers say leads to optimal sleep.

People who are suffering from chronic sleep deprivation are not just fatigued. Researchers now know that people are sick and dying from the resulting health complications: obesity, diabetes and heart disease.

While the research has focused primarily on working adults, children experience the same poor sleep conditions as their parents. Children in Boston are subjected to the added stress and sensory input of long commutes on subways and buses, which can leave them unfocused, anxious and overwhelmed.

Most people are well aware of the inequities between urban and suburban schools — per pupil spending, school facilities and teacher-to-student ratios. However, we must consider more basic needs. Are children getting good nutrition? Are they safe, loved and nurtured at home and at school?

And, are they getting enough sleep?

Friday, April 22, 2016

Part I - Gatekeeping 101: Withholding Needed Services

From Parents Have the Power
to Make Special Education Work

By Judith Canty Graves and Carson Graves
March 21, 2016

"...All students in special education who receive services under IDEA are automatically protected by Section 504 (of the Rehabilitation Act of 1973)."


Schools sometimes rely on a parent being unaware of their child’s rights to deny services that might cost money or be inconvenient to provide, as illustrated by a case that occurred in 2013 in the city of Somerville, Massachusetts. A local newspaper article provided the details along with a number of compelling (and revealing) quotations from the parties involved. (1)

The issue was that a high school student in special education was denied the opportunity to participate in a summer soccer camp attended annually by members of his high school soccer team. The school district had decided that the student, who was an active member of the team, must have an aide accompany him to the camp to act as a chaperone. Every year, the school didn’t seem to be able to locate a suitable one.

Though the parents (and grandparents) had offered to accompany their son and act as a chaperone, the school refused to consider their offer, telling them that they were not qualified. The parents then offered to pay for an aide that the school approved, but the school would not discuss their offer with them.

The result was that their son was not allowed to attend the camp with his teammates.

Each year was the same story. The parents would call school officials, including the district’s director of special education, asking to arrange for their son to attend soccer camp, and each year no one from the school would return their calls.

Finally, the summer before their son’s senior year, not knowing what else to do, the parents contacted the city’s disability coordinator, a person who worked for the city and not for the school system. Within days of this contact, and to the complete surprise of the family, the school managed to find a suitable aide.

The article quotes the district’s assistant superintendent as saying: “I think the school department has gone above and beyond, we’re really pleased to be able to send [the student to camp],” while adding that the school was not legally required to provide access to an extracurricular program.

The Legal Reality

Fortunately for all children in special education, the assistant superintendent does not get to decide what the law requires.

Section 504 of the Rehabilitation Act of 1973 was explicitly written to protect individuals with disabilities from this sort of discrimination. One of the regulations authorized by this statute, 34 C.F.R. § 104.37, specifically refers to this situation:

“No qualified handicapped person shall, on the basis of handicap, be excluded from participation in, denied the benefits of, or otherwise be subjected to discrimination under any program or activity which receives Federal financial assistance.”

All students in special education who receive services under IDEA are automatically protected by Section 504. Had the parents known their rights about this basic protection, they would not have had to put up with years of frustration and gatekeeping by their school district.

It is always possible that the assistant superintendent was speaking out of a combination of ignorance and hubris, but it is not possible to believe that the special education department was unaware of the school’s obligation to this student. In fact, the school has the responsibility to inform all parents with children in special education of their rights, including this one, in writing. (2)

A Final Thought

In addition to prohibiting discrimination against people with disabilities, Section 504 also contains a provision that permits the “prevailing party” in a lawsuit over a violation of the statute “to collect reasonable attorney’s fees as part of the cost of remediation.” (3)

We are sure that this possibility is one that the school district in question should devoutly hope the parents of the child described in the article do not pursue.

Notes

1.) Family: Special Ed `Run-Around’ Nearly Kept Somerville Senior From Soccer Trip By Dan Atkinson, Somerville Journal, August 22, 2013. (accessed 5 September 2013)

2.) 20 U.S.C. § 1415 (d). The statute says, in part, that a copy of the procedural safeguards available to the parents of a child with a disability shall be given to the parents at least once a year. What is more, the notification should be written in the native language of the parents if necessary. In all cases the notification should be written in an easily understood manner. Model procedural safeguards form. (accessed 6 September 2013)

3. 29 U.S.C. § 794a (a)(1)

Tuesday, April 19, 2016

What is Pediatric Neuropsychology?

