High School Halt: Ways to Support Youth Working on Adult Life Plans During COVID-19

A Brief Overview

  • The pandemic and its impact on education may feel especially confusing for youth working toward graduation and life-after-high-school plans. Read on for information about how to support young people working on their diplomas and goals for college, vocational education, independent living, and more.
  • The state continues to navigate questions related to graduation pathways and credit requirements for students impacted by COVID-19. This article includes links to resources where information is regularly updated.
  • Students learning from home may need support to organize their days and incorporate the activities of daily living into their educational programs. This article includes some ideas for organizing at-home learning.
  • Another article from PAVE provides more information about vocational rehabilitation options for young people, during COVID and beyond: Ready for Work: Vocational Rehabilitation Provides Guidance and Tools.

Full Article

The COVID-19 pandemic and its impact on education may feel especially confusing for those who are working toward graduation and life-after-high-school plans. Parents and students may be wondering what will enable students to complete work toward their diplomas, meet college admission requirements or continue work toward vocational and/or independent living goals.

Since March 2020, the National Technical Assistance Center on Transition (NTACT) has provided webinars and other materials to promote home-based learning for transition-age youth with disabilities. This article includes some of NTACT’s ideas. The agency’s website provides webinar recordings and additional materials: Transition Resources in the 2020-2021 School Year.

In collaboration with the Center for Parent Information and Resources (CPIR/ParentCenterHub.org), NTACT provides an interactive tool for young people: Secondary Transition Considerations and Guiding Questions for Youth Exiting from High School. Throughout the document, a young person is guided to a variety of links and resources based on the way questions are chosen and answered. For example, “Things you can do now to help meet your postsecondary employment goal” provides a set of suggestions:

“Make a list of your career interests, the best work location for you, and types of jobs that best fit your skills. If you aren’t sure what jobs or careers interest you, explore your options at ‘Get My Future’ on the Career One Stop website.”

Graduation requirements shift

The Washington State Board of Education (SBE) provides information about graduation impacts of COVID-19. SBE in summer 2020 began a rulemaking process to provide districts more flexibility to:

  • Award credit based on demonstration of mastery or competency
  • Offer courses that meet more than one subject area graduation requirement
  • Waive the Washington state history requirement for some students impacted by school closures or other disruptions. Waivers are individually determined.

The State Legislature passed a law in response to coronavirus (EHB 2965) that supported emergency waivers for the graduating Class of 2020. The goal was to ensure that students on track to graduate would not be held back because of the pandemic.

Graduation standards and requirements also are impacted by a 2019 law that provides multiple pathways toward a diploma. The Office of Superintendent of Public Instruction (OSPI) offers a website page describing the Graduation Pathways, with toolkits for families and students.

For a student eligible for an Individualized Education Program (IEP), the IEP team determines what criteria are met for the student to earn a diploma and the timeline for graduation. Families are encouraged to reach out to IEP team members, district staff, and school counselors to collaborate on how the IEP and graduation targets are adjusted in light of the pandemic.

Recovery services and/or compensatory services may be available

The Office of Superintendent of Public Instruction (OSPI) provides a 60-page booklet: Reopening Washington Schools 2020: Special Education Guidance. The guidance defines recovery services, as “additional, supplemental services needed to address gaps in special education service delivery due to COVID-19 health and safety limitations, of which districts had no control.”

Compensatory services are provided as a remedy when a school is found through a dispute resolution process to have denied a Free Appropriate Public Education (FAPE). By federal law (Individuals with Disabilities Education Act/IDEA), a student with an IEP is entitled to FAPE, which provides an individualized program to enable progress appropriate in light of a student’s unique circumstances. Those circumstances include strengths and assets, disability condition, family considerations, the pandemic, and more.

Students in transition programs who aged out during Spring 2020 may be eligible for recovery and/or compensatory services. Other students who missed key learning also could be eligible. Families can reach out to their IEP teams and/or district special education program staff to discuss options. Data about school/family communications, accessibility of educational materials, and IEP/transition services provided/not provided will contribute to conversations about recovery/compensatory services.

Creativity may be needed to ensure educational access in all areas of learning, including those related to the transition into adulthood. OSPI’s guidance includes a section on Graduation & Secondary Transition, with step-by-step instructions for educators supporting youth with transition programming:

“Secondary transition is more than providing pathways for the individual’s movement from high school to employment,” the guidance states. “It is a comprehensive approach to educational programs, focused on aligning student goals with educational experiences and services. When we move these activities to the continuum of reopening models, we have to stretch our thinking about how this can be done.”

What about college admission requirements?

Students who are college-bound may have questions about admissions requirements and whether they can still be met. The National Association for College Admission Counseling has encouraged colleges to be flexible and has created a central resource for information related to Coronavirus and College Admission.

How can I help my student organize the day to include learning?

NTACT offers a range of downloadable Transition Focused Instructional Resources, including tools to help with scheduling and others for helping young people stay socially connected. In a March 24 webinar, the agency encouraged creative ways to support regular work in each of the key areas of learning for a student with an IEP:

  • Life skills
  • Self-determination
  • Self-advocacy
  • Desire to work
  • Enriching experiences
  • Appropriate goals

Teachable moments might include real-life situations related to the pandemic and a new routine. Students still can have the opportunity to make choices and to live with the consequences of choices and actions. For example, a student-made meal might not be gourmet but can be enjoyed on its merits of life-skill-building and risk-taking.

How can the IEP support work at home?

NTACT recommends development of a consistent routine and documentation of daily work and any progress or regression. To help with planning, anyone supporting the student can take a close look at the current IEP.

The Present Levels of Academic Achievement and Functional Performance, which are built from evaluation results, can provide inside about the student’s strengths, interests, and capacities. Annual goals will highlight the areas of specially designed instruction being provided through the IEP. Consider how instruction might be adapted for at-home instruction—or whether a more suitable goal might be considered. School staff and family members can collaborate to set up a shared approach.

For a student older than 16, a post-secondary transition plan is included in the IEP and includes projections about adult goals and the skills being worked on to get there. NTACT provides Choice Boards to support ongoing work in three key areas that are aspects of a transition plan:

  • Career exploration
  • Education and training
  • Independent living

The Choice Boards are pre-loaded with resource linkages and suggestions.

