2. CONTINUUM OF SUPPORTS AND SERVICES

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1 Continuum of Supports and Services 2. CONTINUUM OF SUPPORTS AND SERVICES This section will review a five-step process for accessing supports and services examine each step to determine who is involved and what is occurring provide a case study of the five-step process All schools have a variety of supports and services that can be used to meet the individual requirements of all students, including those who are alcohol-affected. Schools need to articulate the types of supports and services that are available to students and clarify the process for accessing them. The levels of supports and services available will depend on the school size and the availability of support staff. Each school division or district provides unique supports to meet the varying needs of students. In the diagram below, supports and services are shown as a series of steps, beginning with the classroom teacher and proceeding to external agencies/ community supports. This continuum of supports and services ensures that every child receives the level of support necessary for his or her success. Continuum of Supports and Services formal responses External/ Community Supports Educational Support Team In-School Support Team informal responses Pre-Referral Consultation Core Team (Note that this diagram is only an example of how supports and services can be organized. The steps may need to be adjusted to meet the needs of small and/or remote schools and divisions/districts.) Providing Appropriate Supports and Services Today, all schools are faced with the challenge of providing supports and services to students with a broad range of needs. Student needs range from minor problems to major issues. Similarly, responses need to range from minor adaptations to major interventions. The responses available to schools can be divided into two forms: informal and formal. 2.1

2 Towards Inclusion: Tapping Hidden Strengths Informal Responses Informal responses are provided by the classroom teacher. The teacher uses his or her repertoire of strategies and techniques to address initial concerns. The teacher is not alone in this process but rather uses the expertise of parents, colleagues, and specialists. For the vast majority of students, it is the actions taken by classroom teachers in ordinary settings that are key to meeting their individual needs. The Student Support Team Mental Health Worker External/ Community Supports Autism Outreach Team Psychiatrist Educational Support Team Reading Clinician Family Physician Child & Family Services Social Worker In-School Support Team Speech- Language Pathologist Probation Services Consultant for the Blind and Visually Impaired Principal Core Team Student Special Education/ Resource Teacher Consultant for the Deaf & Hard of Hearing ESL Teacher or Consultant Parent(s) Teacher(s) Audiologist Elder(s) School Counsellor Paraprofessional Psychologist Daycare Nurse Child Development Clinic Children s Special Services Divisional Resources Occupational Therapist Physiotherapist Vocational Rehabilitation Services The following two sections Core Team and Pre-Referral Consultation provide suggestions for learning about students and developing appropriate classroom interventions for academic or behavioural difficulties. 2.2

3 Continuum of Supports and Services Core Team External/ Community Supports Educational Support Team In-School Support Team Pre-Referral Consultation Core Team Who is Involved? teacher(s) parent(s) the student What is Occurring? The teacher begins to collect information about the student by examining existing files (cumulative files, resource files, report cards, screening reports, medical reports) talking about the student with the parent(s) discussing the child with the previous years teacher or daycare staff determining if other agencies, medical practitioners, or support workers are involved observing and talking to the student at the initial meeting with the parent(s) The teacher begins the school year using the same classroom supports, routines, and differentiated instruction strategies used with the student in previous years and continues observing the student conducting classroom-based assessments using a variety of strategies that can assist all students within the regular classroom These strategies might include establishing specific goals for the student creating flexible groupings of students employing differentiated instruction strategies teaching with a variety of learning modalities providing learning activities that address the multiple intelligences pre-teaching important concepts providing extra instruction within the class or at other times involving the parent in home instruction Meeting Learning Modalities Individual Adaptations Wide Range of Learning Materials individual student needs In Positive Classroom Environment Teacher Multiple Intelligences the classroom Groupings of Students Differentiated Instruction Learning Styles 2.3

