Tag: special needs

Find Civilian Services for Your Child With a Disability When You Leave the Military

Posted on by Barb Koumjian

A guide to finding civilian supports and services when your service member separates or retires from the military if you have a child (including an adult dependent child) with disabilities. If you are PCSing to a “forever” home location, it includes resource finders available across the United States and Territories.

As you read down the columns, you will see references to Parent Centers. Parent Centers are funded by Office of Special Education (OSEP), US Department of Education to support parents of children age birth to 26 with disabilities. If you are reading this article through the website for PAVE (*******) or through their Pipeline newsletter, you are in the right place because PAVE is the Parent Training and Information Center (Parent Center) for Washington State.

 You can also use resources at the Center for Parent Information and Resources (CPIR), a national center serving Parent Centers and families with online information. According to the CPIR:

“There are nearly 100 Parent Training and Information Centers PTIs) and Community Parent Resource Centers (CPRCs) in the US and Territories. These Centers perform a variety of direct services for children and youth with disabilities, families, professionals, and other organizations that support them. Some of the activities include:

  • Working with families of infants, toddlers, children, and youth with disabilities, birth to 26
  • Helping parents participate effectively in their children’s education and development
  • Partnering with professionals and policy makers to improve outcomes for all children with disabilities” – https://www.parentcenterhub.org/the-parent-center-network/ “

Quick-find links:

Children’s Benefits or Services
Active Duty
or Active Reserve

Keep Benefit or Service?
(retiring after 20 yrs service)

Equivalent Civilian Resources

TRICARE Medical Coverage (may include case management, mental health, hospice care)

Yes, but there may be extra financial costs

Private insurance (useful article at the Military Wallet website)
Medicaid  NOTE:  your child can be enrolled in both Medicaid and TRICARE

TRICARE for children after age 21, up to age 26 (including college students)

Yes-up to age 23 if in college (or up to graduation); after which and up to age 26, child may be eligible for TRICARE Young Adult, which charges premiums, has co-pays and deductibles.

Private insurance

Medicaid NOTE:  your child can be enrolled in both Medicaid and TRICARE

TRICARE benefits after age 26 through secondary dependency

Yes

Medicaid NOTE:  your child can be enrolled in both Medicaid and TRICARE

Supplemental Security Income (SSI) (in some states, receiving SSI helps determine Medicaid eligibility)

Private insurance

ABA Services through TRICARE’s Autism Demonstration Project

Yes, but only if the service member retires, as opposed to leaving the military prior to fulfilling the terms of service for retirement. If the service member leaves without retiring, try the resources in the right-hand column.

Medicaid NOTE:  your child can be enrolled in both Medicaid and TRICARE

Medicaid Home and Community Based Services (HCBS) Waiver * NOTE:  your child can be enrolled in both Medicaid and TRICARE

Autism resources by State (Easter Seals)

State Agencies on Developmental or Intellectual Disabilities

Extended Care Health Option (ECHO) provides supplemental support and services not available through TRICARE’s regular coverage. Some benefits similar to Medicaid HCBS waivers

No

Medicaid HCBS Waiver * NOTE:  your child can be enrolled in both Medicaid and TRICARE

Respite Care through ECHO and other programs

No, but check with the community family center at a local installation to identify any military-family support organizations which may offer funding or locator services.

Medicaid HCBS Waiver * NOTE:  your child can be enrolled in both Medicaid and TRICARE

Lifespan Respite (WA)

EasterSeals Respite locator: https://archrespite.org/respitelocator

Exceptional Family Member Program (EFMP) Family Support (help with navigating military and some civilian service systems)

Yes, at the discretion of installation

PAVE (Parent Center, Washington State)

Parent Centers

Military Child Care BenefitsMilitary Child Care Benefits

No

Private: not subsidized, but can use the directory: ChildCareAware.org. If a family has income restrictions, many States have subsidized care through Department of Health and Human Services (or equivalent)

School Liaison Office for help navigating school systems and services, especially under MIC3 (Interstate Compact)

No, except that the Interstate Compact covers your child for one year after you retire

PAVE (Parent Center, Washington State)

Parent Centers (other states)

Home for the Holidays: The Gift of Positive Behavior Support

Posted on by Nicol Walsh

A Brief Overview

  • This article provides examples and simple guidance about how to be more strategic in parenting a child who struggles with behavior—during the weird winter of 2020 and beyond.
  • PAVE consulted with University of Washington positive behavior support expert Kelcey Schmitz for this article.
  • Anticipating trouble and making a best guess about the behavior’s “purpose” is a great place to start.
  • Listen and look for opportunities to praise expected behavior. It’s easy to forget to pay attention when things are going well, but keeping the peace is easier if praise is consistent while children are behaving as expected.
  • Read on to gift the family with a plan for improving holiday happiness.

Full Article

Holidays can be challenging for families impacted by disability, trauma, grief, economic struggles, and other stressors. Holiday season 2020 has its own flavors of confusion. Families with children who struggle with behavior may want to head into the winter with plans in place. Anticipating where trouble could bubble up and developing a strategy for working it out provides all family members with opportunities for social-emotional growth, mindfulness, and rich moments.

