Self-Advocacy: Becoming an Active Member in Your Community

Brief overview:

  • Self-advocacy means taking responsibility for telling others what you need and want in a respectful and direct way. Anyone can be a self-advocate
  • This article will share ways to learn and practice self-advocacy.
  • It will share ways you can get involved in your community and how being a good self-advocate can help you do that.

If you have ever defended your rights or the rights of other people, you were acting as an advocate. Self-advocacy means taking responsibility for telling others what you need and want in a respectful and direct way. Anyone can be a self-advocate. Speaking up for yourself or someone else can help you be independent, and in charge of decisions for your life. However, it’s not always an easy thing to learn to do. It takes time and practice. This article will share ways to learn and practice self-advocacy. It will share ways you can get involved in your community and how being a good self-advocate can help you do that.

When you might need to be a self-advocate:

  • In your IEP meeting if you are in high school
  • When you ask for accommodations in high school or college
  • Asking for accommodations on the job
  • Asking for assistance and accommodations so you can be involved in your community
  • At a medical appointment

Things you need to know to become a better self-advocate:

  • Understand your civil rights and responsibilities
  • Know about the topic you are speaking about
  • Listen to other people and think about what they are saying
  • Make decisions based on what you need or want
  • Know that it’s ok to change your mind
  • Know that it’s ok to make mistakes
  • Express your feelings clearly and calmly
  • Ask to be always treated with dignity and respect
  • Learn to be assertive without being aggressive or disrespectful

Nemours TeensHealth has resources that can help you practice self-advocacy by being assertive. Assertiveness is the ability to speak up for yourself in a way that is honest and respectful. The articles have a built-in listening app (ReadSpeaker) to hear articles instead of reading them.

One way to help meetings and discussions be calm and respectful is to ask for meetings to be a “gracious space”. “Gracious space” is about people meeting together in person or online. It has a lot in common with being a good self-advocate. “Gracious space” is a way to describe how meetings and discussions can include people, and how people can behave during a meeting.

  • If the meeting is in-person, the physical meeting space is accessible for people with all types of disabilities. If it is online, the people setting up the meeting make sure the online platform is accessible for people with all types of disabilities.
  • People feel safe in the meeting. This means everyone treats everyone else with dignity and respect. Make an agreement about how everyone at the meeting will behave with each other.
  • People in the meeting are willing to listen and think about different opinions
  • The people in the meeting get to know each other

Learn more about Gracious Space:

Person Centered Planning:

Your person-centered plan, if you have one, can help you find ways to be involved in your community. Your person-centered plan team can help you practice being a self-advocate with people you already know and trust. If you don’t have a person-centered plan, and are interested in how they work, here are links to information from PAVE: What is Person Centered Planning?

PAVE has programs and resources to help individuals build and strengthen self-advocacy skills.

Ways to get involved in your community, including people with and people without disabilities

  • What are you interested in? Here are some ideas:
  • Work with other people to change government policies and advocate for people with disabilities
  • Volunteer for a cause you believe in
  • Share what life is like living with a disability with other people with your type of disability
  • Careers and businesses that can work well for people with disabilities.
  • Friendship and socializing with other people with disabilities
  • Join a club or group to do activities you like, such as sports or crafts or music or board games or movies

When you join a group or talk with someone in a group you are interested in, you can use your self-advocacy skills to make sure that people in the group or program can give you assistance, accommodations if you need them, and treat you with respect.

You can find groups and organizations that do all these things on social media!

Social media gives you ways to meet people through online groups, if you have difficulty with in-person activities. You can check if a group or organization is disability-friendly in their profile. Remember to use social media safely!

You can also do an internet search using terms like “disability organizations in [name of state or town]. And of course, you can ask your family and friends and, if you have one, the people on your person-centered plan team!

Becoming a strong self-advocate is important for successful independence and healthy living as an adult in your community. Always remember there are many people who are ready and willing to help you, so don’t be afraid to reach out and ask for assistance along the way!

Helping a Loved One with a Fear of Needles Get Vaccinated

Families have different reasons for not vaccinating their children against COVID or other illnesses. The Washington Department of Health (DOH) reports that vaccination rates dropped 13 percent in 2021. If you’ve put off taking your child to get a vaccine because your child falls apart with fear at the sight of a needle, here are some tips and tricks to break through that barrier.

Tips and Tricks

  • Explain why they are getting a vaccination in words they understand. For example, “If you don’t get vaccinated you might get sick and miss your birthday party.”
  • Bring brave with you. A favorite superhero on a picture, a hat, a shirt, or a mask provides something to look at and makes them feel brave while they get their shot. If Grampa is their superhero, bring a picture of him!
  • Don’t lie. Be honest that this isn’t fun. Let them know you understand their feelings and reassure them that they are brave enough to get this accomplished.
  • Tell their doctor or nurse before the appointment that your loved one has a fear of needles and ask for ideas. Go in with a shared plan for how to calm, distract, or reward your brave one.
  • Ask if there’s a cream or spray to numb the injection site. If yes, use this information to explain why they probably won’t feel a thing.
  • Give them control. When do they want to go? Do they want company? Do they have any ideas about how to feel brave or how to earn a reward?
  • Practice breathing slow and easy and talk about how to use that breath anytime you are feeling afraid or anxious. You might mention that calm breathing reduces pain.
  • Bring a treat or preferred distraction for the waiting room: games, shows on the tablet, a favorite toy…or plan some new jokes.
  • If it’s better not to look at anything, help them close or cover their eyes. You can offer a hand to squeeze or something to hold or touch—like a favorite blanket, pillow or stuffed animal—to direct sensory attention away from the place where the needle goes in.
  • If they want you to stay during the injection, be calm yourself. Calm is contagious.

Resources and Related Information

  • Pediatricians build vaccination schedules for children at specific ages and stages to maximize their effectiveness. Waiting until later might harm your child.
  • The federal Centers for Disease Control and Prevention (CDC) has detailed recommendations for Child and Adolescent Immunizations, including a schedule.
  • If a person is allergic to eggs, gelatin, polyethylene glycol, or yeast, let a doctor know. Some vaccines include these ingredients. If you ask, there may be another option.
  • All CDC recommended vaccinations go through a rigorous Testing and the Approval Process.
  • If you have read, heard, or thought about something that makes you nervous, tell your doctor. Always ask where information comes from, and check to make sure the source is trustworthy.

COVID Considerations for Families to Plan for Fall 2022

A Brief Overview

  • Free COVID vaccinations are available for adults and for children as young as six months.
  • Washington State does not require students to be vaccinated against COVID to enroll for school in the 2022-23 academic year.
  • Local school districts establish their own policies and procedures for health and safety and illness response.  

Full text of video

Over a million Americans have died of COVID, and transmission rates  in Washington State remain high as we head into the 2022-23 school year.

Individual school districts decide what restrictions and policies to put in place for students, teachers, and staff. Families can ask their school district for specific information about safety measures and what to do if a student is ill or exposed to someone who is ill or testing positive for COVID.

The Office of Superintendent of Public Instruction, OSPI, provides guidance and suggestions for school staff and families on its COVID-19 Resources Page.

