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Signs of Mental Health Problems In Children

May 1st, 2016

To learn more about both the effects of bullying and mental health and what you can do, you are invited to a seminar on May 10, 2016:  Understanding the Legal Obligations of a School District Regarding Bullying and Student Mental Health

By Marion M. Walsh, Esq.

Every parent and school professional must be aware of the mental health crisis confronting our youth and take steps to understand and advocate. Parents and schools must act together to protect children become educated on risk factors and symptoms.

If your child has a mental health issue, it is important to understand how to seek community supports and to understand the legal obligations of your school district.  Too many parents view mental health issues as a “private issue” or believe that things will improve. It is almost impossible for parents to handle mental health issues alone.

Signs of Mental Health Problems in Children:

Parents must be aware of signs of mental illness. Early identification is key to help children.  The Mayo Clinic and other professionals list the following signs of mental illness in children, but the list is not exhaustive:

  • Mood changes: Look for feelings of sadness or withdrawal that last at least two weeks or severe mood swings that cause problems in relationships at home or school. Some students simply withdraw. School avoidance or physical symptoms without physical causes can also be a sign of mental distress.
  • Intense feelings: Be aware of feelings of overwhelming fear for no reason — sometimes with a racing heart or fast breathing — or worries or fears intense enough to interfere with daily activities.
  • Behavior changes: Look for drastic changes in behavior or personality, as well as dangerous or out-of-control behavior. Fighting frequently or expressing a desire to hurt others also are warning signs.
  • Difficulty concentrating: Look for signs of trouble focusing or sitting still, both of which might lead to poor performance in school.
  • Unexplained weight loss: A sudden loss of appetite, frequent vomiting or use of laxatives might indicate an eating disorder.
  • Physical harm: Sometimes a mental health condition leads to suicidal thoughts or actual attempts at self-harm or suicide.
  • Substance abuse: Some children use drugs or alcohol to try to cope with their feelings.

School District Legal Obligations to Help:

Littman Krooks special needsIf a child is showing signs of mental illness, it is important for parents to understand school district legal obligations and also how to get community support.   Not every child with mental health issues has a disability but if a condition affects educational performance, the school district has an obligation to refer a student for special education and related services.

  • Pursuant to the Individuals with Disabilities Education Improvement Act (IDEA), 20 USC §1400, seq. and parallel state law, school districts have a responsibility to identify and provide appropriate services to students with disabilities, including those who have an emotional disturbance or disability, including another health impairment, such as ADHD.
  • As the Supreme Court noted in Honig v. Doe in 1988, “Among the most poorly served of disabled students were emotionally disturbed children: Congressional statistics revealed that for the school year immediately preceding passage of the Act, the educational needs of 82 percent of all children with emotional disabilities went unmet. See S. Rep. No. 94-168, p. 8 (1975).”  

If your child has mental health needs impacting education, you should refer your child for special education services and, if the child has a disability, he or she should qualify for an IEP and receive special education supports, such as counseling, flexibility with assignments, or a therapeutic environment. Some children with mental health needs may need building level help or need accommodations under Section 504 of the Rehabilitation Act.  

Steps to Take:

On a broader scale,  work with your school district and community to develop a task force to create systems and policies to proactively address student mental health needs and make sure interventions are in place.  Talk to your child’s school district administrators about making mental health and social emotional health a priority in your school district and ask about what programs are in place to ensure children are served.   Much training is available and many organizations have resources to help.

As just three examples of what you can do:

  1. Become Certified in Youth Mental Health First Aid
  2. Consider taking the Sandy Hook Promise, which encourages safer schools and more mental health treatment.
  3.  Attend a screening of No Letting Go, on mental health and youth and one family’s story, aimed at helping to end the stigma:

Read more on how to educate, advocate and support mental health awareness month by clicking here.

Learn more about our special needs planning and special education advocacy services at www.littmankrooks.com or www.specialneedsnewyork.com.


