Virtual Special Education Isn’t Working, But Maybe It Never Worked

From Newsletter — More here

Nearly 15 percent of all students in the United States — 7.1 million kids — have been identified as having a disability that requires special accommodations from the school district. 

Although that number has slowly been rising every year since they started keep track, 15 percent is probably the low end of children with disabilities in this country. Some kids might not be diagnosed and labeled, so they do not receive any help from their schools. Other children’s disabilities might be mild enough that schools doesn’t have formally classify them, but are helping them out informally with some extra time in the resource room with a specialist. 

The biggest chunk of those kids with disabilities — 33 percent — have what is termed as “specific learning disability,” which is edu-speak for learning problems like dyslexia or dysgraphia. Those kids need academic help, but are otherwise able to blend into the school population. The rest — 67 percent — have issues, like autism, language impairments, and hearing impairments, that cannot be solved simply with a reading specialist in the resource room. 

Enter the therapists. 

To meet the needs of that other 67 percent of special ed students, school districts must employ a variety of specialized therapists to help kids with everything from speech to behavior to physical strength and coordination. Special education teachers only handle the school work. For some kids, their biggest needs are handled by therapists, not their teachers.

A child with autism, for example, might get help from a Physical Therapist (PT) for weak muscle tone, an ABA specialist for OCD behaviors, a speech therapist to help them expand their expressive language skills, and a occupational therapist (OT) for handwriting and sensory needs. 

When I was teaching special education in the South Bronx, there was one classroom in the school where the students arrived every morning in an ambulance. They were in a semi-vegetative states. The teacher would dress in a kimono and play classical music for the kids all day, as the aides changed diapers and PTs moved their limbs, so they didn’t get bedsores. 

School therapy falls in a grey area between education and health care. Some say that schools should not be in the business of health care. If kids need help for physical or neurological differences, then our health care system should provide that help. But the health care system doesn’t. Many folks in this country don’t have any health care insurance at all, despite years of ACA laws. Even those with health insurance are not able to get coverage for issues like the poor social skills from autism. 

I have never, ever been able to get our insurance companies to cover common services for autism for our son. Over the years, we have supplemented his education with private, after-school help — academic tutoring, social skills groups, special sports groups, and so on. I periodically try to submit those expenses to the insurance company, but have never had any luck. This year, we had to supplement quite a bit and are paying nearly a $1,000 per month to various groups and individuals. It’s all out-of-pocket. No help from schools, insurance companies, or the government.

Without any movement to get help from other sources, schools have to provide all these services, which are expensive. So, they aren’t very happy about it. Parents often have to fight to get this help. 

Enter COVID. 

Pre-COVID, this therapy-end of special education was problematic. Now, imagine trying to provide all those services over a Zoom call. 

A couple of months ago, Edutopia — a positive solution-based education website run by the George Lukas Foundation — asked me to talk to special education teachers and therapists to find out how they were doing doing it. After some discussions, we decided to focus on one kind of therapist — Occupational Therapists (OTs).

Despite their name, OTs don’t do anything about jobs or careers. Their primary job is to help kids with their handwriting. This is a big issue for kids with autism, but it’s a common problem that impacts a lot of kids. Typically, OTs provide this help by standing behind the child and doing hand-over-hand to guide them as they form their letters. They might give students special pencils or strength children’s hand muscles with special exercises. 

In addition to help with handwriting, their jobs have expanded in recent years to include helping kids with sensory needs, executive functioning, core strength, and even mental health. They might provide fidget toys to a child with ADHD, so he can focus on his lessons. Or they might help a child with tactile sensitivities overcome his refusal to wear long pants to school. But the reason for this massive expansion of the job responsiblities of OTs is a subject for another day. Today, let’s just talk about doing all those tasks via virtual education. 

For my article for Edutopia, I interviewed several OTs in different schools around the country. They all say that they’ve worked super hard this year. In some cases, they’ve been successful. In other cases, less so. 

You can read the whole article here

One OT told me that her school has been all virtual for this entire year. Her students, which included little kids with non-verbal autism, were in one room in the school with their aides, while she and the other staff were in another room in the same school. She helped them with everything from handwriting to sensory integration over a computer. Therapists have not physically guided student’s hands and bodies for a year. 

All the OTs told me that when the kids were working from home, they could not do their jobs without the full-time assistance of a parent. Parents, who have not been paid or compensated or supported in any way this year, have kept schools afloat (and free from subsequent legal issues) and have kept kids somewhat normal this year. 