4 Towards Inclusion: Tapping Hidden Strengths Core Team External/ Community Supports Educational Support Team In-School Support Team Pre-Referral Consultation using classroom volunteers or student helpers providing student-specific adaptations (e.g., more time to complete work, large print materials) selecting learning resources at a variety of levels using a variety of strategies to deal with behavioural issues Pre-Referral Consultation For additional information on teacher strategies for meeting student needs, see Success for All Learners: A Handbook on Differentiating Instruction (Manitoba Education and Training, 1996). Who is Involved? teacher(s) parent(s) the student other teachers pre-referral team other school/division personnel such as the resource teacher, school counsellor, school clinicians, school administrators, or external professionals may be consulted during this step What is Occurring? During the pre-referral consultation stage, the teacher continues to search for strategies, supports, and interventions that can help the student. This may include collecting additional information on the student discussing concerns with the parents and exploring what strategies are working at home asking other teachers for ideas and suggestions beginning to experiment with individual strategies that will address the concerns that are observed using informal consultations with support professionals, such as the resource teacher or school clinician accessing the pre-referral team (if one exists in the school) informing the principal of the concerns Pre-referral teams are often developed in schools/divisions as a method of helping teachers address individual student problems. Teams are made up of knowledgeable teachers and support staff who can provide the teacher with ideas, strategies, and interventions that can be used in the classroom with the student prior to the initiation of a formal referral. Teams meet on a regular basis and often use a structured approach. 2.4

5 Continuum of Supports and Services There are several models of pre-referral teams that can be effectively used in schools. Two of the more common ones are the Teacher Assistance Team (Chalfant and Pysh, 1989) and the Instructional Support Team (Kovaleski, Tucker, and Stevens, 1996). Additional information on the Teacher Assistance Team referral teams can be found at the end of this section. For further information on the Instructional Support Team, visit the Manitoba Education, Training and Youth website at: < instruct/regsupp/sar-innovations-grant% html>. Core Team External/ Community Supports Educational Support Team In-School Support Team Pre-Referral Consultation Formal Responses Formal responses are provided when all informal strategies have not been effective in addressing the student s learning needs. These responses should be reserved for students who have more significant needs and who require a greater level of staff expertise. The key test of the need to move to formal supports is that current rates of progress are inadequate and the student is struggling in the classroom. Formal responses require an application process with parental consent. As formal responses come into effect, other professionals join with the teacher to provide an appropriate program. In-School Support Team Who is Involved? school administrator resource/special education teacher school counsellor classroom teacher may also involve school clinicians What is Occurring? In many schools today, an in-school support team is in place to coordinate the services that are being offered to students with special needs. The team meets on a regular basis to consider formal referrals for service and to plan the school s responses to special service issues. The duties of the in-school support team often include receiving and considering formal referrals for resource, guidance, or clinical assistance conducting assessments as required providing one-on-one or small group interventions developing school supports and procedures for use with students experiencing difficulties (e.g., peer tutors) coordinating the assignment of paraprofessionals if necessary collaborating with external agencies assigning in-school case managers and team members for the Individual Education Plan teams 2.5

6 Towards Inclusion: Tapping Hidden Strengths Core Team External/ Community Supports Educational Support Team In-School Support Team Pre-Referral Consultation In-School Case Managers Once formal services are to be provided to a student, an in-school case manager should be assigned. The in-school case manager is the person who coordinates the student s school program. The in-school case manager does not always have to be the resource teacher, but should be someone who can relate to the student. This may include classroom teachers, counsellors, administrators, special education teachers, clinicians, and outside agency representatives. The duties may include determining the members of the Individual Education Plan (IEP) team arranging meeting locations and times determining which members of the team are needed at a meeting recording the outcomes and action plans from the meeting maintaining contact with the parent ensuring that the necessary paperwork and reports are completed Educational Support Team When specialized services are required for the student, the members of the Educational Support Team are involved. Who is Involved? The actual members of the educational support team will vary, depending on the resources available within the division/district. The members may include a speech-language pathologist school psychologist social worker occupational therapist physiotherapist reading clinician consultant for the deaf and hard of hearing consultant for the visually impaired behaviour specialist consultant for special education other divisional resources 2.6

