Tag: child

Dyslexia Screening and Interventions: State Requirements and Resources

Posted on by Nicol Walsh

A Brief Overview

  • Dyslexia is a common condition that makes it hard to work with language. Reading difficulties are one sign of dyslexia.
  • Washington passed a law in 2018 requiring schools to screen young children for indicators of dyslexia. The law took effect in the 2021-22 school year.
  • Dyslexia is a Specific Learning Disability. Students with learning disabilities are eligible for an Individualized Education Program (IEP) if they demonstrate a need for Specially Designed Instruction (SDI). SDI is key when a student isn’t keeping up with grade-level work and standard teaching strategies aren’t working.
  • The Revised Code of Washington (RCW 320.260) requires schools to support literacy with “multi-tiered” programming. That means schools provide different levels of help for all students who need it, regardless of special education eligibility.
  • Washington Office of Superintendent of Public Instruction (OSPI) has handouts about dyslexia screening and supports in WA Schools, some in multiple languages.
    [ ខ្មែរ (Khmer), 한국인(Korean), ਪੰਜਾਬੀ (Punjabi), Русский (Russian), Soomaali (Somali), Español (Spanish), Filipino/Tagalog, 中國人(Traditional Chinese), and Tiếng Việt (Vietnamese)] They are listed at the end of this article.

Full Article

A child who struggles to read can quickly fall behind in school. Nearly every learning area includes some reading, and children might become confused or frustrated when they don’t get help to make sense of their schoolwork. Behavior challenges can result, and sometimes schools and families struggle to understand why the student is having a hard time. Reading difficulties affect a student’s literacy. One definition of literacy is the ability to read, write, speak and listen in ways that let people communicate well. The Revised Code of Washington (RCW 320.260) requires schools to support literacy with “multi-tiered” programming to help with reading difficulties.

One cause of difficulty with reading is a specific learning disability called dyslexia. The state’s definition of dyslexia, adopted in 2018, is similar to a definition promoted by the International Dyslexia Association. According to Washington State’s definition:

“Dyslexia is a specific learning disorder that is neurological in origin and that is characterized by unexpected difficulties with accurate or fluent word recognition and by poor spelling and decoding abilities that are not consistent with the person’s intelligence, motivation, and sensory capabilities.”

Understood.org provides a video and additional materials to learn about dyslexia. Here’s their plain language definition: “Dyslexia is a common condition that makes it hard to work with language.”

Washington State requires dyslexia screenings (tests to find out if a student may have or be at risk for dyslexia) and interventions (help with reading). Lawmakers in 2018 passed Senate Bill 6162 to require schools to screen children from kindergarten through second grade using state-recommended literacy screening tools. The law took effect in 2021-22.

Since reading is used in almost every learning area, this law means schools have a duty to identify students who show signs of possible dyslexia while they are in their early reading years. The law also requires schools to provide “interventions” (help) to students identified through the screening.

OSPI offers a Fact Sheet about the screening in multiple languages. It includes the reason for the screening, who gives the screening, the skills that are screened, the process, and information about dyslexia.

What happens if the screening shows indicators (signs) of dyslexia?

The law requires the school to:

  • Notify the student’s family of the identified indicators and areas of weakness
  • Share with the family the school’s plan for multitiered systems of support to provide supports and interventions (help with reading)
  • The notice should include resources and information about dyslexia for the family’s use.
  • Update families regularly on the student’s progress

How can families tell if a student has trouble, or may have trouble with reading and language? Families can look for these signs in children who are toddlers and pre-kindergarten:

  • Trouble learning simple rhymes
  • Speech delays
  • following direction
  • Difficulty reading short words or leave them out
  • Trouble understanding the difference between left and right
    -Child Mind Institute Parent Guide to Dyslexia.

Screening happens in kindergarten through grade 2. If a student is already older than that, families can check for these signs of reading and language difficulty at home.

Understood.org states: “Dyslexia can also cause trouble with spelling, speaking, and writing. So, signs can show up in a few areas, not just in reading.” Understood.org lists these signs for students older than grade 2: Signs a Student May Have Dyslexia (handout)

The Washington Office of Superintendent of Public Instruction (OSPI) offers a Family and Caregiver Discussion Guide that may help when families are planning to speak to their child’s teacher or school administrators about their student’s reading difficulties, behavior, or other concerns.

