Sensory Processing and Autism: A Piece of the Puzzle

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Question: I’ve read that Autism Spectrum Disorder and Sensory Processing Disorder are two distinct conditions. With that said, why do my child’s therapists and teachers keep talking about his sensory processing problems when he is diagnosed as having Autism?

Answer: With at least three quarters of children with Autism Spectrum Disorder (ASD) showing signs of Sensory Processing Disorder, (SPD) your child is not alone! Interestingly, the reverse is not so – most children with SPD do not have ASD, according to research conducted or compiled by the STAR Institute (SPDStar.org).

While diagnosis is important, one of the essential matters here is the processing of sensation, the basis for our understanding of ourselves and our world, and for our everyday interactions with the people, objects and surroundings of our lives. The bottom line – while there are many factors that could contribute to behavior that is well suited to life’s occurrences, the more accurately and efficiently we’re able to pick up on, and understand sensory information relevant to our daily lives, the better equipped we are to respond. Unreliable and/or insufficient sensory processing is often a foundation of inappropriate or less-than-desirable behavior. It can contribute to limited tolerance for everyday situations, outbursts & tantrums, repetitive actions, inflexibility or rigidity related to environmental characteristics, an inability to fit in or “sync up” with others and/or the pace of daily events, difficulty figuring out how to do things, difficulty acquiring and applying skills, and so much more. Disordered sensory processing also can affect sleep/rest, nutritious eating and movement, the mainstays of our wellbeing.

Since both Autism and Sensory Processing Disorder both involve differences in patterns of responsiveness to sensation, when it comes to planning how we can help with change it seems easiest and most logical to think sensory. Over responsiveness to sensory input, such as certain sounds and touch, as well as light, movement (including dynamically moving surroundings such as a crowded place or a playground) is very common. People with over responsiveness are extra sensitive to, cannot filter, and are often uncomfortable with or frightened by stimulation that neurotypical people may not even notice. Their heightened sensitivity is apt to interfere with their ability to engage and discriminate because they move into a state of heightened arousal often associated with “fight, flight, fright or freeze”. On the other hand, those who are under responsive generally need a good deal of stimulation, beyond what is provided in so-called typical daily life, in order to be alert, discriminative and active. Under responsiveness is also prevalent. Often people who are under responsive seek the sensation they need; craving and seeking of movement, deep pressure, and sensations gained through intense physical effort are most common. Many people with sensory processing differences present both under responsiveness and over responsiveness; day-to-day variability is also frequently noted. While standardized testing (such as the Sensory Integration and Praxis Tests administered by certified professionals) is helpful in diagnosing and understanding sensory issues, observation and careful consideration of a child’s behavior in home, school/daycare and community settings by an OT trained in sensory integration assessment and methodology often proves to be most useful, particularly in cases of more severe sensitivity, behavioral challenges and inattentiveness or age. Assessing and treating disordered sensory processing involves both the individual and the environment.

The good news – decades worth of neuroplasticity research supports the basic premise of treatment of sensory problems – experience can bring about change, or, in other words what we sense and how we respond to it is transformational! Opportunities for participation and adaptation, created with priority given to the nature of the stimulation provided and individuals’ characteristic patterns of responsiveness, can nourish change in central nervous system structure and/or function, and change in our abilities through our lifespan. While those of us experienced in serving people with sensory differences know this because we see it, most people within the general public have come to realize for themselves that, somehow, what we experience shapes who we are and how we function. The other news – there’s still an inconceivable amount of information to be learned about sensory processing. Your child’s therapists and teachers know and respect this! Likely they are continuously bringing up his/her sensory processing because they believe it is at the foundation of his/her performance, from his/her ability to control himself in varied situations, to his/her ability to successfully interact interpersonally and form relationships and his/her ability to experience the success and fun that helps bring about brain and functional change.

