What to do when you worry about school

Dr. Bethany Ziss

Your kindergartener gets a brightly colored

“AIMSWEB” report showing skills below the basic level. Your first grader still does not pronounce the “R” sound clearly. Your second grader is reversing letters in writing. Your third grader is spending hours on homework and doesn’t seem to understand the directions.

Some children have delays that are identified very early on, and enter school already receiving services. But often concerns emerge in the early grades. It can be challenging to know where to go when you have worries about your child’s academic progress. And while everyone knows what a grade of A or D means in high school, young children often come home with reports using terms such as “progressing” or “mastered” which are a lot less clear.

The first step with any concern about academic skills or progress should be your child’s teacher. She or he should be receptive to an e-mail or to schedule a meeting. You can go over report cards, test scores and your observations from home, and your child’s teacher can share observations as well as expectations for your child’s grade level. Sometimes worries can be eliminated at this step. For example, some speech sound errors are not concerning in the youngest grades if a child’s speech is otherwise understandable. Some letter reversals are also common as children are learning to read and write.

If concerns persist, there are several steps to getting children additional evaluation and support.

Public schools provide academic intervention through a program called Title 1, and this is sometimes also available for children attending private schools. This is not considered special education. Typically, the school gives a computerized assessment to all the children several times a year. DIBELS, Aimsweb and STAR are three commonly used tests. Children who score below a cut-off are entitled to additional help in reading, math or both, usually in a small group setting. Title 1 support is sometimes also given to children where there is some concern about academic progress even if they do not score in the concerning range on the test.

Sometimes this process is referred to as “RTI” or “response to intervention” because many children make good progress or “respond” to the support and do not need further evaluation or services. This program is also called MTSS, or Multi-tiered System of Supports. All students receive Tier 1 services, and Title 1 instruction is considered the second tier.

Sometimes there are more significant concerns about skills, or children do not make expected progress after trying Title 1 services. Or there may be additional concerns about language, motor skills or behavior. In these cases, schools are required to evaluate children for an IEP, or individual education plan, to see if a child qualifies for special education services. An IEP is considered Tier 3 support because it is individualized to each child. The requirement to evaluate children and provide services if appropriate is part of a federal law, the IDEA, or Individuals with Disabilities Education Act. Children are entitled to a Free and Appropriate Public Education. Here, “appropriate” includes any needed services, accommodations and modifications.

Nearly 20% of children receive special education services. Special education is a plan, not a place, and most children who get services are in a regular education class for most or all of the school day. Specific learning disabilities and speech and language impairments are the most common reasons for children to have an IEP. Children can receive speech therapy, work with a special education teacher in certain areas and modifications such as easier work or oral rather than written testing. Children can also get accommodations such as using audiobooks or help organizing their writing assignments.

The request for an IEP evaluation needs to be made in writing. It can be a simple letter stating your child’s name and asking for an evaluation for a possible IEP. Sometimes the school will have a form for you to sign which counts as a written request. The evaluation is done by the district or by the Intermediate Unit, an agency in Pennsylvania that supports multiple school districts. The district or IU has 60 days to do the evaluation, not counting summer vacation. If the school thinks an evaluation is not necessary, it has to provide a written explanation. The district or IU can also evaluate children who are enrolled in private schools or homeschooling.

The evaluation may include several different parts, depending on your child’s needs. A psychologist may do individual testing, including IQ test and achievement tests to measure academic skills. If there are concerns about attention or behavior in or out of the classroom, a psychologist may also observe your child in class and other school settings. You and your child’s teacher may be asked to complete checklists describing your child’s abilities and challenges. A speech language pathologist or occupational therapist may also do evaluations. At the end of the evaluation, there is a team meeting of the school staff as well as the child’s family to discuss if the child qualifies for an IEP and what services will be provided. You are part of the IEP team and need to agree to the proposed plan. Older students can participate in their own meetings as well.

Parents often ask about getting an evaluation outside school. These evaluations are available but may not be covered by insurance. In addition, schools are not required to follow the recommendations of an outside evaluation, although they are required to review any outside information you provide. A letter from your pediatrician or any outside specialists taking care of your child can provide useful information, but again, schools are not required to follow their recommendations.

What to do if the school does not agree your child needs support or does not provide the support you think your child needs? You could agree together to monitor progress for awhile, perhaps one marking period. You could seek out a private evaluation. There is an appeals system including mediation and a legal step called Due Process. Very few families need to escalate concerns to this extent.

Every state has a parent support organization which can provide information and support. In Pennsylvania, this is provided by the PEAL Center. (www.pealcenter.org) Their services are free and they can advise you on the process, your child’s rights and steps to take to get additional support if needed. They run trainings throughout the year. PATTAN, the Pennsylvania Training and Technical Assistance Network (www.pattan.net) also provides trainings and has information online about special education rules and regulations. Wrightslaw (www.wrightslaw.com) is a national site that provides a lot of free information as well.

Your child’s pediatrician may be able to advise you through the process and also evaluate for medical or behavioral problems that may be affecting a child at school.

Children spend a lot of time at school, and when school isn’t going well, it often seems like nothing is going well. I encourage families to nurture their child’s strengths and interests while also working on the challenges. Tutoring and homework are important for growth, and so are scouts, sports, dance and just running around in the park. Getting support, through school, and if needed, outside school, can often make a difference in identifying challenges and helping children succeed to be the best selves they can be.

Bethany Ziss, MD is a Developmental and Behavioral Pediatrician at AHN Pediatrics Multi-Specialty in Bloomfield at the Mellon Pavilion at West Penn Hospital. Dr. Ziss has a strong background in disability advocacy, and throughout her career she has worked to bring a neuro-diversity and disability community perspective to her clinical care.

Now that Pediatric Alliance is part of Allegheny Health Network, we’re moving from Patient Portal to MyChart.

MyChart is a secure online platform that gives you a quick and easy way to connect with our office: • Book appointments • View test results • Communicate with our care team • Request prescription refills • Review your child’s health history • Pay bills and view statements Follow these steps to register for MyChart now: 1. Visit mychart.ahn.org and click “Sign Up Now.” 2. On the next screen, under “No activation code?” click “Sign Up Online” and follow the onscreen prompts. 3. Once you’re logged in, click “Profile” in the top right and then “My Family Access.” 4. Based on your child’s age, follow the instructions to get proxy access.