The school system will provide special education and related services for school-aged children, including preschoolers.  School staff and parents will work together to develop an Individualized Education Program (IEP) that will describe the child’s unique needs and the services that have been designed to meet those needs.  Special education and related services, including PT, OT, and ST, are provided at no cost to parents.

Boy smilingThe Individuals with Disabilities Education Act (IDEA) guides how early intervention services and special education and related services are provided to children with disabilities. Under IDEA, cerebral palsy is considered an “orthopedic impairment,” which is defined as :

“. . . a severe orthopedic impairment that adversely affects a child’s educational performance. The term includes impairments caused by congenital anomaly (e.g. clubfoot, absence of some member, etc.), impairments caused by disease (e.g., poliomyelitis, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).” 34 Code of Federal Regulations Section 300.7(c)(8)

There are several steps under the IDEA process.

  1. Identify the child who may need special education and related services
  2. Evaluate the child
  3. Decide whether child is eligible – does the child have a “disability” as defined by IDEA
  4. If child has a disability, then he or she is eligible for services and IEP team must write an IEP within 30 calendar days after child is determined to be eligible.
  5. IEP meeting is scheduled by the school system. Staff must follow specific guidelines for scheduling and conducting the meeting.
  6. IEP meeting is held and IEP is written.
  7. Services are provided.
  8. Progress is measured and reported to parents on a regular basis.
  9. IEP is reviewed at least once a year, or more often if parents or school request a review.
  10. Child is reevaluated at least every three years.

The US Department of Education Guide to the IEP – This is an archived guide and some items have changed.

IEP Classifications of Children who have Hemiplegia

Parents suggest that you use whichever classification allows your child to receive the services that he or she needs. Classifications may vary, depending on where you live. Classifications commonly reported by parents of children who have hemiplegia include:

  • Orthopedic Impairment
  • Other Health Impaired
  • Speech or Language Impairment
  • Communication Impairment (not speech)
  • Brain Injury or Traumatic Brain Injury
  • Attention Deficit Disorder
  • Multiple Disabilities
  • Specific Learning Disability
  • Intellectual Disability
  • Autism
  • Developmental Delay
  • Physical Disability

What Parents Would Like Teachers to Know

Students with hemiplegia may at first appear to simply have difficulty in using one hand and maybe milder challenges with walking and balance. The majority of students with hemiplegia have hidden disabilities and many have multiple disabilities. The same brain injury that causes hemiplegia or weakness on one side can also cause challenges with learning, speech and language, vision, executive functioning, emotions, behavior, and more. We urge you to consider hidden disabilities when evaluating your students who have a diagnosis of hemiplegia.

Individualized Education Plan (IEP) Examples

Individualized Education Plan (IEP) Ideas  – Preschool through High School

  • Classroom Tools – holding a crayon and coloring; holding a pencil and drawing or writing; trace within 1/4 inch or 1/8 inch of straight line, circle, diagonal, trace letters in name, draw person with body, head, arms, fingers, legs, face or you could say draw a person with 8 body parts, create a recognizable drawing using appropriate pencil /crayon grip; cutting with scissors and using left-handed scissors as needed; keyboarding with one hand
  • Eating Skills – opening milk carton; holding and opening yogurt cup; carrying and balancing a food tray
  • Self Care Skills – Opening, closing and putting away a backpack; Putting on a coat, mittens, gloves, shoes and brace without assistance; Zipping and buttoning clothing without assistance
  • Sports Related – Skipping; kicking a balland staying balanced; passing a ball two handed; dribbling a basketball; handling a soccer ball; adaptive PE program
  • Playground Skills – Safely accessing playground equipment; balancing on a swing; pumping legs on swing; balancing on a balance beam, both forward and backward;
  • Attention Skills – Extra time to complete assignments; wait or think time before looking for an answer when asking questions; if processing time is an issue, have speed drills excused or have her compete against her own time – not the standard time. Speed drills can also be given orally;
  • Organizational Skills – A bin at the side of his desk with hanging folder which are easier to access than a horizontal bin desk;
  • Navigating the Environment – two desks or a table will give the student more room to spread out and manage belongings; left handed desk if needed; desk position so student can see teacher and board if field cuts are present; tennis balls on chair legs to make pulling chair out easier; some classes change the students to different desks once a week – ask that your child be allowed to stay at the same desk; desk height evaluation
  • Avoiding Fatigue – If there is lots of up and down movement and sitting on the floor in the classroom, ask that your child’s desk be near the area where they sit down so she can stay seated at her desk if needed. This sames time, energy and helps with focus; If your child is unable to put his chair away and pull it out everyday, ask that they be allowed to leave it in place
  • Support Team – Having a POHI (Physically and other health impaired) professional on your IEP team; access to an aide as needed
  • Testing Adaptations – During a test, allow the student to mark their answers in the actual test booklet.  Typically children should be able to just mark the correct answer directly in the booklet using whichever method is easier – circle or mark through the correct answer. Then, a  neutral bubbler (usually an office aide) can copy the answers onto the answer sheets; Testing in a quiet, non-distracting environment; Use of ear plugs or sound blocking headphones while testing
  • Curriculum Adaptations – Use of calculator to check compuations in math; Extra time to complete assignments; Decrease the length of assignments; Work at her level (may not be grade level); Resource classes where the child is pulled out of the regular classroom for additional instruction; Provide written or pictorial instructions; Use voice recordings of verbal instructions; Have a peer buddy take notes for the student or permit tape recording; Divide large tasks into smaller steps; Provide a checklist of assignments and a calendar with due dates; Decrease memory demands during classwork and testing (e.g., use recognition rather than recall tasks).
  • Health Concerns – Be flexible about time missed from school to seek treatment or adjust to new medications; Provide extra time for assignments and a modified workload (fatigue is a common side effect of seizures and medications); Replace fluorescent lighting with full spectrum lighting; Provide private area to rest or recover from a seizure; Educate staff about what to do in case of a seizure.