To finish up, here are a few suggestions to get started thinking and working “sensory” with your child’s therapists and teachers:
• If you haven’t done so already, ask your OT about both you and your child’s teachers completing either the Sensory Profile or the Sensory Processing Measure (both are checklists), and arranging a meeting to discuss patterns and/or dissimilarities that emerge. Both provide nice structure to help frame, interpret and understand observations.
• Consider both sensory-based assets & liabilities, and recognize both preferences & aversions.
• Get to know more about your therapists’ and teachers’ frames-of-reference and approaches to sensory processing.
• With your OT or team, make a list of specific desired home and school behaviors, discuss sensory contributions to those behaviors (or current less-than-desirable behaviors)/functional skills, and develop a few sensory strategies that can be implemented consistently at home and school. Make sure to consider what is done proactively and what is done in response to your child’s actions, as well as how desired behaviors will be acknowledged.
• Stimulation your child loves is so important! Be mindful of how/when it’s provided, and make sure you get involved and share his/her joy!

-Sheila Allen, MA OT

Moving in Time: Beat & Rhythm in the Sensory Gym

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Create & Grow with “OT Flo”

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How can I help my child navigate the world of competition with greater understanding and more fun?

Q: How can I help my child navigate the world of competition with greater understanding and more fun?

A: With the 2018 Winter Olympic Games coming to an end and the 2018 Paralympics set to begin in PyeongChang from March 8-18, it is an excellent time to discuss how competition and “games” affect us all. The 2018 Special Olympics will be in Seattle from July 1-6 this summer and will provide another rich opportunity for continued conversation. It is certainly not just about sports and athleticism but how we each perceive the interaction between ourselves and our teammates, classmates, friends and family members.

For those who have watched, the past two and a half weeks of Olympic coverage have provided moments of suspense, rattled nerves, sheer determination, loss, immense gratitude, relief and joy. We have witnessed inspiring glimpses of positive sportsmanship, team work and even photo finishes! There have been opportunities to cheer one another’s successes as well as comfort those in despair.

What has been YOUR favorite scene or sensation from these Winter Games? What have your children enjoyed? Questioned? Favored? What lessons can we each take away from this shared global experience? How one chooses to react to these myriad examples can and will inform how our children view themselves. Competition obviously doesn’t just take place on the half pipe or skating rink or bobsled track. It is present in every facet of our lives. Ongoing research continues to remind us of the effects of anxiety and stress on ourselves and our developing children. Every skater falls, every commentator fumbles and every participant has challenges. How each one responds to the ups and downs is the place where learning occurs!!

One way to continue the FUN of the Games while furthering the conversation about resiliency and participation can be found in working together on some simple but stimulating crafts which illuminate the spirit of collaboration without the angst or nerves of competition.

Use this printable worksheet to make flags of the world or flags of your own choosing. What a fun and informative way to discuss similarities and differences between cultures.

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• Trace the rings and give examples of each of the qualities listed and how they overlap and intersect each other. How can this apply to activities on the playground or in the lunchroom or during recess? (c/o Pinterest)

OLYMPIC RINGS

• Enjoy easy, delicious, healthy, and FUN snacks—Olympic-style! Cut and toast bagels and decorate with cream cheese and colorful fruit pieces. (c/o Cool Mom Picks)

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Try this super easy and quick way to make a ring toss game using just some cardboard and empty toilet paper holders along with markers or paint and some glue. Play for prizes or just play for FUN!

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May all your adventures, whether Olympic in size or not, be inclusive, be rewarding and be FUN!

–Anne Toolajian, MA, CCC-SLP

Juicy in 2018!

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Image from https://juicing-for-health.com/

Did you know that freshly extracted fruit and vegetable juices “flood your body with a river of goodness”, providing your body with a dense concentration of the nutrients it needs? Have you ever tried to get your kids to eat (or eat enough) of vegetables you know are good for them? If you’re interested in nutrition, and believe in the importance of eating vegetables and fruit, you must check out juicing-for-health.com. Here you’ll find basically all you need to get yourself started with making fresh juices, and a good deal of interesting information and recipes if you’re already an established juicer. Combine what juicing-for-health.com has to offer with advice, ideas and more recipes from all-about-juicing.com, and even more Jessica Fisher’s Best 100 Juices for Kids (Harvard Common Press, 2014), and you’ll be set! Even better, you’ll also be ready to have your kids help you and you’ll all experience a sensory and language-rich fine motor/sequential processing activity.

