Upcoming IEP meeting- need help/ questions

[waverly]

DS is currently receiving 30 minutes of speech Mon and Fri and consultation time for speech.
He has a hearing itinerant teacher and is meeting with her 20 minutes every 2 weeks. And an FM system daily. And annual audiology appointment. 

Not part of his IEP, but we keep asking about OT and OT refuses services, but OT did suggest that the teacher work on a behavior chart for DS to slow down with his work and writing.  If that doesn't help the teacher said the OT might consider an eval.  However, we had a private eval done last year, and they refused services.  So they should have that eval on file still, and speech had told me they do evals every 3 years.  So she might not do one anyway, and my expectation is no services because they had refused the last 2 years.  They feel he is on the low side of the normal range, but it does look like with this OT behavior chart that they are doing an informal response to intervention.  I don't know if that means he has dropped below a certain level?  Last year in February I was assured handwriting did not matter as it was first grade.  I asked about second grade, but no one said anything.  

The speech teacher just emailed me and said his articulation sounds good, and she wants to drop speech but keep the consultation.  Speech is really not a big concern of mine, I think last year they mostly just worked on the letter V.  Do you think that it is appropriate to drop it?  He sounds OK to me.  I mean he could talk louder and clearer when reading aloud, but I think that is a kid thing and not related to hearing loss or speech.  I understand 98% of what he is saying, and I myself have some old age mild heredity hearing loss (I am not that old).  

Do you think anything else might come up in the meeting?  I mean I am sure it is hard to tell but based on previous experience?  Would they drop speech to add OT, or are they still going to stand firm on the OT no?  I guess stand firm since she did the informal response to intervention.  Did she start the response to intervention now so she would have a couple of weeks in before the IEP to see if they would offer it or not?

Would they drop the IEP and convert it to a 504 if speech is dropped or no because she is still consulting?  

ETA- would it be appropriate to continue asking about OT since to me that is at the point more needed than Speech.  However, I understand their bar to treat in education is very low for OT, so he would likely not qualify, but it definitely appears to me to be affecting his work.  

I need a magic mind reading ball. 

[funchicken]

What did the private OT eval say? Are you only concerned about handwriting or do you have additional concerns? Does he have low tone or issues with motor planning or bilateral coordination that might put him at greater risk of injury on the playground or during PE? I know someone who was able to argue for it from that standpoint.

Several years ago, when I tried to get OT services for DD1, our school told me that they don't offer OT in isolation and that it needs to be part of a larger developmental profile. Every school system is different though, so it's worth bringing up again in the meeting.

[waverly]

Private OT had a list of concerns. He does have low tone and motor planning issues and bilateral coordination issues, but it does not put him at greater risk of injury on the playground as they are on the mild side.

Hmm no one mentioned a larger developmental profile, just that their criteria is higher in education than private practice. I am not sure it is worth pursuing psych testing to try to tease out something just to try to get something I might not get anyway.

In my gut, I think OT is trying to again not serve him. And DS said with the behavior chart he was close to earning his prize so it must be working, which means they probably won't offer it since the intervention is working.

So I guess my main question is does dropping speech change it from an IEP to a 504? Should I ask the speech teacher or would only the case manager know?

DS is a bit young, but I wanted his input, and he agreed that he could drop speech. I asked about OT and he did not seem to think he needed it, but I still think he does, so we disagree there, but it is likely a moot point for public, and I won't do private again unless I really see a large need due to driving time, money, having to take off work early, and him missing instruction time.

[funchicken]

Are they going to start teaching cursive in second? Will he need to continue having support like the intervention the teacher is doing now in order to continue to make progress in line with his peers? If the intervention is working, I would want it formalized in the IEP so they can track his progress. The same goes for the speech consult--does the SLP have a goal in mind with the weekly consults?

I think I would think about it in terms of where will he need to be with his fine motor/writing skills and speech to be ready for third grade? I would think of that as the goal and consider what interventions you need in place in order for him to meet the goal. He might not need pullouts anymore but that doesn't mean he no longer needs an IEP.

[waverly]

Yes the speech teacher mentioned formalizing the consultation in the IEP. Good point to formalize the intervention the teacher is doing! This is why I ask.

Yeah that's why when they said he was fine for first I said, but what about second to which they had no answer. So Yeah progress towards third another good point.