Think into the future

PAVE provides a webinar and a comprehensive article about life-after-high-school planning with further guidance about the transition process in general. More time at home together might give families a good opportunity to sit back and consider key questions to help the student make future plans:

  1. Where am I now?(strengths, interests, capacities—the Present Levels of Performance in the IEP)
  2. Where do I want to go?(aspirations, dreams, expectations—Transition Plan Goals in the IEP)
  3. How do I get there?(transition services, courses, activities, supports, service linkages, community connections, help to overcome barriers—Annual Goals, Accommodations and other provisions included in the IEP)

What can we do at home today?

Consider how transition programming can be adapted to current circumstances so a young person continues to be connected to important relationships and inspired toward the future. Daily successes are to be celebrated, and high expectations elevate everyone. Below are some typical home-based subject areas that might support learning and skill-building, with a few linkages to resources that might help.

  • Leisure and Recreation
  • Home Maintenance
    • Organizing
    • Cooking
    • Cleaning
    • Yard Work
  • Personal Care
  • Finances
    • Budgeting—Cents and Sensibility from the Pennsylvania Assistive Technology Foundation provides an approach for individuals with autism.
    • Practice with money by paying for things throughout the day
  • Communication
    • Letter and email writing
    • Webinars
    • Phone calls/interview a friend or relative about their career path and write about it?

Other places that provide vocational questionnaires and forecasting tools

  • AgExplorer.com helps students imagine themselves in fields related to farming and beyond
  • ExploreWork.com helps students with disabilities consider their strengths and interests and how to relate them to work options
  • RAISECenter.org offers a variety of tools related to vocational rehabilitation. (RAISE stands for Resources for Advocacy, Independence, Self-determination and Employment.)
  • CareerOneStop.org, sponsored by the US Department of Labor, provides career assessments through its website and a mobile app.
  • Options for further information related to higher education
  • ThinkCollege.net
  • OffToCollege.com
  • ParentCenterHub.org provides a library of college preparation resources related to specific disability categories

For additional ideas about supporting a student with in-home learning please refer to PAVE’s Links for Learning at Home During School Closure.

Please note that any resource list provided by PAVE is not exhaustive, and PAVE does not endorse or support these agencies. Links are provided for information only.

Key Information and Creative Questions for Families to Consider During COVID-19 Closures

A Brief Overview

  • While schools are operating, districts are responsible to provide a Free Appropriate Public Education (FAPE) to students within their boundaries with known or suspected disabilities that significantly impact access to learning. Read on to learn more about FAPE and student rights.
  • Federal and state requirements to ensure that children with qualifying disabilities can access early learning services and make the transition to school-based services if eligible at age 3 also are still in place, without waivers.
  • FAPE requirements for high-school transition services apply now, as always. PAVE’s article, High School Halt, includes more information on topics impacting graduating seniors and youth transitioning through high school and beyond.
  • How a student of any age accesses FAPE during a national health crisis is a work-in-progress. A Continuous Learning Plan (CLP) is a tool schools and families might use for temporary circumstances. PAVE provides another article describing that process: IEP on Pause? How to Support Continuous Learning with School Buildings Closed.
  • Families might be interested in attending a school board meeting to learn more about decisions being made at this time. Read on for more information about Open Meetings.
  • The final section of this article includes creative conversation starters, some ideas and prompts that might help your family prepare to talk with school staff.
  • To support well-being for family members of all ages and abilities, PAVE provides this article, which includes links to videos with simple mindfulness/breathing practices: How to Get Organized, Feel Big Feelings, and Breathe.

Full Article

With schools closed and lives disrupted by the COVID-19 crisis, families impacted by disability have unique questions. This article includes key information about student rights and creative conversation starters that family caregivers might consider when planning to meet with school staff over the phone, through written communication or over a web-based platform.

Student rights have not been waived

Students with disabilities have protections under federal and state laws. Those rights and protections are not waived during the school building closures. While schools are operating, districts are responsible to provide a Free Appropriate Public Education (FAPE) to students within their boundaries with known or suspected disabilities that significantly impact access to learning. The protections of FAPE include the right to:

  • Appropriate evaluation if there is a known or suspected disability condition that may impact educational access (Please refer to PAVE’s articles on Evaluations Part 1 and Child Find for more information)
  • Specially Designed Instruction (SDI) in areas of learning with significant educational impact from the disability and an identified need for SDI
  • Meaningful progress toward goals, which are developed to measure the effectiveness of Specially Designed Instruction (SDI)
  • Accommodations (extra time, videos with captioning or embedded sign language interpreting, accessible reading materials, other Assistive Technology…)
  • Modifications (shorter or different assignments, testing, etc.)
  • Special services (speech/language, occupational or physical therapy through video conferencing, for example)
  • Not get bullied or discriminated against because of a disability circumstance

FAPE rights related to accommodations, modifications and anti-bullying measures are protected by the Rehabilitation Act of 1973 and apply to all students with disabilities, including those who have Section 504 Plans and those with Individualized Education Programs (IEPs). FAPE rights related to evaluation process, SDI, and formal goal setting are aspects of the IEP and are protected by the Individuals with Disabilities Education Act (IDEA).

In accordance with the IDEA, the IEP includes a description of the student’s present levels of academic achievement and functional performance. Special education attorneys Pam and Pete Wright have published books about special education law and maintain a website, Wrightslaw.com. Included during the pandemic is this page: IEPs During the COVID-19 Era: Your Parental Role and Present Levels in IEPs.

The Wrightslaw page encourages parents to read and re-read the present levels statements before meeting with the school. These statements form the basis for the student’s goals and other services. Up-to-date and comprehensive data within the present levels section of the IEP can be key to a successful outcome.

Wrightslaw encourages family caregivers to provide input for the present levels statements and to request further evaluation if the statements are incomplete or out of date. Creativity and collaboration are encouraged to allow for data collection while school buildings are closed: “Parents, never forget why you are essential members of your child’s IEP team. You are essential because your job is to represent your child’s interests. So, you need to be an active member, not a spectator. Your goal is to work with other members of the team to develop IEPs tailored to meet your child’s unique needs.”

No Waivers to Early Learning Requirements

Federal and state requirements to ensure that children with qualifying disabilities can access early learning services and make the transition to school-based services if eligible at age 3 also are still in place, without waivers.

