Getting the Most from an IEP or 504 Plan

Earlier this week I had the opportunity to present a national webinar for ADDitude Magazine on "A Parent’s Guide to Evaluating and Troubleshooting Your Child’s IEP or 504 Plan." 

As with other presentations I have done, I planned out a series of slides (and you can see them and the entire free presentation if you click on the link above) that set out how to tell if there were problems with an IEP or 504 Plan and what parents can do if there are such problems. Some of the remedies I mentioned were:

• How minor issues with an IEP can be dealt with without needing to hold a meeting of the IEP Team. These include increasing or decreasing the frequency of a service (such as OT or PT) that is already provided in the IEP, or adding a minor accommodation, such as having exams taken in a quiet location in addition to extended time.
• More extensive changes to an IEP will likely need a meeting of the IEP Team. These might include adding a service or support, changing a class setting, or even changing the school a child is attending. Parents need to keep in mind that they are entitled to request an IEP meeting at any time, not just once a year as is customarily scheduled. That is a right, not a favor being done by the school.
• Parents are also entitled to a new evaluation once each year. The IDEA requires re-evaluation every three years, but if parents feel that circumstances warrant it, they can have their child re-evaluated more often. As with a new IEP meeting, this isn't something that the school might do as a favor. It is a legal right. 
• Also, parents who have had a recent evaluation and realize that it was inadequate, can seek a publicly funded Independent Educational Evaluation, an IEE, which can then be the basis for a modified IEP. We have an extensive blog post on this subject.

Almost as interesting to your blogger as preparing and presenting a webinar, are the questions parents have during (and after) the webinar. Some parents wanted to know:

• What happens to their child's IEP when they move? We were able to point them to a blog post on this too. 
• Several folks wanted me to explain again the differences between an IEP and a 504 Plan. We were able to tell them that these stem from two different laws, both designed to help individuals with disabilities, but having different procedures and sometimes offering different supports.

In addition to this recent webinar, you can check out and listen to my several other webinars for ADDitude. 
 

First Stop: Your Pediatrician

Our colleagues at the American Academy of Pediatrics (AAP) just released an extensive report aimed at informing their members of their important role in recognizing and helping to treat many problems that relate to learning and development,. Starting in infancy, long before a child is first enrolled in school, it is the pediatrician who often can spot a problem that can be addressed early to improve a child's chances of success in school. Screening for vision and hearing deficits, lags in motor and language development, and psycho-social family issues can all lead to interventions that can improve a child's chances of succeeding in school and in life.

As children reach school age, even before parents turn to their school system for help with learning or behavior issues, a child's pediatrician can pick up on a wide array of conditions -- genetic, neurological, medical, emotional -- that can have a wide ranging affect on how a child functions in and outside of school. While the AAP article is aimed at pediatricians, to guide them in their role in diagnosing issues that can get in the way of school success, it is also important that parents understand how their child's pediatrician can be an important first stop when things are not going well developmentally or academically.

There is a concept in medicine called "differential diagnosis" that plays an important role in helping to understand what is going on when children struggle. Pediatricians are trained to apply this concept when dealing with their patients and it is at the core of what we do here at The Yellin Center. As Dr. Yellin (a pediatrician and a member of the AAP) explains, you can use the analogy of a child with a cough. Before treating the cough, it is crucial to understand why the child is coughing. Does he have an upper respiratory infection, a bone stuck in his throat, asthma, or pneumonia? Only by looking for the cause of a problem can an effective solution be applied. Many learning or school problems require this same approach; only by looking deeply and ruling out many of the problems pediatricians are trained to consider can families begin to help their child get the help he or she needs.

Pediatricians are also excellent sources of referrals. They will be able to suggest educational evaluators (and many of our families are sent to us by their pediatrician for an evaluation for suspected learning or attention difficulties), or send a child to have their vision or hearing explored in depth, or recommend a therapist or other professional if there are signs of serious emotional or family difficulties. Parents should use their child's pediatrician, and the expertise and experience he or she offers, as an important resource when children are struggling in school.

Photo: Alex Proimos/Flickr Creative Commons

The Joys of Comic Books and Graphic Novels

Here at The Yellin Center, we have long recommended comic books and graphic novels as ways for children who struggle with reading and writing to experience success.