7 Continuum of Supports and Services Core Team External/ Community Supports Educational Support Team In-School Support Team Pre-Referral Consultation What is Occurring? Referrals are made to clinicians and require written parental permission. The services provided by the Educational Support Team may include conducting individual student assessments providing recommendations based on the assessments participating in program planning on Individual Education Plan teams providing individual or small group interventions collaborating with external agencies consulting with parents providing workshops and training on a variety of topics completing reports on individual students External/Community Supports For some specialist services, referral outside of the school division is required. Often these referrals are made when the school division has exhausted the resources that are available internally. Sometimes the request is to have a specialist join a student s planning team. At other times, the request is to access services offered by a community agency. In rare circumstances, it may become necessary for the student to temporarily leave the school system in order to access more appropriate services. It is very important that student services personnel become aware of and communicate with community agencies to see what types of services are available. Staff should Additional information on community resources is available online at < metks4/instruct/specedu/review/ family>. This site provides a listing of many professional organizations, advocacy groups, service organizations, and government services that would be useful to schools or families. The community organizations are included in a database that allows searches based on disability area, community, or organization type. Searching under Fetal Alcohol Syndrome will also provide a list of available community resources. keep an up-to-date listing of the services available with the name of the contact person for each service. 2.7

8 Towards Inclusion: Tapping Hidden Strengths Community Services HealthxServices Regional Health Authorities Mental health offices Regional hearing centres Manitoba Health Child and Adolescent Psychiatry (Health Sciences Centre, St. Boniface Hospital) Northern nursing stations Clinic for Alcohol-Exposed Children Child Development Clinic Family Services Child and Family Service agencies Children s Special Services Community living Daycare Youth emergency services Justice Services Community and Youth Correction Services Manitoba Youth Centre Agassiz Youth Centre Youth Justice Committees Police services R.C.M.P. local detachments Recreation Services Community clubs Summer camps Boys and Girls clubs Education Services Special Education Support Unit School Therapy Services Deaf and Hard of Hearing Services Unit Blind and Visually Impaired Services Unit Employment centres Community Agencies Manitoba Adolescent Treatment Centre Child and Adolescent Treatment Centre (Brandon) Macdonald Youth Services (Winnipeg, Thompson) Marymound, Inc. New Directions for Children, Youth, and Families, Inc. Canadian National Institute for the Blind (CNIB) Addictions Foundation of Manitoba Rehabilitation Centre for Children Each community resource has specific entrance requirements and referral criteria. Staff and/or parents should contact the agencies prior to making a formal referral. 2.8

9 Continuum of Supports and Services Close Up A Closer Look at the Five-Step Process A new student - "Sarah" - moves into the school catchment area from another community. She was registered in Grade 2 by her adoptive parents. Her parents have a report card showing that Sarah had some difficulty in Grade 1, but was promoted to Grade 2. The teacher's comments indicated that Sarah was very verbal, likeable, and active. Her parents confirm this. From the first day of school, Sarah stands out in class. She is small for her age but very verbal and active. She is constantly out of her seat and interrupting other students. To address these concerns, the teacher begins to collect information. She places a phone call to Sarah's last school. The school informs her that the cumulative file has been sent. The former school principal indicated that services were very limited in their school and that Sarah was not a high priority. He described her as a very active and talkative young girl. The parents were supportive of the school, and well-liked in the community. The cumulative file arrived with few new pieces of information. A Kindergarten screening form indicated that Sarah had normal hearing and vision, but concerns were raised with regard to her receptive language and concept development. The teacher had observed the student and noted she was having difficulties in printing words and in reading comprehension. At the first meet-the-teacher evening, the teacher asked Sarah's mother how Sarah was finding her new school. The mother indicated that Sarah found school hard and hadn't met any new friends in the neighbourhood yet. By the middle of September, the concerns of Sarah's teacher had continued to escalate. She had moved Sarah to a desk immediately in front of her desk. She implemented a strategy where Sarah would be given a cue when her talking became too loud for the classroom. She spent several days getting Sarah to follow a simple procedure for staying in her seat. After several attempts, the teacher became frustrated because Sarah was having difficulties remembering the steps. The teacher had met with the resource teacher to see if she could help her conduct a running record to determine the extent of Sarah s reading problems. The resource teacher also provided some basic reading resources including visual and printing aids. (continued) 2.9

