Early Intervention
what is a direct service? when is it appropriate?
"Hands-on" intervention that does not occur during actual school activities. Appropriate when student is acquiring new and specific skills in a controlled environment or when intervention cannot be executed safely or easily in a classroom setting Intervention focus is on the student; task and environment may also be addressed
How does the IDEA define the EI evaluation?
"procedures used by appropriate qualified personnel to determine a child's initial and continuing eligibility under this part, consistent with the definition of infants and toddlers with disability in Sec. 303.16 including determining the status of the child in each of the developmental areas" Summarizing the key issues and whether intervention would be appropriate. In NYC, you can recommend based on clinical opinion.
When was the EHA amended and what changes were made?
(1986). Extended special education services to children 3-6 years of age Part H-discretionary program for states to provide early intervention (EI) services for infants and toddlers 0-2 years of age and their families.
What is the mandated family involvement in EI in the EHA
- Establish outcomes for the child within the context of the family - Design strategies for intervention - Help determine the progress that their child is making.
What ages are appropriate for EI?
0-2 years
What is included under the parent's right to due process?
1. An impartial hearing, 2. Be represented by counsel, 3. A verbatim transcript of a hearing & written findings. 4. Can appeal and obtain an independent evaluation employing nondiscriminatory tests 5. Reimbursed for legal fees if they prevail Nothing can be done to the child without the express consent of the parent
What settings are included on the participation scale of the SFA?
1. Regular or special education 2. Playground or recess 3. Transportation to / from school 4. Bathroom / toileting 5. Transitions to / from class 6. Mealtime / snack time
What are the 5 program recommendations ranked from least to most restrictive?
1. Related services only 2. Special education itinerant teacher services only (SEIT) 3. Related services with SEIT 4. Special class in an integrated setting (half or full day) 5. In state residential program
What are the 6 school placement options ranked from most to least restrictive?
1. Residential setting 2. Home-based schools 3. Special schools (run year round) 4. Special classes in regular school 5. Regular classes with resource assistance 6. Regular classes in the neighborhood school with children without disabilities
What types of supports are included under the task supports scale of the SFA?
1. Supports currently provided during school related functional tasks 2. Assistance (adult) 3. Adaptations (modifications to the environment or program - specialized equipment or adapted materials)
What ages are considered preschool age?
2-4 years
How is developmental delay defined in NYS?
25% or 1.5 standard deviations delay in two or more functional areas 33% or 2.0 standard deviations delay in one functional area 12 month delay in one functional area
What is a barrier free site?
A school that has accommodations and procedures for kids with limited mobility
What is special education?
A service designed to tailor instruction differently so the child can get more out of his or her education; helps kids that learn differently
What is zero reject?
ALL children are to receive an education including children with severe & profound disabilities Prior to this, schools were only provided to those with near normal intelligence and those who met special criteria (i.e. toilet trained).
What was accomplished by the 2011 amendments to the IDEA?
Allows states more flexibility, but requires more accountability Measuring and improving outcomes to prepare children for preschool and kindergarten (more focused on younger kids after EI)
What is the process of starting EI?
Anyone can refer the child to EI. Then, an assigned service coordinator meets with family to explain process, determine which evaluations needed. The evaluation team goes to family's home, evaluates the kid and sends the eval to the family (NO JARGON). Individualized Family Service Plan (IFSP) meeting is held to determine services, goals and method & location to achieving goal. Then appropriate providers are located and services initiated. Services are authorized for six months, but IFSP can be modified AT ANY TIME! Acceptance of services is voluntary and family may revoke plan at anytime. EI is really about getting the family involved.
What are the eligibility criteria for EI?
Born low birth weight Developmental Delay Diagnosed physical or mental condition that has a high probability of resulting in developmental delay They are "at risk" of developmental delay if services are not provided.
What is the evidence for embedded intervention?
Children acquired targeted skills or made progress in each developmental area in which this approach was used. Maintenance and generalization of these skills once the intervention had ended was reported in 50% of the studies (children learn best in context)
What kids are eligible for Extended school year programming (ESY)?
