Dr. Yellin Contributes to New Book on Medical Education

We are pleased to announce the publication this week of Remediation in Medical Education: A Mid-Course Correction, featuring a chapter by Dr. Paul Yellin on "Learning Differences and Medical Education."

As many of our readers are aware, Dr. Yellin works regularly with medical students and other young adults in professional and graduate schools, helping them to deal with newly discovered or long-standing academic challenges to their academic success. In his chapter, he describes the wide range of normal variation in how medical students learn, describing both "learning variations" and "learning disabilities." He discusses various aspects of learning, which he calls "constructs" -- memory, attention, language, temporal-sequential ordering, spatial ordering, and higher order cognition -- and how difficulties in any of these constructs can impact academic success in light of the demands of medical training. He goes on to discuss the legal implications of a disability of learning and to offer strategies and resources for both medical students who struggle and their instructors.

Remediation in Medical Education edited by Adina Kalet, MD, MPH and Calvin Chou, MD, PhD (Springer, 2014), covers a wide range of issues relating to medical education, from how medical schools can provide remediation for struggling students, to how cultural issues can impede effective communication, to medical students with underlying disorders, such as autism spectrum disorders, that affect their interpersonal interactions. Both editors have worked extensively in the field of medical education and effective communication between physicians and patients.

IEP and 504 - What Parents Ask

Your blogger presented a webinar earlier today for ADDitude Magazine, for which she writes the "Your Legal Rights" column.  The topic was "IEP vs. 504 Plans: Which Does Your ADHD/LD Child Need and How to Go About Getting It." Hundreds of parents listened in and many of them had questions, some of which are no doubt shared by most parents who deal with these two laws. There is a link to hear the complete webinar but in the meantime, some of the most common questions -- and their answers -- were:

Can a student have both a 504 Plan and an IEP at the same time?

No. Section 504 (of the Rehabilitation Act of 1973) specifically states that having an IEP (an Individualized Education Program under the Individuals with Disabilities Education Act -- IDEA) satisfies the requirements of Section 504. So, if a student would qualify for services under both laws, the student should get an IEP.

Which law would apply to a student with ADHD? 

It depends on the extent to which the student requires special education or related services because of his ADHD. If the student's attention problem is so significant that it seriously impacted his ability to learn, or if the student also has a specific learning disability, he would qualify for an IEP under the category of Other Health Impaired or Specific Learning Disability. [IDEA requires that a student fall within one of ten categories of disability in order to receive services.] If the student has ADHD but the impact is less significant and doesn't rise to the level of his needing special education services because of it, he would generally not qualify for an IEP but would be eligible to receive services under Section 504.

How do I start the process of getting my child an IEP or a 504 Plan?

First, parents should have met with their child's teacher and discussed how things are going in school. Once they have done so, if they believe that their child needs a 504 Plan they should make a written request to their school's 504 Team. Most schools have specific forms for this and you can obtain them from the school office or even the school website. Complete the form, along with any documentation you may have, and submit it to the 504 Team. You may be invited to their meeting, but the law does not require this and the procedure varies from place to place. The 504 Team will decide if more information is needed (and any evaluations they require will be at school expense) and will decide upon a plan for your child. 

To begin the IEP process, parents need to advise the school -- the guidance office or principal is generally the point of contact -- that they believe that their child requires special education services and sign a consent for their child to be evaluated. The evaluation process must be completed within 60 days of the consent and is followed by a meeting which includes the parents, to decide whether the student qualifies for IDEA services and to create the IEP, which must be in writing.

We have a written a number of blogs, linked below, which deal with some of these topics, including:

• Section 504 Q and A
• Special Education Terminology
• Getting Services in Private Schools
• Preparing for IEP Meetings
• Changing an IEP
• IEP Tips and More Tips

Social-Emotional Education

While academic skills are an important part of what schools need to impart to their students, there are a number of competencies that are as important -- and sometimes more so -- in helping children become happy, successful adults. These competencies are generally referred to as "social-emotional learning" and have been the subject of much attention from schools, researchers, and organizations in all areas of education. Here at The Yellin Center, we look at social and emotional issues as potential areas of strength or challenge for all of the students we see, and have long noted the importance of what we call social cognition as a part of success in school and life.

CASEL, the Collaborative for Academic, Social, and Emotional Learning, is an organization whose mission is "to help make social and emotional learning an integral part of education from preschool through high school."

CASEL has described five areas of social-emotional competence:

"Self-awareness: The ability to accurately recognize one’s emotions and thoughts and their influence on behavior. This includes accurately assessing one’s strengths and limitations and possessing a well-grounded sense of confidence and optimism.

Self-management: The ability to regulate one’s emotions, thoughts, and behaviors effectively in different situations. This includes managing stress, controlling impulses, motivating oneself, and setting and working toward achieving personal and academic goals.