What happens if the screening shows a student has signs of dyslexia, or if families or teachers notice signs and want a student to get help?

The school puts multi-tiered systems of support (MTSS) into action. “Multi-tiered systems” usually means beginning reading help as part of regular classroom reading instruction. If a student’s reading difficulties continue, the student may get more intensive instruction in smaller groups, and perhaps move up to intensive one-on-one time with a reading instructor. For any of these levels, the reading instruction must be “evidence-based” methods which means the methods have been tested and shown to be useful in helping with reading difficulties.

This guide for schools from OSPI has details about MTSS.

These more intensive levels of reading help may work very well. Not every reading difficulty is due to dyslexia, and not every person with dyslexia has the same level or type of reading difficulty.

At any point during these interventions, families or teachers may see a student is not making progress and ask that the student be evaluated for special education to see if the student qualifies for an Individualized Education Program (IEP). An IEP can provide Specially Designed Instruction (SDI), which means instruction will be based on the student’s unique needs and provide extra instructional time, assistive technology, and other supports.

The federal law that provides special education eligibility and funding is called the Individuals with Disabilities Education Act (IDEA). According to the IDEA, Dyslexia is a Specific Learning Disability. Specific Learning Disability is a category of eligibility for an Individualized Education Program (IEP). IDEA states that students have the right to a Free, Appropriate Public Education (FAPE), and the IEP is a key factor in a student having FAPE.

What types of help can a student get with reading and literacy?

Multi-tiered systems of support (MTSS) use instruction methods that have been proven to work for many students, starting with help in the general (regular) classroom. If a student doesn’t make progress that way, the student may join a smaller group for that gives each student more time with a teacher or reading specialist and even move on to one-to-one instruction with a reading specialist. These options are available to any student who shows signs of dyslexia or reading difficulty. OSPI offers Dyslexia Guidance (for schools): Implementing MTSS for Literacy with more specific information.


IEP: Students can get Specially Designed Instruction (SDI) based on their unique needs, such as particular areas of language and literacy where they have difficulties. Reading programs offered by the school can be included in an IEP. IEPs can include accommodations, which may include texts and instructions in audio format, text-to-speech/speech to text software, recording oral answers to assignment or test questions, access to distraction-free location for reading, allowing extra time to complete work or tests, and many more. Accommodations for Students with Dyslexia by the International Dyslexia Association lists many other options.

Section 504 Plan: Section 504 plans don’t include Specially Designed Instruction. They do include accommodations.

The National Center on Improving Literacy has information on when a Section 504 plan may make sense for a student with reading difficulties or dyslexia. They note that Section 504 Plans, which fall under Section 504 of the Rehabilitation Act of 1973, do not provide for Specially Designed Instruction. If a student’s reading has improved without an IEP by receiving multitiered systems of support, a Section 504 plan may offer Assistive Technology options, spelling checks, extended time on assignments and testing and other accommodations.

PAVE has articles and a video with more information about special education, IEPs, and Section 504 plans.

Interventions (help with reading) are schoolwide

Not all students who need reading support will need IEPs or a Section 504 Plan. The Revised Code of Washington (RCW 320.260) requires schools to support literacy through “evidence-based multi-tiered” programming. That means schools provide different levels of support for all students who need help, whether or not the student has an IEP or Section 504 Plan.

Some schools have reading programs funded by Title 1, which is part of a federal law called Every Student Succeeds Act (ESSA). Title 1 is funded to close opportunity gaps related to poverty and other measures.  

TIP: Ask about all options for reading support at your school. If a student with an IEP participates in a schoolwide reading program, then the IEP can list that program as part of the student’s services.

Dyslexia can be identified and helped without a diagnosis

Students do not need a diagnosis of dyslexia to be evaluated (tested) for special education eligibility. If the family has concerns, they can ask the school to evaluate the student. Requests should be in writing. PAVE provides a sample letter to help families request an educational evaluation.