PAVE consulted with a University of Washington (UW) expert in positive behavior supports to provide insight and information for this article. Kelcey Schmitz is the school mental health lead for the Northwest Mental Health Technology Transfer Center, housed at the UW School Mental Health Research and Training (SMART) Center. An area of expertise for Schmitz is Multi-Tiered Systems of Support (MTSS), a framework for schools to support children’s academic, social, emotional, and behavioral strengths and needs at multiple levels. An MTSS framework makes room for Positive Behavioral Interventions and Supports (PBIS). When done well, PBIS teaches and reinforces positive social skills, communication strategies and “restorative justice” (working it out instead of punishing).

“This holiday season may present additional challenges given the pandemic,” Schmitz says. “Families, like educators, need to go back to the basics during times of stress and uncertainty. Remembering core features of PBIS at home, such as predictability, consistency, safety, and positive interactions are going to be key. In fact, lessons learned during stay-at-home orders during the pandemic can and will carry us through the holidays and beyond. Never before have routines, regulation, relationships, and reinforcement been more important for everyone in the family than they will be this winter.”

Schmitz has provided articles and content to support PAVE families over the years and offers the following tips for navigating the holidays by using PBIS strategies at home.

Make a list and check it twice to know what troubling behaviors are about

Whatever the holidays mean and include, family routines can shift. Food can look and taste different. The house may be decorated in a different way. School takes breaks. Weather changes, and sunrise and sunset are closer together.

Children may struggle with changes in routines, different food items on the menu, overstimulating environments, long periods of unstructured activities, or sensory issues that make long pants, socks, gloves, coats, and hats feel like shards of glass.

Keep in mind that all behaviors serve a purpose; they are a way for the child to solve a problem. Without appropriate social skills, children will do what is necessary to have their needs met in the quickest way possible. However, adults who can predict problem behaviors may also be able to prevent them.

TIP: Anticipate trouble and make a best guess about the motivation

Set your child (and family) up for holiday success by thinking ahead about the types of routines and situations that might be challenging. Craft a plan to intervene early, before a full-blown escalation.

Create a best guess statement to better understand the relationship between an unwanted behavior and the child’s environment. Summarize what usually happens by describing:

  • The behavior (tantrum, hitting, refusal)
  • Circumstances that set the stage (what’s going on right before the behavior?)
  • What happens after the behavior (time out, angry adults, something removed or given)
  • A best guess about the child’s motivation/the “purpose” of the behavior (to get something or get out of something)

Here is an example:

At Grandma’s holiday gathering, an adult encourages a child to try a food, demands a “please” or “thank you,” or scolds the child. Note if the child is tired, hungry, or uncomfortable in an unusual or unpredictable situation. These are the circumstances that set the stage.

The child cries and yells loud enough to be heard in another room (description of the behavior).

During the child’s outbursts, others leave her alone (what happens after the behavior).

Best guess about the purpose? The child may want to avoid unpleasant people, food, or situations.

Making a good guess about what causes and maintains the behavior (crowded or overstimulating environment, being rushed, being told they can’t have or do something they want, different expectations, demands, exhaustion, hunger) can support a plan and potentially avoid worst-case scenarios.

Determining the purpose or function of a behavior may require a closer look at what typically happens (what others say or do) after the behavior occurs. The behavior may be inappropriate, but the reason for it usually is not.  Most of the time there is a logical explanation. Here are some questions to help think it through:

  • Does the child get something–or get out of something?
  • Does the child generally seek or avoid something, such as:
    • Attention (from adults or peers)?
    • Activity?
    • Tangibles (toys/other objects)?
    • Sensory stimulation?

Make a list and check it twice: Prevention is key

Many behaviors can be prevented using simple proactive strategies. Adults can use their best-guess statement to build a customized strategy. Here are some starter ideas that might help prevent or reduce the intensity, frequency, or duration of unwanted behaviors:

  • Make sure the child is well rested and has eaten before going out.
  • Bring food that is familiar and appealing.
  • Anticipate challenges, and plan accordingly.
  • Pre-teach family expectations (respectful, responsible, safe) and talk about how those expectations work at grandma’s house: “When someone gives you a present, say thank you and smile at the person who gave you the gift.” For information about developing family expectations, see PAVE’s article, Tips to Help Parents Reinforce Positive Behaviors at Home.
  • Encourage the child to bring a comfort item (toy, book, blanket).
  • Give more “start” messages than “stop” messages.
  • Teach a signal the child can use to request a break.
  • Create a social story about family gatherings; review it regularly.
  • Rehearse! Practice/pretend having a meal at Grandma’s house, opening gifts, playing with cousins, and other likely scenarios.
  • Arrive early to get comfortable before the house gets crowded.
  • Create a visual schedule of events, and let the child keep track of what’s happening or cross off activities as they happen.

Respond quick as a wink: Reward replacement behavior

An essential prevention strategy is teaching what to do instead of the unwanted behavior. “What to do instead” is called replacement behavior. To be effective, the replacement behavior needs to get results just as quickly and effectively as the problem behavior.

For example, if a child learns a signal for taking a break, adults need to respond to the signal just as fast as they would if the child starts to scream and cry.

Responding quickly will strengthen the replacement behavior and help make sure that the unwanted behavior is no longer useful.

