Friday, December 30, 2011

Best Musings of 2011

In taking inspiration from Dr. Branstetter over at Notes from the School Psychologist, I decided to debut my first "best of" showcase. 2011 was a big year for me: my first full year as an employed school psychologist. There was tons on learning and laughs, of which there will continue to be many more of. Here are highlights of the year, as measured by most viewed, most comments, or my personal favorite:

January -- A post about The Semantics of Stigma associated with "mental retardation" vs. "intellectual disability."

February -- A case study about a kiddo who moved from an Integrated Co-Teaching classroom to a 6:1+1. (and a bonus update on how he settled in!)

March -- The Cross Country Team, a post about "runners," or kids who leave the classroom during instruction and roam/run the school building. This post gets a huge amount of hits for the graphic, not the content. Alas!

April/May/June -- A compilation of the 8-week anger management/social skills group that I co-facilitated during the spring in the 5th grade 6:1+1 class. All boys, all shenanigans.

July -- I didn't have any posts in July... :(

August -- E=mc... huh?, a case study about a kiddo with a nonverbal learning disability. And because I couldn't choose (and slacked in July), a playful reflection post linking my shoe collection to key events in my career.

September -- A post about Jamie Nabozny and the documentary "Bullied," which every one should order and use because it's FREE! I'll reiterate again: "Bullying: Confront it. Report it. End it."

October -- A post about interview questions I was asked when I was interviewing for positions after grad school. I'm so glad that this post has been helpful to those just starting out!

November -- An important post about the current New York mandate relief proposal to remove psychologists from the CSE. Speak up, advocate for yourself and your colleagues, and make everyone know the importance of psychologists in the schools.

December -- If you missed it the first time, a good laugh for the holidays, with inappropriate Christmas carols for those who work in mental health.

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Thursday, December 29, 2011

Multiply Disabled, Doubly Blessed

Earlier this month, we had a Committee on Special Education (CSE) meeting on a rather tough case. X, a kindergarten student, was referred by his foster mom/aunt and his doctor due to suspected developmental delays. I had to blog about X and his CSE referral, since cases like his don't come around very often. Here's a list of notable things in X's social history, shortened for brevity:

Facial features of children with Fetal Alcohol Syndrome
-heavily exposed to alcohol and marijuana in utero. Recently diagnosed with Fetal Alcohol Syndrome. (also exhibits facial features)
-traumatic brain injury at 6-months (suspected that biological mother dropped him, cracking his skull).
-no medical care after first well-visit after birth.
-significant history of malnutrition (often left to fend for himself to eat, which led to injuries as he attempted to cook for himself; currently, hoarding food and pica-like behaviors of eating inedible objects).
-not toilet trained (a requirement for attending kindergarten in my district--he was asked not to return to school until he was toilet trained, because he was having accidents throughout the day).
-much smaller than is typical for his age--looks about 3 years old when he's 5-years, 7-months.
-speech concerns (articulation, voice tone and quality, expressive and receptive language deficits).
-underdeveloped fine motor abilities (shoe tying, writing, cutting; also sensory concerns).
-removed from biological mom's care 6-months ago due to severe neglect; living with his aunt.
-no exposure to school or age-appropriate social interactions prior to entering kindergarten this year.

During testing with me, X exhibited no spontaneous conversation, and when he did speak, it was in a whisper (I must've driven him nuts asking him to repeat himself so much because I couldn't hear him!). His sentences were no more than three words and he would gesture or point rather than speak at times. Throughout our time together, he exhibited flat affect and appeared lethargic. He was slow to respond to many assessment tasks. He rarely smiled or responded appropriately when I tried to make him laugh (I probably am not funny).

Lots of assessments were done, to get a full picture of X's developmental levels. Speech/language and occupational therapy evaluations were indicative of significant delays, so he qualified to receive those related services. My cognitive testing was in the borderline intellectually disabled range, as was standardized academic testing (i.e. standard scores in the 70 range). Behavioral rating scales were also completed by X's teacher, which indicated high levels of atypical or "strange" behaviors and moderate hyperactivity and attention problems. Adaptive behavior was also delayed, with daily living skills (self-care skills) and socialization were the lowest areas.

Standard scores within the 70 range across all areas (cognitive, academic, adaptive behavior) would in most cases lead to a classification of Intellectually Disabled. However, I recommended a classification of Multiple Disabilities. What are the criteria for this disability, in New York State?
Multiple disabilities means concomitant impairments..., the combination of which cause such severe educational needs that they cannot be accommodated in a special education program solely for one of the impairments. The term does not include deaf-blindness. [Part 200.1(zz 8)]
Due to his pervasive level of delays and needs, and concurrent head trauma and Fetal Alcohol Syndrome, Multiple Disabilities was a more appropriate classification for X. After the New Year, we are going to look into an agency self-contained classroom for him to be placed in. This setting will meet not only his educational needs, but also his daily living, self-care, and toileting.

So with all these hurdles to overcome, why is X "doubly blessed?" Because of his foster mother and aunt. She is working so hard to support him and provide him with the nurturing environment that he has lacked for the last five years. He is receiving routine medical care, nutritious food, an education, and most importantly, love and social interaction. She has advocated for him in ways that most people would find difficult, starting first by taking him in when she has other children of her own, and by initiating the special education referral that will get him the support he needs. I am confident that X will quickly catch up to where he needs to be with her care and appropriate educational services.

