Educational Needs and Services for Children with Epilepsy David H. Salsberg, Psy.D., DABPS © Rusk...
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Transcript of Educational Needs and Services for Children with Epilepsy David H. Salsberg, Psy.D., DABPS © Rusk...
Educational Educational Needs and Needs and
Services for Services for Children with Children with
EpilepsyEpilepsyDavid H. Salsberg, Psy.D., DABPS David H. Salsberg, Psy.D., DABPS ©©
Rusk Institute of Rehabilitation Rusk Institute of Rehabilitation The Stephen D. Hassenfeld Children’s Center The Stephen D. Hassenfeld Children’s Center
for Cancer and Blood Disordersfor Cancer and Blood DisordersNYU Langone Medical CenterNYU Langone Medical Center
When to become concernedWhen to become concerned What professionals do you consult What professionals do you consult
withwith What evaluations are availableWhat evaluations are available How to prepareHow to prepare What to do with the informationWhat to do with the information Special Education or notSpecial Education or not InterventionsInterventions
Parents and Parents and ProfessionalsProfessionals
Myriad of Labels/Diagnoses, Myriad of Labels/Diagnoses, Tests, Scores, and Tests, Scores, and
InterventionsInterventions
WPPSI-III, WISC-IV, WIAT-II, NEPSY-WPPSI-III, WISC-IV, WIAT-II, NEPSY-II…II…
LD, PDD, ADD, ADHD, SI, ED, APD, LD, PDD, ADD, ADHD, SI, ED, APD, TBI…TBI…
PT, OT, ST, IEP’s, EI, CPSE, CSE, 504 PT, OT, ST, IEP’s, EI, CPSE, CSE, 504 ……
Educational Implications for Children with
Epilepsy Etiology of Seizuresunderlying causes/conditions
Seizures frequency/control Medications and effects Age at Onset Secondary effects
missing schoolavailability for learningemotional/family/psychological
All can contribute to a variety of learning and attentional difficulties in children.
Issues in Educational Planning
Seizure plan Nurse Health paraprofessional Medications and effects Effects on learning
AttentionFatigue
Stigma and Social Considerations Dietary or activity restrictions Emotional and family issues affect
educational planning
When to take notice Developmental lags noted Discrepancy between skill area and
“norm” or expected Discrepancy between child’s own
individual strengths and weaknesses Signs/expressions of frustration; low self-
esteem Social skills difficulties Mood/behavior changes Academic and achievement difficulties
Birth to 3
Start with Evaluations – specific or more comprehensive?
Early Intervention – funded Private therapists Need team – integrated approach Center-Based Program / Home
program
When in doubt refer for evaluation Need to refer early If too early to qualify – need to
monitor Need to intervene earlier or can
miss developmental window of opportunity
Imperative in language skills development
Ages 3 - 5
Start with Evaluations – Specific or more comprehensive?
Therapy specific treatments CPSE – Board of Education/District Preschool options SEIT Crucial to evaluate early enough to
make decisions prior to Kindergarten.
School Age Schools start with pre-referral interventions Evaluations – specific or more
comprehensive? Committee on Special Education (CSE)
Pros and cons of evaluations, classifications,Section 504, legal issues
Therapies School Placement considerations
Primary EvaluationsPrimary Evaluations
PsychologicalPsychological
PsychoeducationalPsychoeducational
NeuropsychologicaNeuropsychologicall
HistoryHistoryIntelligence TestingIntelligence TestingBehavioral AssessmentBehavioral AssessmentEmotional/PersonalityEmotional/Personality
PsychologicalPsychologicaland Full Academic and Full Academic AchievementAchievement
All of the above and All of the above and further exploration of further exploration of areas of strengths and areas of strengths and weaknessesweaknesses
Developmental EvaluationsDevelopmental Evaluations
Developmental snapshots to guide Developmental snapshots to guide current treatment planning and current treatment planning and diagnosisdiagnosis
Needs ongoing monitoring and Needs ongoing monitoring and reassessment of treatment planreassessment of treatment plan
Not correlated with later IQNot correlated with later IQ Limitations of diagnoses/labels at an Limitations of diagnoses/labels at an
early ageearly age
Goal of Neuropsychological Goal of Neuropsychological TestingTesting
Go Beyond IQ and academic scores to Go Beyond IQ and academic scores to provide a complete picture of the provide a complete picture of the child’s cognitive, learning and child’s cognitive, learning and social/emotional functioning across social/emotional functioning across many domains related to brain many domains related to brain function. function.