Whether to vaccinate your children remains a personal choice. The Washington State Board of Health has the authority to require COVID-19 immunization for children in K-12 schools but has not done that, as of Summer 2022.

Although not responsible for deciding whether to require vaccines, the state’s Department of Health, DOH.wa.gov, is a place to get current information and recommendations.

What protections against COVID are there for children and teens?

The federal government is providing COVID-19 vaccines free of charge to everyone living in the United States, regardless of their immigration or health insurance status.

Free vaccinations are available to people 6 months and older. The Centers for Disease Control and Prevention, the CDC, has approved the two-dose Pfizer and Moderna vaccinations for toddlers, children, and teens.

Here are three ways to find out how and where to get vaccinated for free:

  1. Search vaccines.gov
  2. Text your ZIP code to 438829
  3. Call 1-800-232-0233

Children and teens ages 5 through 17 are advised to get a third “booster” dose of the vaccine if they have moderate or severe difficulties with their immune system.

All employees in educational settings are required to be fully vaccinated or have a medical or religious exemption. OSPI provides more information about that requirement in a document that includes Frequently Asked Questions.

The Washington Department of Health has created Requirements and Guidance for minimizing transmission of COVID in schools and childcare settings, including isolation of anyone who shows symptoms of COVID.

Click Get Help at wapave.org for individualized support from PAVE.

Summer Daily Activity List – Taking care of YOU!

PAVE has created a suggested list of activities to follow every day this summer. Give yourself grace if you cannot do everything on the list. Nobody is keeping track. Your reward will be a healthy mindset! Type Mindfulness into the search bar on our website to find other articles and videos to support self-care for everyone in the family. 

List of Daily Activities for the Summer Print list on wapave.org

Click to view this list in PDF form

Start the day with a self-care routine – Do all!

  • Eat breakfast
  • Get dressed and take a shower if needed
  • Brush teeth and hair
  • Pick up your room and make your bed
  • Put away four things that are out of place

Take care of your home – Pick one!

  • Help to wash dishes
  • Load /unload the dishwasher
  • Vacuum one room
  • Empty the garbage
  • Do a new chore!

Build your body – Pick one or more!

  • Challenge yourself to do something outside for at least one hour
  • Go for a walk, walk a pet, or draw with sidewalk chalk
  • Help make a yummy healthy meal
  • Play with friends or swing at a nearby park
  • Tired or crabby? Take a nap!

Build your brain

Build your brain – Pick one or more!

  • Do a puzzle, play with Lego bricks, make music
  • Write a story, read a book (at least 1 chapter or 20 minutes)
  • Choose something else creative that you enjoy

Build up others – Pick one or more!

  • Write a letter to a friend or family member
  • Give a compliment
  • Find a small or large way to help someone: a little kindness goes a long way!

Self-Care is Critical for Caregivers with Unique Challenges

  • Self-care is not selfish. Self-care is any activity or strategy that helps you survive and thrive in your life. Without regular self-care, it can become impossible to keep up with work, support and care for others, and manage daily activities.
  • PAVE knows that self-care can be particularly challenging for family members caring for someone with a disability or complex medical condition. This article includes tips and guidance especially for you.
  • For a quick takeaway, here is a short video to inspire self-care today: Self Care for Caregivers.
  • PAVE provides a library with more strategies to cultivate resilience, create calm through organization, improve sleep, and more: Self-Care Videos for Families Series.

Full Article

Raising children requires patience, creativity, problem-solving skills and infinite energy. Think about that last word—energy. A car doesn’t keep going if it runs out of gas, right? The same is true for parents and other caregivers. If we don’t refill our tanks regularly we cannot keep going. We humans refuel with self-care, which is a broad term to describe any activity or strategy that gives us a boost.

Self-care is not selfish! Without ways to refresh, we cannot maintain our jobs, manage our homes, or take care of people who need us to keep showing up. Because the demands of caring for someone with a disability or complex medical condition can require even more energy, refueling through self-care is especially critical for caregivers. This article is for you!

Before you read anymore, try this simple self-care tool called Two Feet, One Breath. Doctors use this one in between seeing patients:

  • Notice your two feet on the ground. Feel the ground and feel your feet under you, with the weight of your body dropping into the ground through your feet. If you don’t stand on two feet, then notice whatever part of your body is connecting you to furniture or the floor.
  • Notice that you are breathing in and imagine that breath starts in your feet (or seated body) and travels all the way to the top of your head.
  • Notice that you are breathing out and imagine that your outbreath goes all the way down and out through your feet (or seated body).

Two Feet, One Breath can become part of every transition in your day: when you get out of bed or the car, before you start a task, after you finish something, or any time you go into a different space or prepare to talk with someone. This simple practice highlights how self-care can become integrated into your day.

Keep in mind: Although a day at the spa might be an excellent idea, self-care doesn’t have to be fancy or expensive to have a big impact!

These practices matter a lot, especially because almost everyone knows or cares for someone with special needs. According to the Centers for Disease Control (CDC), at least 26 percent of the population experiences a disability. The result is widespread compassion fatigue, which is a way to talk about burnout from giving more than you get.

Anyone who isn’t convinced that self-care matters may want to watch a film by National Geographic, Stress, Portrait of a Killer, which includes research data to show how caring for a child with special needs can impact parents (minute 38 includes that report).

Below are some ways to pull on your own oxygen mask first!

Connect with others

Meet up regularly with people who have similar life stressors. The Parent-to-Parent network can help by matching parents with similar interests or by providing regular events and group meetings.

Caregivers of youth who are Deaf or Hard of Hearing (DHH) can connect with other family caregivers at Washington Hands and Voices

For caregivers of young people with behavioral health conditions, there are several family-serving agencies that might provide help and solidarity. Some agencies are listed at the end of this article and in PAVE’s Behavioral Health Toolkit.

Here are additional places to find one another:

  • School
  • Sports teams
  • Community center
  • Special Needs Parent Teacher Association
  • Extracurricular events
  • Online support groups

Get Enough Sleep

The body uses sleep to recover, heal, and process stress. If anxiety or intrusive thinking consistently interrupts sleep, self-care starts with some sleeping preparations:

Move the Body

Moving releases feel-good chemicals into the body, improves mood, and reduces the body’s stress response. Walk or hike, practice yoga, swim, wrestle with the kids, chop wood, work in the yard, or start a spontaneous living-room dance party.

Here is information from the Mayo Clinic about exercise:

  • It pumps up endorphins. Physical activity may help bump up the production of your brain’s feel-good neurotransmitters, called endorphins. Although this function is often referred to as a runner’s high, any aerobic activity, such as a rousing game of tennis or a nature hike, can contribute to this same feeling.
  • It reduces negative effects of stress. Exercise can provide stress relief for your body while imitating effects of stress, such as the flight or fight response, and helping your body and its systems practice working together through those effects. This can also lead to positive effects in your body—including your cardiovascular, digestive and immune systems—by helping protect your body from harmful effects of stress.
  • It’s meditation in motion. After a fast-paced game of racquetball, a long walk or run, or several laps in the pool, you may often find that you’ve forgotten the day’s irritations and concentrated only on your body’s movements.
  • It improves your mood. Regular exercise can increase self-confidence, improve your mood, help you relax, and lower symptoms of mild depression and anxiety. Exercise can also improve your sleep, which is often disrupted by stress, depression and anxiety. All of these exercise benefits can ease your stress levels and give you a sense of command over your body and your life.

