Apple Health for Kids: Medicaid and Children’s Health Insurance Program (CHiP) in Washington State

Posted on May 22, 2024May 22, 2024 by Nicol Walsh

Overview

In Washington State, Medicaid, which includes the Children’s Health Insurance Program (CHiP) is called Apple Health. Medicaid and CHIP are medical insurance programs run by the state and funded by the federal government and the state.
Children can get free or low-cost health insurance from birth to age 19.
A child’s eligibility is based on living in Washington State, and the family level of income. Immigration status does not apply to Apple Health for Kids, and family information will not be shared with immigration officials.
There are links in this article to information on Apple Health insurance coverage for parents and caretakers, pregnant individuals, young adults, and children in foster care or who have been in foster care.

Where to apply or find more information about Apple Health for Kids:

To apply for Apple Health for Kids, or other Medicaid programs, go to Washington Healthplanfinder.
Visit WA State’s Health Care Authority page about Children
For information on the phone, call the Apple Health hotline at WithinReach: 206-204-3503 (weekdays).

Full Article

In Washington State, Medicaid, which includes the Children’s Health Insurance Program (CHiP) is called Apple Health. Medicaid and CHIP are medical insurance programs run by the state and funded by the federal government and the state.

The state agency that runs Apple Health programs is the Health Care Authority. This is the official website to get information about Apple Health programs. For some programs, such as Home and Community-Based Services Waivers (HCBS waivers) the Health Care Authority partners with the Department of Social and Health Services (DSHS). Find out more about HCBS waivers and similar programs at Informing Families.

Apple Health for Kids is free or low-cost health insurance for children from birth to age 19.

It covers the costs of medical, dental, vision (eye) care, hearing care, and behavioral (mental) health.

Medicaid programs, including CHiP, make sure that children get Early and Periodic Screening, Diagnostic, and Treatment services.

These services mean children get regular physical exams, are screened (checked) for any problems with physical and mental health, developmental delays, dental health, hearing, vision, and other tests to find any problems and treat them.

Are complex medical needs covered under Apple Health for Kids?

Yes, the Medically Intensive Children’s Program (MICP) is a Medicaid program for children who need a registered nurse to provide support. Visit the MICP page at WA State’s Health Care Authority.

Who can get Apple Health for Kids?

The child must live in Washington State.
The family income must be below a certain amount. Based on the family income level, a child may qualify for either the free Apple Health for Kids (Medicaid), or for Apple Health for Kids with premiums (CHiP).

Important! Children and pregnant individuals may qualify for WA Apple Health coverage regardless of their immigration status.

Information from WashingtonLawHelp.org says:

“All children up to age 19 who have low income are eligible for free medical coverage (“Washington Apple Health”) in Washington State. There are no immigration status requirements for this coverage. Children from families with moderate income can also get coverage. They may have to pay a small monthly premium.

Your children may also be eligible for other programs, including Head Start and other education programs, school meals, and child nutrition programs

It’s generally very safe to apply. State and federal laws protect the privacy of the information you put on your application. Your information should not be shared with immigration officials.

If you prefer, you can choose to apply for benefits for other family members, such as your children, and not for yourself. You won’t have to give information about your own immigration status, but you may have to give proof of your family’s income.”

Costs of Apple Health for Kids:

People on Apple Health (adults and children) do not pay cost-sharing, co-payments, or deductibles for any service.

There are three premium price levels for Apple Health for Kids:

Free (no monthly premiums)
Low monthly premium (payment to get the Apple Health Insurance plan)
Slightly higher monthly premium

Every year in April, WA State may adjust the amount of income a family can make to qualify for Apple Health for Kids. The premium amounts for Apple Health for Kids with premiums may also change. These changes take inflation and Apple Health program costs into account.

To check if your family income meets the limits for Apple Health for Kids, go to the WA State Health Care Authority page for Children.

Exception: children of public and school employees who have access to, or are enrolled in health insurance coverage under PEBB or SEBB programs may be eligible for Apple Health for Kids with premiums.

Important to Know:

Apple Health for Kids includes “continuous coverage”. This means a child or youth can stay on Apple Health for Kids even if their family’s income goes above the Apple Health income limits during the continuous coverage period.

This rule applies to free Apple Health for Kids (Medicaid) and Apple Health for Kids with premiums (CHiP). The rule applies to both “with premium” plans.

For free Apple Health for Kids: Children birth to age 6 have continuous coverage from when they are enrolled until their 6th birthday.
For Apple Health for Kids with premiums, children from birth to age 6 have continuous coverage for 12 months at a time.
From age 6 to age 19, all three Apple Health for Kids programs have continuous coverage for 12 months at a time.

If a child loses their coverage and needs to re-enroll, learn more on the HCA website or by emailing HCA at AskMAGI@hca.wa.gov.

Protections for children’s health insurance: New federal rules for Medicaid and CHiP

The new rules start as of June 1, 2024, but states have some time to make changes to their programs. WA State already follows these rules, but the new rules prevent WA State from doing any of these things in the future.

States will not be allowed to:

Require a waiting period before a child can be covered by Medicaid or CHiP health insurance
Stop a child’s Medicaid or CHiP health insurance if the family misses premium payments, during the continuous coverage period
Make a family pay back the unpaid premiums before a child can re-enroll after their continuous coverage period runs out, or charge an enrollment fee
States can’t put a dollar limit on benefits for CHiP. (Medicaid doesn’t allow dollar amount limits). Benefits can be limited in terms of what services are covered, or how often a service can be used. For instance, a state could decide CHiP will only cover a total of 12 visits for physical therapy in one benefit year

Health Coverage for Teens and Young Adults

Teens under age 18 who want or need to get health care coverage without their parents may be eligible for Apple Health under one or more of these conditions:

Live separately from parents or guardians and are not claimed by them as a tax dependent
Are pregnant
Need birth control or STI (sexually transmitted infection) care

To apply, follow these instructions on the Fact Sheet for Apple Health Teen Application Process.

Young adults aged 19 and up may be eligible for Apple Health if they meet income guidelines or have been in foster care. Apply online at Washington Healthplanfinder.

Other WA State Medicaid programs that may help people who care for children, or who are pregnant:

Parents and Caretakers

Pregnant Individuals

Foster Care

Resources:

The Family to Family Health Information Center (F2FHIC)

Helpline at PAVE

Informing Families

Medicaid Basics (article from PAVE)

WashingtonLawHelp.org

Washington State Health Care Authority

Washington State Healthplanfinder

WithinReach

Changes to improve monitoring for quality and improve oversight of HCBS Waiver Programs

New rules

The new rules will apply to § 1915(c) HCBS waivers and §§ 1915(i) state plan services, (j) personal assistance services, and (k) Community First Choice. The new rules will also apply under § 1115 demonstration projects unless specifically waived, and under FFS and managed care delivery systems.

Update functional assessments and person-centered plans at least once every 12 months;
Establish grievance procedures for Medicaid beneficiaries receiving certain HCBS services in FFS (there are already grievance procedures applicable to managed care);
Establish an incident management system to identify, investigate, and resolve critical incidents, including reports of abuse, neglect, and financial exploitation;
Provide assurances that payment rates are adequate to ensure a sufficient direct care workforce;
Collect and report data to monitor access (e.g., waiting lists, average amount of time between approval for and delivery of HCBS services, percent of authorized hours provided); and
Report on core measures in the HCBS Quality Measure Set.

Healthcare Transition and Medical Self-Advocacy

Posted on April 26, 2024May 8, 2026 by Nicol Walsh

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.