Should beShould be functional perspective with functional perspective with clear and practical recommendations.clear and practical recommendations.
Testing ProfessionalsTesting Professionals
PsychologistsPsychologistsSchool/Educational (Master’s, School/Educational (Master’s, Doctorate)Doctorate)Clinical Ph.D., Psy.D.Clinical Ph.D., Psy.D.
NeuropsychologistsNeuropsychologists
Other Disciplines/TeamOther Disciplines/Team Neurology Neurology Pediatrician/Developmental Pediatrician Pediatrician/Developmental Pediatrician NursingNursing Psychiatry Psychiatry PhysiatryPhysiatry Physical TherapyPhysical Therapy Speech and Language Therapy Speech and Language Therapy Occupational TherapyOccupational Therapy Special Educators/learning specialistsSpecial Educators/learning specialists
All have specific scopes of practiceAll have specific scopes of practice
Pediatric SpecializationPediatric Specialization
ExperienceExperience RapportRapport Knowledge of educational systemKnowledge of educational system Limits of overly specialized, Limits of overly specialized,
diagnosis focused evaluations, diagnosis focused evaluations, clinicsclinics
Specific Issues in Specific Issues in EpilepsyEpilepsy
All of the aboveAll of the above Experience with Epilepsy and range Experience with Epilepsy and range
of learning, attentional and of learning, attentional and psychological issuespsychological issues
Timing and locations of evaluationsTiming and locations of evaluations Reason for referral may dictate or Reason for referral may dictate or
limit evaluation (i.e.: pre-surgical limit evaluation (i.e.: pre-surgical evaluation)evaluation)
District/School vs. District/School vs. Independent EvaluationsIndependent Evaluations
Independent evaluation:Independent evaluation: Parental controlParental control Timing/flexibility of evaluationTiming/flexibility of evaluation Goal should be to evaluate the child Goal should be to evaluate the child
holistically not just to get an evaluation doneholistically not just to get an evaluation done Specific recommendationsSpecific recommendations No conflict of interestNo conflict of interest
Needs to provide appropriate documentation Needs to provide appropriate documentation and recommendations to be accepted and and recommendations to be accepted and usefuluseful
Be sure to understand timing/procedural Be sure to understand timing/procedural issuesissues
Variability in ReportsVariability in Reports
Tester:Tester:TrainingTrainingStyleStyleOrganization/SettingOrganization/Setting
Tests usedTests used Who person is writing forWho person is writing for Referral QuestionReferral Question
Variability in Tests UsedVariability in Tests Used
Examiner’s choice/comfort levelExaminer’s choice/comfort level Availability of TestsAvailability of Tests Age of childAge of child Clinical JudgmentClinical Judgment
Preparation for Evaluation Preparation for Evaluation - Parents- Parents
Educate yourself regarding learning issues Educate yourself regarding learning issues and processand process
Delineate areas of concern/goals of evaluationDelineate areas of concern/goals of evaluation Understand clinician’s scope of experience Understand clinician’s scope of experience
and practice and ability to assess with a teamand practice and ability to assess with a team Should not focus primarily on single labelShould not focus primarily on single label Expect written report with practical Expect written report with practical
recommendations that is also geared toward recommendations that is also geared toward specific goal (ie: funding, admission…)specific goal (ie: funding, admission…)
Assure ongoing communication/follow-upAssure ongoing communication/follow-up Parents should receive feedback and then Parents should receive feedback and then
written report before school, districtwritten report before school, district
Preparation for Evaluation Preparation for Evaluation - Child- Child