Two recipes to get you started:

a basic, simple, loved-by-kids juice,
Apple Berry Juice (15-20 ounces)
1 1/2 c. berries, mixed if preferred (strawberries, blueberries, raspberries)
2 medium apples
Use whatever berries you have on hand.
Add extra apples if you’re short on berries.
Remove hulls, if using strawberries.
Core apples (I like to remove skin, too).
Juice berries and apples according to juicing machine directions.
Whisk to combine.
Add water to taste if a milder juice is preferred.
(from Best 100 Juices for Kids)

a green juice believed to help with calming nerves, relaxing the body and falling asleep,
Green Sleep Juice (1 serving)
½ a bunch of watercress
8 ribs of celery
4-5 heads of Romaine lettuce (or a bunch of spinach)
2 green apples
1 lemon (peeled)
Put all of the above through your juicer.
(from juicing-for-health)

–Sheila Allen, MA, OT

There’s Something About the Beginning of a New Year

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Resolutions? You bet. Within our Pediatric Therapeutics community, our therapists and staff are, for the most part, resolution setters who made commitments to themselves at the beginning of 2017 that, a year later, have been integrated into the rhythms of their lives. How about that?! Moving into 2018, most of us have moved on to other resolutions, while some of us see ourselves as more involved in an ongoing process of goal setting. The New Year as a source of inspiration? We all consider it as such! More of us are inspired by the new year than by our own birthdays or those of others (except the birthdays of our own children or family elders, which were highly inspiring ). More of us are inspired by the New Year than by the beginnings of new days. Even those of us who feel the inspiration brought by a new day feel the uniqueness of January 1.

The end of a year and beginning of a new one come to mind as a singular event that’s not only acknowledged but celebrated throughout the world and marked by most people. When else does the world community join together as it does when ushering in a new year, and when else do so many people think and speak about personal change? Humankind continues a profound practice of honoring time, its steady beat of passage and the multitude of rhythms within it. At the beginning of a year the power of this practice seems to be at its all time highest, likely contributing to the infectious cycle of renewal, refreshment and resolve that January 1 spurs in a way unlike any other day of the calendar year.

Most Pediatric Therapeutics therapists and staff resolutions/goals center around a few common themes – simplification; slowing down to fully experience, enjoy and appreciate; positivity; and physiologic foundations of wellbeing (aka sleep, diet and movement). Some of us make ourselves accountable with very specific commitments and plans, while others among us hold our pledges as conscious thoughts. With either approach, living the process of making personal change includes granting oneself permission to start anew, no matter what, no matter when…not such an easy thing, as a few of our group wisely point out.

What if the New Year came with a wish list? Our does! Health (personal, family members, friends) topped the Pediatric Therapeutics New Year’s wish list. More family time, at home and away, was right up there too. A wish for longer lasting special moments also got a shout out. It may come as a surprise, but we’re not a group in which winning the lottery is the top wish…oh, but wouldn’t that be something!

The newness time can offer us is a gift like no other, whether it begins with January 1, a birthday, a day, January 1, or one of those special moments. A true gift that keeps giving, and ours for the taking, to be and do with it what we will! Powerful, perhaps daunting, and an undeniable source of inspiration!

–Sheila Allen, MA, OT

The Importance of Sensory Awareness

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The processing of sensory information is something we all do. Sensory processing is the means by which we receive, interpret, organize and use the stimulation that activates our eight senses – hearing, sense of position/movement (vestibular), sense of body part position/movement (proprioception & kinesthesia), feelings of what’s going on within our bodies (interoception) touch/tactile, vision, taste, and smell.

Each one of us is processing sensory information continuously, consciously and subconsciously.

When sensory processing is effective we respond to life’s sensory events (both those related to ourselves and those within our surroundings) adaptively. When sensory processing is a problem, it may be related to the function of a specific sensory organ or sensory system, or it may be related to a neurologically-based condition known as sensory processing disorder, whereby sensory function is less than reliable to varied degrees. Stimulation may be poorly adjusted to, misinterpreted, missed, tuned into with heightened sensitivity, sensed as uncomfortable or adverse, avoided, craved, or inadequately filtered. Most frequently, with a sensory processing disorder more than one sensory system is involved and there is variability among the systems involved. Those with disordered sensory processing either must work harder to respond adaptively, or they experience problems that could manifest in many different ways because the processing of sensory stimulation is at the foundation when it comes to how we function.

