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» LymeNet Flash » Questions and Discussion » Medical Questions » IEP accommodations for Lyme student

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Author Topic: IEP accommodations for Lyme student
hshbmom
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Hello lyme fighters,

Do any of you have suggestions for accommodations for either a 504 plan or an IEP?

We're in the process of having my daughter evaluated to see if she qualifies as Other Health Impaired through special education.

I've learned that many students with Lyme qualify for this classification.

So far, my daughter has qualified for an assistive technology program called Dragon Naturally Speaking. It's a voice recognition program that transmits your voice into typed text. She tried it out last week and is excited to implement it.

She has a lot of pain in her hands and body; I hope this program will allow her to produce more school work.

Here are some accomodations for my child:

reduce work load
give homebound authority to reduced the work load
increased time allowed to take tests and complete homework
write in the test booklet for acheivement tests
homebound instruction
receive instruction at a time most beneficial to the student (such as afternoon)
type answers or dictate answers to parent to type or write


What accommodations have been helpful for your students struggling with Lyme?

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bettyg
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up for day crowd! hi nancy!! good luck; best wishes! [group hug] [kiss]
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pineapple
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Some children with late stage Lyme will qualify under the acquired brain injury category. Acquired brain injury refers to various
injuries to the brain that are not a result of
a traumatic external force injury to the
head. Unlike traumatic brain injury, there is no
external force to the head. An acquired brain injury may be caused by:
- illnesses such as meningitis and encephalitis (LYME)
- anoxic injury, i.e., oxygen flow to the brain is disrupted as in strokes, metabolic disorders (e.g.,insulin shock, liver and kidney disease),
aneurysms or during cardiac arrest, or neardrowning

Although, the consequences of nontraumatic
brain injury are often similar to
those seen with a traumatic brain injury,
there are important differences.
* Acquired brain injuries take place at the
cellular level within the brain.
* Although, the consequences of nontraumatic
brain injury are often similar to
those seen with a traumatic brain injury,
there are important differences. Injury from acquired brain injury can affect cells throughout the entire brain, instead of
just in specific areas of the brain.

Cognitive Changes often associated with Acquired Brain Injury are:

- Short and long-term memory loss
- Slowed ability to process information
- Attention issues
- Difficulty keeping up with a conversation
Cognitive Changes
- Organizational problems and impaired judgment
- Spatial disorientation
- A lack of initiating activities, or once started,difficulty completing tasks
- Decision making difficulties


Educational Implications
* Cognitive Needs
- Attention and concentration
- Thinking and reasoning
- Ability to adjust to change
- Communication, language, speech
- Memory, especially learning new information
- Judgment, decision making
- Planning, organization
- Perception


Educational Implications:
* Sensory-Motor Needs
- Vision and hearing
- Spatial coordination
- Speed and coordination of movement
- Balance

Educational Implications
* Academic Needs
- Prolonged absence from school during
rehabilitation phase

Instructional Strategies and Classroom Accommodations
* While no two children with brain injury will
need precisely the same assistance, there
are a number of strategies that can help
brain injured students succeed in school.

* Many of these are similar to strategies
used for students with learning disabilities
or ADHD. Remember, though, that brain
injury is a different condition requiring
individualized responses.


**** Lyme Disease: Educational Implications

Physical Symptoms

Inflammation causes redness, swelling, warmth, and soreness in joints, although many children with Lyme may not complain of joint pain.

Any joint can be affected and inflammation may limit the mobility of affected joints.

Typically, there are periods when symptoms of LD are better or disappear (remission) and times when symptoms are worse (flare-ups). Some have symptoms that never go away.

Lyme disease can strain a student's participation in social and after-school activities and make schoolwork more difficult.

Lyme arthritis or neurological Lyme disease can affect the student's mobility, strength and endurance.

Students may come to school with varying degrees of pain and stiffness or mobility issues.

The nature of Lyme Disease may cause irregular absences, because lyme can go from symptom-free periods to flare-ups of swelling and pain very quickly.

Children with Lyme disease may be frequently absent from school which can impact their academic performance. They may also have difficulty concentrating and attending in class due to discomfort.

Educational Implications

Students may be feeling:

-pain and fatigue from disease symptoms
-the desire to be like peers
-isolated and insecure
-anger and depression about the restrictions
-imposed by the disease
-embarrassment about having the disease

Instructional Strategies and Classroom Accommodations

Treat the student, as much as possible, like other students.

