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Is Cognitive Behavior Therapy Right For Your Special Needs Child?

 

CBT

This article is based on a podcast I recorded with Dr. Perry Passaro, a licensed psychologist in Cognitive Behavioral Therapy (CBT). CBT benefits many, especially children with special needs, autism or high-functioning autism. It also helps people suffering from depression, OCD, and anxiety.

Cognitive Behavioral Therapy: A research-based practice that helps people observe and recognize their negative thought process and replace it with more positive thoughts.

  • Highly effective on kids with special needs, along with other people.
  • Changes the thinking process, resulting in a change in the mood and behavior too.
  • With kids, working with proper tools, CBT can actually make a difference in both their mood and behavior as well.

Components of Cognitive Behavioral Therapy: Basically there are two main components of CBT. First is, bringing change in behavior and second is bringing change in the thinking process.

  1. Behavioral Change: This treatment is mostly used in case of a person or kid having fear or anxiety. In such case, CBT uses gradual exposure as the solution, to eventually reprogram their mind about fear or anxiety.
  2. Thinking Change: This is more helpful in case of negative bias, where one is judgmental and thinks that he/she is not good enough. It also helps children with low self-esteem and a generalized negative assumption or core-beliefs about themselves. This Automatic Negative Thought makes people sad and depressed.

In such cases, the Socratic questioning method is used along with evidence to change the self-image.

Who CBT is Appropriate For:

  • Kids with ADHD, having problems with self-strategizing (monitoring, management, regulation).
  • Students with emotional disturbance, depressive disorders, anxiety disorders, high-functioning autism.

Minimum Age:

  • For Cognitive Therapy: Begins with 9 to 10 years old.
  • For Behavioral Therapy: Much earlier.

Sessions in CBT: There are total 10 to 15 sessions, divided into three categories.

  1. First Session: Meeting with parents. Interviewing, reviewing records, test results etc. Identifying the triggers, specific behavior and consequences of that behavior. ExplainingProgressive Exposure.
  2. Mid-Session: Both child and parents are present. Involves generalization of skills, teaching, and application of these skills in real life. Also, collecting data, monitoring and measuring the progress, which is visible with 5 to 6 sessions.
  3. End Session: Usually results in a confident child, who has overcome and understands the anxiety and learns about the tools to tackle his/her life.

Success Rate of CBT:

  1. Very effective for kids with special needs who have parents’ support.
  2. Much more difficult and takes 15-20 sessions for moderate depressive disorders. Longer for more serious depressive disorders.
  3. Takes even longer in case of High-functioning Autism.

Post-completion: Fading Technique is used. Gradually reducing the visits to the center. Follow-ups and booster sessions are also done.

CBT is for Everybody: Helps people understand themselves better, improves their personal relationships, by replacing negative thought process with a positive one and lifting their mood overall, thus changing their behavior too.

CBT has a very good prognosis that it does help people, even in the most resistant or hopeless cases.

Final Thoughts

Wow! I learned a ton of new information from our discussion. I had “heard” about CBT for a little while now and liked its mantra and focus on taking action now to replace negative thoughts.  It reminds me of the tenants of Mindfulness.  My son’s autism is very profound, so he would not be able to try CBT right now.

Maybe someday! 😉

More Information

Read more about Dr. Passarro and listen to the full interview here.

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Disability Rights California, A Fantastic Resource For All Disabilities

Disability Rights California is a non-profit organization with a mission “…to advance dignity, equality, independence and freedom for all Californians with disabilities.”  It provides information and advocacy.

Receiving Help

DRC, explains on their front page, some of the services they provide:

  • Direct representation in criminal law, family law, bankruptcy or evictions
  • Personal injury lawsuits
  • Filling out Social Security application forms
  • Obtaining guardianship or conservatorship

More specific details on how they serve, and who they help, are explained on their eligibility page

For information on how to contact them at a local office, see here.

Self Advocates

If you are advocating for yourself or someone else, the website features the Special Education Rights and Responsibilities (SERR) manual loaded with information on specific rights and how they apply in different situations.  We use this site for training here at CSNLG and find it one of our top resources.

This PDF has a link to all their resources. It is a bit overwhelming though.

In general, the website is loaded with links and options and the organization of it all can be hard to follow. It takes some time to “learn” how the site is organized and the areas that are best for your situation.

