Parents, Navigate Adapted Physical Education, IEPs, and 504 Plans

Overview

  • Physical Education (PE) can be adapted in four main ways to support students with disabilities.
  • Federal and state law protects a student with disability’s rights to access (be taught) PE. Adapted PE can be provided as a special education service in a student’s Individualized Education Program (IEP). It can also be included in a Section 504 plan.
  • Changes in WA State regulations mean that more teachers will qualify to design and teach Adapted Physical Education. These regulations are in effect as of May 1, 2024.
  • The Updated Guidance on Adapted Physical Education from the Washington Office of Superintendent of Public Instruction (OSPI) quoted in this article gives more information about Adaptive PE and how it fits into special education in WA State. Download or read Updated Guidance on Adapted Physical Education.

Full article

Physical Education (PE) is part of school for all students and may be particularly important for your student with a disability. What are the ways in which PE (general curriculum or Adapted PE) can improve their quality of life, now and into their adult years? This short list may give you ideas for your student’s IEP or 504 plan, and to discuss with your student for them to bring to a meeting with the IEP/504 team.

Classes teach students to care for their body and develop physical, mental, and emotional skills that include:

  • Motor skills (training to use muscles for a specific task, such as swinging a baseball bat to hit a ball, or running very hard in a race)
  • Physical fitness (keeping healthy and strong by exercising the body)
  • Social-emotional skills, teamwork, social play skills
  • Skills for athletics like team sports like soccer or basketball or individual athletics like gymnastics or dance
  • Skills for recreation like biking, swimming, hiking, throwing frisbees,

How Adapted PE works:

Access or accessible means how easy it is to do, to get, or understand something.

There are four main areas where adjusting or changing the general PE curriculum (school courses) may help students with disabilities access PE. Some of these changes will benefit ALL students using the general PE curriculum.

  • The physical space can be adjusted to work well for all students:
  • The size of the space and the number of other students can affect how accessible the PE class is for some students
  • Lighting, sound, and what someone can see may all affect comfort in a class.. Making thoughtful changes to these things can make a PE class more accessible.
  • Teaching: the teacher gathers information about individual students to ensure they use teaching methods accessible to everyone. This might mean spoken instructions, movements, pictures, written words, showing how to do something, or videos.
  • Equipment: depending on a student’s disability, some students might need PE equipment to move more slowly, be bigger or smaller, more tactile (easier to feel), be easier to see, and similar changes.
  • Rules: to make sure PE is inclusive, rules of the game may need to be added or taken away.

The information-gathering process above is a good place for you and your student to provide information about your student’s supports such as doctors, therapists, and interests outside of school that might be supported by Adapted PE. This information can be offered to the entire IEP/504 team, to give a well-rounded view of your student. You might want to review PAVE’s articles for students in the References section, below. It’s a good start for your student to self-advocate and practice self-direction.

Examples of Adapted PE

The point of Adapted PE is to change the general PE curriculum so that it is accessible for all students based on their individual strengths and needs. How it looks varies a lot depending on the student, but here are a few examples of Adapted PE in action:

  • A third grader with autism spectrum disorder uses a play script on her communication device to invite other students to play tag with her.
  • A high-school senior with Down syndrome is introduced to adult recreation opportunities in his community so he can continue building healthy habits beyond graduation.
  • A seventh grader with Cerebral Palsy attends general PE class. The Adapted PE teacher, general PE teacher, and the physical therapist collaborate to create an exercise plan to strengthen the student’s legs while using their gait trainer (walker).

Adapted Physical Education teachers are trained to make changes to the general education PE curriculum to make it accessible to students with disabilities.

IEPs can include Adapted PE as a service

Eligibility for an Individualized Education Program (IEP) uses an evaluation. The process helps to decide whether a student has a disability, whether the disability has a significant impact on (really affects) learning, and whether the student needs Specially Designed Instruction (SDI) and/or related services to access a Free Appropriate Public Education (FAPE). FAPE is the right of any student, ages 3-21, who is eligible for school-based services delivered through an IEP.

If a student’s access to PE really affects learning and the student needs the school’s PE course to be individualized, then Adapted PE can be given as an IEP service. IEP teams discuss how Specially Designed Instruction (SDI) is delivered for each individual student.

When Adapted PE is part of the IEP, there is a range of options for placement. A student might be in a general PE class, with or without accommodations. Additional aids, services, and modifications may be added depending on what the student needs. Get more details in the Updated Guidance on Adapted Physical Education.

This is a great opportunity for a student to share their goals and needs about physical activities with their IEP team. The topic might be a way to interest your student in IEP meetings even before the required age for planning their life after high school. See the Resources section below for information about students attending or leading their IEP team.

Rules changed and removed some difficulties with getting Adapted PE

Until spring of 2024, Adapted PE was not recognized as a separate subject matter area or specialty that the state would endorse (add to the training listed on a teacher’s professional certificate). This meant a shortage of teachers who could design Adapted PE for students. It made it difficult for some students with disability in Washington State to get SDI in physical education.

As of May 1, 2024, qualifying[1] teachers in Washington State can be trained for and receive a specialty endorsement in Adapted Physical Education. The endorsement shows the teacher has specific skills and knowledge in both PE Learning Standards and special education competencies. As more teachers are taught this specialty, it will be easier to find teachers with Adapted PE training in Washington State.

The OSPI Updated Guidance says that in addition to teachers with an Adapted PE endorsement, SDI for physical education can be provided by “any other appropriately qualified special education endorsed teacher, or an “appropriately qualified Educational Staff Associate (ESA) such as an Occupational Therapist (OT) or a Physical Therapist (PT).”

Summary:

  • Physical Education (PE) is an important part of school. Students with disabilities have the right to be taught physical education.
  • Adapted Physical Education (APE) is when the general PE curriculum is changed or adjusted to accommodate the individualized needs of a student with disability.
  • Adapted PE can be included in an Individualized Education Plan or a Section 504 plan.
  • If a student needs Adapted PE, it’s important to include someone on the IEP team who is qualified to design individualized adapted PE, as well as the teacher or other school personnel who will be teaching the student.
  • Only certain qualified education professionals can design and supervise other educators and school staff teaching Adapted PE. Changes in WA State rules in 2024 allow more education professionals to qualify in Adapted PE.

Resources:

Updated Guidance on Adapted Physical Education  (WA State Office of Superintendent of Public Instruction (OSPI))

Attention Students: Lead your own IEP meetings and take charge of your future (PAVE)

Students: Get Ready to Participate in Your IEP Meeting with a Handout for the Team (PAVE)

Who’s Who on the IEP Team (PAVE)

Student Rights, IEP, Section 504 and More (PAVE)

A previous version of this article was based on information provided by two experts in the field of Adapted Physical Education, Toni Bader, and Lauren Wood, who are Adapted Physical Education teachers in the Seattle area:

  • Toni Bader, M.Ed., CAPE – SHAPE Washington, Adapted Physical Education, Seattle Public Schools (tonibader24@hotmail.com)
  • Lauren Wood, NBCT, Adapted Physical Education Teacher, Highline Public Schools, and SHAPE Washington Board Member (lauren.wood@highlineschools.org)

[1] “Certificated teachers who hold any special education endorsement or a Health/Fitness endorsement are eligible to add the APE specialty endorsement to their certificate”  –OSPI Updated Guidance

Youth, Explore Adapted Physical Education in Your IEP or 504 Plan

Overview

  • Physical Education (PE) can be adapted (changed) in four main ways to support students with disabilities.
  • Federal and state law protects your rights to be taught PE. Adapted PE can be included in your Individualized Education Program (IEP). It can also be included in a Section 504 plan.
  • Taking part in IEP and 504 meetings is important when looking at adapted physical education. It lets you share your needs, preferences, and goals. This helps create a physical education program that fits your abilities, supports your well-being, and creates a positive and inclusive environment. (Click on the links in the reference section to learn more about going to IEP and 504 meetings.)
  • Changes in WA State rules mean that more teachers will qualify to design and teach Adapted Physical Education. These rules are in effect as of May 1, 2024.
  • The Updated Guidance on Adapted Physical Education, from the Washington Office of Superintendent of Public Instruction (OSPI) quoted in this article gives more information about Adaptive PE and how it fits into special education in WA State. Download or read Updated Guidance on Adapted Physical Education.