Present evaluation in non-threatening, relevant Present evaluation in non-threatening, relevant and developmentally appropriate mannerand developmentally appropriate manner
Coordinate terminology and evaluation process Coordinate terminology and evaluation process with clinicianwith clinician
Consider classroom/therapy observationsConsider classroom/therapy observations Discuss specific behavioral/stylistic issues with Discuss specific behavioral/stylistic issues with
clinicianclinician Provide work samples, book bag, outside of Provide work samples, book bag, outside of
school examples of concernsschool examples of concerns Child should receive some form of feedback at Child should receive some form of feedback at
the endthe end
Factors Impacting TestingFactors Impacting Testing Why referred?Why referred? Motivation/AttitudeMotivation/Attitude RapportRapport Time Frame of testingTime Frame of testing DisabilitiesDisabilities Need to know what each test measures/doesn’t Need to know what each test measures/doesn’t
measuremeasure AgeAge Culture/LanguageCulture/Language Qualitative information necessary with scoresQualitative information necessary with scores MedicationMedication Seizure statusSeizure status In hospitalIn hospital
Overall Cognitive FunctioningOverall Cognitive FunctioningIntelligence Testing - IQIntelligence Testing - IQ
In neuropsychological and/or In neuropsychological and/or educational evaluation IQ test is educational evaluation IQ test is used as starting pointused as starting point
Normative ComparisonNormative Comparison Limitations of overall scoresLimitations of overall scores Limitations of IQ as a constructLimitations of IQ as a construct
IQ ScoresIQ Scores
IQ scores are often used as marker – IQ scores are often used as marker – need to make sure it is a good one!need to make sure it is a good one!
Overall scores do not take into Overall scores do not take into account variability in scores, account variability in scores, especially Full-Scale IQespecially Full-Scale IQ
Discrepancy Based LD Discrepancy Based LD EvaluationEvaluation
Discrepancy between IQ and achievementDiscrepancy between IQ and achievement Discrepancy between child and same Discrepancy between child and same
age/grade peersage/grade peers *Discrepancy between child’s own *Discrepancy between child’s own
abilities and what should be expectedabilities and what should be expected
What is clinically meaningful should What is clinically meaningful should translate to what is educationally and translate to what is educationally and legally relevantlegally relevant
IQ ScoresIQ Scores
In an effort to broaden the construct of In an effort to broaden the construct of IQ newer IQ measures incorporate IQ newer IQ measures incorporate numerous skillsnumerous skills
Most notable – WISC-IV – can have high Most notable – WISC-IV – can have high “traditional” IQ areas (Verbal, “traditional” IQ areas (Verbal, Performance) and have Full-Scale IQ Performance) and have Full-Scale IQ lowered by Processing Speed and lowered by Processing Speed and Working MemoryWorking Memory
General Abilities Index – not always used General Abilities Index – not always used but should be in many casesbut should be in many cases
PreschoolPreschool
Wechsler Preschool and Primary Wechsler Preschool and Primary Scale of Intelligence-III (WPPSI-III) Scale of Intelligence-III (WPPSI-III)
Ages 2:6 – 7:3Ages 2:6 – 7:3
Limitations of ERBLimitations of ERB
School Age IQSchool Age IQ Wechsler Intelligence Scale for Children-Wechsler Intelligence Scale for Children-
Fourth Edition (WISC-IV)Fourth Edition (WISC-IV)Ages: 6 – 16:11Ages: 6 – 16:11
Stanford Binet Intelligence Scales – 5Stanford Binet Intelligence Scales – 5thth EditionEditionAges 2:0 – 89:11Ages 2:0 – 89:11
Wechsler Adult Intelligence Scale-Fourth Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV)Edition (WAIS-IV)Ages: 16 and upAges: 16 and up
Wechsler Abbreviated Scale of Intelligence Wechsler Abbreviated Scale of Intelligence (WASI)(WASI)Ages: 6 and upAges: 6 and up