Download The Five Tips for Success in Healthcare Transition

Self-Advocacy: Becoming an Active Member in Your Community

Posted on March 21, 2024May 8, 2026 by Nicol Walsh

Brief overview:

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

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

When you might need to be a self-advocate:

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

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

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

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

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

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

Learn more about Gracious Space:

Person Centered Planning:

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

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

The Parent Training and Information Program (PTI) isn’t just for parents! PAVE staff in this program help parents, teens, and young adults know about their rights and responsibilities in school, and after high school when you get a job or go to college.
Family to Family Health Information Center website has a section called “Youth” that has many resources to help you be a self-advocate for your own health care, as a teen and as you get older.

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

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

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

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

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

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

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

Medicaid Basics

Posted on March 21, 2024May 19, 2026 by Nicol Walsh

A Brief Overview

Medicaid is state-run health care for those with limited income or individuals with chronic or complex health care needs with special circumstances.
Medicaid is available to many families In Washington state who are not eligible for Medicare and are below certain income levels.
Apple Health for children has broader eligibility requirements, meaning that more children in Washington state can be covered for low or no cost.
You can apply for Medicaid through the Washington Health Plan Finder.

Full Article

Medicaid is a federal health care program that each state manages based on their own states legislative system. It is set up for individuals and families with limited income or special circumstances such as a genetic, medical, or job or accident-related disability. This health care covers physical and mental health and can be low to no-cost. To be eligible for fully subsidized (free) Medicaid you must meet the household income eligibility and not be eligible for Medicare. However, Medicaid for those with Medicare can help with some expenses not covered by Medicare for those with low income. It is available for an individual on classic Medicaid whose parent or guardian has died and whose benefits pass to their child. In the state of Washington, Medicaid is generally known as Apple Health and is administered by the Health Care Authority.

There are two main types of Medicaid available in the state of Washington: Apple Health (income based), and Classic Medicaid. The day-to-day administration of Apple Health and Classic Medicaid is run by one of five Managed Care Organizations, or MCOs. Apple Health covers individuals up to the age of 6 and eligibility is based on household income. Apple Health has higher income limits for children than adults, meaning that many children in Washington State are eligible for free Apple Health, even when their parents or guardians are not.. If you have Apple Health, you will get healthcare from the providers at one of those MCOs. If you are found (determined) to have a disability or a disabling medical condition and are under the age of 65, you are eligible for Classic Medicaid if you are on Social Security Income or Supplemental Security Income (SSI). This is also considered Apple Health and under one of the 5 MCOs. If an infant, child, or youth through age 21 is in the foster care system they will be covered by Apple Health and will get their healthcare from one specific MCO no matter where they live in the state.

Determining Eligibility for Apple Health

Apple Health has different eligibility requirements for children and adults. These differences are listed below, including the maximum monthly household income requirements that families may have to obtain coverage.

Eligibility for Apple Health for Children:

Children of public employees with access to health insurance coverage under the PEBB or SEBB programs are not eligible for Apple Health for Kids with premiums.
Low-cost coverage (Apple Health with premiums) is only available to children who are uninsured when household income is too high to qualify for free Apple Health (no premiums)
Income requirements for free coverage: (2024)

Eligibility for Apple Health for Children:

Service	Single Person	2-Person Household	3-Person Household	4-Person Household	5-Person Household	6-Person Household	7-Person Household
Apple Health for Kids	$2613 monthly	$3534 monthly	$4455 monthly	$5375 monthly	$6296 monthly	$7217 monthly	$8138 monthly

Income requirements for Tier I subsidized coverage ($20 monthly per child; $40 family maximum):

Service	Single Person	2-Person Household	3-Person Household	4-Person Household	5-Person Household	6-Person Household	7-Person Household
Apple Health for Kids Tier I	$3220 monthly	$4355 monthly	$5490 monthly	$6625 monthly	$7761 monthly	$8896 monthly	$10031 monthly

Income requirements for Tier II subsidized coverage ($30 monthly per child; $60 family maximum):

Service	Single Person	2-Person Household	3-Person Household	4-Person Household	5-Person Household	6-Person Household	7-Person Household
Apple Health for Kids Tier II	$3852 monthly	$5210 monthly	$6568 monthly	$7925 monthly	$9283 monthly	$10641 monthly	$11999 monthly

Eligibility for Apple Health for Adults:

For those aged 19 through 64.
For U.S. citizens or those who meet Medicaid immigration requirements. (Including Washington residents from the Republic of Palau, the Republic of the Marshall Islands, and the Federated States of Micronesia)
For those who are not entitled to Medicare.
Have annual household income at or below the Medicaid standard:

Eligibility for Apple Health for Adults:

Service	Single Person	2-Person Household	3-Person Household	4-Person Household	5-Person Household	6-Person Household	7-Person Household
Apple Health for Adults	$1677 monthly	$2268 monthly	$2868 monthly	$3450 monthly	$4042 monthly	$4633 monthly	$5224 monthly

How to Apply

There are a couple of ways to start the process of getting Medicaid or other subsidized health care plans. The Health Insurance Marketplace Calculator provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges or “Marketplaces.” The Washington Health Benefit Exchange can help families and individuals find subsidized health care in their area.

When ready to apply for coverage from Apple Health:

Review adult and/or child income eligibility requirements.
Read the Eligibility Overview to determine if Apple Health is the best fit for you and your family.
Create an account on Washington Health Plan Finder.
Collect and enter information into the Washington Health Plan Finder application, WAPlanfinder Mobile App, downloadable paper form, or call the Washington Healthplanfinder Customer Support Center at 1-855-923-4633.
Review the five Integrated Health Care Plans responsible for Medicaid in Washington, not all of which may be available in your location.
If you need further help, contact a free Health Plan Navigator.

To get signed up with Medicaid Classic, go online to WashingtonConnection and select “Apply Now,” or call 1-877-501-2233. For additional help signing up for Medicaid in Washington, help is available from Parent help 123, which can be contacted at 1-800-322-2588, or PAVE. If, in looking at the information above, you feel that you or the person you care for has lost Medicaid through a mistake or a problem with the system and going through the Washington Connection is not resolving the issue, the Federal Government is asking that you go through Healthcare.gov to get help with re-enrollment.

Step-By-Step Guide to Requesting Accommodations on SAT and ACT Exams

Posted on October 25, 2023November 9, 2023 by Nicol Walsh

How to Request Accommodations on College Entrance Exams

The transition from high school to college can be a daunting experience for any teenager. Part of the transition process is preparing for and taking the entrance exams for college. If the student is receiving accommodations in school, they may qualify to receive special accommodations while taking a college entrance exam.

The ACT and College Board Services for Students with Disabilities (SSD) do not approve accommodations for all college entrance exams. Contact your school, college, or testing center for the CLEP and ACCUPLACER tests. Students with documented disabilities may request accommodations on PSAT-related assessments with the help of their school counselor.

Differences Between SAT and ACT Exams

Most universities accept both SAT and ACT and the length of both tests is approximately the same. ACT has more questions in that same period, so fast workers may prefer it. However, the best one for a student is the one they feel best about, so trying sections of both before choosing which one to study for is recommended by most test prep professionals. Both ACT and SAT have free practice sections available.

SAT	ACT
Reading (65 min, 52 Questions)	Reading (35 min, 35 Questions)
Writing (35 min, 44 Questions)	English (45 min, 75 Questions)
Math (80 min, 58 Questions)	Math (60 min, 60 Questions)
Optional essay (50 min)	Science (35 min, 40 Questions)
Scored 400-1600	Optional essay (30 min)
	Scored 1-36

A student must have approval from the College Board SSD (for the SAT) or ACT to use accommodations on an exam. If a student uses extended test time or other accommodations without prior approval, their test results will be invalid.