Full article

Why is physical education important? How is it helpful to me, as an individual with a disability?

Classes can teach you to care for your body and learn physical, mental, and emotional skills that include:

  • Motor skills (training to use your muscles for certain things, such as swinging a baseball bat to hit a ball, or running very hard in a race)
  • Physical fitness (keeping healthy and strong by exercising your body)
  • Social-emotional skills, teamwork, social play skills
  • Skills for athletics like team sports like soccer or basketball or individual athletics like gymnastics or dance
  • Skills for recreation like biking, swimming, hiking, throwing frisbees, playing games with friends

How Adapted PE works:

Access or accessible means how easy it is to do, to get, or understand something.

There are four main areas where changing general PE curriculum (school courses) may help you access PE. Some of these changes will benefit ALL students using the general PE curriculum.

  • The physical space can be changed to work well for all students:
  • The size of the space and the number of other students can affect how accessible the PE class is for you.
  • Lighting, sound, and what you see can all affect your comfort in a class. Making thoughtful changes to these things can make a PE class more accessible.
  • Teaching: the teacher gathers information about individual students to make sure that they use teaching methods that are accessible to everyone. This might mean spoken instructions, movements, pictures, written words, showing how to do something, or videos.
  • Equipment: depending on your disability, you might need PE equipment to move more slowly, be bigger or smaller, easier to feel, be easier to see and other changes like those.
  • Rules: to make sure PE includes everyone, rules of the game may need to be added or taken away.

Examples of Adapted PE

The point of Adapted PE is to change the general PE curriculum so that it is accessible for you or any other student with a disability. The changes can be individualized, which means it is designed for one individual student with disability. Changes will depend on what your needs are and will be different from student to student. Here are some examples:

  • A third grader with autism spectrum disorder uses a play script on her communication device to invite other students to play tag with her.
  • A high-school senior with Down Syndrome is introduced to adult recreation choices in his community so he can continue building healthy habits after graduation.
  • A seventh grader with Cerebral Palsy attends general PE class. The Adapted PE teacher, general PE teacher, and the physical therapist work together to create an exercise plan to strengthen the student’s legs while using their walker.
  • Design a unified team for sport activities and competitions, so a high school student with disabilities can play in the same team with students without disabilities
  • Adapted Physical Education teachers are trained to make changes to the general education PE curriculum to make it accessible to students with disabilities.

IEPs can include Adapted PE as a service

To get an Individualized Education Program (IEP) you need an evaluation. This process helps to decide if a student has a disability, if the disability has a significant impact on (really affects) learning, and if you need Specially Designed Instruction (SDI) and/or related services to access a Free Appropriate Public Education (FAPE). FAPE is the right of any student, ages 3-21, who is eligible for school-based services delivered through an IEP.

If a student’s access to PE affects learning and needs the school’s PE course to be individualized, Adapted PE can be given as an IEP service. IEP teams discuss how Specially Designed Instruction (SDI) is delivered for each individual student.

If you have Adapted PE in your IEP, there is a range of options for placement. You might be in a general PE class, with or without accommodations. Additional aids, services, and modifications may be added depending on what you need. Get more details in the Updated Guidance on Adapted Physical Education.

You can go to IEP and 504 meetings to let the team know what you want and need.  Beginning at age 14, you can participate in IEP and 504 meetings. You do not have to be invited by the school or your parents, but it’s a good idea to let your parents know you want to go, and to get ready before the meeting. When you are at these meetings, you can show other team members what is important to you about your learning, including Physical education. (Click on the links in the reference section to learn more about going to IEP and 504 meetings.)

All of you on the team can work out a PE plan, which may include Adapted PE, and put it in your IEP. There are two articles in the References section at the end about going to your IEP meeting.

Rules changed and removed some difficulties with getting Adapted PE

Until spring of 2024, Adapted PE was not accepted as a specialty that the state would endorse (add to the training listed on a teacher’s professional certificate). This caused a shortage of teachers who could design Adapted PE for students. It made it difficult for some students with disability in Washington State to get SDI in physical education.

As of May 1, 2024, qualifying[1] teachers in Washington State can be trained for and receive a specialty endorsement in Adapted Physical Education. The endorsement shows the teacher has specific skills and knowledge in both PE Learning Standards and special education competencies. As more teachers are taught this specialty, it will be easier to find teachers with Adapted PE training in Washington State.

The OSPI Updated Guidance says that in addition to teachers with an Adapted PE endorsement, SDI for physical education can be provided by “any other appropriately qualified special education endorsed teacher, or an “appropriately qualified Educational Staff Associate (ESA) such as an Occupational Therapist (OT) or a Physical Therapist (PT).”

Summary:

  • Physical Education (PE) is an important part of school. Students with disabilities have the right to be taught physical education.
  • Adapted PE is when the general PE school course (curriculum) is changed to accommodate (meet the needs) of an individual student with disability.
  • Adapted PE can be included in an Individualized Education Plan or a Section 504 plan.
  • If a student needs Adapted PE, it’s important to include someone on the IEP team who is qualified to design adapted PE, as well as the teacher or other school staff who will be teaching the student.
  • Only certain qualified education professionals can design and supervise other educators and school staff teaching Adapted PE. Changes in WA State rules in 2024 allow more education professionals to qualify in Adapted PE.