Here are steps to help teach replacement behaviors:

  1. Demonstrate/model the wanted behavior
  2. Provide many opportunities for practice
  3. Let the child know they got it right (as you would if they learned a skill like riding a bike, writing their name, or saying their colors)

Praise a silent night

Inspect what you expect. Listen and look for opportunities to praise expected behavior. It’s easy to forget to pay attention when things are going well, but keeping the peace is easier if praise is consistent while children are behaving as expected.

Evidence indicates that children’s behavior improves best with a 5:1 ratio of positive-to-negative feedback. Increasing positive remarks during difficult times—such as holidays and pandemics—might reduce escalations.

Provide frequent, genuine, and specific praise, with details that help encourage the specific behavior being noticed. For example, say, “You did a nice job sharing that toy truck with your cousin!”

All is calm: Intervene at the first sign of trouble

Be ready to prompt appropriate behavior, redirect, or offer a calming activity when there are early signs of agitation or frustration.

  • Provide early, clear instructions about “what to do instead,” using language and modeling consistent with what was pre-taught and practiced (see above).
  • For example, if a child is getting frustrated, say, “Remember, you can give me the peace signal if you need a break.”
  • Redirect the child to another activity or topic when appropriate and practical.
  • Hand the child a comfort item (stuffed animal, blanket).
  • Show empathy and listen actively: “It seems like you’re having some big feelings right now. Want to talk about it?” After listening, maybe say, “Wow, that’s a lot to feel.”

Do you hear what I hear? Heed alarm bells when plans need to shift

Not all challenging behaviors can be prevented, and adults may overestimate a child’s ability to control emotions. A child experiencing significant distress may be unable to process what is going on around them and follow what may seem like simple instructions.

If an adult’s best efforts are unable to prevent or diffuse a behavior escalation, a graceful exit may be the best strategy. It’s important for adults to remember that a child’s crisis isn’t their crisis. An adult’s ability to remain level-headed is critical, and children may ultimately learn from the behavior they see modeled.

Wait for a child to calm down before addressing the issue: An overwhelmed brain is not able to problem solve or learn. Later, everyone can review what worked or did not work in order to adjust the strategy for next time.

Believe: Be a beacon for hope

Support a child to learn, practice, and perform behaviors that enable fun, rich family experiences. The work may feel challenging—and the scale of the project may be impacted by a unique set of tough circumstances—but expecting and accepting the challenge enables the whole family to move toward new opportunities. Trust that the work will pay off—and relish the moments of success, however large or small. Believe that consistency and predictability can make a big impact this holiday season and beyond.

Here are a few points to review:

  • What might seem fun and relaxing to adults, could be overwhelming and upsetting to children.
  • Children are more likely to exhibit the behavior that will most quickly get their needs met, regardless of the social appropriateness.
  • Acting out is typically a symptom of an underlying issue – it’s important to examine the root of the problem for long-term positive results.
  • Prevention strategies and intervening early can be very effective, but they are often underutilized. Plan ahead to eliminate, modify, or neutralize what might set off behavior.
  • Support wanted behaviors by teaching them, practicing them, modeling them, and making them consistent sources for praise and encouragement.

Resources:

COVID-19 Handbook and Family Binder (multiple language options) from the Autism Intervention Research Network on Behavioral Health (airbnetwork.org)

The Comprehensive, Integrated Three-Tiered Model of Prevention (ci3t.org) provides videos and other COVID-Related Resources for Families in English and Spanish

The Center on Positive Behavioral Interventions and Supports (PBIS.org) provides a downloadable booklet (English and Spanish) for Supporting Families at Home with PBIS

Parent Training Modules from Vanderbilt University’s Center on the Social and Emotional Foundations for Early Learning (CSEFEL), available in English and Spanish

YouTube video interview with Mark Durand, author of Optimistic Parenting: Hope and Help for You and Your Challenging Child

Self-Care is Critical for Caregivers with Unique Challenges

Posted on by Nicol Walsh

Consider that 20 percent of the population has a disability. That’s one-fifth of all people who need extra support! Caregivers for those high-needs individuals may experience compassion fatigue and stress at high levels. National Geographic’s film, Stress, Portrait of a Killer, provides an overview of the risks and includes a story of parents who care for a child with special needs (See Minute 38 for that section of the report). 

The way to manage chronic stress is consistent self-care. Here are ways to stay mentally and physically healthy. In other words, here’s how caregivers can pull on that oxygen mask first in order to be well enough to assist others!

1. Connect

Meet up with people who get what you are going through. Schedule coffee with another parent with similar challenges on a regular basis. Parents often find each other at school, but here are other ideas about where you might find one another: Special Olympics practice, Special Needs Parent-Teacher Association, extracurricular events. A local Parent-to-Parent network can help by matching parents with similar interests or by providing a regular parent-group meeting.  

2. Sleep

The body uses sleep to recover, heal, and process stress. Here are ideas if anxiety or intrusive thinking interrupts sleep: Turn off screens after 7 p.m.—or use a blue-light filter; find sleep-music beats or a hypnosis program online; drink a calming herbal tea, such as chamomile; journal to process thoughts before bed. For more ideas, visit Sleepfoundation.org.