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When You Suspect Your Child May Have a Disability…

January 19th, 2016

By Felicia Lebewohl Rosen, Esq., Ed.M. (Edited by Marion M. Walsh, Esq., Littman Krooks LLP)

Take a deep breath … It can be emotionally difficult to accept and deal with the fact that your child has a disability. If you want your child with a disability to receive appropriate services to make his or her life (and yours) easier and more productive, you should acknowledge the possibility and consider seeking services.   First, you need a good diagnosis, to which interventions can be geared. This diagnosis can occur at any point during a child’s development, most commonly during infancy or early childhood. However, some parents only realize that their child has a disability in adolescence, when work and social demands become more difficult. If your doctor or psychologist makes a diagnosis, keep in mind that you need to share this information with your school district or preschool and determine whether your child is eligible for services.

The Law Protects Students with Disabilities and Requires Evaluations and Services

The Individuals with Disabilities Education Improvement Act of 2004 (“IDEA”), protects children with disabilities ages birth to 21 or until a student graduates with a regular high school diploma. The IDEA requires each state and school district to identify and evaluate all children who need special education and/or related services. Related services include physical, occupational and speech and language therapy and more depending on need.

Early Intervention (EI) is a system of services, free of charge to parents, that help children with disabilities or at risk for a disability, ages birth – 3 years old, and their families. For a child to receive EI services pediatricians, other service providers and parents may refer a child for EI. The Center for Disease Control and Prevention recommends that children be screened for developmental delays and disabilities during regular well-child doctor visits at 9, 18 and 24 or 30 months and additional screening may be warranted if a child is at high risk.

Once your child is school age and you suspect a disability or receive a diagnosis, parents may contact their school district and request that their child be evaluated for eligibility for special education and related services. School districts are responsible to provide educational and related services, free of charge to parents, for children with disabilities ages 3 – 21 or until a student receives a high school diploma. The law requires that school districts receive informed consent from parents before the child is evaluated by the school district to determine if the child has a disability under the IDEA. The individual evaluation must include a variety of assessment tools and strategies. A school district must conduct the evaluation within 60 days from the date that the parent consents to testing. At a minimum, an evaluation must include: a psychological evaluation, a classroom evaluation, a social history, a physical examination and other appropriate assessments or evaluations.

An evaluation is intended to address the following three questions:

  1.  Does the child have a disability that requires special education and related services?
  2. What are the child’s specific needs? and
  3. What special education and related services are appropriate for addressing those needs?

If parents disagree with the school district’s evaluations, they have a right to an Independent Educational Evaluation (IEE) and request that the school system pay for the IEE. A diagnosis from a doctor or psychologist of a disability does not guarantee that a child will be eligible for special education or related services. The law requires that the disability impacts the child academically.

Littman Krooks Special NeedsIn New York, a Committee on Special Education (CSE) for students in grades K-12, and a Committee on Preschool Special Education (CPSE) for students ages 3-5, are multi-disciplinary teams that include, at the very minimum, the parent, a general and special educator, a school psychologist or another professional who is qualified to interpret evaluations, and a district representative. The CSE and CPSE will convene to review the evaluations and determine if the child is a “student with a disability”, as defined by the IDEA. If the parents do not agree with the evaluation decision, they may ask for an impartial hearing to challenge the decision. Some neurological conditions, such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder/Attention Deficit Disorder (ADHD/ADD) and a Learning Disabilities (LD) are often difficult to diagnose because there is no medical test, like a blood test or an MRI, to diagnose these disorders. Further, many other conditions have symptoms that are similar to those of ADHD/ADD and there is a great deal of comorbidity with other conditions. For example, anxiety can mask as ADHD.

At the CPSE and CSE meetings, if a child is deemed eligible, the team will draft an Individualized Education Program (IEP). The IEP is a legal document which discusses the child’s strengths and areas of need. It specifies the special education and related services that the child will receive free of charge to the parents. If the parents disagree with the IEP or the placement recommended by the CSE, the parent may request a Due Process Hearing. In some cases, filing a complaint with the New York State Education Department may be appropriate. Parents may proceed pro se (without a lawyer) or be represented by counsel.

Personal Advice on Keeping it all in Perspective

If your child has a disability, try not to waste your emotional energy on self-blame. Disorders such as autism, ADHD, and emotional and learning disabilities can be disorders in certain regions in the brain. They are not caused by bad parenting, chaotic home environments, ineffective teachers, too much sugar in the child’s diet or the child himself. Your child is still the same child you had before the diagnosis. Love, play, engage, have fun, enjoy, hug and laugh with your child. If your child is an adolescent, give your child support along with the space he or she needs to grow at their own pace.

