Did You See The Memo About…Interventions?

I’m starting a new series on this blog, called “Did You See The Memo?” because there are so many things I have to say in my job in urban public schools over and over and over and over and over again. And then one more time after that. And again. You get the point. Like that annoying boss in Office Space, I am that person asking if you got the memo about [insert special education referral process question] more than I would like to be. In the public schools, school psychologists are often the "gatekeepers" to special education assessments, deciding who can proceed for testing and who cannot. It is a role I hate, because all that energy could be spent on doing interventions with kids instead of fighting off inappropriate referrals. I know, I know, it's my job, but after 10 years of saying the same thing, you start to wonder if you have turned into a psych-bot-info-kiosk. It's one of the reasons I started this blog. You know, to mix it up. At times, I’ve fantasized about recording a conversation I have repeatedly, and then playing it back to people as needed instead of saying things again and again. Or, I could just type up the script and hand it over as a memo. That would create a lot of crying trees though, and like that fairy in Fern Gully, can’t you feel its pain?

The good news is (you know me, all about the silver lining) is that I’ve gotten pretty good at some of my schpeals (sp?) and I now get to share them with you. If you are a school psychologist, you will be nodding your head and saying, “YES. This sounds familiar.” If you are a teacher or parent who has been on the receiving end of this memo, know that I hate saying it as much as you hate hearing it. I get it. You want help for the student, and special education seems like a reasonable place to start. It can't start there for a number of reasons.*

The conversation that follows is one I have had 6, maybe 7,000 times, and it's time to convert it to a memo. It’s called:

“You can’t refer a child for special education without trying general education interventions first.”

How many of you have heard or given this speech?

Here’s the logic behind it. If you have a student struggling in reading, and he or she is not responding to the general education curriculum, standard teaching practices, or even extra help in the classroom, you begin to wonder why. Fair enough. I do too. Now let’s say I test this student (we’ll call her Sally), for a reading disability. Let’s say she has one. The intervention is to target her reading deficits and help her learn strategies. Let’s say Sally does not have a reading disability. The intervention is to target her reading deficits and help her learn strategies. Whoa! They’re the same. That’s right. There is no magical reading dust in special education, it is really just targeted intervention in the area of need with ongoing progress monitoring. A lot of the time, special education is basically just good teaching.

So I say, why not give Sally intervention in the first place, when she first shows signs of difficulty, way before she is so far behind that we spend 6 months in a bureaucratic-laden process to call her “disabled”? If after 6 months of intervention and good data collection, you will have a lot of information to work with if you end up doing an evaluation. But logic will get you nowhere in a school district that is under-resourced or hasn't bought into a response to intervention(RtI) framework yet.

All too frequently, special education becomes the only intervention, and that is just sad. There has to be an intervention before you can make a case that you need special intervention. Also, not all students with disabilities need special education. They may just need modifications in the general classroom. That is why I am repeatedly asking what interventions have been done in general education before I will entertain the need for a special education evaluation. I need to be convinced the problem can’t be remediated with targeted intervention in general education before I suspect a disability or a need for special education. Nevermind that you could go through the whole special education testing process and find there is no disability and that whole time you could have been doing something for the student.

Also, one of the “rule outs” of learning disability is that the problem isn’t due to other factors (second language acquisition issues, hearing or vision issues, poor instructional opportunities, poor attendance, etc). You can’t find out if the problem is truly neurological unless you rule out the environmental causes. The best way to do that is to provide the intervention and see if the student responds to it.

Now let’s make an important distinction between supports and interventions. I have sat in many student success team meetings (they are called several different names, but they are basically strategic parent-student-teacher-specialists meetings where interventions are generated for a struggling student.) At these meetings, ideas are generated about how to help students. Nine times out of ten, the “interventions” are actually supports. Here’s what I mean. Let’s play “spot the intervention” in the list below:

1) Sally will do her homework at a special desk at home
2) Sally will remain on task during silent reading
3) Mom will read with Sally 20 minutes a day
4) Mom will peak in the classroom from time to time to make sure Sally is working
5) Sally will not flirt with boys during silent reading time.

Ha! Trick question! There are no interventions in that list. There are only supports and expectations for Sally. So let’s put yourself in Sally’s shoes through an analogy. Let’s say you are in a foreign country and you are having difficulties reading in that language. Let’s say it’s Mandarin. Let’s say you get the 5 “interventions” above. Will this help your reading? Meh. Maybe? Or if you don’t know what you’re reading and you don’t have the skills, you might just sit at your special desk at home or during silent reading and just stare at the books you can't read. And as an added bonus, your mom is checking in on you and you can’t do fun stuff like interact with others. Now let’s say the intervention is a 6 week program with a Mandarin reading tutor who teaches you vocabulary, sound-symbol correspondence, Mandarin pronunciation, and does guided reading with you to give you corrective feedback. Will this help your reading? Um, I’m pretty sure it would.

The bonus is you can also do intervention PLUS supports. Just don’t leave out the intervention and then expect a school psychologist to take your referral for testing a student for a disability seriously. My eyes hurt sometimes from holding back the eye-rolling when I see only supports on pre-referral paperwork. I know the referrals come from a place of caring for the student and wanting to see progress. But let’s not be surprised when students have no intervention and do not progress. Friends, it’s not that your school psychologist doesn’t want to test the student for a disability, it’s that s/he doesn’t have any evidence that the problem can’t be remediated with a decent targeted intervention. And this is a clause that is in the law that we have to consider. It's a two part deal: 1) Have a disability, 2) Need special education. So if the students needs can be met in general education, no matter what their processing and IQ scores are, they don't qualify for special education. You can't find that out if you haven't tried targeted interventions first.

