SPD support in the schools -sorry long

[Rose-Roget]

I have a 6 year old ds who has SPD.  We've been in private OT for 3 months, and it's helping and giving us lots of techniques for the home.  He has no other dx, although his SPD can look like ADHD traits if you don't look closely.  I could probably get him an ADHD dx if I wanted to, but I'm convinced it's more related to his SPD than ADHD.  He has no IEP or 504 in the schools yet.

I tried from the start to communicate with the teacher some of the issues we've had in the past, but again, I was just dismissed because he "looks" totally typcial and is performing above grade level.  I received daily or weekly notes for most of the semester saying "very distractible today."  When I would ask ds, he said that there is a lot going on in the room or that people's computer headphones were too loud and bugged him.  Another student in the class reported to me that he tried to work but that other students would interrupt him.  I sent him a Time Timer to school to help him with time-management, but it was rarely used because (I only found out after asking how it was working) the battery didn't work well.  (In fact, it did, but someone needed to care enough to place it right.)

Toward the end of the semester, things came to a head with a few impulsive acts, not intended to harm but involving touching other students.  One was hair pulling.  One was biting after a student was yelling in his ear at an all-school assembly and then hissed in his face when he told her to stop yelling in his ear.  One was poking a student with a pencil, which it turns out was meant to be a tap but his proprioception was off and he poked instead.

So now things are moving toward I don't know what.  With the inflammatory language the principal was using with me, I thought he was angling toward BD (which is NOT at all an appropriate verification for ds).  Now the school is moving toward the SAT or RTI process and the first step is to tally his work completion and hands-to-self behaviors.  They are calling it a "behavior plan" but there are no teaching strategies or environmental modifications put into place, so it's not setting him up for any new successes (except that I know the time before the holidays has historically been hardest for him and then he settles in 2nd semsester, and I'm hoping this is what happens this time around too). 

I want to get him 504 accommodations - for noise-cancellation headphones, a quiet spot, encouragement for sensory calming activities, the option to opt out of all-school volleyball games and such, etc, if needed.  My understanding is that since SPD is not in the DSM-IV that this will not entitle him an OHI verification.  Is this true?  Should I pursue an ADHD verification, even though it doesn't really explain his needs and it's not really what's going on?

Also, I had read somewhere (don't remember where at this point) information about how traditional behavior modification techniques (like "no recess if you do/don't do these things," "get 10 stars and get an ice cream party," or "sit and watch" other kids sitting quietly and doing their work in order to learn the expected behavior, etc) don't necessarily work for sensory driven behaviors.  That the intervention, the changing of the behaviors, needs to come at the sensory level itself, and to reduce the interfering stimulation and desensitize the individual to the stimulation over time.  Does anyone have a reference for that kind of information?  Some b-mod type things are understandable, but I don't want the putting him on another sticker system - this teacher has had 6 classwide discipline systems in place this year.  He doesn't do things to be "bad" and he would really like to get the positive incentives, so when he fails, I think it discourages him.

[Emmeline II]

They are calling it a "behavior plan" but there are no teaching strategies or environmental modifications put into place, so it's not setting him up for any new successes

We wasted a lot of time on this last year. It doesn't take into account that there are impulses they can't control.

Ds' last school was not responsive and K was horrible; though he behavior issues seem to have been in excess of what you described. He did have issues with using more force than 'necessary', touching others, and had to sit next to the teacher the entire year to actually get any work done. 

We had ds evaluated by an OT just before 1st grade, who noted that he did have some sensory issues and possibly ADHD and Asperger's as well. His psychiatrist diagnosed ADHD with possible ODD, and said Asperger's is a possibility as well (we have an apt. with an dev. ped. next month).

He started Concerta just before school began and there was a dramatic improvement in his behavior at school. But his impulsive behaviors in unstructured situations started getting worse in mid-October. By December his psychiatrist suggested switching to a different medication and it seems to be impacting is impulsivity; we haven't had a single report from any of his teachers and he behaved amazingly well in the chaos of a family birthday party and Christmas parties--we used to have to watch him closely around his cousins. He is also finally starting to show significant progress in his CBT therapy.

Behavior modification techniques are working better this year as well. I just collected behavior screening forms from all his teachers and they are essentially doing the same things for ds, though there have been days (before Christmas) that he has not been receptive.

I think it is possible that ADD (there are several types, like ADD-inattentive) may be having a greater impact than you think. Having a diagnosis from a doctor seemed to make things go smoothly at his 504 meeting, though his school is very cooperative; it is probably more important to have a diagnosis from an MD when you are dealing with a difficult school.

I don't have time to read them all, but I did a search "sensory processing disorder and 504 plan"; you may find something that will help you figure this out  http://www.google.com/search?q=sensory+processing+disorder+and+504+plan&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a

Edited by Emmeline II - 1/7/11 at 2:14pm

[KCMichigan]

You are correct- a SPD dx does not qualify for school services as a stand alone dx. Even if it did, services would only be offered if it was impacting his academics or he had severe behavioral issues that involved safety.

