Guest Post! - Confessions from a Former School Psychologist

It's that time again... a guest post! This guest blogger gives unique insight into leaving the field for bigger pursuits--namely, school administration. Trained as as a school psychologist at Temple University, Dr. Ari Yares is currently the Upper School Principal at the Schechter School of Long Island. He has previously worked as Head of Middle School at Krieger Schechter Day School and as a school psychologist for the Anne Arundel County Public Schools. Visit his blog Not Reinventing the Wheel!

Confessions from a Former School Psychologist

It has been five years since I last touched a WISC or any other testing kit.

No, this is not my introduction to a school psychologists’ anonymous meeting, but rather a reflection on the biggest change that I have undergone since handing in my testing kits and becoming a school administrator.  Otherwise, so many of my skills and training as a school psychologist have transferred directly to my new role.

As a school psychologist, I was very fortunate. I worked in a school district with an excellent student to school psychologist ratio and our leadership in student services pushed us to support our students through more than just the refer-test-place process. I actively consulted with teachers, had ample time for counseling, and was heavily involved in the implementation of my schools’ Positive Behavior and Intervention Support (PBIS) programs. I helped develop student support teams in my schools while working to make sure that the more restrictive special education placements that I supported worked successfully. All of this existed in a collegial atmosphere of our psychological services office which encouraged us to grow and collaborate as practitioners.

Somehow, in the midst of this, I came to a conclusion that I was feeling limited by my role. As I worked to support PBIS and other programs, I was restricted, not because of anyone’s conscious desire, but because as a school psychologist, I often functioned parallel to the educational system that I supported. While I could consult, advise, and plan, I was unable to supervise or mandate and certainly did not have direct access to a budget to support my efforts. Perhaps most importantly, I wanted to have a different kind of impact on changing the school environment that I saw as a factor in my students’ difficulties.

It was at this point that I decided to pursue additional training as a school administrator. Since that initial certification as a school administrator, I have continuously marveled at the overlap between my two chosen fields. While I am now in a position to supervise teachers, I get my best results when I apply my skills as a teacher consultant. The line of students and teachers who just want a few moments to chat and get something off their chests has not changed-- I’m just in a different place to address them. Likewise, I still support our intervention teams as we work collaboratively to eliminate student problems.

There are differences, of course. As an administrator, I worry about the budget that I once longed for. Sometimes, what had been a supportive consultation with a teacher needs to move to being a directed conversation where my authority as the principal is used. Mundane issues, like the boiler or trash in the cafeteria, can fill my days and sometimes I feel a greater distance from the students that I went into both of my careers to help.

At the end of the day, though, I am grateful to have had the opportunity to have crossed the bridge between school psychologist and school administrator. Most of my colleagues in administration are former teachers. Very few share my background as a school psychologist. Yet, it is this background that I feel has made me a more effective instructional leader and helps me navigate the murky waters of school administration.

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Guest Post! - Conducting Comprehensive Autism Evaluations

Another marvelous guest post, and very timely since April is Autism Awareness Month! Today, we discuss best practices for Autism evaluations from an expert. “Dr. Tonya” Gscheidle, NCSP received her PhD in School Psychology from UNC-Chapel Hill, which is the home of TEACCH. She has been actively participating, leading, and/or training others in the art of Autism evaluations for the past 7 years. Tonya currently has the pleasure of “torturing” public school kiddos through evaluation in the Oklahoma City area. 

Conducting Comprehensive Autism Evaluations

According to the CDC, 1 in 88 children have been diagnosed with an Autism Spectrum Disorder (ASD), with boys four times more likely than girls to receive that diagnosis. While no one cause for Autism has been identified, many debates are ongoing with various hypotheses about a cause(s), as well as if Autism is being overly diagnosed. The rapid increase in prevalence also prompted significant changes to the diagnostic criteria for Autism in the soon-to-be-published DSM-5, due to be released May 2013.  One way we, as school psychologists, can help ensure that only students who meet diagnostic criteria are labeled as having Autism is by conducting comprehensive evaluations. How can we be sure our evaluations cover all bases?  