Here’s a sentence to include in the evaluation request letter:

“I need my child tested for a specific learning disability. I believe there is a problem with reading that is disability related.”

TIP: When a student’s need for reading help qualifies for an IEP, there are important things that families need to know about how IEPs work, what the goals are for the student’s reading abilities, what type of reading help will be given, where the Specially Designed Instruction will take place, and what the parent’s and student’s roles and responsibilities are when their student has an IEP. These are the basics:

  • IEP Eligibility is based on a student’s needs
  • Specially Designed Instruction (SDI) serves the identified needs
  • The IEP tracks learning progress with specific goals in each area of SDI

What options do families have if they disagree with a school’s decisions about their student’s reading supports or other decisions?

  • If a student has not been screened for signs of dyslexia and the family has concerns, a first step is to meet with the student’s teacher. This article by the International Dyslexia Association offers specific steps families can take.
  • Families can request an evaluation to see if the student qualifies for an IEP or a Section 504 Plan.
  • If families disagree with the evaluation, they can request an Independent Educational Evaluation (IEE) from a provider outside the school. This article from PAVE gives steps and a sample letter to request and IEE: Evaluations Part 2: Next Steps if the School Says ‘No’
  • If the student has an IEP, this article gives specific steps to follow: Parents as Team Partners: Options When You Don’t Agree with the School.
  • For students with a Section 504 Plan, OSPI recommends:
    “The Section 504 coordinator in each district makes sure students with disabilities receive the accommodations they need and respond to allegations of discrimination based on disability. [Section 504 coordinators are members of a school’s Section 504 team which develops 504 Plans to accommodate a child’s needs]. A discussion with your school principal, or Section 504 coordinator at the school district, is often the best step to address your concerns or disagreements about Section 504 and work toward a solution. Share what happened and let the principal or coordinator know what they can do to help resolve the problem. If you cannot resolve the concern or disagreement this way, you can file a complaint.”

What else to know:

Keep in mind that families and schools don’t need to use the term dyslexia at all. They can talk about a student’s learning disability in reading, writing, or math in broader terms such as “Specific Learning Disability.” Under the Individuals with Disabilities Education Act (IDEA), dyslexia is a Specific Learning Disability that qualifies a student for special education.

Specific Learning Disability is defined by the Washington Administrative Code (WAC 392-172A-01035):
“Specific learning disability means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia, that adversely affects a student’s educational performance.”

The state’s definition of learning disability excludes “learning problems that are primarily the result of visual, hearing, or motor disabilities, of intellectual disability, of emotional disturbance, or of environmental, cultural, or economic disadvantage.”

Here’s a handout on Accommodations and Modifications for Students with Dyslexia.

Resources

From PAVE:

Special Education is a Service, Not a Place
Student Rights, IEP, Section 504 and More (video)
Steps to Read, Understand, and Develop an Initial IEP
Supporting literacy: Text-to-Speech and IEP goal setting for students with learning disabilities
IEP Tips: Evaluation, Present Levels, SMART goals
Section 504: A Plan for Equity, Access and Accommodations
Evaluations Part 2: Next Steps if the School Says ‘No’
There’s more: just type “Special Education,” “IEP” or “504” in the search bar

From OSPI:

Family and Caregiver Discussion Guide with Educators and Schools
Understand Literacy Screening: Parents and Families
Available in ខ្មែរ (Khmer), 한국인(Korean), ਪੰਜਾਬੀ (Punjabi), Русский (Russian), Soomaali (Somali), Español (Spanish), Filipino/Tagalog, 中國人(Traditional Chinese), and Tiếng Việt (Vietnamese)
Best Practices for Supporting Grades 3 and Above
Section 504 & Students with Disabilities (web page)
Dyslexia Guidance (for schools): Implementing MTSS for Literacy

Dyslexia awareness is promoted by the National Center on Improving Literacy (NCIL), which provides resources designed to support families, teachers, and policy makers. On its website, the agency includes state-specific information, recommends screening tools and interventions and provides research data about early intervention.

The International Dyslexia Association has many detailed resources for families.

