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Meeting the school needs of patients with chronic conditions
- 1. 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
- 5. 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 Childhood By reason of the condition, the student requires special education supports and services
- 6. 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.
- 7. 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
- 8. 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.
- 9. 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
- 10. 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
- 11. 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
- 12. 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
- 15. 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
- 16. 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
- 17. 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
- 21. 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 21
- 22. 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 22
- 23. 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, car diovascular, 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. 23
- 24. SERVICES VS PROTECTIONS Substantial limitation resulting from a disability History of… Regarded as…. Service Protection 24
- 25. 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. 25
- 27. 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
- 28. 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