The process of requesting accommodations varies depending on the exam. These are the steps to request accommodations on SAT and ACT college entrance exams:

Step 1: Document the need for accommodations.

The student must have a documented disability. Documentation can be a current psycho-educational evaluation or a report from a doctor. The type of documentation depends on the student’s circumstances. The disability must impact the student’s ability to participate in the college entrance exams. If the student is requesting a specific accommodation, documentation should demonstrate the difficulty the student has performing the related task. The College Board provides a disability documentation guideline and accommodation documentation guideline, as does the ACT. Doctor notes and Individualized Education Program (IEPs) or 504 plans may not be enough to validate a request for accommodations; you must provide supporting information, such as test scores.

While students typically only receive accommodations if they have a documented disability, some (very few) students who have a temporary disability or special healthcare need can also be eligible. The request is different in these circumstances for those who wish to take the SAT exam and students are often urged to reregister for a date after they have healed. If the student cannot postpone their test, the request form for temporary assistance must be completed by a school official, student (if over 18) or parent, doctor, and teacher. Then, the form must be faxed or mailed to the College Board for processing.

Step 2: Allow plenty of time for processing.

It takes time to apply for accommodations, including a processing period of up to seven weeks after all required documentation has been submitted to the College Board SSD or ACT. If they request additional documentation, or if a request is resubmitted, approval can take an additional seven weeks. Start as early as possible before the exam date to allow enough time for processing, responding to a request for more documentation, and additional processing time. If the student will take the exam in the fall, they should begin the process in the spring to allow sufficient time for processing.

Step 3: Identify appropriate accommodations.

If the student has a formal education plan, review the current plan, and note accommodations listed throughout, especially (but not only) those the student uses during assessments. Read through recent medical evaluations, prescriptions, and records to ensure all accommodations have been included in the formal education plan, if the student has one, or to locate appropriate accommodations recommended by medical professionals. You may recognize some of the Possible Accommodations for SAT and ACT Entrance Exams.

Some accommodations may only be provided during certain sections of the exam, depending on the specific accommodation requested. For example, a student with dyscalculia may receive extended time during the math section of the exam but not for any other subject.

Step 4: Submit the request for accommodations.

The easiest way to request SAT accommodations is to go through your student’s school. If you choose to go through the school, the school’s Services for Students with Disabilities (SSD) Coordinator (Special Education Coordinator, Guidance/School Counselors, etc.) can go online to review the SAT Suite Accommodations and Supports Verification Checklist and submit the application. Having the coordinator submit the application will help streamline the process. Homeschooled students or those who choose not to go through the school may request accommodations on the SAT exam by printing the Student Eligibility Form and submitting all documentation by fax or postal mail.

Requesting accommodations for the ACT exam requires working with a school official who is a part of the IEP team. The accommodations requested should be similar to the accommodations currently being received in school and must be approved by ACT before the test. All requests, including appeals, must be submitted by the late registration deadline for the preferred test date. Homeschooled students may request accommodations on the ACT exam by creating an ACT account online and submitting the required documents electronically.

Step 5: Register for the college exam.

Once the student is approved for SAT accommodations, they will receive a Service for Students with Disability (SSD) number that must be included when registering for the test. The school’s SSD Coordinator should ensure all the correct accommodations are in place when it is time to take the college exam. Approved accommodations will remain in effect for one year after graduation from high school.

Additional Information

College Board Services for Students with Disabilities (SSD)
PAVE’s College Readiness Workbook
Possible Accommodations for SAT and ACT Entrance Exams
Requesting Accommodations in Post-Secondary Education
This article is available as a handout: How to Request Accommodations on College Entrance Exams

Dyslexia Screening and Interventions: State Requirements and Resources

Posted on October 24, 2023June 4, 2026 by Nicol Walsh

A child who struggles to read can quickly fall behind in school. Nearly every learning area includes some reading, and children might become confused or frustrated when they don’t get help to make sense of their schoolwork. Behavior challenges can result, and sometimes schools and families struggle to understand why the student is having a hard time. Reading difficulties affect a student’s literacy. One definition of literacyis the ability to read, write, speak and listen in ways that let people communicate well. The Revised Code of Washington (RCW 320.260) requires schools to support literacy with “multi-tiered” programming to help with reading difficulties.

A Brief Overview

Dyslexia is a common condition that makes it hard to work with language. Reading difficulties are one sign of dyslexia.
Washington passed a law in 2018 requiring schools to screen young children for indicators of dyslexia. The law took effect in the 2021-22 school year.
Dyslexia is a Specific Learning Disability. Students with learning disabilities are eligible for an Individualized Education Program (IEP) if they demonstrate a need for Specially Designed Instruction (SDI). SDI is key when a student isn’t keeping up with grade-level work and standard teaching strategies aren’t working.
The Revised Code of Washington (RCW 320.260) requires schools to support literacy with “multi-tiered” programming. That means schools provide different levels of help for all students who need it, regardless of special education eligibility.
Washington Office of Superintendent of Public Instruction (OSPI) has handouts about dyslexia screening and supports in WA Schools, some in multiple languages.
[ ខ្មែរ (Khmer), 한국인(Korean), ਪੰਜਾਬੀ (Punjabi), Русский (Russian), Soomaali (Somali), Español (Spanish), Filipino/Tagalog, 中國人(Traditional Chinese), and Tiếng Việt (Vietnamese)] They are listed at the end of this article.

Full Article

One cause of difficulty with reading is a specific learning disability called dyslexia. The state’s definition of dyslexia, adopted in 2018, is similar to a definition promoted by the International Dyslexia Association. According to Washington State’s definition:

“Dyslexia is a specific learning disorder that is neurological in origin and that is characterized by unexpected difficulties with accurate or fluent word recognition and by poor spelling and decoding abilities that are not consistent with the person’s intelligence, motivation, and sensory capabilities.”

Understood.org provides a video and additional materials to learn about dyslexia. Here’s their plain language definition: “Dyslexia is a common condition that makes it hard to work with language.”

Washington State requires dyslexia screenings (tests to find out if a student may have or be at risk for dyslexia) and interventions (help with reading). Lawmakers in 2018 passed Senate Bill 6162 to require schools to screen children from kindergarten through second grade using state-recommended literacy screening tools. The law took effect in 2021-22.

Since reading is used in almost every learning area, this law means schools have a duty to identify students who show signs of possible dyslexia while they are in their early reading years. The law also requires schools to provide “interventions” (help) to students identified through the screening.

OSPI offers a Fact Sheet about the screening in multiple languages. It includes the reason for the screening, who gives the screening, the skills that are screened, the process, and information about dyslexia.

What happens if the screening shows indicators (signs) of dyslexia?

The law requires the school to:

Notify the student’s family of the identified indicators and areas of weakness
Share with the family the school’s plan for multitiered systems of support to provide supports and interventions (help with reading)
The notice should include resources and information about dyslexia for the family’s use.
Update families regularly on the student’s progress

How can families tell if a student has trouble, or may have trouble with reading and language? Families can look for these signs in children who are toddlers and pre-kindergarten:

Trouble learning simple rhymes
Speech delays
following direction
Difficulty reading short words or leave them out
Trouble understanding the difference between left and right
-Child Mind Institute Parent Guide to Dyslexia.

Screening happens in kindergarten through grade 2. If a student is already older than that, families can check for these signs of reading and language difficulty at home.