Children who require structured learning environment to prevent substantial regression such that Inability to maintain developmental levels due to loss of skill or knowledge that will require significant review (> or = 8 weeks) at the beginning of the year to reestablish and maintain IEP goals previously mastered. Have to show that there would be significant regression if they had the summer off; can be for any kind of limitation.
Who is protected under 504?
Children with a Documented "physical or mental impairment that substantially limits one or more major life activities"
How are the self contained classrooms defined?
Children with special needs only defined by ration of max students:teachers:additional support three models: 12:1:4 12:1
What is CPSE?
Committee on Preschool Special Education (CPSE) Ages 3-4 (Preschool)
What is CSE?
Committee on Special Education (CSE) Ages 5-21 (Primary & Secondary School)
What is an IEP?
Comprehensive plan outlining the specific special educational & related services the child is to receive A written document for planning and decision making Every child that needs special education services should have an IEP
How are children referred to EI
Contact agency directly Call 311 ANYONE can refer a child to EI
What is the Purpose of the CPSE?
Coordinates evaluations & recommends programs & services for children with disabilities
What is a specialized school?
District 75 / Specialized school operate a full 12 months during the year These programs are available for kids what are clssified as: • Emotionally challenged • Significant cognitively delays • Autistic • Emotionally disturbed • Hearing and/or visually impaired Require higher ratios: 8:1:2 6:1:3
What is the EHA Law of 1975? What did it guarantee?
Education for All Handicapped Children's Act (EHA) Part B guaranteed the rights of all children to a free and appropriate public education (FAPE). 6-21 years of age.
What is the EHA? when was it written?
Education for all Handicapped Children Act (1975)
What is the purpose of the IDEA?
Ensures services to children with disabilities. It governs how states and public agencies provide early intervention, special education and related services to more than 6.5 million eligible infants, toddlers, children and youth with disabilities.
What is the purpose of the SFA (school function assessment)
Evaluate and monitor a student's performance of functional tasks and activities; identifies strengths and needs
What is the ESSA?
Every Student Succeeds Act Signed into law by President Obama on December 10, 2015; Addresses complaints about NCLB States given more flexibility to setting standards for measuring school and student performance.
Who has to have an IEP?
Every child receiving special education services must have an IEP
Who is eligible for EI?
Experiencing developmental delays (as defined by NYS) as determined through informed clinical opinion and standardized testing in: • Cognitive development • Physical development (inc. hearing and vision) • Communication development • Social or emotional development • Adaptive development Have a diagnosed physical or mental condition that has a high probability of resulting in developmental delay (i.e. down syndrome, CP, VLBW) New York State also provides services to children (i.e. children in domestic violence centers, shelters, prematurity etc) who are "at risk" of having substantial developmental delays if EI services are not provided
From which law did NCLB originate?
Extension of Elementary and Secondary Education Act of 1965 (ESEA)
What are the EI requirements for goal writing?
Family-focused or child-focused Written in family-friendly terms (jargon free). Any parent should be able to understand this without help from a professional
What is FERPA?
Federal law that protects the privacy of student education records Parents have: • Right to view and inspect records • Right to request that corrections be made Written permission needed to release any information from a student's record, except: • School officials • Auditors / evaluators • Financial aid department • Accrediting organizations Parents have access until years of age, until it is "transferred" to the student
What is the focus of collaborative coaching?
Focus on family priorities for child development, integrating professional opinion within the family's priorities.--> Discuss with the family potential approaches or strategies, together refine them so the final approaches and strategies are collaboratively decided (have to get the family on board)
What were the provisions of the EHA?
Free & appropriate public education (FAPE) for all children with disabilities from the age of 6 to 21 years Zero reject Least Restrictive Environment (LRE) Right to Due Process Nondiscriminatory evaluation Individualized Education Program (IEP) Parent participation Right to related services
What are the guidelines for writing IFSP Functional Outcomes and Short-term objectives (STO)?
Functional Outcomes (i.e. long-term goals) should be achieved in 6 months. Progress is rated as: no progress, little progress, moderate progress, great deal of progress, outcome achieved Short-Term Objectives (i.e. short-term goals should be achieved in less than months) Progress is rated (yes, no, emerging); no specified time frame but will have to re-eval in 3 mo
What Things were provided for kids with disability after the 1997 changes to the iDEA?