Take care of yourself or you will not be able to take care of your child. We are all familiar with the stewardess’ message on airplanes to put your oxygen mask on before you place one on your child. So take care of yourself so you can better take care of your child. Put on your oxygen mask by joining support groups, finding solace in supportive family and friends or religion, joining support groups, exercising and eating well and remembering to enjoy and laugh. It can be a long journey.

For more detailed information about disability laws, see www.nysed.gov/specialed.

 

Felicia Rosen is a legal intern with Littman Krooks LLP and is an attorney. She graduated from New England School of Law and Columbia University Teachers College. 

 

Learn more about our special needs planning and special education advocacy services at www.littmankrooks.com or www.specialneedsnewyork.com.


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Avonte's Law Addresses School Safety for Children with Special Needs

September 22nd, 2014

Avonte’s Law, which calls for audible alarms on school building doors, was passed by New York City Council and signed into law by Mayor Bill de Blasio in August. The law is named for Avonte Aquendo, a 14-year-old boy with autism who went missing from his school in Queens and was later found dead. Avonte’s Law is one action among many that are needed to protect students with special needs.

The new law requires the New York City Department of Education to evaluate the need for audible door alarms and install them where they are deemed necessary. The evaluation and a timeline for installation must be completed by May 30, 2015. The law as passed is not as strong as the original proposal, to simply require audible alarms on school doors.

On October 4 of last year, Avonte Aquendo went missing from the Center Boulevard School in Long Island City, Queens. Avonte had severe autism and was not able to speak. Volunteers participated in a massive search for the boy. His body was found in College Point along the East River three months later.

Mayor de Blasio said that the legislation would protect other children from tragedy. Vanessa Fontaine, Avonte’s mother, said she supported the new law, but the family still had unanswered questions. She filed a wrongful death lawsuit against several city agencies in June.

Avonte’s Law is one practical response to the tragedy, but more action is needed to keep children with special needs safe. Children with autism in particular may be prone to bolting or wandering, but children with other special needs often require additional supervision as well. On September 15, a 15-year-old girl with an emotional disabilities and ADHD disappeared from her school in Brooklyn, leading to a search by family members and police. Thankfully, Nashaly Perez was found safe, but her mother said that officials at the special needs school did not take the disappearance seriously enough. How many times does a child with a disability have to disappear from school before New York City takes strong and effective action?

Every child with special needs has different needs, and parents must ensure that a child’s Individualized Education Program (IEP) reflects the level of supervision that is needed, and that school officials are aware of the requirements and follow them. However, Avonte’s case is one tragic example that reveals that school officials do not always follow through on instructions in a student’s IEP. Avonte’s IEP included a warning from his mother that he needed one-on-one supervision, because he liked to run and would leave the building. An investigation showed, however, that no one who was with Avonte the afternoon he ran had been informed of that tendency.

Avonte’s Law represents a step in the right direction, but school officials and teachers can and should do more to protect children with special needs.

 

Learn more about special needs planning and special needs advocacy by visiting www.specialneedsnewyork.com.


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How Respite Care through Medicaid Helps Parents Care for their Children

December 5th, 2013

Our latest guest blogger is Nanette Saturn, Educational Advocate, Westchester Independent Living Center and Putnam Independent Living Services

Clearly, parents of a child with a developmental disability experience stress far beyond what most parents of neuro-typical children experience. In fact, a recent study noted that mothers of children with autism experience as much stress as combat veterans.

I didn’t need to see the data to believe this. I am the mother of a 9 year-old neuro-typical daughter, and a 13 year- old son who is diagnosed on the Autism Spectrum, along with ADHD and anxiety. When my daughter started getting older, I noticed how easy it was to do things with her, compared to my son. This is when I began to realize how different and challenging my life was compared to the average mother.

Since many children with developmental disabilities require a tremendous amount of one-on-one support, it’s difficult to take them on basic errands or to places where a child may have to sit for a period of time. Many parents take for granted the fact that they can bring their typical children to appointments or make a quick run to the store or send their child into the yard to play so they can get things done in their home. Parents of children with disabilities cannot often do this. The most basic of tasks – the supermarket, the pharmacy, a haircut, or a visit to a friends’ home – can be stressful, frustrating or simply avoided.

