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About Neuropsychological Evaluations

September 5, 2012 in Special Education Articles by Jess

What is a Neuropsychological Evaluation?

A neuropsychological evaluation is comprehensive battery of tests that provides a detailed picture of a person’s aptitude, achievement, and social and emotional status as compared to others at the same stage of development.  Only a trained neuropsychologist administers such assessments.  The evaluation involves a clinical history and interview, completion of standardized checklists, completion of paper and pencil tasks, hands-on activities, and computer-based tasks. Read the rest of this entry →

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Pre-School Assessments Can Serve Many Purposes

August 23, 2012 in Special Education Advisor Blog by Dennise Goldberg

The new school year has begun for many of us, which means another year of IEP’s.  For some parents, it’s their introduction into the world of Special Education.  The pre-school assessments might be their first experience hearing about their child’s areas of strengths as well as areas of needs.  As we all know, the latter is much more difficult to deal with because when our son or daughter was born all we were concerned about was making sure they ate, slept and had on a clean diaper.  The thought of having a child with special needs was not on the list of concerns.  So when a few years pass in a child’s life and they begin to show signs of developmental delay, behavioral problems, etc…parents have to ask the hard question “does my child have special needs?”  Read the rest of this entry →

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XXX Syndrome: early learning and sensory developmental implications

August 15, 2012 in Special Education Articles by Jess

This rare but potentially devastating condition affects girls born to older mothers.  And as we as OT’s working in schools and preschools have already observed, many of our “first time moms” are often in their late thirties and early forties.

It is not a given that all older moms give birth to children with issues.  But in the case of XXX Syndrome that is one of the prominent factors.  XXX Syndrome is characterized by the presence of an additional X chromosome in each cell of female children/fetus.  If the extra X chromosome occurs only in some of the cells it is called a mosaic, and has less developmental impact.  It is not an inherited condition and usually occurs during conception and is related to a delayed or incomplete splitting of the egg during fertilization.  Occurrence is about 1 in 1,000. Read the rest of this entry →

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It’s Not All about the Numbers

July 15, 2012 in Special Education Articles by Jess

Funny thing happened to the learning field in the 21st century- numbers now rule the world.  Parents, administrators, politicians, clinicians, educators . . . everyone seems to be clamoring for (and clinging to) numerical data.  To be sure, scores are important sources of information.  But they almost never tell the whole story about a learner.

Qualitative findings are observations made about learner behavior.  Such findings may focus on process (how the learner arrived at a response or completed a task) or product (such as accuracy, types/patterns of errors, and organization of work).  Quantitative findings are numerical and often normative, meaning that the test developers administered the task to numerous students (usually at different age/grade levels) to generate means and standard scores (like an IQ score).  Contrary to what many believe, a standard score does not represent an amount of ability or level of skill.  Rather it is a comparison between a learner’s ability level in a defined area or skill with that of other, similar-age students.  Both qualitative and quantitative assessment information serve important purposes in assessments.  Each type of information has its advantages and disadvantages. Read the rest of this entry →

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The Common Core Standards: How Will They Change Teaching and Assessment?

May 22, 2012 in Special Education Articles by Jess

As of May 11, 2012, forty-eight states, the District of Columbia, and two American territories have adopted the Common Core State Standards (CCSS).  That means, whether your state is one of the adopters or not, CCSS are changing the face of education.

So what are the CCSS and what does this all mean for your child?  The Common Core State Standards are a set of expectations for what students should learn during the course of their educational careers.   CCSS create a measure of continuity across state lines in the content that will be taught and, more importantly, raises the bar for students and teachers alike.  States and territories using CCSS are charged with teaching standards that are often more complex than most states’ current academic content standards—demanding a change in how teachers present information to their students as well as demanding a deeper level of comprehension from the students themselves.  How is this achieved?  CCSS requires a focus on higher-order thinking questions and skills.  For instance, in math class, rather than asking which numbers are even, students will be asked which numbers are even and how do they know that (i.e., the numbers are divisible by two, they have a pair).   English Language Arts (ELA) is now explicitly tied to history/social studies, science and technical studies, meaning that all of these content areas will require complex thinking and analysis rather than rote memorization. Look at the difference between these two questions: Read the rest of this entry →