Social Media

DRC has a social media presence, and if that is a preferred source for you, be sure to check out them out:

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Understanding ABA and Verbal Behavior

If you have a child with special needs such as autism, you may quickly start hearing about Applied Behavioral Analysis (ABA) and Verbal Behavior (VB) as therapies that are helpful to children.

Today I talk with Dr. Denise Eckman president and executive director of Creative Behavior Interventions. We discuss an overview of what ABA is and which types of children, and even adults, benefit from this type of intervention. We go a little deep and by the end of this show, you will have a functional understanding of behaviors, their antecedents and a breakdown of different types of communication we find in language. In fact, if you listen carefully, you may be able to discuss Mands, Tacts, Intraverbal and Echoic communication!

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Five Things To Consider When Seeking an Independent Evaluation (IEE)

 

An independent educational evaluation (IEE) may be requested by parents when they do not agree with a district’s results or it is not seen as comprehensive enough.

As a parent, you have the right to request an IEE at the district’s expense if you do not agree with their evaluation. Once you have made the request the district has two choices: to approve and fund the evaluation or to deny it and file a due process complaint against you.

Here are a few IEE facts that we want you to be aware of:  

  1. If your district approves your request for an IEE, they cannot limit your choices. Most of the time districts will send you a list of what they consider “approved” assessors and a maximum amount they will pay for the evaluations.
  2. This list is merely a suggestion by the district and we do not recommend using assessors on this list. CSNLG has a great list of assessors who provide helpful and comprehensive evaluations. 
  3. A district cannot give you an expense cap in order to prevent you from obtaining an evaluation from a qualified assessor. Although there is no law preventing districts from trying to place these limits on you, it is possible to challenge them to provide you with the best evaluation possible. 
  4. Recently we have come across a new limit being given to parents, a restriction regarding the mileage between the assessor and the district. There is also no law to limit the location of a provider and you may consider challenging this limit if it occurs.
  5. An IEP must consider these evaluations and the comments and recommendations of the evaluator. The independent assessor typically has a more comprehensive evaluation than the district assessor. More times than not these evaluations bring to light other areas of need that had been missed with more vague evaluations. 

Fighting a district’s limitations may be stressful and draining. It is always best to consider the trade off’s between accepting a district’s limits and the effort it will take to overcome it.

 

 

 

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Cognitive Behavioral Therapy with Dr. Perry Passaro

Cognitive behavioral therapy (CBT) is an empirical, research-based practice that helps individuals recognize their negative thoughts and replace them with more positive ways of thinking. It can be especially helpful to those with anxiety, depression and OCD.

I talk with Dr. Perry Passarro, a licensed educational psychologist about CBT. We discuss what it is, how it works for students with special needs and what a typical therapy session looks like.

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Dyslexia and Other Specific Learning Disabilities: Is there a way to help our children?

 

 

 

Marcus, a hard-working father of four children, describes the determination of his nine-year-old son building a full-size Batmobile by dumping out all of the Legos he had accumulated over the years and designing it on his own. Despite the fact that his son was told his family could not afford the expensive kit, he persisted by deciding he could make what he wanted using photos he found online. Imagine the pride and satisfaction of accomplishing what others would not even fathom undertaking.

Now, fast forward to six years later and see that same, determined, bright, teenage boy spending countless hours every day of the week to grasp the most basic and fundamental skills in reading, spelling, and writing. Who was there to help? Did anyone, such as staff, recognize a problem or diagnosis to help him excel as he brilliantly did with those Legos? If so, was there anyone trained in effectuating this assistance? Unfortunately, this was not the case for Adam. Fortunately, he did not give up and even without proper assistance managed to complete as many tasks he could.

This story pertains to the student in California’s Office of Administrative Hearings’ (landmark decision, (July 2017)). The names are fictional. This case demonstrates the dangers of districts not providing appropriate training with regard to Specific Learning Disabilities (SLDs) by pertinent staff including teachers all the way up the principal. A lack of training withholds our children’s federal right to a Free Appropriate Public Education (FAPE).

The 2017 Guidelines (CDG) state, “Although the problems experienced by students with dyslexia may originate with neurobiological differences, the most effective treatment for these students and for those who struggle with related reading and language problems is skilled teaching. For that reason, it is critical that educators receive accurate and current information about evidence-based instructional strategies.”