Social awareness: The ability to take the perspective of and empathize with others from diverse backgrounds and cultures, to understand social and ethical norms for behavior, and to recognize family, school, and community resources and supports.

Relationship skills: The ability to establish and maintain healthy and rewarding relationships with diverse individuals and groups. This includes communicating clearly, listening actively, cooperating, resisting inappropriate social pressure, negotiating conflict constructively, and seeking and offering help when needed.

Responsible decision making: The ability to make constructive and respectful choices about personal behavior and social interactions based on consideration of ethical standards, safety concerns, social norms, the realistic evaluation of consequences of various actions, and the well-being of self and others."

CASEL works with schools, districts, and policy makers at state, federal and local levels to advance legislation and programs that promote social-emotional education in schools. Their work is highlighted in the first of a series of reports entitled From Practice to Policy, from the National Association of State Boards of Education.

No discussion, however brief, of social-emotional competence can be complete without mention of Daniel Goleman, a co-founder of CASEL and generally credited with popularizing the term "emotional intelligence" or "EQ" (as opposed to "IQ) in his best-selling 1995 book of the same name. By bringing the concept of emotional intelligence into popular culture, he helped to lay the groundwork for applying its tenets to education and business, and facilitating research into the connections between social-emotional competence and brain development. And, in his new book, Focus, Goleman discusses how the pathways that regulate social cognition and attention are interrelated. Dr. Yellin has read it and strongly recommends it.

Learn to Add with Addimal Adventure

Wouldn’t it be great if few Ph.D.s from Columbia University’s Teachers College could be on hand 24-7 to teach your child to add? If you have an iPad, download the free Addimal Adventure app from the iTunes store and you’ll get just that. 

Addimal Adventure is the brainchild of Teachley, a foundation that creates interactive electronic learning tools based on cognitive science research. In Addimal Adventure, Captain Memo and his pals will recruit your child to defeat the evil Professor Possum. The sharp graphics pop off the iPad’s screen appealingly, looking more like a show on Cartoon Network than an educational computer game. There’s a storyline here, and an engaging one at that, and your child will giggle at the characters’ funny quips and delight in being included in the adventure.

Addimal Adventure isn’t just great at catching and holding your child’s attention, though. It teaches genuinely useful strategies for learning and using addition. In each “Tool Round,” simple problems are presented and children can choose which strategy they want to use to solve each one. For example, the “Count All” button will present the problem using digital manipulatives. Kids count them, then indicate the answer using the number line at the bottom of the screen. Three additional, more advanced strategies are also taught. Between Tool Rounds, kids can watch the plot of the game unfold in short scenes, then practice their fact speed in the Speed Round. If they’re stumped, they can choose to get a hint that will remind them how to use one of the strategies they've learned. 

Addimal Adventures keeps track of all the facts a child answers correctly and incorrectly and displays them between rounds. The result is a motivating display of all the facts kids got right, which grows as they progress through the app.

Currently, Addimal Adventures is intended for home use. In January, however, Teachley will be launching a pilot data- reporting system for classrooms that will allow teachers to track students’ progress. Think your school might be interested in participating? Sign up now.

When Must School Districts Pay for Evaluations?

Parents sometimes ask us if they can have their school district pay for their child's evaluation at The Yellin Center. The simple answer is "maybe, under certain circumstances," and we thought it might be helpful to explain the laws and regulations that govern this area.

The Individuals with Disabilities Education Act (IDEA) recognizes that an evaluation of a student in all suspected areas of disability is a crucial first step to determining whether that student is eligible for IDEA services and what kind of services will help that student to succeed in school. In fact, the "clock begins to run" with respect to the time limits set forth in the IDEA only once the parent consents to an evaluation of the student. The law anticipates that the school will then conduct an evaluation of the child and share the results with the parents and the IEP team, the committee that creates the student's Individualized Education Program. 

It's Our City

In many situations, this works out well for all concerned. The school district conducts an evaluation at no cost to the family; the findings make sense to the parents; the findings are incorporated into the student's IEP; and nothing more needs to be done. 

However, sometimes families do not agree with the findings of the school district evaluators and feel there may be something more going on with their child. Sometimes parents have had a long history of difficulties with the school and simply do not trust them to do an evaluation. Some parents of children enrolled in a private school do not want to have to work with the local public school district (especially in New York City). And, quite often, parents want the kind of in-depth, multi-disciplinary kind of evaluation done here at The Yellin Center, rather than a more "cookie-cutter" series of tests given by their school's evaluators. In each of these situations, the parents seek an Independent Educational Evaluation (IEE) such as the ones we conduct here at The Yellin Center.

Before we look at specific rules and scenarios, we need to emphasize one important point. Parents have the absolute right to have their child independently evaluated and federal law requires that the public school district must consider the results of such evaluation. Dr. Yellin and his team frequently attend IEP meetings (via phone or other technology) to discuss the results of our evaluations and have been universally well-received by schools. However, the law does not require that districts follow the recommendations of our reports (or any outside evaluator).