10 Towards Inclusion: Tapping Hidden Strengths Core Team External/ Community Supports Educational Support Team In-School Support Team Pre-Referral Consultation In October, the resource teacher and classroom teacher reviewed Sarah's running record and printed work samples. Together, they hypothesized that Sarah was not comprehending what she was reading, even though she could recognize most words at the Grade 2 level. It was decided to have a pre-referral conference with the speech-language pathologist. As well, the teacher decided to contact the parents, to review the difficulties Sarah was experiencing. During the meeting with parents, Sarah's mother became very upset and indicated that behavioural problems were developing at home. She felt the school was not helping her daughter adjust to the new school situation. The pre-referral team met to review the information that was available about Sarah. It was decided that several assessments were required. The resource teacher agreed to include Sarah in a Grade 2 small group reading program to provide her with extra support. As difficulties continued, the teacher working with Sarah decided that the development of an IEP would be beneficial. As a result of their initial findings, the team decided to focus on Sarah s hyperactivity, inattention, memory problems, receptive language difficulties, and social deficits. The IEP team decided to develop an initial intervention plan with additional components being added as the psychologist completed his assessment. The basic domains that were included in the plan were: Social domain - to assist Sarah in developing skills to make friends Behavioural domain - to help Sarah manage her hyperactivity Communication domain - to provide suggestions for the teacher to assist Sarah in understanding the language used in the classroom. Academic domain - to provide reading assistance for Sarah The psychologist had initially suspected that Sarah was Attention Deficit Hyperactivity Disordered (ADHD). However, as more information became available, he believed there were other factors involved. The psychologist was concerned that Sarah had several characteristics that might indicate prenatal exposure to alcohol. He believed that more needed to be done to confirm his suspicions (continued) 2.10

11 Continuum of Supports and Services and to find ways to support the parents. He met again with the parents to explain the results of the initial assessment. The parents agreed to take Sarah to a local pediatrician for a full physical assessment. Prior to Sarah having her physical assessment, the psychologist talked to the pediatrician about his concerns. This prompted the doctor to take a greater interest in the prenatal information that was available. During his initial interview with Sarah's mother he raised the issue of Sarah's birth mother. The mother indicated that she knew very little about the birth mother, other than that Sarah had been removed from her mother at birth by the local child welfare agency. The doctor also was concerned by Sarah's hyperactivity and behaviour, and the frustrations and grief that were being expressed by the mother. The doctor returned a call to the school psychologist to ask if a social worker from the school division could be involved with Sarah s mother to help her deal with behavioural issues at home, obtain some respite supports, and to explore further the possibility that Sarah was prenatally exposed to alcohol. The school psychologist brought the information back to the team. A referral to the social worker was made by the team. The social worker met with the mother and helped her access community supports and contact the placing agency to learn more about the birth mother. Based on the information obtained, it was confirmed that Sarah had been prenatally exposed to alcohol. The social worker then explained the issues to the mother and discussed the possibilities of referring Sarah to the Clinic on Alcohol and Drug Exposed Children for a diagnostic assessment. The social worker provided the parents with information about the Clinic, the pros and cons of having an assessment, and suggested they take some time to come to a decision. Three months later, the Clinic assessed Sarah and a diagnosis of Alcohol-Related Neurodevelopmental Disorder was made. The diagnosis helped the IEP team understand the issues and develop strategies to meet Sarah s specific learning needs. 2.11

12 Towards Inclusion: Tapping Hidden Strengths Finding the appropriate level of service is a key to success. This section has examined the variety of supports and services that may be available to help develop effective programming, not just for students who are alcohol-affected, but for all students in the classroom. It is important to remember that although classroom teachers are responsible for providing academic and behavioural programming for each student in their classroom, they are not alone. By using the informal and formal supports available in the school, division/district, and community, we can begin to put together the appropriate services and supports that can assist in developing an appropriate plan for even the most challenging students. 2.12

13 Section 2 Support Materials Teacher Assistance Team Information Teacher Assistance Team Request For Assistance/Collaboration Child Guidance Clinic Consultation Request Form