3. Exercise

Go for a walk, practice yoga, swim, wrestle with your kids, chop wood, work in the yard, or have a living-room dance party. Moving releases feel-good body chemicals. Check out the Mayo Clinic for more information on exercise and stress.

4. Be Mindful

Mindfulness can be as simple as taking time to notice your breath and focus attention there. Other ways to focus the mind for a general calming benefit: meditate, color, work on a car, build something, do art, put together a puzzle. The key is to find a quiet place that feels nurturing and calming. For more resources, check out mindful.org.

5. Make Time

An overfull calendar or unscheduled chaos can take over the day. A carefully organized calendar, managed with realistic boundaries, can help: If someone requests time, the calendar clearly shows when a meeting is possible. Parents can set SMART goals for a day, week or month: Assess whether the goals are Specific, Measurable, Achievable, Relevant and bound by a clear Timeframe. PAVE’s article on SMART Goals can help parents manage time while learning about how to assist with educational planning. Another resource with time-management tools: calendar.com: Why Stress Management and Time Management Go Hand in Hand.

6. Seek Help

Respite care provides temporary relief for a primary caregiver. In Washington State, a resource to find respite providers is Lifespan Respite. Parents of children with disabilities can apply through the Developmental Disabilities Administration (DDA) to seek eligibility for in- home personal care services and to request a waiver for respite care. For further detail about how to access services, refer to wapave.org DDA Access video or Informingfamilies.org DDA services.

Response to Intervention (RTI) – Support for Struggling Students

Posted on by Nicol Walsh

Brief overview

  • Students struggle in school for different reasons.
  • RTI is an acceptable way of identifying students with learning disabilities.
  • RTI isn’t a specific program or type of teaching.
  • RTI works on a tier system with three levels of intervention.

Full Article

Students struggle in school for different reasons. Response to Intervention (RTI)  can help by combining high quality, culturally responsive instructions with assessments and interventions that are proven to work by evidence from research.

RTI was originally recognized in the 1970s as a system for helping students with potential learning problems early, instead of waiting until they fail. With the reauthorization of the Individuals with Disabilities Education Act (IDEA) in 2004, RTI was noted as an acceptable way to identify students with learning disabilities. RTI can help students who haven’t yet been identified as eligible for special education or those who struggle but don’t qualify for special education services.

At any time during the RTI process, parents or teachers can request an evaluation for special education services.  The evaluation can determine whether a student qualifies for an Individualized Education Program (IEP) or accommodations through a Section 504 Plan. RTI does not replace a school’s responsibility to evaluate students who might qualify for special education services. See PAVE’s article on Child Find, a mandate of the Individuals with Disabilities Education Act (IDEA).

RTI’s goal is for schools to intervene before a student falls too far behind. RTI is not a specific program or type of teaching, but rather a proactive way to check in with a student to see how things are going. Data help school staff decide which types of targeted teaching would work best for the student. If a student’s progress is slow or stagnant, then teachers adjust based on the student’s needs. 

RTI has three levels, or tiers, for intervention:

  • In the general education classroom
  • In a special education classroom, resource room, or small group
  • For an individual student

RTI works best when parents are involved

Parents can monitor their child’s progress and participate in the process. Parents can talk to the school about which instructions or reinforcements are working and boost the benefit by being consistent with the same strategies at home.

As military families move from one location to another, they may notice that each school uses different techniques to implement RTI programs.  Schools will format their programs to best fit the needs of their students by using a variety of tools to improve learning for all students. Keeping up with what’s happening at school might be challenging but can help the student find success.

RTI is part of a Multi-Tiered System of Supports (MTSS) framework.  MTSS provides a method for intervention in academic and non-academic areas, including Social Emotional Learning or behavior support. MTSS is used to support adult students and professionals as well. In this video, a researcher from the American Institutes for Research, Rebecca Zumeta Edmonds, Ph.D., discusses differences between MTSS and RTI.

PAVE has an article that describes MTSS and how it can provide a larger framework for Positive Behavior Interventions and Supports (PBIS), when a child’s behavior becomes a barrier to learning.

For more information on RTI, MTSS, and PBIS:

The Three RTI Tiers

Center on Response to Intervention

Response to Intervention (RTI)

 What is the Difference Between RTI and MTSS?

MTSS: What You Need to Know

Positive Behavioral Interventions & Supports (PBIS) in Schools

I want the kind with the people and the pictures

Posted on by Nicol Walsh

By John O’Brien

After a Difficult Start…

Institutionalized from age three to twenty-three in a place where “they treated us like animals”– Mike has composed a good life, taking many valued roles: husband, father, worker, home owner, friend, organizer, advocate, mentor, teacher, neighbor.[1] Anticipating the changes that come with aging, Mike requested funding for a person-centered plan from his case manager (a service option in his state). The case manager said that it was unnecessary for him to spend any of his budget on a plan because a new Federal Rule requires that Mike’s annual plan of care meeting be a person-centered plan. Mike, who has participated in many person-centered plans organized through self-advocacy, asked some questions about the required plan and concluded, “I still want the kind with the people and the pictures.”

