Episode 11- What do I ask for at the IEP (Setting Parent IEP Priorities)
"What do I ask for?" You know you are supposed to advocate for your child in the IEP, but HOW are you supposed to know WHAT to ask for? Learn the 4-step process to gaining insight on what your priorities are, how to communicate them, and who the service providers are.
DON’T FORGET! Registration is OPEN for Parent IEP Priority Workshops! Head to facebook to register for this 2-hour workshop where we will go through the process of setting your priorities for the next IEP year! You don’t want to miss it! Head to www.facebook.com/parentfriendlyOT and sign up right from Facebook! Space is limited to just 10 people in each workshop, so snag your spot QUICK! See you there!
This is one of those smaller-topic podcasts, but it’s really important. If you’ve listened to me for any length of time or followed me on Instagram, you know that I encourage parents to ask for RESULTS instead of MINUTES. We are also talking about the difference between school based therapy and outpatient therapy.
I’ve served more than 10 teams at once from one school year to the next. We generally have a team meeting every week for each team, and the differences between those meetings and the way IEPs are run, as well as the way the minutes are served are astounding. Even though I love my colleagues-well-most of them, there are definitely professionals that are more effective than others.
I’ve seen a ton of posts lately on parent support facebook groups about “will a specific label get us more services” and “do we need speech” and the one I will be specifically addressing today: “I want an IEP so my child can access therapies at school instead of outpatient therapies.”
It’s here that I will back up and remind you that my philosophy is that I will never, ever tell you how to parent your kid or what your kid needs. You alone, and of course close people around your child that you know like and trust, are the only people that truly know what’s best for your child. I CRINGE when I see parents giving other parents advice when there is a CLEAR story about why they feel so strongly. They are projecting their own experience onto others. It’s helpful, yes, because you need to know what could go wrong. But just like childbirth, you will hear everything that has gone wrong, and almost nothing of what’s gone right-and there is plenty of both.
I started my career in an outpatient clinic. I always knew I wanted to be in schools-I was a para in schools while I was trying to get into OT school. But my mentor, Heather, the OT that worked at my school, gave me the best advice to start in an outpatient clinic and not a school. Why you ask? Because school is very theoretical, and the only thing that makes us better is actually doing therapy and working with parents. So, I worked for an amazing clinic that specialized in AAC (or Augmentative and Alternative Communication Devices). I shared an office with 3 other OT’s, and if I ever had a question about what activity to do to increase this skill, or behavior management questions, I just turned around in my office and asked.
The schools aren’t like that-at all. I actually know more about how my team members work than I do the other OTs in the district. I never see the other OTs except for a once per month meeting-if we are lucky. We don’t know one another’s kids, and we don’t ask each other for specific advice for many reasons-one being confidentiality, but the other being that if you haven’t met a child, it’s very hard to give advice that fits the needs of that child.
Therapists are very much shaped by their mentors and experiences. And so-if someone has a great first few years with some amazing colleagues who keep “in the know” with best practices, then they will create those habits. And if someone doesn’t have great supervisors and perhaps no mentors at all, the opposite happens.
So, to take it back to the minutes conversation, more minutes of a less effective therapist isn’t going to have your child build skills any quicker-and they will have a lesser LRE (or least restrictive environment-the % of time they are in their general education classroom). Whereby a very effective therapist or teacher can help your child build those skills and communicate with other team members to carryover skills in less time-and be more effective. So I will always encourage you to interview and get to know your child’s service providers-from their background to their philosophies (such as the neurodiversity movement). And of course, track progress and ask for more communication if you need it to see how effective and knowledgeable the team is.
Now, for the second mini topic, we are talking about the differences in those two settings from a parent/child perspective.
