Questions and Answers

A: I hear you. I hear your frustration and your concern & love for your daughter. So the first thing I want to say is that the most important piece is in place. Keep letting your daughter know you love her, that you believe in her, and that you will continue to fight for the help she needs.

Yours is a common question and problem. To answer it we need to look at the law. The federal law that governs special education is the Individuals with Disabilities Education Act (IDEA). It was just reauthorized late last year and it now titled the Individuals with Disabilities Education Improvement Act (IDEIA). The vast majority of the law will take effect on July 1, 2005, although one piece, regarding Highly Qualified Teachers (HQT), took effect immediately.

IDEA defines a child with a disability as a child "with mental retardation, hearing impairments (including deafness), speech or language impairments, visual impairments (including blindness), serious emotional disturbance (referred to in this title as 'emotional disturbance'), orthopedic impairments, autism, traumatic brain injury, other health impairments, or specific learning disabilities; and, who, by reason thereof, needs special education and related services."

When the school evaluates a child to determine if they would meet this definition of disability, they identify a specific disability/disabilities that are suspected and evaluate for those. What often occurs in the evaluation of these children is that the school evaluates the child for a learning disability. If that testing concludes that the child does not have a learning disability, the child is determined to be ineligible for special education services under the disability category of Specific Learning Disability.

The federal Department of Education regulations define Specific Learning Disability as: "A disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. The terms does not include learning problems that are primarily the result of visual, hearing, or motor disabilities, of mental retardation, of emotional disturbance, or of environmental, cultural, or economic disadvantage."

The regulations also identify criteria for determining the existence of a learning disability. A portion of that criteria states: "The team finds that a child has a severe discrepancy between achievement and intellectual ability…" This is the current language of the regulations. (This language will change with the July 1, 2005 implementation of the reauthorized law when the use of the discrepancy formula will no longer be required, although use of the formula will be allowed.)

Therefore, in looking at the law and the regulations we see that the school was applying the criteria for a Specific Learning Disability classification when they deemed the child ineligible. A child with a mental illness typically qualifies for the Emotional Disturbance or Other Health Impairment classifications as defined by Department of Education regulations below.

Emotional Disturbance is defined as follows: "The term means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:

• An inability to learn that cannot be explained by intellectual, sensory, or health factors.
• An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
• Inappropriate types of behavior or feelings under normal circumstances.
• A general pervasive mood of unhappiness or depression.
• A tendency to develop physical symptoms or fears associated with personal or school problems
• The term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance."

Other Health Impairment means "having limited strength, vitality or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, and sickle cell anemia; and adversely affects a child's educational performance."

From the definitions above we can see that the child's diagnosis alone does not qualify the child for special education services. In fact, you can see that there is no mention of a diagnosis. Of paramount importance in eligibility decisions is that the condition must "adversely affect the child's educational performance".

Given that background, request in writing that the school evaluate your daughter for special education services under an Emotional Disturbance or Other Health Impairment classification. You are part of the planning team for that evaluation process. At the planning meeting offer to write a background history of your child's mental illness, treatment, and other pertinent factors, defining in detail how this illness has adversely impacted her education. Include areas such as grades, high stakes test results, and all other areas where her illness affects her education, such as: (a fictitious name has been used)

• Delusions and Hallucinations: Alexa's illness presents itself with delusions and hallucinations. Rarely will Alexa disclose these events to anyone other than his doctor and parents for obvious reasons. Her delusions can make her suspicious and afraid of others and these thoughts and sounds can preoccupy her mind at times.

• Diagnostic testing and doctor appointments: At times when we cannot schedule an appointment after school or on the weekend, Alexa loses school time attending doctor appointments and diagnostic exams.

• Frustration Tolerance: When Alexa is very depressed or in an irritable mania her frustration tolerance can bottom out. At times she is unable to complete homework. During periods of instability Alexa tends to accumulate daily frustrations and fall apart at home and then can't get herself in a frame of mind to do homework.

• Hospitalization: Occasionally Alexa is hospitalized for her illness. If it is during the school year some schoolwork can be done at the hospital, but the focus of each day is on illness management.

• Increased Psychomotor Agitation (racing thoughts, increased talkativeness, increased distractibility): When Alexa is in a manic mood swing the psychomotor agitation can lead to reduced ability to focus and stay on task.

• Memory: Alexa's meds, as well as her mood fluctuations, can result in reduced ability to retain and recall. Alexa often needs multi-step directions given slowly and repeated.

• Rages: When Alexa is manic, she can have rages that last for hours. Homework cannot be done when Alexa is raging and often after the rage subsides due to exhaustion.

• Sleepiness: When Alexa is depressed she can get very lethargic and sleepy. Her medication mix at times also can make her sleepy, mostly in the mornings. When related to depression, Alexa sometimes is unable to do homework due to the sleepiness.

• Somatic Complaints: When Alexa is depressed she can often experience headaches and stomach aches. When these occur during school hours she may spend school hours in the health clinic. When they occur at home they can get in the way of completing homework.

• Tardiness: When Alexa is in a manic mood swing his circadian cycle shifts and she is difficult to arouse in the morning and is very irritable when she awakens, at times resulting in Alexa being tardy for school. In addition, certain blood work can only be performed in the morning (i.e., testing for medication levels called trough levels). When the hospital is busy and the wait is long, Alexa arrives late to school.

• Educational Performance: Alexa's education has been impacted by the above factors and has resulted in Alexa only being able to achieve D's and F's despite an IQ of 127. In addition, Alexa has consistently failed all high stakes testing for the last 2 years in math, writing, and reading.

In addition to providing this documentation also secure a letter from her psychiatrist and therapist identifying how Alexa's illness has impacted her education.

There are additional strategies that can be used in the eligibility process but selecting the correct eligibility classification to evaluate and providing adequate documentation are the essential components.

Remember, once she is identified as eligible for special education purposes the work then turns to identify an appropriate array of services that will assist her in achieving academic success.

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