Washington’s Department of Children, Youth and Families (DCYF) provides COVID-19 guidance for families of children in early learning through the Early Support for Infants and Toddlers (ESIT) program. Included is information about the Individual Family Service Plan (IFSP), how to manage a transition from IFSP to school-based services during the pandemic and tips for telemedicine appointments and protection of confidentiality.

The Office of Superintendent of Public Instruction (OSPI) provides guidance to schools in Washington. In early May 2020, OSPI issued guidance specifically related to early childhood programs during the COVID-19 closure. In particular, the document addresses a child’s rights through the federal Individuals with Disabilities Education Act (IDEA).

Services for children Birth-3 are defined by IDEA’s Part C, and school-based services for children 3-21 are defined by IDEA’s Part B. About 3 months before a child with an IFSP turns 3, the school district is responsible to evaluate the child to determine eligibility for an IEP. PAVE provides a general article about the early learning transition process.

According to OSPI guidance, “School districts are expected to move forward with initial Part B evaluations as specified in the Early Childhood Transition from Part C to B Timeline Requirements. School districts must make reasonable efforts to comply with the requirement and may utilize alternative means for conducting virtual assessment and IEP team meetings, such as telephone or videoconferencing.”

Communication is key

How a student of any age accesses FAPE during a national health crisis is a work-in-progress that requires communication and collaboration between schools and families. On its website page titled Special Education Guidance for COVID-19, OSPI provides links to numerous documents that guide schools in best-practice for outreach to families.

On May 5, 2020, OSPI issued a Question & Answer document to address special-education delivery. “This is a national emergency,” the document states, “and districts should be communicating with families and making decisions based on student need and how those services can be provided. There is no one right way to provide services.”

IEP and Section 504 meetings are encouraged, and teams can build different versions of the documents to support at-home learning now and in-school services when buildings reopen. A Continuous Learning Plan (CLP) is a tool schools and families might also use for temporary circumstances. PAVE provides an article describing that process, with linkages to the plan’s template: IEP on Pause? How to Support Continuous Learning with School Buildings Closed.

OSPI notes that health and safety are top priority and that some aspects of a student’s program may not be possible to implement during the crisis. Discussion about Compensatory Services to make up for elements of FAPE not provided during the closure will require a review of documentation.

Keep notes about student learning

Schools and families are encouraged to keep notes about student learning and access to education and/or special services during days that schools are providing educational services to all students. Parents can ask the district to define its official dates of operation. When a school is officially closed, the district is not responsible to provide FAPE, according to OSPI guidance.

State guidance related to the provision of FAPE aligns with federal guidance issued since the pandemic began. On March 16, 2020, the U.S. Department of Education Office for Civil Rights (OCR) and the Office for Special Education and Rehabilitative Services (OSERS) issued a fact sheet describing the federal rights of students with disabilities:

“If the school is open and serving other students, the school must ensure that the student continues to receive a Free Appropriate Public Education (FAPE), consistent with protecting the health and safety of the student and those providing that education to the student.”

Families can reach out to School Boards and Counselors

Families are meeting these emergency circumstances from a wide range of places economically, medically, emotionally, and logistically. School districts statewide have different staffing arrangements and approaches, and Washington schools are locally managed and overseen.

Families might be interested in attending a school board meeting to learn more about decisions being made at this time. Families have the option of making public comment at meetings to share thoughts or concerns. School board meetings are required monthly and must follow the state’s Open Public Meetings Act (Chapter 42.30 in the Revised Code of Washington).Families can reach out to their local district for information about how and when school boards meet. The Washington State School Directors’ Association provides a guidebook about the rules for Open Public Meetings. The rules apply in any meeting space or platform.

For additional support, families might consider reaching out to the school counseling office. The president of the Washington School Counselor’s Association, Jenny Morgan, provided comments in a May 7, 2020, webinar moderated by League of Education Voters. She said school counselors provide a broad range of services, from academic advising to social and emotional support. The American School Counselor Association provides a handout describing the roles of a school counselor.

Morgan says school counselors are uniquely trained to address the academic, career, and social/emotional development of all students through a comprehensive school counseling program. “We are advocates for your child’s educational needs,” she says. “Please do not hesitate to reach out to your school counselor for assistance and support. We are here for you.”

Creative conversation starters

Here are some ideas and prompts that might help your family prepare to talk with school staff. Keep in mind that some answers will not be easily provided, and conversations are ongoing.

  • My child struggles to understand social distancing. What strategy can we use to teach and practice this skill so it will be ready to use when schools reopen?
  • What social story does school staff have to share that will be accessible for my student to understand the coronavirus and why we need to stay home and practice good hygiene?
  • How can the school help my student cope with a high level of anxiety, grief, fear (any emotion that significantly impacts a student’s ability to focus on learning)? Which school counselor can help?
  • My child is turning 3 this month. Who can we talk to at the school district to help get our child ready for preschool? 
  • My student does not want to do school right now. How can we work together to motivate my student to participate in learning and do the work?
  • My student wants to cook, research cars, talk about space flight, do craft projects, walk in nature, play with the family dog, plant a garden … right now. How can we make sure that continuous learning objectives match my child’s natural curiosity?
  • My student loves to play the drums (or something else specific). How can drumming and music (or any interest) be part of the math (or other subject) assignment?
  • The homework packet, online platform, etc., is not accessible to my child. How can we work together and create a learning plan that will work for our family at this time?  
  • My child has a health condition that creates a greater risk for COVID-19 exposure. What could school look like for my child if buildings reopen but my child cannot safely re-enter a traditional classroom?
  • My student is in high school. How can we work together to make sure that the IEP Transition Plan and the High-School and Beyond Plan align? Can we invite the school counselor to our next meeting if we need more help?
  • Can my student do a self-directed project or an alternative assignment to earn a grade or meet a specific objective? Is there a modified way to demonstrate the learning, perhaps through a video, an art project, or a conference with the teacher?
  • Who is the transition counselor assigned to our school by the Division of Vocational Rehabilitation (DVR)? What tools and people can my student work with right now to explore career options and prepare for adult life?
  • What can school staff do to make sure that my student’s current education includes progress toward independent living goals? (Note: PAVE’s article, High School Halt, includes more information on topics impacting graduating seniors and youth transitioning through high school and beyond.)

