This year the waves of information have been high at times, often, and the content can shift or change. And here comes the much anticipated COVID Vaccines. This video was created to address some of the most common questions that may rise to the surface and where to go to find how the vaccine is rolling out in Washington State. Visit the Department of Health for the most up-to-date vaccine distribution plans.
A Brief Overview
- 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 are still in place, without waivers. PAVE provides an article: Early Intervention: How to Access Services for Children Birth to 3 in Washington.
- Students retain the right to access high-school transition and vocational rehabilitation services. PAVE provides an article: Ready for Work: Vocational Rehabilitation Provides Guidance and Tools.
- 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.
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.”
Keep notes about student learning
Schools and families are encouraged to keep notes about student learning and access to educational services. 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.”
IEP and Section 504 meetings are encouraged, and teams can discuss whether Recovery Services are needed to make up for services not provided or accessible due to the circumstances of the pandemic. Documentation from families and schools will support conversations about what was needed and what was provided. Families can collect and share their own observations about progress toward goals and whether materials provided by the school have been accessible.
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 coronavirus pandemic, families with students of all ages and abilities are figuring out strategies for coping with the disruptions. This article may provide some help: How to Get Organized, Feel Big Feelings, and Breathe during the crisis.
PAVE provides ongoing 1:1 support. Fill out a Helpline Request online or call 800-572-7368. Language access services are available.
When a student is struggling in school and there is reason to suspect the challenges are disability related, anyone can refer the student for an educational evaluation. The final section of this article includes a sample letter for requesting a no-cost evaluation from the school district. PAVE provides an article with more detail: Evaluations Part 1: Where to Start When a Student Needs Special Help at School.
Rights are upheld during COVID pandemic
No rights are waived during the COVID-19 pandemic. Schools and families can collaborate to determine what data is needed and how to be creative about collecting data if person-to-person contact needs to be limited or avoided for health and safety reasons. An agency called Presence Learning is among those offering teletherapy training and support for special education teams during COVID-19.
The Office of Superintendent of Public Instruction provides guidance to schools in Washington, where local districts establish and regulate policy. OSPI on July 10, 2020, issued an updated Question and Answer document about special education services delivery during the pandemic, including this statement (page 19):
“OSPI does not support unilateral district decisions to delay all meetings during COVID-19. IEPs and evaluations that were delayed due to COVID-19 should be prioritized for timely completion during summer and/or fall 2020 and follow those decisions with a prior written notice to the parent.”
Request evaluation formally, in writing
State-specific deadlines apply when a school district receives a formal request to evaluate a student. In Washington, evaluation deadlines are described in the Washington Administrative Codes (WAC 392-172A-03005). In short, a school district has 25 school days to respond to a request, 35 school days to complete an evaluation, and 30 calendar days to write and implement an Individualized Education Program (IEP) for an eligible student.
Family caregivers/guardians must sign consent for an evaluation to begin. How signatures are provided during the health emergency can be discussed to avoid slowing the process.
Make a special education referral in writing. This is important because:
- There will be no confusion about how/when/why request was made.
- The letter provides critical initial information about what is going on with the student.
- The letter supports a written record of family/school interactions.
The school district is required to collect and consider school, medical and other records provided by the district and/or the family. Families may choose to disclose all, a portion, or none of a student’s medical information. Schools may not require disclosure of medical records.
If the family wishes, letters about diagnoses, concerns, and recommendations from outside providers may be attached to the evaluation request. The district is responsible to review all documents and respond with written rationale about how the information is incorporated into recommendations.
Prior Written Notice (PWN), IDEA, FAPE, and Child Find
After receiving an evaluation request letter and supporting documents, the district is required to respond formally, through a Prior Written Notice (PWN), within 25 school days. A PWN is a legal requirement any time there is a proposal to initiate or change the identification, evaluation, or educational placement of a student through a special education process. These provisions are from the federal Individuals with Disabilities Education Act (IDEA). In Washington State, PWN requirements are described in WAC 392-172A-05010.
A PWN is required if the school district agrees or refuses to initiate or change the identification, evaluation, or educational placement of the student. A PWN is also required any time there is a change or a refusal to change any aspect of how the district provides Free Appropriate Public Education (FAPE) for a student with a disability.