Resources:

Updated Guidance on Adapted Physical Education  (WA State Office of Superintendent of Public Instruction (OSPI))

Attention Students: Lead your own IEP meetings and take charge of your future (PAVE)

Students: Get Ready to Participate in Your IEP Meeting with a Handout for the Team (PAVE)

Who’s Who on the IEP Team (PAVE)

Student Rights, IEP, Section 504 and More (PAVE)

A previous version of this article was based on information provided by two experts in the field of Adapted Physical Education, Toni Bader, and Lauren Wood, who are Adapted Physical Education teachers in the Seattle area:

Toni Bader, M.Ed., CAPE – SHAPE Washington, Adapted Physical Education, Seattle Public Schools (tonibader24@hotmail.com)

Lauren Wood, NBCT, Adapted Physical Education Teacher, Highline Public Schools, and SHAPE Washington Board Member (lauren.wood@highlineschools.org)


[1] “Certificated teachers who hold any special education endorsement or a Health/Fitness endorsement are eligible to add the APE specialty endorsement to their certificate”  –OSPI Updated Guidance

Ready for Work: Vocational Rehabilitation Provides Guidance and Tools

A Brief Overview

  • Vocational rehabilitation (VR) is a federal right. Pre-Employment Transition Services (Pre-ETS) are one way to get support. Another is through 1:1 counseling and an Individualized Plan for Employment (IPE).
  • In Washington State, the Division of Vocational Rehabilitation (DVR) provides Pre-ETS and VR services. To seek support for a student still working toward a diploma, contact the DVR counselor assigned to the student’s school. DSHS maintains an interactive map: Find a School Transition Counselor.
  • Individuals with vision impairment and blindness are served through a separate vocational rehabilitation agency in Washington State, the Department of Services for the Blind (DSB).
  • After graduation, a student with a tribal affiliation may be eligible for support from Tribal Vocational Rehabilitation (TVR). Each TVR agency operates independently. Contact information is listed on a TVR website page, within DVR’s website.
  • Graduating seniors can seek DVR, TVR, or DSB services now!

Full Article

Teenagers and young adults with disabilities have additional considerations when deciding what life looks like after high school. The transition planning process begins in middle school, when all Washington State students work with counseling staff to begin their High School and Beyond Plan.

For students with disabilities, that lengthy planning process is enhanced when the Individualized Education Program (IEP) adds a Transition Plan, required by the school year when a student turns 16.

Vocational rehabilitation agencies can be part of that process and support a warm hand-off into the world of work. PAVE provides an infographic Transition Triangle with more about the way these services can wrap around a student as they move through school and beyond.

Vocational Rehabilitation services are a civil right

The right to vocational rehabilitation (VR) services is an aspect of Title 1 of the amended Rehabilitation Act of 1973. In 2014, the Rehabilitation Act, which guarantees equitable access to public spaces and programs, was further amended to include the Workforce Innovation and Opportunity Act (WIOA).

Pre-Employment Transition Services (Pre-ETS) were already an aspect of the Rehabilitation Act, but WIOA further defines Pre-ETS and requires that VR agencies set aside 15 percent of their funding to provide or arrange for the provision of Pre-ETS.

Note that Section 504 is also a feature of the Rehabilitation Act. Section 504 guarantees the right to accommodations for equitable access in public facilities and programs.

Section 504 is the basis for a student’s “504 Plan” that provides accommodations, modifications, and anti-discrimination measures for educational access. Section 504 protections aren’t limited to school: Like the Americans with Disabilities Act (ADA), Section 504 protects a person in higher education, work, and elsewhere throughout the lifespan. Students with IEPs also have Section 504 protections.

In other words, the accommodations from a student’s 504 Plan or IEP travel with them into higher education, work, and more. Section 504 and the ADA protect an individual with disabilities throughout their life. Denial of accommodation is considered discrimination under these civil rights laws.

In Washington State, vocational rehabilitation services are provided by the Division of Vocational Rehabilitation (DVR), which is housed within the Department of Social and Health Services (DSHS).

After graduation, a student with a tribal affiliation may be eligible for support from Tribal Vocational Rehabilitation (TVR). TVR agencies operate with sovereignty; contact information is included within DVR’s website, on a TVR website page.

Individuals with vision impairment and blindness are served through a separate vocational rehabilitation agency in Washington State, the Department of Services for the Blind (DSB).

Pre-ETS help students look ahead to their job options after graduation

Pre-Employment Transition Services (Pre-ETS) include job exploration, work-based learning, counseling about further educational options, workplace readiness and self-advocacy training.

Summer programs are available in some areas. To find the forms to enroll in Pre-ETS and for information about programs and regional counselors in your area, visit DVR’s website page called High School Transition.

Pre-ETS include five required services. Each service in this list is linked to a resource for further investigation. DVR counselors can provide additional resources to suit an individual’s unique circumstances:

  1. Job exploration counseling: career speakers, interest and ability inventories, investigation of labor market statistics and trends, and more
  2. Work-based learning experiences: in-school or after school opportunities, including internships, provided in an integrated environment to the maximum extent possible. According to the Brookings Institution, work-based learning is predictive of future job quality.
  3. Counseling on opportunities for further education: How to complete the Free Application for Federal Student Aid (FAFSA®) and how to locate disability resource centers at colleges and universities are part of college readiness.
  4. Workplace readiness training to develop social skills and independent living
  5. Instruction in self-advocacy, which may include peer mentoring, training in disability disclosure, and more

Order of Selection impacts access to 1:1 DVR support

The Individualized Plan for Employment (IPE) is a DVR program that is separate from Pre-Employment Transition Services (Pre-ETS). The IPE is supported 1:1, whereas pre-employment services are generally provided to groups of students.

DVR operates with Order of Selection when clients apply for individualized vocational rehabilitation (VR) counseling. Through Order of Selection, individuals with the highest needs for support are prioritized.

When developing an IPE, the client and counselor establish a goal for employment; the counselor provides coaching, logistical and sometimes financial support to help make that happen. The case remains open until the employment goal is met if the client remains meaningfully engaged in the process. IPE services might include educational support if further education is needed to achieve a job goal.

Can a student get Pre-ETS and 1:1 help?

A student might receive services through both programs—Pre-ETS and the Individualized Plan for Employment (IPE). However, families should be aware that there are some specific rules related to Order of Selection.

  • If a student is already participating in Pre-ETS, the student can apply for an IPE and Order of Selection will not impact the student’s ongoing engagement in Pre-ETS.
  • If the student applies for an IPE first and is put on a waiting list, then the student also will have to wait to begin Pre-ETS.
  • A student will have more access to DVR services by engaging with the Pre-ETS first and then considering whether to also apply for individualized support.

Resources for more information

Research shows that access to an array of collaborative services during high school improves post-secondary outcomes, especially when school staff and service providers get to know one another and there are “warm hand-offs” between individuals who develop trusted relationships with the young person, according to data shared by the National Technical Assistance Center on Transition (NTACT). Another place for data and detail about WIOA is the Workforce Innovation Technical Assistance Center (WINTAC).

Engagement with vocational rehabilitation services is supported by initiatives endorsed by the U.S. Department of Labor and its Office of Disability Employment Policy (ODEP). These federal agencies promote the concept of Employment First, a framework for systems change centered on the premise that all citizens, including individuals with significant disabilities, are capable of full participation in integrated employment and community life. 

The PACER Center, a Minnesota-based agency founded in 1977 to promote a “parents helping parents” philosophy, supports the National Parent Center on Transition and Employment, which offers a collection of materials with more information about vocational rehabilitation and how to benefit from pre-employment and employment services. Included in the PACER Center’s materials is a booklet for parents to help young people prepare for college and careers.

Washington’s DVR program provides a video about the school-to-work transition with young people talking about their experiences with the agency and how it helped.

Healthcare in Transition

Healthcare transition, like all other aspects of transitioning to adult care and services, can be difficult. However, if teenagers and families plan ahead for healthcare changes that occur when a child becomes an adult, things can go smoothly and be successful. Here are some resources and information for making the health care transition to adult care successful and seamless.

There are two main components for individuals transitioning from pediatric (children’s) to adult health care.

  • New medical providers and systems, including changes in insurance.
  • The young adult’s new responsibility to be in charge of their own health care.

