Parent Advocacy Series: Early indicators of Neurodevelopmental Disorders and how to access special education services in school.

Last week, Behind the Behavior Psychology posted another blog in the Parent Advocacy Series titled “What is a Specific Learning Disability,” which discussed one of the most common classification categories of special education in schools, as well as early signs and means for support. If you would like to learn more about the special education process, as well as tips in how to be a strong advocate for your child, check out “What is the difference between an Individualized Education Program (IEP) and 504 plan in school?”  Today’s post will highlight additional classifications in special education, but more importantly signs and symptoms of how Neurodevelopmental Disorders may present themselves in home and school. Let’s break it down- “Neuro,” means brain and “developmental” indicates manifestation in a child’s early growing years. A “disorder” simply means that the symptoms are significantly impairing some aspect of a child’s ability to function in their environment. Neurodevelopmental Disorders are diagnoses that occur within a child’s early developmental period and they can impact thinking, communication, behavior, motor, or other developmental skills due to differences in the brain. Why is this important? Students with Neurodevelopmental Disorders can be challenged with weaknesses in attention, memory, behavior, social engagement, speech, or other skills that are observed as behavior or learning challenges when they transition to mainstream education. Similar to how weaknesses in these areas may impact us at work or in day-to-day activities, children will also struggle with aspects of functioning in their “job” of learning in school. Therefore, even though symptoms are likely evident prior to school entrance (and may be diagnosed at this time), they are recognized most often as a child enters the structured and mainstreamed school setting as this is where impairment in their functioning becomes most apparent.

If you recall, Neurodevelopmental Disorder is not one of the 13 eligibility categories for special education. So how does my child get support? First, let’s highlight some of the developmental signs and symptoms of some common Neurodevelopmental Disorders, such as Attention-Deficit Hyperactivity Disorder, Autism Spectrum Disorder, and Intellectual Disability, as well as eligibility categories in school. Consistent with previous informational blogs, the below content does not represent all symptoms or intervention services, but captures some of the most common seen in schools.

Attention-Deficit/ Hyperactivity Disorder (ADHD)

• Difficulty paying attention to details or frequently making “careless” mistakes

• Difficulty following instructions or failing to follow through with new or routine tasks

• Appears fidgety or has a difficult time staying still

• Hard time resisting temptation and may frequently speak out of turn, interrupt others, take things that are not theirs, hit peers, or run out of their seat

• Forgetfulness

• Frequent disorganization or losing of materials

• Difficulty sustaining attention during activities

• Difficulty shifting focus (hyperfocusing) from something of interest

• Daydreaming

• Difficulty regulating emotions and becoming frustrated easily

Children with ADHD may experience obstacles in their path to success in school due to impairments resulting from paying attention, sitting still, organization, and controlling impulses in the classroom. Most children with ADHD receive some school services. Children with ADHD may differ in their symptoms (primarily inattention, hyperactivity, or combined) and whether your child receives support through an Individualized Education Program (IEP) or 504 Plan may depend on the level of impairment those symptoms have on their success in school. Children can be diagnosed with ADHD by a professional outside of the school system with expertise in child development, such as a pediatrician or psychologist. A child may be eligible for an IEP under the classification of “Other Health Impairment,” which is one of the most common classifications in school behind Specific Learning Disability. Other Health Impairment is a category that captures any students with limited alertness, vitality, or strength to environmental stimuli. ADHD falls under this category as symptoms impact a child’s ability to attend, think, or respond to certain stimuli in school. IEP and 504 Plans can offer accommodations for students to help them manage their symptoms and learn skills to make them more independent and confident in school. Examples of accommodations can include: Extra time on tests, allowing breaks, breaking down long tasks to short manageable steps, environments with minimal distractions, support with organization, or teacher check-ins. For additional strategies of how to support your child’s activity levels, attention, or behavior or behavior in school, click here.

Autism Spectrum Disorder (ASD)

• Delayed milestones or losing skills they once had, such as no longer saying words they previously spoke

• Trouble interacting with peers or relating to other children in school (may have preference for adults)

• Difficulty sustaining or contributing to back and forth conversations regarding a range of topics

• Unusual or repetitive movements, such as hand flapping, tapping items, or spinning

• Unusual speech patterns or tone

• Difficulties with transitions or changed routines

• Difficulties with interpreting non-verbal communication

• Avoidance of eye contact or desire to be alone

• Appearance of seeming “unaware” when people talk to them

• Fixation on preferred items, such as trains or characters, which tends to be the focus of their conversations

• Repetition or echoing of words or phrases said to them

• Having strong or unusual reactions to how things may feel, smell, taste, look, or sound

Children with ASD may struggle with social, communication, academic, or behavioral expectations in school. It is important to note that Autism Spectrum Disorder is just that, a spectrum. Therefore, children diagnosed with ASD all look different and what sets them apart from other people is the way that they may communicate, interact, think, or learn in school when compared to children without ASD. The spectrum of learning, communication, behavior, and problem-solving abilities in children with ASD can range from severely limited to incredibly gifted. Therefore, it is important to consult with your child’s school regarding what type of school services, if any, are necessary to support your child’s success based on their strengths. Similar to ADHD, children with ASD are diagnosed with this Neurodevelopmental Disorder by an outside professional that has expertise with Autism Spectrum Disorder, such as a psychologist. Early intervention services are important to help children with ASD and their families and it is not uncommon for children to be diagnosed with ASD prior to school entry. Children with ASD may be eligible for an IEP under the classification of “Autism Spectrum Disorder” or “Multiple Disabilities,” if other eligibility categories, such as speech impairment, anxiety, or ADHD are also present. Examples of accommodations can include: Specialized instruction for content areas, support with transitions, avoidance of busy hallways, access to technology, additional skills training, visual schedules, advanced coursework, or developmental support with specialists.