Awareness of sensory stimulation and individuals’ patterns of responses to basic sensory information is not only helpful, it’s essential in understanding and changing behavior and performance.

Here’re a dozen reasons why sensory awareness is important –

1. Sensory stimulation affects our physiology, psychology, emotionality, motor function, language, thinking, learning, interaction and development through our lifespan.
2. Reliable and sufficient sensory input is necessary for adaptive appropriate output.
3. Everyone tunes into sensory information his/her own ways.
4. How a person takes in sensory information naturally varies from day to day, and within the 24 hours of a day.
5. Different types of sensory information may be processed and affect behavior in different ways
6. Sensory stimulation (aka our experiences) can affect brain change when provided with at critical intensity and frequency over a span of time, for better or worse. With brain change, sensory processing can change.
7. The chicken or the egg? Dysfunctional sensory processing can lead to other problems such as inadequate sleep, attentional limitations, anxiety, emotional reactivity and motor skill deficits, and in turn, problems such as these can affect how sensory information is received.
8. Stress can interfere with sensory processing.
9. Oftentimes if someone is feeling the need to protect him/herself from a certain type of stimulation that isn’t comfortable or tolerable, discrimination of the qualities of the stimulation ultimately suffers.
10. Sensory processing affects the value of repetition. Repetition, which is a valuable tool for learning, is not true repetition if the stimulation taken in and responded to is processed differently from day to day.
11. Sensory processing can affect our awareness of and thoughts about ourselves, as well as our awareness and interaction with others and our surroundings.
12. Sensory processing dysfunction can exist without a known cause, yet it can also alongside other conditions, such as autism, ADHD, ADD, prematurity, it often subjectively appears to be genetically related, and can also be related to trauma.

Each occupational therapist at Pediatric Therapeutics is trained and experienced in the evaluation, treatment and management of sensory processing disorder. Interested in learning more about sensory processing disorder and other sensory based problems? Give us a call, or email info@pediatrictherapeutics.org and we’ll be in touch to answer your questions and direct you to resources.

–Sheila Allen, MA, OT

A Note from Griffen…

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Earlier this month Griffen’s parents were checking his work for school (explain and relate to an assigned precept) and what they found sent them “over the moon”… It did the same for us, and we can only imagine what his teachers felt when they received it.  Sometimes the teacher isn’t giving the bonus points when assignments are completed, he/she gets them…the honest, trusting sharing of an appreciative student, not to mention an endearing and engaging fulfillment of an assignment.  Thanks to Griffen and his parents for allowing us to share this inspiring, heartfelt, unedited message he simply referred to as “homework”. 

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“This precept means to me that you should never doubt yourself, like when you feel you can’t do something, but you actually can do it. I think you chose this precept because it can mean a lot to a child in a way that it feels like you feel it inside you. This precept can relate to my life because, honestly, I normally doubt myself in ways, like thinking I can’t do sports, but I can. It feels like a very honest thing to me, and I realize that I CAN BE GOOD ENOUGH and never give up.

I hope you understand everything I’ve told to you thus far, and I will try everything I can. I feel happier now that I told that to you, just got it off my chest. I feel…actually cheerful for once.

I love being your student, Mr. ____. Thank you SO much for doing teaching so well in ways even a kindergartner would understand (in a nice way, because your teaching are easy to understand and happy to work with), and I hope you continue this even when I’m in middle school. High school. COLLEGE. Thank you. Innovation is abound when you and Mrs. ___ teaches, and also Ms. _____ as well.

: D : D : D : D..wait, I’m going off topic, aren’t I?.. Sorry, I just answered all the questions and I’m not sure how to continue at this point, OK?