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15 Continuum of Supports and Services Teacher Assistance Team Information A Teacher Assistance Team (TAT) is an in-school team that usually involves a school administrator, resource teacher, and two or three highly regarded staff members. Staff members complete a Teacher Assistance Team Request Form, and the TAT meets to discuss the concern. Meetings are structured and usually kept to a 30-minute timeframe. At the completion of the meeting, the teacher will agree to try one or two intervention strategies. As well, a measurement plan is agreed to and a follow-up meeting is scheduled. A pre-referral process requires a structured approach to work successfully. This structure may include a referral form, a meeting format or structure, regular meeting times, brainstorming of solutions, a follow-up process, and notification of the parent. When the process is working well, the teacher will receive a number of strategies and interventions for working with the student. The 30-Minute Meeting For more information on Teacher Assistance Teams, see Teacher Assistance Teams: Five Descriptive Studies on 96 Teams (Chalfant, James, and Margaret Pysh, 1989). The pre-referral stage involves meetings regarding individual students. These meetings are necessary, but can take time away from a teacher s already heavy workload. Therefore meetings need to be carefully planned and conducted. One method that has been used successfully is the 30- minute meeting. Example: discuss the student s recent successes and identified strengths 5 minutes identify the areas that need attention 5 minutes establish specific goals and SMART objectives 5 minutes brainstorm interventions 5 minutes select ideas for trial (teacher) 5 minutes agree on measurement plan 3 minutes determine date of follow-up meeting 2 minutes 2.15

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17 Teacher Assistance Team Request For Assistance/Collaboration* Continuum of Supports and Services Name: Date: Room: Grade: Age: 1. Describe what you would like the student to be able to do that she/he does not presently do. 2. Describe what you have done to help the student cope with her/his problem. (continued) * Copyright 1971 by Dr. James C. Chalfant and Dr. Margaret V. Pysh. Reprinted by permission. 2.17

18 Towards Inclusion: Tapping Hidden Strengths 3. Describe what the student does (assets/strengths) and what he/she does not do (deficits/problem areas). Assests/Strengths Deficits/Problem Areas 4. Other (or what else should we know?) Requesting teacher: Grade: Room: 2.18

19 Continuum of Supports and Services Child Guidance Clinic (C.G.C.) Consultation Request Form * Date: Name: Address: School: Teacher: Date of birth: Phone number: Grade: Academic Performance More than 2 years below grade level Less than 2 years below grade level At grade level Above grade level Reading decoding q q q q Reading comprehension q q q q Math computation q q q q Math problem solving q q q q Writing copying skills q q q q Writing composition q q q q Has the student ever been retained? q No q Yes (What grade?) Attention Span/Behavior q No concerns Please describe your concerns: Social/Emotional Functioning q No concerns Please describe your concerns: Family Situation q No concerns Please describe your concerns: Communication Skills Hearing q Passed hearing screening (date): q Failed hearing screening (date): q Hearing screening not completed * Copyright Child Guidance Clinic. Reprinted by permission. blah vlah bhah blah (continued) 2.19

20 Towards Inclusion: Tapping Hidden Strengths Speech q No concerns q Difficulty producing sounds (e.g., ) Fluency/Stutttering q No concerns q Repeats parts of words or whole words Voice q No concerns q Has breathy, hoarse voice q Is continually congested q Talks too loudly/too softly Language q No concerns q Weak vocabulary skills q Difficulty recalling specific words q Difficulty following directions and classroom routine q Difficulty understanding academic themes and concepts q Weak grammar skills q Asks for repetition of directions and/or explanations q Difficulty explaining and describing q Takes a long time to respond q Has trouble staying on topic q Weak thinking and reasoning skills Comments on communication skills: FOR C.G.C. USE ONLY Discussed by on (name) (date) Outcome: q additional suggestions for school-based intervention q request for academic resource testing and report q classroom observation or screening of student by clinician q formal referral to C.G.C. (discipline: q Psych q SW q SLP q Ptry) q referral to outside agency q other Details: Submitted by (print name): Signature: Reviewed by resource team (sign and date): 2.20