Health Insurance and Providers

For individuals on Medicaid, Medicare, or private health insurance, eligibility, cost, and what services are covered may change.

Washington’s Medicaid option, Apple Health, has different financial requirements for adults than they do for minors. See the chart below for current income requirements for Apple health.

ProgramSingle person2-person house-hold3-person household4-person household5-person household6-person household7-person household
Apple Health for Adults, age 19 through 64 years of age$1,677 monthly$2,268 monthly$2,859
monthly
$3,450
monthly
$4,042
monthly
$4,633
monthly
$5,224
monthly
Current income requirements for Apple Heath
  • To apply or renew for Apple Health, go to the Health Plan Finder website.  Even if an individual is not eligible for fully subsidized healthcare, the Health Plan Finder can reveal some low-priced options. 
  • For young adults on their parents’ private insurance, they will have coverage under their parent’s plan until they are 26, at which time they will need to apply for their own health insurance.  The Health Plan Finder can help you find affordable options, including Apple Health.
  • For individuals under 65 who are receiving Medicare due to a disability, insurance should not change due to the transition to adulthood.

A person’s health insurance may limit the health care providers available. Once you and your family know what type of health insurance you will have, you can select from physicians and other health professionals who accept that insurance. Most medical practices either list what insurances they accept, or you can call the office and ask. Health care insurance plans may also send information on where to find a provider, or you may find it on their website.

Taking on Responsibility for Health Care and Decisions

Healthcare is just one of many new responsibilities that young people take on as they become adults.  Parents can avoid overwhelming a teen with new obligations, beginning with giving younger teens options and increasing tasks to help them adapt to this change.  There are several resources for families and youth to use in this transition:

  • Family to Family has a youth-written curriculum about Transitioning to Adult Doctors for individuals with disabilities that can help teens start their medical transition journeys.
  • Charting the LifeCourse™ was created by families to help individuals and families of all abilities and all ages develop a vision for a good life, including their health care.
  • Got Transition is a comprehensive website about the transition to adult health care, with quizzes, FAQs, and timelines to make it easier to understand.
  • The Center for Transition to Adult Health Care for Youth with Disabilities is a national health care transition resource center. The goal of the center is to empower youth and young adults with intellectual and developmental disabilities (ID/DD) ages 12-26 to direct their own transition from pediatric to adult care with no reduction in quality of care and no gaps in service.

Beyond these resources, the most useful are the young adults, whether you are the parent/caregiver or a transitioning individual. It’s important to recognize that lived experience gives knowledge even in a new situation. There is the knowledge of medical need that may not be in a chart, emotional or behavioral challenges, developing self-determination that supports transition, and other important things only you know.  Next in line are the current medical providers and specialists.  They not only have helped numerous other teens transition to adult healthcare, but they are a part of developing the care plan, a critical resource for transitioning to an unfamiliar doctor or clinic when a young adult may have complex care needs.   Doctors’ office staff are also used to dealing with these issues and may have some good planning advice for families.  Lastly, advice from families who have already helped a child transition to adult care can help to know what to do—and what not to do!  Parent-to-Parent can match parents up with families who have already gone through such transitions with those who seek their knowledge and experience.

5 Tips for Success in Healthcare Transition


Including Health Considerations in the Transition Plan

Parents, Students, and everyone on the IEP team should think about how health and healthcare can affect a student’s goals for college, work and living on their own. PAVE has made a fillable form that you can download when starting to think about this area in transition.

Including Health Considerations in the Transition Plan

Healthcare Transition and Medical Self-Advocacy

When young people turn 18, a lot happens. Adult responsibilities and decisions can feel scary and confusing for the unprepared. Becoming responsible for medical care is part of growing up, and that process is so critical that there’s a specific name for it: healthcare transition.

For example, at age 18 a young adult is responsible to sign official paperwork to authorize procedures or therapies. They must sign documents to say who can look at their medical records, talk to their doctors, or come to an appointment with them. Those rules are part of HIPAA, which stands for the Health Insurance Portability and Accountability Act. HIPAA is a federal law that protects confidentiality, regardless of disability.

In this video, young adults living with various disability and medical conditions talk about their journeys in the adult healthcare system. They talk about how they make decisions and how they ask for help. Their ability to explain their needs, make decisions, and speak up for themselves is called self-advocacy. Take a look and listen to what they have to say in their own words!

For more information and resources around healthcare transition and self-advocacy, follow these links to the Family to Family Health Information website.

PAVE also has a Healthcare In Transition article that will give you detailed information for individuals transitioning from Pediatric (Children’s) to adult health care including information on health insurance and providers.

Another place for information is the Informing Families website, which includes a section called got transition.

Including Health Considerations in the Transition Plan

Parents, Students, and everyone on the IEP team should think about how health and healthcare can affect a student’s goals for college, work and living on their own. PAVE has made a fillable form that you can download when starting to think about this area in transition.

Including Health Considerations in the Transition Plan

What’s Next? High School Transition Planning Timeline

High School Transition Timeline

Description of the above graphic:

What’s Next?

High School Transition Planning

Mapping the Future

Check these milestones to ensure high school paves a pathway for young adult success and achievement!

Ages 13-14
Student begins High School and Beyond Plan in Middle School—a WA State requirement for all students.

Ages 15-16
IEP includes a Transition Plan, aligned with High School and Beyond Plan. Student is a member of the IEP team, which plans a pathway toward a diploma and target graduation date.

Age 16
Get state identification card. Consider Pre-Employment Transition Services from DVR/DSB or School-to-Work planning with DDA.

Ages 17-18
Coursework, IEP, High School and Beyond Plan, DDA/DVR all support student’s life goals and progress toward a diploma.

Age 18
Register to vote! Participate in Commencement and senior year activities, regardless of when diploma is earned.

Ages 18-19
Student may continue education in a high school transition program.

Ages 20-21
Student earns a diploma. May apply for individualized employment support from DVR/TVR/DSB or DDA.

DVR: Division of Vocational Rehabilitation

TVR: Tribal Vocational Rehabilitation

DSB: Department of Services for the Blind

DDA: Developmental Disabilities Administration

Download this graphic to print and keep handy!

Need more information? Consider reading the article School to Adulthood: Transition Planning Toolkit for High School, Life, and Work

Exploring Assistive Technology: Understanding, Access, and Resources for All Ages and Abilities

Brief overview:

  • Access to assistive technology (AT) is protected by four federal laws.
  • The U.S. Department of Education has released guidance on the specific requirements about providing AT under the Individuals with Disabilities Education Act (IDEA). The guidance takes the form of detailed explanations for many misunderstood facts about using AT in schools and early intervention services. It is available online and in PDF form in English and Spanish.
  • AT can be very simple and low-cost, or it may be high-tech or large and expensive. Resources for deciding on AT devices and services and buying or getting low-cost or free TA are included in the article.

Full Article

You can also type “assistive technology” in the search bar at wapave.org to find other articles where assistive technology is mentioned.

What is assistive technology (AT)? Who uses it? Where is it used?
Assistive technology (AT) is any item, device, or piece of equipment used by people with disabilities to maintain or improve their ability to do things. AT allows people with disabilities to be more independent in education, at work, in recreation, and daily living activities. AT might be used by a person at any age—from infants to very elderly people.