There are many reasons why a child might find reading, especially chapter books with complex plots, hard to follow. Reading disorders, such as dyslexia, can make it difficult for a child to decode the words on the page. Sequencing problems may cause a reader to confuse the order of events in a chapter or story. Memory difficulties may make it hard for a child to keep the beginning of a story in his or her head by the time they get to the end. Even attention difficulties may get in the way of concentrating on the material with sufficient depth to retain what was read.

Similarly, there are many reasons why children may struggle with writing. They may have limited expressive (oral) language, which makes it hard for them to find appropriate words to express what they are trying to say. They may have difficulties with organization, which make presenting a story step by step to be a struggle. They may have a reading disorder, such as dyslexia, which makes it hard for them to spell. They may even have an attention issue which makes it hard for them to concentrate on a complex task like writing for the time needed to produce written work.

For all of these children, graphic novels and comic books may provide access to written materials that can help build the skills children need to be successful readers and writers. These mediums are no longer just the sensationalist superhero stories (POW!, BAM!) many of us encountered in our own youth. Today's graphic novels are sophisticated and contain the same kinds of themes, characters, and language that can be found in books. Many comic books are very similar to graphic novels, with somewhat shorter stories. The key to both of these are that they are supported by high quality graphic images that allow students to more readily access the written words that accompany the illustrations.

These forms of storytelling are not just for reading. Creating comics (or even graphic novels, for older, more sophisticated writers) can allow children to tell their story through the medium of pictures, without needing to use the language skills that are so difficult for them. There are a number of good tools available. Take a look at the list from Common Sense Education or at some of the tools we often recommend to students: Storyboard Creator and Comic Creator. And we have written about some terrific graphic novels in prior blog posts:

• Graphic Novels - Don't Call Them Comic Books
• Great Graphic Novels for the Middle Grades
• Motivating Reluctant Boys to Read

Finally, there is a great story in today's New York Times about Loot, a comic book store in Brooklyn where children are encouraged to read, borrow, and create their own comic books. It sounds like fun for kids and the parents who accompany them.

Photo: Enokson

Learning Faster vs Learning Better

A discussion in Ed., the magazine of the Harvard Graduate School of Education, looks at the flaws in the assumption that students who are "fast learners" or "quick to get it" perform better than those students who take more time to work their way through course material.

This assumption was challenged by Parisa Rouhani, Ed.D., as part of her doctoral dissertation. Dr. Rouhani noted that the way our educational system looks at those who need more time as somehow "deficient" or "less capable" is reflected in the need for students to be diagnosed with a learning or attention problem in order to be entitled to extended time on exams.

However, Dr. Rouhani's study of a group of ninth graders found that there was "no meaningful relationship between time and performance. Some students who did well in the course took a long time, while others did not." By analyzing the performance of her class of subjects, she found that the most important determinant of whether students did well in the course was whether they had mastered the material. The question that this small study raises is why do we continue to use time as a measure of competence and limit time for high stakes testing and even classroom evaluations? Clearly, this issue needs more study, with a larger group of subjects.

Behaviors That Impact Impulsivity

Research findings published in the September issue of Pediatrics look at the effects of "Movement Behaviors" on impulsivity in more than 4500 children, ages 8-11. These guidelines (The Canadian 24-Hour Movement Guidelines for Children and Youth) aren't really all about movement; they are evidence-based recommendations that children 5 to 13 years old:

• Accumulate a minimum of 60 minutes per day of moderate to vigorous physical activity; and
• Spend not more than 2 hours a day on recreational screen time; and
• Get between 9 and 11 hours sleep each night.

The researchers were interested in looking at whether these behaviors would have an impact on impulsivity, which is a core characteristic in attention disorders as well as certain behavior disorders and emotional dysregulation. They began with the hypothesis that children who met all of the recommendations for these parameters would show less impulsivity than those who did not. 

They looked at various combinations of physical activity, sleep, and screen time and determined that 30 percent of the children did not meet any of the recommendations. Less than 5 percent of the children met all the guidelines. The researchers found that the most important factors in whether children demonstrated reduced impulsivity (and its positive counterpart, perseverance) was sufficient sleep and limited screen time. Physical activity seemed to have much less of an impact.

 The researchers note, "Our findings highlight that sleep and [screen time] interact in a fashion that provides unique benefits compared with meeting either movement behavior alone and may be especially clinically relevant to target concurrently in interventions, given a small percentage of children meet these movement behavior guidelines."

They conclude that while physical activity may not impact impulsivity, it has other important benefits. Furthermore, strategies to limit recreational screen time while encouraging early bedtimes and sufficient sleep, can help avoid and treat impulsivity related disorders. 