Speech and LanguageSpeech and Language
Neuropsychologists screen these areas in Neuropsychologists screen these areas in relation to full battery – gather from Speech-relation to full battery – gather from Speech-Language EvaluatorsLanguage Evaluators
Speech/Oral-Motor not the same as LanguageSpeech/Oral-Motor not the same as Language Need to gather audiological testing informationNeed to gather audiological testing information Look at expressive and receptive skills in a Look at expressive and receptive skills in a
variety of contextsvariety of contexts Auditory Processing - APDAuditory Processing - APD Adds valuable information to IQ scoresAdds valuable information to IQ scores Augmentative CommunicationAugmentative Communication
Visual-Motor/Visual-Visual-Motor/Visual-PerceptualPerceptual
Parts of evaluations overlap w/ OT, Parts of evaluations overlap w/ OT, especially in neuropsychological especially in neuropsychological evaluationevaluation
Visual-PerceptualVisual-Perceptual Neglect / InattentionNeglect / Inattention Visual-MotorVisual-Motor ApraxiaApraxia Sensory IntegrationSensory Integration Assistive TechnologyAssistive Technology Gross-Motor - PTGross-Motor - PT
Other Areas of Other Areas of Neuropsychological EvaluationNeuropsychological Evaluation Attention and ConcentrationAttention and Concentration
(In 1:1 structured testing setting)(In 1:1 structured testing setting) MemoryMemory
visual; verbal; procedural; recall vs. visual; verbal; procedural; recall vs. recognitionrecognition
Executive Functioning: Executive Functioning: Planning, organization, sequencing, Planning, organization, sequencing, working efficiently, flexibility, working efficiently, flexibility, impulsivityimpulsivity
Executive Functioning/Attention and Executive Functioning/Attention and ConcentrationConcentration
Impulse controlImpulse controlDistractibilityDistractibilityAttention: Focused; selective; sustained/vigilance Attention: Focused; selective; sustained/vigilance Auditory/VisualAuditory/Visual
Not only attention – but organization, Not only attention – but organization, consolidation, etc…consolidation, etc…Planning, organization, time managementPlanning, organization, time managementMental flexibilityMental flexibility
May not manifest until olderMay not manifest until older
MemoryMemory
Most common complaint – but influenced Most common complaint – but influenced by attention/executive functioning skillsby attention/executive functioning skills
VisualVisualVerbalVerbalProceduralProceduralRecall vs. recognitionRecall vs. recognitionShort-term vs. long-termShort-term vs. long-termLong-term – usually intact – but retrieval Long-term – usually intact – but retrieval strategies may be impactedstrategies may be impacted
Academic Achievement Academic Achievement Tests:Tests:
Limitation of brief screening of single-Limitation of brief screening of single-word reading, spelling and arithmetic in word reading, spelling and arithmetic in diagnosing learning problems.diagnosing learning problems.
Reading: decoding, sight words, Reading: decoding, sight words, comprehension, speed, fluency…comprehension, speed, fluency…
Need different tests for reading Need different tests for reading comprehensioncomprehension
Teacher estimates are too subjective.Teacher estimates are too subjective. Importance of, but also limitations of Importance of, but also limitations of
Grade-Equivalents.Grade-Equivalents. Standard Scores may be based on age or Standard Scores may be based on age or
grade – very important.grade – very important.
Problems in Diagnosing LDProblems in Diagnosing LD
Discrepancy analysisDiscrepancy analysis
Qualitative/subtleties of difficultiesQualitative/subtleties of difficulties
Structured 1:1 settingStructured 1:1 setting
Difficulties do not always manifest Difficulties do not always manifest themselves yet or on certain tests.themselves yet or on certain tests.