[funchicken]

I'm glad that helped As he gets older he'll start doing oral presentations, so you might want to consider whether he'll need individualized support for that at some point, too. Our school does a lot of project-based learning, so the kids are frequently giving presentations and oral reports.

[auntie]

Aug 31, 2018 8:55:13 GMT -5 waverly said:

Private OT had a list of concerns. He does have low tone and motor planning issues and bilateral coordination issues, but it does not put him at greater risk of injury on the playground as they are on the mild side.

Hmm no one mentioned a larger developmental profile, just that their criteria is higher in education than private practice. I am not sure it is worth pursuing psych testing to try to tease out something just to try to get something I might not get anyway.

In my gut, I think OT is trying to again not serve him. And DS said with the behavior chart he was close to earning his prize so it must be working, which means they probably won't offer it since the intervention is working.


The bar for educational impact is pretty high. DS has never had OT in school. He has hypotonia, ASD and specific LD; fine motor is good although crossing the midline was emerging at that age. Graphomotor was emerging but not incredibly worse than same aged peers. Handwriting is no longer the "Big thing" it was when you were a kid. Schools will not be excited about this and if he continues to "struggle" he'll be offered assistive technology rather than weekly OT sessions. 



So I guess my main question is does dropping speech change it from an IEP to a 504? Should I ask the speech teacher or would only the case manager know?


Not necessarily. Generally, you can keep an IEP with certain classifications, especially if there is extra cost involved like itinerant support for teachers or training. An IEP offers certain legal protections you might want going forward- easier to re-open than re-create should he need help later.  DS had an IEP through graduation although he had no actual services after middle school. I wanted certain protections vis a vis discipline and also the ability to have teachers "trained" if I had an issue with them. It suited the school because AYP on high stakes testing is a challenge for students with IEPs in secondary. DS tested well enough to boost their performance for this population. 

DS is a bit young, but I wanted his input, and he agreed that he could drop speech. I asked about OT and he did not seem to think he needed it, but I still think he does, so we disagree there, but it is likely a moot point for public, and I won't do private again unless I really see a large need due to driving time, money, having to take off work early, and him missing instruction time.


YMMV, I find DS was always willing to drop services because he didn't like people who make him work hard at stuff he doesn't easily do well and he didn't like leaving class for services. We talked about his IEP and he participated at IEP meetings from about 6th grade, and I would consider his thoughts, but I made the call. DS always thought he didn't need his psychologist and probably loathes him today, but it's why he's employed and a college graduate. 

[waverly]

Thanks for the info auntie. I asked the speech teacher, and she agreed that it would remain an IEP. Good to know I can keep that without services. He would likely need audiology for the duration even if he eventually drops FM system and hearing itinerant.

Also good to know that they really don’t care about handwriting and would just have him start typing which is kind of the opposite of what I want for him for now because I think he needs practice to get stronger in the hands.

I was just curious what DS would say but I would definitely make all the calls.

Would you go back to private OT just for handwriting? I mean he has other things to work on but they were much improved after he was discharged.

[auntie]

Aug 31, 2018 20:35:26 GMT -5 waverly said:

I asked the speech teacher, and she agreed that it would remain an IEP. Good to know I can keep that without services. He would likely need audiology for the duration even if he eventually drops FM system and hearing itinerant.


That's good. An IEP is legally binding; a section 504 is less so. 

Also good to know that they really don’t care about handwriting and would just have him start typing which is kind of the opposite of what I want for him for now because I think he needs practice to get stronger in the hands.


It's not so much that they don't care. It's more that it is not a "subject" as it was when we were kids. Now it's more a skill that's introduced in the primary grades with minimal focus on practice. By 3rd grade, most public schools don't spend any time on penmanship. 

I was just curious what DS would say but I would definitely make all the calls.

Would you go back to private OT just for handwriting? I mean he has other things to work on but they were much improved after he was discharged.


That depends on how important it is to you and whether the time invested in this would lead him to become resistant to other kinds of therapy that might be needed. 


There are certainly more amusing ways to work on hand strength. Tone is tone- it is neurologically set. Often kids who have hypotonia in their fingers also have it in their core which makes sitting at a desk fatiguing for them. Sometimes, you need to build strength and stamina in the core area before you can focus on the fingers and see improvement.


