The mechanics are simple. A psychologist (or speech-language therapist, or occupational therapist, etc.) meets with the child one-on-one and administers a series of tests. The test-giver then sits down and looks over the results, scoring everything and coming up with a set of numbers that tells you how your child did in comparison to the rest of the known universe (well, at least our little corner of it). They then send their report outlining the student's strengths and weaknesses back to the school, where the SPED Coordinator processes it and schedules a Multidisciplinary Team (MDT) meeting.
The MDT is made up of a diverse group of people, including minimally the coordinator, the student's teacher, the school social worker/psychologist, any other related service providers and a SPED teacher. At the meeting, the MDT (adults only at C.J.'s age) reviews the findings. If a disability is identified (so if there is a large enough gap between how the student should be achieving based on their abilities and how they are achieving) they then develop an Individualized Education Plan (the IEP) to serve the child, including goals they will need to achieve that year and accommodations that will allow them to be successful at achieving those goals.
It is a beautiful system on paper, one that would result in all students with IEPs sailing through the rest of their school years completely at ease with their surroundings and achieving at high levels. The reality, however, is often much messier, with stressed-out parents and over-whelmed teachers meeting to try and determine what is feasible to do for that child (the ideal is out there but not anywhere near possible at this point). Especially in places like DC, the needs of students (those with and without IEPs) far outstrip the resources of the school system. I have seen teachers go to heroic lengths to reach out to and help students, but it is often done on their own time and their own dime. Teachers at our school average a 55 hour work week and there is only so much more any of them can do. The other problem is that to be identified for extra support students need to have already fallen behind, so teachers expend a great deal of effort trying to get students back to where they should be, much less moving them forward.
There is a new model out there that is trying to fix this. Response to Intervention (RTI) is based on the simple idea that we should catch students before they fail, not afterwards. In this model, which we are beginning to implement at my school, students are assessed at the beginning of the year to identify those at risk for failure and a series of interventions are put in place to support them. Ongoing progress monitoring identifies students who still struggle and they receive additional supports. Those who require even more support are identified the same way and receive IEPs. The theory is that the number of students needing IEPs would drop from 10% of the school population to 4-5%.
Monday, February 9, 2009
Saturday, February 7, 2009
The Details
C.J. was diagnosed with a Nonverbal Learning Disorder (NLD). This means that he operates very well in the world of words but struggles with non-verbal cues and more abstract ideas.
Academically, the problems won't really set in for a few years. Learning to read for him will be easy (and he is already well on the road to that). He will struggle with ideas like cause and effect and more complex interpretations of what he reads. In math, he'll be fine until he gets to the higher order geometry and algebra. Luckily, his Verbal IQ is through the roof so he'll be able to compensate by talking through ideas and problems, some of which he already is doing himself.
The real challenge right now is with social interactions. Most estimates show that at least 65% of communication happens non-verbally, through tone of voice or expression. C.J. does not pick up on those cues and this can have a dramatic impact on how he interacts with the people around him. He will need to be trained to recognize what people are telling him without words, not an easy process.
He also doesn't generalize well. So for C.J., a concrete explanation for how to act in the doctor's office will not necessarily translate into his knowing how to act in the dentist's office. Every new situation will be stressful because he won't be able to look back through his memory and make connections to similar situations from before.
The ADHD diagnosis is currently listed as a Rule Out. This means that he has all the characterstics of it (the psychologist apparently spent a lot of time following him around the room during testing) but she was not willing to give him an actual diagnosis. This was because he is young and also because it is unclear how the NLD might be impacting his behavior.
She recommends doing a neurological exam to see if there is an organic cause for the NLD (damage to the executive functioning area of the brain is the most common) and to get more input on the ADHD diagnosis.
I think that is all of it. I'll write more after we have an IEP hammered out.
Academically, the problems won't really set in for a few years. Learning to read for him will be easy (and he is already well on the road to that). He will struggle with ideas like cause and effect and more complex interpretations of what he reads. In math, he'll be fine until he gets to the higher order geometry and algebra. Luckily, his Verbal IQ is through the roof so he'll be able to compensate by talking through ideas and problems, some of which he already is doing himself.
The real challenge right now is with social interactions. Most estimates show that at least 65% of communication happens non-verbally, through tone of voice or expression. C.J. does not pick up on those cues and this can have a dramatic impact on how he interacts with the people around him. He will need to be trained to recognize what people are telling him without words, not an easy process.
He also doesn't generalize well. So for C.J., a concrete explanation for how to act in the doctor's office will not necessarily translate into his knowing how to act in the dentist's office. Every new situation will be stressful because he won't be able to look back through his memory and make connections to similar situations from before.
The ADHD diagnosis is currently listed as a Rule Out. This means that he has all the characterstics of it (the psychologist apparently spent a lot of time following him around the room during testing) but she was not willing to give him an actual diagnosis. This was because he is young and also because it is unclear how the NLD might be impacting his behavior.
She recommends doing a neurological exam to see if there is an organic cause for the NLD (damage to the executive functioning area of the brain is the most common) and to get more input on the ADHD diagnosis.
I think that is all of it. I'll write more after we have an IEP hammered out.
And so it begins...
Transitions, I keep telling myself, are a normal part of life. I have had many thus far and have survived them all. I've transitioned from city to city and school to school as my family moved during my childhood, from high school to college, from college to grad school and then into the working world. After several years in the "real" world, I made another transition when I realized I wanted to go to work everyday and SEE the impact I was having right in front me. I went back to grad school and emerged into my new life as a special education teacher. I've also transitioned from single, to dating, to married and to parent. None of these transitions have been without setbacks, but all have been full of rewards that made them more than worth the effort.