Develop a plan for medication administration.

Encourage participation in physical activities, but modify activities to recommendations of the student's doctor and/or physical therapist.

Adjust school schedule for optimal performance.
Give extra time to change classes.

Plan stretch breaks to relieve stiffness.

Depending on symptoms, a different chair or desk may be needed.

Allow for a quiet area for student to periodically rest / lie down.

Writing may be difficult when arthritis affects the student's hands.

-Extend timed written assignments/tests or allow oral responses.
-Use foam shells to build up pens and pencils.
-Use computers or other electronic devices for assignments.
-Record or copy another student's notes.
-Give teacher's notes or overheads to the student.
-Shorten or modify long written assignments.

Provide extra set of textbooks, so that these books won't need to be carried home and recruit a ``buddy'' to help carry heavy items.

Make arrangements for assignments to be sent home when the student misses school because of his or her condition.

Use assistive technology as necessary to help student attain educational goals.


Lyme Disease: Instructional Strategies and Classroom Accommodations

In addition to physical symptoms, Lyme disease may cause neurological problems that result in cognitive deficits.

These deficits may relate to difficulties with speech, dementia, dyslexia, problems maintaining focus, retrieving information, and short- and long-term memory loss.

These problems may manifest in the classroom with forgetfulness, inattention, distractibility, restlessness, articulation errors and reversals in math and spelling.

Students may need to compensate for these deficits by improving their ability to process and use information, and by restoring impaired function through repetitive exercises reserves.

Instructional strategies and classroom accommodations will vary depending on the student's symptoms and behaviors.

In addition, the symptoms and behaviors may disappear for weeks or months and then recur.
Staff needs to monitor the student's health and cognitive deficits for recurrence of symptoms and report changes to parent / guardian.

Develop a plan and accommodations for physical limitations if the student suffers from related health problems such as arthritis, Bell's palsy, or heart problems.

Teach the student to take notes using note-books, post-it notes and other aids. A notetaker may be needed for the student unable to process verbal information. A teacher provided outline is helpful if the student is able to fill in key concepts.

Use alarms to signal changes, meds, etc.

Teach internal memory aids (including rehearsing information).

Teach how to use mnemonic devices.

Use repetition of instruction and concepts.

Use multi-sensory instruction.

Consider modifying or adapting the curriculum to better suit the student's learning style.

Provide consistent structure and clearly define expectations.

Assist the student in tracking missing assignments due to frequent absences.

School nurse should develop an Individualized Healthcare Plan.

Teach the student to use an assignment book and daily schedule to help with organization.


****Documentation gathered PRIOR to team EVALUATION for IEP or 504:

1. Written and signed documentation by a licensed physician of a medically diagnosed chronic or acute health condition (must be dated within the previous 12 months.)

2. In comparison with peers, the health condition adversely affects the student's ability to complete educational tasks within routine timelines as documented by 3 or more of the following:

--Excessive absenteeism linked to the health condition. For example, medical treatments,
surgeries, hospitalizations, or illness. (John has missed twelve days every two months due to treatments and medical appointments. Sometimes he needs to be sent home/kept home from school due to illness.)

--Specialized health care procedures that are necessary during the school day. (Provide
examples.)

--Medications that adversely affect learning and functioning in terms of memory, comprehension, attention or fatigue. (ie John's Lyme disease treatments and anti-pain medications cause fatigue and sedation. The fatigue impacts his daily learning.)

--Limited physical strength resulting in decreased capacity to perform school activities. (ie. During the systematic observation, John completed 6 of 20 multiplication problems. The teacher interview also gave evidence of inability to complete assignments within routine timelines. John also is unable to participate in physical education due to limited physical strength. Documentaion from the physical therapy dept. is attached.

--Limited endurance resulting in decreased stamina and decreased ability to maintain
performance. (ie. John is unable to stay in the classroom for the full day due to fatigue. He takes breaks as needed depending upon treatment.)

--Heightened or diminished alertness resulting in impaired abilities. For example,
prioritizing environmental stimuli, maintaining focus, sustaining focus, or accuracy.
(ie John is off task 55% of the time compared to peers who are off task only 10% of the time. John's off task behavior is due to fatigue, global hypoperfusion to the brain, delayed processing speed, etc. Attach neuropsych. testing results, SPECT results, teachers assessments, etc.)

