Service Details

As a technologist, I look at the IEP as something of a requirements document – it specifies the goals for his services for the coming year, and the acceptance criteria to decide whether or not the goals have been met.  As everything out there reminds us, these goals should be SMART – Specific, measurable, attainable, relevant and timely.

Some of the objectives under each goal don’t fit these.  Most notably, the wife and I insisted on the striking of an objective that called for a ‘sensory diet’ for the Monster, since that’s not truly an objective – that’s part of the method of delivery.  As such, it’s not acceptance criteria like the others, and shouldn’t be listed as such.

I think, when we went for the meeting last week, what annoyed me most was the fact that the occupational therapist wasn’t there (she was ‘excused’ due to other commitments) and had, in the IEP, recommended cutting the Monster’s OT from 45 minutes a week to 30.

I don’t mind the idea, in theory, of a reduction of services if he were making adequate progress.  The problem was that this woman’s report in the IEP clearly indicated that she felt he was not making adequate progress.  Or, as an example of what she wrote:

“We have been attempting to elicit some visual tracking but without success.  It has been noted that he is not motivated by paper and pencil tasks so we are using other media to address his fine motor skills.”

Um… duh.  The first of these problems, though, is that his pencil-and-paper skills are part of the objectives from the last IEP.  It doesn’t matter that he’s not motivated by them – it’s her job to get him to do them.  He has clear objectives about pre-writing skills, including acquisition of a modified-tripod grip on a pencil for imitating strokes.

There are a few other examples of this through her report – mind you, she’s perhaps communicated with us once, during this entire school year.  The fact is, however, she emphasizes at the beginning of her report that “He has done very well since the beginning of the school year and has achieved some of his objectives.  [The Monster] is making progress in OT.”  To me, the issue is that she’s asserting something that she directly contradicts lower down, when she emphasizes that he has trouble with scissors use (issues with bilateral coordination), has no clear hand-dominance, cannot practice with buttons without “maximum assistance”, requires assistance to hang his coat on a hook and needs hand-over-hand assistance to engage a zipper.

And then she didn’t show up to defend her opinion that a service reduction is appropriate.

I’ll go a step further, however.  If you really want to have fun with the IEP, it’s nice how she subtly modified her goals for this year (and we caught it).  The direction regarding the modified tripod grip has been changed to an ‘efficient grasp’ – in theory, if they determined that his gripping the pencil in his fist was ‘efficient’, that would be sufficient.  No, that’s not sufficient for us.

Now, mind you, the wife has also spoken with her and the IEP coordinator by phone since this document was delivered to us, and part of the issue is that the Monster is apparently easily distracted in his classroom, which is where he’s been receiving his OT services.  The new IEP calls for OT as a pull-out instead of push-in, but doesn’t give – to my satisfaction – a sufficient justification for the reduction in services.

From where I stand, 45 minutes a week isn’t enough OT, then, apparently.  The wife and I are pushing for an hour of pull-out, in two 30 minute segments.  I would love to hear what her justification would be for denying it, given her own report that she’s clearly not been as successful as she tries to make it sound.

As the wife pointed out to me when I got home, there’s a slight inaccuracy in what I’m recalling above, and I’m going to correct it.

Both of us do indeed feel that he needs more OT than they are offering.  We are still pushing for the hour of pull-out services, but for the time being, he’s been officially cut to 30 minutes of pull-out, as the therapist feels that is sufficient.  We have another meeting with them in a month or two for setting up his placement for 2013-2014, and intend to push for more at that point.

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