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Bring ABA into Inclusive Classrooms Instead of Sending Students with ASD to ABA Schools and Programs

March 15, 2012 in Special Education Articles by Jess

As you may have already figured out by the title of my book and my previous blog posts, one of my missions is to help educators and caregivers learn how to design meaningful ABA interventions that can be implemented within everyday home, school, and community routines. More and more special schools (segregated settings) for children with ASD are opening up across the country to provide 1:1 ABA instruction. The problem I have with this is that these children are missing out on thousands of learning opportunities that occur in inclusive classrooms and inclusive schools. The reason why these schools keep popping up is that there is strong research support for ABA interventions for kids with ASD, and the truth of the matter is public schools typically do not provide intensive ABA interventions for kids with ASD within the context of general education classrooms (or even special education classrooms). So, private or publicly funded schools are setting up camp to deliver 1:1 ABA interventions. Here’s one very important word of caution, though: While there is research support for the use of ABA interventions with kids with ASD, there is also research that documents that many kids do not maintain and generalize skills being learned when they are taught outside of the environments in which they will use them. Children may not maintain or generalize skills taught in isolation because the contexts in the natural environment are so significantly different from the therapeutic setting. They also may not maintain or generalize skills taught in isolation if the skills being learned are not meaningful and useful across contexts. All ABA intervention program goals should be able to answer the “So what?” question: If the child masters the goal, so what? How will it positively impact the child’s life and/or the life of those the child interacts with? If this question cannot be answered, the goal should not be included in the child’s program. Read the rest of this entry →

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When an Attention Deficit Isn’t

March 6, 2012 in Special Education Articles by Jess

Addison is in the 6th grade, her first year in middle school. She did pretty well in elementary school, but she’s getting slammed in 6th grade. A couple of her teachers have described her appearing distracted, making mistakes with details, and being disorganized with her work. Addison admits to “zoning out” a lot during classes like English, Spanish, science, and geography. So clearly she has ADHD and could use some medication to help her focus.

Except that maybe she doesn’t have ADHD at all. Read the rest of this entry →

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Driven to Distraction by Anesthesia

February 29, 2012 in Special Education Articles by Jess

The Mayo Clinic recently reported that researchers have found that children exposed to anesthesia multiple times before the age of 3 have double the incidence of ADHD than those with no exposure to anesthesia. You can read the report here. In a 2009 report Mayo linked multiple anesthesia exposures before age 4 to learning disabilities.

Great. My son, has arthrogryposis and had three major surgeries and at least four smaller surgeries before age 3. Nothing we can do about that now. He has had many more surgeries since then. We have long noticed that he is inattentive. We also see that his memory suffers after surgeries. Nevertheless, without those surgeries his ability to walk, run, write, and feed himself would all be more severely impacted.For my child, and many like him, surgery is a necessity. Read the rest of this entry →

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I’ve decided to pay for a private evaluation for my child – what should I expect?

November 16, 2011 in Special Education Articles by Jess

The decision about whether or not to have your child evaluated by the school or by a private practitioner can be a difficult one, as discussed in my prior post My Child Needs a Psychological Assessment: Should I Have This Done Through the School or Privately. Once you have made the decision to invest in a comprehensive independent evaluation outside the school, you may wonder what you can expect from the psychologist. Private evaluations are not inexpensive – you are paying for many benefits that are not necessarily part of the testing process within the school. Parents should expect to receive the following services as part of the evaluation when seeing a psychologist in private practice.

1) AN INITIAL MEETING PRIOR TO THE START OF TESTING: This meeting gives the psychologist a chance to gather relevant information about your child’s medical, psychological and neurological history, past and present school performance, and overall functioning. In addition, this is when the “referral questions” should be clarified. The referral questions are the specific questions that the parents and other professionals treating the child have been unable to answer. The initial meeting is an important tool in helping the testing psychologist develop an individualized assessment that will best answer those questions. Evaluation should not be “one size fits all” but rather tailored to the particular needs of each child. Depending on the age and circumstances of your child, they may be invited to join this meeting as well.