Funds for children with disabilities in private / parochial schools IEP focus on helping children with IEP's succeed in general curriculum Increased emphasis on educating children with disabilities alongside those without. Greater expectations of children with disabilities and agency accountability.
What is mainstreaming?
General term frequently used when referring to general education opportunities for children with special education needs Educational team's recommendation for a special education program as the student's primary placement & includes opportunities in the general education setting
Why is family centered care important?
Helps the family be involved enough and on board because the child is not going to get better just meeting with the PT for 2 half hour sessions per week - parent needs to be prepared to help the child for life.
What was the impact of the Willowbrook state school expose?
I was part of the impotus for a lot of the changes to special education and disability services that we have seen since.
What did EHA turn into and when?
IDEA in 1990
What were the 2 primary purposes of the amendments to the IDEA?
Improve educational results. Functional, measurable goals. Assess and ensure the effectiveness of education for children who have disabilities (i.e. evidenced based practice)
What is an IFSP?
Individualized family service plan Document outlining the child's plan for services for the next 6 months, as well as current status in the 5 developmental areas, and outlining parent concerns, daily routines, parent priorities and resources, functional outcomes. service plan, service authorization, co-visit, transportation, assistive technology and respite services, service coordination, transition plan, attestation, consent for services, and consent to release information. Legal document outlining what you get in terms of services
How is an embedded intervention implemented?
Interventionists limit changes in the way the routine activity happens, and suggest only those changes necessary for the child to successfully participate and learn (may watch the family tackle the issue and make suggestions). It is a way for the family to do interventions since they are tasks they are doing anyway. Agreed-upon developmental strategies takes into account: • strengths and needs of the child • family's routine activities • family's own cultural values
What is the definition of an embedded intervention?
Learning opportunities / intervention that occur during the child's everyday routine activities. They occur when, where, how and with who typically takes part in the activity/routine. Targeted home and community based activities that are specifically identified by family members as areas of concern
What is an LRE?
Least restrictive environment To the maximum extent appropriate, children with disabilities are educated with children who are non-disabled. when we recommend the LRE, Have to identify one level above and one below to justify which one is LRE Special classes, separate schooling, or other removal of children with disabilities from the regular education environment occurs only when the nature or severity of the disability is such that education in regular classes with the use of supplementary aids and services is not satisfactory.
How is the classification of "other health impaired" defined?
Limited strength, vitality, or alertness due to chronic or acute health problems which adversely affect their educational performance. Includes: Heart condition, tuberculosis, rheumatic fever, nephritis, asthma, sickle cell anemia, Tourette's syndrome, hemophilia, epilepsy, lead poisoning, leukemia, or diabetes
What is an integrated co-teaching class?
Looks like a gen ed class but 40% of the kids have special needs or have special supports. General education teacher and a full or part-time support of a special education teacher to assist in adapting and modifying instruction. Ensures that students master specific skills and concepts in the general education curriculum, as well as ensuring that their special education needs are being met, including meeting alternate curriculum goals" Really only for kids who don't need extensive support.
Who is eligible for school based PT services?
MUST meet one of 13 disabling classifications under IDEA Stipulations - these must all be met 1. The student's educational needs are greater than can be addressed by educational personnel in his/her educational setting 2. The services are necessary for the student to benefit from the educational program 3. Removal of these supports would negatively affect educational performance /participation to the extent that appropriate learning would not occur. The problem has to be something functional that can only be addressed by PT to allow them to participate in education.
What are the disability classifications in CPSE?
Medical dx not listed on the IEP- give the child time to develop and see what they will be like when they get in the school environment IEP will just say preschooler with a disability
What is the purpose of the CSE
Multidisciplinary team that coordinates evaluations & recommends programs & services for children with disabilities AFTER preschool
How does a child qualify for CSE services?
Must fall into one of the following categories: • Autistic • Emotionally Disturbed • Learning Disabled • Mentally Retarded • Deaf • Deaf-Blindness • Hard of hearing • Visually impaired • Orthopedically impaired • Other health impaired • Multiply handicapped • Traumatic brain injury • Speech or Language impaired NO standardized test requirements (per IDEA)
What are the parameters for a nondiscriminatory evaluation?
