LEARNING DIFFICULTIES: HOW TO ADVOCATE FOR CHILDREN IN THE SCHOOL SETTING ICAAP Education Conference – March 3, 2017
BRIANNE N. DOTTS, JD (Chicago Medical-Legal Partnership for Children, a program of Legal Council for Health Justice)
DISCLOSURES
I have no relevant financial relationships with the manufacturers(s) of any commercial products(s) and/or provider
of commercial services discussed in this CME activity.
I do not intend to discuss an unapproved/investigative use of a commercial product/device in my presentation.
PRESENTATION OBJECTIVES
Basic overview
IEPs & 504 Plans: What are they and what is the difference
Who is eligible?
How does a child get one? What types of services can they get?
Issue Spotting
Questions to Ask
Signs and Symptoms
What can you do to help?
Please feel free to interrupt me with questions at any point
during the presentation
IEPS AND 504 PLANS – WHAT ARE THEY?
SIMILARITIES
They are both legal documents that describe what the school district agrees to provide
If it is not in the document, it does not count – the parent should always take the time to review
The school must review each document at least once per year
The parent has a right to request a meeting more often – request should be in writing
Parents can invite anyone who has knowledge of the child (as determined by the
parent) – this includes physicians, therapists, other clinicians, and family members
WHAT IS AN IEP?
It is a legal document that describes the special education and related services that the
public agency will provide – if it is not in the IEP, it does not count
Must be reviewed by full IEP team (including parent) at least once per year
Child must be re-evaluated at least every 3 years
Created by IEP team (can consist of: School Staff, Medical Staff, Parents)
IEP should include BIP (Behavior Intervention Plan) if student has interfering behaviors
IEP should include Transition Plan for students 14 ½ and older
WHAT IS A 504 PLAN?
A 504 Plan provides accommodations & modifications to a student with a disability
Accommodations: A change in how students are taught or assessed
Modifications: A change in what students are expected to learn or demonstrate
A 504 Plan does not generally provide a student with services
Frequently used for students with medical needs (e.g. asthma, diabetes, sickle cell)
Also frequently used for students with ADHD, but may not be appropriate in most
cases
WHAT IS THE DIFFERENCE?
504 is appropriate when disability does not impact educational performance (e.g., asthma, peanut allergy, etc.)
Appropriate: Student with ADHD gets B’s or C’s, no significant behavior concerns, but needs nurse to administer medication and the ability to stand at his desk and/or use a fidget toy
Inappropriate: Student with ADHD C’s or F’s, has uncontrollable outbursts in class, and struggles to complete work on time (e.g., forgets his homework all the time). Should have an IEP and NOT a 504 plan.
IEP is appropriate when disability impacts educational performance
Appropriate: Student with no diagnosis who acts out or becomes aggressive to the point where Student is frequently removed from class whether or not his grades are impacted by his absence
Inappropriate: Student with no diagnosis who acts out in class, may be identified as “class clown” or “active,” but Student is only removed from class occasionally and his grades are not impacted
If you are not sure which one your patient needs, request an evaluation for an IEP.
WHO IS ELIGIBLE?
IEP ELIGIBILITY
To be found eligible for an IEP, student must:
Meet requirements for at least one of the 13 classifications
(which are different than diagnoses); AND
Disability must adversely affect educational performance;
AND
Because of the disability, the student needs “special
education and related services”
Classification is merely the threshold to get services – it does not
determine what services should be provided, so don’t get stuck on
the category.
IEP Eligibility Categories
Mental Retardation or Cognitive Impairment
Hearing Impairment
Speech or Language Impairment
Visual Impairment
Orthopedic Impairment
Autism
Deaf-Blindness
Traumatic Brain Injury (TBI)
Multiple Disabilities
Emotional Disturbance (ED)
Other Health Impairment (OHI)
Specific Learning Disabilities (SLD or LD)
Developmental Delay (until age 9)
504 ELIGIBILITY
Student must:
Have a physical or mental impairment (any physiological disorder or condition, cosmetic disfigurement, or anatomical loss
affecting a major body system); OR
Have a history or record of such an impairment; OR
Be regarded (is assumed) to have such an impairment;
THAT that substantially limits one or more major life activities.
Caring for one’s self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, working, eating, sleeping,
standing, lifting, bending, reading, concentrating, thinking, and communicating.
Major bodily functions: functions of the immune system, normal cell growth, digestive, bowel, bladder, neurological, brain,
respiratory, circulatory, endocrine, and reproductive functions
More students will qualify for a 504 plan than an IEP.
HOW DO YOU GET AN IEP OR 504 PLAN? or or
EVALUATION, ELIGIBILITY, EXECUTION
Request evaluation
14 days to respond
Assessment Planning
14 days to hold meeting
Evaluation
60 school days to complete
from receipt of written consent
to evaluate
Eligibility
60 school days to complete
Anyone with knowledge of the child can attend
School should make accommodations for participants by
phone if given advance notice
Meeting
60 school days to complete
(Usually same day as Eligibility)
Same rules apply Parent can bring
people for support
Execution
10 calendar days unless waived by
Parent
Written consent only required for
initial IEP
If parent disagrees with IEP and wants
child to stay in pre-IEP program, they have 10 days to file a complaint
WHAT DO THEY EVALUATE?
Cognitive Functioning (or General Intelligence)
Academic Performance
Functional Performance
Communication
Social & Emotional Status
Motor Abilities
Vision
Hearing
Health
Other areas as needed (e.g., assistive technology, transition)
School Districts must assess the child
in all areas of suspected disability.