• Screen, screen, screen! How many times have you been pulled aside by a teacher or parent stating that a student may have Autism because they do not make eye contact? Or does not speak in class? Prefers to play alone? Each one of those observations is a symptom of ASD, but in isolation, does not necessarily mean a child warrants a formal diagnosis of an Autism spectrum disorder. Just as we do not automatically rush to evaluate for Emotional Disturbance based on a single tantrum or ADHD if they are easily distracted, it is best practice to do classroom observations and gather information to develop a profile of behaviors for a particular student before rushing to obtain consent for an evaluation for special education. Screening is a relatively quick and easy way to do that – and there are screeners published for both the home and school settings. (We use the Autism Screening Instrument for Educational Programming – 3^rd Ed (ASIEP-3) for school and Social Communication Questionnaire (SCQ) for parents.) Screeners help you know how to proceed with your evaluation, as well as to help further educate parents and teachers. If they are insistent on an Autism evaluation based on one isolated symptom (e.g., does not make eye contact) but the screeners do not show that a full evaluation is warranted, you have documentation that you addressed their concern and can provide that information to the team without completing a full Autism evaluation (though an evaluation in another area may be indicated). 
• Social-Developmental/Medical History is crucial! Diagnostic criteria clearly state that symptoms must be present before age 3 for a student to be diagnosed with Autism. How else can you gather that information other than interviewing a parent?  Although some questionnaires can be sent home with a student for the parent to complete and return, I have found that it is better to do these interviews face to face or via phone conference so that you can ask follow up questions. Remember to include questions about sensory differences, responses to transitions/schedule changes, and family/peer relationships in any interview you use. Part of the history gathering should also include a medical history to rule out any possible diagnosis that could be causing the behaviors of concern.
• 

  There is no “I” in play based evaluations! ASD is characterized by significant disruptions in language and communication, reciprocal social interactions, and repeated/restricted stereotyped behaviors. The best way to assess those areas is thru a structured play-based assessment. The Psychoeducational Profile – 3^rd Ed (PEP-3) and Autism Diagnostic Observation Schedule – 2^nd Ed (ADOS-2) are the two most commonly used standardized play-based assessments used in Autism evaluations and allow direct assessment of those specific areas through activities or presses. As communication and sensory differences are two main diagnostic areas, Autism evaluations should be completed using a multi-disciplinary team approach to the greatest extent possible. If that is not the practice in your school district, consider seeking out your Speech/Language Pathologist or Occupational Therapist to see if the findings they found in the course of their evaluations support or contradict your own. The ADOS-2 has a scoring algorithm built in to quantify observations through ratings to determine if a student’s behaviors rise to the diagnosis of an ASD. When doing the PEP-3, teams in my district complete the CARS-2 rating scales to quantify our observations. The focus of your report should be on the behaviors observed in response to the presses/activities and NOT on the scores obtained.  In fact, the authors of the ADOS-2 advise NOT to report scores from the ADOS-2 in the report.  
• What – more behavior rating scales? In most instances, Autism is considered to be a life-long disability. A student may (and should!) learn compensatory strategies to be productive in school and the community, but in most cases Autism will always be present.  This “life-long disability” label should not be taken lightly. Additional rating scales can be collected to further validate your observations. Preferred rating scales for teams I have been involved with include the Social Responsiveness Scale (SRS) and Gilliam Autism Rating Scale-2^nd Ed (GARS-2). 

A word about cognitive testing: I would strongly recommend using low-verbal batteries that utilize manipulatives such as the KABC-II NVI or Stanford-Binet 5.  Remember that while we engage our worlds socially and through language, those with ASD tend to engage through the sensory realm.  It may help to start a student with a brief sensory activity (e.g., using a Rain Stick, Bumble Ball, texture bocks, or digging through a bucket of dried beans) to help them regulate emotionally before putting academic stressors on them. To keep sessions structured, I almost always use a sticker chart and allow students to put a sticker in a box for every activity (subtest) completed. The chart gives students a visual of the progress made, how much is left, and something to take with them as tangible evidence of how much was able to be completed during a given session.

Recommendations should address particular concerns that drove the initial referral as well as behaviors observed throughout the evaluation. Commonly, recommendations include strategies to increase structure in the classroom (including structuring play scenarios for younger students), warn students of impending transitions, provide frequent sensory breaks, and explicit teaching of expected behaviors followed by immediate consequences or rewards.  Often, it takes students with ASD a significantly longer time to directly associate specific behaviors with rewards or consequences. Many more discreet trials are often needed. Visual supports and hands-on learning may also be considered depending on the needs of the student.

I end with a few recommendations of my own. The number of resources out there for Autism is exponential but there is a handful that I use regularly when consulting with parents and teachers and keep close when asked for resources that I will share with you lucky readers out there. This list is not at all meant to be comprehensive, rather just “tried and true” suggestions you may want to consider adding to your toolbox.

Parent/Teacher Resources

-Practical Ideas That Really Work for Students with Autism Spectrum Disorders – Kathleen Mc Connell and Gail R. Ryser

-Educating the Young Child with Autism Spectrum Disorders – Michael Abraham

-*Anything* by Temple Grandin [side note from Musings--I'm reading The Way I See It, 2nd Edition and it's stellar)

Student Resources (fictional stories about living with an Autism spectrum disorder)

-Understanding Sam and Asperger’s Syndrome – Clarabelle van Niekerk and Liezl Venter

-Mockingbird – Kathryn Erskine

Websites

www.do2learn.com (picture cards and picture schedules)

www.autism-society.org

www.autismspeaks.org

www.teacch.com

Please consider “Lighting it Up Blue” this April to show support for those with Autism Spectrum Disorders! 

