IEP ? - Adding/Changing Services

kar5162

Anyone BTDT? We are considering proposing a change to DS's IEP. Right now he gets PT and itinerant teaching (for adaptive skills). Really his adaptive skills are delayed because of motor reasons, not educational ones ( for example - taking on/off a coat is physically challenging). His fine motor skills were technically less than 1 std deviation off when they did the initial IEP evaluations. They are delayed (or at least quality is off) and he does private OT (school prep focused) for them now.

We think he would be better served with PT and OT, but that the itinerant teaching (though they are lovely) does not add a lot of value vs what OT could do based on the way the service is delivered and the nature of the service itself.

Does that automatically mean reevaluation? (He is currently 2 years into his 3 year evaluation cycle.)
Are there any cons to reevaluating a year early? FWIW, he will be in his final year of preschool in the fall. He currently attends a private preschool and we will not be moving him to developmental preschool in the fall regardless of what services he receives. His school is at an elementary so he gets PT (and would get OT) there - they just go to his preschool and him pull out.

kar5162

-auntie- said:

kar5162 said:

Anyone BTDT?

I've tweaked a couple IEPs in my time. How old i your DS? What dx does he have and how is he classified on his IEP.

He is 4. He has CP, his IEP is under other orthopedic impairment.

 We are considering proposing a change to DS's IEP. Right now he gets PT and itinerant teaching (for adaptive skills). Really his adaptive skills are delayed because of motor reasons, not educational ones ( for example - taking on/off a coat is physically challenging).

Does he have some sort of medical condition like MD or a stroke and a specialist physician who can help make the case that he needs a more medically based approach to his IEP goals or are you assuming an OT would be more successful that a  in teaching a skill most kids learn at home or along with other students in a preschool setting? What does his PT work on?

PT works on balancing, moving over uneven surfaces, carrying things, etc. All things he will need be able to do at school, especially for safety. He is an independent walker, but still a slow and not so stable one. Getting his medical doctor to write a note might help.

 His fine motor skills were technically less than 1 std deviation off when they did the initial IEP evaluations. They are delayed (or at least quality is off) and he does private OT (school prep focused) for them now.

If you are hoping to prove a need for OT, he would have to demonstrate an actual delay which would mean another assessment. Less that 1 std deviation isn't considered a delay. Honestly, it's a gamble. You could do another assessment which might show an larger deviation in skills because the standards are higher for older kids. Or you could do another assessment and find he's stayed fairly average or improved as a result of maturity and/or the private OT he's been getting.

He will certainly still qualify in PT . He will qualify in adaptive still even if he doesn't qualify for OT. For OT it is a crapshoot. I don't know that he has lost much ground and may not qualify, but he may be behind enough now. He didn't qualify at the time because expectations at 3 are low and we had been doing 60 min a week OT (fine motor, no specific sensory issues that maturation might help) plus he was receiving it at playgroup. He will very likely get it in school regardless. Think kid who *can* write or cut (or whatever), but it takes 3x as long as typical to do so.

We think he would be better served with PT and OT, but that the itinerant teaching (though they are lovely) does not add a lot of value vs what OT could do based on the way the service is delivered and the nature of the service itself.

You have the cart before the horse. Need drives the goals which determine what services a child gets. You need to re-examine his goals and progress toward them and think of ways you can tweak them so that the intervention to help him can only be delivered by an OT.

Well, technically, I believe I have it right . School district says adaptive = sp ed teaching. I know however that his adaptive needs are due to motor control. He doesn't need specifically instruction on how to put on your coat as much as techniques to adapt the process that will specifically help him given where he is at motor control wise (just an example). FWIW, I know his school based PT agrees. It is really figuring out the best way to make it happen. His goals are already really written where they would make more sense delivered by an OT. Perhaps the best approach is to start with that one and show the limited progress towards them this year.

Another option could be to have an OT offer itinerant support to his teacher to help her help him more effectively. But without a significant delay, you probably won't get school district 1:1 OT.