During the school closures related to the coronavirus pandemic, families with students of all ages and abilities are figuring out strategies for coping with the disruptions. Additional articles from PAVE provide information about working with the school to design a Continuous Learning Plan, preparing for a virtual meeting, student rights during the School Shutdown and How to Get Organized, Feel Big Feelings, and Breathe during the crisis.

Quick Look: How to Prepare for a Virtual Meeting

Schools and families continue to meet virtually to discuss special education services during the closures related to the coronavirus pandemic. Here are tips to help family members prepare for remote meetings to discuss a student’s Individualized Education Program (IEP), a Section 504 Plan, evaluation for special education services or something else related to a special education student’s needs and learning program.

For more comprehensive information, see PAVE’s article, IEP on Pause? How to Support Continuous Learning with School Buildings Closed.”

  • Determine a regular communication plan with the school. That might include email, telephone, text, web-based meetings, U.S. mail, packet delivery by school bus…  whatever works for regularly checking in.   
  • Family caregivers can request meetings. PAVE provides a template to formalize the request: Sample Letter to Request an IEP Meeting. Included with the letter template is detail about who is required to attend IEP meetings, and those requirements have not changed.
  • The Special Education Continuous Learning Plan is provided by the Office of Superintendent of Public Instruction (OSPI) to support but not replace the IEP during the national crisis caused by the coronavirus pandemic. Included in the form is a sample meeting agenda.
  • Consider confidentiality and privacy issues. Ask school staff to describe how privacy and confidentiality are protected through a suggested meeting platform, and make sure to have any passwords or PINs ready to use when you log in or call into a meeting.
  • Before a meeting, ask to sign any necessary paperwork or releases to have special education records sent electronically via email. Special education records can include meeting notifications, IEP or Section 504 documents, assessments, progress reports, Prior Written Notices that describe meetings and planned actions, or other materials that contribute to the program review and goals.  
  • Review records before the meeting and write down questions to ask during the meeting. PAVE provides a Parent Handout Form or, for self-advocates, a Student Handout Form, that can help organize concerns and questions. Another version of a Parent Input Form is provided by the Washington Office of Superintendent of Public Instruction (OSPI).
  • Carefully review goals, services, accommodations, modifications and consider how they might apply or need to be adjusted for current circumstances. Think creatively and prepare to collaborate and request expertise from school staff. Pay special attention to the present levels of academic achievement and functional performance. These present levels statements, within the first pages of the IEP document, describe how the student is doing and where there are challenges. Wrightslaw.com provides tools specifically to support parents in reviewing IEP present levels in preparation for a meeting during COVID-19.
  • Consider whether the student will attend the meeting. A student who is 14 or older is invited as part of the state’s Pathways to Graduation planning. PAVE provides an article: Attention Students: Lead your own IEP meetings and take charge of your future.
  • Communicate early—before the scheduled meeting—to request updates about progress, a student’s present levels of performance, or other concerns. If family caregivers build a handout for the meeting, that can be submitted ahead of time to ensure that this information is part of the agenda.
  • Family members can request a practice session to test the technology. Part of that training might include practice sharing the screen to make sure everyone will be able to view important documents during the formal meeting.
  • As with in-person meetings, family participants can invite support people. A friend or family member might be able to attend and take notes.
  • Refer to parent and/or student input forms to stay on topic and ensure that all concerns and questions are addressed.
  • When the meeting ends, family participants can ask for a copy of the program recommendations page.
  • After the IEP meeting, the school provides a Prior Written Notice (PWN) to the family participants to review meeting notes and any decisions, agreements, or disagreements. Ask when and how the PWN will be provided. Family participants have the right to request amendments or corrections to the PWN.
  • Be sure to leave with a clear action plan. Here are key questions to ask and record:
    • What will happen?
    • Who is responsible?
    • When will the actions happen? Are there timelines?
    • How will we communicate for follow through?
  • As with any meeting, any unresolved issues can be addressed in a follow-up meeting.

To learn more, PAVE provides a six-minute overview of IEP basics and a 30-minute training video about special education.   

Technology Provides Options for Medical Care from a Distance

A Brief Overview

  • During the coronavirus pandemic and statewide stay-home orders, some providers are offering online appointments. This article includes information about access to telehealth and how to prepare for a virtual visit.
  • Federal privacy laws have been relaxed during the shutdown to allow more opportunities for on-screen healthcare. Washington’s telemedicine parity law was updated by the 2015 legislature. Those updates went into effect in 2017 (SSB 5175).
  • Generally, military families with TRICARE and families with state insurance, Apple Health, have coverage for medically necessary services provided through telemedicine.
  • A 6-minute video tutorial from the Hawaii Department of Health provides information about what to expect during a telehealth session.
  • Washington’s Department of Social and Health Services (DSHS) is providing free cell phones and minutes to low-income families through a federal program called Lifeline. State-specific information about this option is available from the Health Care Authority.
  • See Links to Support Families during the Coronavirus Crisis for additional resources.

Full Article

Families staying home during the coronavirus pandemic need new ways to access medical care. Onscreen appointments—telehealth, telemedicine, teleintervention, telepsychiatry—meet some needs.

The U.S. Department of Health and Human Services (hhs.gov) in early March 2020 relaxed legal requirements related to confidentiality in order to support the delivery of telehealth services while families shelter in place. Roger Severino, director of the Office for Civil Rights (OCR), issued the following statement: “We are empowering medical providers to serve patients wherever they are during this national public health emergency. We are especially concerned about reaching those most at risk, including older persons and persons with disabilities.”

The federal guidance refers to confidentiality rules under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The HHS website states that OCR will use discretion and relax compliance under HIPAA if services are delivered in good faith:

“During the COVID-19 national emergency, which also constitutes a nationwide public health emergency, covered health care providers subject to the HIPAA Rules may seek to communicate with patients, and provide telehealth services, through remote communications technologies.  Some of these technologies, and the manner in which they are used by HIPAA-covered health care providers, may not fully comply with the requirements of the HIPAA Rules.”

Washington State has grown telehealth since 2015

Even before social distancing requirements, virtual appointments for diagnoses and treatments that don’t require direct physical examination have gained popularity. Before COVID-19 took hold, Washington’s 2020 legislature passed HB 2728 to support further development of children’s behavioral health services delivered through telemedicine.