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Guest Post! - A Positive Approach to Professional Transitions

Eliane Hack, a fellow member of the NY Association of School Psychologist Executive Board (NYASP; representing Chapter F) and school psychologist in the Queensbury Union Free School District, graciously offered to share this article she wrote for the New York School Psychologist newsletter as a guest post! This article is the perfect positive pick-me-up and revitalizer as we school psychologists go through March Madness and the last push to finish all those evals before June hits. Thank you, Eliane! :) If you would like to contact Eliane, drop her a line at Eliane.hack@gmail.com.

A Positive Approach to Professional Transitions

It is an unceremonious transition, and one that happens at different times for different people, but one transition that cannot be overlooked is that of the budding, energetic, newly-hired school psychologist to the tired, underappreciated, and frustrated professional. In my case, this shift happened somewhere between my fourth and fifth year on the job. I had secured my tenure position and established myself as a trusted person in my building, but I found that the daily hurdles and sentiments of wanting to “vote someone off the island" made me question my ability to envision myself in this career through the year 2038 (when I am first eligible for retirement). It may be inevitable that this happens to you, or possibly already has. Here are the bits of advice I have found essential in staying positive and sticking with the career for which I know I was meant.

• Surround yourself with “balcony people” (those who encourage us, rather than “basement people”, who seek to hold us down with negativity). If you spend your time around perpetual cynics it is going to be hard to remain an eternal optimist, or even a realist. Negativity breeds negativity and the surefire way to make a bad situation worse is to harp on it without envisioning the solutions. I can thank my consultation coursework at Marist College for the solution-focused push on that one. It is also just as important to pass along compliments about others to others. Be a balcony person, a bucket-filler, and a genuine encourager wherever you can. The favor will gladly be returned.
• Create a "smile file". It may be corny, but it helps. Keep all of those nice notes from students, parents, fellow staff members, supervisors, and administrators. Look them over from time to time, to remind yourself that on that day, you made a difference to someone.
• Keep in touch with other graduates from your training program. You build strong bonds when you are in school together, and it will be important to share opinions and trade stories once you are employed. It is incredible how differently districts operate across the state and country. Trading stories also helps to keep perspective in that your "issues" might not be that bad! If we all threw our problems in a pile and saw everyone else’s, we would likely grab ours back.
• Find an activity that recharges your batteries - a quick activity that gives you a short break from the rat race, and keeps you grounded in the reasons you became a school psychologist in the first place. This may be something different for everyone, but for me, it is taking a few short minutes to visit one of my school's kindergarten self-contained classrooms. I feel like a rock star as I walk in to bear hugs and exclamations of, "Ms. Hack is BACK!" And, at five years old, they often say the funniest things. It's a guarantee that I will smile when I visit that room.
• Of course it helps to work with a solid group of school psychologists within your district. I am lucky to work with four other school psychologists in a district of about 3,700 students. As you have probably realized, being a school psychologist can be a lonely position, often being the sole psychologist in your building. Arrange monthly or quarterly meetings with your fellow school psychologists. It helps in terms of consistency across the district, as well as camaraderie and communication on some tough issues. Some of you may be the only psychologist in the entire district. This is where it helps to stay connected with others in your field, but more on that later. 

• Professional development should be about more than accruing credits for NCSP or district requirements. Find trainings that speak to your interests. I find that for many school psychologists, it is not only our job but our hobby. A friend who works in the computer industry could not believe that I wanted to go to a work-related conference on my own time and that I would drive several hours to get to it. I get excited about big name speakers in “our world” and related fields, such as George McCloskey, Jim Wright, Ross Greene, and Michelle Garcia Winner. I stop just short of asking for autographs.
• Speaking of professional development, I think it is important to take opportunities to deliver your own professional development. School psychologists are often looked to as experts on topics such as learning styles, behavior, mental health and disabilities, just to name a few. If you can present information to your colleagues that will ultimately help them to be more successful educators, they will be thankful, and you will feel useful! Feeling useful is one of the biggest motivators that keep me going each day. Another way to help others help themselves is to catalog the books in your office to establish a lending library. I compiled a list of over 200 books available for staff to borrow as needed, which I “advertised” throughout my building at various points throughout the school year. Of course this will not completely eliminate the need to be called on to put out fires, but it can help better equip others.
• My last bit of advice is something you have already heeded since you are reading this article. Stay involved in your state and national associations. Being current with the goings on of your field is a necessary step in staying fresh and being re-inspired to carry on!

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