Additional Resources for IEP

IEP and Inclusion Tips for Parents

The IEP Team

When the IEP Team Meets

Individualized Education Plan – Wrightslaw

Regional Parent Technical Assistance Centers – focus is on helping families to understand special and general education laws and evidence-based practices and to actively participate in planning and decision-making about supports and services for early intervention, education, and transition to adult life

Mainstream Classroom or Self-Contained Classroom –
Tips from Parents of Children with Hemiplegia

I am a former special education teacher who now has a son with cerebral palsy and slow processing. I strongly advise not going the self-contained route unless all options have been exhausted for success in the mainstream. Often I have heard general education and even placement specialists advise self-contained out of some inaccurate idea of this being a safe panacea for kids who struggle; where they’ll get all kinds of individual instruction. Yet, often that is not the case. Furthermore, it can be difficult to get out of self-contained once in. Academically the pace is slower than general education which means falling rapidly behind typical peers. On the continuum of services, self-contained is one of the most restrictive environments and therefor should only be chosen when, for an individual student, it is the least restrictive placement in which to have his or her needs met. There are many accommodations which can be made in the general education classroom to help a child with hemiplegia succeed.

Our son was mainstreamed in elementary school. He always loved being in the standard classrooms. When he started middle school, we tried mainstreaming all classes, but that quickly fell apart, and he needed to be in the resource room for certain classes because the pace was too fast and there was too much note taking and homework for him to keep up (even though he had a 1:1 aide). Now in 7th grade, we have had to continue mainstreaming for some classes and resource room for others. He needs resource room for reading and writing, and we have kept him mainstreamed in technology, math, and science. We almost had to move math to the resource room, but the IEP leader had the brilliant idea of dropping social studies and going to the math class a second time each day. That saved the day with math.  Try to adapt to things as they unfold and hopefully you will have an IEP group that stays flexible. For our son, the mixture of mainstream and resource room classes works the best.

Our son was academically ruined by a self-contained classroom. At the time I loved it because he was safe and the teachers were so loving. But he didn’t receive an education! There was no lesson plan and they had him in a functional curriculum. That means counting nickels and dimes for 12 years. So now he’s in an online public school and goes to regular 8th grade Science and Social Studies and has web-based, leveled learning for Math and Language Arts. It’s a good combination. It’s tragic to see how far behind he is. I wish I had stayed with the mainstream with supports.

As a former special education teacher and now, a mom of a child with hemiplegic cerebral palsy secondary to strokes in utero, I understand the concerns of mainstreamed versus self-contained. Least restrictive environment is what you should focus on when determining what is best for your child. Do *YOU* feel he would be OK in an inclusive setting for first grade with pull out services and accommodations in the classroom? Is there a specific teacher you can request by name based on his needs? If you can say, “Yes” to these questions, I’d say inclusion is the least restrictive environment for him. If you say, “No” to either, self-contained might be the way to go (noticed I said ‘might’).  In Kindergarten, starting in an inclusion classroom and moving him to self-contained later on, might effect his self-esteem quite a bit, but it depends on his maturity and understanding of what is going on. However, I’ve seen all too many times a child is placed in self-contained and allowed to stay there without having supports/plans in place to move the child towards inclusion (but this depends on the teachers and administration of the school). Oftentimes, I’ve attended IEP meetings where the IEP was already written and plans had been made relative to the child’s goals and educational placement (a HUGE no, no!). The IEP is a “team effort”, and the parent’s input has a lot of weight, more so when they are knowlegable and heavily involved in the child’s education. Furthermore, I’d ask for a “drop by” observation of the classroom (manybe even more than one visit) to the classrooms in question. I had to approach the topic of moving a child from LD to a mild mentally handicapped class due to 2 point change in IQ on her 3 year re-eval, and I went with the mother to visit 2 classroom options to ease her fears and answer questions that she might have regarding the classroom and her daughter. It worked for us.  If I had a child with slower processing speeds, (and my LH will be in 1st next year as well), I’d put her in an inclusive setting with heavy supports in place that can be lifted as success is met. If the K teacher accommodates for the slower processing speed, the first grade teacher doing the same might allow for success (as this is the major concern you mentioned). I’m just wondering if the teachers have other concerns that they aren’t sharing. If he is successful in the inclusive setting now, this should be considered his LRE for next year.

A Little Humor

Dr. Suess on IEPs
Author Unknown

I do not like these IEPs
I do not like them, Jeeze Louise!
We test, we check,
We plan, we meet,
But nothing every seems complete.
Would you, could you like the form?
I do not like the form I see,
Not page 1, not 2 not 3
another change,
A brand new box,
I think we all
Have lost our rocks,
Could we all meet here or there?
We cannot all fit any where.
Not in a room, Not in a hall,
there seems to be no space at all.
Could you, could you meet again?
I cannot meet again next week.
No Lunch, no prop,
Please hear me speak.
No, not at dusk. No, not at dawn.
At 4 P.M., I should be gone.
Could your hear while all speak out?
Would you write the words they spout?
I could not hear, I would not write,
This does not need to be a fight.
Sign here, date there,
Mark this, check that,
Beware the students ad-vo-cat(e)
You do not like them,
So you say
Try again! Try again!
And you may
If you will let me be,
I will try again,
You will see
Say! I almost like these IEPs
I think I’ll write 6,003
And I will practice day and night
until they say
You got it right.