Virtual Special Education Isn't Working, But Maybe It Never Worked

A close up look at one group of school therapists -- the OTs.

Nearly 15 percent of all students in the United States — 7.1 million kids — have been identified as having a disability that requires special accommodations from the school district.

Although that number has slowly been rising every year since they started keep track, 15 percent is probably the low end of children with disabilities in this country. Some kids might not be diagnosed and labeled, so they do not receive any help from their schools. Other children’s disabilities might be mild enough that schools doesn’t have formally classify them, but are helping them out informally with some extra time in the resource room with a specialist.

The biggest chunk of those kids with disabilities — 33 percent — have what is termed as “specific learning disability,” which is edu-speak for learning problems like dyslexia or dysgraphia. Those kids need academic help, but are otherwise able to blend into the school population. The rest — 67 percent — have issues, like autism, language impairments, and hearing impairments, that cannot be solved simply with a reading specialist in the resource room.

Enter the therapists.

To meet the needs of that other 67 percent of special ed students, school districts must employ a variety of specialized therapists to help kids with everything from speech to behavior to physical strength and coordination. Special education teachers only handle the school work. For some kids, their biggest needs are handled by therapists, not their teachers.

A child with autism, for example, might get help from a Physical Therapist (PT) for weak muscle tone, an ABA specialist for OCD behaviors, a speech therapist to help them expand their expressive language skills, and a occupational therapist (OT) for handwriting and sensory needs.

When I was teaching special education in the South Bronx, there was one classroom in the school where the students arrived every morning in an ambulance. They were in a semi-vegetative states. The teacher would dress in a kimono and play classical music for the kids all day, as the aides changed diapers and PTs moved their limbs, so they didn’t get bedsores.

School therapy falls in a grey area between education and health care. Some say that schools should not be in the business of health care. If kids need help for physical or neurological differences, then our health care system should provide that help. But the health care system doesn’t. Many folks in this country don’t have any health care insurance at all, despite years of ACA laws. Even those with health insurance are not able to get coverage for issues like the poor social skills from autism.

I have never, ever been able to get our insurance companies to cover common services for autism for our son. Over the years, we have supplemented his education with private, after-school help — academic tutoring, social skills groups, special sports groups, and so on. I periodically try to submit those expenses to the insurance company, but have never had any luck. This year, we had to supplement quite a bit and are paying nearly a $1,000 per month to various groups and individuals. It’s all out-of-pocket. No help from schools, insurance companies, or the government.

Without any movement to get help from other sources, schools have to provide all these services, which are expensive. So, they aren’t very happy about it. Parents often have to fight to get this help.

Enter COVID.

Pre-COVID, this therapy-end of special education was problematic. Now, imagine trying to provide all those services over a Zoom call.

A couple of months ago, Edutopia — a positive solution-based education website run by the George Lukas Foundation — asked me to talk to special education teachers and therapists to find out how they were doing doing it. After some discussions, we decided to focus on one kind of therapist — Occupational Therapists (OTs).

Despite their name, OTs don’t do anything about jobs or careers. Their primary job is to help kids with their handwriting. This is a big issue for kids with autism, but it’s a common problem that impacts a lot of kids. Typically, OTs provide this help by standing behind the child and doing hand-over-hand to guide them as they form their letters. They might give students special pencils or strength children’s hand muscles with special exercises.

In addition to help with handwriting, their jobs have expanded in recent years to include helping kids with sensory needs, executive functioning, core strength, and even mental health. They might provide fidget toys to a child with ADHD, so he can focus on his lessons. Or they might help a child with tactile sensitivities overcome his refusal to wear long pants to school. But the reason for this massive expansion of the job responsiblities of OTs is a subject for another day. Today, let’s just talk about doing all those tasks via virtual education.

For my article for Edutopia, I interviewed several OTs in different schools around the country. They all say that they’ve worked super hard this year. In some cases, they’ve been successful. In other cases, less so.

You can read the whole article here.

One OT told me that her school has been all virtual for this entire year. Her students, which included little kids with non-verbal autism, were in one room in the school with their aides, while she and the other staff were in another room in the same school. She helped them with everything from handwriting to sensory integration over a computer. Therapists have not physically guided student’s hands and bodies for a year.

All the OTs told me that when the kids were working from home, they could not do their jobs without the full-time assistance of a parent. Parents, who have not been paid or compensated or supported in any way this year, have kept schools afloat (and free from subsequent legal issues) and have kept kids somewhat normal this year.

I’m exhausted, as are all parents with kids like mine. It’s been a long year. If schools can’t open (my son is back to learning virtually upstairs in his bedroom), then parents need a bailout. I’m keeping an eye on Romney’s Child Tax Credit, but we need more.

Occupational Therapy Shifts From Tactile to Digital

Since last spring, occupational therapists have been unable to touch and guide students in person—and have had to completely reinvent how they work.

Every day, occupational therapists (OTs) get their hands dirty as they work with students who struggle with fine motor and sensory skills.

OTs guide children’s hands as they learn how to correctly grip a pencil and draw letters, and they help children use various manipulatives, like Play-Doh and blocks, to build strength. They set up Sensory Rooms, where children can bounce on balls and jump on trampolines to release energy so that they can focus on learning. Sometimes, when children are upset, the OTs hold them to calm them down.

But since last spring, when the Covid-19 pandemic arrived in the United States, most occupational therapists have been unable to touch and guide students in person—and have had to completely reinvent how they work. The adaptations have been especially challenging because many children with special needs depend heavily on parent/caregiver oversight to help them with tech tools or even to sit still to focus during remote education.

“I’m incredibly proud of myself and my team here, because we weren’t even sure how to get kiddos to the screen at first. I really didn’t know much about technology when we went to remote learning in March. We’ve come so far,” said Monica Keyser, an occupational therapist in San Ramon Valley Unified School District in California.

OTs like Keyser say they’ve found new apps and tech tools or modified their traditional methods for use in virtual and in-person sessions. All said that they are most successful when a parent is available during the day to assist their child, but that equity issues tied to families’ resources can create barriers to that engagement. While exhausting, these experiences have helped therapists evolve their work, which will benefit kids long after the vaccine arrives.

More here….


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I wrote about our weekend adventures on the blog.