Health care is a basic human right, not a privilege. For some reason, we’ve allowed ourselves as Americans to be fooled into accepting that one must be blessed with “means” to actuate appropriate health care. As a nation we have failed to realize that our health care system is a barometer of our society’s value for human life.


Wednesday, January 24, 2007

IEP Written Correspondence - Letter #1

A key trait of effective parental advocates in any IEP is written correspondence. I have learned this through extensive conversations with Sandis’s social worker, personal advocates, special education teachers I know, and parents of children with existing IEPs. The point is to get in writing a communication trail that can be verified and holds everyone accountable. Phone conversations carry so much information, but they are he said/she said when it comes down to documented communication.

I have posted letter #1 in my written correspondence with Sandis’s school for his IEP journey. I had a lot of help from an acquaintance of mine who is a special ed teacher and sits in many IEP meetings. One point she made clear to me was to respect the politics of the school and then point out behaviors I am noticing and concerns I have with Sandis that I have witnessed in the school and in the community. She also told me to include things I am doing at home that have helped Sandis see improvement.

I plan to have written correspondence with Sandis’s case worker once per week concerning Sandis’s IEP.

January 23, 2007

I have been putting a lot of thought into Sandis’s IEP and I wanted to share my chief concerns and observations concerning Sandis with you.
1. Sandis’s hyperactivity and impulsivity were some of the first challenging behaviors that Sandis had at school. This behavior is seen at home and in the community as well. Some of the things that I am doing at home to address this behavior is brushing/joint compression every 1-1/2 hours, spinning, and visual schedules. A lot of Sandis’s hyperactivity is in part due to physical stimming in response to outside stressors and sensory overload. I’d like to see a visual schedule used with Sandis daily in the classroom as I think that the use of visual schedules along with the brushing and spinning has notably reduced hyperactivity at home and in the community.
2. Sandis has many problems with sensory integration. Sandis has a large increase in physical and vocal stims when in situations that are high anxiety for him. Examples at school are spacing out, spinning, pacing, playing with hands, sucking and chewing on items or clothing. Sandis has higher anxiety before, during, and after transitions and in new situations that he is unfamiliar with. Sandis also has high anxiety in settings where there is a lot of noise, a lot of movement, and a lot of space. It is quite common to have all of these things in a classroom! I personally have observed Sandis in his classroom and have witnessed some of the stimming he does in the classroom (rocking, pacing, chewing, spinning). Currently I have Sandis going to Occupational Therapy twice per week where they do things like the brushing/joint compression regimen, spinning, large muscle group activity, and listening therapy to help him with his sensory integration. I also allow Sandis “breaks” from normal activities if he has having too hard of a time staying on task with us. I think it would be incredibly helpful for Sandis to have sensory breaks at school on a regular basis. I also think a wonderful goal for Sandis on his IEP would be for Sandis to recognize when he needs a sensory break. Sandis has a quiet area (his bunk bed) where he can retire to at home with his cars if he needs a few minutes for a break. This is not a punishment but rather a time for Sandis to calm down and get himself out of sensory overdrive. Sandis needs help learning to listen to when his body has had too much and he needs a break. I would love for Sandis to have a Quiet Area in his classroom or in the school where he can go to unwind with a few select items to help calm him.
a. Music – Sandis has a lot of problems with hyperactivity and impulsivity during music. In the community, when I take Sandis to church (another loud and musical event) I make sure that I only take Sandis when I can be 1:1 with him. I do brushing/joint compression before and during church, and I allow Sandis as many breaks as he needs. Sandis greatly enjoys music, but the sensory demands for him are very great and need to be met!
3. Social - Sandis has quite a few problems with bullying. Sandis has had problems with bullying at the bus stop, during class, during breakfast, and after school during kid stop. Some of the reasons Sandis has problems with bullying is he fails to understand nonverbal cues from other children, he does not engage in regular eye contact during conversations, and he has very little conception of personal space. Sandis’s deficits in social conversation have limited his ability to make and keep friends, initiate and participate in activities with other children, maintain conversations with peers, listening and offering feedback, participating in group activities with peers, and conversation outside of monologuing. I myself have witnessed parallel play in his classroom, but very little interactive play with his peers.