The right to FAPE is federally protected by the IDEA. A non-discriminatory evaluation process is part of the protections for a student with a known or suspected disability that may significantly impact access to education (Child Find Mandate). Child Find protections apply whether there are academic and/or non-academic school impacts. Note that another foundational principle of the IDEA is parent/student participation in special education process. The IDEA protections cover the decision process about whether to evaluate.
Special Education is a service, not a location within the school
Please note that a request for special education evaluation is NOT a recommendation to remove a student from the regular classroom and move them into an exclusive learning environment. Federal and state laws require that students eligible for special education services receive their education in the Least Restrictive Environment (LRE) to the maximum extent appropriate.
Special Education is a service, while LRE refers to placement. PAVE’s article provides further information: Special Education is a Service, Not a Place.
General education classrooms and spaces are the least restrictive. A child may be placed in a more restrictive setting if an IEP team, which includes family participants, determines that because of the child’s circumstances and capacities, FAPE is not accessible even with specially designed instruction, accommodations, modifications, ancillary aids, and other documented attempts to support a Free Appropriate Public Education (FAPE) within the general education environment.
Parents can appeal decisions and/or seek a 504 plan
If a student is evaluated and determined ineligible for IEP services, the family has a right to appeal the decisions and/or to seek an Independent Educational Evaluation (IEE). The rights are similar if the district refuses to conduct an initial evaluation. See PAVE’s article: Evaluations Part 2: Next Steps if the School Says ‘No’ to Your Request.
Family caregivers also can work with the school to develop a Section 504 plan, which accommodates a person with a disability that impacts a major life activity (learning, walking, speaking, writing, socializing, etc.). Section 504 is an aspect of the Rehabilitation Act of 1973, which protects the civil rights of individuals with disabilities against discrimination throughout the lifespan. See PAVE’s article for more detail about Section 504 rights, which also protect students who qualify for an IEP: Section 504: A Plan for Equity, Access and Accommodations.
Sample letter for a special education referral
Below is a sample letter that family caregivers can use when writing a request for an educational evaluation:
City, State, Zip
Name (if known, otherwise use title)
Title/Director of Special Education/Special Services Program Coordinator
City, State, Zip
Dear Name (if known, otherwise use title):
I am requesting a full and individual evaluation for my (son/daughter), NAME, (BD: 00-00-0000), for assessment as a special education student as stipulated in the Individuals with Disabilities Education Act, (IDEA, Public Law 108-446), and in the Washington Administrative Code (WAC 392-172A).
I have concerns that (NAME) is not receiving full educational benefit from school because of [his/her] struggles with [brief sentence that summarizes the bullet points listed below].
I understand that the evaluation is to be in all areas of suspected disability, and that the school district is to provide this evaluation at no charge to me. My reasons for requesting this evaluation are: (be as specific as you can).
- Use bullet points if the list is long.
- Use bullet points if the list is long.
- Use bullet points if the list is long.
My [son/daughter] has been medically diagnosed with [DIAGNOSIS, if available…Or, you might write: My son is awaiting a medical evaluation for … note that a medical diagnosis is not required for schools to conduct an educational evaluation].
I have attached documentation from [list any outside providers who provided letters or reports]. Please take note that [Dr. NAME] recommends [highlight any specific recommendations from those attached documents] because [reason].
I understand that I am an equal member of the team for development of an Individualized Education Program (IEP) and that I will be involved in any meetings related to evaluation, identification of disability, provision of services, placement, or other decisions regarding my child’s access to a Free Appropriate Public Education (FAPE). I would appreciate meeting with each person who will be doing an evaluation before [name of child] is tested so that I might share information and history. I will also expect a copy of the written report generated by each evaluator so that I might review it before the team meeting.
I understand you must have my written permission for these tests to be administered, and I will be happy to provide that upon receipt of the proper forms.
I appreciate your help in behalf of [child’s name]. If you have any questions please call me at [telephone number] or email me at [email address, optional].