Be Mindful

Mindfulness can be as simple as the Two Feet, One Breath practice described at the top of this article. Mindfulness means paying attention or putting your full attention into something.

Focusing the mind can be fun and simple and doesn’t have to be quiet. Here are a few ways to practice that don’t involve a yoga mat or a meditation cushion:

  • Color
  • Work on/wash the car
  • Build something
  • Make art or do a craft project
  • Put together a puzzle
  • Laugh
  • Clean
  • More ideas: Mindful.org

Schedule Time

A day can disappear into unscheduled chaos without some intentional planning. A carefully organized calendar, with realistic boundaries, can help make sure there’s breathing room.

Set personal appointments on the calendar for fun, dates with kids, healthcare routines, and personal “me time.” If the calendar is full, be courageous about saying no and setting boundaries. If someone needs your help, find a day and time where you might be able to say yes without compromising your self-care. Remember that self-care is how you refuel; schedule it so you won’t run out of gas!

One of PAVE’s self-care videos for families is this one: Get Calm by Getting Organized.

Here’s more guidance: calendar.com: Why Stress Management and Time Management go Hand in Hand.

Seek Help

Respite care provides temporary relief for a primary caregiver. In Washington State, a resource to find respite providers is Lifespan Respite. PAVE provides an article with more information:  Respite Offers a Break for Caregivers and Those They Support.

Parents of children with developmental disabilities can seek in-home personal care services and request a waiver for respite care from the Developmental Disabilities Administration (DDA). Here are resources to help with that process:

For parents whose children and youth experience conditions related to behavioral health, PAVE provides a toolkit with resources for navigating crisis systems, medical care, school, and family support networks. Here are some family serving agencies:

Parents of youth who are blind or low vision may seek support from the Washington State Department of Services for the Blind (DSB). Learn from youth at PAVE: My story: The Benefits of Working with Agencies like the Washington State Department of Services for the Blind.

Parents of youth who are Deaf or Hard of Hearing (DHH) can connect with the  Office of the Deaf and Hard of Hearing | DSHS or connect with other family caregivers at Washington Hands and Voices.

Mental Health Education and Support at School can be Critical

A Brief Overview

  • Alarming statistics indicate the pandemic worsened many behavioral health outcomes for young people. Governor Jay Inslee on March 14, 2021, issued an emergency proclamation declaring children’s mental health to be in crisis.
  • President Joe Biden issued a Fact Sheet about the nation’s mental health crisis on March 1, 2022, as part of his State of the Union message. This article includes some of what the president shared about youth impacts.
  • Washington State’s 2021 Healthy Youth Survey confirms that children and youth are struggling to maintain well-being.
  • These outcomes make adolescence a critical time for mental health promotion, early identification and intervention. Read on for information and resources.
  • The emotional well-being of students may be served through Multi-Tiered Systems of Support (MTSS), which provide a structure for schools to provide education and supports related to student well-being schoolwide.
  • Students with high levels of need may access mental health support through the special education system. Emotional Disturbance is a federal category of disability under the Individuals with Disabilities Education Act (IDEA).

Full Article

Alarming statistics indicate that children and young people are in crisis. Governor Jay Inslee issued an emergency proclamation for children’s mental health on March 14, 2021. Data from Washington’s 2021 Healthy Youth Survey confirm the distressing trends:

Seven out of ten students in tenth grade report feeling nervous, anxious, on edge, or cannot stop worrying. Eight percent said they tried suicide within the past year. Almost 40 percent said their feelings were disturbing enough to interrupt their regular activities, and more than 10 percent of students said they didn’t have anyone to talk to about their feelings. According to the Centers for Disease Control and Prevention (CDC), only about half of young people who need behavioral health services get them.

According to the 2021 statewide survey, students with disabilities struggle more than most. Also over-represented are girls, students from lower income households, and students whose gender or sexuality is non-binary. Non-binary refers to more than two things; it’s a term often used when discussing people who identify as Lesbian, Gay, Bi-sexual, Transgender, Queer, or questioning (LGBTQ+). LGBTQ+ youth can seek crisis help and more from The Trevor Project.

“Reports of our children suffering with mental health issues are a worrisome public health concern,” said Umair A. Shah, MD, MPH, Washington’s Secretary of Health. “Mental health is a part of our children’s overall health and well-being. It is imperative that we all continue to work together to fully support the whole child by providing information and access to behavioral health resources to youth and the trusted adults in their lives.”

Concerns are nationwide. On March 1, 2022, President Joe Biden issued a Fact Sheet stating that grief, trauma, and physical isolation during the past two years have driven Americans to a breaking point:

“Our youth have been particularly impacted as losses from COVID and disruptions in routines and relationships have led to increased social isolation, anxiety, and learning loss.  More than half of parents express concern over their children’s mental well-being. An early study has found that students are about five months behind in math and four months behind in reading, compared with students prior to the pandemic.

“In 2019, one in three high school students and half of female students reported persistent feelings of sadness or hopelessness, an overall increase of 40 percent from 2009. Emergency department visits for attempted suicide have risen 51 percent among adolescent girls.”

Mental Health support to students is a statewide priority

Recognizing the unmet needs, Washington State’s 2022 legislature passed a variety of bills to increase support to children and youth with behavioral health conditions. Here are a few examples:

  • HB 1664: Provides funding and incentives for schools to increase numbers of staff who provide physical, social, and emotional support to students. Schools are responsible to report to the state how these funds were used for hiring staff that directly support students and not something else.
  • HB 1800: Requires Health Care Authority (HCA) to build and maintain a website (“parent portal”) to help families seek out behavioral health services. Also supports growth and training requirements for behavioral health ombuds serving youth through the Office of Behavioral Health Consumer Advocacy.
  • HB 1834: Establishes a student absence from school for mental health reasons as an excused absence.
  • HB 1890: Creates an advisory group under the Children and Youth Behavioral Health Work Group (CYBHWG) to build a strategic plan for children, youth transitioning to adulthood, and their caregivers. Also establishes a $200/day stipend (up to 6 meetings per year) for members of the CYBHWG with lived experience who are not attending in a paid professional capacity.

TIP: Family caregivers can get involved in advocacy work!

Here’s another TIP: Families can ask their school who is on site to support students with their mental health needs. Some school districts seek support from an Educational Service District (ESD) to meet student behavioral health needs, so families can also ask whether ESD supports are available. Some ESDs are licensed as behavioral health providers—just ask.

What is MTSS, and why learn this acronym to ask the school about it?

A priority for agencies involved in statewide work is implementation of Multi-Tiered Systems of Support (MTSS). Through MTSS, schools support well-being for all students and offer higher levels of support based on student need. Social Emotional Learning (SEL) is key to MTSS, which creates a structure for positive behavioral supports and trauma-informed interventions.