In order to meet needs in some rural communities and underserved fields, such as psychiatry, Washington’s telemedicine parity law was updated by the 2015 legislature. Those updates went into effect in 2017 (SSB 5175).

The law enables providers to seek reimbursement for most services provided virtually if those same services would be covered by insurance if they were delivered in person. The law defines telemedicine as “the delivery of health care services through the use of interactive audio and video technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment.”

Telephone (“audio only”) services or provider guidance by facsimile (FAX) or email may not be covered. Families can check with their insurance carrier to make sure an appointment would be covered if video could fail during the appointment or is unavailable because of a technology complication.

Generally, telemedicine is covered by insurance if:

  • The payor would cover the service if it was provided in-person, and the service can reasonably be provided without direct contact.
  • The health care service is medically necessary.
  • The service is recognized as an essential health benefit under the federal Patient Protection and Affordable Care Act

Individual providers create their own policies about whether they provide services electronically, and the parity law doesn’t guarantee equal reimbursement. Washington is part of the Interstate Medical Licensure Compact, making it easier for providers to get licensed in multiple states and provide services to a broader clientele, including through telemedicine.

Families with Medicaid in Washington State, which is called Apple Health, can find information related to telehealth from the Health Care Authority. In keeping with federal guidance, Medicaid in general is reimbursing telehealth services at the same rate they would reimburse in-person services during the pandemic.

TRICARE expands options for military families, including ABA

TRICARE provides coverage for medically necessary telemedicine visits from providers who offer that service. Preventive health screenings, psychiatric care and medication consultations are examples of appointments that are most easily held virtually. Depending on the TRICARE plan, an authorization or referral may be needed.

In addition, TRICARE is extending telehealth for families who access Applied Behavior Analysis (ABA) and are enrolled in the Autism Care Demonstration (ACD) March 31- May 31, 2020. This temporary extension includes ABA support to parents/caregivers, and the services don’t require the child to be present at the telehealth appointment.

How do I prepare for a telemedicine appointment?

Before services are rendered, providers are required to seek informed consent from patients and/or legal guardians and to provide information about how the technology works and how privacy is protected. Electronic signatures are generally acceptable, particularly as the state requires social distancing. The Washington State Department of Social and Health Services (DSHS) provides a downloadable guidebook about telehealth

Prepare for a routine check-up like you would if you were visiting the clinic: Write down questions and concerns, including any changes related to health or medication. A visual tutorial, created by the Department of Health in Hawaii, walks through the different types of telehealth and what someone might expect.

If you suspect COVID-19, carefully document symptoms. The Centers for Disease Control (CDC) provide a COVID-19 screening tool. Be sure to note anything about the illness or its possible treatment that might be affected by a disability condition.

If testing is prescribed, a drive-through testing site may be suggested. The Americans with Disabilities Act (ADA) affords individuals the right to accommodations when accessing what is publicly available. The Northwest ADA Center provides guidance about drive-through testing, specifically addressing topics related to blindness, deafness or wheelchair access, for example. Prepare for the telehealth appointment with any questions related to drive-through testing and disability, if that topic might come up.

What if I don’t have internet or a cell phone?

Families who do not have internet at home may be able to get service for free or low cost because of the pandemic. Some internet providers offer free internet for a limited time, based on income. Internet Essentials from Comcast and Charter Communications are examples. Their services are based on income, and students with free and reduced lunches are among those who may qualify.

Washington’s  Department of Social and Health Services (DSHS) is providing free cell phones and minutes to low-income families through a federal program called Lifeline. State-specific information about this option is available from the Health Care Authority.

How can I plan for an in-person doctor visit or emergency?

Children with complex medical needs may still need an in-person doctor visit for some conditions. General guidance is to call ahead if there is concern that anyone in the family might be ill so medical staff can take precautions to protect everyone from exposure to illness. In many locations, individuals are screened and checked for fever before they enter the facility.

For a medical emergency, prepare to offer first-responders clear information about the nature of the emergency. If a member of your household has a chronic condition that may create an urgent care situation, prepare a handout with basic information in advance. PAVE’s article about a Care Notebook might help. Because personal protective equipment (masks, gloves, gowns) are in short supply, responders will send minimal staff for less urgent circumstances. If the situation is clearly life or death, a larger team may suit up with personal protective equipment in order to help.

Many dental offices have closed, although some may remain open for emergency procedures. Call ahead: Schedules and policies are changing rapidly.

Caregivers of children with complex needs face additional challenges

Being the caregiver for a child with significant medical needs adds additional layers to current circumstances. Here are questions some will face:

  • Is my child’s medical need worth the risk of exposure to a hospital setting?
  • What are the short-term and long-term considerations in changing the plan for care during this time of national crisis?

The answers obviously are personal and different for every family’s circumstances.

While facing tough choices and uncertain times, your self-care is critical, and PAVE offers an article with ideas just for you. Of course, start with the basics: breathe with intention, nourish your body and seek points of fun and connection each day. Staying connected to a child’s care team can help, so you’re already in touch if there’s an emergent medical situation.

PAVE’s Family-to-Family Health Information Center continues to provide information for families and caregivers of children with disabilities and special healthcare needs in Washington State. Fill out a Helpline Request Form at wapave.org for individualized assistance.

Stay-Home Help: Get Organized, Feel Big Feelings, Breathe

A Brief Overview

Full Article

Big feelings are happening. We feel them, and we care for others who are having them. Times of uncertainly cause stress that makes big feelings feel bigger. Emotions might seem to run away with all the energy we had left. It can feel hard to breathe, and it’s easy to lose a sense of control over what happens within the span of a day.

Taking time to pause and organize the days ahead can help, especially if mindfulness and breath practices are built into the schedule.

Here’s a to-do list for every day

  1. Have a plan
  2. Be real with big feelings
  3. Breathe

The rest of this article provides ideas about these three strategies. Please note that resources included are not affiliated with PAVE, and PAVE does not recommend or endorse these programs or services.

Organize the day to create predictability

Getting organized with a clear routine is helpful because predictability calms the nervous system, suggests the Collaborative for Academic, Social, and Emotional Learning (CASEL). CASEL offered a webinar in early April to help parents and educators explore Social Emotional Learning (SEL) during the stay-home order related to COVID-19.