CC: (Names and titles of anyone else you give copies to)
You can email this letter or send it by certified mail (keep your receipt), or hand carry it to the district office and get a date/time receipt. Remember to keep a copy of this letter and all school-related correspondence for your records. Get organized with a binder or a filing system that will help you keep track of all letters, meetings, conversations, etc. These documents will be important for you and your child for many years to come, including when your child transitions out of school.
Please Note: PAVE is a nonprofit organization that provides information, training, individual assistance, and resources. PAVE is not a legal firm or legal service agency, and the information contained in this handout is provided for informing the reviewer and should not be considered as a means of taking the place of legal advice that must be obtained through an attorney. PAVE may be able to assist you in identifying an attorney in your area but cannot provide direct referrals. The contents of this handout were developed under a grant from the US Department of Education. The contents do not represent the policy of the US Department of Education and you should not assume endorsement by the Government.
Washington State Superintendent Chris Reykdal predicts that 2020-21 will be “the most complicated school year in American history.” In preparation, the Office of Superintendent of Public Instruction (OSPI) is turning out new guidance for school districts that serve more than a million students.
About 143,000 Washington students receive special education and related services. No federal or state protections for students with disabilities are waived due to the pandemic.
Decisions about what school looks like are left to local districts, which follow policies established by elected school boards. 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. Public comment is part of each public meeting, and open meeting rules apply in any space or platform.
Among OSPI guidance released in summer 2020 is a 60-page booklet: Reopening Washington Schools 2020: Special Education Guidance. Recommendations encourage schools to collaborate with families in providing equitable access to learning opportunities and to include all students when designing curricula for a range of delivery methods.
PAVE provides an article that summarizes some content from OSPI’s guidance and provides more detail about navigating special education regardless of what school looks like: IEP on Pause? How to Support Continuous Learning.
Reykdal and WA Governor Jay Inslee spoke Aug. 5, 2020, at a press conference about school decision-making amid the nation’s ongoing struggle to contain the COVID-19 pandemic. Gov. Inslee said he would not order the closure of all schools, as he did in spring 2020. Instead, Inslee said he would rely on local districts to use sound judgment about whether school buildings can open safely, in light of a region’s health data.
At the August press conference, Inslee announced plans to send $8.8 million in federal CARES Act stimulus money to OSPI, which will use some funds to cover the costs of internet for students eligible for free or reduced-price meals. OSPI has committed to partner with community-based organizations to help families secure childcare, engage in language translation services, and other parent and family engagement strategies.
CARES Act funds also will support professional development to upgrade how distance learning is delivered statewide. In partnership with OSPI, the state’s nine regional educational service districts (ESDs) will provide support and training to help districts choose a consistent online platform and train staff about best practices. “Last spring, we heard consistently from educators that they needed more training on how to effectively use online learning management systems,” Reykdal said, adding:
“To make online learning more effective this fall, we have to streamline this. Students and parents should be able to focus on learning, and educators should be focused on teaching, without the modality of the instruction getting in the way. Our ESDs will provide educators with training in a handful of learning management systems consistent with guidance we have already sent to districts to simplify their remote learning management systems for families.”
Reykdal and Inslee encouraged school districts in areas of the state with low rates of COVID-19 infection to prioritize face-to-face instruction for those who are most likely to struggle with remote learning: elementary schoolers and those with disabilities.
In circumstances where in-person school is offered, families will make their own decisions about whether to send children or keep them home. Here are a few tools families might use to prepare for the school year:
- The Washington State Hospital Association provides a Coronavirus Tracking Map.
- The Centers for Disease Control and Prevention (CDC) provides a School Decision-Making Tool for Parents, Caregivers, and Guardians.
- Doctors from the Infectious Diseases Society of America (IDSA) offer their recommendations in a July 28, 2020, Podcast. Here are the IDSA’s primary questions:
- Is the rate of infection in the community going down?
- Does the community have a clear protocol for testing and contact tracing?
- Does the school provide a clear protocol for what to do if/when a student or staff member tests positive for COVID-19?
- Team Child provides direct assistance to family caregivers of children with special needs in King, Pierce, Spokane, and Yakima counties. A free online manual provides information for all families: Education in the wake of COVID-19 Know Your Rights.