Sadly, here’s the rub. At some school sites, there are no decent targeted interventions because the school can’t afford a reading specialist or intervention specialist. Not all parents can afford outside support either. And here we have the perfect example of theory and practice being at odds. I totally get why special education is so popular as an "intervention." And I know teachers are doing their best with the resources they (don't) have. I get that they get blamed if the student is not progressing. And parents worry that their child will slip through the cracks. I'm with you. But I fear if urban public schools don't shift to RtI soon, I will have to bust out my memo for years to come. And nobody likes the person with the daily memo that says the same thing. Yeah....


*It can start there in the private sector. There is nothing stopping any interested parent from getting a private evaluation to undercover a student's learning strengths and areas of need and if there is disability causing academic or social challenges. In the public schools, its a whole another ball of legal and procedural wax. So to speak.

Special Education, IEPs, and Due Process, Oh My.

For those of you who missed it, here's my appearance on Learning and Laughter with Louise on the topic of special education. I did this radio appearance at 6:00 am on my summer break, since Louise is on east coast time. That means I had to get up at 5:30 to make a coffee the size of my head to be somewhat normal by 6am. I did it for the children.

We talked about a variety of topics, from the basics of Individual Education Plans (IEPs) to warning signs for Autism. At the end, there is a Q and A with parents who want to know if their child's behavior is typical, or a sign of a disability.

Also, may I note that I never want to hear myself laugh on the radio again, even if it is on a show called Learning and Laughter. I checked the url to make sure it was the right episode and I managed to skip right to the part where I laugh at my own joke. I die of embarrassment.

Enjoy!

Click here to download the episode onto iTunes. I tried for 2 days to embed a media player in this post so y'all could just listen here, but alas, FAIL. I guess if I were one of those fancy Web2.0 education people, I could do it. And if I even knew what Web 2.0 was, that would be even better.

IN THRPY.

I have run into this issue lately working with my teenage clients. They answer texts during therapy. Now I have to admit, I am an iPhone junky myself, so I can see the inclination. My iPhone alerts are like a baby calling. I know when my iPhone wants its mama even when it’s buried in my purse or far away in another room. *Ding!* That’s a text! Mama’s coming! While I’m being honest, I actually texted during my cardio workout the other day. So embarrassing. Why don’t I just get me a teacup poodle to put in my gym bag to complete the look? But it was important! At least I don’t have too loud conversations on public transit like the one I overhead last night: “Pookie! You know I want to see the kids, but I’m busy! Damn!” Everyone on the train knows about your marital issues. Fabulous.

So kids aren’t the only culprits.

In fact, I have had parents answer calls in the middle of presentations about whether or not their child has a disability. I have had parents check their email while their kid is telling them how they feel. A while back, I was working with a kid who did a drawing for me that was so telling. I have kids do what is called a “Kinetic Family Drawing” which is essentially a drawing of each family member doing something (to avoid the stick figure linear array and to get more at the roles the family members have). This girl, about age 12, drew a picture of her sitting on a chair in between her two parents, each with a cell phone on their ears, with a bubble coming out of their mouths saying, “Blah! Blah! Blah!” We had been talking for a while about her feelings, it was the end of the session, and I asked her, “Would you feel comfortable with me sharing this with your parents?” She said okay. I asked her, “Shall we bring them in right now?” She said, “Oooh. It’s just like Oprah. Bring them in.” Ha! I love that girl.

So what do you do when a kid is texting during treatment? I have taken several approaches. First, I think about the quality of the texting. Is it just one text and they say, “Sorry, I just have to respond to this because it’s my friend waiting for me?” Or, is it whenever we start talking about a touchy subject, the phone comes out? These are qualitatively different. I typically “notice and explore” to see if it is poor cell phone manners or a symptoms of something else (e.g. boredom, avoidance, passive aggressiveness). I say something like, “I notice when we started talking about school, you started texting. Is this an uncomfortable subject for you?” or “I notice that in the first few minutes of our session, you seem distracted with your phone. Can you tell me what that is about?” Usually, this ends up being a great starting point for other issues, such as parents trying to control them and their cell phone use, or how they get in trouble at school for their phone, or even how friends misinterpret what they text and they don’t understand why. I would have missed all that good stuff if I had been authoritarian about it, and stated “There are no cell phones during therapy.”*

Much of the time, when the phone comes out, it is just absent-minded poor cell phone etiquette.** So how do I address that? I think about what the underlying social skill violation is, and what the appropriate teaching point should be (usually, that it's rude to not pay attention to someone sitting 2 feet from you). Then, and give an “I message” to the student. As in: “I feel left out when you answer a text from your friend during session. Would you like to share what you are texting about?” Nine times out of ten, I only have to say that once, and I never see the phone again. On that tenth time, they sometimes share what the texting is about and it's a good topic to discuss in therapy. I can only hope my "I message" also planted the seed for preventing them from being that person who texts while doing cardio at the gym. Or at least that person who feels shame about it….

*In the public schools, I’m more rigid than in private practice. If there is a school-wide no cell phone rule, I give a warning and tell them the rules still apply in my office. They usually just put it away, no prob.

**In searching for a New York Times article I read a while back about how kids feel neglected by their parents because of excessive Blackberry use, I found this nice one on teaching kids cell phone etiquette. I couldn't find the original article I was looking for, so if anyone has the link, please share!