Respite Care Can Help You Be a Better Parent

Too often, parents are homebound and lose patience and time with their other children and relationships with family and friends suffer. I did not want to feel that I had to escape. I wanted to be a better mom, a healthier mom, a happier mom. I wanted to feel rested in order to enjoy the times I would be taking both of my children on an outing and to have some time to myself as well, to build and maintain my own relationships. I required time during the week or weekends to engage in activities without the stress automatically attached to each venture. I needed someone to engage my son and keep him properly occupied so I could have some time for whatever I needed to do.

Help is Available!

The good news is help is available for parents in this situation. If you are married or a single parent, respite care can help you maintain or build a relationship. It also benefits the siblings and allows them to access your time and attention. It allows for down time to re-group and re-energize yourself. Many parents feel that our needs are not as important as our children’s needs. They are! The stress, anxiety, frustration, anger and solitude aren’t healthy and do not help make you a stronger parent.

The goal of respite care is to provide relief to parents so they can find free time to take care of needed tasks or simply to maintain balance. The Office of People with Developmental Disabilities (OPWDD) Home and Community Based Medicaid Waiver may be an option to assist you in accessing this service through Medicaid, despite parental income level. There are limitations to the hours you are approved for, but even a few hours a week can make a significant difference in your family’s quality of life.

Don’t Give Up

I had always known respite care was available but had a difficult time finding a provider and, quite frankly, the thought of looking for someone on my own was daunting. I am so happy that I didn’t give up because since hiring my respite worker almost a year ago, I have never looked back. In fact, it has prompted me to make additional changes in my life that have benefited not only myself, but more importantly my children. I’m able to run out of the house at the last minute for something at the market, give my daughter some well-deserved attention, enjoy a bath or work on my personal relationships. My respite worker helps with homework and interacts with my son by playing games or doing some outdoor activities. This time not only allows me to have some freedom but provides the necessary one-on-one interaction my son requires. It also provides him with healthy alternatives to play. He’s no longer sitting in front of video games or movies, which in all fairness, may be the only respite I was getting. I challenge anyone to try to perform the daily tasks parents have to accomplish while simultaneously providing the constant attention required for their child. It’s impossible!

I cannot imagine how I was able to do it for so many years without this help. It’s important for every parent to know about the Medicaid waiver and the many services it provides. The initial set up or application process may seem daunting but the reward is tremendous.

Contact OPWDD Office

There are eligibility requirements through the Office of People with Developmental Disabilities (OPWDD). You must contact your local OPWDD office and explain that you have a child with a developmental disability and would like to apply for eligibility for OPWDD services. You can get information at http://www.opwdd.ny.gov/

Once your child is found eligible for OPWDD, you will be directed to attend a Front Door Session for individuals and families of people with Developmental Disabilities. Here, you will learn about the different services OPWDD offers and how you can obtain respite services through the Medicaid waiver or through the many different Family Support programs offered throughout New York State.

Nanette Saturn is an educational advocate with Putnam Independent Living Services, a satellite office of Westchester Independent Living Center. She is a mother of two children, one of whom has autism.

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Girls and ADHD: Why the Disorder Looks so Different in Girls and Boys

November 25th, 2013

Attention deficit hyperactivity disorder, or ADHD, is often associated with behavioral problems such as acting impulsively or disruptively. It is also diagnosed in boys three times more frequently than in girls. While the disorder does affect girls, symptoms may be harder to identify.

According to experts, the symptoms of ADHD are actually identical for boys and girls, but they often manifest differently. The symptoms include issues with concentration, attention and focus. The difference is that girls are more likely to attempt to hide their difficulties. While a boy with ADHD may be hyperactive, a girl with ADHD may be withdrawn. Girls with ADHD may try to avoid letting anyone know that they are distracted or not paying attention. Such behavior is often interpreted simply as shyness and is not readily associated with ADHD.

For girls, ADHD is also often connected to self-esteem issues. A girl who has trouble paying attention in school may say she is not as smart as the other children or that she does not like going to school. While her difficulties with concentration may be reflected in her school performance, ADHD is often not suspected simply because the girl is not disruptive but is instead withdrawn.

Another type of behavior that may be connected to ADHD is perfectionism. Girls with attention issues may try to hide their symptoms and control their world by engaging in the type of over-organization behavior more commonly associated with obsessive compulsive disorder.