Understood.org states: “Dyslexia can also cause trouble with spelling, speaking, and writing. So, signs can show up in a few areas, not just in reading.” Understood.org lists these signs for students older than grade 2: Signs a Student May Have Dyslexia (handout)

The Washington Office of Superintendent of Public Instruction (OSPI) offers a Family and Caregiver Discussion Guide that may help when families are planning to speak to their child’s teacher or school administrators about their student’s reading difficulties, behavior, or other concerns.

What happens if the screening shows a student has signs of dyslexia, or if families or teachers notice signs and want a student to get help?

The school puts multi-tiered systems of support (MTSS) into action. “Multi-tiered systems” usually means beginning reading help as part of regular classroom reading instruction. If a student’s reading difficulties continue, the student may get more intensive instruction in smaller groups, and perhaps move up to intensive one-on-one time with a reading instructor. For any of these levels, the reading instruction must be “evidence-based” methods which means the methods have been tested and shown to be useful in helping with reading difficulties.

This guide for schools from OSPI has details about MTSS.

These more intensive levels of reading help may work very well. Not every reading difficulty is due to dyslexia, and not every person with dyslexia has the same level or type of reading difficulty.

At any point during these interventions, families or teachers may see a student is not making progress and ask that the student be evaluated for special education to see if the student qualifies for an Individualized Education Program (IEP). An IEP can provide Specially Designed Instruction (SDI), which means instruction will be based on the student’s unique needs and provide extra instructional time, assistive technology, and other supports.

The federal law that provides special education eligibility and funding is called the Individuals with Disabilities Education Act (IDEA). According to the IDEA, Dyslexia is a Specific Learning Disability. Specific Learning Disability is a category of eligibility for an Individualized Education Program (IEP). IDEA states that students have the right to a Free, Appropriate Public Education (FAPE), and the IEP is a key factor in a student having FAPE.

What types of help can a student get with reading and literacy?

Multi-tiered systems of support (MTSS) use instruction methods that have been proven to work for many students, starting with help in the general (regular) classroom. If a student doesn’t make progress that way, the student may join a smaller group for that gives each student more time with a teacher or reading specialist and even move on to one-to-one instruction with a reading specialist. These options are available to any student who shows signs of dyslexia or reading difficulty. OSPI offers Dyslexia Guidance (for schools): Implementing MTSS for Literacy with more specific information.

IEP: Students can get Specially Designed Instruction (SDI) based on their unique needs, such as particular areas of language and literacy where they have difficulties. Reading programs offered by the school can be included in an IEP. IEPs can include accommodations, which may include texts and instructions in audio format, text-to-speech/speech to text software, recording oral answers to assignment or test questions, access to distraction-free location for reading, allowing extra time to complete work or tests, and many more. Accommodations for Students with Dyslexia by the International Dyslexia Association lists many other options.

Section 504 Plan: Section 504 plans don’t include Specially Designed Instruction. They do include accommodations.

The National Center on Improving Literacy has information on when a Section 504 plan may make sense for a student with reading difficulties or dyslexia. They note that Section 504 Plans, which fall under Section 504 of the Rehabilitation Act of 1973, do not provide for Specially Designed Instruction. If a student’s reading has improved without an IEP by receiving multitiered systems of support, a Section 504 plan may offer Assistive Technology options, spelling checks, extended time on assignments and testing and other accommodations.

PAVE has articles and a video with more information about special education, IEPs, and Section 504 plans.

Interventions (help with reading) are schoolwide

Not all students who need reading support will need IEPs or a Section 504 Plan. The Revised Code of Washington (RCW 320.260) requires schools to support literacy through “evidence-based multi-tiered” programming. That means schools provide different levels of support for all students who need help, whether or not the student has an IEP or Section 504 Plan.

Some schools have reading programs funded by Title 1, which is part of a federal law called Every Student Succeeds Act (ESSA). Title 1 is funded to close opportunity gaps related to poverty and other measures.

TIP: Ask about all options for reading support at your school. If a student with an IEP participates in a schoolwide reading program, then the IEP can list that program as part of the student’s services.

Dyslexia can be identified and helped without a diagnosis

Students do not need a diagnosis of dyslexia to be evaluated (tested) for special education eligibility. If the family has concerns, they can ask the school to evaluate the student. Requests should be in writing. PAVE provides a sample letter to help families request an educational evaluation.

Here’s a sentence to include in the evaluation request letter:

“I need my child tested for a specific learning disability. I believe there is a problem with reading that is disability related.”

TIP: When a student’s need for reading help qualifies for an IEP, there are important things that families need to know about how IEPs work, what the goals are for the student’s reading abilities, what type of reading help will be given, where the Specially Designed Instruction will take place, and what the parent’s and student’s roles and responsibilities are when their student has an IEP. These are the basics:

IEP Eligibility is based on a student’s needs
Specially Designed Instruction (SDI) serves the identified needs
The IEP tracks learning progress with specific goals in each area of SDI

What options do families have if they disagree with a school’s decisions about their student’s reading supports or other decisions?

If a student has not been screened for signs of dyslexia and the family has concerns, a first step is to meet with the student’s teacher. This article by the International Dyslexia Association offers specific steps families can take.
Families can request an evaluation to see if the student qualifies for an IEP or a Section 504 Plan.
If families disagree with the evaluation, they can request an Independent Educational Evaluation (IEE) from a provider outside the school. This article from PAVE gives steps and a sample letter to request and IEE: Evaluations Part 2: Next Steps if the School Says ‘No’
If the student has an IEP, this article gives specific steps to follow: Parents as Team Partners: Options When You Don’t Agree with the School.
For students with a Section 504 Plan, OSPI recommends:
“The Section 504 coordinator in each district makes sure students with disabilities receive the accommodations they need and respond to allegations of discrimination based on disability. [Section 504 coordinators are members of a school’s Section 504 team which develops 504 Plans to accommodate a child’s needs]. A discussion with your school principal, or Section 504 coordinator at the school district, is often the best step to address your concerns or disagreements about Section 504 and work toward a solution. Share what happened and let the principal or coordinator know what they can do to help resolve the problem. If you cannot resolve the concern or disagreement this way, you can file a complaint.”

What else to know:

Keep in mind that families and schools don’t need to use the term dyslexia at all. They can talk about a student’s learning disability in reading, writing, or math in broader terms such as “Specific Learning Disability.” Under the Individuals with Disabilities Education Act (IDEA), dyslexia is a Specific Learning Disability that qualifies a student for special education.

Specific Learning Disability is defined by the Washington Administrative Code (WAC 392-172A-01035):
“Specific learning disability means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia, that adversely affects a student’s educational performance.”

The state’s definition of learning disability excludes “learning problems that are primarily the result of visual, hearing, or motor disabilities, of intellectual disability, of emotional disturbance, or of environmental, cultural, or economic disadvantage.”

Here’s a handout onAccommodations and Modifications for Students with Dyslexia.

Resources:

From PAVE:

Special Education is a Service, Not a Place
Student Rights, IEP, Section 504 and More (video)
Steps to Read, Understand, and Develop an Initial IEP
Supporting literacy: Text-to-Speech and IEP goal setting for students with learning disabilities
IEP Tips: Evaluation, Present Levels, SMART goals
Section 504: A Plan for Equity, Access and Accommodations
Evaluations Part 2: Next Steps if the School Says ‘No’
There’s more: just type “Special Education,” “IEP” or “504” in the search bar

From OSPI:

Family and Caregiver Discussion Guide with Educators and Schools
Understand Literacy Screening: Parents and Families
Available in ខ្មែរ (Khmer), 한국인(Korean), ਪੰਜਾਬੀ (Punjabi), Русский (Russian), Soomaali (Somali), Español (Spanish), Filipino/Tagalog, 中國人(Traditional Chinese), and Tiếng Việt (Vietnamese)
Best Practices for Supporting Grades 3 and Above
Section 504 & Students with Disabilities (web page)
Dyslexia Guidance (for schools): Implementing MTSS for Literacy

Dyslexia awareness is promoted by the National Center on Improving Literacy (NCIL), which provides resources designed to support families, teachers, and policy makers. On its website, the agency includes state-specific information, recommends screening tools and interventions and provides research data about early intervention.