I’m exhausted, as are all parents with kids like mine. It’s been a long year. If schools can’t open (my son is back to learning virtually upstairs in his bedroom), then parents need a bailout. I’m keeping an eye on Romney’s Child Tax Credit, but we need more.

21 thoughts on “Virtual Special Education Isn’t Working, But Maybe It Never Worked

  1. I do think this is a moment to advocate again for fully funding IDEA. I don’t know the details of the bill, but Senator Van Hollen seems to be the current advocate, introducing it every year for the last four years: https://www.congress.gov/bill/116th-congress/senate-bill/1172

    https://www.baltimoresun.com/education/bs-md-vanhollen-bill-education-20210129-yys5fawmafd7hpb5l7f7a6d7vu-story.html

    I don’t mind $3000 credits for children, but would be concerned about the rejiggering of the rest of the system that supports families that is part of Romney’s bill. I’m not saying those things should be rejiggered, because I am becoming an advocate of transparency and simplicity. I think there’s a at least a three-fold effect going on with the complicated systems. First, just barriers, the complications that decrease the number of people who access the resources; second, the money wasted in enforcement and appeals and paperwork; third, the hiding of the benefit so that most people don’t know it exists. I think the last is often done in the hopes that people who don’t benefit won’t know it exists, but I think we need to know.

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  2. I don’t like the term “semi-vegetative”, but, wrapping the funding of physical needs into education and then hiding them in local education budgets is an example.

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      1. Certainly not an expert, and I don’t know what the status of the children you are referring to is, but maybe “minimally conscious state”? There’s been some controversy over the use of vegetative, which is supposed to mean “unaware of surrounds and unresponsive” because some people who have appeared that way have turned out to have some brain activity and some, and using “semi” suggests that you don’t mean the children were completely unresponsive. But probably better than my opinion is asking some of your journalist friends.

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  3. Laura said, “School therapy falls in a grey area between education and health care. Some say that schools should not be in the business of health care. If kids need help for physical or neurological differences, then our health care system should provide that help. But the health care system doesn’t.”

    Plus, the kids are at school already, and ferrying them back and forth to outside therapy a) consumes a lot of parental time during working hours and b) means that instructional time for the kid is unnecessarily lost.

    I’ve done it both ways, and at least for our particular needs, it is currently working out a lot better to have an outside private therapist come in 6+ hours a week to work with our ASD/ADHD youngest in school rather than to have me go to school, pick her up, drive her to therapy, wait while she does therapy and then drive back. It’s also true that it’s helpful for teachers to have some level of interaction with the therapy team. Our current therapy providers schedule in teacher training time as part of their program. I’ve also found it helpful to have the therapy people as a buffer between us and school complaints, as opposed to me being the buffer. For example, if the music teacher has a beef, I can tell her, the therapist is at school 6 hours a week–you should talk to her! It makes for a much more seamless experience and speeds up communication a lot. Also, our 2nd grader is getting more therapy while missing less instructional time.

    With good insurance, we are spending the equivalent of a small car payment a month on this. We didn’t have the in-school therapy last year (1st grade) and we do this year (2nd) and the difference is night and day. I am hopeful that we will not have this particular monkey on our backs indefinitely, but in the meantime, everybody has a much higher quality of life: me, our 2nd grader and her teachers.

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    1. It’s generally recognized that independent private schools in our area have to provide some form of “learning specialist” for children with specific learning disabilities (dyslexia, for example). A mom in my kiddos class described to me the labor required to get her kid services (at a time when the school did not provide them in house) and said that she just could not manage that for her younger children and chose another school for them.

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  4. Providing the service at the place the children are already is clearly a benefit if it can be done, but that doesn’t mean that all health care should be wrapped into school budgets. I don’t know that it is — I certainly don’t understand the details of how different services are paid for, and it could be that school districts get money from elsewhere for some of the services they provide.

    Our kiddo’s HS houses a health care clinic (which is open now, though the school isn’t) that provides primary care services to students and, if you have insurance, will take the insurance (including, presumably, medicare, which apparently covers 1/2 of the children in our state right now).

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    1. bj said, “Our kiddo’s HS houses a health care clinic (which is open now, though the school isn’t) that provides primary care services to students and, if you have insurance, will take the insurance (including, presumably, medicare, which apparently covers 1/2 of the children in our state right now).”

      Is it open?

