Meeting the school needs of patients with chronic conditions

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SCHOOL-BASED SERVICES FOR STUDENTS WITH

DISABILITIES

Gail M. Cheramie, Ph.D., NCSP, LSSP

Associate Professor and Director,

School Psychology Program

Univ. of Houston-Clear Lake

SPECIAL EDUCATION

Disability

Condition

Educational Need

Special Educatio

n

SPECIAL EDUCATION

Disability Condition

Educational Need

Special Education

SPECIAL EDUCATION

Disability Condition

Educational Need

Special Education

DISABILITY CATEGORIES

Autism, Deaf-Blindness Auditory Impairment Emotional Disturbance Intellectual Disability

(previously Mental Retardation)

Multiple Disabilities

Orthopedic Impairment Other Health

Impairment Learning Disability Speech Impairment Traumatic Brain Injury Visual Impairment Non-categorical Early

ChildhoodBy reason of the condition, the student

requires special education supports and services

WHAT IS SPECIAL EDUCATION?

Specially designed instruction – adapting content, methodology, or delivery of instruction to meet the individual, unique needs of the student that result from the child’s disability

Modifications – changes that affect standards and expectations

Accommodations – reasonable when they provide students with disabilities an equal opportunity to participate without lowering or fundamentally altering the academic standards.

RELATED SERVICES Assistive technology Speech therapy Physical therapy Occupational therapy Psychological services Social work Counseling Special transportation Audiology services Orientation and mobility training Rehabilitation counseling School nursing services and school health services Interpreter services

Services that are necessary for the

student to benefit from special education services; Require

evaluation

REFERRAL FOR SPECIAL EDUCATION EVALUATION (19 T.A.C. 89.1011)

Prior to referral, students experiencing difficulty in the general education classroom should be considered for all support services available to all students, such as tutorial, remedial, compensatory, and other services.

PROCESS OF REFERRAL Concerns expressed about a student by teacher –

concerns can also be brought by parents Case presented and discussed at the school

Problem-Solving Team (PST) Data are gathered (e.g., grades, criterion-

performance levels, cumulative record, information brought by parent) and determinations are made regarding next steps

If student is identified as at-risk, then standard intervention protocol is usually applied e.g., student below specified %ile rank or level in first

grade receives Reading Recovery services Progress-monitoring data is collected throughout

intervention

PROCESS OF REFERRAL

PST meets again to review progress Depending on progress, action

recommendations can include Discontinue intervention due to criterion

performance met Maintain intervention type and intensity Increase intensity Change intervention Suspect disability condition – Refer for FIE

This process is usually referred to as a Response to Intervention (RtI) model

RTI DEFINITION

“Response to intervention integrates assessment and intervention within a multi-level prevention system to maximize student achievement and to reduce behavior problems. With RTI, schools use data to identify students at risk for poor learning outcomes, monitor student progress, provide evidence-based interventions and adjust the intensity and nature of those interventions depending on a student’s responsiveness, and identify students with learning disabilities or other disabilities.”

• National Center on Response to Intervention

THREE-TIER MODEL

80%

15%

5%

Universal Interventions•All students•Preventative, proactive

Group Interventions•Some students (at risk)•High efficiency•Rapid response

Intensive, Ind. Interventions•Individual students•Assessment-based•High intensity•Longer duration

FULL AND INDIVIDUAL EVALUATION (FIE) Must meet certain standards (e.g., multiple

measures, valid & reliable, evaluate in all areas of suspected disability, …)

Determines if student meets the criteria for a disability condition – there are specified conditions in the IDEA and Texas Commissioner’s Rules

Makes recommendations

CONDITION: DISORDER + ADVERSE IMPACT

Presence of a disorder that meets legal and professional criteria IDEA criteria for disability categories Consider additional professional

standards that would apply if IDEA not specific (e.g., ADHD: DSM-IV-TR, NASP, AAP)

Adverse impact on educational performance Academic Behavior Developmental

FIE determines condition

ADMISSION REVIEW DISMISSAL COMMITTEE (ARD)

Required members: Parents/adult student Administrator Special education teacher Regular education teacher Assessment professional Others (related services professionals, invitees,

etc.) Determines eligibility for special education Develops IEP

CONTINUUM OF SERVICESG

ener

al E

d.

Wit

h A

cc./

Mo

ds

Co

-Tea

chin

g

Res

ou

rce

Sp

ecia

lize

d C

lass

es

ADDITIONAL SERVICES

OT/PT

Community

Based

Instruction

Vocational

CounselingO&M

Speech

Therapy

Diagnostic Assessment

Section 504

SECTION 504: INTENT

Designed to eliminate discrimination on the basis of disability in any program or activity receiving federal funds

Must have disability to be protected

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DISABILITY DEFINITION

Individual must have… Physical or mental impairment that

substantially limits one or more major life activities,

Have a record of having such an impairment, Or is regarded as having such impairment

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PHYSICAL OR MENTAL IMPAIRMENT

Any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one of more of bodily systems (e.g, neurological, musculoskeletal, respiratory, cardiovascular, digestive, etc.) or

Any mental or psychological disorder (e.g., mental retardation, emotional or mental illness, learning disability).

No exhaustive list of specific diseases or conditions.

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24

SERVICES VS PROTECTIONS

Substantial limitation

resulting from a disability

History of…Regarded

as….

Service

Protection

REASONABLE ACCOMMODATIONS

This term applies to many things ranging from making a facility accessible to providing an accommodation on an examination.

An accommodation is reasonable if it does not compromise the nature, content, and integrity of the test.

Accommodations are reasonable when they provide students with disabilities an equal opportunity to participate without lowering or fundamentally altering the academic standards.

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Discussion Issues

POINTS FOR DISCUSSION

Many services and interventions can be provided outside of special education; special education should be last resort

Schools can refuse to evaluate if data do not indicate a suspected disability or need for specially designed instruction

Clinical or Medical Diagnosis ≠ “Student with a Disability” under IDEA

Parents can refuse special education placement / revoke consent for placement to terminate services

Parents can refuse to provide consent for evaluation, but district can seek override

POINTS FOR DISCUSSION

Parents can disagree with school FIE and request and Independent Educational Evaluation (IEE)

If evaluation or other information is given to school, school personnel will likely contact the service provider (if parent gives permission)

It is important for external evaluators to contact school personnel (if they have parent permission) to determine how the student is performing in school and what interventions are being done

Best practice is collaboration