Monday, March 21, 2016

Letter Request Initial Educational Testing per IDEA

Okay, I know I homeschool but I still engage in educational advocacy for others.  Why?  Because I feel like I have a lot to offer others in the way of service, and to be honest, I HATE seeing how public schools abuse/misuse special needs students!  So my help for today is how to request educational testing. You must request the start of educational testing!  Should you HAVE to? NO! See here, here, here, here, and here on the case law.  BUT most schools will do nothing until you speak up and start advocating for your child!  Here is a sample letter to request testing by the school district.

Please double check the law quoted in here since the regulations can move from time to time.  I hope you find this helpful!

Dear (Principal,Guidance Counselor, or School Psychologist's name),

I would like to request comprehensive educational testing for my child ________________ who is in _____ grade at __________________school. 

I would like a full psycho-educational evaluation together with appropriate testing for learning disabilities. I request my child be tested in all suspected areas of disability (34 CFR 300.304), including the areas (in this area to add any specific disability such as of auditory processing, executive function, OT, speech and language, reading disability, etc).

I understand I need to sign a consent form so the school can conduct the evaluation (34 CFR 300.300). If I do not hear from you in three days I will call to set up a time to sign the consent form.

After testing, and at least 5 days prior to attending the IEP team meeting to discuss the testing results [34 CFR 300.613(a)], I request I have a chance to review the result and ask any questions I have with the evaluator so that I may be an active part of the team (34 CFR 300.321).

I understand the school system has 60 days to complete testing and hold a meeting to discuss eligibility [34 CFR 300.301(c)(1)(i)]. Please note, at the IEP meeting I will be recording the meeting and any subsequent IEP meetings. I want to make sure I do not miss anything and an audio recording will help me immensely. I look forward to meeting with you on that date. 

(your name)

When you deliver your letter to the school you need to do so in one of two methods.

Method 1: Write the letter and print out two copies.  Take one copy to the post office and send the letter certified mail with signature card and return receipt. Once you get the signature card back take it and staple it to the other copy you saved.  This copy should then be placed in a file folder, or better yet, hole punched and put into a three ring binder you use and organize for your child each year.

Method 2: Print off two copies.  Take both copies into the front office and ask the secretary to stamp both copies as received with the school stamp WITH DATE! You will give her one of the copies to deliver and the other will be retained for your files.

It is important you keep up with ALL paperwork and have it stored in one place.  I also like to scan all paperwork and store it in a cloud.  I like Dropbox for this purpose because it accepts all file types (so audio records along with paper docs) and it is easy to share files if I wish to do so.  I am not associated with Dropbox in any way.  I just like their product. :)  I hope this helps. If you have questions please write me a post.  I will answer your questions to the best of my abilities.

Thursday, March 10, 2016

Executive Functioning and Its Impact on Learning

Executive functioning is a complex issue.  I know since all my children have executive functioning issues! The real question is how does executive functioning issues impact learning in both the homeschool and public education environment?

First, let's discuss homeschool.  It is easier, when you homeschool, to address executive functioning issues because you can tailor a child'e learning environment around their disabilities.

So what is executive functioning?

WebMD defines executive functioning as a set of mental skills that help you get things done. These skills are controlled by an area of the brain called the frontal lobe.

Executive function helps you:
  • Manage time
  • Pay attention
  • Switch focus
  • Plan and organize
  • Remember details
  • Avoid saying or doing the wrong thing
  • Do things based on your experience

When executive function isn’t working as it should, your behavior is less controlled. This can affect
your ability to:

  • Work or go to school
  • Do things independently
  • Maintain relationships
This is a huge problem for children with ADHD, depression, and learning disabilities. These conditions are often associated with issues with executive functioning. 

How does executive functioning impact homeschool?

When you have a child with executive functioning problems you cannot expect them to manage their time, day, or classwork.  They will have a difficult time organizing information and paying attention to the task at hand.  They will have problems with switching between tasks and are horrible multi-taskers. This means you will need to give them more one-on-one attention in both tasks and academics.  For my three children this means I have to teach them all separately.  They cannot be taught as a group in reading and math.  We do these separately.  For science, history, and social studies we learn these together.  I often have James or Margaret read while the others listen and ask questions. Since retaining information is also an executive function issue and an issue with working memory (another common problem with EF and in my children) we often will repeat the same lesson 2 to 4 times in the same week.  This helps the children to retain the information they are learning. This is something I can do in a homeschool setting that would not typically occur in the public school setting.