AT includes the services necessary to get AT and use it, including assessment (testing), customizing it for an individual, repair, and training in how to use the AT. Training can include training the individual, family members, teachers and school staff or employers in how to use the AT.

Some examples of AT include:

  • High Tech: An electronic communication system for a person who cannot speak; head trackers that allow a person with no hand movement to enter data into a computer
  • Low Tech: A magnifying glass for a person with low vision; a communication board made of cardboard for a person who cannot speak
  • Big: An automated van lift for a wheelchair user
  • Small: A grip attached to a pen or fork for a person who has trouble with his fingers
  • Hardware: A keyboard-pointing device for a person who has trouble using her hands
  • Software: A screen reading program, such as JAWS, for a person who is blind or has other disabilities

You can find other examples of AT for people of all ages on this Fact Sheet from the Research and Training Center on Promoting Interventions for Community Living.

Select the AT that works best:

Informing Families, a website from the Developmental Disabilities Administration, suggests this tip: “Identify the task first. Device Second. There are a lot of options out there, and no one device is right for every individual. Make sure the device and/or apps are right for your son or daughter and try before you buy.”

AT3 Center, a national site for AT information, has links describing, finding and buying a wide variety of assistive technology, with text in English and Spanish.

Understood.org offers a series of articles about AT focused on learning in school, for difficulties in math, reading, writing, and more.

Who decides when AT is needed?  Your child’s medical provider or team may suggest the AT and services that will help your child with their condition. If your child is eligible for an Individualized Education Program (IEP), an Individualized Family Services Plan (IFSP), or a 504 plan, access to AT is required by law. In that case, the team designing the plan or program will decide if AT is needed, and if so, what type of AT will be tried. Parents and students, as members of the team, share in the decision-making process. A process for trying out AT is described on Center for Parent Information and Resources, Considering Assistive Technology for Students with Disabilities.

Access to assistive technology (AT) is protected by four laws:

  1. The AT Act of 2004 requires states to provide access to AT products and services that are designed to meet the needs of people with disabilities. The law created AT agencies in every state. State AT agencies help you find services and devices that are covered by insurance, sources for AT if you are uninsured, AT “loaner” programs to try a device or service, options to lease a device, and help you connect with your state’s Protection and Advocacy Program if you have trouble getting, using, or keeping an assistive service or device. Washington State’s AT agency, Washington Assistive Technology Act Program (WATAP), has a “library” of devices to loan for a small fee and offers demonstrations of how a device or program works.

IDEA Part C includes AT devices and services as an early intervention service for infants and toddlers, called Early Support for Infants and Toddlers (ESIT) in Washington State. AT can be included in the child’s Individualized Family Service Plan (IFSP). When a toddler transitions from early intervention services to preschool, AT must be considered whether or not a child currently has AT services through an IFSP.

It’s important that a student’s use of AT is specified in their post-secondary Transition Plan. This will document how the student plans to use AT in post-secondary education and future employment and may be needed when asking for accommodations from programs, colleges and employers when IDEA and IEPs no longer apply.

Guidance on assistive technology (AT) from the U.S. Department of Education

In January 2024, the U.S. Department of Education sent out a letter and guidance document on the Individuals with Disabilities Education Act (IDEA) requirements for assistive technology for children under Part C and Part B of IDEA.

The guidance document is available online and in a downloadable pdf in English and Spanish. It includes common “Myths and Facts” about AT. The document is designed to help parents, early intervention providers, educators, related service providers, school and district administrators, technology specialists and directors, and state agencies understand what IDEA requires.

For instance, there are examples of what IFSPs might include:

  • A functional AT evaluation to assess if an infant or toddler could benefit from AT devices and services;
  • AAC devices (e.g., pictures of activities or objects, or a handheld tablet) that help infants and toddlers express wants and needs;
  • Tactile books that can be felt and experienced for infants and toddlers with sensory issues;
  • Helmets, cushions, adapted seating, and standing aids to support infants and toddlers with reduced mobility; and
  • AT training services for parents to ensure that AT devices are used throughout the infant or toddler’s day.

For IEPs, some important facts from the guidance document are:

  • Each time an IEP Team develops, reviews, or revises a child’s IEP, the IEP Team must consider whether the child requires AT devices and services (in order to receive a free appropriate public education (FAPE).
  • If the child requires AT, the local educational agency (LEA) is responsible for providing and maintaining the AT and providing any necessary AT service. The IEP team can decide what type of AT will help the child get a meaningful educational benefit.
  • The IEP must include the AT to be provided in the statement on special education, related services, and supplementary aids and services.
  • A learner’s AT device should be used at home as well as at school, to ensure the child is provided with their required support.
  • AT devices and services should be considered for a child’s transition plan as they can create more opportunities for a child to be successful after high school. (Note: AT can be an accommodation used in post-secondary education and in a job).

If a student is already using AT devices or services that were owned or loaned to the family, such as a smartphone, theguidance includes information about how to write it into an IEP or an agreement between the parents and school district.

Paying for AT

Some types of AT may be essential for everyday living including being out in the community and activities of daily living like eating, personal hygiene, moving, or sleeping. When a child has an AT device or service to use through an IFSP, IEP, or 504 plan, the device or service belongs to the school or agency, even if it’s also used at home. All states have an AT program that can help a school select and try out an AT device. These programs are listed on the Center for Assistive Technology Act Data Assistance (CATADA) website. A child’s AT devices and services should be determined by the child’s needs and not the cost.

When a child graduates or transitions out of public school, they may need or want AT for future education or work. In these cases, families can look for sources of funding for the more expensive types of AT. Here are some additional programs that may pay for AT devices and services:

AT for Military Families

Some programs specific to the United States Armed Forces may cover certain types of assistive technology as a benefit.It’s important for Active-Duty, National Guard, Veteran and Coast Guard families to know that they are eligible for assistive technology programs that also serve civilians, including those in Washington State.

If the dependent of an Active-Duty servicemember is eligible for TRICARE Extended Care Health Option (ECHO), assistive technology devices and services may be covered with some restrictions. The program has an annual cap for all benefits and cost-sharing, so the cost of the AT must be considered. The AT must be pre-authorized by a TRICARE provider and received from a TRICARE-licensed supplier. If there is a publicly funded way to get the assistive technology (school, Medicaid insurance, Medicaid Home and Community-Based Services Waiver, state AT agency loaner device, or any source of taxpayer-funded access to AT), the military family must first exhaust all possibilities of using those sources before ECHO will authorize the AT.

Some types of AT, such as Durable Medical Equipment, may be covered under a family’s basic TRICARE insurance plan.

The United States Coast Guard’s Special Needs Program may include some types of assistive technology as a benefit.

Additional Resources
Assistive Technology

Does my child qualify for Assistive Technology (AT) in school?

Movers, Shakers, and Troublemakers: How Technology Can Improve Mobility and Access for Children with Disabilities

Low tech tool ideas that can be used to increase Healthcare Independence

Supported Decision Making is an Option for Adults with Disabilities

A Brief Overview

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

Full Article

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

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

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

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

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

What is Supported Decision Making?

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

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

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

What should be included in the agreement?

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

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

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

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

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

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

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

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

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

Help me communicate my decision to appropriate persons.”

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

Is Supported Decision Making free?