Intellectual Disability

• Delayed milestones, including delays in walking, speaking, or toilet training

• Difficulties with memory or having a hard time following routine tasks

• Difficulty with understanding and following social rules

• Difficulty with novel problem solving in school

• Difficulty seeing the consequences of their actions

• Difficulty with learning school content or thinking logically

Intellectual Disability is a diagnosis used when an individual has certain limitations in brain functioning, such as communication, learning, or problem solving abilities, as well as limitations in caring for themselves in a developmentally appropriate manner. Intellectual disabilities are diagnosed by psychologists or neuropsychologists who can assess the child’s mental abilities, as well as their adaptive skills. Specifically, a psychologist will examine two main areas of developmental functioning, which include a child’s ability to learn, think, or solve problem (often described as “cognition”) as well as that individual’s life skills or ability to function independently. Children diagnosed with Intellectual Disability have mental abilities significantly below that of others their age and struggle with basic life skills when compared to others their age. After a child is diagnosed with an Intellectual Disability, an individualized plan should be established for home and school settings to help them reach their goals. To do so, schools should look at the student’s strengths and weaknesses and determine how much and the type of support that is needed at school, home, and in the community. A child diagnosed with an Intellectual Disability tends to struggle in school without intentional strength-based supports. With appropriate support services, children with Intellectual Disabilities grow and learn like others, and their ability to function and succeed in school also grows. A child with an Intellectual Disability can be eligible for an IEP under the classification of “Intellectual Disability” or “Multiple Disabilities” if other diagnoses are also present. Of note, prior to a formal diagnosis of Intellectual Disability, children may also first qualify for special education services in pre-school or kindergarten under the category of “Developmental Delay.” Examples of accommodations can include: Specialized instruction for content areas, placement in skill-based programs, access to technology, access to support staff, or proximity to teachers. 

How can I work with the school to support my child?

Neurodevelopmental Disorders are diagnosed by professionals in child development, such as your child’s pediatrician, child psychologist, or neuropsychologist. Schools may gather their own data from an evaluation or refer you to get an outside evaluation for a specific diagnosis, and then use it for eligibility purposes. Just because a child has a diagnosis, does not guarantee they will be eligible for special education services in school, as there must be evidence that this diagnosis impacts their ability to learn/function in school. What many families find helpful is having a comprehensive psychoeducational evaluation conducted by an outside psychologist who will assess for Neurodevelopmental Disorders. Psychologists with training in schools, testing, and child development will write up a report highlighting your child’s strengths and weaknesses, and provide school-based recommendations. They will also work with you in sharing this with the school. If your child already has a diagnosis or you have concerns about their school performance, here are ways to continue to be a strong advocate for their success in school.

• If you are recognizing signs of a Neurodevelopmental Disorder, talk with your child’s school about a referral for an evaluation or schedule an appointment to discuss these matters with your child’s pediatrician or psychologist.

• If your child has been diagnosed with a Neurodevelopmental Disorder or has been classified in school to be eligible for services, talk with others about understanding your child’s diagnosis, how it may impact their education, as well as ways to support their school success at home.

• IEP’s can be confusing and difficult to interpret. If your child has an IEP, talk with their school team or consult with an outside psychologist specializing in schools. It is important to ask questions, as this document helps identify your child’s strengths, areas in need of support, means for tracking goals, and specific accommodations/services.

• Keep a binder of all of your child’s IEP documentation, correspondences with providers or school teams, evaluations, progress reports, and other helpful information and bring this to appointments or school meetings.

• Communicate openly and frequently with your child’s providers and teachers. Research supports that comprehensive and consistent support across settings is one of the best ways to support child development, functioning, and skills.

• Know your rights! As a parent, you and your child have rights to appropriate and necessary supports in school. If you are unsure of your rights, ask “What are my parental rights,” to the school. By law, they should provide you documentation of your rights and ensure you understand these rights.

• Try and maintain a good working relationship with school providers as the shared goal is often to support your child in reaching their highest potential. If you are having a difficult time working collaboratively with your child’s school, you can request an advocate or seek support from a psychologist or educational advocate outside of the school setting.

• Stick with what you know and learn every day. Children with Neurodevelopmental Disabilities, like others, still thrive and are able to learn and grow everyday. If you are unsure about how to best support your child in a given day, stick with what you know, which is encouraging them, supporting them, and keeping them safe every day. Other strategies can be learned and you can access support. If you have questions, there are individuals at your child’s school or in the community that can help you.

*For more general information about special education eligibility, other common concerns, and the testing process, stay tuned for the next Behind the Behavior Psychology blog in the Parent Advocacy Series. Next up, child mental health in the school setting! Included within these informational blogs will be tips about the testing process in schools and how to be an informed advocate for your child.