Does that automatically mean reevaluation? (He is currently 2 years into his 3 year evaluation cycle.)

I suspect it would. And it should, younger kids change so quickly.

Are there any cons to reevaluating a year early? FWIW, he will be in his final year of preschool in the fall. 

There could be repercussions. They could re-evaluate and find he no longer qualifies for all of some of the services he is getting now. Normally schools leave IEP services in place for the full year the IEP is valid. But with an new eval, they could pull it if they can document he no longer qualifies.

Haha . He will so easily qualify for PT. Perhaps he will be above the 1st % for motor skills now, but I doubt it. I doubt they will get it done much before the end of the year at this point so he would keep itinerant teaching for the year. I don't feel strongly about him having it. As I said, I don't think it really helps.

The other downside is that it best to have his transition to kindie eval done as close to his transition IEP as possible- it gives them the best shot at getting the right supports in place. If you pull the eval now, they won't do another one.

Hm. This makes me think it is a real benefit to doing it now. Right now his re-eval will be after his placement will be set for kindie. Since his IEP will reset in May/June, it would be after the school assignment dates so they would otherwise do an interim meeting next year to review placement. Since he has a few specific quirks in his needs that may make our neighborhood school not his LRE (pretty straightforward, small, slow, independent kid with a neighborhood school being the biggest in the district, needing to change floors multiple times a day for lunch, recess, etc), we have already started talking with his PT about what the team needs to consider. Doing another eval now may make those discussions easier.

He currently attends a private preschool and we will not be moving him to developmental preschool in the fall regardless of what services he receives. 

Why not? Often the self contained settings have things like OT and PT pushed in. If he's developmentally delayed, it might be a good sort of "boot camp" to get him ready to bridge to mainstream kindie.

Our school delivery system stinks. I think they mostly do a good job, but the timing is horrible and they have few to no typical peers (max 4 out of 16 and many have only 1-2). Since he is verbally, socially and cognitively typical, that is our priority. His preschool does a phenomenal job with him and his itinerant teachers have been very impressed with it. They are doing a great job of prepping him for kindie and I have no concerns (aside from his disability which isn't going anywhere ).

His school is at an elementary so he gets PT (and would get OT) there - they just go to his preschool and him pull out.

Thanks!

kar5162

I am going to drop the quotes .

For writing I think adaptive tools are fine as needed, but not in preschool/to start kindie. If he wasn't starting to write, maybe as a bridge, but since he is, I think that can come later as needed, especially as speed expectations increase.

It is true re the OT. They may not *have* to give it. Silly as it is since it is what he needs.

I think his itinerant teacher is great! Just not at his needs specifically. I just don't think this is what they typically work on (generally it seems they are in the room for social reasons or cognitive/play skills) plus the set up is not right. Since they push in, she works with him during the classroom. That might work for say the coat if she was there when they were going outside and could incorporate it, but if they aren't (and they don't then), he isn't cooperative to go practice putting on his coat when the other kids are playing. I can see where the same model works great for social/cognitive/play skills though - there are endless opportunities to help facilitate, build those interactions in the classroom at almost any time. But what he really could use is 5 attempts at practicing it once a week with someone who can watch him and figure out how best to set it up (sit down, stand up, kneel, twist, and when) or games to play that work through the same skills to build up to success without it being boring. That is just an example. I might be able to his private OT to focus on it more, but they have a lot of other things they work on (also all important ). I hadn't had her working on adaptive skills since he (in theory) gets some of that at school, but no fine motor work). I do think her expectations are fine in general. Maybe a little low, but not extreme. He is a charmer and can be a bit of a stinker.

And yeah, the schools are not integrated. Luckily, his preschool is awesome. Actually, in many ways, I think it is better for him. He *has* to be more independent because there are more kids (and most are typicals). He definitely tried to bat his eyelashes and get extra help before when he was in a lower ratio, developmental playgroup. Preschool has been great for his independence.