Regulations that require a person-centered plan as a condition of receiving Medicaid Waiver funds introduce a distinction between Want-to-plans and Have-to-plans. Each can make a positive contribution; both must creatively respond to constraints. A good Want-to-plan supports discovery of possibilities and life direction and mobilizes a person’s allies at important moments in their lives. A good Have-to plan gives a person effective control of the Medicaid waiver funded assistance they rely on. Committed and skilled facilitators with the time necessary to prepare and follow-up make a difference to the impact of both kinds of plan. How well either process works for a person depends on conditions outside the planning process: the extent, diversity and resourcefulness of the person’s social network; the openness of the person’s community; the flexibility and responsiveness of providers of necessary assistance; the sufficiency of public funds for necessary assistance and the means for people to control those funds. Good plans will identify the current reality of these conditions and consider how to engage them.

Mike’s is a want-to-plan. At his initiative, he and his invited allies (the people) collaborate to create a customized process to address his desire to deal proactively with the new responsibilities and increasing impairments that show up with aging. Mike chose Michele, an experienced facilitator, to guide the process. Their agreement makes it clear that Michele is responsible for facilitating a process of change over time, not just a meeting.[1] A graphic record (the pictures), created by Alex, provides an energizing memory of what emerges, a way to track and update action plans, and a way to orient new people to Mike’s intentions.[2] Occasional check-ins and revisions guide continuing action. One-to-one meetings assist Mike in sorting through all the suggestions and offers of help he receives to assure a good fit with who he is. Mike will bring some the information generated by this work to inform the required annual person-centered support plan, but his Want-to-Plan does not substitute for it.

Mike’s experience unfolds under highly favorable conditions for any person-centered plan. He has a strong desire to assure his wife and himself the best possible old age. Reciprocity for decades of generous neighborliness, concern for co-workers and leadership in advocacy give him a diverse network to call on. He is not inhibited in asking for help when he needs it. The help he needs is largely with navigating the unfamiliar territory of selling and buying property and preparing wills and other necessary documents and demands no change in his current paid services. Hard work and careful management has accumulated equity in family home. Many Want-to-plans will need to include provision for strengthening or establishing the social and material conditions for moving toward a desirable future.

Want-to-plans can also originate in a person’s positive response to an invitation to join a process of organizational change. This sort of plan poses a challenge that an organization must stretch its capacities to meet.

Have-to-plans are a necessary step in determining expenditure of Medicaid funds on services to meet the assessed needs of eligible people. They are the final responsibility of system staff assigned to coordinate services. While the process can vary to accommodate a person’s preferences, the process and resulting plan must comply with detailed standards. The New York OPWDD Person Centered Planning Regulation Checklist enumerates 23 requirements, 21 of which track US Federal Regulations.[3]

Have-to-plans serve a worthy purpose. The rules set conditions for the person to direct the meeting, understand the results and assure that the person-centered service plan documents the person’s needs strengths, preferences, goals and appropriate services.

This checklist item, based on a Federal requirement, identifies the intended result of Have-to plans:

2‐5. The plan documents the necessary and appropriate services and supports that are based on the individual’s preferences and needs and which will assist the person to achieve his/her identified goals. [Complies with CFR 441.301©(2)(v)]

This form of words sets Have-to-plans in the context of publicly funded disability services. Offering increased influence on which available provider(s) will serve a person and how those services will be of assistance is a clear benefit of Have-to-plans when there is a real choice among providers with a capacity to individualize supports.

This standard also locates a tension that constrains Have-to-plans as two impulses struggle with each other within the same sentence. One impulse, energized by commitment to self direction and the development of people’s strengths, expresses the life a person wants to live and the supports that they prefer to live that life. The other, tied to the historical anomaly of funding US disability support as if it were a medical service, aims to select necessary and appropriate services that are clearly linked to professionally assessed need. State policy can bias the struggle toward one impulse or the other. In some states[1] the person centered plan is bracketed between an assessment of need that involves an extensive inventory of a person’s deficiencies and writing an Individualized Service Plan (ISP) that must demonstrate a direct connection between assessed need and specified services and avoid public funding of “wants” or “lifestyle choices”. Without the skillful facilitation of an intentional shift in perspective, a Have-to-plan will be primed by a focus on deficiencies and develop within unconscious boundaries set by judgements of what can realistically be funded.

A Want-to-plan can safeguard a Have-to-plan. A person and those who care can choose to create a space outside the world of disability services for conversation about a person’s identity, gifts and capacities and the circumstances that offer the best life chances. Often, as with Mike, some action will result from this conversation that requires no change in publicly funded services. When the sort of changes in services that require a Have-to-plan are necessary, a person and their allies have a foundation for negotiating what they need from publicly funded services.

____________________________________________________

[1] See for example, NJ Division of Developmental Disabilities (March 2016). Supports Program Policies & Procedures Manual (Version 3.0).

[1] Other agreements might suit other circumstances. A different person might agree to fill the necessary follow up role.

[2] Denigrating graphic records has become a cliche criticism of person-centered planning (“people have colorful pictures on their walls but their lives are unchanged”). Lack of commitment or capacity for creative action seem to me more likely causes of inaction than a vivid record of people’s thinking does.

[3] http://www.opwdd.ny.gov/sites/default/files/documents/PCPChecklist.pdfThe 22nd standard, specific to New York, defines a person-centered planning process as a right and requires written notice of that right. The 23d assures that all relevant attachments are filed with the plan. The rule itself, Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers, Provider Payment

Reassignment, and Home and Community-Based Setting Requirements for Community First Choice (Section 1915(k) of the Act) and Home and Community-Based Services (HCBS) Waivers (Section 1915(c) of the Act), was published in the Federal Register on January 16, 2014.

