Post by stephm0188 on Apr 21, 2014 13:08:10 GMT -5
My kid has diagnosed hypotonia (low muscle tone) tibial torsion, and femoral anteversion. Hypotonia is affecting him all over, from speech to fine motor to gross motor, and the last two impede his ability to run and move as fluidly as other peers his age.
He's currently in kindergarten this year and received services for speech, OT, PT, and adapted PE. Because the school is all on one level and he doesn't have a need that would impact his performance at school, PT is being dropped from his IEP for next year. That's fine.
I had a voice mail this morning regarding adapted PE. They want to discontinue this service as well, but continue to monitor him over the course of the school year with plans to reintroduce this service if needed. So adapted PE is missing from his IEP. I'm not comfortable with a verbal "we'll watch and see what happens." What do I need to ask for to get this documented?
You could even ask to schedule a conference now to reevaluate, say, 6 weeks into the new school year? I'm not sure if this is possible but might not hurt to ask.
Just for my own curiosity, are you okay with them removing this service for now?
I would want criteria specified in the IEP regarding what triggers the adapted PE being reinstated or not as the case may be, what expectations are for him in regular PE, and also periodic "checkpoints" so that he doesn't spend the whole year needing the adapted PE and not getting it. I would also want to know what factored into the decision to discontinue it for next year in the first place.
Post by UMaineTeach on Apr 21, 2014 13:17:15 GMT -5
In my limited experience, I have not seen great gains come out of APE, even with fantastic PE teachers. So I don't think it's a huge loss - but I would make sure that the monitor status is documented somewhere.
I would be much more concerned about the loss of PT. Did they give you things to do at home to continue treatment?
It could be how I'm reading it, but it doesn't seem as if you are comfortable dropping adapted PE. In which case, I would fight it. If you are comfortable dropping it can you still include in his IEP that he needs to be able to do x, y & z (skipping, galloping, whatever it is that kids do in PE) by December? Then you can address either the need for PT or adapted PE again.
Post by stephm0188 on Apr 21, 2014 13:41:28 GMT -5
I have not seen an exit eval or transition documentation yet, but I will ask.
I'm not thrilled about PT being dropped, but can't really fight it. The building is all one level with no steps or steep ramps. The bathrooms don't have doors (aside from stall doors), and all other doors are motion activated, so he is able to independently move around the building. His PT needs don't impact his ability to perform at school, so they're not obligated to provide that service.
I just don't want anything wishy washy. Either he needs APE or he doesn't. If so, it needs to be on his IEP with measurable goals. If not, then there needs to be documentation showing why. I don't like the verbal "let's see what happens" with nothing in writing to back it up.
If they are discontinuing services/ exiting him from a program, there should be some sort of evaluation by the service provider, with details on the transition process. The results should be presented at an IEP meeting. At the meeting, you can request more details on how progress will be monitored to ensure that it's more than just watch ans see. I mean, what specifically are they looking to see? Who is responsible for tracking? Who is responsible for communicating to the parent, and at what frequency?
Exactly this. If they are dropping a service there needs to be an eval to back it up. My school district did service plans for cases like this where goals and objectives were delineated over the span of 8 weeks, and data was collected. Then the team met after 8 weeks to review data and make sure the decision was the best for the child. There was also a clear if...then statement. If "Joey" (insert clearly definable decline) for a period of 4 weeks, the team will re meet to reevaluate needs.
If they are discontinuing services/ exiting him from a program, there should be some sort of evaluation by the service provider, with details on the transition process. The results should be presented at an IEP meeting. At the meeting, you can request more details on how progress will be monitored to ensure that it's more than just watch ans see. I mean, what specifically are they looking to see? Who is responsible for tracking? Who is responsible for communicating to the parent, and at what frequency?
I always ditto Kirkette if she gets to an IEP question before me.
In my limited experience, I have not seen great gains come out of APE, even with fantastic PE teachers. So I don't think it's a huge loss - but I would make sure that the monitor status is documented somewhere.
I would be much more concerned about the loss of PT. Did they give you things to do at home to continue treatment?
APE is a great concept, but the reality of delivery is an additional pull-out of the classroom which means missed instructional time and the potential for your child becoming a guest in the classroom. In my district at the elementary level, PE s taken with the homeroom class and APE is an additional period.
I'd be more inclined to do this during the summer and privately. DS attended a camp that had a couple APE instructors who taught zero order sports skills like batting, soccer, basketball, swimming and riding a bike.
PT would be dropped if he's met goals and is "caught up". If you don't feel he is truly caught up, can you come up with an educational need that would only be served by PT?
In my limited experience, I have not seen great gains come out of APE, even with fantastic PE teachers. So I don't think it's a huge loss - but I would make sure that the monitor status is documented somewhere.