The Office of Superintendent of Public Instruction (OSPI) is the state educational agency for Washington schools. In its 2021 budget, OSPI prioritized MTSS as part of a plan to Empower all Schools to Support the Whole Child. In January, 2021, OSPI was awarded a five-year, $5.3 million grant from the U.S. Department of Education help districts implement MTSS. As a local control state, Washington districts determine their own specific policies and procedures.

TIP: Families can ask school and district staff to describe their MTSS work and how students are receiving support through the various levels/tiers.

Special Education is one pathway for more help

Students may access mental health support through the special education system. Emotional Disturbance is a federal category of disability under the Individuals with Disabilities Education Act (IDEA). Appropriate support can be especially critical for these students: According to the U.S. Office of Special Education Programs (OSEP), students eligible for school-based services under the ED category are twice as likely to drop out of high school before graduating.

How a student is supported in their life planning could have an impact. PAVE provides a toolkit of information about how to support a student in their preparations for graduation and beyond: School to Adulthood: Transition Planning Toolkit for High School, Life, and Work.

Note that a student with a mental health condition might qualify for an Individualized Education Program (IEP) under the category of Other Health Impairment (OHI), which captures needs related to various medical diagnoses. Other categories that often overlap with behavioral health are Autism and Traumatic Brain Injury (TBI). IEP eligibility categories are described in the Washington Administrative Codes (WAC 392-172A-01035).

In Washington State, the ED category is referred to as Emotional Behavioral Disability (EBD). If the student’s behavioral health is impaired to a degree that the student is struggling to access school, and the student needs Specially Designed Instruction (SDI), then the student may be eligible for an IEP. Keep in mind that academic subjects are only a part of learning in school: Social Emotional Learning (SEL) is part of the core curriculum. 

An educational evaluation determines whether a student has a disability that significantly impacts access to school and whether Specially Designed Instruction (SDI) and related services are needed for the student to receive a Free Appropriate Public Education (FAPE). FAPE is the entitlement of a student eligible for special education services. An IEP team determines how FAPE/educational services are provided to an individual student.

Behavioral health counseling can be part of an IEP

Counseling can be written into an IEP as a related service. When included in a student’s IEP as educationally necessary for FAPE, a school district is responsible to provide and fund those services. School districts can receive reimbursement for most of the cost of behavioral health services for students who are covered by Medicaid and on an IEP. The Health Care Authority provides information about school-based health services for students who are covered by Medicaid and on an IEP.

A student with a mental health condition who doesn’t qualify for an IEP might be eligible for a Section 504 Plan. A disability that impairs a major life activity triggers Section 504 protections, which include the right to appropriate and individualized accommodations at school. Section 504 is an aspect of the Rehabilitation Act of 1973, a Civil Rights law that protects against disability discrimination. Students with IEPs and 504 plans are protected by Section 504 rights.

Behavioral Health encompasses a wide range of disability conditions, including those related to substance use disorder, that impact a person’s ability to manage behavior. Sometimes students with behavioral health disabilities bump into disciplinary issues at school. Students with identified disabilities have protections in the disciplinary process: PAVE provides a detailed article about student and family rights related to school discipline.

Placement options for students who struggle with behavior

IEP teams determine the program and placement for a student. In accordance with federal law (IDEA), students have a right to FAPE in the Least Restrictive Environment (LRE) to the maximum extent appropriate. That means educational services and supports are designed to help students access their general education classroom and curriculum first. If the student is unable to make meaningful progress there because of their individual circumstances and disability condition, then the IEP team considers more restrictive placement options. See PAVE’s article: Special Education is a Service, Not a Place.

If general education is not working, the IEP team is responsible to consider all placement options to find the right fit. There is not a requirement to rule out every “less restrictive” option before choosing a placement that the team agrees will best serve the student’s needs.

Sometimes the IEP team, which includes family, will determine that in order to receive FAPE a student needs to be placed in a Day Treatment or Residential school. OSPI maintains a list of Non-Public Agencies that districts might pay to support the educational needs of a student. Districts may also consider schools that are not listed. Washington State has almost no residential options for students. Schools almost always send students to other states when residential placement is needed.

On May 23, 2022, a Washington affiliate of National Public Radio (KUOW) provided a report about the lack of residential programs in the state and the challenges for families whose students go out of state for residential education: Washington is sending youth in crisis to out-of-state boarding schools; taxpayers pick up the tab.

Residential placement may be necessary because educational needs cannot be served unless medical needs are fully supported. School districts may be responsible in those situations to pay for a residential placement. A precedent-setting court ruling in 2017 was Edmonds v. A.T. The parents of a student with behavioral disabilities filed due process against the Edmonds School District for reimbursement of residential education. The administrative law judge ruled that the district must pay for the residential services because “students cannot be separated from their disabilities.”

Strategies and safety measures for families and teachers

The Healthy Youth Survey is conducted every other year and was delayed from 2020 to 2021 because of the pandemic. Over the years, results are shared along with tips for families and schools. Here are a few considerations built from various data points within the survey:

Hopeful students:

  • Are more interested in schoolwork: Is there a way to make every day at school more connected to what a child cares about?
  • See people who can help: Who are the adults at school that a student can trust and go to for encouragement or guidance?
  • Believe that school is relevant to life: Who is helping the student connect what they are learning now to who they want to become?
  • Are academically successful: Are supports in place to provide adequate help so the student can succeed in learning? Evidence-based instructional strategies are key when students struggle in reading, writing, or math because of learning disabilities, for example.

TIP: Make sure these four topics are part of a school/family discussion when a student is struggling with emotional well-being or behavior that may be impacted by hopelessness.

A 2018 handout includes tips for parents and other adults who support teens who feel anxious or depressed:

  • Bond with them: Unconditional love includes clear statements that you value them, and your actions show you want to stay involved in their lives.
  • Talk with teens about their feelings and show you care. Listen to their point of view. Suicidal thinking often comes from a wish to end psychological pain.
  • Help teens learn effective coping strategies and resiliency skills to deal with stress, expectations of others, relationship problems, and challenging life events.
  • Have an evening as a family where everyone creates their own mental health safety plan.
  • Learn about warning signs and where to get help
  • Ask: “Are you thinking about suicide?” Don’t be afraid that talking about it will give them the idea. If you’ve observed any warning signs, chances are they’re already thinking about it.
  • If you own a firearm, keep it secured where a teen could not access it.
  • Lock up medications children shouldn’t have access to.

A press for school-based services and mental health literacy

Advocacy for direct school-based mental health services and education about mental health topics comes from the University of Washington’s SMART Center. SMART stands for School Mental Health Assessment Research and Training. The SMART center in 2020 provided a report: The Case for School Mental Health. The document includes state and national data that strongly indicate school-based behavioral health services are effective:

“Increased access to mental health services and supports in schools is vital to improving the physical and psychological safety of our students and schools, as well as academic performance and problem-solving skills. Availability of comprehensive school mental health promotes a school culture in which students feel safe to report safety concerns, which is proven to be among the most effective school safety strategies.”