Personality/Emotional Personality/Emotional TestingTesting
ProjectivesProjectivesRorschach (Exner Comprehensive System Scoring)Rorschach (Exner Comprehensive System Scoring)Thematic Apperception TestThematic Apperception TestRoberts Apperception Test – 2Roberts Apperception Test – 2Sentence CompletionSentence Completion
Clinical InterviewClinical Interview Objective measuresObjective measures
MMPI-A or MMPI-2MMPI-A or MMPI-2BASC-2BASC-2
PIC/PIYPIC/PIY All dependent on cognitive skillsAll dependent on cognitive skills Rating Scales – limitations but widely used – be Rating Scales – limitations but widely used – be
careful – needs to correspond with clinical careful – needs to correspond with clinical observation, other data….observation, other data….
DepressionDepression AngerAnger AnxietyAnxiety Reality TestingReality Testing DefensesDefenses Coping abilities/styleCoping abilities/style MotivationMotivation Self-esteem/confidenceSelf-esteem/confidence Frustration toleranceFrustration tolerance
Emotional functioning needs to be given Emotional functioning needs to be given more concern before behavioral more concern before behavioral manifestationmanifestation
Family/Developmental Family/Developmental issuesissues
Independence/DependenceIndependence/Dependence Depending on age of onset may not Depending on age of onset may not
have a goal of returning to previous have a goal of returning to previous level of independence and level of independence and autonomy/achievement.autonomy/achievement.
Parents often more protective ‑ Parents often more protective ‑ furthering these difficultiesfurthering these difficulties
Fantasy of all-protective parent/safe Fantasy of all-protective parent/safe world potentially impactedworld potentially impacted
Social IssuesSocial Issues
Adaptive FunctioningAdaptive Functioning
Activities of Daily LivingActivities of Daily Living Measures:Measures:
Vineland-2Vineland-2ABAS-IIABAS-II
ObservationObservation InterviewsInterviews Needed for diagnosis of Mental Needed for diagnosis of Mental
RetardationRetardation
Individuals with Disabilities Individuals with Disabilities Education Improvement Act of Education Improvement Act of
2004 (IDEA 2004)2004 (IDEA 2004)Purpose:Purpose: To ensure that all children with To ensure that all children with disabilities have available to them a free disabilities have available to them a free appropriate public education that appropriate public education that emphasizes special education and related emphasizes special education and related services designed to meet their unique services designed to meet their unique needs and prepare them for further needs and prepare them for further education, employment, and independent education, employment, and independent living. 20 U.S.C. Sect. 1400(d)living. 20 U.S.C. Sect. 1400(d)
Individuals with Disabilities Education Act
All children with disabilities receive a free appropriate public education (FAPE)
A school district must provide special education and related services (PT, OT, Speech, Special Education, Counseling, Health paraprofessional) at no cost to the child or his/her parents.
Only required to provide what’s appropriate – not optimal or best
Parental Referral to Local Parental Referral to Local Education AuthorityEducation Authority
Write a letter to the Chairperson of your Committee Write a letter to the Chairperson of your Committee on Special Education requesting an evaluation for on Special Education requesting an evaluation for possible special education needs.possible special education needs.
Federal and New York State law requires that Federal and New York State law requires that Districts complete the evaluation process within 60 Districts complete the evaluation process within 60 school (business) calendar days. school (business) calendar days.
All communication with your district should be in All communication with your district should be in writing, and you must have proof of delivery of all writing, and you must have proof of delivery of all communication.communication.
Your School District cannot refuse to evaluate your Your School District cannot refuse to evaluate your child upon your request.child upon your request.