Thanks for teaching me so far. I feel happy. Sorry for doing this later than expected. When I wanted to do it on Thursday, my internet went down due to cleaners getting the Wi-Fi router wet. Had to wait until yesterday to get on the Internet. It was excruciating. At least my family went to Arturo’s (the pizza shop, Griffen recommends) the night before I got back on.

I hope you like this!

You’re a very nice teacher! (out of things to say at this point) (ONE MORE THING) It’s awesome that you teach. Is this too many lines for one answer now? Not sure.

I hope you’re having a nice day. Sorry about the situation you’re in, and that you can’t get much done. I hope you never give up, despite the situation.”

–Griffen, Age 10

Getting Back into the Swing of Things with School-Year Resolutions

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The morning air is crisp. Pencils are sharpened. Folders and papers are smooth and organized. And just like new shoes have a little room to grow, so do our lives in this back-to-school season. It’s time for a fresh start, and it’s the perfect time to set some school-year resolutions!
 
Resolutions made in January often come from reflection on a previous calendar year, and for many, might come from a source of unhappiness or stress, coming off a hectic holiday season. Individuals often want to make more drastic changes (e.g. “I’m going to lose 20 pounds, so I’m never eating sweets again!”). Those individual/personal resolutions might be somewhat easier to implement, but since families are already in the routine of the school year (with all their individual moving parts and schedules), it can be more challenging to make changes as a family unit. The summer season likely slows us all down a bit, giving us the ability to think more clearly, forecast and dream up our ideals for how we might want our lives to run when school starts again. And that time is here again, now.

The idea of school year resolutions isn’t a new one. In her book Happier at Home, Gretchen Rubin describes “September as the other January”, as she created her own “happiness project” that spanned only the months of school year. She stated, “September, for many people, marks a fresh start and a new beginning, so it’s good to think about changes to make with this clean slate.” To read more, go to gretchenrubin.com, or to hear more, listen to her Happier podcast, Episode 129 with September is the Other January in the the title, at gretchenrubin.com/podcasts.

A September 24, 2016 Wall Street Journal article by Anne Marie Chaker also speaks to school year resolutions in its title alone: September is the Real New Year: More than just back-to-school; people improve routines, consider career moves and join the gym.

And in 2015, Pearson and NBC teamed up to coordinate the School Year Resolution Program, which consisted of resolutions from thousands of parents, students, educators, grandparents, celebrities and public figures. Examples of such resolutions included

• “to help my children deal with their emotions”;

• “to get all my homework done before I watch YouTube, etc., and stop procrastinating so much.”

To read more examples and view video clips, click here!

As a pediatric occupational therapist, I am constantly thinking about the changes that are taking place in my clients’ schedules and lives and how I can best support them and their families during this transition to a new school year. Occupational therapists consider a person’s occupational profile, which consists of a “client’s history and experiences, patterns of daily living, interests, values and needs” to guide their practice (AOTA, 2014). Part of this profile includes analyzing performance patterns of engagement – routines, roles, habits and rituals – and how they change over time (like how they are changing now!), while also considering the environment, context and client/family’s goals. 
 
Take this opportunity to think about your family’s patterns in daily life, how they are shifting, and where opportunities for change come into play. As a parent of two school-age children, thoughts ranging from establishing ease in morning and bedtime routines, to the amount and variety of afterschool and weekend activities, to the nights we can be home to have dinner as a family, etc. replay each day in my mind. 

To set a resolution, think of an ideal or goal, and behind each a goal, think about the intention for that resolution to give further meaning to “why” you have set this goal. Consider individual roles, habits and rituals and how they influence each other.

Are your resolutions personal? Professional? Related to specific family members or your family as a whole?

Furthermore, are your resolutions measurable? e.g. Are you going to do this “new something” every day, or just on school/work days, or just on the days the kids have activities?

Two of my personal resolutions include:

• I will do some sort of fun, easy and helpful brain-based movement activity (such as a BrainGym activity) with my child(ren) before the school day at least 3 days a week.

• I will leave my phone in my purse when I arrive home until after all bags have been gone through and emptied, mail has been sorted and I have thoroughly checked in with everyone about their day. 
(intention- being present with my family, relationship building, organization and peace at home).