- PAVE provides a variety of articles, videos, and resources:
- Links to Support Families During the Coronavirus Crisis
- Links for Learning at Home During School Closure
- A library of short Mindfulness Videos for all ages/abilities
- Stay-Home Help: Get Organized, Feel Big Feelings, Breathe
- Lessons at Home—Teaching Ideas for Parents (videos)
- IEP on Pause? How to Support Continuous Learning
- Key Information and Creative Questions for Families to Consider During COVID-19
- Webinars offer Parent Training to Support Behavior during Continuous Learning
- Willa Discovers Telehealth (video)
- Technology Provides Options for Medical Care from a Distance
- Quick Look: How to Prepare for a Virtual Meeting
- High School Halt: Ways to Support Youth Working on Adult Life Plans During COVID-19
A Brief Overview
- Positive Behavioral Interventions and Supports (PBIS) is a strategy schools use to teach children expected behavior. Read on for PBIS strategies families can use at home.
- A key PBIS principle is that punishment fails to teach children and youth what they should do instead. Adults can direct a child toward a better choice or interrupt an escalation cycle.
- The easiest way to change a behavior is to point out what a person does right. Remember this catchy phrase, “5:1 gets it done,” to ensure five positive interactions for each negative interaction.
- Parents might find success with strategies they can share with school staff eventually.
- For additional strategies unique to COVID-19, the Office of Superintendent of Public instruction (OSPI) offers a series of 3 webinars for family caregivers. For information and links to the videos, see PAVE’s article: Webinars offer Parent Training to Support Behavior during Continuous Learning.
Schedule changes and seasonal transitions cause emotional upheaval for some families in typical years. Summer 2020 includes unique conditions, with families moving into a summer with fewer-than-usual options to keep children busy after months of learning from home due to the COVID-19 building closures. A few strategies, described below, might help families keep things chill this summer.
Experts in education use a framework for creating a positive environment called Positive Behavioral Interventions and Supports (PBIS). PBIS has been implemented in more than 26,000 U.S. schools. The PBIS framework has been shown to decrease disciplinary removals and improve student outcomes, including grades and graduation rates. When done well, PBIS provides positive social skills, communication strategies and “restorative justice,” (working it out instead of punishing) and may prevent 80-90 percent of problem behaviors.
Punishment does not teach
PBIS requires an understanding that punishment fails to help a child know what to do instead. Researchers have learned that a child who is being punished enters an emotionally dysregulated state (fight/flight/freeze) that blocks learning. Adults who calmly direct a child toward a new way of problem-solving can interrupt or prevent an escalation.
Keep in mind that adults need to stay regulated to help children. For strategies related to mindfulness, see PAVE’s article: Stay Home Help: Get Organized, Feel Big Feelings, Breathe. PAVE also provides a library of short videos with mindfulness and breath practices for all ages and abilities: Mindfulness Videos.
Within a PBIS framework, de-escalation strategies might include:
- Remove what is causing the behavior
- Get down to eye level
- Offer empathy—the ability to understand and share the feelings of another
- Provide choices
- Re-teach expectations
- Reinforce desired behaviors
- Communicate care instead of control
Behavior is a child’s attempt to communicate
Simple, consistent, predictable language is a critical component. Insights about these strategies and more were shared in a webinar by Change Lab Solutions on April 30, 2019.
Among experts talking about PBIS are staff at the University of Washington’s School of Mental Health Assessment, Research and Training (SMART) Center. Staff from the SMART center lead the School Mental Health supplement of the Northwest Mental Health Technology Transfer Center (NWMHTTC). These agencies, in collaboration with the League of Education Voters, in June 2019 hosted a webinar: How to Implement Mental Health Supports in Schools, focused on the importance of blending school and community supports with PBIS.
A University of Washington (UW) expert who participated in the webinar is Kelcey Schmitz, a former OSPI staff member who has written articles for PAVE about positive behavior supports and state initiatives and has experience helping families and schools implement PBIS.
“PBIS is a game changer for children and youth with behavior challenges and their teachers and caregivers,” Schmitz says. “In fact, everyone can benefit from PBIS. Behavior is a form of communication, and PBIS aims to reduce problem behavior by increasing appropriate behavior and ultimately improving quality of life for everyone. The same approaches used by schools to prevent problem behaviors and create positive, safe, consistent and predictable environments can be used by families at home.”