a. Generalization Skills – Sandis has in the past avoided favored activities because of bullying. Sandis does not tell teachers or me about instances of bullying often because of the “No Tattling” Rule. I have reinforced to Sandis how important it is to tell teachers and myself if someone is being mean to him at school. I would like this reinforced to Sandis at school and I would like Sandis to have help understanding when you need to “tattle” and when a secret is not okay. I believe this is pivotal for Sandis’s safety.
4. Transitions – Sandis has a lot of troubles with transitions. At home it is often difficult to move from a task that Sandis does not enjoy to a task he does enjoy just because it requires Sandis to move from one thing to the next. Sandis will often engage in more physical and verbal stims during transition periods and he is also more likely to be impulsive or aggressive during these times. At home we have used visual schedules, brushing/joint compression, spinning, alerts before the transition, and timers to help ease transitions. I have witnessed Sandis during transitions in the hall at school and have seen that he has a very hard time staying with the group, staying on task in the bathroom, and following the class from one place to the next. Sandis is often very far behind or forced to hold the teacher’s hand to help keep him with the class. Sandis also has tantrums more often during periods of transitions. Sandis’s tantrums may be short lived, but they are injurious to him socially when they happen on any regular basis at school. Sandis requires 1:1 help during transitions at home and in the community.
5. Through conversations with Sandis’s teacher, I have learned that Sandis struggles in following busy worksheets and does much better with help focusing on one problem at a time, rather than trying to focus on one worksheet with many problems on it. I think it would be wonderful to try and find remedies that will help assist Sandis go through tests and worksheets. I do know that what has helped Sandis with some of his worksheets was to have someone cover up all of the text except for the text associated with the problem he is working on.
6. Organization – Organization is a major concern in all areas of Sandis’s life. If something is not right in front of Sandis, he will lose or forget it! Sandis has had problems with keeping track of his snack, mittens, back pack, lunch box, papers going to and from school, Guided Reading Books, Boots, Snow Suit, library books, sensory and fidget toys. At home, I assist Sandis in organizing all of his things and ensure that everything he needs is in his backpack. Sandis needs help to actively organize his paperwork and possessions he has at school. I am not sure of the best way to do this, but I would like to see someone at least overseeing Sandis’s organization.
7. Aggressive Behavior – Sandis has had some problems with aggression both at home and at school. At school aggressive instances would include spitting on other students, pushing, and hitting. At home Sandis is aggressive some towards his sister, but is mostly aggressive towards inanimate objects such as hitting walls, kicking walls, throwing toys, etc. Sandis is generally aggressive in situations that have a lot of sensory input (i.e. High noise volume, a lot of activity) or when he doesn’t understand what is expected of him. At home we have talked about alternatives to this type of aggressive behavior. I also try and prevent the high stress situations which will lead most often to this type of behavior. I would like Sandis to have a Positive Behavior Plan at school that addresses Sandis’s most challenging behaviors and has actions put in place to help prevent them and a positive reinforcement plan for his continuing good behavior.

I do appreciate all the time Oak Hill has spent in evaluating Sandis and I am looking forwards to our IEP meetings as we put together appropriate interventions for Sandis. Please contact me when Sandis’s evaluations are completed and we can arrange to meet and review them.

Thank you and please contact me with any questions!

Sarah C. Rittmann


Molly said...

Sandis' teachers are fortunate to have you as a resource and team member.
I love sensory integration. In fact, I was trained in therapeutic listening (did my master's thesis on it's use in my classroom), and have many OT friends. If the teacher or case manager is might want to have the outside OT come to a meeting and share ideas. Sometimes teachers are more receptive to those strategies when someone other than mom shares them. Email me sometime...I have a sensory idea to share.
Good job Sandis' mom!!

Amberthyme said...

Thank you for posting this wonderful letter. This is great! I have written notes to Therin's teachers but this is absoultely beautiful. I am so glad that you have so many wonderful resources that you are able to call upon to aid you and Sandis in your journey through public school. Is Katie his teacher or his case worker or someone from the IEP team?