Photo by Alfred Rowe on Unsplash

Sleep and Memory

We've written countless times about sleep, and the importance of sleep for children of all ages.* Now, a new study paints a clear picture of how academic learning is significantly affected by sleep deprivation - and how this impact continues in effect over a period of several weeks.

A new study in the Journal of Adolescent Health, noted in AAP News, examined the effects of sleep deprivation on 59 teens ages 15-18 at a boarding school in Singapore. The group was divided into two parts; one set of students could sleep for nine hours, which is the generally recommended length of sleep for teens of that age group. The other set of students were permitted only five hours of sleep, an amount not unusual for sleep deprived students.

After a period of four days, designed to replicate a typical school week, both groups of students were taught detailed facts about ants and crabs over the course of a six hour day. The students were tested on what they had learned 30 minutes and then three days after the lesson concluded. Some of the students (from both the sleep deprived and the control groups) were also tested six weeks after the lesson.

The study authors noted, " We found significantly reduced retention of factual knowledge after four nights of restricted sleep, and this deficit was still evident when tested 6 weeks later." The data shows:

• 30 minutes after the lesson, the sleep deprived students retained 26% less information than the control group, a finding that the researchers note may be attributed to impaired encoding of the material in the first place.
• After three days, the sleep deprived students retained 34% less than the control group.
• Six weeks later, among those of the students who returned for follow up (14 sleep restricted and 22 of the control group), the sleep restricted participants retained 65% less of the learned material for certain responses.  

This study should be required reading for all teens who dismiss the importance of a full night's sleep.

*The links to our blog posts on sleep are too numerous to include. You can find them by searching the term "sleep" or selecting "sleep" from our list of blog topics, both of which are located on the right hand side of this post. 

Photo by Tracey Hocking on Unsplash

Avoiding the October Surprise

Tomorrow is the first day of school for New York City students, but their older siblings and friends at college likely started classes days or weeks ago. College students who are new to campus living need to adjust to a wide array of  "self care" responsibilities. These are things that used to be done with parental support or, at least, parental awareness. They include getting adequate sleep, eating well, avoiding dangerous situations, and staying up-to-date on assignments.

One responsibility in particular can make or break a student's chance of success in college: maintaining his or her medication regime. Students who require medication, whether to treat a health condition, a mental illness, or AD/HD, have likely been taking these medications regularly, perhaps reminded by or assisted by their parents. They have parental help with obtaining prescriptions, including making appointments with their doctors, knowing about their drug plan coverage, and getting refills (in general, controlled substances - which include most medications for attention and psychiatric conditions - require that the patient be seen by the prescribing physician at least every three months), and monitoring side effects. Parents can often tell when their adolescent is not taking prescribed medications just by observing how they feel and behave.

Not infrequently, when a student arrives to begin college, they are eager to assert their independence and might decide they don't really need their medication. Or, they may have the best of intentions to continue their medication regime, but become distracted and don't follow through with taking their meds regularly.

Why do we call this the "October Surprise"? We first heard the term from a colleague who was describing a regular experience in her legal practice, when parents would call her and report that their college student suddenly was failing, or in the infirmary, or decided they couldn't handle college. Why? After some investigation, many of these students had stopped their medications as soon as they got to school. Since most of these medications don't stop working immediately, it took until late September or early October for them to be fully out of the student's system and for the student to feel the full effects of functioning without needed medication. Hence, the surprise in October.

College students may not realize that there is no opportunity for a "do over" in college. If a student fails a course, that "F" is there forever, impacting his or her GPA. I've sat with more than one set of parents who sought guidance in what they could do once their child has failed several courses and have been able to offer little solace.

Families need to begin when a student is in high school to create medical independence, but it is not too late to speak to a college student to make sure he or she has the tools to manage their medication. Students need to understand their medical or psychiatric conditions, know what medications they are taking and why, and how to keep their medication secure from those who would like to try their attention meds to "help" them study. Your student needs to understand that in addition to the legal and ethical issues involved, ADHD stimulants are called “controlled substances” because of their potential for side effects. They can do harm to individuals who are not under the supervision of a physician. Your son or daughter should know how to obtain more medication when they need it -- even if that means letting a parent know rather than making arrangements for a refill themselves.

Speaking with your student about his or her medications, the importance of taking them, and when and how to reach out for additional medication or to report problems is an important part of college readiness and can make a real difference in college success.


Photo by Sharon McCutcheon on Unsplash