The SMART Center in partnership with the non-profit Chad’s Legacy Project in 2021 established an online Student/Youth Mental Health Literacy Library. Intended for staff at middle and high schools, the library provides resources to help schools choose curricula for mental health education on topics that include Social Emotional Learning, Substance Use Disorder, and Suicide Prevention.

Goals of mental health literacy are:

  • Understanding how to foster and maintain good mental health
  • Understanding mental disorders and their treatments
  • Decreasing Stigma
  • Understanding how to seek help effectively for self and others

TIP: Families can direct their schools to this resource to support development or growth of a mental health education program.

For information, help during a crisis, emotional support, and referrals:  

  • Suicide Prevention Lifeline (1-800-273-TALK): After July 16, 2022, call 988
  • Text “HEAL” to 741741 to reach a trained Crisis Text Line counselor
  • Trevor Project Lifeline (LGBTQ) (1-866-488-7386)
  • The Washington Recovery Help Line (1-866-789-1511)
  • TeenLink (1-866-833-6546; 6pm-10pm PST)
  • Seattle Children’s Hospital has a referral helpline. Families can call 833-303-5437, Monday-Friday, 8-5, to connect with a referral specialist. The service is free for families statewide

Further information on mental health and suicide:  

Family Support

  • PAVE’s Family-to-Family Health Information Center provides technical assistance to families navigating health systems related to disability. Click Get Help at wapave.org or call 800-572-7368 for individualized assistance. Family Voices of Washington provides further information and resources.
  • A Facebook group called Healthy Minds Healthy Futures provides a place to connect with other families.
  • Family caregivers can request support and training from COPE (Center of Parent Excellence), which offers support group meetings and direct help from lead parent support specialists as part of a statewide program called A Common Voice.
  • Washington State Community Connectors (WSCC) sponsors an annual family training weekend, manages an SUD Family Navigator training, and offers ways for families to share their experiences and support one another. With passage of HB 1800 in 2022, WSCC is working with the Health Care Authority to build a statewide website to help families navigate behavioral health services.
  • Family, Youth, and System Partner Round Table (FYSPRT) is a statewide hub for family networking and emotional support. Some regions have distinct groups for young people.

WISe Provides Team-Based Services for Washington Youth with Severe Behavioral Health Disorders

A Brief Overview

  • WISe behavioral healthcare teams serve children and youth 20 or younger whose conditions are too severe to benefit appropriately from regular visits to a community clinician and/or therapist.
  • To qualify for WISe, the young person must be eligible for Apple Health, which is the public health program for Washington State. WAC 182-505-0210 describes Apple Health eligibility standards.
  • WISe was created as a response to the T.R. et al. lawsuit, settled in 2013.
  • Different agencies manage WISe programs in various regions of the state. The Health Care Authority manages a downloadable list of WISe agencies, organized by county. Families can contact their area agency by calling the phone number on this referral list.
  • Read on for various places families might seek solidarity and support. One option is Family, Youth, and System Partner Round Table (FYSPRT), which is a network of groups that meet to discuss what’s working/not working in behavioral healthcare systems in their communities.

Full Article

Children and youth with intensive needs related to behavioral health may be eligible for services from a statewide program called WISe–Wraparound with Intensive Services. A WISe team includes various clinical and professional staff and certified peers, who may support the emotional needs of family members.  

WISe services are provided in the community—outpatient—for children and youth 20 or younger who are eligible for public insurance, called Apple Health in Washington State. To be assigned to a WISe team, the young person must demonstrate a need for services that are more intensive than what is provided from regular visits to a community clinician and/or therapist.

What does behavioral health mean?

Behavioral health is a broad term describing services for people with conditions based in the brain that impact their behavior. Bipolar disorder, schizophrenia, and substance use disorder (SUD) are examples of severe behavioral health conditions impacting some adults and young people.

Other childhood conditions are many and varied, and not everyone uses the same terms for the same symptoms. The Child Mind Institute is a place for information about childhood symptoms, diagnoses, and options for treatment and support.

Some developmental conditions, such as autism, are considered behavioral health conditions when symptoms have a significant impact on behavior. A person with a complicated behavioral health condition may have impacts in multiple areas and may be given a “dual diagnosis.”

Who is eligible for WISe services?

WISe services are for children and youth until their 21st birthday. WISe is only approved if the patient has used other, less intensive therapies, with little to no improvement.  Once approved for services, a young person may spend time on an “interest list,” receiving limited support, before a full team is formed to serve them.

The young person is evaluated with a Child and Adolescent Needs and Strengths (CANS) intensive mental health screening tool, called the CANS-SCREEN.

Five core areas are evaluated:

  1. Life functioning
  2. Behavioral and emotional needs
  3. Risk behaviors
  4. Caregiver resources and needs
  5. Diagnosis and prognosis

According to the CANS-SCREEN, “The care provider, along with the child/youth and family as well as other stakeholders, gives a number rating to each of these items. These ratings help the provider, child/youth and family understand where intensive or immediate action is most needed, and also where a child/youth has assets that could be a major part of the treatment or service plan.”

WISe requires public health insurance eligibility

In addition to meeting criteria based on their symptoms, a young person must be eligible for Apple Health, which is the name for public health insurance in Washington State. The Washington Administrative Code (WAC 182-505-0210) describes Apple Health eligibility standards for children.

Apple Health is most often administered by Managed Care Organizations (MCOs). In 2022, plans are provided by Amerigroup, Community Health Plan of Washington (CHPW), Coordinated Care, Molina, and United Healthcare. Families can request case management from their MCO to help them navigate and understand healthcare options available to them.

An MCO care coordinator/case manager commonly is the person who refers a young person into WISe, although referrals also can be made by the family, a provider, a county health agency, or someone else with knowledge of the circumstances.

Different agencies manage WISe programs in various regions of the state. The Health Care Authority manages a downloadable list of WISe agencies, organized by county. Families can contact their area agency by calling the phone number on this referral list.

Who is on the WISe team?

Team members include:

  • Natural supports (family, friends, religious leaders…)
  • A Care Coordinator (who oversees clinical aspects of the case)
  • Therapist
  • Professionals (clinicians/prescriber if needed, Child Protective Services, probation officers and others who are relevant)
  • Certified peer support specialist
  • Others upon request (youth peer, school staff…)

The clinical group creates a Team Vision Statement, explaining what they plan to achieve and how they will accomplish it through collaborative work. The family also creates a Vision Statement, showing what strengths they would like to build in their family and what tools they need to make their goals possible.

WISe requires family engagement

The time commitment for WISe is significant. Clinicians engage with the whole household on topics related to school, health, work, relationships, home organization, and more.

WISe publishes data about its service delivery. According to January 2021 Service Intensity Estimates, an average family spends 10 or more hours per week engaged with WISe services. This could be much higher, especially in the beginning. Parents/Caregivers are offered therapy sessions and opportunities to engage with parent peers. 

WISe clinicians are responsible to integrate their work to fit with a family’s schedule, often seeking creative ways to tuck sessions into already busy days. For example, a clinician describes a day when they picked up a child at school and conducted a session in the car while driving the child to their next activity. After work, parent met with the clinician while the adults watched the child swim.