--Impaired abilities to manage/organize materials and complete classroom assignments
within routine timelines. Provide examples.

--Impaired ability to follow directions; or initiate and complete a task. Provide examples.

3. Standard Test results (comparison to peers)

4. Do not share medical records with school. This is not necessary!!!

5. Reports from evaluation team or independent evaluations (good neuropsych that understands Lyme and does cognitive testing)


Example of request of Educational Accommodations:

Educational Needs:
Due to his health-related absences, student has experienced gaps in his instruction and
needs to learn multiplication skills. He also needs instruction in reading comprehension and
fluency.

Due to his health related absences, he needs to have education available on a continual
basis.

Due to his medical regime, student is experiencing difficulties with comprehension and
memory. Student needs instruction delivered with repetition and a multi-sensory approach.

He also needs shortened assignments.

Due to his limited strength and endurance, student needs rest period in the nurse's
office 1 - 3 times/day or a shortened day.

Due to his limited strength and endurance, student needs a decreased amount of
written work.

Due to his limited strength and endurance, the rigors of physical education class needs to
modified. (i.e. attend class to learn game rules and skills without actual physical exertion)

Due to diminished alertness resulting in inability to focus and sustain effort, John needs
small group instruction in the areas of math and reading. He also needs teacher cues to
redirect him.

Adaptations:
Because of John's medical condition, he needs the following adaptations:
Shortened school day
Modified assignments
More time for work completion
A buddy to help with note-taking
Special education bussing can be provided, when needed
On call home-bound instruction, when needed
Breaks during the school day
Physical assistance with carrying textbooks or extra set of textbooks for home
Use of elevator as necessary instead of stairs
Written assignments may be scripted
Written list of assignments
Assistive technology
Designated place for rest away from communicable disease (not in nurse's room w/ vomiting kids)
Modified Diet per physician statement

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Tracy9
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Wow, Pineapple....YOU ROCK!!!!

[woohoo]

--------------------
NO PM; CONTACT: [email protected]

13 years Lyme & Co.; Small Fiber Neuropathy; Myasthenia Gravis, Adrenal Insufficiency. On chemo for 2 1/2 years as experimental treatment for MG.

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Geneal
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Oral test taking.

Smaller assignments.

Extended school year program (if she qualifies).

Assistance with carrying books/etc.

Extended test taking time.

Extended work assignment time.

Nap daily (if in school).

I am going to think some more and see what else I can come up with. [Smile]

Good news.....finally!

Hugs,

Geneal

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hshbmom
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I want to repeat what pineapple said about your child's medical records...

I consulted an education attorney. The attorney said the school does not need access to your child's medical records. They may not be real happy about that, but that's the law.

The school may try to intimidate you into providing the medical records but they have no right to your private records.

They also do not need to know the exact medications your child is taking. As long as your child is in treatment and it's noted in the doctor's letter, the school has all it needs.

The school may ask you for a list of every medication, dose, and dose schedule, but you DO NOT have to provide that information. You may tell them your child is taking antibiotics, but you don't have to provide more information.


Pineapple, my child's 504 is for homebound. I assume the IEP will be for homebound also. Should I be concerned right now about any accommodations needed for returning to school, even if it's part time?

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hshbmom
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I want to repeat what pineapple said about your child's medical records...

I consulted an education attorney. The attorney said the school does not need access to your child's medical records. They may not be real happy about that, but that's the law.

The school may try to intimidate you into providing the medical records but they have no right to your private records.

They also do not need to know the exact medications your child is taking. As long as your child is in treatment and it's noted in the doctor's letter, the school has all it needs.

The school may ask you for a list of every medication, dose, and dose schedule, but you DO NOT have to provide that information. You may tell them your child is taking antibiotics, but you don't have to provide more information.


Pineapple, my child's 504 is for homebound. I assume the IEP will be for homebound also. Should I be concerned right now about any accommodations needed for returning to school, even if it's part time?

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hshbmom
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Hi Geneal, how do I know if they are giving my child an extended school year?

The school told me if it takes my daughter 3 years to complete this year's work, then that's how long she'll have to do the work. She'll just get an incomplete until she finishes.

They haven't mentioned providing summer service. They told me they would give it last year, but didn't do it.

They're trying to make her take an elective this semester, but she hasn't completed the basics from last semester. That doesn't seem right.