Must use a WIDE variety of tests and measures. No single test score is to be used to determine whether a disability exists or to determine appropriate educational placement Chose a tool with high reliability and validity. In addition, selection of a tool whose standardization sample is appropriate for the child student's Age, Language, and Culture
Where does EI take place?
Natural environment: "A variety of settings where children live, learn, and play" Not just physical environment, includes people and relationships, activities and routines and learning opportunities Want these kids to be interacting or be amongst peers.
What is NCLB?
No child left behind Standards-based education reform. States that high standard and the establishment of measurable goals leads to improvement in educational outcomes; funding is based on school outcomes Problem: too much emphasis on testing and not enough emphasis on real life skills.
What are regional/community schools?
Open 10 mo per year, and have lots of different options of classroom environments
What are the key characteristics of family centered care that promote positive outcomes?
Parent - child focused interactions better than just child focused Interventions focused on everyday experiences improve skill acquisition more than general Parent education critical (greatest impact noted in impoverished families) Training on parenting and family support decreases parenting stress
What are the 3 scales included in the SFA?
Participation, task supports, and activity performance
What is the multidisciplinary team model?
Professionals work independently, but recognize and value contributions of other team members. The role of each team member is strictly defined. Professionals provide separate: evaluations, discipline specific goals for the child, and implement individual intervention plans. (might be a lot for the family to take in) The team members communicate less frequently and formally. (typical in the hospital and educational environment)
What is the definition of family centered care?
Recognizes that each family is unique that the family is the constant in the child's life and that they are the experts on the child's abilities and needs The family works with service providers to make informed decisions about the services and support the child and family receive.
What is full inclusion?
Refers to a program that is primarily general education with special education resources & supports provided as needed. No more than 12 kids/instructor
What is the least restrictive type of educational setting?
Regular classes in the neighborhood school with children without disabilities
What was required by the 1991 Amendment to the IDEA?
Required states to implement policies and procedures needed to transition from EI to Part B programs
What are the 3 major themes of family centered care?
Respect for children and families Acknowledgment of the family's impact on the well being of a child Family - professional collaboration
What 4 areas are addressed in school based PT?
School mobility - Student's ability to access various areas of the school via walking, using a wheelchair or by other means of mobility Classroom activities- Function related to participating physically and maneuvering within the classroom environment Accessing (and participating in) Lunchroom, playground, bathroom, transportation, etc. Transitioning from school to post school activities
What is section 504?
Serves kids who may not have an IEP but still need accommodations and modifications; may not have a full complement of services Less stringent guidelines to qualify than IDEA but kids aren't protected as well so kids tend to get a full IEP because that is a legal document that the state has to be observant of
What are the "related services"?
Services required to assist a handicapped child to benefit from special education • Transportation • Speech pathology • Audiology • Psychological services • Physical therapy • Occupational therapy • Recreation • Medical services • Counseling
Who is eligible for CPSE?
Signicant delay or disability in one or more functional areas: Cognitive, language / communication, adaptive, social- emotional, motor • 12 month delay in one or more functional area(s) • 33% delay in one functional area or 25% in two or more functional areas • 2.0 standard deviations below in one functional area or 1.5 standard deviations below in two or more functional areas
What activities are included in the activity performance scale of the SFA?
Student's performance of specific school related activities: • Moving around the classroom and the school • Using school materials • Interacting with others • Following school rules • Communicating needs
How are school based PT services initiated?
Teacher, parent/guardian or other involved person can request the school to consider an evaluation. The IEP Team determines need and mandate for school based physical therapy services (not physician). Therapy addresses the student's ability to access the curriculum and participate in school related functional tasks (not impairments/age matched norms).
What is the transdisciplinary team model?
Team members provide joint evaluations & work together to develop goals & carry out interventions. A primary provider, the professional that the family interacts with on a regular basis, is assigned based on the child's and family's current needs & concerns This assignment can vary as needs & concerns change. This provider implements the intervention plan & consults with other providers, with co-visits scheduled as needed. The amount of consultation is based on the child's family's need & the primary provider's knowledge base Professionals practice "role-release" by sharing aspects of their discipline & learning aspects of other team members' disciplines Team members strive to communicate, collaborate, and cross disciplinary boundaries. - best when team members know each other well.
Who is a part of the IEP team?