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  5. In NZ there is no IEP – education is pretty much one-size-fits-all. With the provisio, that different schools offer a more (or less) welcoming environment to special needs kids – and parents can make choices about where to place their child.
    There are also a few special education schools (usually for children who are at the more severe end of the disability arc) and some special education pods embedded in standard schools (so separate classrooms, but same playground)

    The bar for getting educational support services for special needs kids in NZ is set ridiculously high. So you have a series of complicated bureaucratic hoops to jump through (get a diagnosis, get evaluation (pass or fail the qualifying criteria), then attempt to get either physical (e.g. ipads/laptops with reader software), or staffing (e.g. teacher aide) support – which can take months. The whole process can often take several years – during which time the kid has zero support.
    Some schools are ‘good’ at this (i.e. they understand the bureaucratese, and have figured out ways to expedite this for their students/parents) – others are …. poor.

    Sometimes this comes down to an individual SENCO (special needs co-ordinator) at the school (Mr 13 had a truly excellent one for 3 years at primary school, then an abysmal one – same school – for the next 3 years).
    Sometimes the school attitude is deliberate – they don’t want the special needs kids, and will do a lot to ‘persuade’ their parents to go somewhere else.

    So – every school will have a tranche of kids who don’t qualify for the additional funding, but need additional support. And the support they can afford to fund is quite limited – since they’re funded for the cost of general education, not for support services.
    Schools can ask parents for additional ‘donations’ and for a lot of schools, this goes into funding educational support. For a lot of the ‘mild’ end of the disability kids, this is enough – and they are able to cope and learn in mainstream education.

    However, parents get really angry when ‘their’ kid’s education is being disrupted by a child with mid-level needs who needs support – but isn’t getting it. [Thinking here of kids physically disrupting classes, attacking other kids, and running away – all of which Mr 13 has experienced in his classes]
    The ‘simple’ solution for those parents, is to get the school to exclude the ‘problem’ child.
    And, these are the parents who are likely to be on the school board, dealing with discipline issues….

    Also, and really importantly, parents have no control over which teacher aide (or support person) is assigned to their kid. When it comes to learning support, it’s frequently critical to have the teaching style and the personality mesh with the learner.

    We’ve been dealing with an (apparently undiagnosable) learning disability for Mr 13 for the last 6 years. I tried the learning support within the primary school – but he didn’t like the teacher, and the programme just did not work for him. Luckily the excellent SENCO recommended an outstanding tutor (retired teacher with a whole suite of teaching styles to call on), and he’s gone from strength-to-strength with her.
    This is entirely my cost – he doesn’t ‘qualify’ for education support, the teacher is sourced from outside the education system, and insurance won’t pay for learning support (that’s not as relevant here in NZ, where not many people have health insurance anyway)
    For the last 2 years (at his intermediate/high school) he’s been able to have sessions twice a week with his tutor at school (it comes out of his ‘learning enhancement’ time – where they give kids a taste of the subjects they’ll choose when they start to specialize).
    But this year, he no longer has that option, and will be having a session with her before school starts.

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    1. Ann,

      That’s really interesting. I’ve always gotten the vibe that English-speaking countries are more alike than different in their handling of disabilities and special education. Anglosphere special needs school stories almost always sound really familiar.

      The French, on the other hand, are big into the “blame mom” approach:

      https://www.theguardian.com/world/2018/feb/08/france-is-50-years-behind-the-state-scandal-of-french-autism-treatment

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      1. The blame the Mum thing is here too (especially with ADD, ADHD) – where there’s a lot of unspoken (and sometimes loudly spoken) attitude that ‘the parents’ (i.e. Mum) should just discipline their kids.

        And (unfair as it may be) to the outside observer, it’s pretty difficult to see whether the kid annoying everyone in the cafe is an ADHD kid, or one with permissive parents)

        We also get a lot of the reverse as well: i.e. parents of ASD kids who are *desperate* to find anything to blame except themselves (not their parenting, as such, but genetics and/or delaying children until later in life – both of which have *some* impact on the chances of having ASD kids).
        It seems to be really hard for people to accept that this is just the way things are – they seem to be determined to find someone/something to blame.

        This include the anti-vaxers. Even though the research has long-since been invalidated – they still believe that routine vaccinations caused the ASD in their kids.
        This includes a good friend of mine (who is otherwise sane on most topics).
        I’ve come to the conclusion that this is their religion – and their is no point in arguing facts when it comes to religion…..

        But it does make me worry about vaccination if/when we have one for kids. I think there are going to be a whole tranche of kids whose parents will not have them vaccinated under any circumstances.
        How will schools/teachers handle this?

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      2. But it does make me worry about vaccination if/when we have one for kids. I think there are going to be a whole tranche of kids whose parents will not have them vaccinated under any circumstances.
        How will schools/teachers handle this?