In an outpatient clinic, and specifically the OT perspective, I could help the family and the child with anything that fell into my scope of practice. We worked a ton on ADLs or activities of daily living. So a lot of tooth brushing, toileting, dressing. I also worked a ton on fine motor strength, sensory regulation and self regulation tools and activities, and facilitating regulation in part so the speech therapist could access working on communication as we co-treated a good bit in the clinic. I even made splints to increase stability of joints for functional activities.
Similarly, SLPs could work on any form of communication, from AAC devices to articulation therapy, language treatment, and even one SLP who had additional training to help with dyslexia and other language impairments. We had an SLP and OT that specialized in feeding therapy, too.
In the schools, we are a related service. So in very rare cases, in some states, a student can have OT or psych as a related service. BUT in most states, students have to qualify in areas of special education (academics) or speech and language as their primary service, and only after the goals are set are they allowed to pull in the related services. NOW-that last statement….that the goals have to be written first…I wish it was so nice and pretty like that, but you know it’s not. We have to have an evaluation by a professional to highlight areas of need in order to add the service. BUT the true process really is that goals and objectives are made, and then the related service such as the OT or psych can service those needs as a specialty.
For many, many years and even decades, OTs have been focused on fine motor function to increase access to writing and handwriting. OTs across the country are pushing for us to use more of our scope of practice, but we overlap with many other professionals in the school environment, and so sometimes we really are serving the child better if we are a consult for that student (so supporting the case manager or whoever is there everyday working with the student everyday rather than seeing them directly every week. If you want to know more about that topic head over to Episode 10: Deciding Services for your Child and listen there! And yes, we are seen as sensory specialists as well and I would agree that we get pulled into that role. We are starting to get pulled in to support executive functioning work, especially with ADHD and TBI (traumatic brain injury), and I am in support of this except that sometimes, again, consult is better instead of having one more chef and not enough sous chef’s!
Regardless, OTs in particular in the schools are very limited to what we are able to address in this environment. Now-I’ve said it in past episodes, and I’ll say it again 1000x. Things are different in every state-AND-things are different district to district!!! It’s ALL about the special education director’s philosophy, and also the culture of the school that dictates what we are able to address.
For example, I contract with a district that is VERY academically focused. In the past several years, I’ve heard parents, particularly of transition-aged students, so 14 years old, that when they get to the high school and the focus is more on skills for LIFE-they say “FINALLY!!!!”
As an OT, that SO makes my heart hurt! After all, the largest outcome for children with disabilities in “success” later in life has been life skills (things like managing money, dressing, etc). My team with our center based Autism program have started to expand the way we think about our goals and objectives based on this, so that we can work on more concrete, functional tasks that the students actually understand and learn from (vs worksheets all the time!) So we are a team that is still addressing academics, but believes the focus should be on functional everyday tasks. I know with other districts they DO have more of a focus on these functional tasks that trickles down from administration. So it really, really depends on the district with some of these approaches, and I encourage you to get to know your teacher’s and district’s philosophy on any skills or programing that you feel is really important for your child.
So, to sum everything up, we first discussed how asking and monitoring for RESULTS is wayyyyy better for your child than focusing on minutes. Once you know your team, you may want to ask for more minutes! And that’s OK! But I really want you to understand that certain providers are more effective and some don’t need as much time to be effective.
The second item on the agenda today was the difference between outpatient and inpatient therapy. SO to answer the parent question in the beginning, therapy services may overlap between what skills they would address in the outpatient setting vs the school setting. BUT I would never tell you to skip outpatient therapy because your child is getting it in school. AND I would never tell you to not seek out outpatient therapy for your child just because they don’t get that service in school.
As always, you know what your child needs, and focus on what the therapy is necessary to solve a particular problem or hurdle your child or you are experiencing. If it’s a school related problem, it can come from the IEP plan and addressed with services to address the barrier. If it’s a home challenge, I’m a huge fan of short “bursts” of therapy for 8-10 weeks with an emphasis on parent collaboration to get support for a particular challenge you are encountering (but of course, that’s my opinion!)
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