So, when can a parent have a district pay for an IEE? 

1. The parent must disagree with the evaluation conducted by the district or consider it inadequate and notify the district of their intention to obtain an IEE.
2. The district must then either file for a due process hearing with a State Hearing Officer or agree to pay for the IEE.
3. The district can set criteria for the IEE's they will fund -- how much they cost, the geographic location of the evaluator(s), and the specific qualifications of the evaluator(s). However, the U.S. Department of Education notes that, "the district must allow parents the opportunity to demonstrate that unique circumstances justify an IEE that does not fall within the district's criteria. If an IEE that falls outside the district's criteria is justified by the child's unique circumstances, that IEE must be publicly funded." So, even if your district tells you that you are restricted to using the private evaluators on a list they provide, that is not strictly correct and you can and should push back to obtain the services of the evaluator you choose. 
4. An IEE can also be ordered by a State Hearing Officer as part of a due process hearing when aspects of an IEP are in dispute. 

We also encounter situations where a district paid evaluation at The Yellin Center is part of an ongoing discussion between a family and a school district, especially when the district has not been successful in addressing a child's educational needs. And families need to keep in mind that The Yellin Center has always had a sliding scale for families who need assistance in paying for our services. 

There are countless resources available to explain this process to parents and school administrators, but some you might find useful are:

• For New Jersey familes, a memo from the New Jersey Department of Education, with a list of Frequently Asked Questions about IEEs.
• From the U.S. Department of Education, a memo discussing why districts cannot set absolute cost limits on IEEs and a link to a number of other memos discussing other aspects of the IEE funding process.
• For a review of court cases that have dealt with the IEE issue, a law review survey of cases by Perry Zirkel.

Testing as a Way to Boost College Achievement

While parents and students throughout the country lament the constant testing of students in elementary and high schools, a new study has found that frequent testing of college students -- each day of class -- boosted achievement of all students, especially those from lower income backgrounds.

Robert S. Donovan

The findings, from a team of psychology professors at the University of Texas at Austin, were published in the online science journal PloS One. The professors were co-instructors of two large introductory psychology classes, with a total of over 900 students. They had taught the same course for several years and thus had data on student performance to compare to the classes in which they implemented the daily testing. Students were advised to bring their laptops to class and were given personalized online quizzes containing eight questions at the beginning of each class, one of which was a question that the student had gotten wrong on a prior quiz. Students could drop their lowest quiz grades and could take a limited number of quizzes outside class. The quizzes included material from both the course lectures and the assigned readings.

The professors found that the students in the classes subject to quizzing did better not just in the introductory psychology course, but in other courses that semester and in courses in subsequent semesters. There was also a significant reduction in the difference in performance between students of higher and lower socioeconomic standing, something that had been notable in prior sections of the course.

The professors noted that the improvements they observed "most plausibly reflect changes in students’ self-regulated learning – their ability to study and learn more effectively." They also noted that attendance was high in the classes where quizzes were given, which would also influence student performance. It stands to reason that when students attend class regularly and do the course reading, that they will learn more and that their performance on tests will be improved. No one likes testing, but it can help keep students -- at least college students -- on track for success.

The Importance of Being There

When most parents think about student absences from school, they think of high school students who skip school or cut classes -- something we generally think of as truancy. But absence from school is also an issue for students as young as kindergarten and first grade and the organization Attendance Works notes that, "one in 10 kindergarten and 1st grade students misses a month of school every year. In some districts, as many as one in four students in the primary grades are missing too much school time."

Students in primary grades are rarely absent without parental knowledge. Many parents don't really think too much of having a young student miss school for a family event, or even just parental convenience. For many families the impact of occasional absences may not be significant, but for students who are at risk of failure -- whether because of poverty, English language barriers, or unstable family situations -- absences even in early grades can have a cumulative impact upon academic performance. A seminal paper on this topic, Present, Engaged, and Accounted For: The Critical Importance of Addressing Chronic Absence in the Early Grades, from the National Center for Children in Poverty, found that for students in ninth grade, missing 20 percent of the school year is a better predictor of dropping out than test scores.

Furthermore, students with chronic or frequent illness may have excused absences, but unless efforts are made to continue their schoolwork or to make up missed work, something that is often difficult or impossible in less affluent school districts, the fact that these absences may be unavoidable does not diminish their impact upon future performance and graduation. 

via boostattendance.org

In an effort to raise awareness of the impact of absences, The Advertising Council and the U.S. Army created a website, boostattendance.org which includes tools to help parents understand the impact that absences can have on student achievement. There is also a link to a student-focused tool which enables students to sign up for celebrity wake-up calls. As Woody Allen is credited with saying: "80 percent of life is just showing up." Showing up for school, even in early years, can have an important and positive impact on a student's educational success.