        Are you actually asking “How *will* schools/teachers handle this?” or are you asking “How *should* schools/teachers handle this.”

        If you are asking the second question then the clear answer should be a strict requirement to be vaccinated to be in school, with only narrow *audited* medical exceptions (I don’t want to see immunocompromised kids being forced to take a vaccine) and no religious/conscience exceptions.

        What *will* actually happen? I imagine nothing. The anti-vax crazies will get away with it again.

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      3. Jay said, “What *will* actually happen? I imagine nothing. The anti-vax crazies will get away with it again.”

        …plus a lot of poor people, minorities, etc., who are vaccine-skeptical. I’m sure you’ve seen the stories about large numbers of nursing home employees refusing vaccines.

        The continuing pattern is that even when you place vaccine sites in poor neighborhoods, the profile of people rushing to get vaccinated there is very well-heeled.

        Your preferred strict standard will keep many poor kids out of school for years, unless you are also planning to go full CPC on their parents.

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      1. Just based on some of the teacher union concerns to date – I can definitely see that, in the short term (i.e. the next couple of years – until this Covid just becomes another type of flu) – that at least some union members will refuse to teach-in-person if the class includes unvaccinated children.
        Especially, as it now seems as though it *is* possible to catch covid once vaccinated (but you get a lighter dose – just like the flu).

        That puts schools in the position of:
        * Having unvaccinated kids attend school – and risk them passing on Covid to other children and/or staff. While having certain teachers refuse to teach them in person, so the teacher is remote while the class is at school (and you can imagine just how happy *those* parents are going to be).
        * Or trying to have all the unvaccinated children in a single (remote) class – even though they know remote education is less effective.
        * Or having unvaccinated kids at school (taught by teacher who are OK with this), but still mixing on the playground – so heightened risk of passing on the virus. I can see both some teachers and parents of immunocompromised kids being unhappy with this solution.

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  6. I haven’t had a chance to get into the details myself, but my twitter people are going bonkers about the new CDC school reopening guidelines.

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    1. I’m kind of going bonkers.

      I pretty much think it is a deliberate attempt to keep most schools closed in the long short term (for example, through the end of this year). It was reported badly as a “push” to open schools by offering clear guidelines, but the firm thresholds put most of the country in the “continue remote education category”. In the Orange/Red levels (anything over 50 cases/100K/7 days, 95.3% of counties (Ben Renton’s graph), and probably a higher percent of the population), the guidance says “Schools may consider hybrid learning models or instructional modes where substantial percentages of students are in virtual instruction”. And, the press quotes the “schools should be the last thing to close and the first to open”, but, much more is open in the 95% of the country that’s in the red/orange zone, and I don’t think there are any plans to close any of those things.

      In WA state, 5 counties, 3% of the population are in the Yellow zone — the rest are orange or red.

      I can only hope our cases keep dropping.

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      1. Yep.

        “I pretty much think it is a deliberate attempt to keep most schools closed in the long short term (for example, through the end of this year). It was reported badly as a “push” to open schools by offering clear guidelines, but the firm thresholds put most of the country in the “continue remote education category”.”

        I’ve seen it said (probably by @politicalmath) that the only way the new CDC guidance makes sense is if they are planning to give a revised version soonish. The problem is, that if these recommendations are left standing longer, it’s a recipe for continued remote schooling for 2021-2022 for many schools.

        The question also arises–is the CDC suggesting that schools that are currently open ought to close?

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      2. No they don’t have to close. The guidance explicitly states that HS and MS in red zones “may” stay open (if they are already open) as long as the schools have “few” cases even though the recommendation is that MS and HS in red zones stay virtual.

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  7. One of the most questionable aspects of the CDC recommendations is the requirement that students be spaced 6 feet apart. If obeyed, that one rule makes full-time school impossible in nearly every school in the country.

    It also isn’t clear that it is necessary, particularly for small children.

    I don’t worship WHO, but it has to be mentioned that their spacing rule is for 3 feet, even for adults.

    https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

    “Maintain at least a 1-metre distance between yourself and others to reduce your risk of infection when they cough, sneeze or speak. Maintain an even greater distance between yourself and others when indoors. The further away, the better.”

    https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-schools

    WHO’s advice for schools with regard to spacing is as follows:

    “Physical distancing of at least 1 metre between individuals including spacing of desks, frequent hand and respiratory hygiene, age-appropriate mask use, ventilation and environmental cleaning measures should be in place to limit exposure.”

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