[1] You can view Mike’s witness to growing up in an institution and a snapshot of his life today in this 2015 TV investigation into his state’s continuing operation of institutions: http://www.king5.com/news/local/ investigations/wash-decades-behind-in-serving-developmentally-disabled-1/48265785

 

Early Learning Transition: When Birth-3 Services End

Posted on by Nicol Walsh

The Individualized Family Service Plan (IFSP) ends when a child turns 3. A transition to a preschool plan with an Individualized Education Program (IEP) requires a new evaluation and is a team-led process:

Planning begins 6-9 months before the third birthday.

  • The Family Resource Coordinator (FRC) schedules a transition conference to design a written Transition Plan.
  • The transition includes an evaluation that is conducted by the local school district and usually begins 2-3 months before the child’s third birthday.
  • If the child is determined eligible, the child will transition from a family-centered program of early learning (IFSP) into a school-based program (IEP).
  • Parent participation is critical: You are an important member of the transition planning team!

To qualify for an IEP, the child must meet evaluation criteria under the Individuals with Disabilities Education Act (IDEA). Criteria for Birth-3 services (Part C of the IDEA) are slightly different than the criteria for Special Education programming available for ages 3-21 (Part B of the IDEA).

To qualify for an IEP: (1) The student is determined to have a qualifying disability.  (2) The disability adversely impacts education. (3) The evaluation indicates a need for specially designed instruction.

Differences in Eligibility

IDEA Part C
(Also called Early Intervention -IFSP)

IDEA Part B
(Also called Special Education – IEP)
25% or 1.5 SD (Standard Deviation) Below the mean in one area of development – OR-2 SD (Standard Deviation ) below the mean in one or more areas of development – OR –
Diagnosed physical or medical condition that has a high probability of resulting in delay 1.5 SD below the mean in two or more areas of development

Qualifying Disability Categories for IEP:

  • Developmental Delay (ages 3-8)
  • Specific Learning Disability
  • Intellectual Disability
  • Autism
  • Hearing Impairment
  • Emotional Disturbance
  • Deaf-blindness
  • Multiple Disabilities
  • Orthopedic Impairment
  • Other Health Impairment
  • Deafness
  • Speech/Language Impairment
  • Traumatic Brain Injury

A child who doesn’t qualify for an IEP:

  • May qualify for a Section 504 plan, which provides accommodations under the Rehabilitation Act of 1973 when:
    • The disability significantly limits one or more major life activities.
    • The student needs accommodations to access the general education curriculum.
  • May qualify for other services like Head Start, co-operative pre-school, paid pre-school or day care with early achievers, play-to-learn programs, and other early learning opportunities in a community setting.

Use this checklist to help track your family’s transition steps:

6-9 months before the child’s third birthday:

  • The Family Resource Coordinator (FRC) starts talking about transition.
  • The FRC transmits your child’s records to the school system, with your written consent. The most recent IFSP and evaluations/assessments are included.
  • If your child is potentially eligible for Part B services, a transition conference is scheduled.
  • Community resources are located.

Transition Conference:

  • Parent’s rights in special education are explained.
  • Options for early childhood special education and other appropriate services are discussed.
  • A transition time line is developed.
  • A transition plan is written into the IFSP.

Evaluation:

  • If you agree, you sign consent for evaluation.
  • Records from Early Intervention Services are received at the school.
  • Information from the family is considered.
  • Evaluation is completed, and the eligibility meeting is held within 35 school days so that an IEP can be developed before the child’s third birthday.

IEP Meeting:

  • The IEP meeting is scheduled with a formal written invitation with date, time and location.
  • Discussion and decision-making include the family, the FRC (with parent permission), and an early childhood special education staff member.
  • Eligibility for special education is decided.
  • If the child is eligible, the Draft IEP is brought to the team meeting and you will have the opportunity to agree or disagree.
  • You receive a copy of your rights and procedural safeguards.
  • If you agree, you sign consent for services to begin.

The IEP in action:

  • The child makes the transition from Early Intervention to Early Childhood Special Education or another pre-kindergarten arrangement, if chosen.
  • The IEP is in place by our child’s third birthday.
  • The team of professionals and parents continue working together to resolve any issues that arise.
  • All IEP team members communicate during this time of change.

What’s Next when Early Childhood Services End at Age 3?

Posted on by Nicol Walsh

A Brief Overview

  • Services for families with infants and very young children include family-focused, home-based support. Families are served with an Individualized Family Service Plan (IFSP). An IFSP ends when the child turns 3.
  • A child who qualifies for an Individualized Education Program (IEP) receives those services at school. Not all children who qualified for an IFSP will quality for an IEP. An IEP is for children ages 3-21, or until high-school graduation.
  • Families may transition from getting in-home help for their child with special needs to participating as members of an IEP team. This can feel like a big change. The information in this article can empower parents.
  • Transition planning starts at least half a year before the child’s third birthday. Providers, teachers, school administrators and the family start thinking and collaborating early about what the child might need to do well.
  • Read on to learn what parents need to know when a young child with special needs makes the transition from Birth-3 services into preschool or another program.
  • A parent-support agency called Informing Families provides a 12-minute video to guide parents through the early-learning transition process. 