NCIL provides a unique resource in the format of an online or downloadable comic book: Adventures in Reading Comic Books stars Kayla, a girl with dyslexia.

Georgetown University’s Director of the Center for the Study of Learning provides a researcher’s perspective: What do we know about what’s different in the brain of a person with dyslexia?
A psychology professor from the University of Wisconsin-Madison discusses early intervention: What has scientific research taught us about how children learn to read?
A TEDx talk called The True Gifts of a Dyslexic Mind features Dean Bragonier describing how dyslexia impacts the brain.
Your Guide to Dyslexia in English and Spanish, Oregon Branch of International Dyslexia Association

The International Dyslexia Association has many detailed resources for families.

Possible Accommodations for SAT and ACT Entrance Exams

Posted on August 14, 2023August 14, 2023 by Nicol Walsh

The following information is part of the college readiness workbook. You can download this and other parts of this workbook for your personal use. Each document is fillable.

Download Possible Accommodations for SAT and ACT Entrance Exams

Extended time

Only if the disability causes them to work more slowly than others
May not be necessary for every section
If necessary for reading, will be provided for every section

Reading and seeing accommodations

Large-print test book
Braille with raised line drawings
Tactile graphics with a human reader or prerecorded audio
Assistive technology, such as text-to-speech

Recording responses

Large-print answer sheet
Recording answers accommodations
Computer for word processing for essay and short answer only
Record answers in their test books
Scribe to record both multiple-choice and essay or short answer

Use of four-function calculator

Assistive technology

Must request each device or software separately
Electronic magnifying machines
Text-to-speech (screen readers) and speech-to-text
Electronic/talking calculators

Breaks

Extended time (10 minutes)
Additional (5 minutes each)

Other accommodations

Signing or orally presenting instructors
Printed copy of verbal instructions
Colored overlays
Preferential seating
Wheelchair accessibility
School-based setting
Permission for food, drink, or medication
Permission to test blood sugar and access to testing supplies

COVID – 19 Updates:

Check the for updates related to COVID-19 and guidelines for participating in testing
Check the test center’s website for any additional or specific entry requirements, including College Board or local public health guidelines
If students don’t feel well on test day, they should contact Customer Service immediately to set a new test date.

Source:

Accommodations and English Learner Supports for Educators

Accommodations on College Board Exams

Disclaimer: All content is for informational purposes only. The information on this page is not a substitute for legal advice. When it comes to the law and policy matter, please consult an attorney or advocate on your child’s behalf.

How to Decide on a Post-Secondary Program

Posted on August 14, 2023August 14, 2023 by Nicol Walsh

The following information is part of the college readiness workbook. You can download this and other parts of this workbook for your personal use. Each document is fillable.

Download How to Decide on a Post-Secondary Program

Talk with your parents and/or guardians:

What are my abilities and strengths?
How does my disability affect my learning and ability to show what I know on tests?
What accommodations do I need to be successful?
What postsecondary education or training programs do my teachers and school counselors recommend for my areas of interest?

Talk together about your concerns with Student Support Services / Disability Office

A school’s location could deter your child, even if the program is perfect. Where is the school located and does that school setting (urban, suburban, or rural) meet your student’s needs? If they cannot live independently, what is the distance from home?
Does the student/instructor ratio ensure your student can access office hours with their instructor as needed?
Not all programs provide the same accommodations, and colleges do not make modifications to alter academic requirements. Accommodations are what make it possible for your student to access the curriculum. An inaccessible program would be a waste of time and money.
Are the housing options accessible for your student’s individual needs?
Will they require someone to assist with self-help (like bathing), managing their medications and medical treatment, or nutrition and hygiene needs (like laundry, washing dishes, cooking)?
Do they have a service or emotional support animal?

* High school counselors and teachers are resources for connecting with colleges and training programs. Many schools have “College Fairs.”

*This resource describes a typical process to ask for accommodations, and also lists key questions to ask of the Disability Office: How to Request Disability Supports in College

*You can also call postsecondary school admission officers to request brochures and fact sheets about the school and its programs. Schools almost always include information about their programs online.

Source: PACER’s National Parent Center on Transition and Employment – Preparing for Postsecondary Education

How to Decide on a Post-Secondary Program Worksheet

Posted on August 14, 2023August 14, 2023 by Nicol Walsh

The following information is part of the college readiness workbook. You can download this and other parts of this workbook for your personal use. Each document is fillable.

Download How to Decide on a Post-Secondary Program Worksheet

Fill in your answers to the questions.

Talk With Each Other

What are my abilities?
What are my strengths?
How does my disability affect my learning and ability to show what I know on tests?
What accommodations do I need to be successful?
What postsecondary education or training programs do my teachers and school counselors recommend for my areas of interest?

Talk Together About Your Concerns With Student Support Services

Where is the school located and does that school setting (urban, suburban, or rural) meet my needs?
If I cannot live independently, what is the distance from home?
Does the student/instructor ratio ensure I can access office hours with my instructor(s) as needed?

Not all programs provide the same accommodations, and colleges do not make modifications to alter academic requirements.

Does the program offer the accommodations I need to be successful?
Are the housing options accessible for my individual needs?

Do I require someone to assist with:

Self-help (like bathing)?
Managing my medications and medical treatments?
Nutrition and hygiene needs (laundry, washing dishes, cooking?)
Do I have a service animal?

College Experience Terms: Non Degree Post-Secondary Transition Programs

Posted on August 14, 2023May 12, 2026 by Nicol Walsh

The following information is part of the college readiness workbook. You can download this and other parts of this workbook for your personal use. Each document is fillable.

Download College Experience Terms

These are some terms for post-secondary education programs that are unique to those supporting students with intellectual disabilities. Click on each term for more information.

Transition and postsecondary education program for students with intellectual disability (TPSID)

A federally funded model demonstration grant that allows schools to create and/or further develop their program.
Programs receiving the TPSID grant are more likely to have accommodations to support students with IDD because they’re literally being paid to create and expand their programs.
Students attending schools that are CTP approved can apply federal funding from the Department of Education to pay for non-degree programs.
Some programs may use the acronym “IPSE” to indicate they are focused on supporting students with IDD.

Inclusive post-secondary education (IPSE)

Sometimes used to refer to college programs for students with intellectual disability; also referred to as inclusive higher education programs.

Comprehensive transition program (CTP)

Approved by the U.S. Department of Education and eligible for federal student aid.

*If a student has an IEP and they intend to participate in a non-degree college program, their transition goals don’t have to be focused on a major to help them prepare for higher learning.

Requesting Accommodations in Post-Secondary Education

Posted on August 14, 2023August 17, 2023 by Nicol Walsh

The following information is part of the college readiness workbook. You can download this and other parts of this workbook for your personal use. Each document is fillable.

Download Requesting Accommodations in Post-Secondary Education

Post-secondary schools each set their own procedures and requirements to request accommodations. Here are some key points and tips on effective ways to request accommodations.

Accessibility is one important way a post-secondary school can show it is inclusive. Over the last few years, many colleges and universities have been highlighting accessibility and the services they offer students with disabilities. This may help a student to decide to apply to a particular school and make it easier to find out how to apply for accommodations at a school they have selected. (Check out the College Readiness Workbook created by PAVE to see resources for post-secondary program selection.)