A key presenter was Jennifer Miller, founder of Confident Parents, Confident Kids, which  provides an article for parents: Setting up for Homework Success. Miller offers a video describing how to establish a morning routine to give each day a predictable jump-start. She advises families to schedule intentional moments for loving connection throughout each day. For example, one of her family’s rituals is a hallway hug first thing out of bed.

To support children in feeling safe, confident and in control, Miller recommends that adults plan-ahead to speak out loud when they notice children taking care of business: “I notice you are getting dressed…brushing teeth…feeding the dog… all by yourself.”

Predictability, contribution and accomplishment are all feelings that calm the brain and can be part of making and maintaining a family schedule. Miller advises that all members of the family work together to design the plan.

The family’s daily schedule can include a wake-up routine, movement, nature time, academics, rest time, meals and shared cooking/cleaning, screen time, art time, chores, reading, bath time, bedtime…. The schedule can have words and/or pictures and should be posted where everyone can refer to it.

Generally, children respond well to having some built-in choices and a variety of brain breaks. Sample family schedules are easy to search for online; families might prefer to design their own format, just for them.

Here are some places to look for ideas:

  • Mother.ly shares a mom’s family schedule that “went viral” during the pandemic.
  • Get-Organized-Mom.com offers printable forms and samples for how to use them.
  • Adding Homeschool to an online search brings up a wide selection of options, some for free and some with a small cost.

Feel big feelings, and let others feel theirs too

Generally, humans are emotional. We feel, and we respond to what we feel. Squished emotions usually don’t go away but loom larger. Here are a few strategies for being with big feelings:

Talk openly: Big feelings can be more manageable when they are spoken and shared. Ask another person, What are you feeling right now? Listen without judgment or analysis. Here’s one way to respond: Wow, that’s a lot to feel. Tell me more. A Sesame Street program called  Here for Each Other offers a 90-second video posted to YouTube to help adults talk to children about Big Feelings. To help families discuss feelings specifically related to COVID-19, PBS.org provides toolkits in English and Spanish.

Name it to tame it: Dan Siegel, a neuroscientist, recommends calling out emotions in order to manage them. Here’s a short video: Name it to tame it. To make brain science practical, Siegel talks about an upstairs brain and a downstairs brain. When the downstairs brain (emotion) controls the show, the upstairs brain (learning/problem-solving) clicks offline. Here are some ideas for what to do if someone is overwhelmed by emotion:

  • Create a safe physical space: Offer a drink of water, a blanket, a stuffed animal.
  • Keep a kind voice, move slowly, and back away/get low if your energy might feel like a threat (if you are a bigger or have more power, for example).
  • Turn down lights or turn on music if that makes sense for the other person.
  • Say something to simply acknowledge the big feelings: “I understand that (this is hard, makes you mad, scares you…).”
  • Allow enough time for the brain finds a way back “upstairs.”
  • When things are calm, work together to describe the big feelings and the experience of being with those feelings. 

Use pictures to identify emotions: Charts to help identify emotions are easy to find. Here’s a link on Pinterest with dozens of examples of printable or hand-made options. Making a chart together can create learning on many levels. A teacher might have a feelings chart to share.

Notice that feelings aren’t who you are: This strategy is from a meditation technique called Integrative Restoration (iRest.org). Notice a feeling as separate from the bigger picture of who you really are. Here’s a statement to sort that out: I have feelings, but I’m not my feelings. What happens when that statement is made? Is it possible to catch feelings in the act of forming or changing? This can be a conversation you have in your own mind or with another person.

Explore feelings through the body: This technique is common in yoga. Ask someone else or yourself: What feelings are happening right now, and where is the body feeling them? Talk about how a feeling seems to “live” in a certain place—or travel around the body. There is no good, bad, right or wrong way to feel. Give yourself or a family member permission to move around and maybe make sound in a way that safely helps the emotion express itself.  GoNoodle.com offers additional strategies for children to explore movement and mindfulness.

Schedule mindfulness: Make sure that big feelings have time to be seen and heard. According to an article for parents from the Child Mind Institute, “Designating time to practice mindful activities as a family will help everyone feel less anxious. It could be a daily family yoga session, or a quiet walk in the woods as a group, taking time to focus on the way the air feels, the sound of the birds and the smell of the trees. Another good family mindfulness idea is asking everyone to mention one good thing they heard or saw that day over dinner.” The Child Mind Institute provides access to live video chats with clinicians, telemedicine and more. The agency provides guidance in English and Spanish and offers parents an opportunity to sign up for a COVID-19 tip of the day.

Breathe with trees and plants

A calming breath works like a life vest when it feels like emotions are rushing us downriver and threatening to take us under. The basic goal is to regulate the flow of oxygen into the bloodstream and to make sure that carbon dioxide is being expelled in a balanced way. Here’s one idea for a breath that might boost relaxation:

  • Find a place where you can see a tree or a plant. Notice details about the leaves, needles or branches.
  • Note that trees and plants release oxygen into the air.
  • Breathe in gently and feel like the plant or tree is giving oxygen to you.
  • Breathe out gently and consider that your carbon dioxide is the food the tree or plant needs.
  • Experience a moment of being grateful that nature is breathing with you. Say thank you if it feels good to say it out loud.

PAVE provides a 5-minute video to help you breathe with trees and plants!

Feeling panic? Breathe easy and smooth

When anxiety causes feelings of panic, easy is the magic word for breathing. Some evidence suggests that a stressed-out person might feel more anxious by taking breaths that are too slow or deep. Dizziness, shortness of breath and feelings of suffocation can be signs that the gases exchanged during a breath aren’t balanced well. Here’s one source for information about why even breathing might be more calming than a really big, deep breath: LiveScience.com.

Here’s something to practice regularly to help your body find its calm, easy breath:

  • Notice your breath and just watch it for a little bit.
  • Start counting as you inhale and notice how long that lasts.
  • Start to match the inhale count and the exhale count.
  • Don’t try to slow your breath down, but gently try to make each breath about the same, counting the same time on the inhale and the exhale.
  • Don’t work to fill or empty your lungs all the way. Keep it easy.
  • Try breathing evenly for at least a minute—longer if you enjoy it.

Bonus Ideas: Consider whether there’s a young person in your house who could learn this breath, practice and then teach it to someone else. Another idea is for a child to practice breathing with a stuffed animal. On their tummy, the stuffed animal goes for a ride. Being hugged, the animal can feel the breath too.