Family experiences with WISe are varied. Some say WISe created a critical turning point that enabled family survival. Others cite high staff turnover as a barrier to ideal therapeutic outcomes. The program is most effective with buy-in from the young person and their caregivers and when services are provided to match family needs and schedules.

Does my child have to agree to WISe services?

WISe is a voluntary program. Families may be able to motivate their child to participate by getting services started through Family Initiated Treatment (FIT). FIT was established as a pathway to treatment for youth 13-17 when Washington passed the Adolescent Behavioral Health Care Access Act in 2019. A parent/caregiver can initiate outpatient services to attempt to get the youth to engage. If after 12 visits (within 3 months) the youth is still unwilling to engage with the treatment, the family must end services. They have the option to engage a different provider to try FIT again.

What if WISe isn’t enough?

The WISe program is the most intensive outpatient program that the state offers. If services don’t seem to be working, the family might check the WISe Service Delivery, Policy, Procedure and Resource Manual to see whether there is more the program could be doing. The family also might check if the child could get additional services from another agency to complement the work with WISe. For example, service providers from a special education program at school or from the Developmental Disabilities Administration (DDA) can collaborate with a WISe team.

If a child needs inpatient services, they may be eligible for a referral into the Children’s Long-term Inpatient Program (CLIP). Children placed on a waiting list for CLIP often receive ongoing services from WISe. PAVE provides an article: Children’s Long-Term Inpatient Program (CLIP) Provides Residential Psychiatric Treatment.

History, Advocacy, and Family Support

WISe was created as a response to the T.R. et al. lawsuit, settled in 2013. The class-action lawsuit named ten plaintiffs who were denied treatment for schizophrenia, depression, bipolar disorder, and other serious psychiatric conditions. Most were institutionalized repeatedly and for extended periods, despite recommendations by therapists and case workers that they return home and receive services in their homes and local communities.

Disability Rights Washington (DRW) provided attorney support for the settlement of the T.R. et al. lawsuit. DRW is monitoring current issues related to children being underserved through WISe and encourages families with concerns to contact attorney Susan Kas: susank@dr-wa.org.

Another result of the legal settlement was a statewide network of stakeholders who meet regularly to discuss what works/doesn’t work within the behavioral health system for youth. That network is called Family, Youth, and System Partner Round Table (FYSPRT). Regional FYSPRTs report to a statewide FYSPRT to share input for system improvement. Regional groups are a hub for family networking and emotional support in addition to serving as a place to engage with community health providers, insurance case managers, and other professionals. Some FYSPRTs have distinct groups for young people to meet and support one another. Many FYSPRT groups use online meeting platforms due to the pandemic.

Another place for families engaged in behavioral health services to network is Washington State Community Connections (WSCC), which sponsors an annual family training weekend, manages an SUD Family Navigator training, and offers a variety of ways for families to share their experiences and support one another. WSCC in 2022 is engaged in work to help build a statewide website to help families navigate behavioral health services across systems. Stay tuned!

Families can get direct support from A Common Voice, a statewide non-profit staffed with Parent Support Specialists who have lived experience parenting a child with challenging behavioral health conditions. The program offers virtual support groups and 1:1 help. A Common Voice is part of the Center of Parent Excellence (COPE), managed by the state’s Health Care Authority. The COPE project website provides a schedule of support group meetings and contact information for regional lead parent support specialists.

An informal place to connect with other families is a Facebook group called Healthy Minds Healthy Futures. Advocates in this group initiated work for an interactive website for parents and are engaged in a push for HB 1800 to expand behavioral health services for minors statewide.

Families wanting to advocate for system change can participate in meetings of the Children and Youth Behavioral Health Work Group (CYBHWG). The work group was created in 2016 by the Legislature (HB 2439) to promote system improvement. CYBHWG supports several advisory groups, including one for Student Behavioral Health and Suicide Prevention. The work groups include representatives from the Legislature, state agencies, health care providers, tribal governments, community health services, and other organizations, as well as parents of children and youth who have received services. Meetings include opportunities for public comment. Meeting schedules and reports are posted on the Health Care Authority (HCA) website.

Parity laws, thoughtful language, stopping stigma

Keep in mind that a healthy mind is part of a healthy body, and U.S. laws protect parity for all illness conditions. Despite those protections, discrimination and stigma are commonly discussed within behavioral healthcare systems. Here are a few tips and considerations to help reduce stigma:

  • All behaviors start in the brain, so an impairment that impacts the brain is going to affect behavior. Some behaviors are not a person’s fault; that’s why they need treatment, support, and services.
  • Specific person-first language can help reduce stigma. For example, instead of calling someone bipolar or schizophrenic, say they are a person with bipolar disorder or schizophrenia.
  • An exception to person-first language is in the autism community, which has collectively agreed to use the term “autistic” to describe someone on the spectrum.
  • Saying that someone has “behavioral health,” or “mental health” does not describe their condition or what they need help with. Everyone has mental health! A better choice is to describe the condition/concern and the need for help: “This youth’s schizophrenia is impacting every aspect of life, and they need a range of services and treatments to recover and move forward with their life plans.”
  • A person who dies from suicide did not commit a crime, so the word “commit” is inappropriate to use when discussing suicide.

For additional information on related topics, including areas where behavioral health impacts school, see PAVE’s article: Mental Health Education and Support at School can be Critical

Self-Care Videos for Mindfulness – Families Series

Take a Mindful Walk in Nature

Mindfulness can mean anything that helps you slow down and show up for what’s happening in a moment. This video demonstrates how to notice all of the body’s senses on a nature walk. Once it’s familiar, the concept could be useful in any environment, including indoors. Get creative and if it’s developmentally appropriate, you can encourage children to make up their own journey through their senses.

Get Calm by Getting Organized

When overwhelm is happening, it’s hard to imagine that getting organized will help. But here’s why it’s worth it: When you feel satisfied that you’ve done something, your brain releases happiness chemicals and hormones. This video provides information about how that works and how families can tap into happy by getting organized and taking time each day to celebrate everyone’s accomplishments.

How to Cultivate Resilience like a Starfish

Starfish are masters at letting turmoil wash around them. They are also excellent models of resilience. This short video uses imagery from the sea and provides a strategy to get grounded, steady the breath, and cultivate four key aspects of resilience: purpose, connection, adaptability, and hope.

Become present and let thinking float away as you treat yourself to this opportunity to take a few minutes to care for yourself.

Breathe Mindfully and Give Your Favorite Stuffy a Ride

Even young children can become grounded and calm if breathing with intention is fun and accessible to them. This short video features two young models showing how they give their stuffed animals a ride while they breathe into and out of their tummies.

Have your child choose a comfortable place to lie down and place their stuffed animal on their tummy. Help them to notice what it’s like to breathe and watch the stuffy go up and down. Ask them what it feels like to notice their breathing and their stuffy taking a ride.

Our five-year-old model says, “I loved it and felt like I could fall asleep.”