Our school OT deal with 'functionality' primarily (handwriting, fine motor control, etc) rather than sensory. They do do some sensory stuff, but never in isolation.

You could go the 504 route, but again, the school may or may not see it as a qualifying dx for 504 if it does not majorly impact life functions (often defined as mobility, hygiene needs, eating, life threatening conditions (allergies/asthma), or the ability to function appropriately in a normal setting (ADHD/ADD).

check into www.wrightslaw.com it has a whole section on rights, 504s, ADD/ADHD, and SPD.

I can say that with RTI, they DO have to implement some sort of 'plan' that angles toward improvement. His current 'plan' may be a baseline (data for how often behaviors occur) and have no behavior changing point to it at this time. They need to know how 'often' a behavior occurs in order to have a goal to improve it (a definitive frequency and outcome goal). Hopefully, that is what they are doing now and will put some strategies in place after a week or two of baseline data.

I would pursue ADHD/ADD assessment, if only to clarify ADHD/ADD or SPD or a combo. It will help in the future to be clear to the schools what you are dealing with and help develop a plan suited to his needs. Sometimes ADD/SPD strategies are very similar---as well as symptoms and issues students struggle with. A professional is the best person to get an eval to distinguish what is what. ADD- non attentive may also not 'look' like ADHD and play a large impact in behavior.

As for SPD--- I would try to move some home therapies to school if you can. Some ideas are a weighted lap pad, fidget things to keep hands busy, intensive 'heavy' work before school starts *at home*, weighted pencil if that helps, etc. You may see improvements.

I would talk to the teacher about seating as well, it may help if he is placed in an idea location (either close to teacher, or maybe in the front with least distractions, or in the back to keep it quieter...), and to make sure the is getting enough movement in his day ( both for SPD and ADHD it is very helpful!).

Also check and see if the school has anyone that works with kids on social skills. Ours did (one I worked at) and it was filled by students per teacher/parent suggestion. No dx was needed- rather it was to help role-play and encourage appropriate social behaviors. Some kids had dx and others were referred due to difficulties in the classroom.

[Linda on the move]

I'd pursue any dx that got my child the accommodations they needed. Without a qualifying dx and a 504, you'll end up starting over every year, trying to get the teacher to believe you, but a 504 follows the child from year to year.

My dd's dx is Aspergers, but her school was great about accommodations related to sensory issues. Their hands were tied without the dx, but once we had the "golden pass" they did everything they could to make school work for her.

I really wouldn't mind what label my child was given for the school's sake, but since schools can't do squat for just spd, take ANY label you can to get a 504.

My experience with sensory related behaviors is that punishing them either has no impact or makes them worse, but I've not seen a study on it. If the school insist on a "behavior plan" I'd insist on trying it for a set amount of time (such as 4 weeks) with a meeting at the end to discuss the effectiveness. I'd also keep my own log during that time of any stress related behaviors at home.

Good luck! We had really good experiences with public school working to figure out what really worked for our dd. She now attends a private alternative school that is a better fit for her, but the staff at her traditionally was really super last year.

[Rose-Roget]

Thanks for all that information.  I actually work in special education at the middle school level (SLP), but it's interesting being in a different district, a different grade level, and on the other side of the table.  I very rarely have dealt with qualifying factors beyond language in my current state, so some of this is foreign to me. 

Emmeline - it IS possible that ADHD is a factor; however, I see major changes in behavior when his more of his sensory needs are met, which is why I'm not totally convinced.  My mom is a dev'l psych.  She and I have talked a lot about Asperger's over the years, but he doesn't fit the profile.  PDD-NOS at best, but again, he just doesn't quite seem to be there.  Thank you for the link - I haven't had a chance to read through it yet, but I always appreciate resources!

KCMichigan - That makes sense about the RTI.  I will be following up regarding strategies in a couple of weeks.  They shouldn't need much more baseline data than that.   Our OT's also only do functional skills (if you can even get services for those!).  Sensory may be addressed in a cursory way, and usually only secondary to an ASD dx.  So I'm really not looking for services in the schools other than accommodations, and the only accommodations I'm looking for are those related to sensory.  The school psych has told me that there is no clear academic impact to qualify for a 504 at this time because he is performing above grade level.  I know that social-behavioral is part of academic impact, though, and he definitely struggles in these areas.  His handwriting is laborious, although because he can - with great effort and time - write mostly legibly, he would not qualify for OT in the schools. His distractibility during work time is also a major player in academic performance, no matter what grade level he's working at.  Plus, his coordination (again, SPD related) has him performing weaker in PE.  So I definitely see academic impact.  But I guess I'm not here to debate that with you guys - I guess that was just an additional vent on my part.

He's in a public Montessori-like classroom (not authentic Montessori which would create a much less distracting atmosphere), so fortunately, he has some things built into the environment like freedom of movement, usually very hands-on materials...  I've managed to get the teacher to let him chew gum, so that he stopped chewing the pencils, erasers, his papers, etc.  That has helped.  But beyond those things, I run into a lot of resistance.