How does executive functioning impact school?

Executive functioning in a public school setting can be a nightmare and this is one of the reasons why I enjoy homeschooling.  It is often called by parents an "invisible" disability.  The signs are often subtle but there. Then there is the challenge for parents to figure out the symptoms are issues of executive functioning and request a school district to test for EF issues. 

So which tests can tell if a child has a problem with executive function issues? Well, the sky is the limit!  LOL   There are a LARGE verity of tests, partially because EF covers so many functional areas, so it is hard to say which test could be used to test your child.  Some of the more common tests are:

  • Wisconsin Card Sorting Test
  • Category Test
  • Stroop Test
  • Trail Making Test-B
  • WAIS Subtests of Similarities and Block Design
  • Porteus Maze Test
  • Multiple Errands Test (MET)
  • Serial Sevens
  • Mini-Mental State Exam
These tests should be used in conjunction with other other testing to examine Intellectual functioning, Academic achievement, Language processing, Visuospatial processing, Attention/ concentration, Verbal learning and memory, Visual learning and memory, Speed of processing, Sensory-perceptual functions, Motivation, and Personality assessment. All of these tests play a role in defining issues with executive functioning and other learning disabilities. Most of these tests are best completed by a neuropsychologist.  I promise you a school district will never have a neuropsychologist on staff no matter what they say.  If it does ever happen someone please let me know but I feel confident in my statement. Why? It is because a neuropsychologist is a specialist and schools tend to only employ psychologist for testing. 

What is a neuropsychologist and how are they different from a school/typical psychologist?

There are basically three types of psychology: clinical, school, and neuropsychology. Clinical psychologists assess and treat children with a wide variety of psychological problems, but particular with emotional/behavioral issues. They may be found working in hospitals, community health centers, or private practice. Although most clinical psychologists are generalists, who work with a wide variety of populations and problems, some may specialize in a specific population and specific disorders (e.g. attachment or post-traumatic stress disorder). They are trained in universities or professional schools of psychology and may not be very familiar with school settings. Clinical psychologists provide both assessment and treatment (psychotherapy).

School psychologists are involved in enhancing the development of children in educational settings. They assess children's psychoeducational abilities and recommend actions to facilitate student learning and overall school functioning. They are typically trained in the Schools of Education at universities and work in school systems, community-based agencies, or private practice. A few may specialize in a particular school-related problem such as learning disabilities or ADHD. While specializing in educational issues, they may not be well trained in medical-based disabilities and disorders. School psychologists usually administer both norm-based psychological tests and criterion-referenced educational (achievement) tests.

Neuropsychologists represent a specialized discipline within the field of psychology that mostly focuses on cognition (the ability to think, remember, learn, etc.) in relation to the effects of brain damage and organic brain disease. A neuropsychologist can administer standardized psychological and neuropsychological tests to patients in private office and hospital settings.

Why is a neuropsychologist examination helpful? 

A pediatric neuropsychologist work closely with schools to help them provide appropriate educational programs for the child. There are five major reasons why a thorough neuropsychological evaluation performed by an pediatric neuropsychologist is superior to a psychoeducational evaluation. These are the inadequate range of a psychoeducational evaluation, the training of the personnel performing psychoeducational evaluations, the narrow focus of psychoeducational evaluations, the level of performance model employed in psychoeducational evaluations, and the failure of psychoeducational evaluations to assess brain behavior relationships. The school and general psychologist tend to 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.

Even in the homeschool setting this testing is very helpful to the parent so the parent can understand the learning deficits and strengths of their child.  This will help the parents to better teach their child in the home setting.

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.

A pediatric neuropsychologist can evaluate school-age child many areas such as:

  • General intellect 
  • Achievement skills, such as reading and math 
  • Executive skills, such as organization, planning, inhibition, and flexibility 
  • Attention 
  • Learning and memory 
  • Language 
  • Visual–spatial skills 
  • Motor coordination 
  • Behavioral and emotional functioning 
  • Social skills 
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.

So what can the results from the testing tell you?

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.