If there is an specific area you feel is necessary,
make sure to include that it in your request
TYPES OF SERVICES
Occupational Therapy
School Health/Nurse Services
Speech & Language Therapy
Physical Therapy
Parent Training & Counseling
Assistive Technology
A shared or dedicated aide
Social Work Services
Independence Training
Vocational Rehab Services
Behavior Intervention Plan
Alternative/Augmentative Communication Device
Audiology services
Interpreting services
Psychological services
Therapeutic Recreation
Counseling services
Orientation/Mobility Services
Career development counseling
Transportation
IEP services and accommodations should be tailored to the individual need of the Student.
The School District must provide what the Student needs (not what they have),
but it may mean the Student’s placement will change.
DOES MY PATIENT NEED AN IEP OR 504 PLAN?
QUESTIONS TO ASK
Does the child have a medical diagnosis or developmental delay that can impact their education?
Has the child ever been recommended for Special Education by an educator or evaluated for Special
Education and/or Early Intervention?
How is school going?
Grades and/or test results
Behavior
Interaction with peers
Ability to communicate effectively
Ability to access classroom (reading, writing, physically)
Does the student take medication or need special medical treatment during the school day?
Is the student absent frequently or refusing to go to school?
SIGNS & SYMPTOMS
Poor Attendance: Student refuses to go to school or do school work
Poor grades (D’s and F’s) or being retained/held back
Difficulty with classroom activities like writing, coloring, or learning
Problems with memory or attention
Problems performing activities of daily living
Frequent behavioral issues or being labeled a “problem child” (e.g., School calls Parent repeatedly to pick
up Student because “we can’t deal with him/her”)
Frequent suspensions or removals from classroom; expulsion
Mental Health diagnoses, including ADD/ADHD, Bipolar Disorder, Depression, Learning Disability, and/or
PTSD
SCHOOL DISCIPLINE: A SYMPTOM?
All students, including special education students, are required to follow the Student Code of Conduct. Any
failure to do so can result in disciplinary action, including but not limited to:
Suspension = any removal for up to 10 consecutive days
Expulsion = any removal for 11 days or more (up to 2 years)
If a student is expelled, School District has NO obligation to provide education
Students may be expelled for up to 2 years
Expelled from one school district = expelled from all school districts
District may enroll the student in an alternative school, but it is not required (suburban districts usually don’t)
Special Education students have special protections – including some students without IEP or 504 plan.
Suspensions and Expulsions are often (but not always) a symptom of unmet needs.
Always demand written notice of suspension or expulsion.
WHAT CAN I DO TO HELP?
20
GENERAL TIPS
Help families request evaluations from the school – more details to come
The more detail you can provide, the better!
Your recommendations should be based on the child’s needs, not what you think the school district can do
Help facilitate communication between the child's hospital-based therapists and school-based therapists.
Carefully fill out school paperwork/reports. Include details!
Help students get referrals to specialists for evaluations of areas of concern.
IMPORTANT NOTE: All requests and communication should be done in writing. Parents should follow all
discussions with a summary letter to confirm. If it isn’t written down, it didn’t happen!
HOW TO WRITE AN EFFECTIVE LETTER
Write a letter to request an evaluation for an IEP, request a 504 plan, or to add/change services in an IEP or 504 plan
Letter must be included with a written request for an evaluation or meeting from the parent – your signature alone is not enough
Providing less information is typical, but not helpful. Schools require specifics to justify levels of service. Too much detail is better than too little.
Identify the disability or area of concern
Describe the medical issues and the current treatment, including medications
Describe how the child’s medical issue or condition impacts their functioning on a day to day basis.
Avoid language like “best,” “maximize” and “optimal”
Schools are not required to provide what is “best” or “optimal”
Focus on what the child needs – BE SPECIFIC!
Offer suggestions to meet the needs if you have them
Advise parent to keep proof the letter was provided to the school
SAMPLE EVALUATION REQUEST
Key components:
Date
Child’s Name & DOB
Request for evaluation
Difficulties child is having in school
Date for response (14 days)
SCHOOL MEDICAL FORMS
DON’T LIMIT YOURSELF TO THE FORM
Feel free to write a separate letter, or write in explanations – put “see separate letter” on the form
Make sure to answer the questions on the form
Include specific diagnoses, as applicable, but specific symptomology (as it pertains to school) is more helpful
Avoid language like “best,” “maximize” and “optimal”
Offer suggestions to meet the patient’s needs if you have them
School Nurse is often asked to review medical information and can override recommendations by a physician
If this happens and you disagree, it is very helpful if you write a letter explaining why you disagree
Keep proof the form was provided to the school – Fax confirmation is sufficient
I HAVE AN IEP OR 504 PLAN – NOW WHAT?
WHAT SHOULD HAPPEN?
504 plans should be implemented immediately and reviewed at least once per year.
The IEP should implemented within 10 days of the IEP meeting.
For the initial IEP, implementation is within 10 days of when written parental consent is received
Types of IEP meetings:
Annual review
Three-year re-evaluation
A parent may request an IEP meeting at any time.
An evaluation can be requested up to once a year for each area of evaluation
PROBLEM AREAS
School does not respond to a written evaluation request
School takes too long to convene domain meeting or evaluate
Evaluations are inaccurate
Student is found ineligible for services
Student’s program changes without notice
School does not provide paperwork in native language and/or interpreter at the meeting
Student has 504 plan and parent thinks child needs IEP
School does not provide the services in the IEP or 504 plan
May be time for the family to get an advocate or attorney.
There are free and low cost options if they qualify.
QUESTIONS
Go to UpstreamHealth.org
Chicago Medical-Legal Partnership for Children,
a program of Legal Council for Health Justice
Brianne N. Dotts
312-605-1945