Linda - I definitely see your point about pursuing anything that could get your ds what he needs.  And I know that I will be repeating this down the road, if I don't get something that the schools can use.  I'm not sure where my own reluctance stems from, other than I know the stigma attached to ADHD, and I worry about him being underestimated or "dismissed" even moreso.  I know that sounds awful, and maybe it's just the caddy teachers I've worked (or tried to work) with that influences that perception.

Honestly, if I didn't need to go back to work, and ds didn't love having other kids around, I would homeschool him in a heartbeat.

[KCMichigan]

Originally Posted by Rose-Roget 

 The school psych has told me that there is no clear academic impact to qualify for a 504 at this time because he is performing above grade level.  I know that social-behavioral is part of academic impact, though, and he definitely struggles in these areas.  His handwriting is laborious, although because he can - with great effort and time - write mostly legibly, he would not qualify for OT in the schools. His distractibility during work time is also a major player in academic performance, no matter what grade level he's working at.  Plus, his coordination (again, SPD related) has him performing weaker in PE.  So I definitely see academic impact.  But I guess I'm not here to debate that with you guys - I guess that was just an additional vent on my part.

504 does not have to have an educational impact (IEPs do) as evaluated by the schools (usually seen as performing below grade level)  Read below for 504 details.

What is an “impairment” as used under the Section 504 definition?

An impairment as used in Section 504 may include any disability, long-term illness, or various disorder that “substantially” reduces or lessens a student’s ability to access learning in the educational setting because of a learning-, behavior- or health-related condition. [“It should be emphasized that a physical or mental impairment does not constitute a disability for purposes of Section 504 unless its severity is such that it results in a substantial limitation of one or more major life activities” (Appendix A to Part 104, #3)].

Many students have conditions or disorders that are not readily apparent to others. They may include conditions such as specific learning disabilities, diabetes, epilepsy and allergies. Hidden disabilities such as low vision, poor hearing, heart disease or chronic illness may not be obvious, but if they substantially limit that child’s ability to receive an appropriate education as defined by Section 504, they may be considered to have an “impairment” under Section 504 standards. As a result, these students, regardless of their intelligence, will be unable to fully demonstrate their ability or attain educational benefits equal to that of non-disabled students (The Civil Rights of Students with Hidden Disabilities under Section 504 of the Rehabilitation Act of 1973—Pamphlet). The definition does not set forth a list of specific diseases, conditions or disorders that constitute impairments because of the difficulty of ensuring the comprehensiveness of any such list. While the definition of a disabled person also includes specific limitations on what persons are classified as disabled under the regulations, it also specifies that only physical and mental impairments are included, thus “environmental, cultural and economic disadvantage are not in themselves covered” (Appendix A to Part 104, #3).

Note: 504 can offer accommodations as well as related services (OT or PT or social skills, etc). But most, if not all districts will fight this point. I would get your Drs involved and see where you can go with that. Then at least you could get more accommodations in writing.

As a parent, it is hard to see your child not reach his/her academic potential, even if they are at grade level- if they struggle it is hard to watch. I know- one of my DDs had an IEP for two years and now we are headed for a 504. She no longer qualifies for IEP services since she performs above grade level, but she has SPD in addition to a prior PDD_NOS dx. We had OT & PT services in place- we moved and new state, new district: reevaled her and she no longer qualifies. I see her having trouble in the classroom focusing, following the group, and dealing with the chaos. It is hard to see knowing that is is harder for her than it has to be and she could be learning more. Since she is performing at grade level and not a serious behavior concern, the schools hands are tied (for an IEP).  I taught Spec.Ed. for years before she was born (different district) and it IS so different on the other side of the table. and frustrating that districts can look the 'same' on paper and handle things so differently.

Edited by KCMichigan - 1/7/11 at 7:13pm

[Rose-Roget]

Originally Posted by KCMichigan 

504 does not have to have an educational impact (IEPs do) as evaluated by the schools (usually seen as performing below grade level)  Read below for 504 details.

The definition does not set forth a list of specific diseases, conditions or disorders that constitute impairments because of the difficulty of ensuring the comprehensiveness of any such list. While the definition of a disabled person also includes specific limitations on what persons are classified as disabled under the regulations, it also specifies that only physical and mental impairments are included, thus “environmental, cultural and economic disadvantage are not in themselves covered” (Appendix A to Part 104, #3).

Note: 504 can offer accommodations as well as related services (OT or PT or social skills, etc). But most, if not all districts will fight this point. I would get your Drs involved and see where you can go with that. Then at least you could get more accommodations in writing.

 Right - this is another reason we're looking at a 504, instead of IEP in this case. 

Since there is no set list of specific disorders, can SPD alone be considered sufficient?  I know there is no "diagnostic code" for it, and this is where I think/know I'll run into problems.

[Linda on the move]

Spd alone isn't enough for accommodation.