Tips to Organize Your Child’s Medical and School Documents

Posted on by Nicol Walsh

A Brief Overview

  • Keeping track of important documents for your child’s health can save you time and give you less stress.
  • Take advantage of technology! If you choose to build a digital storage system, integrating it with your smart phone will make it easy to share information on-the-go with doctors, day care providers, school staff, and other professionals.
  • Plan a grab-and-go handout, notebook, or phone app to make it easy to find and share critical information during an emergency.
  • Read on for information about how to get started!

Full Article

Care planning and a well-organized system to keep track of important documents can save time and create comfort during uncertain times. This article provides some tips for building a “care notebook,” which might be a three-ring binder, an accordion file, or a portable file box—whatever makes sense for your organizational style and the types of materials you need to sort.

A portable Care Notebook can include the most current versions of medical and/or school documents, while older files can be archived separately. Here are some examples of formal documents you might organize:

  • Medical paperwork: diagnoses, assessments, surgeries, medications, provider contacts
  • School paperwork:  Individualized Education Program (IEP), Section 504 Plan, assessments, meeting notifications, progress notes, correspondence, telephone logs
  • Personal care notes: hygiene routines and concerns, food preferences and issues, sleep schedules and challenges
  • Community access: transportation needs, hobbies, clubs, activities

Click to print out the infographic above

Consider what else to include, such as business cards and contacts, a call log, a calendar, emergency/crisis instructions, prescription information, history, school schedule…

Each primary category can be a section of a large notebook or its own notebook. Consider how portable the notebook needs to be and where you might take it or share it. Will the size and shape be practical for where you plan to go? Do you need more than one notebook or system?

One way to make the most current medical information more mobile is to use an app on your phone or tablet. Here are two options:

  • Specifically for an iPad or iPhone and available through Apple, My Health Tracker was developed through Boston Children’s Hospital and Boston University.
  • Available for android phones through Google Play, MyCookChildren’s provides categories and ways to take pictures of documents and/or store information that you enter.

Both mobile apps help you track medication, care needs, illnesses, and appointments. Having this information in one place is especially helpful when you are working with specialists and medical providers from different medical groups that use different calendar and records systems.

Another way to maintain records and information is to create a digital “notebook” on a personal computer. You might build folders just like you would in a physical notebook. Dr. Hempel Digital Network provides 10 health-record applications with options that combine electronic medical records with telehealth capabilities. Other applications work with cellular phones. Here are three: MTBC PHR, Medical Records, and Medfusion Plus.

Keep emergency information handy and easy to clean

A small “on the go” handout might be helpful for critical care appointments or emergencies. A laminated handout or a page tucked into a protective sleeve will be easier than a large notebook to disinfect after being in public. Depending on a child’s needs, caregivers might create multiple copies or versions of an on-the-go handout for easy sharing with daycare providers, school staff, babysitters, the emergency room, camp counselors or others who support children.

Key information for a quick look could include:

  • medications and dosages
  • doctors and contact information
  • emergency contacts—and whom to call first
  • allergy information
  • preferred calming measures
  • Plan for a caregiver’s illness

Another pull-out page or small notebook might include specific instructions about what to do if a caregiver gets sick. These questions could be addressed:

  • Who is the next designated caregiver?
  • Where can the child live?
  • What are specific daily care needs and medical care plans?
  • Is there a guardianship or a medical power of attorney?
  • Are there any financial or long-term plans that need sharing?

Step-by-Step Instructions

Building a Care Notebook does not have to be daunting. Most people start small and try different approaches until they find the best fit.  Here are a few ideas to start the process:

  • Choose a holding system that makes sense for your organizational style: notebook, accordion file, small file box, or a primarily digital system with limited “to-go” handouts.
  • Identify and label the document sections by choosing tools that fit your system: dividers, clear plastic document protectors, written or picture tabs, color coding, card holders for professional contacts, a hierarchy of folders on your computer…
  • Include an easy-to-access calendar section for tracking appointments.
  • Include a call log, where names are recorded (take time to spell full names correctly!) and phone numbers of professionals. Take notes to create a written record of a conversation. It is also practical to send a “reflective email” to clarify information shared in a call, then print the email, and tape it into the call log to create a more formal written record of the call.
  • A separate sheet of easy-reference information can be used to share with a caregiver in a new situation, such as daycare, doctor, camp, or a sleepover. Mommies of Miracles has an All About Me template that serves this purpose.
  • When appropriate, invite the child to participate.