PAVE hopes the ideas in this article might help your family members organize themselves around days and weeks at home that might nourish everyone with moments of peace, personal growth and learning. Understanding how to be with big feelings and breathe with ease can take a bit of practice, but the result can build emotional resilience. We hope all can find simple ways to make emotional learning and self-care part of each day to support the well-being of all.

If you need direct support in caring for children with special educational or medical needs, please click Get Help from our home page, wapave.org.

For serious conditions related to mental health and to find a professional provider, contact the Washington Recovery Help Line: 866-789-1511.

The WA State Department of Health provides a Behavioral Health Toolbox for Families Supporting Children and Teens During the COVID-19 Pandemic, published in July 2020. Each age-specific section (toddlers, school-age children, teens) includes information on common emotional responses, helping children heal and grow, and managing feelings and behaviors children may experience.

School Shutdown: Pandemic Guidance for Families also Impacted by Disability

A Brief Overview

  • Governor Jay Inslee announced April 6, 2020, that Washington school buildings are closed to regular instruction at least through the end of the school year because of the COVID-19 pandemic.
  • During the shutdown, schools and families are seeking creative ways to help all children learn, said Washington’s Superintendent of Public Instruction, Chris Reykdal, who participated in the April 6 press conference with Gov. Inslee.  “Especially during times of uncertainty,” Reykdal said, “students need our support. They need grace, and structure, and routine. Even though the world may feel like it’s upside down, our students need to know that we will move forward.”
  • PAVE’s program to provide Parent Training and Information (PTI) continues to offer 1:1 support by phone in addition to online learning opportunities. Please refer to our home page at wapave.org to “Get Help” or to check the Calendar for upcoming events. A PTI webinar recorded live March 26, 2020, provides information about the rights of students with disabilities.
  • For questions about delivery of special education during the school building closures, families also can visit the website of the Office of Superintendent of Public Instruction (OSPI), which maintains a page, Special Education Guidance for COVID-19. Ways to support inclusion during the closures and a downloadable spreadsheet of online and offline resources for continuing learning are clickable links on that page.
  • Providing families with access to meals has been a priority for schools. An interactive map on the website of Educational Service District 113 includes information from schools across Washington about where meals are delivered and addresses for where families can pick up free food by “Grab-and-Go.”
  • The U.S. Department of Education has created a website page to address COVID-19. Links on the website, gov/coronavirus, include a Fact Sheet titled, Addressing the Risk of COVID-19 in Schools While Protecting the Civil Rights of Students, issued by the department’s Office for Civil Rights (OCR).
  • For additional resources, see Links to Support Families During the Coronavirus Crisis and Links for Learning at Home During School Closure.

Full Article

With school buildings closed to help slow the spread of the novel coronavirus (COVID-19), families have many questions about how children can access meals, childcare and basic education. Recognizing that too much information can be overwhelming, PAVE provides this article to help families with children impacted by disability understand a few key issues during this challenging time. Included throughout are links to information on official websites that are frequently updated.

Nationally, agencies that provide guidance to schools have been in conversation about the challenge of providing equitable education to all students as learning that respects the requirement for “social distancing” becomes the only option. The U.S. Department of Education is tracking much of that work on its website, gov/coronavirus.

Most schools in Washington resumed services with distance learning on March 30, 2020. Some districts planned a later start because of spring break schedules. Chris Reykdal, Washington’s Superintendent of Public Instruction, issued guidance that all schools within the state offer something in order to engage students in learning.

He emphasized that families and schools should maintain an attitude of creativity and patience and that the goal is not to overwhelm parents and students. The guidance is not a mandate for students, Reykdal said, and the state is not directing schools to grade student work during this period of distance learning. The expectation is that districts “are sending opportunities for families and checking in,” he said in comments quoted in a March 30 broadcast and article from KNKX, a National Public Radio affiliate.

Various federal and state laws protect students with disabilities and their right to a Free Appropriate Public Education (FAPE), regardless of the nature or severity of the disability. How to provide education that is appropriate and equitable when school buildings are closed is a national conversation. In Washington State, the Office of Superintendent of Public Instruction (OSPI) is continuously updating guidance for schools and families on these topics.

An OSPI website page devoted to special education topics during the COVID-19 shutdown includes this guidance: “If the district continues providing education opportunities to students during the closure, this includes provision of special education and related services, too, as part of a comprehensive plan.”

In a March 18, 2020, letter to school staff who support Individualized Education Programs (IEPs), OSPI encouraged IEP reviews and evaluations to continue as possible: “School districts are encouraged to continue to hold IEP and evaluation meetings through distance technology whenever possible, and if agreed upon by parents and school staff are available.”

Meals are a top priority

The Superintendent of Public Instruction, Chris Reykdal, provided information March 19, 2020, in a webinar sponsored by the Washington League of Education Voters. Note: the League of Education Voters offers a comprehensive listing of COVID-19 resources.

Reykdal said that OSPI has prioritized food distribution for students as its most important role during the shutdown. He said some districts deliver food to stops along regular bus routes. Others have food pick-up available in school parking lots. For the most current information about how a district is making meals available for students, families are encouraged to check their local district website or call the district office. OSPI provides a list of districts throughout the state, with direct links to district websites and contact information.

An interactive map on the website of Educational Service District 113 includes information from schools across Washington about where meals are delivered and addresses for where families can pick up free food by “Grab-and-Go.”

Childcare options are difficult to design

Second priority, according to Reykdal, is childcare for parents who rely on outside help so they can work. Families are encouraged to contact local districts for current information about childcare. OSPI encourages only small and limited gatherings of children, so provisions for childcare and early learning have been difficult to organize, Reykdal said. He emphasized that public health is the top concern. “We have to flatten that curve,” he said, referencing a widely shared graphic that shows what may happen if the virus is not slowed by intentional measures.

Note that the Centers for Medicare and Medicaid have relaxed rules in order to give states more flexibility in providing medical and early learning services through remote technologies. The Early Childhood Technical Assistance Center (ECTA) has created a webpage on teleintervention. Topics include training for families learning to navigate technology for online learning and appointments.