Full Article

When a child is born with a disability or the family realizes early that an impairment might impact a young child’s ability to learn and develop at a typical rate, the family can get help from the state. Early Support for Infants and Toddlers (ESIT) is managed by Washington’s Department of Children, Youth, and Families (DCYF).

Services for families with infants and very young children include family-focused, home-based support. When a child is ready to graduate from those early-learning services, the school district determines whether to conduct an educational evaluation to see whether the child qualifies for school-based services. If a child qualifies, the family and school district work together to generate an Individualized Education Program (IEP), which can begin at age 3 in preschool.

A child who qualifies for an IEP receives those services at school. Families transition from getting in-home help for their child with special needs to participating as members of the IEP team. The goals change, and parents help teachers and school staff talk about what the child needs to successfully access school and learning. This transition can be disorienting to some families. Read on for more detail.

Early Intervention can start from birth

Early intervention services are guaranteed by the Individuals with Disabilities Education Act (IDEA), under “Part C” of the IDEA. The U.S. Department of Education manages a federal grant program under the Office of Special Education Programs (OSEP) that helps states manage early intervention programs to support infants and young children and their families.

Part C services are available for infants and young children who:

  1. Experience developmental delays, which are medically diagnosed to impact cognitive, physical, communication, social-emotional and/or adaptive skills
  2. Have a diagnosed physical or mental condition that has a high probability of resulting in a developmental delay

Washington’s ESIT program assigns agencies in each county to serve as a “lead agency” to coordinate early learning services and testing. The lead agency works with service providers and the family to review a child’s medical record, discuss any observations by caregivers, and conduct screenings to see what’s going on and whether the issues of concern meet criteria under Part C for early intervention. 

When a child is found eligible for services, a Family Resource Coordinator (FRC) manages the case. The FRC helps to develop an Individualized Family Service Plan (IFSP). Each plan is unique and may involve individualized instruction, therapy services and supported access to community resources. The plan is designed around the needs of the child and family and is not based on a predetermined program model.

Family-based, early learning services end on the child’s third birthday. A new educational evaluation is required to see whether the student qualifies for an IEP under “Part B” of the IDEA.

Part B services are available for children ages 3-21 (or until high-school graduation) who:

  1. Have a qualifying disability in at least one of 14 federal qualifying categories
  2. Are significantly affected by that disability at school (“Significant Educational Impact” is determined with evidence and data)
  3. Require specialized instruction to overcome the barriers of that disabling condition

To qualify for an IEP under the IDEA, a student meets criteria in one of 14 disability categories

Autism

Deaf-blindness

Deafness

Emotional Disturbance

Hearing Impairment

Intellectual Disability

Multiple Disabilities

Orthopedic Impairment

Other Health Impairment

Specific Learning Disability

Speech / Language Impairment

Traumatic Brain Injury

Visual Impairment/Blindness

Developmental Delay (ages 0-8)

 

Note that the disability category of developmental delay can qualify a child for free, family-focused services to age 3 and school-based, IEP services through age 8.

Helpers get creative during “Part C-to-B Transition” planning

The FRC helps the family and school district get ready. Often this is referred to as “Part C-to-B Transition” planning, so it’s helpful when families understand that Parts C and B come from federal law, the IDEA (Individuals with Disabilities Education Act), designed to ensure that children with disabilities get the help they need to be successful at school and prepared for life.

For families who have received services through the state’s early-learning program (ESIT), Part C-to-B Transition planning starts at least half a year before the child’s third birthday. Providers, teachers, school administrators and the family start thinking and collaborating about what the child might need to do well. The work includes a “Transition Planning Conference,” which happens about 90 days before a child turns 3. The participants at this meeting write a plan for what services or community supports the child might receive. 

Each plan is unique and designed to respond to individual needs. A child’s plan might indicate need for a specific child-care setting or medical-based therapies. The plan might include a referral to a specific, state-funded special-education preschool program through Head Start or the Early Childhood Education and Assistance Program (ECEAP, pronounced “E-Cap”). A transition plan also can name local playgroups or parent-support networks to connect the family to community resources. If a child’s educational evaluation has determined that the child is eligible for an IEP, then information about that is included.

Not all children who qualified for early-learning support will qualify for an IEP. Children who are not eligible for IEP services might be eligible to receive accommodations and support through a Section 504 Plan.

Early learning isn’t the only pathway to an IEP evaluation

Children who didn’t receive early-learning interventions can also be evaluated to determine whether they qualify for school-based services that can start as young as age 3 and can continue through age 21, or until a student graduates from high school.

Anyone with concerns about a child can refer the child for an educational evaluation. These referrals usually come from parents, teachers, medical providers or early-learning specialists. When a concerned adult formally requests an evaluation from the school district (best-practice is to make the request in writing), then the district is bound by the IDEA to respond to that request within 25 school days. PAVE provides a comprehensive article about the evaluation process.

The school district has a responsibility under the Child Find mandate of the IDEA to seek out and evaluate children with known or suspected disabilities who may need services. 