2) HOMEWORK: Yes, parents and teachers get homework too! It is very helpful for the psychologist to understand how your child has been functioning in both their home and school settings. Thus, it is common for psychologists to provide questionnaires for parents and teachers to fill out. Depending on your child’s age, they may also be given self-report measures to complete. Parents will also be asked to bring copies of any prior testing that has been done for the examiner to review.

3) A COMPREHENSIVE SET OF TESTS AND SUFFICIENT TIME FOR THE EVALUATION: While the actual amount of time needed to complete the testing depends on your child’s age and the referral questions that are being addressed, a comprehensive evaluation typically requires approximately 7-12 hours of testing. While that may seem like a lot of time, it is necessary in order to properly and thoroughly assess IQ, achievement, underlying cognitive abilities such as attention, information processing, executive functions, memory, and language functions, as well as personality structure and current symptomotology. The testing is typically broken down into 2-4 sessions, often with breaks for lunch and/or snacks. The number of sessions generally depends on the age and temperament of your child, although certain tests must be administered in a single sitting and this should be considered when scheduling the assessment sessions. It is generally preferable to start testing in the morning, rather than after a full day of school.

4) A COMPREHENSIVE, INTEGRATED, INTERPRATIVE REPORT WITHIN A REASONABLE AMOUNT OF TIME: A good report will not merely list the test scores, as a list of data is not overly helpful. Rather, the psychologist should discuss and explain the findings, and then interpret them within the context of answering the referral questions. Discrepancies within the data and with prior testing should be addressed and explained, not glossed over. The report should include specific and detailed recommendations for intervention and treatment – this is essential in order to make use of the findings and utilize them in a concrete manner to help your child. A full list of tests administered, as well as an Appendix with all of the test scores, should be included so that parents will have the ability to let other professionals review and interpret the scores if they wish. Good reports cannot be written quickly, but three to six weeks after the testing is completed would be a reasonable expectation for parents.

5) AN OPPORTUNITY TO REVIEW THE FINDINGS WITH THE PSYCHOLOGIST: A comprehensive psychological report is long and often complex. Parents should be given the opportunity to meet with the psychologist to review the findings, and to ask any questions that they may have about the report. While this in-person feedback session with the psychologist to discuss the report is essential, many parents have questions that arise after the feedback session, and the psychologist should be available and willing to answer them by phone.

6) COLLABORATION WHILE MAINTAINING CONFIDENTIALITY: Parents have the right to determine who views their child’s psychological evaluation. While it can be very helpful for the school and other professionals treating their child to view the results, parents are not required to share them with anyone. Once completed, the report is the property of the parents, and they may copy and distribute their child’s report however they see fit, without needing any approval from the psychologists. However, given that other clinicians working with the child (e.g. therapists, psychiatrists, tutors etc.) would likely be able to utilize the information in the report to enhance their work with the child, it is often recommended to the parents to share this information. If shared, reports should not be transmitted through email or fax, as confidentiality cannot be guaranteed in those mediums. If parents do choose to share the report and give consent, the psychologist should be available to discuss their findings with the other treating professionals. The psychologist should not release any information regarding the report without written consent from the parents.

Psychological evaluation can be extremely helpful, as long as both the parents and child fully understand all parts of the process. Parents have the right to speak up and ask questions. Ultimately, the hope and expectation in commissioning a comprehensive psychological evaluation is that the private psychologist will address and answer the referral questions provided by the parents in a manner which provides a clear plan for effective interventions and treatment that will improve the quality of life for your child, and your family, going forward.