In the case mentioned above, the court voted in favor of Adam, that 15-year-old teenage boy, hereby granting and ordering a long list of remedies. The Court recognizes the failures of the District but does not blame it per se. It further states that “school districts may be ordered to provide compensatory education or additional services to a student who has been denied a FAPE but … the award must be fact-specific.” Compensation may not always get to the student directly in monetary form but instead in services.

The court further states, that the IDEA can satisfy the compensatory remedy by staff training.  The decision goes on to discuss the importance of appropriate goals and services to meet Student’s unique needs in the areas of reading, spelling, and writing. For Student’s needs in this case it would be one hour per day of instruction in Orton-Gillingham, or the Slingerland method each school day or the equivalent thereof.  These are the methods most effective for dyslexia.

The CDG suggests standards for reading teachers that have been developed by the International Dyslexia Association (IDA) and the types of educators who can serve students with dyslexia and includes a list of salient personnel to obtain and use this knowledge. It emphasizes, “There is a great need for all educators and related service providers to be prepared to meet the needs of students with dyslexia, including speech-language pathologists, school psychologists, school counselors, school administrators, and paraprofessionals.”

Yes there is a way to help our children. Fortunately, in California, the decision along with CDG guidelines will help rectify wrongdoings mostly unbeknownst to district personnel. With this knowledge, now is the time to be informed and help our students overcome these tremendous barriers to an appropriate education. It is more expensive for districts not to abide by these words of wisdom. As a single mother of a 6-year-old boy struggling with similar obstacles, I feel blessed knowing that he can and will have appropriate services.

If he does not, I have the knowledge to pursue and advocate for him. With diligence, adherence to authority and guidelines, and patience we can do right by our children with SDLs and there will be no one left to blame.

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10 Steps to Make the Most of Your IEP Meeting

 

 

The IEP meeting is a crucial opportunity for you as a parent or caregiver to understand what the school district is providing for your child. Being prepared and ready to go means you will be at your peak performance.

We put together some tips below to help you with your meetings. Give them a try; we are confident they will help you feel strong, organized and empowered.

1. Bring Somebody With You

Always bring someone with you. This may be your spouse, advocate, lawyer (although that will change the tone of the meeting) neighbor or friend. Having someone with you means you feel more confident and are not alone as you face a room full of district employees all speaking about your child.

Talk about a high-pressure situation!

Have him, or her, take notes on what is said, offer an occasional clarification question and simply be there to make you feel better. By having an additional set of ears, your understanding of the meeting will be significantly improved. My wife Lori, and I were never alone during IEP meetings, and every single time (yes every single time) we had two different understandings about what was said. 😉 By talking it through, we were able to come to a common understanding.

Imagine if we had been alone!

2. Be Polite

Lots of “hellos,” handshakes, “thank you’s” “and please’s” sets a positive, helpful tone during the meeting. I know I sound like my mother here, but it does help. People are more open when they are comfortable, and you want district employees to be as open as they can.  Also, we found that by being polite, it helped us if we became upset at something that was said or a service that was not delivered. The meeting participants then gave more legitimacy to our irritations as it was out of the ordinary.

3. Be and Look Prepared

Take a look at our post on what to bring to your IEP meeting and have it ready to go. Make sure the paperwork you bring is organized, a binder or similar with tabs is best, and that you have extra copies to distribute as needed. Looking and being prepared creates a strong first impression on people in meetings.  We strongly believe in this approach when talking to any providers (school or otherwise) about our son. It elevates the conversation to a higher level with more details and ultimately leads to a better outcome. Teachers labeled us as being “very involved” in our son’s education; they meant that as a positive comment.

4. Assume Best Intentions

Teachers and other professionals involved in working with students are there to help students learn and be successful. By assuming everybody in the room is working to help your child, you will feel more relaxed and present a non-threatening demeanor. They, in turn, will assume best intentions in you and everybody will be off to a great start.

5. Take Notes and Show That You Are Taking Notes

I use my laptop to take notes during meetings. Lori likes to write it down. Either way is good. Taking notes also lets you write down questions you have and ask them later on during the discussion. I promise you, no matter how smart you are, having notes will be a huge help later on when you are recalling or looking back at a previous meeting.

6. Ask Questions for Clarification

During the IEP you are going to hear information and ideas that may be new or confusing. Sometimes it is hard to explain an accommodation, service or classroom interaction. By asking questions, you not only help yourself understand the information, but you also give feedback to the district employee that you are listening and processing what they are saying.