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

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

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

Resources for Supported Decision Making

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

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

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

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

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

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

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

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

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

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

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

Additional Resources

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

How to Navigate School for Youth with Mental Health Concerns

Staff from PAVE’s Parent Training and Information (PTI) program provided a workshop as part of the statewide virtual conference hosted by NAMI Washington October 16, 2021.

This recorded training provides a general overview of student rights in education. Some information is specific to students impacted by mental health conditions.

The formal content begins about four minutes into the video and ends at about 46 minutes.

Here are a few examples of topics addressed:

  • Does my student have the right to be evaluated for special education if they refuse to go to school because of anxiety?
  • What accommodations are reasonable to ask for?
  • What services might be possible for my student who struggles with emotional regulation?
  • Can counseling be a related service?
  • Are there protections for a student because of suicidal thoughts or attempts?
  • What support is available for a student with a disability condition who isn’t prepared for adulthood because high school got interrupted by the pandemic?

Additional information about mental health education and services at school, the overall layout of youth behavioral health in Washington State, and where to find family support is included in a PAVE article: Mental Health Education and Support at School can be Critical.

To seek education, training, and support from the National Alliance on Mental illness, look for a virtual training or information about a local affiliate near you, listed on the NAMI WA website.

One place to access behavioral health services for children and youth anywhere in Washington is through the Seattle Children’s Hospital Mental Health Referral Service: 833-303-5437, Monday-Friday, 8 a.m. to 5 p.m.

Families and young people can reach out for individualized assistance from PAVE’s Parent Training and Information (PTI) staff at PAVE. Click Get Help or call 800-572-7368.

After you view the video, please take a quick moment to complete our survey. Your feedback is valuable!

Special Education Process Demystified in 10 Steps

Here is basic guidance about how special education works. For a bit more detail, visit How Special Education Works A 10-Step Guide to the Special Education Process provided by Washington’s Office of Superintendent of Public Instruction (OSPI). Procedural Safeguards protect family and student rights throughout the process.

  1. Referral: Is there a known or suspected disability condition that may significantly impact educational access? If yes, family or anyone with knowledge of the student can request an evaluation from the school district in writing.
  2. Consent to evaluate: The school district has 25 school days to consider the referral and whether to evaluate. Family signs consent for an evaluation to begin.
  3. Initial Evaluation: The district has 35 school days to conduct an evaluation that comprehensively addresses all areas of suspected disability.
  4. Initial Evaluation Report: Family and school meet to review the findings. Discussion includes:
    • What did the evaluation find?
    • Is the student eligible?
    • What category of disability is the right fit for eligibility?
    • What services is the student eligible for?
    • Does the family have suggestions for goal areas or accommodations that school staff can consider for the initial IEP draft?
  5. Eligibility and Consent: For special education and related services to begin, family signs consent.
  6. Creating an Individualized Education Program (IEP): An IEP team meets within 30 days of the eligibility determination to write the IEP.
    • A DRAFT IEP may be reviewed and discussed. Family can request a copy of the DRAFT before meeting.
    • The team decides what the final IEP includes.
    • School provides family with Prior Written Notice after the meeting to reflect the discussion and actions being taken.
    • Family has an opportunity to request further changes or more meetings.
  7. Special Education Begins: All teachers and service providers receive a copy of the IEP and implement the services, accommodations, and other elements of the program.
  8. Progress Monitoring and Annual IEP Review: The IEP team meets to discuss the program at least once a year. Changes can be made then or any time a team meeting is called because of concerns raised by the family or school.
  9. Reevaluation: The student is re-evaluated at least every 3 years to determine ongoing eligibility and to assess any needed changes to the program. If a student’s needs change, reevaluation can happen sooner.
  10. Transition: By the time a student turns 16, the IEP must have a plan in place for when the student will either graduate from high school or continue to receive school-based services, an option through age 21. Postsecondary goals drive the IEP process from that point forward.

Transition Training Series: Preparing for High School and Beyond (In English and Spanish)

English Video

Last month, PAVE partnered with Clark County to start the Family Training Series for families and educators supporting individuals with disabilities.  It is offered by the Clark County Developmental Disabilities Program, the Clark County Parent Coalition, the Vancouver, Camas, and Evergreen School Districts, PAVE, and ESD 112. While the information in the sessions are targeted for families and educators, it is valuable information for any county you find yourself in! Below is this training in Spanish.

Additional ideas and information are provided by ReadyWA.org, a coalition of state education agencies, associations, and advocacy organizations focused on student success beyond graduation. The agency provides an article: High School and Beyond Planning: What’s New for 2020-21. The article includes a section about aligning general education future planning with the IEP transition planning process and includes links to key documents in English and Spanish.  

Video en español

El mes pasado, PAVE se asoció con el Condado de Clark para iniciar la Serie de Capacitaciones para familias y educadores que apoyan a las personas con discapacidades.  Este entrenamiento fue ofrecido por el Programa del condado de Clark para discapacidades del desarrollo, la Coalición de Padres del Condado de Clark, los Distritos Escolares Vancouver, Camas y Evergreen, así como organizaciones como PAVE y ESD 112. ¡Aunque que la información de las sesiones está dirigidas a familias y educadores, es información valiosa para cualquier condado en el que usted se encuentre! Este video está en español para el apoyo de familias latinas.

Usted puede encontrar sugerencias e información en ReadyWA.org, que es una coalición de agencias estatales de educación, asociaciones y organizaciones que tienen como propósito ayudar a los padres de familia a defender a los derechos de sus hijos. También les ayuda a enfocarse en el éxito estudiantil que va más allá de la graduación de secundaria. Esta misma, proporciona un reportaje llamado:  High School and Beyond Planning: What’s New para 2020-21. Este reportaje incluye una sección que prepara a las familias en como planificar el proceso de transición del IEP e incluye enlaces o links claves proporcionados en inglés y español.

Adolescent Health Care Act Provides Options for Families Seeking Mental Health and Substance Use Help for Young People Resistant to Treatment

A Brief Overview

  • The Adolescent Behavioral Health Care Access Act, passed into law by the Washington Legislature in 2019, gives parents and providers more leverage in treating a young person who won’t or can’t independently seek medical help for mental illness and/or substance use disorder.
  • The Washington State Health Care Authority (HCA) in March 2020 launched several website links with information about the new law, which includes an option for Family Initiated Treatment (FIT).
  • The Washington State Hospital Association on July 9, 2019, provided a slide presentation describing the law’s history and its primary features.
  • A place to connect with other families concerned about adolescent mental healthcare access in Washington State is a group called Youth Behavioral Healthcare Advocates (YBHA-WA) on Facebook. Included on the page are handouts that summarize key aspects of the new law. 

Full Article

Getting mental health help for a youth in crisis can be complicated, frustrating and frightening.

Mental Health America ranks states based on the incidence of mental illness and access to services. The agency’s 2020 rankings list Washington in the 43rd position, based on various measures that indicate a higher prevalence of mental illness and lower rates of access to care.

Often a barrier to treatment is the youth, who may not be able to see a problem or want to get professional help. Parents often struggle to navigate systems that must balance a young person’s autonomy with concern that they may not be able to make good decisions because of their development, specific illness circumstances or symptoms that impact the brain.

In Washington State, the age of medical consent is 13. That means that a person 13-17 years old can independently seek medical treatment, without the consent or knowledge of parents.