Melissa B. Singer, Ph.D. is a clinical psychologist in Westchester County, New York. She specializes in comprehensive psychological, cognitive, educational and neuropsychological assessment for children and adolescents. You can learn more about her practice at these websites:

www.melissabsingerphd.com

http://www.facebook.com/DrMelissaSinger

http://twitter.com/#!/DrMelissaSinger

 

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The Federal Register is a Goldmine of Information Regarding IDEA

November 14, 2011 in Special Education Advisor Blog by Doug Goldberg

Ever wonder:

1) If Parents can add a written report to their child’s Individualized Education Program (IEP); or

2) Whether placement decisions in an IEP can be made based on the category of disability; or

3) How do you protect the rights of a child who is a ward of the State in an IEP; or

4) Does the School need to have highly qualified staff to teach Extended School Year (ESY); or

5) Whether Children with a Disability should be included in State Assessments.

All of the above questions and many, many more can be answered by reviewing the Federal Register. Section 607 of the Individuals with Disabilities Education Act (IDEA) requires that the Secretary of Education, on a quarterly basis, publish in the Federal Register a list of correspondence. This is correspondence from the Department of Education received by individuals that describes the interpretations of IDEA or the regulations that implement IDEA. You can find a list by topic or date of these letters on the US Department of Education’s website.

I review these letters regularly as it gives me guidance on how to communicate with School Districts. Especially, when I need answers to questions like the one’s presented above. For instance:

1) Federal Register / Vol. 71, No. 156 Page 46678 states that, “Parents are free to provide input into their child’s IEP through a written report if they so choose.” This is important information to know when the School District’s IEP notes are skewed or missing information the Parent’s feel is important to get on the record; or

2) In a Letter to Tom Trigg dated November 30, 2007, the Office of Special Education Programs (OSEP) answered a question regarding Least Restrictive Environment (LRE) where they stated, “The public agency should exercise caution in making such a determination [location of services] so that the placement of the child with a disability is not based on factors such as the category of disability, configuration of the service delivery system and the availability of staff and instead is based on the factors stated in §300.552;” or

3) In a letter to Dr. Mary J. Ford dated July 10, 2003, OSEP answered a question regarding protecting the rights of a child who is a ward of the State where they stated, “The first part of your question, regarding the appointment of a surrogate parent for a child who is a ward of the State, involves 34 CFR §300.515(a). This regulation requires the public agency to ensure that the rights of a child are protected if 1) no parents (as defined in §300.20) can be identified, 2) the public agency, after reasonable efforts, cannot discover the whereabouts of a parent; or 3) the child is a ward of the State under the laws of the State. The duty of the public agency under §300.515(a) includes the assignment of an individual to act as a surrogate for the parents. The public agency must have a method for determining whether the child needs a surrogate parent and for assigning a surrogate parent for the child. (34 CFR §300.515(b));” or

4) In a letter to Dr. John Copenhaver dated November 7, 2007, OSEP answered a question about the qualifications of school staff during ESY where they stated, “Under Part B regulations, no distinction is made between the personnel qualifications for special education and related services provided pursuant to a child’s IEP as part of the regular school program and those provided pursuant to an IEP as ESY services. Personnel providing ESY services should meet the same requirements that apply to personnel providing the same types of services as a part of a regular school program;” or

5) In a letter to Congressman Weldon dated October 10, 2001, OSEP answered a question about state assessments where they stated, “The requirements for including children with disabilities in assessments are based on a number of federal laws, including Title II of the Americans with Disabilities Act of 1990, Section 504 of the Rehabilitation Act of 1973, and most notably the IDEA and Title I of the Elementary and Secondary Education Act. These laws recognize that an assessment is often connected to student benefits such as moving to the next grade or graduating. Assessment is also an important factor in school accountability as well as individual benefits provided to children. Excluding children with disabilities from assessments may violate these Federal laws.”

Knowledge and information are two of the most important tools that Parents have to ensure their child receives a Free Appropriate Public Education (FAPE). Answers to these and other questions like them can be the difference between a child with a disability receiving FAPE or that child receiving a failing education. Stay informed by reviewing new letters as they become available quarterly on the Department of Education website.

 

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