The IEP team is multidisciplinary and includes the parent (or family), student, and (when indicated) the physical therapist; they are the people who are involved in the educational setting
What is the role of the IEP team?
The team identifies the student's needs and sets measurable goals. The team identifies the resources, including physical therapy, needed to meet a goal. The team determines the frequency and duration, location, and specific criteria of all services, including the physical therapy service
What is the interdisciplinary team model?
The team members interact somewhat for the evaluation, assessment, and development of the intervention plan. Role definitions are relaxed but not a total role release. Communication among team members emphasized. Goals are developed by the team - IDEA says it should be a team based goal that encompasses all the areas. Intervention services are typically provided individually by each discipline. However, providers co-visits or group interventions to facilitate coordination and communication among team members are scheduled.
According to the collaborative coaching model, how should the therapist include the parent during the intervention?
Therapist should Interact with the child for the explicit purpose of demonstrating to the family how to use a strategy, by explaining to the family the steps of the strategy and the child's response. Have the family practice the strategies during the visit so both family and professional know the family can and will use them in between visits. To do this, family and professional(s) provide feedback and their thoughts about the potential and strategies
Where are services provided in school based PT?
Therapy is integrated and provided in the student's natural environment (e.g. classroom, lunchroom, stairs, hallways, playground, work-study sites or other instructional settings)
What was the key provision of the IDEA?
To ensure that children with disabilities receive a free and appropriate public education (FAPE) in the least restrictive environment (LRE)
What is the model for PT services in the school based setting?
Top down - participation focused (have to justify why they need PT in that environment) PT has to look at: • Activities (functional limitations) • Body Structure & Function • Environmental Factors, Demands & Expectations • Personal Factors
How is the classification of "multiply handicapped" defined?
Two or more disabilities that result in multisensory or motor deficiencies & developmental lags in the cognitive, affective, or psychomotor areas
What law is section 504 covered under? From which act did it originate?
Under the ADA originated as part ot the Rehabilitation act of 1973
What is the positive outcome of embedded intervention for the parent?
We are providing interventions that help them feel successful as a parent which is empowering for them and helps with compliance.
What new roles does a parent have to step into when they have a child with a disability?
advocacy, negotiation, collaboration, coordination & intervention
Is the SFA norm or criterion referenced?
criterion
What service delivery methods are included in school based PT?
direct, integrated & consultative
What is considered best practice in delivering health care to kids?
family centered care
What is FAPE?
free and appropriate public education
To who were services extended when the EHA was reauthorized in 1986?
infants, toddlers, and preschoolers
What ages can be assessed using the SFA?
kindergarten to 6th grade
What is the most restrictive type of educational setting?
residential setting - Kids live and go to school there; kids with a lot of management needs or on the autism spectrum
What 18 services are provided by EI?
• Assistive technology • Audiology • Family training • Parent support group • Counseling • Health services • Medical services (for diagnostic and evaluation) • Nursing • Nutrition • Occupational therapy • Physical therapy • Psychological services • Service coordination • Social work • Special instruction • Speech and language pathology • Transportation • Vision services • Respite services
What disabilities are included under CPSE?
• Autism • Deafness • Orthopedic impairment • Traumatic brain injury • Deaf-blindness • Hearing impairment • Visual impairment, including blindness • Other health impairment
What are the 4 things PTs are responsible for in the educational environment?
• Compensation • Remediation • Prevention • Adaptations Our role is to make sure that the child is getting an education so we have to do things that aren't necessarily a direct service
What is the role of the parents in he IEP process?
• Parents are considered major decision-makers in the development of the IEP • Give permission for the evaluation • Restrict the release of information • Access to their child's records • Request due process hearing
What 12 things are included in the IEP?
• Present levels of performance, individual academic / educational needs of the child, learning characteristics • Social development • Physical development • Management needs, including affect of disability on participation • Classification of disability • Measurable goals / objectives • Special education program and / or services, including frequency, duration, location and date services commence • Supplementary aids and services • Participation with non-disabled peers • How progress reported to parents • Need for assistive technology • Program recommendation
What is the IEP process?
• Referral (need parent permission) • Evaluation • Eligibility • Individual Plan (with goals) • Service (what & where)