Some additional Pediatric Therapeutics therapists goals include:

One said,
“Mine – for myself and my kids is to have outfits picked out and lunch made the night before, for the next day.” The intention behind this resolution is “peaceful mornings and peace of mind- as well as a more restful sleep because it’s done.”

Another therapist said,
“I definitely think the beginning of the school year is a natural time for resolutions.  My “school year” resolutions for this fall – 1.) healthy, delicious dinners on the table by 7:15 at least 4:7 days 2.) no screentime after 9:30, with bedtime by 10:30 (my new year’s resolution; I did well for keeping it up for several months, but it slid in the spring…thanks to the beginning of the school year, I’m consciously back on it).”

Whatever YOUR school year resolutions might be, we hope they bring you and your families joy, peace and the fresh-start you are looking for. Please share them in the comments! We are here to support you and help you achieve them

–Liz Duffy, OT

The IEP Process Must Involve Parents!!!

The Individuals with Disabilities Education Improvement Act (IDEIA 2004) mandates that every child identified as having a disability and in need of special education services be provided an Individualized Education Program or IEP. Parents must be in included in the process of developing these plans and are considered members of the IEP team along with school personnel. Seven steps are involved in the IEP Process. These and the parents’ role and rights in each step are outlined below.

1. Pre-referral
This entails parents and school personnel working collaboratively to determine if general education teachers can appropriately address any educational or behavioral difficulties in the general or regular education classroom. Teachers may try different techniques and strategies, alter instructional delivery, and make accommodations tailored for the students. If concerns persist, a referral for a special education evaluation should occur.

2. Referral
A referral for evaluation may be generated through the process detailed above. Parents may also make a written request for an evaluation. In New Jersey the Child Study Team (CST) receives this written request. The CST is comprised of a Learning Disabilities Teacher-Consultant (LDT-C), a School Psychologist, and a School Social Worker.

Next, an Initial Evaluation Meeting to determine whether an evaluation is warranted is conducted within 20 calendar days of the receipt of the written request. At least one parent, the CST, and the student’s regular education teacher are required participants in this meeting. If this team determines that an evaluation is warranted, they will then plan the nature and scope of the evaluation. Parents must give written consent in order for the evaluation to proceed. If it is determined that an evaluation is not warranted, the team must delineate other appropriate actions to address the presenting concerns. Other participants may include a Speech and Language Pathologist, Occupational Therapist, Physical Therapist, and Behaviorist as these professionals may also be needed to evaluate areas of concern. Parents may invite other individuals to attend the meeting.

3. Evaluation
The CST and possibly some or all of the other professionals listed above will review records including existing evaluation data, attempted interventions, work samples, classroom-based assessments, teacher observations, and information provided by parents. The Initial Evaluation will consist of a multi-disciplinary assessment in all areas of suspected disability. At least two assessments must be performed by at least two CST members. A CST member, usually the School Social Worker, will conduct an interview with the student’s parents. A minimum of one structured observation by one CST member must also be performed. This can be in the general education classroom, or for a student of preschool age, an environment appropriate for that age.

The main purposes of the Initial Evaluation are:

• To determine whether the student has a disability under the New Jersey Special Education Code

• The present levels of academic and functional achievement and educational needs

• Whether the student needs special education and possibly additional therapy

• Provide a baseline of performance that informs the development of the IEP if the child is found eligible for special education

• Evaluation results will be used later to assess the efficacy of the IEP that was implemented

Parents must be provided with reports of the evaluations no more than 80 days after signing initial consent to perform them. A meeting to determine eligibility for special education must be convened no more than 90 days following initial consent.

4. Eligibility
If the evaluation process has identified that a student has a disability and the IEP team classifies that disability, an eligibility meeting is conducted. This meeting occurs following the discussion of the evaluation results. At this point the parents may sign that they either agree or disagree with the determination made from the evaluation process. If the parents agree, the participants immediately shift to an IEP Development meeting. If the parents do not wish to make a decision immediately they have the right to consider eligibility for 15 days and no IEP can be developed at that time. In this case a meeting would be rescheduled for approximately 15 days later.