From Beyond BookSmart's
Executive Functioning Strategies Blog

By Laura Jansons, Psy D.
April 18, 2016

According to the American Psychological Association, Pediatric Neuropsychology is a professional specialty concerned with learning and behavior in relationship to a child’s brain.

A pediatric neuropsychologist is a licensed psychologist with expertise in how learning and behavior are associated with the development of brain structures and systems. Formal testing of abilities such as memory and language skills assesses brain functioning. The pediatric neuropsychologist conducts the evaluation, interprets test results, and makes recommendations.

The neuropsychologist may work in many different settings and may have different roles in the care of your child. Sometimes, the pediatric neuropsychologist is a case manager who follows the child over time to adjust recommendations to the child’s changing needs. He or she may also provide treatment, such as cognitive rehabilitation, behavior management, or psychotherapy.

Often, the neuropsychologist will work closely with a physician to manage the child’s problems. Some neuropsychologists work closely with schools to help them provide appropriate educational programs for the child.

How Does a Neuropsychological Evaluation Differ from a School Psychological Assessment?

School assessments are usually performed to determine whether a child qualifies for special education programs or therapies to enhance school performance. They focus on achievement and skills needed for academic success. Generally, they do not diagnose learning or behavior disorders caused by altered brain function or development.


Why Are Children Referred to a Pediatric Neuropsychologist?

Children are referred by a doctor, teacher, school psychologist, or other professional because of one or more problems, such as:
  • Difficulty in learning, attention, behavior, socialization, or emotional control;
  • A disease or inborn developmental problem that affects the brain in some way; or,
  • A brain injury from an accident, birth trauma, or other physical stress.

A neuropsychological evaluation assists in better understanding your child’s functioning in areas such as memory, attention, perception, coordination, language, and personality. This information will help you and your child’s teacher, therapists, and physician provide treatments and interventions for your child that will meet his or her unique needs.

What is Assessed in a Neuropsychological Evaluation?

A typical neuropsychological evaluation of a school-age child may assess these areas:

  • General intellect;
  • Achievement skills, such as reading and math;
  • Attention;
  • Learning and memory;
  • Language;
  • Visual–spatial skills;
  • Motor coordination;
  • Social skills;
  • Personality functioning.

Some abilities may be measured in more detail than others, depending on the child’s needs. A detailed developmental history and data from the child’s teacher may also be obtained. Observing your child to understand his or her motivation, cooperation, and behavior is a very important part of the evaluation.

Emerging skills can be assessed in very young children. However, the evaluation of infants and preschool children is usually shorter in duration, because the child has not yet developed many skills.

What Will the Results Tell Me about My Child?

By comparing your child’s test scores to scores of children of similar ages, the neuropsychologist can create a profile of your child’s strengths and weaknesses. The results help those involved in your child’s care in a number of ways. Testing can explain why your child is having school problems.


For example, a child may have difficulty reading because of an attention problem, a language disorder, an auditory processing problem, or a reading disability. Testing also guides the pediatric neuropsychologist’s design of interventions to draw upon your child’s strengths. The results identify what skills to work on, as well as which strategies to use to help your child.

Testing can help detect the effects of developmental, neurological, and medical problems, such as epilepsy, autism, attention deficit hyperactivity disorder (ADHD), dyslexia, or a genetic disorder. Testing may be done to obtain a baseline against which to measure the outcome of treatment or the child’s development over time.

Different childhood disorders result in specific patterns of strengths and weaknesses. These profiles of abilities can help identify a child’s disorder and the brain areas that are involved. For example, testing can help differentiate between an attention deficit and depression, or determine whether a language delay is due to a problem in producing speech, understanding or expressing language, social shyness, autism, or cognitive delay.


Your neuropsychologist may work with your physician to combine results from medical tests, such as brain imaging or blood tests, to diagnose your child’s problem.

Most importantly, testing provides a better understanding of the child’s behavior and learning in school, at home, and in the community. The evaluation can guide teachers, therapists, and you to better help your child achieve his or her potential.


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Laura Jansons, Psy.D. is a Licensed Clinical Psychologist and recently entered Board Certification with the American Board of Professional Neuropsychology (ABN). Dr. Jansons assesses developmental disorders including autism and ADHD, learning disabilities, executive dysfunction, learning and memory problems; she also provides assessments for degenerative disease including Alzheimer’s and other dementias and TBI. Her practice is in Arlington Heights, IL.