I would be much more concerned about the loss of PT. Did they give you things to do at home to continue treatment?
APE is a great concept, but the reality of delivery is an additional pull-out of the classroom which means missed instructional time and the potential for your child becoming a guest in the classroom. In my district at the elementary level, PE s taken with the homeroom class and APE is an additional period.
we do this as well. We try to schedule the APE for 15 minutes before the class has PE, but that doesn't always work.
I did sub in one school that had the entire (mostly) self-contained class have APE together with 1:1s. That was...interesting.
504s offer accommodations only, no services. So her child would get no speech or OT at all- and being orthopedically impaired, that would be an issue. Also wouldn't get adaptive tech or other school provided devices.
I agree with Kirkette too - what is the data that shows that your child is ready to exit adaptive PE? A lot of times, adaptive PE is as much about having a kid do what he/she can do, and not feeling as different.
In my school (middle school), adaptive PE students don't dress, out, where regular do. So if this is going to be an issue going forward, it's something else to think about.
In my limited experience, I have not seen great gains come out of APE, even with fantastic PE teachers. So I don't think it's a huge loss - but I would make sure that the monitor status is documented somewhere.
I would be much more concerned about the loss of PT. Did they give you things to do at home to continue treatment?
APE is a great concept, but the reality of delivery is an additional pull-out of the classroom which means missed instructional time and the potential for your child becoming a guest in the classroom. In my district at the elementary level, PE s taken with the homeroom class and APE is an additional period.
I'd be more inclined to do this during the summer and privately. DS attended a camp that had a couple APE instructors who taught zero order sports skills like batting, soccer, basketball, swimming and riding a bike.
PT would be dropped if he's met goals and is "caught up". If you don't feel he is truly caught up, can you come up with an educational need that would only be served by PT?
I can talk to our ortho and see if she can come up with something.
He's a bit of a mixed bag. He can hit a baseball further than any other kid on his team, he can play soccer well, ect. He's good at sports because he works hard to be good at sports, and they see that when they work with him at school. He can throw and catch a ball with them because he practices it for hours on end at home. He is a people pleaser, and if his PT wants him to be able to stand on one foot for 30 seconds, he'll practice it over and over at home until he can do it because he wants to make her happy.
But the other stuff? He can't jump rope. He can't skip. The poor kid has had to repeat the same level in swimming lessons for nearly a year now and is no closer to passing than he was the first time he tried. He can't ride a bike or cross the monkey bars or do a sit up.
I've not seen the data yet, but I will request it before signing the final copy of his IEP.
From my experience (2 kids who have/had IEPs) kids have to meet a certain criteria in order to receive services, or they will try to age them out. My son was aged out even though he has some issues, it doesn't hinder his learning. I assume if they are trying to drop the services he might not meet them in their eyes. I would see if they have done paperwork with new findings. I know when my son aged out, he was evaluated by multiple people along with myself and I signed paperwork to discontinue the IEP. I would check to see if there is documentation from the PE teacher. I would continue parent teacher conferences with the PE teacher or emails. Get a feel to see how he is doing next year and if you feel like he needs adaptive, you can always request another evaluation. Good Luck
Post by hopecounts on Apr 21, 2014 21:06:20 GMT -5
It sounds like he still needs PT so I would finagle a legit reason and fight it's removal. Maybe even push for an OT eval since as auntie mentioned it sounds like he struggles with crossing the midline and OT can help with that too. Basically you need to brainstorm and write down every way his issues affect him and find any that affect him at school and make that part of his IEP to get him his PT.
Is he on spectrum? The unique set of skills you mention are things that require crossing the midline which is an ASD glitch.
He is not. We've had extensive testing done over the last year, and ASD was ruled out. He does have issues with crossing the midline, which is one of the things that led us to a pediatric neurologist. He couldn't find anything either. It's been a frustrating couple of years.
Post by UMaineTeach on Apr 21, 2014 21:26:59 GMT -5
Do some research about how crossing midline effects literacy skills. I have to go to bed now or I would. I have been doing a lot of work this year using parts of Brain Gym (cross crawls and lazy 8's) and we have a consultant working with us who insists these skill are critical, but I haven't actually read the articles, I just followed her directions. If you can find compelling information about crossing midline and reading they might continue services.
You might also look at his eye tracking, that is linked to reading success too. google things like visual tracking/visual pursuit
Post by cinderbella on Apr 21, 2014 21:40:51 GMT -5
I have absolutely nothing to add regarding the IEP but my DD also has tibial torsion (along with severe knock knees) and is actually having corrective surgery on June 3rd. She's in first grade and struggles so much with running and tripping - are there any corrective procedures you would consider?