Age of consent laws also have meant that Washington youth could say no to mental health or substance use treatment, regardless of whether parents and providers agreed that such treatment was necessary to protect the safety and well-being of the adolescent.

A law passed by the Washington legislature in 2019 gives parents and providers more leverage when a young person is struggling with a mental illness or substance use disorder and won’t independently engage with treatment. The law does not limit an adolescent’s ability to initiate treatment on their own.

A January 8, 2020, article in Crosscut profiles several families impacted by the new law. “Until the new law,” the article states, “parents often were shut out of their teenager’s care and treatment plans and couldn’t push a teen toward necessary outpatient or inpatient care without their consent.”

The Adolescent Behavioral Health Care Access Act enables parents/caregivers to bring a child for inpatient or outpatient treatment without requiring consent from the child, ages 13-17. The law includes elements introduced by the state Senate and House of Representatives, which originally titled the bill as HB 1874.

Passage of the law was a win for the Children’s Mental Health Work Group, which studied and reviewed recommendations from a stakeholder advisory group authorized by the 2018 legislature. The final version of the law included input from family members, youth, clinicians, hospital staff and many others who met dozens of times. A June 13, 2019, slide presentation available online provides additional history and detail about the work group and its recommendations: Family Initiated Treatment and Engaging Families in Treatment of Youth. The webinar with sound is available on YouTube.

The 2020 legislature is considering amendments to the law, and the Children’s Mental Health Work Group continues to meet to consider proposals to clarify provisions that relate to residential treatment and referrals for Wraparound with Intensive Services (WISe).

“Parent” is broadly defined

The 2019 law expands the definition of parent to include a wide range of family caregivers, guardians and others who have authority to initiate treatment. The Revised Code of Washington (RCW 9A.72.085) provides standards for “subscribing to an unsworn statement” that can apply to a caregiver initiating treatment. 

Note that parents retain the right to make medical decisions for children younger than 13, and adults 18 and older are responsible for medical decision-making if there is no guardianship.

A substantive change with the 2019 law is that providers may share mental health information with parents without an adolescent’s consent, if the provider determines that information sharing with family is in the best interests of the adolescent patient. A list of information-sharing guidelines is included below.

How Family-Initiated Treatment Works

If a parent/caregiver believes that an adolescent requires mental health or substance use disorder treatment, the adult can escort the young person to an inpatient or outpatient treatment facility even if the adolescent doesn’t readily agree to go.

A provider will assess the adolescent and consider information from the family to determine whether treatment is medically necessary. An adolescent’s refusal to engage with the provider cannot be the sole basis for refusing to treat.

An inpatient facility can detain the adolescent under Family-Initiated Treatment (FIT) if medically necessary. Note: another option could be detention under the Involuntary Treatment Act (ITA), if the adolescent is determined to be gravely disabled or at imminent risk of self-harm or harm to others.

If medical necessity is found by an outpatient provider, a counselor is limited to 12 sessions over 3 months to attempt to work with the adolescent. If the young person still refuses to engage with treatment, then the period of Family-Initiated Treatment with that provider ends.

State laws continue to encourage autonomy for young people, but family engagement is encouraged. According to the Revised Code of Washington (RCW 71.34.010):

 “Mental health and chemical dependency professionals shall guard against needless hospitalization and deprivations of liberty, enable treatment decisions to be made in response to clinical needs in accordance with sound professional judgment, and encourage the use of voluntary services. Mental health and chemical dependency professionals shall, whenever clinically appropriate, offer less restrictive alternatives to inpatient treatment. Additionally, all mental health care and treatment providers shall assure that minors’ parents are given an opportunity to participate in the treatment decisions for their minor children.”

Guidance for Information Sharing

Federal law, 42 CFR Part 2, restricts information sharing related to substance use, and clinicians cannot share that information without a patient’s written consent, regardless of whether the substance use co-occurs with mental illness.

Providers have discretion in determining what information about mental health diagnoses and treatment is clinically appropriate to share with parents of an adolescent 13-17. A provider retains discretion in withholding information from family/caregivers to protect an adolescent’s well-being. In general, the Adolescent Behavioral Healthcare Access Act encourages sharing information to support collaboration between the clinical setting and home. Specifically, providers and families are encouraged to discuss:

  • Diagnosis
  • Treatment Plan and Progress
  • Recommended medications, including risks, benefits, side effects, typical efficacy, dosages and schedule
  • Education about the child’s mental health condition
  • Referrals to community resources
  • Coaching on parenting or behavioral management strategies
  • Crisis prevention planning and safety planning

Information about state laws related to Behavioral Health Services for Minors is available through the Washington State Legislature website under RCW 71.34.

Information about child and youth behavioral health services in Washington State is available from the Health Care Authority (HCA).

Attention Students: Lead your own IEP meetings and take charge of your future

A Brief Overview

  • By the time you are 16 years old, the school is required to invite you to your IEP meetings. You can attend any time, and leading your own meeting is a great way to learn important skills.
  • If you need more help at school or aren’t learning what you need to learn, then your IEP might need some fixing. Your voice matters on the IEP team.
  • A website, I’m Determined.org, provides videos of students describing their goals. You can also print a goal-tracking worksheet from that website.
  • Read on to learn more about the parts of an IEP and how to get more involved in your own education.

Full Article

If you are a student with an Individualized Education Program (IEP), read this article to find out how you can be a leader on your IEP team. Your future is counting on you!

By the time you are 16 years old, the school is required to invite you to your IEP meetings. From that year on, your school program is matched to your long-term goals. It’s important to plan your time carefully so that every school day gets you closer to where you want to be when you are an adult. 

Learn to be a self-advocate

 An advocate (pronounced ad-vo-cut) is someone who asks for something in a public way. Public schools get money from the government, so they are considered public entities. When you ask the school to provide you with something that you need to succeed, then you are being a self-advocate.

The word advocate can also be an action word (a verb), but then it’s pronounced ad-vo-cate (rhymes with date). You advocate for yourself when you ask for what you need to succeed.

Here’s another way to use this hyphenated word: You can say that you “practice self-advocacy.” Leading your own IEP meeting is a great way to practice self-advocacy and develop important adult skills.

Your Transition Plan focuses on where you want to go

 The part of the IEP that focuses on your adult goals is called a Transition Plan. The Transition Plan is added to the IEP by the school year when you turn 16. The plan includes details about:

  • when you plan to graduate (you can stay in school through age 21 if your IEP goals require more time)
  • what jobs you might choose
  • whether college is part of your plans
  • what lifestyle you imagine for yourself (will you drive, cook, shop, live alone?)
  • how school is getting you ready for all of that

The Transition Plan is all about you and your future. You can start taking charge of your future by going to your IEP meetings. You may want to lead all or part of the meeting, and you have that right.

The law says it’s all about you

Your rights as a student with an IEP are part of a federal law called the Individuals with Disabilities Education Act (IDEA). The IDEA says that schools must include family members and students on the IEP team. If you don’t play on the team, you can’t win the game, right? This is more important than a game—it’s Your Life!

The IDEA is a unique law because it says you get what you need in order to access school and learning. Getting an education that is specially designed just for you is called an entitlement. What you are entitled to is called FAPE, which means Free Appropriate Public Education.