To request accommodations:

Begin by locating the campus disability services office on the school website. Type “disability” into the search bar. Often, the first result will be the office that provides accommodation for students with disabilities.

Name of Office: Phone:

Call the office to make an appointment and request any forms you can complete beforehand and how to obtain them (such as by mail or downloading from the school website). Make your appointment well before classes begin. It may take 6-8 weeks to process your request, so start early to have accommodations in place by the time you need them.

Note that some accommodations, such as Braille or interpreter services, may take more time than others to arrange.
If you have an IEP, note that transition planning is mandatory beginning at age 16. Parts of a transition plan can include selecting a post-secondary program, deciding which accommodations you will need, and starting the request process on time.

Appointment Date: Time: Contact:

Requirements to document a disability range widely from one post-secondary program to another. It’s important to reach out to disability services to learn their specific requirements, and if possible, talk with other students who have experience with school services. DREAM (Disability Rights, Education, Activism, & Mentoring) Group has lists of student organizations to contact for this type of information.

Schools may ask for documentation from a medical or other therapeutic provider, or disability services may be able to use a student’s current IEP or 504 plan.

3. You will need to submit proof of a disability that impacts activities of daily living, to meet the requirements to provide accommodations under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act. The proof may be a form letter for a medical or therapeutic provider to fill out, or it may be notes from such a provider. It may be your most recent IEP or 504 plan. It must be specific to the condition or conditions for which accommodation is requested.

Be aware that a disability which is ‘mitigated’, that is, made less of an impairment by a device, an accommodation, or any other strategy for coping does not change a student’s rights under the ADA or Section 504.

The same is true for a condition that ‘comes and goes. For example, bipolar disorder, an autoimmune disorder, a gastrointestinal condition, or similar conditions in which symptoms are present at some times and not at others.

From a medical or therapeutic provider, schools often require that documentation must be in writing, must be current within three years, and include the following where appropriate:
- A description of the student’s disability and how he/she is affected educationally by the presence of the disabling condition.
- Identification of any tests or assessments administered to the student.
- Suggestions for educational accommodations that will provide equal access to programs, services, and activities.

4. Documentation submitted to the college should provide clear evidence of need and demonstrate a history of use of the accommodations requested. While a high school IEP or 504 plan does not “transfer” to the postsecondary program, the disability office may accept these plans as proof of disability or use them as guidance in determining appropriate accommodations.

Collect and check the documentation you need:

Most recent Individualized Education Program (IEP)
Most recent 504 plan, Accommodations Plan, or Service Plan
Most recent educational evaluations
Diagnosis and/or treatment plan
Medical or professional service providers notes, including suggested accommodations (colleges may have a form for this)
Make copies of the completed request forms for your home file
Other

Remember to check the school website for any disability-specific or need-specific documentation requirements. For example, a student may be required to provide the results of a hearing assessment with expected progression or stability of the hearing loss, when requesting accommodations for a hearing disability.

5. Meet with the disability office staff to request and discuss accommodations. Complete the How to Decide on a Post-Secondary Program worksheet to help you prepare for this meeting, including organizing your questions and concerns.

Write down any additional questions to help you remember during the meeting.

6. When you receive written notice of the decision regarding your eligibility for accommodations and the list of approved accommodations, make enough copies to share with your instructors and keep a copy with you in class, in the event of a substitute instructor. Put the original in your home file for safekeeping.

Understand the limits of what the school is providing for assistive technology. For instance, many schools limit the loan of portable screen-readers to specified uses or time frames. Students may have to provide their own equipment or software outside those limits.

It is the student’s responsibility to give the eligibility notice with specific accommodations to each instructor every semester.

7. If accommodations become ineffective or you are not receiving approved accommodations, contact the disability services office immediately for assistance.

8. All accommodations are provided on a case-by-case basis. If your request for accommodations is denied, contact the disability services office to determine the process for appeal and equitable resolution.

9. Once at college, this resources may help:
So, you’re in college, now what next?
College Readiness Workbook

Additional Resources:

So, you’re in college, now what next?
College Readiness Workbook (contains this article and many other helpful resources)

Sources:

How to Request Disability Supports in College

Tacoma Community College, Tacoma, WA Access Services

Traumatic Brain Injury in Youth

Posted on May 18, 2023May 6, 2026 by Nicol Walsh

A Brief Overview

A traumatic brain injury (TBI) is an injury that affects how the brain works.
Approximately 1.7 million people receive traumatic brain injuries every year. Of children 0-19 years old, TBI results in 631,146 trips to the emergency room annually, 35,994 hospitalizations, and nearly 6,169 deaths.
Children have the highest rate of emergency department visits for traumatic brain (TBI) injury of all age groups. TBI affects children differently than adults.
Although TBI is quite common, many medical and education professionals may not realize that some difficulties can be caused by a childhood TBI. Often, students with TBI are thought to have a learning disability, emotional disturbance, or an intellectual disability. As a result, they may not receive the type of educational help and support really needed.
Students with TBI who are not eligible for special education might be eligible for a Section 504 plan.
TBI is a category of eligibility for special education under the Individuals with Disabilities Education Act (IDEA) and the Washington State Administrative Code (WAC)
Washington law requires evaluation referrals in writing. The state provides a form for referrals, downloadable from a website page titled, Making a Referral for Special Education. The person making the referral can use the form or any other format for their written request.
PAVE provides a Sample Letter to Request Evaluation.

Full Article

A traumatic brain injury (TBI) is an injury that affects how the brain works. TBI can affect people of all ages and backgrounds. The exact definition of TBI, according to special education law, is referenced later. This injury can change how the person thinks, behaves, and moves. A traumatic brain injury can also change how a student learns and behaves in school. The term TBI is used for head injuries that can cause changes in one or more areas, such as:

thinking and reasoning,
understanding words,
remembering things,
paying attention,
solving problems,
thinking abstractly,
talking,
behaving,
walking and other physical activities,
seeing and/or hearing, and
learning.

The term TBI is not used for a person who is born with a brain injury or for brain injuries that happen during birth.

How is TBI Defined?

The definition of TBI below comes from the Individuals with Disabilities Education Act (IDEA). The IDEA is the federal law that guides how schools provide special education and related services to children and youth with disabilities.

IDEA’s Definition of TBI

The Individuals with Disabilities Education Act (IDEA) defines traumatic brain injury as

“…an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a student’s educational performance. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psycho-social behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.” [34 Code of Federal Regulations §300.8(c)(12)]

Washington State’s Definition of TBI

“Traumatic brain injury means an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a student’s educational performance. Traumatic brain injury applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech. Traumatic brain injury does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.” (WAC 392-172A-01035)

What Are the Signs of Traumatic Brain Injury?

The signs of brain injury can be quite different depending on where the brain is injured and how severely. Students with TBI may have one or more difficulties, including:

Physical disabilities: Individuals with TBI may have problems speaking, seeing, hearing, and using their other senses. They may have headaches and feel tired a lot. They may also have trouble with skills such as writing or drawing. Their muscles may suddenly contract or tighten (this is called spasticity). They may also have seizures. Their balance and walking may also be affected. They may be partly or completely paralyzed on one side of the body, or both sides.

Difficulties with thinking: Because the brain has been injured, it is common that the person’s ability to use the brain changes. For example, students with TBI may have trouble with short-term memory (being able to remember something from one minute to the next, like what the teacher just said). They may also have trouble with their long-term memory (being able to remember information from a while ago, like facts learned last month). People with TBI may have trouble concentrating and only be able to focus their attention for a brief time. They may think slowly. They may have trouble talking and listening to others. They may also have difficulty with reading and writing, planning, understanding the order in which events happen (called sequencing), and judgment.