Health Information for Families as Schools Reopen During COVID Pandemic

As schools open for the 2021-22 school year, families have decisions to make about health and safety. This article provides information and resources to address some key questions:

  • What measures are schools required to take to keep children and staff safe?
  • What COVID precautions should our family consider?
  • What should we do if returning to in person school doesn’t feel safe for our family?
  • Will schools address children’s social and emotional well-being after everything that has happened?

This article provides information to address these questions and includes state and federal resources to support families in decision making.

Overall priorities at the state and national level include:

  1. Health and physical safety by following a layered approach with COVID protocols for masking and hygiene to the maximum practical extent
  2. Mental health and social emotional learning support for all students, with state and federal funds to enable schools to hire additional staff focused on student well-being
  3. Accelerated academics to help students recover from interrupted learning (See PAVE’s article on Recovery Services)

These priorities are listed in the US Department of Education’s Return to School Roadmap, which includes this guidance in its opening paragraphs:

“We must welcome families back in authentically, listen and seek to understand their concerns, and respond to their needs, so that all families feel comfortable sending their students to school this fall. As we start the 2021-2022 school year, schools and communities must address gaps that were exacerbated by the pandemic and build our education system back better than before.”

What measures are schools required to take to keep children and staff safe?

Washington’s Department of Health (DOH) issued a 13-page document on July 28, 2021, to detail requirements for the 2021-2022 school year. The state’s guidance mirrors recommendations from the Centers for Disease Control and Prevention (CDC). Priority is to minimize virus transmission while maximizing in-person learning.

Families with questions or who need access to the DOH information in another format are encouraged to contact the COVID-19 Information hotline: 1-800-525-0127. Hours are 6 am-6 pm, with additional hours until 10 pm on Mondays. For interpretative services, press # when they answer and say your language. To request DOH information in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov.

Here are key points from Washington’s DOH guidance:

  • Vaccination is recommended for anyone 12 and older, and schools must verify the vaccination status of staff and faculty as required by Labor and Industry. According to DOH, “Schools should promote vaccinations for eligible students, teachers, staff, and families.”
  • Face coverings are required for all students and staff indoors and during school transportation. Exemptions are made for “people with a medical condition, mental health condition, developmental or cognitive condition, or disability that prevents wearing a face covering.”
  • Physical distancing of three feet or more is recommended indoors as practical: “Physical distancing requirements should not prevent a school from offering full-time, in person learning to all students….”
  • Schools must maintain good ventilation: “Offer more outside time, open windows often, and adjust the HVAC system to allow the maximum amount of outside air to enter the program space and increase air filtration.”
  • Schools are tasked to teach and manage proper hygiene, including frequent handwashing and “respiratory etiquette” (cover coughs and sneezes/wash hands after blowing nose, etc.) to minimize viral spread: “Some students with disabilities might need assistance with handwashing and respiratory etiquette behaviors.”
  • Schools must clean and disinfect surfaces and spaces frequently, in accordance with guidance from the CDC and the Environmental Protection Agency (EPA).
  • Symptomatic students and staff are asked to stay home and seek a medical evaluation before returning to school.
  • Schools must ensure students and staff can access timely COVID testing.
  • Schools are recommended to screen students who are not fully vaccinated at least weekly when community transmission is at moderate or higher levels. In accordance with CDC guidance, the state is not recommending fully vaccinated people for routine screening. Additional testing is recommended for athletes, coaches, and others engaged in contact sports or activities such as singing, which generates aerosols from the mouth that can spread virus.
  • Isolation of ill individuals is required to be in a space reserved for first aid or a separated room with an open window or good ventilation: “If no appropriate indoor space is available and the child can be supervised and made comfortable, an outdoor setting is an acceptable emergency alternative if weather and privacy permitting.”
  • If a person tests positive for COVID, here’s when they can return to school:
    • 10 days since they first got sick (up to 20 days for severe illness or if immunocompromised)
    • 24 hours after fever is gone
    • Symptoms have improved

Students who need to stay home have educational rights

The CDC provides a Flow Chart to direct schools, students, and families about what to do if a student becomes ill at school.

Schools are asked to keep records about people who are exposed to others who are sick. If the person who was exposed to illness has not been vaccinated, they will need to stay home/quarantine themselves until it’s clear they aren’t getting sick. If the person exposed to COVID has been vaccinated or has recovered from a past COVID infection, they don’t have to quarantine if they aren’t sick. Schools are required to release information about COVID-19 cases to local public health officials as part of a case or outbreak investigation.

A student staying home sick has the right to educational access, including special education services that are accessible and support progress toward educational goals. According to DOH, “Schools must have a response and communication plan in place that includes communication with staff, families, their school district, and their local health jurisdiction. Schools should prepare for instructing students and their families who are excluded from school due to illness or quarantine in accordance with all federal and state laws.”

What COVID precautions should our family consider?

The CDC provides guidance for families for talking about COVID-19 and slowing its spread. Here are a few ideas: 

  • Reassure children that they are safe. Share how you deal with your stress, so they learn to cope from you. If a child is anxious, reduce exposure to pandemic topics in the media.
  • Avoid language that might blame others and lead to stigma.
  • Provide information that is truthful and appropriate for the age and developmental level of the child. Use the information in this article to share a few ideas about how school might have new rules for protecting everyone.
  • Seek trusted information about vaccines to make an informed decision about who in the family can and should be vaccinated. The CDC provides a three-minute video with overview information, and Family Voices of Washington provides an article with more detail to support decision making. To find a vaccination site in your area, go to COVIDWA.com or call 1-833-VAX-HELP (833-829-4357). Language assistance is available. You can also text your zip code to 438-829 for vaccine locations near you.
  • Teach everyday actions to reduce the spread of germs. Remind children to wash hands frequently and to cough or sneeze into a tissue or their elbow.
  • Practice mask wearing and choose face coverings that will work all day at school. If appropriate, involve students in a plan to keep the face coverings clean and ready for each school day. If a child’s disability prevents mask wearing, talk about why that will be okay and prepare to share disability specific information with school staff. DOH provides guidance about mask wearing and exemptions in an Order from the Secretary of Health

What should we do if returning to in person school doesn’t feel safe for our family?

The U.S. Department of Education with the CDC presented at a Parent Town Hall on July 29, 2021.  During the virtual event, Department of Education staff responded to a question by a parent who wanted her child to keep learning from home for health and safety reasons. The parent was reminded that the department provides guidance and best practice strategies but does not regulate state educational agencies or local districts.

The advice was to ask for a meeting with school and/or district staff to discuss a plan for ongoing distance learning. If a workable plan isn’t developed, families are advised to contact their state educational agency (OSPI in Washington), local school board, or governor’s office. Note that Washington is a local control state, so individual districts are responsible to write their own policies and procedures within the limits of state and federal law.

No student rights are waived due to the pandemic, and students have levels of educational protections depending on their circumstances. Every child has the right to a free public education, through Every Student Succeeds Act (ESSA). Students with disabilities have the right to a Free Appropriate Public Education (FAPE) that is equitable, accessible and designed to meet their individualized needs. The right to FAPE is protected by Section 504 of the Rehabilitation Act of 1973 and by the Individuals with Disabilities Education Act (IDEA).