Tools to help you begin

Quick and easy forms can help you start. Here are two options:

  1. Medical Home Portal Care Notebook and it comes in both English and Spanish
  2. Individual Healthcare and Emergency plans from PACER Center

Guidance to help build a more comprehensive care notebook is available from Family Voices of Washington. Printable forms can be done in stages and updated as needed to slide into a notebook or filing system. The templates include pull-out pages for Emergency Room or Urgent Care visits and forms to help organize medical appointments.

A child’s medical providers might help write a care plan and can provide specific contact information, medication lists and emergency contact procedures for each office. A school can provide copies of an Individualized Education Program (IEP), a Section 504 Plan, an Emergency Response Protocol, a Behavior Intervention Plan or other documents. If a child is in state-supported daycare (on location or in-home), staff can provide forms for emergency procedures and contacts.

You will thank yourself in the future!

Having information organized and ready can make it easier to apply for public services through the Social Security Administration, the Developmental Disabilities Administration (DDA), the Division of Vocational Rehabilitation (DVR) or others. For military families, a Care Notebook can make transitions and frequent moves easier to manage.

A well-established organization system also can help a child transition toward adult life. Easy access to a list of accommodations can ease that first meeting with a college special services office or provide a key set of documents for requesting vocational rehabilitation/employment supports. Easy access to key medical records can be the first step to helping a child learn what medications they are taking and advocate for an adjustment with an adult provider

Additional resources for long-term planning include:

Supported Decision Making is an Option for Adults with Disabilities

Posted on by Nicol Walsh

A Brief Overview

  • In Washington State, Supported Decision Making (SDM) is a legal option for supporting a person with a disability after their 18th birthday.
  • The format for an SDM agreement is up to the individual and their supporters. A sample form is available for download from WashingtonLawHelp.org.
  • The final section of this article provides information about other options to support and protect a loved one with a disability.
  • Help is available from the Developmental Disabilities Ombuds.

Full Article

When a young person turns 18, most decisions are now up to them. In Washington State, age 18 is the “age of majority,” which means a person 18 or older has the right to make their own decisions about education, work, money matters, voting and more.

Note: In Washington the age of independence for health care decisions is 13, with some behavioral healthcare exceptions related to Family Initiated Treatment (FIT).

When a person 18 or older has a disability, family members may want to stay involved in helping them make decisions. Supported Decision Making (SDM) is the formal name for one legal option.

Washington law (Chapter 11.130 in the Revised Code of Washington) includes Supported Decision Making as an option under the Uniform Guardianship, Conservatorship, and Other Protective Arrangements Act. The law changed in 2020 when the state passed Senate Bill 6287. The changes took effect Jan. 1, 2022.

The law includes Supported Decision Making as an alternative to more restrictive arrangements that put limits on an individual’s rights. The final section of this article includes information about other options, such as guardianship.

What is Supported Decision Making?

Supported Decision Making (SDM) is an agreement to make sure an adult with disabilities has trusted helpers watching out for their well-being. An SDM agreement does not remove the adult individual’s rights but creates a way for the individual and their supporters to make choices together.

For example, a student older than 18 who receives special education services at school might agree to have their parent continue to participate in decisions about their Individualized Education Program (IEP). Parent and student then work together as members of the IEP team.

Supported Decision Making may be combined with a Person Centered Plan to ensure that a person has circles of support as they work toward adult life goals. Like Person Centered Planning, SDM changes with the needs of the individual and their supporters.

What should be included in the agreement?

An agreement for Supported Decision Making is written to meet an individual’s needs and preferences. For example, a person might choose support in one or more of these areas:

  • Medical care
  • Dating or sexual intimacy
  • Living arrangements
  • Employment
  • Education
  • Finances

The agreement includes the names of supporters and their relationship to the person. Supporters might be:

  • Parent
  • Other family member
  • Friend
  • Trusted professional
  • Someone else

The agreement is signed in front of a Notary Public by the adult with disabilities and all selected supporters. Everyone must provide picture identification for an in person signing or follow alternative identity verification methods for an online signing.