I have absolutely nothing to add regarding the IEP but my DD also has tibial torsion (along with severe knock knees) and is actually having corrective surgery on June 3rd. She's in first grade and struggles so much with running and tripping - are there any corrective procedures you would consider?
Most of the time, the body is supposed to self correct it and the degree of rotation will decrease. His ortho won't consider anything until age 8, minimum. We've not noticed any rotation yet, but he's compensated for it by adjusting his gait. He fell a lot more when he was younger. That's how he lost his first two teeth :\
Post by cinderbella on Apr 21, 2014 22:08:06 GMT -5
Poor little bug. I have had the hardest time finding parents with similar experiences - that's the only reason I asked. We literally scheduled the surgery today and while I am confident in the decision, it's still a hard pill to swallow. I hope your little guy continues to thrive and get stronger
Post by cinderbella on Apr 21, 2014 22:13:18 GMT -5
Thanks! She's been followed by ortho for about a year and I knew back then that surgery was inevitable. I even had a Shriner pulll me aside at the grocery store to tell me that he raises money to fix kids like her
I am dreading the recovery but selfishly looking forward to a few weeks off with my girls!
Do some research about how crossing midline effects literacy skills. I have to go to bed now or I would. I have been doing a lot of work this year using parts of Brain Gym (cross crawls and lazy 8's) and we have a consultant working with us who insists these skill are critical, but I haven't actually read the articles, I just followed her directions. If you can find compelling information about crossing midline and reading they might continue services.
You might also look at his eye tracking, that is linked to reading success too. google things like visual tracking/visual pursuit
DS has dyslexia in addition to his other gifts- Aspergers, ADHD and GAD. When he was at the special reading school, Brain Gym was something other parents riffed on along with Irlen Lenses and the various listening programs with the clever names (Earobics, FastForWord, The Listening Program, etc). A lot of parents were pretty bitter about these as being woo rather than effective multisensory instruction. To a person, they wish they'd sucked up the $25K a year tuition and started with Orton-Gillingham or Lindamood Bell insted of wasting time and money on these other programs. IME, one of these two programs are the way to go- Orton took DS from a non-reader at 8 to reading on grade level in under 2 years. The foundation he got had him reading college level non-fiction in middle school.
DS main issue was phonemic awareness; tracking was almost a non-issue. Everyone (teachers, head mistress and even the custodian) at his reading school did a daily directionality exercise that incorporated auditory processing skills. Crossing the midline came later for DS, but it wasn't the bigger issue.
The APE thing is sort of weird. In DS's elementary the kids in the self contained classrooms are assigned a mainstream class as their "home room". They attend specials (including gym), assemblies and snack as part of that class. In some cases this makes absolute zero sense- there was a young girl with a degenerative condition who used a wheel chair, was tube fed, on oxygen and appeared asleep much of the time, they'd park her on the sidelines of some game where balls and students would crash into her. I can appreciate that this allowed the IEP team to include this abuse as tie spent in the mainstream, but it was ugly to watch.
@stephmom 0188 You should have the results of any testing done to exit him from PT well ahead of the IEP meeting. Ideally, the meeting is where the IEP is written rather than just presented to the parent as a fait accompli. It's great that he has the rudimentaary sports skills- socially that's important. And it's also great that his building is ADA compliant.
Does his hypotonia impact his stamina in school? I could see where this could be leveraged for PT, especially if he has difficulty remaining seated for classwork because of issues ins his core.
How are his fine motor skills? My son's are terrible. He received OT and they added on PT this year because a lot of his issues stem from core weakness. You need strong gross motors to help your fine motors. This could be something you look into. Hes in first grade and gets OY twice a week and PT once. I would fight to keep it going.
Post by justkeepswimming on Apr 22, 2014 6:22:02 GMT -5
I would be way more concerned with dropping PT then the APE. It sounds like he could probably participate in regular gym class for the most part. PT could be working on those other skills (jumping rope etc.). Also, I call BS on the schools part about him not needing PT anymore because he can move around the building. Eventually he will be somewhere with stairs or ramps, and it is the schools job to prepare him for the future as well. Can he get on and off of the regular school bus? That's a major PT goal at my school.
I would be way more concerned with dropping PT then the APE. It sounds like he could probably participate in regular gym class for the most part. PT could be working on those other skills (jumping rope etc.). Also, I call BS on the schools part about him not needing PT anymore because he can move around the building. Eventually he will be somewhere with stairs or ramps, and it is the schools job to prepare him for the future as well. Can he get on and off of the regular school bus? That's a major PT goal at my school.
One of my 8 year olds has hips that go out more than they should, tibial tortions, and has broken his feet three times, leg once, and arm once. He was dropped from school based PT because he can get around the school functionally. We do private PT in the summer. We see a physiatrist. Have you used one of them? My guy does chipmunks in his high tops to help with ankle support.