Social, behavioral, or emotional problems: These difficulties may include sudden changes in mood, anxiety, and depression. Students with TBI may have trouble relating to others. They may be restless and may laugh or cry a lot. They may not have much motivation or much control over their emotions.

A student with TBI may not have all the above difficulties. Brain injuries can range from mild to severe, and so can the changes that result from the injury. This means that it is hard to predict how an individual will recover from the injury. Early and ongoing help can make an enormous difference in how the student recovers. This help can include physical or occupational therapy, counseling, and special education.

It is also important to know that, as children and youth grow and develop, parents and teachers may notice new problems. This is because, as young people grow, they are expected to use their brain in new and different ways. The damage to the brain from the earlier injury can make it hard for them to learn new skills that come with getting older. Sometimes families and teachers may not even realize that the student’s difficulty comes from the earlier injury.

How to Access Support

If a student is having a tough time at school and has a known or suspected disability, the school evaluates to see if the student qualifies for special education. A student is protected in their right to be evaluated by the Child Find Mandate, which is part of the federal Individuals with Disabilities Education Act (IDEA). if they do have a disability and, because of the disability, need special services under IDEA. These services can include:

Early Supports for Infants and Toddlers (ESIT): A system of family centered services to support infants and toddlers with disabilities (before their 3rd birthday).

Special education and related services: Services available through the public school system for school-aged children and youth, including preschoolers (ages 3-21). It is important to remember that the IEP is intended to be flexible. It can be changed as the family, school, and the student learns more about what support and services are needed at school.

If the student is not eligible for special education, a Section 504 Plan may help. Under Section 504, students with disabilities can access the accommodations, aids, and services they need to access and benefit from education. It also protects students from discrimination based on disability.

When students with TBI return to school, their educational and emotional needs are often quite different than before the injury. Their disability has happened suddenly and traumatically. They can often remember how they were before the brain injury. This can bring on many emotional and social changes which may result in mental and/or behavioral health needs. The student’s family, friends, and teachers also recall what the student was like before the injury. These and other people in the student’s life may have trouble changing or adjusting their expectations of the student. Therefore, it is important to plan carefully for the return to school.

Tips for Families and Caregivers

Learn about TBI. The more you know, the more you can help yourself and your student.
Work with the medical team to understand your loved one’s injury and treatment plan. Ask questions. Share what you know or think. Make suggestions.
Keep track of your loved one’s treatment. A 3-ring binder or a box can help you store this history. As your youth recovers, you may meet with many doctors, nurses, and others. Write down what they say. Put any paperwork they give you in the notebook or place it in a box.
Plan for your student’s return to school after the injury. Contact the school. Ask the principal about an evaluation for special education or a Section 504 plan. You may also consider asking the medical team to share information with the school.
Talk to other families whose loved ones have TBI.
Stay connected with your student’s teacher. Tell the teacher about how your student is doing at home. Ask how your student is doing in school.
Sometimes students who do not qualify for the IEP will qualify for accommodations and other support through a Section 504 Plan. PAVE has an article about Section 504, which provides an individual with protections throughout the lifespan.
Protections against bullying and discriminatory discipline are aspects of Section 504. Watch PAVE’s video, Behavioral Health and School: Key Information for Families.

Help from PAVE

PAVE’s Parent Training and Information (PTI) team provides 1:1 support and additional resources. Click Get Help or Call 1-800-5PARENT (572-7368) and select extension 115, English or Spanish available, to leave a dedicated message.

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

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

Further information on TBI:

The Center on Brain Injury Research and Training
Department of Health and Human Services
University of Washington TBI Model System
Center for Disease Control and Prevention : Report to Congress on the Management of TBI in Children

Family Support

PAVE’s Family-to-Family Health Information Center provides technical assistance to families navigating health systems related to disability. Click Get Help at wapave.org or call 800-572-7368 for individualized assistance. Family Voices of Washington provides further information and resources.
Department of Health and Human Services (DSHS) has a link to Washington TBI Support Groups.
Brain Injury Association of America works to create a better future through brain injury prevention, research, education, and advocacy.

Surrogate Parents Support Unaccompanied Students in Special Education

Posted on January 23, 2023May 6, 2026 by Nicol Walsh

A Brief Overview

Parent participation in IEP process is a protected right for students with disabilities. If a student doesn’t have a family caregiver or legal guardian to advocate in their behalf, a surrogate parent is assigned to fill that role.
A surrogate parent is not paid and cannot be employed by the school system, or any other agency involved in the care or education of the child.
The provision for a surrogate parent is part of federal special education law, the Individuals with Disabilities Education Act (IDEA Section 300.519).

Full Article

If a student eligible for special education services does not have a family caregiver, adoptive parent, or other legal guardian fulfilling the role of parent, then a surrogate parent is assigned to ensure the student’s rights are protected. The surrogate parent fulfills the family caregiver role on a student’s Individualized Education Program (IEP) team and advocates to ensure the student’s needs are met.

A surrogate parent is an individual appointed by the public agency (usually a school district) responsible for the student’s special education services. Schools are responsible to assign a surrogate parent within 30 days after recognizing the need. Note that a child who is a ward of the state may be assigned a surrogate parent by the judge overseeing their case.

If a private individual, such as a neighbor or friend, has explicit written permission from the student’s parent or guardian to care for the student, a surrogate parent is not required.

A student 18-21 is responsible for their own educational decision-making unless they have a guardian to exercise their legal rights. A school district is responsible to assign a surrogate parent for a student declared legally incompetent or if an adult student with a disability asks for a surrogate parent.

A surrogate parent is required for a minor student when the parent cannot be identified or located or if parental rights have been terminated. A student’s parents are considered to be unknown if their identity cannot be determined from a thorough review of the student’s educational and other agency records.

A student’s parents are considered unavailable if they cannot be located through reasonable effort that includes documented telephone calls, letters, certified letters with return receipts, visits to the parents’ last known address, or if a court order has terminated parental rights. A parent is also considered unavailable if unable to participate in the student’s education due to distance or incarceration.

If a parent is too ill to participate at a meeting, either in person or by phone, that parent has the option of giving another individual written permission to act for them.

An uncooperative or uninvolved parent is not the same as an unavailable one. A surrogate parent is not assigned because parents choose not to participate in their child’s education.

A child identified as an unaccompanied homeless youth by the McKinney-Vento Homeless Assistance Act is an example of a student who would be assigned a surrogate parent to support them within the special education system. Children with surrogate parents might live in foster homes, nursing homes, public or private group homes, state hospitals, or correctional facilities.

In some cases, a state agency has guardianship of a student with a disability: That student requires the assignment of a surrogate parent.

Foster parents need to be formally appointed by the school as surrogate parents if they do not have legal guardianship. Relatives without formal kinship rights also can be designated as surrogate parents within the special education process.

A surrogate parent is not paid and cannot be employed by the school system, or any other agency involved in the care or education of the child. However, an unaccompanied homeless youth may be supported by appropriate staff from an emergency shelter, street outreach team, or other agency temporarily until a surrogate parent with no conflict of interest is appointed.

A surrogate parent must have knowledge and skills that ensure adequate representation of the student. A community volunteer, guardian ad litem, or other invested adult might serve as a surrogate parent. The surrogate parent must commit to understanding the student’s strengths and needs and how the educational system is structured to support the student’s services. Ideally, the surrogate parent lives near the student and is a match for providing culturally appropriate help in the student’s language.