How to document their SDM agreement is up to the individual and their supporters. A sample form is available for download from WashingtonLawHelp.org. The sample form offers the following suggested language:

“My supporter is not allowed to make decisions for me. To help me with my decisions, my supporter may:

Help me access, collect, or obtain information that is relevant to a decision, including medical, psychological, financial, educational, or treatment records;

Help me understand my options so I can make an informed decision; and

Help me communicate my decision to appropriate persons.”

The suggested format includes options for the individual to choose whether selected supporters will have access to protected health information under the Health Insurance Portability and Accountability Act (HIPAA) or educational records under the Family Educational Rights and Privacy Act (FERPA).

Is Supported Decision Making free?

There may a small cost to get a document signed in front of a Notary Public.

TIP: If someone on the agreement has a bank account, their bank may provide free Notary services. Public libraries and county courthouses are additional places to ask about free options to have a document notarized.

The SDM agreement does not have to be filed with a court, but it is a legal agreement.

Resources for Supported Decision Making

What if my family wants another choice for support and protection?

Supported Decision Making is one option when a family wants to support and protect a loved one with a disability. Below are options that may involve legal assistance and/or a court process. Washington Courts provides information about various types of courts and how to find them within the state.

Guardianship of an Adult: A court-appointed person makes decisions for the adult with disabilities. Guardianship may be combined with Conservatorship (see below). Guardianship is the most restrictive option and may not be granted unless there is evidence that less restrictive alternatives are unworkable.

Conservatorship of an Adult: A court-appointed person makes property and/or financial decision for the adult with disabilities. Like guardianship, the petition may be denied if less restrictive options are not tried first.

Informed Consent: This is a limited option for supporting medical decisions when a health care provider determines that an individual is unable to properly understand their condition or make fully informed decisions (RCW 7.70.065). Note that an individual with a Supported Decision Making (SDM) agreement may be able to demonstrate they can make their own decisions about healthcare with the help of their supporter.

Power of Attorney: An individual can sign a legal document to give someone else power to make decisions in their behalf under limited or general circumstances. A Mental Health Advance Directive, to be invoked if someone with a mental illness loses capacity, is an example of a limited Power of Attorney document that an individual might choose to sign. Washington Law Help provides a Q and A on Powers of Attorney.

Special Needs Trust: An account can protect funds for individuals receiving Supplemental Security Income (SSI) and/or Medicaid. A Trustee is appointed to manage the funds, which commonly are used to pay for things that SSI or Medicaid benefits do not cover. Trustees are legally responsible if they do not use the Trust for the benefit of the individual. Washington Law Help provides information on Special Needs Trusts.

Representative Payee: The Social Security Administration (SSA) may determine that an individual receiving benefits needs a payee to manage their income. If an individual disagrees with the administration’s decision to appoint a payee, they must present evidence of their ability to manage their money. Disability Rights Washington (DRW) provides information about how to change, remove or report a representative payee.

Protective Arrangement: A court-appointment person makes decisions for the person with disabilities related to specific and limited conditions, such as specific medical decisions or contact with a specific individual who might cause harm. The Vulnerable Adult Protection Act provides protection to adults in Washington State who meet one or more of these criteria:

  • 60 or older and functionally, mentally, or physically unable to care for themselves
  • Have a court-appointed guardian
  • Have a developmental disability
  • Live in a nursing, adult family, or boarding home or other facility
  • Served by home health, hospice, or home care agencies
  • Receive services from an individual care provider or personal aide

NOTE: Anyone who suspects physical harm, someone being held against their will, sexual abuse, neglect, financial exploitation, or abandonment can call Adult Protective Services: 1-877-734-6377 or Report Online.

Additional Resources

Legal Disclaimer: It is the policy of PAVE to provide support, information, and training for families, professionals, and interested others on a number of topics. In no way do these activities constitute providing legal advice. PAVE is not a legal firm or a legal services agency and cannot provide legal advice. The information within this article is not intended as legal advice and should not be used as a substitution for legal advice.