Wrap up

Links have been included in the blog to the sources of my information. Some of the information comes from personal experience. All of my children have executive functioning issues.  The executive functioning is also impacted by their working memory issues and ADHD. Knowing my children have executive functioning issues has really given me a lot of patience since I now understand their limitations and issues.  I don't get so annoyed when I have to repeat myself 6 times or get angry when I ask for a task to be completed and it never gets done. I understand now and know the problem.  It has made me think about how I parent my children, my expectations of them working independently, and what I need to do to help them in the future.

I am including a link to a list of accommodations written up by a school district in New York that covers all areas of executive functioning and has accommodations from Kindergarten to 12th grade. It is a great resource for both the homeschooled and public schooled child.  The link can be found here and it is a PDF.  I am also including a link (click here) to a redacted version of Margaret's last neuropsych report. It is not as comprehensive as it could be because all my children had neuropsych testing completed three years ago but it gives you a good idea how a report should be written and what to expect. I hope this has been help and always feel free to send me questions in the comment section!

Thursday, March 3, 2016

To the Doctor

Doctor Office Selfie
Thankfully this was not for me.  This visit was for the children.  I kept getting calls from Medicaid for the children.  They kept insisting I take the children in for a well visit check. They were busy reminding me vaccines are important.  Yes, they are but we will agree to disagree on that one.

This turned out to be a good time for me to visit the doctor anyways. I had wanted to talk to her about Joseph and his skinny, slow-growing self. Sigh!  We headed off in the morning to see the doctor. It was a 35 minute drive across town on the interstate.  Margaret sat in the back crying and whining the entire time I am on the highway.  I am not sure where this fear came from but I wish it would go away!

We make it to the doctor's office and there is a small playground.  I have to promise the kids I would let the play afterwards as I shove them into the office door.  I yell at everyone to take a seat on the well side of the office but they kept getting drawn back to the sick side. The LAST thing we needed is to pick up some illness visiting the office. That is why I did not want to visit the doctor yet but the calls from Medicaid were harassing!

Thankfully the Little Mermaid started to play on the well child side and the children stayed seated!

We got back into the patient room.  I swear it is the smallest room I have ever been in!  There was not enough space for me and the kids to sit much less the doctor! Kids were sitting in the floor playing their Kindles.  It was SO loud in the room!  LOL

The doctor comes in and we discuss Joseph's poor weight gain.  She said he had been putting on more weight recently.  She told me to keep it up.  I asked about tube feeding and she said we are not quite there yet. I am pleased because I really do not want to tube feed Joseph.  I think there is too much of a risk of infection. We discuss James's weight.  He could stand to lose about 4 pounds. Margaret is skinny but okay. If she is like any of the other ladies in my family I am not worried about her.  ALL women in my family are fat.  It just varies by degree.  I am one of the fattest while my aunt is rather skinny compared to the rest of us.  So I think Margaret will one day weight plenty.  No reason to rush things!
Right as they were finally settled we were called back to get weights and measures. Isn't that how it always is?  LOL   Kids take off their shoes we height and weight check. James weighted in at 72.4 pounds and 54 inches, Margaret was 48.4 pounds and 49.5 inches, and Joseph weighed in at a tiny 35.8 pounds and 45 inches!  

We discuss other issues and talk about some community supports we could look into.  Overall it was a nice visit with the doctor and I am grateful that Joseph never had to go to Urgent Care or the hospital this winter. Flu is at an all time high here. John was sick with Influenza type A but it did not really bother the kids or I so I think we are immune to that one. Now we just need to stay away from any other sickness until cold/flu/RSV season is over in about 8 more weeks.  Keeping my fingers crossed!

After leaving the doctor's office the kids wanted to play with a little girl (15 months) out on the little playground.  Since I promised I said yes.  The grandmother was outside watching the little girl.  She said she was happy my kids came along and would play with her.  They played for about 10 minuted before the mom came outside.  Then she told me that her daughter was sick.  Don't you know, no good deed goes unpunished?  LOL   Luckily I had hand sanitizer with me. I made the kids use it and get in the car.
Playing with Frisbees in the Park

I went to pick them up some cheap sandwiches and water.  Then I headed to the park for them to play.  There was no one there.  They got to play with their frisbees and basketball.  They had a blast!  They ran outside in the 90 degree weather for an 1.5 hours before I told them we needed to go.  Joseph had stopped sweating so I knew he had gotten too hot. I rubbed him down with ice and we left.  Did you know those darn kids did not fall asleep for 2 hours after bedtime!  I thought I had worn them out.
Got a picture of everyone before we left the park.