If a student is eligible for an Individualized Education Program (IEP), the IEP team is responsible to make decisions about the best placement for a student to receive FAPE. FAPE requirements include the right to an IEP that is reasonably calculated to enable progress appropriate in light of the student’s circumstances.

If family caregivers believe that home-based instruction is necessary for safety and well-being, then the IEP team must consider the family’s request and document its decision process through Prior Written Notice (PWN). If the school makes a decision that the family disagrees with, parents of children with disabilities have Procedural Safeguards that protect their right to mediation or a complaint process.

Additionally, Washington families can contact their local school board, which is required to conduct its work through an Open Meeting process that allows for public comment. The Governor’s Office of the Education Ombuds (OEO) provides guidance to families and schools that need support to reach agreement.  

Will schools address social and emotional well-being?

Washington’s Office of Superintendent of Public Instruction (OSPI) has made clear in its guidance that student well-being is a priority as schools reopen. State and federal dollars, including those from the American Rescue Plan, enable schools to hire staff such as nurses and counselors to support student well-being.

OSPI provides a guidebook: Academic and Student Well-Being Recovery Plan: Planning Guide 2021 For School Districts, Tribal Compact Schools, and Charter Schools. Included is information about how state and federal dollars are awarded based on formal plans submitted by districts.

In their plans, districts must include statements about how student well-being will be supported. Districts are asked to prioritize social emotional learning and equity issues related to the disproportionate impact of the pandemic on different populations.

Families impacted by trauma, death, or other challenges during the pandemic can review their district’s Recovery Plan and consider whether their student’s needs are likely to be met. If there are concerns, family members can meet with school and district staff to request a more individualized approach. For students with IEPs, needs related to specific losses and trauma can be discussed in the context of an IEP Recovery Services plan. For more information about Recovery Services, see PAVE’s article: Recovery Services: What Families Need to Know as Schools Reopen.

Families who have experienced elevated stress due to COVID and want more support can reach out to the Washington Listens help line: 1-833-681-0211.

PAVE’s Family-to-Family Health Information Center (F2F) provides direct assistance for questions related to health and wellness, insurance, and access to medical services. For questions about school-based services, our Parent Training and Information (PTI) staff can help. Click Get Help from our home page at wapave.org to request individualized support.

Body Sensing Meditation for Help with Sleep

Anxiety around bedtime is a struggle for many people of all ages. Whether the challenge is to fall asleep or stay asleep, worry doesn’t make getting enough zees any easier. Here is a strategy for calming that uses a body scanning strategy combined with breath awareness.

Parents might share this practice out loud to help a child go to sleep. The child also might learn to use all or parts of the technique on their own. Once you understand the basic strategy you can adapt the wording to meet your own needs or the needs of the person you are sharing this with. Some might even fall asleep before you get through the whole practice!

If you or another person experiencing this practice do not have all of their body parts you can ask whether it feels good to imagine those body parts while doing the body scan or whether it feels better to include only body parts that are present. For a person who is deaf or hard of hearing or for people who respond well to sensory touch, there is the option to gently touch parts of the body while moving through the practice. Once learned, the practice can be silent, internal, and personalized. Be creative about how to make it workable and useful for any person who might benefit.

To help with sleep, body sensing starts with the feet…

Please make yourself comfortable in bed or another space where you can relax and listen to the 10-minute meditation provided in this video.

When you are finished listening, if you are not yet ready for sleep, you may wish to begin again with the body sensing, always starting with your feet and traveling awareness up through the body, noticing the breath throughout your own journey into rest.

The Meditation Script

If you prefer to read this script aloud to someone else or to yourself, here are the words from the video:

Notice that you have two feet. On your feet there are toes, big toes, second toes, middle toes, fourth toes, and baby toes. Notice your feet and toes. Notice what your feet and toes are touching. Is it soft or hard? Cool or warm? Are your toes and feet relaxed? Notice that you have ankles. Your legs have a lower part. You have two knees. Your legs have an upper part. You have hips. Notice what your hips, legs and feet are resting on. Is there anything you could change to be even just a little bit more comfortable?

Notice your tummy. Notice that as you breathe in your tummy goes up. As you breathe out your tummy goes down. Notice what it feels like to breathe in and out of your tummy. As you breathe in, you are noticing that your tummy is filling up. As you breathe out, you are noticing that your tummy is getting empty. What does breathing feel like? Just notice.

Notice that behind your tummy is your back. You have a lower back, a middle back, and an upper back. Inside your back there are ribs, and your ribs have a back part, two sides, and a front part. Your front ribs meet at your chest.

Notice that when you breathe in, your tummy fills up and so does your chest. Your ribs get a little wider. When you breathe out your chest goes down and so does your tummy. Your ribs settle in. See if you can notice what it feels like when your tummy and chest fill up with breath and when they empty of breath. Notice how long it takes for a breath to come all the way in and to go all the way back out again. Your body knows how to breathe all by itself and does this all day long. Notice how it feels to pay attention to your body breathing.

Notice that your chest is in between your shoulders. Your shoulders are connected to your arms.  Your arms have an upper part. You have elbows. Your arms have a lower part, and you have two wrists. Notice your hands. You have fingers. Each hand has a thumb, first finger, second finger, third finger and a baby finger. Your hands have a back part and a palm. Notice what your shoulders, arms and hands are resting on. Is it soft or hard? Cool or warm? Are your arms, hands, and fingers relaxed? Is there anything you could change to be even just a tiny bit more comfortable?

Notice that your heart is beating inside your chest. You are breathing, and your heart is beating. Your body is taking care of its basic needs to be healthy and alive. Notice that right now you are safe. Notice the room you are in and whether there is lightness or darkness or some of both. Notice any sounds that are near or far. Notice that your body is breathing. Your chest and belly fill up each time you breathe in and empty each time you breathe out. Make any little changes that you need to be slightly more comfortable.

Notice that you have a neck and a head. Notice what the back of your head is resting on. Your head has a top part and two sides. You have eyebrows and two eyes. Your eyes can close so that your top eyelashes and your bottom eyelashes touch each other. Imagine that there is a color behind your closed eyes that is a soft dark blue. Notice how you feel when you peer into this deep blue space behind your eyes. Notice if there are any edges to the dark blue or if it seems to stretch forever, like the night sky.

Notice that you have a mouth. Inside your mouth there is a tongue, and you have teeth. Your mouth has a right side and a left side. Your mouth is resting.

Notice that you have a nose with two nostrils. Air comes into your nostrils and goes out through your nostrils. Notice that air traveling into your nostrils moves down into your chest and tummy. After the air empties from your tummy and chest it leaves through your nostrils. Notice the long journey that your breath takes through the body, from the nostrils to the chest and belly. Out from the belly, the chest, and the nostrils. What does it feel like to watch your body breathing?

Notice the shape of your whole body and what your body is resting on. You have feet and legs. You have a tummy and a back. Your arms and hands are resting. Your whole body is comfortable and resting. You are breathing with your nose, your chest and your belly. Your eyes are closed, and there’s a dark blue color behind your eyelids. We’re breathing in and breathing out through our noses. We are safe and resting. We are noticing what it feels like to rest.

Download the meditation script