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Post by deebee on Apr 10, 2008 9:17:39 GMT -5
I have a friend that I met through an educational course on mental illness.
She has a son, now age 10 in 4th grade that has significant stuggles in school. Last year school did an evaluation and found him ineligible for an IEP, though they did recommend follow up as they felt he had neurologically or psychiatric based problems based on their evaluation.
A little history. This child has a family history of mental illness, with one uncle having schizoaffective disorder, and the other having severe bipolar disorder and diabetes. Since the evaluation last year, the child has been diagnosed with childhood onset bipolr, but is not taking any medications yet.
The most significant issues are reading, focusing on classwork, easily distracted, mood related issues, social interaction, problems with transitions, child obsesses on work being perfect.
These are the scores from last year, when the student was 8.9 years old in grade 3.5. Testing completed in Jan/ Feb 2007
Teacher report, reading level 2.6
IRI 2
WISC-IV
Overall IQ 85
VCI : 93
Similarities 10
Vocabulary 7
Comprehension 9
(Information) 12
(Word Reasoning) 7
Perceptual Reasoning: 82
Block Design 7
Picture Concepts 6
Matrix Reasoning 8
(Picture Compeletion) 8
Working Memory 97
Digit Span 10
Letter Number Sequencing 9
(Arithmetic) 7
Processing Speed 83
Coding 6
Symbol Search 8
(Cancellation) 3
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Woodcock Johnson III
Broad Reading 97
Broad Math 110
Broad Written Language 95
Oral Lang 81
Math Calc Skills 108
Written Expression 93
Academic Skills 103
Academic Fluency 96
Academic Apps 99
Letter Word Identification 104
Reading Fluency 93
Calculation 107
Math Fluency 107
Spelling 96
Writing Fluency 96
Passage Comprehension 93
Applied Problems 110
Writing Samples 93
Understanding Directions, 85
Story Recall, 79
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CELF
Core Language Index, 87
Receptive Index, 86
Expressive Index, 85
Language Content Index, 94
Language Structure Index, 83
Concepts following directions, 9
Word Structure, 7
Recalling Sentences, 8
Formulated Sentences, 7
Word Class 2 - Receptive, 7
Word Class Expressive, 8
Word Class Total, 7
Sentence Structure, 7
Expressive Vocab, 11
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Deveraux Scales of Mental Disorders
Parent/ rated very elevated: Conduct Externalizing
Teacher/ rater very elevated: Attention, Autism
Parent rated Elevated: Attention, anxiety, depression, internalizing, autism
Teacher rated Elevated: externalizing, anxiety, depression, internalizing, and critical pathology
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Achenbach
Anxious/ depression: Clinical
Thought: Clinical
Aggressive: Clinical
Social/ Attention: Borderline
Items noted high for thought: Obsessions, strange behavior, picking at self, sleep patterns
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Just a few other notes. It's my understanding that the family doesn't have a very good insurance plan, so the cost of seeking outside evaluations is a concern.
Is it too late for the family to request an IEE assessment especially to look at the elevated scores for Autism and Attention (Devereaux Scales of Mental Illness)? What testing or follow-up would be recommended?
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Post by lillian on Apr 10, 2008 9:44:07 GMT -5
Usually, there is a one-year time limit on requesting IEE's, but I would check with your state's education agency to make sure. If the time limit has passed, then the parent can request another evaluation by the school.
You mention that the child has been evaluated since and has been dxed with bipolar. The parent should take this dx to the school because the child may qualify for a 504. Who said this child was bipolar? Weren't attention and autism evaluations done at that time, especially considering the parent's and the school's concerns in these areas?
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Post by deebee on Apr 10, 2008 9:57:17 GMT -5
I think it has taken a long time for the family just to come to terms with the bipolar diagnosis. The mother's brothers are the ones that have bipolar and schizoaffective disorders so this has been difficult for her to accept her son also has bipolar disorder.
I think one of the reasons for not pursuing the attention problems further has been the fact the mom and dad still haven't agreed to try medication for the bipolar. The mom was told that first they have to treat the bipolar, before they can determine if there are adhd issues because of the overlap of symptoms in both disorders.
It is also my understanding that this referral for special education came from the teacher, not the parent. It sounds like for the past three years that the teachers have been concerned about behaviors.
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Post by lillian on Apr 10, 2008 10:08:16 GMT -5
I would tell the mom to take the bipolar dx to the school, along with a letter that stated the parents had followed the recommendations of the IEP Committee and had their son evaluated by a medical doctor. In the letter, the parents also should request that their son be re-evaluated for SPED services or for a 504.
The parents should know, however, that a bipolar dx means that the child most likely will be considered for an emotionally/behaviorally disturbed (EBD) label in Special Education. This can be O.K. or it can be bad, and it heavily depends upon the school district. In my son's district, the EBD program is excellent, and I know a parent who tried for years to get her son with serious behavioral issues (bipolar/ADHD dxs) in the self-contained EBD class. Once she finally got him into that class, it did wonders for him. He stayed in self-contained for three years and is now very successfully being mainstreamed back into general ed. But, boy, oh, boy, this is often NOT the case!
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Post by carol on Apr 10, 2008 13:03:11 GMT -5
My son is in a school that only has children dx with SED Seriously Emotional Disturbance. Although, it does seem he has learned behaviors we did not want, he does get a wealth of support and is learning strategies to help with coping, express himself appropriately, self-control, behavior, and learning. My best advice would be if you could get the child into a SED classroom or school is to go look at it and ask a lot of questions especially about the therapy. Research on the child's issue and become well versed in it. Good Luck!
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Post by rakuflames on Apr 10, 2008 13:08:37 GMT -5
Usually, there is a one-year time limit on requesting IEE's, but I would check with your state's education agency to make sure. If the time limit has passed, then the parent can request another evaluation by the school. You mention that the child has been evaluated since and has been dxed with bipolar. The parent should take this dx to the school because the child may qualify for a 504. Who said this child was bipolar? Weren't attention and autism evaluations done at that time, especially considering the parent's and the school's concerns in these areas? In fact a child can qualify for an IEP with a diagnosis of bipolar. A child does not have to be academically behind to qualify for an IEP unless the diagnosis is learning based -- ex:, learning disabilities. |
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Post by deebee on Apr 14, 2008 9:24:18 GMT -5
Thank you everyone for your feedback so far. I think the problem would be that if she just requested an IEP based on the bipolar, that the cause of her son's academic problems would not be found.
It's my understanding that there are problems with reading, particularly longer passages, and being able to remember. As well as problems with staying on task and being able to follow directions in class.
If she were to request a new evaluation by the school are there any recommendations on what should be tested?
I felt like there should be a more thorough memory test given the low story recall score (79). I also think there should be an OT evaluation to look at visual perception and visual motor.
What tests are best for identifying reading problems? Are there any speech language tests that would show language comprehension difficulties such as found in the Autism spectrum?
Can she request tests to look at executive function?
Are there any tests that look further at slow processing to determine the cause. I think one of the main problems is how long it takes him to complete classword....
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Post by rakuflames on Apr 14, 2008 9:44:40 GMT -5
Thank you everyone for your feedback so far. I think the problem would be that if she just requested an IEP based on the bipolar, that the cause of her son's academic problems would not be found. It's my understanding that there are problems with reading, particularly longer passages, and being able to remember. As well as problems with staying on task and being able to follow directions in class. If she were to request a new evaluation by the school are there any recommendations on what should be tested? I felt like there should be a more thorough memory test given the low story recall score (79). I also think there should be an OT evaluation to look at visual perception and visual motor. What tests are best for identifying reading problems? Are there any speech language tests that would show language comprehension difficulties such as found in the Autism spectrum? Can she request tests to look at executive function? Are there any tests that look further at slow processing to determine the cause. I think one of the main problems is how long it takes him to complete classword.... In most states he would not qualify for help based on academics because his academic peformance is actually ABOVE his measured IQ. Things like "slow processing" will not qualify a child for services unless some academic struggle can be linked to it. Children are found to be LD (in the public schools) in ACADEMIC areas, not areas of difficulty in using or processing information. By definition, looking at his scores, any slow processing has not negatively affected his academic progress. Classroom measurements and opinions of the teachers can't be used. It has to be revealed in individually administered achievement tests, and under those circumstances he ACED them. The bipolar diagnosis is her path to getting help for her son. The school district is now LEGALLY REQUIRED to NOT give special education help based on academic performance. it couldn't be more clear from his test scores, and if the mother pursues that she will look uncooperative and ill-informed. That is not how she wants to look to the school staff. It's very serious for the schools. By federal law the state must audit the school district's IEP programs, and they specifically look for students who were not eligible for services and yet get them. The district could potentially lose all their state AND federal education monies if they wrote an academic remediation IEP for this child. In fact, this situation is *exactly* why the feds require teacher impressions and information to be confirmed in individually administered academic tests. She has a diagnosis of bipolar for him. He must be having other problems at school besides this apparent academic one. Does he fail to complete assignments? Does he over-react to minor setbacks? These are two areas where I often saw kids with bipolar have real difficulties in school. |
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Post by lillian on Apr 14, 2008 10:31:13 GMT -5
Well, I gave a response, then deleted it because I think it's missing the point, which is...
The school has already done academic, psychological, speech/language, and IQ testing. The child did not qualify for services. The parents can request another education evaluation, like the one done last year, to see if the child qualifies this year. If the child does not qualify, the parents can request an IEE. But...
I am confused. WHAT do the parents want? I think the parents could get a 504 for their child, right now, if they took the bipolar dx to the school. They probably could have gotten an IEP last year, if they had had their child evaluated for ADHD and/or autism, as the school suggested, but the parents didn't. The child was tested a year ago at a teacher's request, and it was recommended that the child have a medical evaluation for ADHD and/or autism. Obviously, the school knows that there is an issue and wants to do something to help this child, but if the child does not qualify under LD, the school is limited in their ability to help the child. It's up to the parents to make the next step, a step the school clearly left open for the parents to make, and it doesn't sound like the parents have done it.
The bipolar dx was before this evaluation, wasn't it? It must have been, or the child would have been evaluated for ADHD and/or autism at the same time. It sounds to me like the parents are not being upfront with the school and taking the bipolar dx to the school. If they did, I bet you they would get help, with at least a 504, because the school wanted the child evaluated by a medical doctor. The school can not dx bipolar, ADHD, or autism. Those are medical dxs and must be made by a doctor; HOWEVER, the school left open the possibility of accepting those dxs by stating that the child's evaluation showed the child to be at-risk and emotionally and suggested a medical dx. In other words, the parents most likely could have received an IEP for their child, IF the parents had done what the school requested. The child could have been given an IEP for autism or ADHD (OHI), but the parents didn't do their part. The child can still receive an IEP for one of these or for bipolar (EBD), but the parents are going to have to take the bipolar dx to the school (which is going to be really embarassing, if they had it all along and never took it) or have their child evaluated for autism or ADHD. Then, the school can decide what to do--re-evaluate for SPED (which they probably will have to do since the evaluation is a year old), give a 504 and see if it is enough intervention without an IEP, or use the evaluation from last year (which I'm not sure they can legally do, at this point) and qualify the child under autism, OHI, or EBD. Still, I think "the ball is in the parents' court" not the school's, so I am confused.
What do the parents want?
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Post by rakuflames on Apr 14, 2008 11:50:57 GMT -5
Well, I gave a response, then deleted it because I think it's missing the point, which is... The school has already done academic, psychological, speech/language, and IQ testing. The child did not qualify for services. The parents can request another education evaluation, like the one done last year, to see if the child qualifies this year. If the child does not qualify, the parents can request an IEE. But... I am confused. WHAT do the parents want? I think the parents could get a 504 for their child, right now, if they took the bipolar dx to the school. They probably could have gotten an IEP last year, if they had had their child evaluated for ADHD and/or autism, as the school suggested, but the parents didn't. The child was tested a year ago at a teacher's request, and it was recommended that the child have a medical evaluation for ADHD and/or autism. Obviously, the school knows that there is an issue and wants to do something to help this child, but if the child does not qualify under LD, the school is limited in their ability to help the child. It's up to the parents to make the next step, a step the school clearly left open for the parents to make, and it doesn't sound like the parents have done it. The bipolar dx was before this evaluation, wasn't it? It must have been, or the child would have been evaluated for ADHD and/or autism at the same time. It sounds to me like the parents are not being upfront with the school and taking the bipolar dx to the school. If they did, I bet you they would get help, with at least a 504, because the school wanted the child evaluated by a medical doctor. The school can not dx bipolar, ADHD, or autism. Those are medical dxs and must be made by a doctor; HOWEVER, the school left open the possibility of accepting those dxs by stating that the child's evaluation showed the child to be at-risk and emotionally and suggested a medical dx. In other words, the parents most likely could have received an IEP for their child, IF the parents had done what the school requested. The child could have been given an IEP for autism or ADHD (OHI), but the parents didn't do their part. The child can still receive an IEP for one of these or for bipolar (EBD), but the parents are going to have to take the bipolar dx to the school (which is going to be really embarassing, if they had it all along and never took it) or have their child evaluated for autism or ADHD. Then, the school can decide what to do--re-evaluate for SPED (which they probably will have to do since the evaluation is a year old), give a 504 and see if it is enough intervention without an IEP, or use the evaluation from last year (which I'm not sure they can legally do, at this point) and qualify the child under autism, OHI, or EBD. Still, I think "the ball is in the parents' court" not the school's, so I am confused. What do the parents want? This simply isn't true: "but if the child does not qualify under LD, the school is limited in their ability to help the child. " There are all sorts of things they can do to help a child who has bipolar. They can use the DOCTOR'S diagnosis of bipolar to provide an IEP, which I would urge over a 504, because an IEP has much more "teeth" behind it and it is so easy for school staff to misinterpret such a child's behavior in an inaccurate and negative way. The old testing is useful because it rules out other causes for the child's difficulty. The teachers IRI can't hold a candle to individual testing, which is what the testing the school did was. I do not think they should ask for more testing. It is very unlikely to change to a significant level in so short a time, and in fact such a request could legally be turned down, and in fact they most likely would. The parents can still ask for help for this child. There's a LOT the school can do to help him. I know, because until I retired it was my job to do so.  |
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