You can improve strength and dexterity in ways that are a lot more amusing than handwriting drills. Playing with clay, drawing, practicing letter formation with a stick in wet sand at the beach, sidewalk chalk, playing with toys that have itty pieces

DS's Handwriting Journey

DS attended a small private lab school from the end on 1st until the start of 4th. They taught using a multisensory OG approach with a lot of focus on handwriting drills as they support auditory training and the directionality of written English. They started the day with a 15 minute directionality sheet (circles and lines) to "wake up one's ears and hands". Every student and teacher- from the littles in DS's class to the post-grad students preparing for grad school- which they traced and colored according to instructions given orally. They also spend 30 minutes as their second period of the day doing formal handwriting drills that focused on letter sounds and directionality. DS's handwriting really improved with this, and after 2 1/2 years it was "acceptable" but within months he reverted to all his old bad habits- forming letters from the bottoms up and general sloppiness.


His public school did not teach handwriting past 3rd grade. His handwriting looked pretty awful but it was readable and he could keep up when taking notes which is kind of the point. By high school his writing started to look a bit better and TBH, after working with hundreds of scouts, his was far from the worst I've seen. I also noticed that there was no real correlation between pretty handwriting and intelligence or success in school. 


My advice, if you really want to do this would be to pick up a Handwriting Without Tears workbook and spend time at home with it. Maybe 10 minutes a day in addition to encouraging the kind of play that strengthens his hands and core and relies on hand to eye coordination. 

[pipsqueak]

I was reading a post in a Down Syndrome specific FB group and one of the moms commented that even though they've gone to having her child using electronic devices to replace handwriting, they have the child using a stylus to type with. The stylus is helping the child develop the hand muscles needed to grip a pencil while helping to eliminate "fat finger typos".

I never would have thought of using a stylus that way myself so I did find that intriguing.

[waverly]

Update:

I could tell they really didn't want to talk about OT. However since the teacher brought it up that she thought he could benefit, I did ask about it and the teacher and I shared that handwriting and rushing is a concern. I told them about his strength issues, and the VP also said his mind is going so fast, he wants to do everything fast so he wanted to blame it all on that.

There are likely multiple causes, but I am not ruling out strength and motor planning, but he is having zero problems with academics, so there would be nothing they could do because there is no educational problems.  They pulled out his test scores for that, which I knew them anyway.  

So it seemed that they were going to stick with the behavior chart, and the VP gave the teacher a tip to stop him at intervals because the teacher is having him re-do his messy work, so might as well stop him earlier so he has less to re-do. If someone is sitting right there and insisting and motivating then he will do it not as messy.

This is all how I guessed it would go. However, the teacher also had to understand why they wouldn't give it to him because she thought they should. It was nice to have a teacher that agreed with me because last year the had talked to the teacher before and said we can't do OT, so she adjusted her answers accordingly, so that was disappointing. But this year the teacher came in with the attitude of he can benefit from OT and with the higher expectations of 2nd grade.  So it is nice that I am not the only one seeing these things since both K and 2nd grade teacher saw it as well.  And 1st grade teacher admitted the Physical therapy was helpful, but just said she didn't care about handwriting in 1st. 


The counselor said that it would be a 504 since everything in the IEP is under hearing loss, if they did do OT, which I know that they won't do anyway, but it was good that she explained the process to me since I would have thought it would all go under an IEP.

I have a couple of action items like resuming his eye exercises and scheduling his audiology appointment. Overall it went well. And they complimented me which I guess is nice, but I don't parent for compliments just do what I think is best, so is a bit awkward for me. 

I am still on the fence on private OT... I mean if the teacher thinks he could benefit, and I think there is still more to work on with walking, his wrists, and hands, motor planning, crossing the midline (opposite arm/ leg movements etc) and the writing.  Also I reached out to a clinic that does bike riding, but I would need a prescription and since summer is over with I might do OT now and table the bike riding maybe until next summer or maybe do the I can ride bike camp.  Although maybe he is done with his OT credits through insurance for this year anyway, not sure if they start over next year.  

[waverly]

auntie- thanks for the rec on handwriting without tears. Between that and the behavior chart they have at school for him to slow down and try hard on writing I can now actually read his writing which was the point I was trying to get to. I had to sign his planner but couldn’t read what he wrote in his planner and his teacher was having similar issues. Curriculum wise there is not much in forming letters anymore. It’s more content, so it’s not really otherwise covered in the classroom.