One of my favorite things to do is ask questions that tap the background and expertise of one of the meeting members. For example, “What do you think Braden’s (our son) initial reaction will be to this accommodation?” I do so in a way that lets the person know I value their opinion. It tends to give them pause from a standard statement they are giving and pushes them to reflect on what they are saying. You can see the body language change right away as they pause, look upward, then give their opinion. They feel valued, and you know if they have a larger understanding of the ideas they are suggesting.

7. Avoid Talking Too Much

An IEP meeting is structured and designed for each district specialist and educator to speak and seek feedback. It is also designed for you to ask questions and seek understanding. It is NOT designed for parents to talk, grieve, and unload the stresses of having a child with special needs. Look, I get it. Having a special needs child is difficult, and we are reminded of this every day. However, an IEP is not a good place to unload those stresses.Save that for friends, support groups, etc.

Lori and I have a signal for each other if we start talking too much. Usually (maybe always) I am the one who needs the signal to stop cracking jokes (my way of dealing with stress) and to just listen. This is yet another reason to bring someone with you.

8. Dress Well

We dress up for religious services, weddings, work, job interviews and more. An IEP meeting is at least as important as those events, so dressing up is equally as important. We all make assumptions about people on how they dress. It may be right or wrong, but we do it. Looking your best can only serve to help. Gentleman, you don’t need a tuxedo though. 😉

9. Don’t Worry If Tears Fall

Early IEP’s, where you have just learned your child has extra learning needs, are emotional events. Often tears may fall as you listen to how your child is not like all the other kids. If you start to cry, don’t worry about it. Members of the IEP team will see a parent who cares deeply about their child. They may even be more empathetic about your situation.

Grab a tissue, recover and move on. 😉

10. Sincerely Thank Everybody at the End of the Meeting

The end of an IEP meeting is a great chance to let people know how much you appreciate the work they are doing. I like to individually thank each person by pointing out an example of their efforts. “Braden loves sensory time, and we are using many of the techniques you suggested at home now.” Now, if you are feeling angry, upset or frustrated at the conclusion, it is just as important to thank everybody for their time. This tells people it is not personal (even if it feels like it is) and that while you must continue to advocate for your child, you will be reasonable.

Thanks for taking the time to read this.  If you have any suggestions, please leave them in the comments section below.

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What Is an IEP?

Overview

An IEP, is an individualized education plan. It is regularly found in public school systems as well as some private schools.

The IEP  is a written document and serves an education plan for students with exceptional (special) needs and is reviewed at least once a year. It sets goals and expectations for your child’s learning and growth. Parents, caregivers and school district representatives (teachers, occupational therapists, speech therapists, special education teachers and more) participate in the drafting and signing of the document.

Done well (and they often are), an IEP is a fantastic document developed with the input of many professionals all looking to design a program that helps your child progress.

The IEP should explain how your child is doing currently (present level of performance) specific goals for your child to meet, services he/she will receive as well as any accommodations that will help him/her to succeed.

What You Should Know

  • A district has 30 days to call an IEP meeting after it has been determined that a student IDEA listed disability. IDEA is the Individual Disability in Education Act
  • An IEP must be reviewed every year
  • An IEP binds a school district to provide the services and accommodations outlined in the document

Additional Resources

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What Does a Special Education Advocate Do?

Overview

A special education advocate is an individual who works on your behalf to help you secure services for your child. Some advocates work for free, while others charge a fee for services. They have varying degrees of experience and many have a child themselves with special needs.

An advocate is much less expensive than an attorney and is the next step up from handling the case yourself.  Fees for an advocate may be recoverable if a settlement hearing occurs.

Sample of services

  • Listen to your situation and help you clarify your child’s needs
  • Attend IEP meetings with you
  • Draft correspondence with the district
  • Suggest and explain services available through your district
  • Explain how the FAPE process works at your district
  • Attend mediation and hearings as your representative
  • Others?
  • Recommend support groups, other parents, and specialists

Questions you should ask

  • Have you been through the IEP process yourself as a parent?
  • What types of cases have you worked on?
  • What is your educational background?
  • Have you been through any advocate training programs?
  • Do you work for or under an attorney?
  • Describe your role when during an IEP meeting.
  • What do you enjoy and not enjoy about being an advocate?

Additional Resources

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