If a parent suspects a daughter may have ADHD, a good first step is to talk to her teachers about how she compares to other girls her age. Further insight can be gained by talking with a school psychologist, school nurse, or pediatrician.

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ADHD Awareness: What Hurts and What Helps

October 1st, 2013

by Dr. Virginia Hurley, Professional ADHD Coach, TimeSavor Coaching.

People with ADHD are people with special needs. They are people with a neuro behavioral disorder that improves or deteriorates based on circumstances. It is linked to many neurological factors that have only become evident in the last two decades with the advent of advances in technology and multidisciplinary, integrated studies. Yet, in the classroom, the workplace, home and social settings, there are still many incredulous and uninformed people who perpetuate the suffering of those with ADHD.

To inform the public, to support those with ADHD, and to provide a more hopeful picture for those in the ADHD community: those are some of the reasons to promote ADHD Awareness

When the ADHD Awareness Campaign first really got off the ground, there were three major ideas the coalition of ADHD communities wanted people to know:

· ADHD is Real

· There is Hope

· Where’s the Help?

The ADHD Awareness Campaign has changed and expanded its impact over the past eight years, although the message that ADHD is real, there is hope, and there are avenues of help, remains the same. The importance of awareness got some traction with the US Congress’ declaration of a single DAY, Sept. 17, 2005.

Five years later, the ADHD Awareness Campaign was sponsored by a coalition of groups serving the ADHD community. The Campaign was not just for one day. Rather, the first ADHD Awareness WEEK was celebrated in the US in 2010. And beginning in October of 2013, the Global ADHD Awareness MONTH Campaign will take place. This year, the ADHD Awareness Month theme is The Many Faces of ADHD.

What else should we know? ADHD can affect anyone of any age (not just children), in any family, of any gender (not just boys), race, ethnicity, occupation or status.

My ADHD coaching clients share their voices to help show you the many faces of ADHD, in honor of the Awareness Month theme:

1. ADHD is Real

  • “Neurotypicals” are the majority on this planet, and get to make nearly all the rules. It’s very tough getting ahead in a system that’s optimized for people not like you. Keep that in mind when you come up with your rules and procedures, when you decide who deserves promotion or a raise, when you decide who’s “the best man for the job.” – From J.G., software engineer
  • “I wish people would recognize ADHD symptoms for what they are, and see the genius and the hard work that those children put in their day to day activities. Instead people still judge children with ADHD as being wild, unmannered, lazy, stupid, disruptive and more.” –  From Y.E., nurse midwife
  • “We’re human beings with feelings and intelligence. Having ADHD doesn’t make us incompetent, irresponsible, or lazy. We work extra hard to keep pace to make deadlines that people with intact executive functioning have no problems meeting.” – From G. K., school psychologist

2. There is Hope

  • “Having a friend or a coach or a secretary (or two!) Who is non-judgmental but persistent is very helpful.” – From G.K., school psychologist
  • “I prefer to invest my efforts into instilling my child with confidence, and shower her with love, and give her all the support and help that she needs to succeed” – From Y.E., nurse midwife
  • “My own experience of ADHD is that it’s like juggling.  The best thing you can do for someone with ADHD is to let them know that it’s OK to drop the balls, even on purpose. It’s OK to leave some of the balls on the floor. It’s also OK to ask for help before you drop the balls. Even better, it’s OK to say “no thanks” when someone tries to toss another ball at them.” From S.H., “Fortune 500” corporate executive

3. Where’s the Help?

  • What helps? Oddly enough, structured assignments but with some flexibility (if assignments have beginning, middle and end components spelled out or expectations clearly provided, that helps). It also helps to have tasks broken down into parts, small goals, not just one big global goal. Allow for creative approaches … If that doesn’t make sense, please ask for clarification.

What else helps?

  • Day planners
  • Personal Organizers
  • Life Coaches!(dead serious) –  From P.M, licensed occupational therapist

More Help for ADHD Accommodations

Help also comes through the many faces of ADHD Awareness Month 2013 Coalition Members. These include:

You can find help through other affiliate groups, and the medical and healthcare partners of the Awareness Campaign. For more detailed information, please visit http://www.adhdawarenessmonth.org/.