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Friday, December 23, 2011

Holiday Wishes for Mental Health Professionals

Just got this in an email through my district's psychologist email group and I simply had to share. Happy holidays everyone! Expect a couple good case study posts next week from the comfort of my couch. :)

Christmas Carols for the Psychiatrically Challenged:
Schizophrenia--Do You Hear What I Hear?
Multiple Personality Disorder--We Three Queens Disoriented Are
Amnesia--I Don't Know if I'll Be Home for Christmas
Narcissistic--Hark The Herald Angels Sing About Me
Manic--Deck the Halls and Walls and House and Lawn and Streets and Stores and Office and Town and Cars and Buses and Trucks and Trees and Fire Hydrants and
Paranoid--Santa Claus is Coming to Get Me
Personality Disorder--You Better Watch Out, I'm Gonna Cry, I'm Gonna Pout, Maybe I'll Tell You Why
Borderline Personality Disorder--Thoughts of Roasting on an Open Fire
Obsessive Compulsive Disorder-- Jingle Bells,Jingle Bells,Jingle Bells,Jingle Bells,Jingle Bells,Jingle Bells,Jingle Bells,Jingle Bells,Jingle Bells,Jingle Bells,Jingle Bells,Jingle Bells,Jingle Bells,Jingle Bells
Agoraphobia--I Heard the Bells on Christmas Day But Wouldn't Leave My House
Autistic--Jingle Bell Rock and Rock and Rock
Senile Dementia--Walking in a Winter Wonderland Miles From My House in My Slippers and Robe
Oppositional Defiant Disorder--I Saw Mommy Kissing Santa Claus So I Burned Down the House
Social Anxiety Disorder--Have Yourself a Merry Little Christmas While I Sit Here and Hyperventilate

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Tuesday, December 13, 2011

Backpack! Backpack! Backpack! Backpack!

(name the obscure children's TV show reference)

I just found Marie's blog over at the South Carolina Counselor Cafe as she posted on my Facebook page, and in looking back through her entries, I found a great reference for helping families faced with poverty and homelessness.

As I've mentioned many a time, my school is high poverty, low SES. We have about 99% of the students receiving free and reduced lunches. At the district level, we find that many of our students do not have enough to eat. As such, we have a breakfast program where every morning, the students are provided with a breakfast pack and milk. I always make sure to have extra breakfasts in my office. Why? Well, if there's a kid having a behavioral fit before 10:00am, there's a pretty good chance they haven't eaten breakfast (and in some cases, since lunch at school the previous day). The first thing I ask when kids are having meltdowns in the morning is whether or not they had breakfast--not "what did you do?" or "what happened?"

A tangential story for a moment. Last winter, we had a terrible snowy day (which never happens in Western NY, right? ha). All the surrounding districts were closed, but not ours. Why you may ask? It was a Friday, and the rumor was that the superintendent kept school open so that the students would get breakfast and lunch in school Friday, and wouldn't have to go three days without food over a long weekend.

This year, we have a new partnership with the local food bank. This was sought out through the community service providers that are housed in my building. Every Friday, the food bank provides backpacks full of nutritious food for our students to take home over the weekend. We have over 50 families participating! It's such a wonderful program and has so many great benefits. Aside from giving families food for the weekend, the backpack program is also designed to increase school attendance. There's nothing like seeing all the little munchkins tearing down the hallway on the way to the bus with their yellow backpacks bouncing on their backs. I'm so glad we have the opportunity to provide for these students!

If you work in a high poverty area, or have a student population that is significant for homelessness, contact your local food bank or soup kitchen and see if they also partner with schools to provide for students. You never know what you might find out.

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Thursday, December 8, 2011

What Do Basketball and Social Skills Have in Common?

One of the big problems with working in an urban area is the lack of enrichment activities for the students. We have no music program aside from one semester per year of general music (although our new music teacher rocks and is trying to expose the kids to more), we have no clubs or activities aside from a fall cross-country team and a winter basketball team, and we have a very limited art class, which is also only for a semester. My principal is trying hard to get the kids out on field trips to local colleges, the theatre, and to see the city orchestra, and she's bringing in a lot of before and after school tutoring programs.

Our gym... go green team!
Today, I stayed after school not to write IEPs or reports (as is the norm lately with the program review I'm wading through), but to go to the boys' basketball game! Some of my 7th and 8th grade friends have been trying to get me to go, so since today was their last home game, I couldn't pass it up. It was a blast! The boys lost by 2 points, but they played hard and enjoyed themselves.

The benefits of extracurricular activities, especially sports, is so incredible for kids. Not only do they learn routines, expectations, rules, and how to follow directions, they increase their social skills. Kids learn about turn-taking and sharing, good sportsmanship, how to deal with upsets and challenging situations, friendship skills, leadership, and problem-solving skills. Research has also shown a positive correlation between participation in sports and academic achievement. Hmm... sounds like all of the "desired behaviors" I write on my Behavior Intervention Plans (BIPs)!

Watching the boys working together, congratulating one another, and cheering each other on was fantastic. The majority of the team is self-contained special ed. students from the 15:1 classes in junior high, who need some social skills training, so this is an excellent opportunity for them. I wish that we had more sports teams for our school. Maybe it would keep me from having to write so many BIPs! ;)

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