You can become a leader on your IEP team by learning more about FAPE and how to talk about what it means to you. Public education is free for all school-age students in the United States, but consider this question: What makes your education appropriate?

Here are some questions to help you think and talk about FAPE:

  • What is it like to have a disability?
  • What about your disability makes school hard?
  • What do you need at school that helps you learn?
  • Are you getting better and better at the skills you need to be good at?
  • Are your teachers helping you see what you do well?

If you are learning important skills at school, and your learning is helping you build on your strengths, then you are probably getting FAPE. If you need more help or aren’t learning the skills that you need to move forward, then your IEP might need some fixing. Keep in mind that the school is responsible to provide you with FAPE. You have the right to ask for FAPE.

Learn what your IEP can do for you

Here’s a starter kit to help you understand what your IEP says and how you can ask for changes. When you go to your IEP meeting, you have the right to ask the teachers and school administrators to help you read and understand your IEP.

These are some important parts of an IEP:

  • Category of Disability: This is on the “cover page” of the IEP document. It lists the type of disability that best describes why you need individualized help at school. You should know this category so you can understand how and why teachers are supposed to help you.
  • The Present Levels of Performance: This is the long section at the beginning of the IEP that describes how you are doing and what the school is helping you work on. The beginning of this section lists what you are good at. Make sure that section is complete so you can be sure the teachers help you build on your strengths.
  • Goals: When you qualified for an IEP, the school did an evaluation. You showed that you needed to learn certain things with instructions designed just for you. To help you learn, the teachers provide Specially Designed Instruction. They keep track of your progress toward specific goals in each area of learning. You can learn what your goals are and help track your progress. A website, I’m Determined.org, provides videos of students describing their goals. You can also print a goal-tracking worksheet from that website.
  • Accommodations: You can ask for what you need to help you learn in all the different classrooms and places where you spend the school day. Do you learn better if you sit in a specific part of the classroom, for example, or if you have a certain type of chair? Do you need to be able to take breaks? Do you do better on tests if you take them in a small, quiet space instead of the regular classroom? Do you need shorter assignments, so you don’t get overwhelmed? Helping your teachers know how to help you is part of your job as an IEP team member.

Get Ready for Your IEP Meeting

You can get ready for your IEP meeting by looking over the IEP document.  You may want to ask a family member or a teacher to help you read through the document. If you don’t understand what’s in your IEP, plan to ask questions at the meeting.

PAVE provides a worksheet to help you prepare for your meeting. It’s called a Student Input Form. You can use this worksheet to make a handout for the meeting or just to start thinking about things you might want to say. If you don’t want to make a handout, you might draw pictures or make a video to share your ideas.

These sentence starters might help you begin:

  • I enjoy…
  • I learn best when…
  • I’m good at…
  • It’s hard for me when…
  • I want more help in these areas…
  • I like school the most when …
  • Teachers are helpful when they…
  • I want to learn more about …
  • It would be great if…

You may want to think about your disability and how it affects your schoolwork. You could work on a sentence or draw a picture to help the teachers understand something that is hard for you. These might be the parts of a sentence that you can personalize:

  • My disability in the area of …
  • makes school difficult because…

Your handout can include a list of what you want to talk about at the meeting. Here are a few ideas, but your options are unlimited:

  • A favorite class, teacher or subject in school?
  • A time during the school day that is hard for you?
  • Your IEP goals?
  • Something that helps you feel comfortable and do well?
  • Something you want to change in your school schedule or program?
  • Graduation requirements and when you plan to graduate?
  • Your High School and Beyond Plan? (see information below)
  • Anything else that’s important to you?

High School and Beyond Plan

Maybe you started talking about what you might do after graduation when you were in middle school. Washington State public schools are required to help all students begin a High School and Beyond Plan by 8th grade. Ask a teacher, a school counselor and/or your parents if you haven’t started one of those: It’s required so you can graduate from high school.

It’s never too soon to think about what you want to do in the future. When you start building an IEP Transition Plan, it’s critical to think and talk through your ideas and how you see yourself moving forward. Here are some starter questions: 

  1. Where am I now? (strengths, interests, abilities)
  2. Where do I want to go? (aspirations, dreams, expectations)
  3. How do I get there? (goals, courses, activities, helpers, accommodations)

Here are some additional questions to help you plan:

Jobs, Trades, & Work

  • What jobs would be a good fit?
  • What training and/or supports will you need?
  • Does your IEP include community work experience?

Education after high school

  • Do your personal goals include college or technical school?
  • What accommodations will you need?
  • Have you contacted Disability Support Services on campus?

Living arrangements

  • Will you live with family, a friend or on your own?
  • How will you cook, clean, shop, & get around town?
  • Does your IEP have goals for Independent living?

Community experiences

  • What will you do for fun?
  • Will you join a club or support group?
  • How will you make friends and keep in touch?

It’s never too soon to plan ahead!

Setting goals and making some plans now will help your school and family help you make sure you’ve got the right class credits, skills training and support to make that shift out of high school easier.

Being a leader at your IEP meeting is a great way to build skills for self-advocacy and self-determination, which is another great two-part word to learn. Self-determination means you make choices to take control of your life. At your IEP meeting, you can practice describing what helps you or what makes your life hard. You get to talk about what you do well and any projects or ideas that you get excited about. In short, you get to design your education so that it supports your plans to design your own adult life.

Here are links to more ideas and tools to help you get involved in your own future planning:

The Center for Change in Transition Services has a toolkit for youth

Youthhood.org also has resources designed just for you

Benefits to Student Led IEPs

The School Might Call to Ask About a Young Adult’s Experience After High School: Here’s Help to Prepare

Post-Graduation Survey Support for Families

Each June 1-Nov. 1, Washington school districts call the homes of former students to reconnect and see how things are going. The information that families share helps the state make decisions about educational programming for students in special education.

If a school district representative calls, the interview will be about 15 minutes long and will include questions about work, further education and whether the student had support from any agencies while making the transition from high school to whatever came next. The caller might be a teacher, secretary, or other staff member.

By answering the survey questions, families provide valuable information that helps improve transition services for current and future students with special education programs. Families with youth still in high school can prepare to participate in this survey after graduation by making sure to provide a teacher with a reliable way to reach the family after graduation (phone, email, text).

Below are a few tips to help you plan for this interview, in case you get called. For a longer version of this guidance, visit the website of the Center for Change in Transition Services (CCTS), which is operated by Seattle University. CCTS provides the “Post-School Survey Student and Family Guide” as a Power Point and/or a downloadable handout in both English and Spanish.

All information is kept confidential. The data are summarized into reports about the post-school outcomes of students throughout Washington State. A statewide post-school outcome report is published by CCTS every December. School district reports are also published in December, and families can request a copy form the district.

Here’s a summary of questions. Families can prepare by writing down the answers and having them ready to access for the telephone survey, which is not pre-scheduled:

Work:

  • Is the young adult working? If so, where? How long?
  • How many hours? What are the hourly wages, or how much is being earned?
  • Whom does the young person work with?
  • If not working, what was the most recent job and its pay?

Schools and Vocational Agencies:

  • Is the young adult going to school? If so, where? How long?
  • Has the family or young person contacted any service agencies for support?
  • What service help is being given or lacking? For example, is the Division of Vocational Rehabilitation (DVR) or a supported employment agency such as Trillium, WorkSource, Vadis or another company helping?