On Monday at noon, I will be making my newest transition. This will be the first in a long time that I did not actively seek and which would not have been my choice. It is also a strange convergence with a choice I did make 10 years ago when I switched careers. In a meeting at the school where I am the Special Education Coordinator and which my two oldest sons attend, I will move from the teacher side of the table to the parent side and help to draft my son's first IEP.
I would like to say that my years in the SPED world have made this transition easier and I'm sure it has in some ways. I understand all the terminology coming at me in a non-stop stream, which makes it less overwhelming. I also know how hard the teachers at our school work to help every child achieve, which gives me comfort. But on a basic level it makes no difference at all. This is the child that I gave birth to and rocked to sleep and have taken care of when he was sick. Every parent reaches a point where there is something for their kids that they can't fix with a bandaid and a kiss, but it should not come this early.
Is it a surprise? Probably not. C.J. was different from birth, harder to manage and a constant challenge to our parenting skills. We sought help when he was two, looking for new strateigies to use with him and that helped. For the last two years, we've been living in the "maybe he'll grow out it" world. We've celebrated every milestone that seemed to indicate a change for the better and worked harder on areas where he didn't seem to be making progress. When things spiraled at school this year, we made behavior plans and talked to his teachers about ways to help him cope in an room with 17 other Pre-K4 students. When things came to a head with incidents that could not be written off to 4 yo high spirits, we signed the consent form thinking that more information and strategies could only be a good thing.
Over the next few weeks, we prepared ourselves for conversations about behavior modification and a recommendation for further testing when he is 6 if there was no significant improvement. We did not, and I think could not have, prepared ourselves for the report that came to us showing a 40 point gap in his IQ subtest scores or the label of Nonverbal Learning Disorder that came with it. The high probability of ADHD and recommendation for a neurological evaluation was less surprising but still not easy to hear.
Is this the end of the world? Definitely not. He is young and testing on children under 6 is by its very nature imprecise, I believe, because they are still developing in so many ways. This gives us a snapshot of where he is now but is not determinative of where he will be in 2 years, when I will insist he is completely reevaluated. It doesn't define him for us or take away all the wonderful things that make him who he is and it will never negate the joy I feel watching him sing and dance around the house with his brothers or the comfort of having him snuggle into my lap for some love.
It does give us insight into why he acts the way he does and gives us and his school a whole new set of strategies to put in place to help him now, which can never be a bad thing.
Transitions, I keep telling myself, are a natural part of life. That they occur is not significant, but how we respond to them is. On Monday at noon, I will become the parent of a student with an IEP. But I have always been and will always be the mother of a wonderful little boy first.
On Monday at noon, I will be making my newest transition. This will be the first in a long time that I did not actively seek and which would not have been my choice. It is also a strange convergence with a choice I did make 10 years ago when I switched careers. In a meeting at the school where I am the Special Education Coordinator and which my two oldest sons attend, I will move from the teacher side of the table to the parent side and help to draft my son's first IEP.
I would like to say that my years in the SPED world have made this transition easier and I'm sure it has in some ways. I understand all the terminology coming at me in a non-stop stream, which makes it less overwhelming. I also know how hard the teachers at our school work to help every child achieve, which gives me comfort. But on a basic level it makes no difference at all. This is the child that I gave birth to and rocked to sleep and have taken care of when he was sick. Every parent reaches a point where there is something for their kids that they can't fix with a bandaid and a kiss, but it should not come this early.
Is it a surprise? Probably not. C.J. was different from birth, harder to manage and a constant challenge to our parenting skills. We sought help when he was two, looking for new strateigies to use with him and that helped. For the last two years, we've been living in the "maybe he'll grow out it" world. We've celebrated every milestone that seemed to indicate a change for the better and worked harder on areas where he didn't seem to be making progress. When things spiraled at school this year, we made behavior plans and talked to his teachers about ways to help him cope in an room with 17 other Pre-K4 students. When things came to a head with incidents that could not be written off to 4 yo high spirits, we signed the consent form thinking that more information and strategies could only be a good thing.
Over the next few weeks, we prepared ourselves for conversations about behavior modification and a recommendation for further testing when he is 6 if there was no significant improvement. We did not, and I think could not have, prepared ourselves for the report that came to us showing a 40 point gap in his IQ subtest scores or the label of Nonverbal Learning Disorder that came with it. The high probability of ADHD and recommendation for a neurological evaluation was less surprising but still not easy to hear.
Is this the end of the world? Definitely not. He is young and testing on children under 6 is by its very nature imprecise, I believe, because they are still developing in so many ways. This gives us a snapshot of where he is now but is not determinative of where he will be in 2 years, when I will insist he is completely reevaluated. It doesn't define him for us or take away all the wonderful things that make him who he is and it will never negate the joy I feel watching him sing and dance around the house with his brothers or the comfort of having him snuggle into my lap for some love.
It does give us insight into why he acts the way he does and gives us and his school a whole new set of strategies to put in place to help him now, which can never be a bad thing.
Transitions, I keep telling myself, are a natural part of life. That they occur is not significant, but how we respond to them is. On Monday at noon, I will become the parent of a student with an IEP. But I have always been and will always be the mother of a wonderful little boy first.
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