EvaluationEvaluation
Parents must consent to an initial evaluation.Parents must consent to an initial evaluation. A variety of assessment tools and strategies must A variety of assessment tools and strategies must be utilized to gather relevant functional, be utilized to gather relevant functional, developmental, and academic information about developmental, and academic information about the child. This includes information provided by the child. This includes information provided by the parent.the parent.
No single measure or assessment may be used as No single measure or assessment may be used as the sole criterion for determining whether a child the sole criterion for determining whether a child is a child with a disability or to determine an is a child with a disability or to determine an appropriate educational program.appropriate educational program.
Must be appropriate to be used with that child. Must be appropriate to be used with that child.
Copies of results of all assessments performed Copies of results of all assessments performed must be provided to the parents, at no cost. must be provided to the parents, at no cost.
Identification/Development of Identification/Development of an IEPan IEP
Determination of eligibilityDetermination of eligibility
ClassificationClassification
Program RecommendationProgram Recommendation
Present Levels of Academic PerformancePresent Levels of Academic Performance
Goals/ObjectivesGoals/Objectives
Related ServicesRelated Services
ClassificationClassification
Section 504 - Section 504 - Section 504 of the American Section 504 of the American with Disabilities Act requires recipients to with Disabilities Act requires recipients to provide to students with disabilities provide to students with disabilities appropriate educational services designed appropriate educational services designed to meet the individual needs of such to meet the individual needs of such students to the same extent as the needs of students to the same extent as the needs of students without disabilities are met. A students without disabilities are met. A 504 Accommodation does not require an 504 Accommodation does not require an IEP, but simply provides for classroom IEP, but simply provides for classroom modifications and/or related servicesmodifications and/or related services
CPSE – Preschooler with DisabilityCPSE – Preschooler with Disability CSE – 13 ClassificationsCSE – 13 Classifications
Classification AutismAutism DeafnessDeafness Deaf/BlindnessDeaf/Blindness Emotional DisturbanceEmotional Disturbance Hearing ImpairmentHearing Impairment Learning DisabilityLearning Disability Mental RetardationMental Retardation Multiple DisabilitiesMultiple Disabilities Orthopedic ImpairmentOrthopedic Impairment Other Health ImpairmentOther Health Impairment Speech or Language ImpairmentSpeech or Language Impairment Traumatic Brain InjuryTraumatic Brain Injury Visual Impairment including BlindnessVisual Impairment including Blindness
*Can have very different implications for services and placement
PlacementPlacement
This is performed at the CSE meeting, This is performed at the CSE meeting, except in New York City, where this is except in New York City, where this is done by the placement office.done by the placement office.
You do have the right to view any You do have the right to view any placement proposed for your child.placement proposed for your child.
Charge and goal is for the least restrictive Charge and goal is for the least restrictive environment (LRE)environment (LRE)
School PlacementSchool Placement Section 504 – Not CSESection 504 – Not CSE Public School General Education with related Public School General Education with related
servicesservicesTherapiesTherapiesSpecial Education Teacher Support Services Special Education Teacher Support Services (SETSS)(SETSS)ParaprofessionalParaprofessional
Inclusion /Co-teaching/CTTInclusion /Co-teaching/CTT 12:112:1 12:1:1, 8, 6….12:1:1, 8, 6…. NPS – approved schoolsNPS – approved schools
http://www.vesid.nysed.gov/specialed/privateschoolshttp://www.vesid.nysed.gov/specialed/privateschools//
Carter FundingCarter Funding
Dispute ResolutionDispute Resolution Independent Educational Evaluation (IEE)Independent Educational Evaluation (IEE)