The surrogate parent represents the student in all matters relating to special education identification, evaluation, and placement and works to ensure that the student receives a Free Appropriate Public Education (FAPE) from their school-based services.

The provision for a surrogate parent is part of federal special education law, the Individuals with Disabilities Education Act (IDEA Section 300.519).

Washington’s Office of Superintendent of Public Instruction (OSPI) includes some downloadable resources about the surrogate parent in its Special Education Resource Library.

PAVE is here to help all caregivers, including surrogate parents. For direct assistance, click Get Help to complete an online Help Request Form.

Bullying at School: Key Points for Families and Students with Disabilities

Posted on December 9, 2022May 6, 2026 by Nicol Walsh

Transcript of this video is below:

When students with disabilities are bullied, schools are legally responsible to end the bullying.

By law, schools must act to restore the safety and well-being of students who are harmed by harassment, intimidation, and bullying.

Those words—harassment, intimidation, and bullying, make an acronym: HIB. This video is about HIB protections for students with disabilities.

Please note that bullying increases the risks for suicide and self-harming behaviors.

For a mental health crisis, call 988

For crisis help on topics related to sexual orientation and identity, call The Trevor Project: 866-488-7386

What law says the school has to end the bullying and help my student?

Specific anti-bullying protections for students with disabilities come from Section 504, which is part of a federal law, the Rehabilitation Act of 1973.

The civil right to be protected from bullying applies to all students with disabilities, regardless of whether they have a Section 504 Plan or an Individualized Education Program (IEP). These rights are upheld by the Office for Civil Rights—OCR.

Anyone who knows about an incident of harassment, intimidation, and bullying at school or during a school-sponsored activity can file an OCR complaint at the local, state, or federal level.

What does state law require?

Washington State’s 2019 Legislature passed a law that requires school districts to write formal HIB policies and appoint a person called a HIB Compliance Officer to spread awareness and uphold the laws.

What can parents do?

If your child is bullied at school, ask for the name of your district’s HIB Compliance Officer. Talk to that person about your options and request a HIB complaint form.

If the act included a physical assault or serious property damage, file a police report.

Request an emergency meeting of the IEP or Section 504 team to add supports for the student to ensure emotional and physical safety at school.

What counts as harassment, intimidation, or bullying?

Washington State defines a HIB violation as an intentional act that:

Physically harms a student or damages the student’s property
Has the effect of substantially disrupting a student’s education
Is so severe, persistent, or pervasive that it creates an intimidating or threatening educational environment
Or has the effect of substantially disrupting the orderly operation of school

A HIB act may be electronic, written, verbal, or physical.

What does a school have to do when a child with a disability is bullied?

The Office for Civil Rights (OCR) requires schools to take immediate and appropriate action to investigate what happened. That means they talk to everyone involved and any witnesses and write a detailed report.

OCR requires the school to stop the bullying now and into the future.

OCR also says that schools must make sure the student who was bullied is helped and not further injured by actions taken in response. The victim should not be suspended, for example.

OCR says: “Any remedy should not burden the student who has been bullied.”

To learn more about federal laws and complaints, contact OCR at 800-421-3481.

Type the word Bullying or Discipline into the search bar at wapave.org to find additional resources.

Willa Decides to Get Vaccinated

Posted on July 21, 2022May 1, 2026 by Nicol Walsh

The decision to be vaccinated or when to mask can be confusing for anyone but for and individual that experiences anxiety, Autism, depression, or an Intellectual or Developmental disability the confusion around these decisions can be even more difficult. Willa experiences both High Functioning Autism and severe anxiety and this is a look into how she and her friends came to their own decisions based on learning about vaccinations and masking then talking together on what they felt is right for themselves and safe for the others around them.

Below are two different versions depicting Willa’s comic page in video form.

Willa decides to get vaccinated against the COVID 19 virus (No narration)

Willa decides to get vaccinated against the COVID 19 Virus (With narration)

*Please note, you can view Spanish subtitles by clicking on the cog on the lower right hand of the video, choose subtitles and then click on Spanish!

Willa Decides to get Vaccinated in comic strip

We also have Willa’s experience in a comic strip! Below each image, you will have the option to download the comic strip.

Comic page about Willa a character that decides to get vaccinated against the COVID-19 virus

Willa Decides to get Vaccinated in comic strip (Spanish Version)

Comic page about Willa a character that decides to get vaccinated against the COVID-19 virus in Spanish

Click to see the comic above in PDF form.

Full text for this comic page:

Willa: Guys, I’m kinda freaking out.

Willa’s Friend: Why Willa? What’s wrong?

Willa: The convention we’re going to has a vaxx card and mask policy and I’m unvaccinated.

Toni: WHAT?!

Willa: Getting vaccinated is scary…and the clinics are intimidating, and I’m scared of needles, and this vaccine came out much quicker than the others, so it’s probably rushed…

Willa’s Friend: Willa it’s important for you to get vaccinated. You have bad lungs, right? So, you’re extra at risk. And the reason why the vaccine came out so quickly in comparison to the others is because it got the funding to be mass produced quickly because it was a global issue. The same amount of time went into researching the COVID vaccine as any other vaccine. It’s completely safe.

Willa: Oh, Okay. That makes-

Toni: Wait, what about me? Why do I have to wear a mask? I’m vaccinated and it’ll ruin my cosplay!

Willa’s Friend: Actually Toni, COVID – 19 is so nasty that getting vaccinated doesn’t give you a 100% chance of not catching the virus. It makes you far less likely to catch it. And if you do, it makes your symptoms much less severe. So, it’s still important to mask to protect the more vulnerable people around you.

Toni: Oh!

Willa’s Friend: So, what are we going to do?

Willa: Get Vaccinated.

Toni: And wear a mask.

About

Programs

Welcome to the area of our website for and from young adults with disabilities!

Brief overview:

When you might need to be a self-advocate:

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

Learn more about Gracious Space:

Person Centered Planning:

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

A Brief Overview

Full Article

Determining Eligibility for Apple Health

Eligibility for Apple Health for Children:

Eligibility for Apple Health for Children:

Income requirements for Tier I subsidized coverage ($20 monthly per child; $40 family maximum):

Income requirements for Tier II subsidized coverage ($30 monthly per child; $60 family maximum):

Eligibility for Apple Health for Adults:

Eligibility for Apple Health for Adults:

How to Apply

When ready to apply for coverage from Apple Health:

A Brief Overview

Full Article

What happens if the screening shows indicators (signs) of dyslexia?

What happens if the screening shows a student has signs of dyslexia, or if families or teachers notice signs and want a student to get help?

What types of help can a student get with reading and literacy?

Interventions (help with reading) are schoolwide

Dyslexia can be identified and helped without a diagnosis

What options do families have if they disagree with a school’s decisions about their student’s reading supports or other decisions?

What else to know:

Resources:

From PAVE:

A Brief Overview

Full Article

How is TBI Defined?

IDEA’s Definition of TBI

Washington State’s Definition of TBI

What Are the Signs of Traumatic Brain Injury?

How to Access Support

Tips for Families and Caregivers

Help from PAVE

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

Further information on TBI:

Family Support

A Brief Overview

Full Article

Transcript of this video is below:

What law says the school has to end the bullying and help my student?

What does state law require?

What can parents do?

What counts as harassment, intimidation, or bullying?

What does a school have to do when a child with a disability is bullied?

Willa decides to get vaccinated against the COVID 19 virus (No narration)

Willa decides to get vaccinated against the COVID 19 Virus (With narration)

Willa Decides to get Vaccinated in comic strip

Willa Decides to get Vaccinated in comic strip (Spanish Version)

Full text for this comic page: