Help for a friend

[lillian]

Rakuflames,

Aren't we saying the same thing? I said the school could not help the child under LD and left open the possibility to help under autism or ADHD, IF the parents would have the child evaluated. From what I am gathering, the school doesn't know about the bipolar, OR the school would have helped last year because the school wants to help this child. I said the child could get either a 504 or an IEP, if the parents would do their part and provide the school a medical dx, which these parents do not seem to want to do. Without a disability, the child is not going to get a 504 or an IEP. The parents need to provide the medical dx, so the school has a disability under which they can qualify the child for either a 504 or an IEP.

[rakuflames]

Apr 14, 2008 11:56:11 GMT -5 lillian said:

Rakuflames,

Aren't we saying the same thing? I said the school could not help the child under LD and left open the possibility to help under autism or ADHD, IF the parents would have the child evaluated. From what I am gathering, the school doesn't know about the bipolar, OR the school would have helped last year because the school wants to help this child. I said the child could get either a 504 or an IEP, if the parents would do their part and provide the school a medical dx, which these parents do not seem to want to do. Without a disability, the child is not going to get a 504 or an IEP. The parents need to provide the medical dx, so the school has a disability under which they can qualify the child for either a 504 or an IEP.

Someone said that if the child wasn't academically behind, then there wasn't much the school could do for her. That's not true. With a diagnosis of bipolar the school can help that child in all sorts of ways. I did not realize that this statement -- that the school couldn't do much -- was tied to anything else.

The parents have to step up to the plate and tell the school what is going on with their child, or their stance will do this child real harm over time. If they tell the school what's going on, in fact, the school has to start helping her IMMEDIATELY. The school has to treat a child as having a problem if it's even suspected, and the parent report of a diagnosis is quite enough for that.

That means that if the parents tell the school TODAY, tomorrow they have to start helping her, even if they can't schedule an IEP for a couple of weeks. They can effectively fight for her if she has an IEP. It can be a little more challenging with a 504 *in some schools,* but the first part of the law I mentioned still applies -- if they know the child has this major problem they have to help. All the parents have to do is tell them and they have to start working on ways to help her immediately.

I MUCH prefer an IEP for a child with a disorder like bipolar, which can easily cause the child to over-react behaviorally. With a 504, for instance, they could just give the child in-school suspensions all year, with no effect. With an IEP, once the total days of either in-school or out-of-school suspensions totals seven full days (partial days go into the count) they HAVE to reconvene the IEP and come up with a POSITIVE approach to managing her behavior.

One effect of this rule is that iEPS are more positively oriented from the get-go, but it educates all involved that simply punishing a child over and over in the same way with no change in behavior won't be tolerated.

The bipolar could also be interfering with her day-to-day classroom performance, even though her reading is progressing. Those interferences, distractions or whatever weren't present in the individualized testing, so it is the best estimate of the child's reading ability.

Also, with an IEP, even though she doesn't have an LD, they could put reading strategies in there. There are a variety of things that can be done for children who struggle with longer reading passages. For instance, there's "active categorization" (what I call it). You give the child a photocopy of the text chaper (that's legal if done to compensate for a disability) and a package of five differently-colored highlighters.

The child highlights important facts in blue, important dates in green, new vocabulary in yellow, etc. The point is to get the child more actively involved in analyzing what she's reading. It also aids review and retention.

The assumption -- when the school has that diagnosis -- would be that bipolar is the cause for any difficulties she experiences, because other causes have been ruled out. If they're doing their jobs, that diagnosis will point them toward solutions. For instance, a very upset child needs a quiet place to calm down, away from prying eyes -- just as an adult would. None of us would choose to go to the grocery door if we were crying our eyes out because our dog had just been hit by a car. Well, this child's emotional upheavals are just as real to her, even if adults don't perceive them that way. It is what she's experiencing, and it needs to be understood rather than punished. We had quet places set up for every child in our school diagnosed with bipolar. If the child had an IEP (not all of them did), then the resource room was one option, but there were always several because when you use one, that one may not be available 100% of the time (for instance, I might have been at lunch, or out of the room for other reasons, or testing.)

[katiekat]

Unfortunately a DX of bipolar does not always mean that the school will do anything for the child. At least that has been my experience. My stepson has been diagnosed with ADHD and bipolar by 2 psychiatrists, both who wrote letters to the CST strongly advising that a complete evaluation be done. Both times we wrote a letter requesting it we were denied. I was told there is no reason for him to have an IEP or a 504-that he does not need it. I strongly suspect he has LDs as well but every time I mention my concerns they say he is "meeting 1st grade benchmarks." If this is true, the standards must be very low in my opinion. He sees the guidance counselor once a week but that is it. He has many behavioral issues at school. I guess our next step is a due process hearing? I am now just waiting for the neuropsych. eval. at the end of this month to see if he can confirm the Aspergers DX that the psych. suspects. I figure that if he is DX with Aspergers that gives 1 more reason that he should be getting some services at school.

[deebee]

Many questions so I will try to respond.

What do the parents want???

The parents are totally new to this. This is their oldest child, and neither of them has dealt with learning issues before. The mother has grown up with two brothers with severe mental health issues, so it is a very emotional thing just for her to come to accept the bipolar diagnosis.

It wasn't that the parents haven't done anything. It is a very time consuming task to have childhood bipolar diagnosed. Just the process of getting the referral and into a psychiatrist can be a several month wait. The family has not wanted to assume that just because there is a history of mental illness that it means the child has bipolar. There are also medical conditions that need to be ruled out (such as blood sugar, thyroid, etc). In the midst of their diagnosis process the families' insurance was changed which changed which doctors were allowed, and what type of medical care they could seek.

As to ADHD, it is my understanding that bipolar must be ruled out first, especially given the family history of mental illness. In my daughter with cyclothymia and adhd we are going through the same. I know there are attentional issues, but until the mood is stabilized, I'm not ready to start trying out stimulant medications with her.

When the mother had their IEP meeting last year, her understanding was that the school strongly suggested psychiatric follow-up, but she had thought that there was no opportunity to get help at school. When I read the report, it clearly states that the child doesn't qualify for an IEP for "Specific Learning Disability". What the parents didn't understand is that there are other IEP categories, and it could still be possible for the child to qualify for an IEP. The reason the parents haven't taken in the diagnosis to the school is likely because they didn't know it would help get an IEP. Also, the child has completely different teachers this year, so this teacher may not know all the history from the previous year.

One of my first questions was whether the parents could seek an IEE if the IEP evaluation was over a year ago. It sounds like the answer to this is it is too late for an IEE based on last year's evaluation and that the family needs to start over.

My other question is whether anyone has advice on other testing ideas. Bipolar in and of itself is not going to cause reading problems. I'm not familiar at all with reading disabilities and what types of test would indicate problems. Both my kids are good readers, but struggle in math.

The one thing that stood out to me was the PSI as the child is being reported as being very slow to get work done. In the report it mentioned that the child sometimes has difficult time walking and can be clumsy. This information combined with the lower scores on some of the PSI makes me wonder is there is a visual perceptual or visual motor problem contributing to the student being slow in getting work done.

The report also mentioned that the school felt a processing disorder should be ruled out. So obviously the teacher was seeing something that indicated that processing was a problem. My question was what testing would indicate that processing is a problem. Couldn't a thorough memory test at least indicate if there are more problems with oral or visual memory??

[rakuflames]

Apr 15, 2008 22:27:52 GMT -5 katiekat said:

Unfortunately a DX of bipolar does not always mean that the school will do anything for the child. At least that has been my experience. My stepson has been diagnosed with ADHD and bipolar by 2 psychiatrists, both who wrote letters to the CST strongly advising that a complete evaluation be done. Both times we wrote a letter requesting it we were denied. I was told there is no reason for him to have an IEP or a 504-that he does not need it. I strongly suspect he has LDs as well but every time I mention my concerns they say he is "meeting 1st grade benchmarks." If this is true, the standards must be very low in my opinion. He sees the guidance counselor once a week but that is it. He has many behavioral issues at school. I guess our next step is a due process hearing? I am now just waiting for the neuropsych. eval. at the end of this month to see if he can confirm the Aspergers DX that the psych. suspects. I figure that if he is DX with Aspergers that gives 1 more reason that he should be getting some services at school.

If the child has significant behavioral or social issues at school and a diagnosis of bipolar, their decision to deny services is highly challengeable. Lots of parents choose not to do that, and I understand the reasons why, but I think it's important for parents to know that it is challengeable.

That doesn't *guarantee* that they'll win. Where I would go first would be the Office of Protection and Advocacy. Each state department of education is required by federal law to have one.

If that didn't work, then I would go to the Office of Civil Rights.

Both are extremely cheap and neither requires lawyers. In fact, OCR won't allow lawyers to participate in their process.

Again, I'm not saying anyone is right or wrong to do this or not do this. It's paths many people aren't very familiar with, however.

[rakuflames]

Apr 16, 2008 8:27:36 GMT -5 deebee said:

Many questions so I will try to respond.

What do the parents want???

The parents are totally new to this. This is their oldest child, and neither of them has dealt with learning issues before. The mother has grown up with two brothers with severe mental health issues, so it is a very emotional thing just for her to come to accept the bipolar diagnosis.

It wasn't that the parents haven't done anything. It is a very time consuming task to have childhood bipolar diagnosed. Just the process of getting the referral and into a psychiatrist can be a several month wait. The family has not wanted to assume that just because there is a history of mental illness that it means the child has bipolar. There are also medical conditions that need to be ruled out (such as blood sugar, thyroid, etc). In the midst of their diagnosis process the families' insurance was changed which changed which doctors were allowed, and what type of medical care they could seek.

As to ADHD, it is my understanding that bipolar must be ruled out first, especially given the family history of mental illness. In my daughter with cyclothymia and adhd we are going through the same. I know there are attentional issues, but until the mood is stabilized, I'm not ready to start trying out stimulant medications with her.

When the mother had their IEP meeting last year, her understanding was that the school strongly suggested psychiatric follow-up, but she had thought that there was no opportunity to get help at school. When I read the report, it clearly states that the child doesn't qualify for an IEP for "Specific Learning Disability". What the parents didn't understand is that there are other IEP categories, and it could still be possible for the child to qualify for an IEP. The reason the parents haven't taken in the diagnosis to the school is likely because they didn't know it would help get an IEP. Also, the child has completely different teachers this year, so this teacher may not know all the history from the previous year.

One of my first questions was whether the parents could seek an IEE if the IEP evaluation was over a year ago. It sounds like the answer to this is it is too late for an IEE based on last year's evaluation and that the family needs to start over.

My other question is whether anyone has advice on other testing ideas. Bipolar in and of itself is not going to cause reading problems. I'm not familiar at all with reading disabilities and what types of test would indicate problems. Both my kids are good readers, but struggle in math.

The one thing that stood out to me was the PSI as the child is being reported as being very slow to get work done. In the report it mentioned that the child sometimes has difficult time walking and can be clumsy. This information combined with the lower scores on some of the PSI makes me wonder is there is a visual perceptual or visual motor problem contributing to the student being slow in getting work done.

The report also mentioned that the school felt a processing disorder should be ruled out. So obviously the teacher was seeing something that indicated that processing was a problem. My question was what testing would indicate that processing is a problem. Couldn't a thorough memory test at least indicate if there are more problems with oral or visual memory??

In the classroom, a processing disorder could be seen in all sorts of ways, and I would hate to see it explored in testing in only one way.

Bipolar can affect processing. Its negative effects on learning can be quite subtle. But the bottom line is that if the child is at or above performance predicted by his IQ, as this child is, it doesn't matter if there is any kind of perceptual or processing weakness. The bottom line for a school LD diagnosis is the results on academic tests. If his academic progress, as measured by individually administered achievement tests, is satisfactory when compared to his intelligence, the child cannot be found to have a learning disability.

[lillian]

The school recommended testing for autism and/or ADHD. Now, the parents can request testing for all the other things you mentioned. Visual/motor integration? The Beery-Buktenica is an excellent test for this. If it comes back showing the child having visual/motor difficulties, it doesn't matter, unless there is another disability to tie it to. There is no IDEA category for visual/motor integration. HOWEVER, many children with autism have visual/motor integration issues, and there is an IDEA category for autism; many children with ADHD have visual/motor integration difficulties, and there is an IDEA category for ADHD (OHI). So, yes, the parents can have the child's visual/motor integration tested, but that test alone will not help the parents much.

Will a good memory test or tests show what aspects of memory the child is having difficulties with? Yes, a good test or tests will. There are many different aspects of memory--nonverbal vs. verbal, long-term vs. short-term, short-term vs. working, long term vs. working, auditory, visual, spatial. And there are many, many tests to test these different memory areas. Again, though, there is no IDEA category for memory, yet particular disabilities are commonly associated with particular memory difficulties.

Can the child's PSI be tested? Yes, and it has been. There's really no reason to test it again or to focus on it alone. There is no IDEA category for processing speed. However, kids with bipolar, ADHD, and autism often have great difficulties with processing speed. Will low processing speed cause a child to work slowly? Yes, very slowly. That's why it's tested. Can low PSI and poor visual/motor be related? Absolutely, especially on the WISC-IV.

Again, though, this information isn't going to help the child, unless the parents want to attach the difficulties to a disability with an IDEA category. The parents can't say, "My child has low processing speed and poor visual/motor integration," and expect to get an IEP or a 504. HOWEVER, if the parents say, "My child has autism, which is resulting in poor visual/motor integration and slow processing speed," THEN the parents may be able to get a 504 or an IEP.

What tests test reading? The GORT-4 or the TOWRE are great ones to use for reading fluency. The Woodcock Reading Mastery (not to be confused with the Woodcock Johnson Reading Battery) is superb for testing basic reading skills. The Woodcock Johnson Test of Academic Achievement or the WIAT is good for testing comprehension, though comprehension is very difficult to test. The child can be given these, but the parents need to realize that ADHD, autism, and/or bipolar can most certainly effect reading! Absofrickinlutely!

Finally, I want to state that the reason for IQ and achievement testing is to give a profile of a child, to look at cognitive issues alongside academic issues, for most disabilities have patterns to them. That DOES NOT mean that all disabilities will fit into those patterns, but patterns are looked for, nonetheless, so that a disability that can help explain the child's issues can be found. For example, with ADHD, certain things are commonly looked for--slow processing speed, memory issues, low fluency scores across the board, poor rapid naming, etc. That does not mean that a child with ADHD will have all these things, but they are commonly related to ADHD, so they give clues to possible disabilities causing the child's issues in school.

You can point out difficulties the child has all you want to and test the child over and over again, but if there is no disability to explain these issues, then all the tests in the world are not going to help this child get an IEP or a 504. Focusing exclusively on the aspects of an IQ test, while avoiding labeling the child with a disability, is missing the point, when it comes to getting the child help in school. Mel Levine does this, and as much as I love him and respect him, it's not realistic in the school system today. If you want the child to have an IEP or a 504, the child must have a disability. Poor visual/motor integration, poor processing speed, poor auditory memory, poor visual memory, and clumsiness are not disabilities.