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hshbmom
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UP
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sixgoofykids
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My daughter had mostly cognitive symptoms ... her IEP allows:

More time on tests, including standardized

Modified tests (ie take out the ambiguous answer on multiple choice)

Special time with a teacher for homework help

Takes tests in another room with other kids on the program so she can ask questions about the test and take as long as she needs to complete it

These are all I can remember off the top of my head ... it took almost a whole school year to come up with the best program for her. She's doing much better now that she's been treated for Lyme. [Smile] Her Lyme treatment is over, but she still has her IEP.

--------------------
sixgoofykids.blogspot.com

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hshbmom
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The school wants to schedule an evaluation for 10:00 am.

Mornings are a very difficult time for her physically. She also had a diagnosis of fibromyalgia.

My child's 504 accommodations are supposed to state she can receive instruction at a time to benefit her the most. ...that's the afternoon for her. But one accommodation in the renewal plan specifically stated her sessions can be held in the morning or the afternoon.

Some accommodations discussed at the renewal meeting were omitted from the plan.

I brought this and a few other mistakes to the attention of the 504 coordinator. She said she corrected the mistakes. I plan to pick up the corrected accommodations before I make a decision.

I feel if I take her in the morning for just one appointment the school may continue to schedule stuff for the mornings.

The special education referral was signed Dec. 14, 2007. I haven't heard when the next meeting will be. Will the next meeting be a summary of the evaluations, or will recommendations/accommodations be offered?

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sixgoofykids
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I don't know. My daughter was referred after we moved here in January of 2006. They knew within two weeks of her starting school here that she needed an IEP. We were declined in the state of Indiana (because it was a small rural school without the resources).

The teachers took good notes and made accommodations right away, then the notes were passed onto the teachers the next year. The accommodations made for her were tweaked along the way, and when we were all comfortable with them, including my daughter, then we signed the IEP .... that was toward the end of the school year last year, so this was a year long process.

My daughter did not participate in the meetings.

This year has been a breeze ... everyone has known from the start what was expected.

--------------------
sixgoofykids.blogspot.com

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MommaK
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Hi Mom!

We didn't have to do a formal plan, the school just worked with us probably because she only had a year & 1/2 of school left.

Just wanted to say the most important thing was flexibility! With due dates, tutoring times, no deadlines! Basically they had to trust that we were working at the best pace that she could, and that it would vary greatly.

As far as summer, I think most lymies do better overall during summer. If you can't get actual tutor visits during summer (we did), then get as much work assignments in advance so you can work on them. Probably a good time for history lessons and book reports. We did most work self study, self-paced anyway. The school might like this idea, cuts back on $ for tutoring hours! It al boils down to $.

As far as summer tutors, perhaps we were lucky the usual tutors were not qualified to tutor the classes my dd needed. Luckily some teachers took on extra duties to tutor my dd, and they liked the extra income in summer.

We had to ask to be able to do one class at a time. If you are strictly homebound this can be done. It was too stressful to try to focus in more than one direction for my dd. Also be careful about the stress level school work will bring. Frustration with limitations, overexerction, ect. Stress is bad for lyme. Maybe it feeds on it!

If needed you can request audio books. Depending on your district they may have access to them. They won't offer if you don't ask. It takes time to get it set up though. Some books for reading assignments can also be found at the library in audio format. Perhaps the requirements can be adjusted to include books easily found in audio.

It is impossible for you to forsee every change than requires new accommodations. Good idea to try and anticipate them though!

Good Luck!
MommaK

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ICEiam
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Back in the days before we knew dd had Lyme and co she developed learning disabilities. Seems to me the people that did the testing would know that an 11 year old child doesn't just "develope" learning disabilities when she was an A B student up to that point.

She was diagnosed by the people through the school system with problems processing things so she was put into "special" classes in Math and Reading. She was given an IEP.

From that point on she hated school and lost all interest in going or being a part of anything to do with school. She only went because she was forced to go. She ended up quitting her Junior year and taking the test for her GED.

Thank God she had her figure skating or we wouldn't have survived those teen years. My point is.........if you have a child that has been "normal" and then you put them into special classes it makes them different.

They are taken away from the children they have gone to class with and put into "special" classes. It hurt my dd's self esteem and embarassed her horribly.