When a school district agrees to evaluate, parents sign consent for the assessments to begin. The IDEA requires schools to complete an evaluation within 35 school days. For a child receiving early-learning services, the first IEP meeting is required on or before the child’s third birthday.

Families may invite whomever they want to an IEP meeting. For example, they can invite the Family Resource Coordinator (FRC), a family member, a friend or any other support person. 

If the school district does not conduct an educational evaluation, or if the evaluation indicates that the child doesn’t qualify for school-based, IEP services, parents have the right to disagree with the school’s decision. The family can request a written statement that describes the school district’s position, with any information or data that was used to justify the decision.

Parents have rights to disagree through a variety of dispute engagement options. PAVE provides comprehensive articles about evaluation, IEP process and Procedural Safeguards, Student and Parent Rights.

PAVE’s Parent Training and Information (PTI) center provides technical assistance and can help parents understand how to participate in their child’s learning. Got to: wapave.org/get-help or call (253) 565-2266, 1-800-5-PARENT ext.115

The Arc of Washington hosts local Parent-to-Parent (P2P) programs across the state. Families can request a “support parent match” to talk with another parent who has already navigated this process. Visit Arcwa.org for more information.

Additional Resources:
Informing Families – informingfamilies.org
Office of Superintendent of Public Instruction (OSPI) – k12.wa.gov   
OSPI Early Childhood services –  k12.wa.us/Specialeducation/earlychildhood
Early Intervention Resources in English and Spanish – ParentCenterHub.org
Washington State Department of Children, Youth, and Families – dcyf.wa.gov

If you are concerned about a child’s development:

Assistive Technology

Posted on by Nicol Walsh

Assistive technology (AT) can dramatically affect the success of your special needs family member.

AT can give students equal access to curriculum, the work environment, or any other environment that use government funding.  Assistive Technology includes devices that are used by individuals in order to perform functions that might otherwise be difficult or impossible.

The AT can compensate for the impairments of the disability, increase classroom participation, foster independence, improve learning and working, assist in communication, and help the individual become successful in multiple aspect of life. In the school environment, assistive technology accomplishes these goals by allowing students with many types of disabilities to see, hear, read, write, and communicate.  In fact, assistive technology often provides the student with the only access to the general curriculum.

People who use AT products and services may have difficulty speaking, typing, writing, remembering, pointing, seeing, hearing, learning, walking, breathing, etc.  Everyone uses assistive technology.  We may not think that the things we use on a daily basis to make our life a little bit easier, like alarm clocks, planners, computers, talk to text software, canes, automatic windows and doors, lined paper, stools or chairs, the list could go on and on.  An individual with special needs may rely on AT devices to perform tasks and be more independent, enriching their life.

AT devices are protected under the law. This means that if there is need for an individual, then the use of the devices cannot be denied.  The Individuals with Disabilities Education Act or IDEA is the federal special education law that addresses services for children with disabilities, set into law in 1975. IDEA requires that states provide a free appropriate public education for children with disabilities, including related services. This law requires schools to provide necessary assistive technology devices and services to help children with disabilities receive an appropriate education. To that end, every child with a disability must be considered for assistive technology.

Section 504 of the rehab act protects qualified individuals with a disability in the US from discrimination in any program or activity receiving FEDERAL FINANCIAL ASSISTANCE—for instance: government offices, banks, educational institutions, hospitals and clinics, etc. So, if money can be traced back to the federal government through grants, loans, tax breaks, and the like. then this law is applicable.

When selecting AT devices, evaluating the product or device is critical.  The goal is to help or improve function, access or ability, not hinder or impede it.  Following the steps below can help us narrow in on the selection process.

Consider: Look at what tools are available and how they may restrict or support skills by doing a skills assessment. With an assessment, we are looking at the easiest or simplest way to solve the problem without distracting others or causing more difficulty for the individual, teachers, or other students.

Consult: After the needs are figured out, ask other people about the AT devices they use. Don’t be afraid to seek out professionals for advice.  Check out websites, blogs, and forums for advice on different devices.  Ask for examples of how the device helps, the limitations one might encounter, and pros and cons of the device.

Conclude:  Once a decision has been made about what is appropriate and what will meet the needs, it then is necessary to purchase, make, or obtain the AT and begin using it.  When we make a decision on AT devices, we must keep in mind that the needs may change, a person’s ability may outgrow the device, or that we might need to reevaluate.

Building in some flexibility when selecting the device can save time and money in the future.  For instance, if a person struggles to turn pages of a book, then an e-reader would be more appropriate.  However, if the person is unable to use a mouse and keyboard as well, then selecting a device that is internet capable may be a better option.  Before you purchase the device, try it out.  Each state has a National Assistive Technology center. Often, families can try out devices or other AT items prior to purchasing.  Below are a few links:

History of Quality Indicators for Assistive Tehcnology

State Tech ACT Projects

Early Childhood Technical Assistance Center

National Center for Technology Innovation

Things to remember about Assistive Technology:

  • AT levels the playing field by providing access
  • Each person requires different types of AT
  • One size does not fit all
  • AT does not have to be expensive
  • AT can change based on the needs, development, and milestones reached by the individual
  • AT is protected by law

“Working Together with Military Families of Individuals with DisAbilities!”