Equity is required in education

Thirdly, Secretary Reykdal on March 19 addressed work underway to create new models for distance learning. “Everyone needs to be super patient about this because while districts are preparing to deploy some education, it will look different. And there are serious equity concerns we have to focus on. We expect districts as they launch this to have an equitable opportunity for all students. English language learners need special supports. Our students with disabilities need supports.”

At the April 6, 2020, press conference, Reykdal mentioned that some schools may open on a very limit basis in order to provide services to a few children with significant disabilities. He said OSPI would be consulting with schools throughout the state to develop models for best-practice IEP implementation during the national crisis. “Especially during times of uncertainty,” he said, “students need our support. They need grace, and structure, and routine. Even though the world may feel like it’s upside down, our students need to know that we will move forward.”

PAVE is here to help!

PAVE’s Parent Training and Information (PTI) program continues to provide 1:1 support by phone and offers online training. Please check our calendar of events and follow us on social media.

PTI director Jen Cole addressed some topics related to educational access during a March 19, 2020, podcast hosted by Once Upon a Gene. In addition to providing general information about the rights of students with disabilities, Cole shares her own experience as a parent of an elementary-age student with a disability.

PAVE has added new links on our website to help families navigate these new circumstances. On our homepage, wapave.org, find the large blue button labeled View Links. Clicking on that button will open a list of options. Two new options provide guidance related to the pandemic:

  1. Links for Learning at Home During School Closure: This a resource collection of agencies providing online learning opportunities for various ages.
  2. Links to Support Families During the Coronavirus Crisis: This is a resource collection of agencies that provide information related to the pandemic.

Please note that resources listed are not affiliated with PAVE, and PAVE does not recommend or endorse these programs or services. These lists are not exhaustive and are provided for informational purposes only.

OSPI offers guidance for families

The Office of Superintendent of Public Instruction (OSPI) is the state education agency charged with overseeing and supporting Washington’s 295 public school districts and seven state-tribal education compact schools. As communities respond to the COVID-19 outbreak, OSPI offers a downloadable guide for parents and families.

Included is a section for parents of students in special education. While in session, districts maintain the responsibility to provide a Free Appropriate Public Education (FAPE) to students eligible for special education. “Districts should be communicating with parents and guardians prior to, during, and after a school closure regarding their child’s IEP services,” OSPI states.

Parents may want to consider whether compensatory education or Extended School Year (ESY) services will be needed. The general rights to these services are further described in an article about ESY on PAVE’s website.

Making notes in order to collect informal data about any regression in learning during the shutdown may be important later. OSPI’s resource guide states: “After an extended closure, districts are responsible for reviewing how the closure impacted the delivery of special education and related services to students eligible for special education services.”

OSPI reminds families that schools are not required to provide special education services while they are fully closed to all students.

OSPI addresses issues related to racism

In its guidance, OSPI encourages schools to intentionally and persistently combat stigma through information sharing: “COVID-19 is not at all connected to race, ethnicity, or nationality.”

OSPI advises that bullying, intimidation, or harassment of students based on actual or perceived race, color, national origin, or disability (including the actual disability of being infected with COVID-19 or perception of being infected) may result in a violation of state and federal civil rights laws:

“School districts must take immediate and appropriate action to investigate what occurred when responding to reports of bullying or harassment. If parents and families believe their child has experienced bullying, harassment, or intimidation related to the COVID-19 outbreak, they should contact their school district’s designated civil rights compliance coordinator.”

U.S. Department of Education provides written guidance and a video

The U.S. Department of Education provides a website page to address COVID-19. Links on the website, ed.gov/coronavirus, include a Fact Sheet titled, Addressing the Risk of COVID-19 in Schools While Protecting the Civil Rights of Students, issued by the department’s Office for Civil Rights (OCR):

“Section 504 of the Rehabilitation Act of 1973 prohibits disability discrimination by schools receiving federal financial assistance. Title II of the Americans with Disabilities Act of 1990 prohibits disability discrimination by public entities, including schools. Title VI of the Civil Rights Act of 1964 prohibits race, color, and national origin discrimination by schools receiving federal funds….

“School districts and postsecondary schools have significant latitude and authority to take necessary actions to protect the health, safety, and welfare of students and school staff….As school leaders respond to evolving conditions related to coronavirus, they should be mindful of the requirements of Section 504, Title II, and Title VI, to ensure that all students are able to study and learn in an environment that is safe and free from discrimination.”

On March 21, 2020, the department issued a Supplemental Fact Sheet to clarify that the department does not want special education protections to create barriers to educational delivery options: “We recognize that educational institutions are straining to address the challenges of this national emergency. We also know that educators and parents are striving to provide a sense of normality while seeking ways to ensure that all students have access to meaningful educational opportunities even under these difficult circumstances.

“No one wants to have learning coming to a halt across America due to the COVID-19 outbreak, and the U.S. Department of Education does not want to stand in the way of good faith efforts to educate students on-line. The Department stands ready to offer guidance, technical assistance, and information on any available flexibility, within the confines of the law, to ensure that all students, including students with disabilities, continue receiving excellent education during this difficult time.”

The Department’s Office for Civil Rights (OCR) released a YouTube video March 17, 2020, to describe some ways that OCR is providing technical assistance to schools attempting to offer online learning that is disability accessible. Kenneth L. Marcus, assistant secretary for civil rights within the Department of Education, opens the video by describing federal disability protections:

“Online learning is a powerful tool for educational institutions as long as it is accessible for everyone. Services, programs and activities online must be accessible to persons, including individuals with disabilities, unless equally effective alternate access is provided in another manner.”

Help is available from Parent Training and Information (PTI)

Families who need direct assistance in navigating special education process can request help from PAVE’s Parent Training and Information Center (PTI). PTI is a federally funded program that helps parents, youth, and professionals understand and advocate for individuals with disabilities in the public education system. For direct assistance, click “Get Help” from the home page of PAVE’s website: wapave.org.

PTI’s free services include:

  • Training, information and assistance to help you be the best advocate you can be
  • Navigation support to help you access early intervention, special education, post-secondary planning and related systems in Washington State
  • Information to help you understand how disabilities impact learning and your role as a parent or self-advocate member of an educational team
  • Assistance in locating resources in your local community
  • Training and vocabulary to help you understand concepts such as Free Appropriate Public Education (FAPE), an entitlement for individuals who qualify for special education under the Individuals with Disabilities Education Act (IDEA).