Preschool children ages 3-5 may be eligible for special education if they meet New Jersey Code specific criteria: A 33% delay in one developmental area or a 25% delay in two or more developmental areas listed below.

• Physical, including gross motor, fine motor and sensory (vision and hearing)

• Intellectual

• Communication

• Social or Emotional

• Adaptive

A preschool child may also be eligible if they have an identified disabling condition, including vision and hearing, that adversely affects learning or development and that requires special education.

Within three years of the previous classification, reevaluation for eligibility for special education services is conducted. It can be conducted sooner if the student’s parent or teacher requests it. Parents also have the right to withhold consent for a reevaluation.

5. Development of the IEP
As mentioned above, the evaluations that were performed provide a baseline of performance that informs the development of the IEP.
Again, parents must be in included in the process of developing the IEP and are considered members of the IEP team along with school personnel. Parents meet with the school-based IEP team, and the child if appropriate, to develop measurable goals and short-term objectives or benchmarks which are driven by the child’s needs. The school-based team must include one general education teacher, one special education teacher, a representative of the school district, and someone to interpret the instructional implications of the assessment results. The interpretation of the instructional implications of the assessment results is usually done by the LDT-C. These implications are typically specified in the educational report that the parents have received prior to the meeting.

The team also determines what constellation of program or services are necessary to meet these needs. When developing the IEP the team must consider the strengths of the student as well as the concerns of the parents for enhancing the education of their child.

It is important to recognize that IEPs are binding legal documents. Five key principles must be adhered to:

I. The student’s needs must be met.

II. Whether services are available or not is not a determining factor as to whether or not they are contained in the IEP.

III. All IEP specified services must be provided.

IV. It is self-evident that INDIVIDUAL Education Programs, as specified in Federal and State Code, are intended to be individually formulated. No two students, even with the same disability category, have precisely the same needs or patterns of strengths and weaknesses. Cookie cutter templates or one size fits all constructs constitute a disservice to all stakeholders.

V. The contents of the IEP should be communicated to all school personnel who interact with the students. This includes the principal and other administrators, teachers, aides, specialists, school nurse, substitute teachers, and other relevant personnel.

It was my practice in the public schools to meet individually with all personnel to discuss each student, have them read the IEPS, and field any questions they might have. They were required to sign that they had read the IEPS and maintain a copy in a safe place for reference. Substitutes were also required to familiarize themselves with the IEPS and know of its’ location in the classroom. Particular attention was paid to the modifications and accommodations specified in the IEP for each student.

6. Implementation of the IEP

This is when service delivery commences. This should begin immediately upon the parents’ consent for implementation being obtained. IEPS may be amended or altered during the course of a school year prior to the annual review due to a variety of reasons. Most amendments do not require any additional meetings, just a parent’s signature. However, if it is proposed that any of the goals or objectives are to be amended, a meeting must be convened to discuss the change(s) before they can be instituted.

7. Annual Review
The student’s progress toward meeting the IEP goals and objectives is reviewed at a yearly meeting known as the Annual Review. Any goals and objectives that have been achieved should either be eliminated or revised with more demanding criteria substituted. Sometimes specific goals and objectives are no longer relevant as the student’s needs and/or program have changed. Thus deletion of these goals or objectives or a tweaking of them is necessary. Parental feedback is important in this process.

I have frequently observed that students’ performance in school can be much different than at home when doing homework. Not only academic performance, but also behaviors often vary considerably across these settings. Thus discussion of how to maximize outcomes across settings and fine tune communication between parents and school personnel is usually another important component of the annual review.

An additional key feature of the annual review is that a new program is developed. As students progress and grow the previous year’s decisions regarding placement and supportive services may not be optimal for the ensuing year. Sometimes more intensive special services may be necessary. In other instances it may be appropriate to diminish the degree of support due to documented progress and increased student independence. Another scenario is when a student has made great academic strides, has often become a strong self-advocate, and is functioning on or above grade level with little or no extra support from school personnel. These students are no longer in need of special education services. When this occurs it has been a source of deep satisfaction and pride for parents as well as for me as a professional.

–Scott Bagish, M.Ed., LDT-C