If you can get home instruction for your child that is the way I would go. These kids have enough of a battle to fight without having to go through any emotional things involved with school.

I don't know if I explained that right or not, but I hope I did. This is just my experience and my opinion. You have to do what you think is best for your child.

Hugs,

--------------------
ICEY

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pab
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My son, Jordan, has been homebound for 5 years. He has had the same teacher for all of the years. At this point, the teacher provides the curriculum.

He has an IEP under OHI.

We haven't had any problems with the school since 7th-8th grade. We fought with the school for 5 years. I contacted an education attorney (found at Wright's Law) and she said what the school was doing was illegal.

She had us contact the Dept. of Ed (which I had many times before this). The person I talked to was so mad about the way the school treated Jordan. She called the Special Ed director and told him he was wrong and we've haven't had any problems since.

The school was requesting a letter from an in-state doctor. Jordan's was seeing Dr. J at the time and they wouldn't except his letter. Minnesota law state the doctor needs to be licensed in the state he practices, not in the state we live in.

Good luck!

--------------------
Peggy

~ ~ Hope is a powerful medicine. ~ ~

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Mo
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pineapple has posted great info on chronic lyme kids. many of them (with preferably independant evaluation data) will qualify for a TBI classification (check state law, some state TBI definitions include aquired brain injury within the TBI catagory, however, federal should trump state, and it's defined under TBI federal IEP definitions as well)

this is a sore subject for our family. we worked hard to get all of the evals and documentation, TBI classification, professional consult over and above what should be needed.

what then happened, was what ICEY is referring to - psychological impact on the child for being different than they once were, only in our case it was fostered by the school that did not feel like complying with the law or the IEP.
meaning, the school used it's employees working with my son by trying to pitt him against his family and his own IEP needs..

doing things like asking him - in school, not in an IEP meeting, things like
"do you think you are really sick, or is this your mom" or "we think you are perfectly capable of doing PE class in school, don't you?" or
"your mom is advocating for things in IEP meetings that we don't think you need".

so, not only did they foster feelings of humiliation and shame in my son for being different, they caused a young boy not to trust his mom, which grew over the years and as you can imagine has effected him in deeply detrimental ways.

all of this was done despite the fact that it was not "mom" making these decisions for him, the accommodations were set due to a wide range of professional and evaluatory
information. certain administrators and staff just didn't like having to comply with the IEP, or the fact that the parents knew their role under federal law.

our school is evil beyond words, but many schools are like this when it comes to IEP's and parental involvement (which usually includes outside professionals).
the thing is - IDEA law federally mandates that parents are part of the team, and mandates that the school accept new information and outside evaluations. parents in the know will exert these rights on their kid's behalf. so some schools can and will use the children to further their own purposes. pretty rotten, but they will.
for older, confused kids, this is a particular problem.

i guess the message for the rest of you would be to be very careful of the psychological impact on your child regarding IEP needs.
make sure they have allot of suport understanding why schools will do what they do at times to save trouble and money, and make sure they understand that school staff are NOT allowed to be asking disabled children whether or not they "agree" with current IEP accommodations (this info is supposed to be confidential), certainly not speak to them outside of a professional and confidential environment in which to work with student and needs in a professional and supportive way.

what our school did hurt my son allot more than lyme ever could.

mo

[ 26. January 2008, 03:03 PM: Message edited by: Mo ]

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sixgoofykids
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I appreciate all the thoughts on this. My daughter has had trouble with learning since the beginning.

Her IEP was prior to her Lyme diagnosis, and she never had an easy time with school. She sees her IEP as a huge help because she was brought to the point of tears in class prior to having it. She also does not have any physical limitations.

She was not badly infected with Lyme, and is finished with treatment. I don't know how much she really needs her IEP anymore, but she is more comfortable having it to fall back on.

She is not in special classes, but goes to see her special teacher during everyone else's study hall or during tests. Our school system is really good about this, and no one really knows where these kids are going as the gifted students also leave. [Smile]

Some kids don't have an IEP and leave for special help in a certain class .... so at one point or another, all kids leave, pretty much. It's a good system.

All this is stuff to think about. My daughter's IEP has been a blessing.

--------------------
sixgoofykids.blogspot.com

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skigal
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This is why I'm homeschooling my dd. I'm scared for her & what the school might say to her, re: (Mo's post)

SG

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sixgoofykids
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quote:
Originally posted by skigal:
This is why I'm homeschooling my dd. I'm scared for her & what the school might say to her, re: (Mo's post)

SG

I homeschooled for 10 years until my own health would no longer allow me to. [Smile] It's a good option.