Schmitz, an MTSS training and technical assistance specialist, provides the following specific tips for creating a successful PBIS home environment.
Support Positive Behavior before there is a problem
PBIS is set up with three layers—called tiers—of support. The parent-child relationship is strengthened by loving and positive interactions at each tier.
Tier 1 support is about getting busy before there is a problem. Much like learning to wash hands to prevent getting sick, expected behavior is taught and modeled to prevent unexpected behaviors. Parents can look at their own actions and choices and consider what children will see as examples of being respectful, responsible, and safe.
Tiers 2 and 3 are where adults provide more support for specific behaviors that are getting in the way of relationships or how the child or youth functions. In a school setting, Tier 2 is for students who need a social group or some extra teaching, practice, and reinforcement. Tier 3 supports include a Functional Behavioral Assessment (FBA) to find out why the behavior is occurring, and an individualized Behavior Intervention Plan (BIP).
Any student may access supports that include aspects of Social Emotional Learning at all three Tiers. At home, Tiers 2 and 3 naturally will be more blended and may include support from a community provider. Note that targeted interventions in Tiers 2-3 work best when Tier 1 is already well established.
Define, teach, and routinely acknowledge family expectations
- Discuss how you want to live as a family and identify some “pillars” (important, building-block concepts) that represent what you value. Talk about what those pillars look like and sound like in every-day routines. To help the family remember and be consistent, choose only 3-5 and create positive statements about them. Here are a few examples:
- Speak in a respectful voice.
- Be responsible for actions.
- Be safe; keep hands, feet, and objects to self.
- Identify a couple of “hot spots” to begin. Challenging behaviors often occur within routines. Perhaps mornings or mealtimes create hot spots for the family. After discussing 1-2 ways to be respectful, responsible, and safe in the morning, teach what each looks like. Have fun with it! Set up “expectation stations” for practicing the plan and assign each family member one pillar to teach to the rest.
- Behaviors that get attention get repeated. Notice when a child does the right thing and say something about each success: “I noticed you stopped to pick up your shoes in the hallway. Thanks for putting them away and keeping the walkway safe for others.” The easiest way to change a behavior is to point out what a person does right!
- Remember this catchy phrase, “5:1 gets it done” to ensure five positive interactions for each negative interaction. When the expected behavior becomes routine, the reinforcement can fade away.
Create engaging and predictable routines
- Children crave structure and routine. Adults may look forward to a relaxing evening or weekend, but kids often need regular activity and engagement. Consider that either the kids are busy, or the adults are busy managing bored kids!
- Use visuals to create predictability. A visual schedule can display major routines of the day with pictures that are drawn, real photos or cut-outs from magazines. Create the schedule together, if possible. Parents can ask a child to check the schedule – especially when moving from a preferred to non-preferred activity. It’s hard to argue with a picture!
Set the stage for positive behavior
- Teach, pre-teach, and re-teach. Children need to learn behavior just like they learn colors and shapes. A quick reminder can help reinforce a developing skill: “When we get in the car, sit up, buckle up, and smile!”
- Give transition warnings or cues to signal the end of one activity and the beginning of another: “In five minutes, it will be bath time.”
- First/then statements set up a child for delayed gratification: “First take your bath; then we can play dolls.”
- Focus on Go instead of Stop. Children often tune out words like No, Don’t and Stop and only hear the word that comes next, which is what an adult is trying to avoid. Tell a child what to do instead of what not to do: “Take your plate and put it in the sink.” Save Stop and No for dangerous circumstances that need a quick reaction.
- Choices prevent power struggles: “Would you rather play for five more minutes or get in the bath now?” “Feel free to choose the pink pajamas or the green ones.”
While these strategies may not eliminate all problem behaviors, they create consistency, predictability, and a more positive atmosphere. They teach new skills to help children get their needs met. The solid foundation will help even if challenging behaviors persist by creating a bedrock for additional layers of support.
Here are places to seek additional information:
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.
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.
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.