Parent has the right to an IEE if they disagree with an Parent has the right to an IEE if they disagree with an evaluation obtained by the districtevaluation obtained by the districtUpon request by a parent for an IEE, a District must Upon request by a parent for an IEE, a District must either file a due process complaint to show that its either file a due process complaint to show that its evaluation is appropriate or ensure than an IEE is evaluation is appropriate or ensure than an IEE is provided at public expenseprovided at public expense
MediationMediationVoluntary; must be conducted by a qualified and Voluntary; must be conducted by a qualified and
impartial mediator; must be paid for by the District, impartial mediator; must be paid for by the District, who maintains a list of qualified mediators that are who maintains a list of qualified mediators that are assigned on a rotational or random basis; It is binding assigned on a rotational or random basis; It is binding
Impartial Hearing – Impartial Hearing OfficerImpartial Hearing – Impartial Hearing Officer
Appeals – State level firstAppeals – State level first
ADHD/ADDADHD/ADD
HyperactivityHyperactivity ImpulsivityImpulsivity DistractibilityDistractibility
Issues to ConsiderIssues to Consider DevelopmentalDevelopmental Gender BiasGender Bias Overly diagnosed/overly simplifiedOverly diagnosed/overly simplified Medication issues in EpilepsyMedication issues in Epilepsy
PDDPDD
AutismAutism Rett’sRett’s Childhood Disintegrative DisorderChildhood Disintegrative Disorder
Asperger’sAsperger’s PDD-NOSPDD-NOS
Wide variability in presentationWide variability in presentation
Learning DisabilitiesLearning Disabilities
SpecificSpecificDyslexia, Dysgraphia, DyscalculiaDyslexia, Dysgraphia, Dyscalculia
Non-Verbal Learning DisabilitiesNon-Verbal Learning Disabilities More GeneralMore General Gaps in abilities/IQ and achievementGaps in abilities/IQ and achievement DevelopmentalDevelopmental Track over time/different demandsTrack over time/different demands
Sensory IntegrationSensory Integration
Organizing, integrating and Organizing, integrating and interpreting sensory input in a variety interpreting sensory input in a variety of modalities including: touch, of modalities including: touch, movement, body awareness, visual, movement, body awareness, visual, and auditory information.and auditory information.
DevelopmentalDevelopmental Does it impact functioning?Does it impact functioning? Overlaps and/or interacts with other Overlaps and/or interacts with other
diagnoses conditionsdiagnoses conditions
Auditory ProcessingAuditory Processing
Difficulties in processing orally Difficulties in processing orally presented information even though presented information even though hearing is within normal limitshearing is within normal limits
Beware of “knee-jerk” labelBeware of “knee-jerk” label Audiologist needs to diagnoseAudiologist needs to diagnose Age expectations – These skills Age expectations – These skills
develop between ages 5-7.develop between ages 5-7. Interventions/recommendationsInterventions/recommendations Overlap with other diagnosesOverlap with other diagnoses
RecommendationsRecommendations School placement School placement Therapies/InterventionsTherapies/Interventions Compensatory techniques and strategiesCompensatory techniques and strategies Modifications in the EnvironmentModifications in the Environment Accommodations/ExpectationsAccommodations/Expectations Assistive TechnologyAssistive Technology Medication/TreatmentsMedication/Treatments Some sound good but may not help (e.g. Some sound good but may not help (e.g.
tape recording lectures requires >2x to tape recording lectures requires >2x to listen and transcribe; laptop in class – only listen and transcribe; laptop in class – only if great/fast typist…)if great/fast typist…)
SummarySummary
Need to incorporate all objective Need to incorporate all objective data, scores from testing, data, scores from testing, observations, outside therapists, observations, outside therapists, history, emotional/personality history, emotional/personality variables, family, and school data in variables, family, and school data in order to make well thought out order to make well thought out decisions for children.decisions for children.
Need to know rights and law as well.Need to know rights and law as well.
Parents Know BestParents Know Best
Trust your instinctsTrust your instincts Be involved / carry-overBe involved / carry-over Educate yourselves Educate yourselves
(pros and cons of internet)(pros and cons of internet) Work closely with medical teamWork closely with medical team Know your rights Know your rights
(Advocacy/Lawyers)(Advocacy/Lawyers)