Many students with ADHD may also qualify for accommodations or special education and related services – through a Section 504 plan or an Individualized Educational Program. Parents who are concerned about their child’s educational performance should contact their school’s district’s Director of Special Education and refer their child to the Section 504 Committee or the Committee on Special Education, for evaluations and consideration of services. If your child simply needs accommodations, a Section 504 plan may be appropriate. But if the ADHD is impacting educational performance, the child may qualify for services under an IEP as a child with an “Other Health Impairment.”


To learn more about Dr. Virginia Hurley, click here. For more information about our legal services, visit www.specialneedsnewyork.com.

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Getting Organized for Back-to-School (Guest Blog)

August 5th, 2013

This week’s guest blogger is Leslie Josel, a nationally recognized expert on chronic disorganization and hoarding issues. Leslie has appeared on several episodes of TLC’s hit television show, “Hoarding: Buried Alive,” the Cooking Channel’s television special, “Stuffed: Food Hoarders,” “dLife-TV” and the nationally syndicated “The Better Show” as an organizing expert. She is frequently quoted in mainstream news media such as MORE Magazine, Better Homes and Gardens, New York’s Daily News, Westchester magazine and many other print media.

In 2004, Ms. Josel launched Order Out of Chaos, a Mamaroneck-based company that provides organization and relocations services for the chronically disorganized (ADHD, students with learning challenges, hoarding behaviors).

Here’s more about how Leslie launched Order Out of Chaos:

“My son was diagnosed with ADHD, executive dysfunction and other learning differences. So, this all started with me trying to untangle his world. I didn’t know how helpful it was until a friend (who was a therapist) saw the work I did for my son and asked if I would be interested in helping a patient of hers in the same way. Not only did I do it, but the results were extremely successful; word got out within the special needs community of what I had done for my son and my friend’s patient and my services became in demand. As the business took off, I became certified in chronic disorganization, as a hoarding specialist and also a certified JST coach for teens and college students with ADHD.”

Click here to continue to Leslie’s blog, “The ABC’s To Getting Organized for Back-to-School. ”

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Funding Helps Inclusion Education For Special Needs Students

October 11th, 2012

As part of the overhaul process of special education in New York City public schools, one of the goals is increased student inclusion, both in individual schools and system-wide. Though inclusive classroom placement for students with disabilities has been the national education policy for some ten years, in New York City public schools, of the approximately 165,000 students with disabilities, some 40 percent of them currently spend all or most of their school day in separate classes from students without disabilities.

According to numerous studies, children with disabilities who are educated with their peers without disabilities in inclusive classrooms show a variety of academic gains, including mastery of  IEP goals, improved standardized test performance, increased motivation, and better on-task behaviors. [1]  In contrast, students with disabilities who are educated in separate classes show a graduation rate of 5 percent, which is far below the citywide overall graduation rate of 65 percent.

Now, as part of the overhaul process, New York City schools will begin incorporating students into inclusive classrooms for grades kindergarten, sixth and ninth. Administrators, including principals, teachers and aids, have been training to work with all levels of learners, their families, and individualized education plans (I.E.P.s), and teachers with special needs students in their classrooms. [2]

Prior to 2012, rather than have every school able to accommodate every student,  New York City students with special needs would often be transferred from their neighborhood school, or even their district school, to attend a school with special needs services in place. These reform plans are one part of a push to comply with the Education for All Handicapped Children Act of 1975 for all 1,700 New York public schools. And while advocates and parents have been working for a broader acceptance of students with special needs in the public school system, some have voiced concern that mainstream educators do not have the necessary resources and training to meet students’ needs effectively, and that some special needs students will be placed in inclusive classrooms when they would be better served working with education specialists. [3]

This past May, The Panel for Education Policy voted to alter New York city’s financing formula to help restructure the city’s special education program by allotting money to the students rather than to special education classes. [4]

For more information, visit our website at www.specialneedsnewyork.com.

  1. http://www.wrightslaw.com/info/lre.incls.rsrch.whitbread.htm
  2. http://schoolbook.org/2012/05/24/city-panel-approves-special-education-inclusion-plan
  3. http://www.nytimes.com/schoolbook/2012/08/09/special-ed-reform-brings-city-more-in-line-with-national-trend/
  4. http://eservices.nysed.gov/sepubrep/
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