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sixgoofykids.blogspot.com

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Mo
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despite the fact that we had an army of people willing to support us and my son's needs, this kind of thing still happened.

i feel very strongly at this point that i regret ever trying in the public school system.

at the time, we thought it was best for our son to get back with his peers, and we thought it was best to stand up for all the families with IEP's by holding the school accountable to what is
FEDERAL LAW. what they do with disabled kids in many schools is just god-awful..

but now i regret ever, ever having taken this on.

now i really believe, in our case, we should have continued home instruction and used other means of community integration.

that said, some school situations can be just fine, it depends on the district and the child's particular needs/age ect.

but a considerable number of schools are woefully inept at best, downright malicious at worst.

just be careful and always have outside professional support/literature to back your concerns and requests.

mo

Posts: 8337 | From the other shore | Registered: Jul 2002  |  IP: Logged | Report this post to a Moderator
pab
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Having BTDT, I would contact an education attorney much earlier than we did.

I feel the same way as Mo about schools.

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Peggy

~ ~ Hope is a powerful medicine. ~ ~

Posts: 2775 | From MN | Registered: Apr 2001  |  IP: Logged | Report this post to a Moderator
Shosty
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I agree, get a lawyer involved. Some schools are calling child protection services in these situations, and parents can get charged with neglect.

Our school has been good, but,since we got a lawyer several years ago, things have been great.I presented the lawyer's ideas in a non-adversarial way, as "great ideas that can help us all" and, in this particular school,it worked.

It helps to think about institutional behavior/psychology. We think of the school as an organism, like a bacteria that shrinks into itself if you touch it. It will do what it has to do to protect itself, and can often appear "evil."

So, whatever you do for your child, can be more palatable to the school if you make it easier or safer for the "organism."

We don't deal with IEP's or special ed staff at all. Working with principal or dean plus nurse is easier. Pick the person in your school who is most easy to work with, and see if they can be the 504 coordinator. There are no written guidelines for 504 stuff, it is flexible.

I write my daughter's 504 myself, make copies for the small "team", we meet, and they usually sign it because I already did the work, and they don't want to deal with details anymore than anyone else. They want to get on with it.

We offer to reduce accomodations whenever possible, and my daughter also refuses them when she can. This increases credibility.

Our system is that she goes to school as much as she is able. If she goes up for one hour and then comes home, fine. Some days or weeks are okay, others not. Over the long term (many years)there have been times when she is totally out for a month, and other times when she is totally in.The school gets the message this way, that she is trying and that parents (Mom) are trying to maximize her attendance, and her normalcy.

She also gets her work done. Might be a different timetable, but it is clear she is working to her max. This hasn't always been possible (a few years ago had to use pictures of China for a segment in history, because she couldn't read). Over time, though, it is clear she hates special treatment and want to do everything rigorously (many kids with special needs have this drive to be "normal")

Yield a little so you seem reasonable, and let them figure some things out themselves. For instance, if a tutor comes at the wrong time for your child, this will become apparent to them, and they can advocate for tutoring only at the right time of day.

We parents get mad when we are not believed. But it is not personal. The school organism is protecting itself from doing things that are expensive, inconvenient, or difficult, and targeting parents' credibility is part of a survival strategy. These are bureaucrats, not sages!

Make it as easy for them as you can, show that you are not making excuses and your child is not a slacker, find allies in the system and use them, yield a little to seem reasonable, rely on experts, and expect the plan to take some time to work out.

Like everyone, we went through hell (10 years ago or so) and still have a sick kid...but the 504 is working great.In fact, I just sent an e-mail to the 504 coordinator and nurse that she is coming out for two weeks.

Our plan includes this: the nurse collects "missed work sheets" from each of her teachers at the end of the day, with what they did in class, what the homework is, grades that are missing, and so on. We collect it, and send in work done. Tests and quizzes are done at home and returned.

We have done homeschooling at times for our kids, but it is hard in high school. So, one other suggestion: go to Educere or some other online program and look at online courses. Our school accepts credits from these. Some are easy, some are AP and hard, whatever you need. The school accepts the credits, and diplomas are also available from the online program itself.
Good luck.

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