Someone please explain IEPs in practice to me!

[popgoestheweezel]

After all this time (two years) on MNSN I still don't understand IEPs! I know there should be targets and that they should be SMART but I don't understand how to devise targets for ds (and certainly don't want the senco to devise tham by herself!)
Ds has today finally received a diagnosis of ASD specifically PDA (!!!!!) so the targets need to be around positive attitude to school and engagement but how can these things be measured? He doesn't have any learning difficulties but does have sensory issues particularly proprioception and auditory.
We have a meeting at school tomorrow to make plans for next academic year and I need help to structure it!!

[claw2]

? What help should be given
? How the help is to be given
? Who will give the help
? How often the help will be given
? How progress will be monitored and how it will be decided if the help has been successful
? What the agreed targets are

I would start with the difficulty for example one of the targets I did for ds;-

Ds physically separates himself from the rest of the class if a lesson involves an activity he dislikes and he becomes non commutative when addressed.

To help ds become more comfortable with daily routines and transitions from one activity to the next, ds will use his NOW/NEXT visual timetable, supplied by Miss X. X will prompt ds to check his timetable after each activity and cross it off/cover each activity after it has happened and look to see what is next.

Ds will be able to use his visual timetable and cross off/cover each activity after it has happened without prompting.

Miss X will observe ds during this time and fade out prompting when appropriate.

[claw2]

Another of the targets I provided for positive interaction, just to give you some ideas.

Ds finds it difficult to build positive relationships with peers Some suggestions.

1. Ds will be provided with the opportunity to play a game of question and answers, in a group, supervised by miss x, x amount of times each week/month, where each child take turns asking questions about each other and providing a short answer. This can be explained to him that a good conversation is where both people get to share the talking equally.
   
   
2. Ds will be provided with the opportunity to role play in a group, the situations he has trouble with: initiating a conversation, joining in another child's activity, or inviting another child to play a game. supervised by Miss x, x amount of times each week/month
   
   
3. Ds will be provided with social stories provided by Miss X about how to handle criticism and rejection from others and managing disagreements with compromise instead of emotional outbursts. The appropriate behaviour and comments to end the interaction. These will be read to ds once a day by Miss X.
   
   
4. Ds will be provided with the opportunity to work in a small group as a team (perhaps building a joint Lego model or a drawing a joint picture), supervised by Miss X, x amount of times a week/month and learn how to incorporating the ideas and suggestions of others into an activity. Give and take in conversation and activity. Recognizing and understanding the opinions of others. Empathizing with others in both positive and negative situations
   
   For ds to able to build positive relationships with peers.
   
   Ds will be observed by X during these activities and will receive praise and feedback on how well he did and what he could do to handle situations that arouse during these activities.

[popgoestheweezel]

That's very helpful. How do you measure progress though?

[claw2]

Ultimately whether the target is met or not

[claw2]

I would start with the difficulty first, be very specific and then work from there.

[popgoestheweezel]

You've got me thinking now claw, I can steal all your ideas for positive interactions for a start.
Transitions are a big difficulty for ds but due to it being PDA timetables are not very effective.... he needs 'motivating objects' to facilitate him moving from one thing to another.

[popgoestheweezel]

Yes, identify the exact nature of the difficulty first, then identify the place you want to get to. Then it will be a lot easier to plan the route.

[claw2]

Ds refuses to use timetables too!

To help ds become more comfortable with daily routines and transitions from one activity to the next, ds will be given a token for 5 minutes of extra play/computer time or whatever motivates him, supplied by Miss X, if he follows instruction after x amount of prompts.

He will be able to follow instruction without any prompts.

Miss X will observe ds during this time and fade out prompting when appropriate.

Maybe something like that.

[claw2]

Sorry without knowing the exact difficulty myself, my ideas might seem a bit wholly, im sure you can fine tune them though

[claw2]

Oh and good luck with your meeting tomorrow, your head must be spinning dx today and setting IEP's targets tomorrow! A lot to take in and deal with, remember to put your feet up and have a at some point too!

[popgoestheweezel]

Rewards can be dangerous ground for ds too (little bugger) as he manipulates the process and he always comes out on top! The motivating objects are better as they are immediate so less opportunity for manipulation.
Thanks for all that claw- really useful.

[popgoestheweezel]

Head is definitely spinning and have been on the wine tonight already! Bedtime now though.

[claw2]

Good night and fingers crossed for you, let me know how you get on

[popgoestheweezel]

Claw, your advice was invaluable at the meeting today- thank you.
School are totally on board and now we are getting it formalised and written down. The only problem I still have is the measuring progress.

Here's an example:
Problem- Sensory issues particularly auditory sensitivity and movement seeking behaviour.

Desired Result- Sensory stressors are minimised as far as possible to reduce ds?s anxiety levels.

What help is to be given
Network of adults to have good understanding of ds?s sensory difficulties (via passport) and be aware that behaviour can be exacerbated by sensory stressors. Proactive strategies to reduce sensory overload; avoid crowds, queues, activities in the hall, singing and loud voices. Provide regular opportunities throughout the day for ?heavy work? (proprioceptive input) and respite (outdoor or sensory room).

?How the help is to be given
ds has an early lunch pass to avoid queues and crowds in dinner hall. He chooses a different child each day to accompany him.
ds will be given an opt out clause for activities he may find sensory challenges (eg. dance festival, swimming, PE, assembly) he can choose to participate if he wishes but alternative activities will be available. Dance Festival- participate via design and art work (fabric painting) for costumes? Swimming- option to watch and keep records (maths skills) as well as stay at school. Assembly- currently drawing or reading but look to using this time for development of empathy and emotional regulation skills in due course.
Access to Sensory Room for respite alone or for mentoring with staff support.
Use of ?Golden Mile? or similar challenge to encourage additional movement. Ensure this is not competing with other children, instead challenge the group as a whole to work together. Useful before and after quiet sitting times and can be used as motivator between activities.

?Who will give the help
Network of staff- CT assisted by additional member of staff in classroom at all times
Occupational Therapist to advise on more strategies particularly incorporating proprioceptive input at key points.

?How often the help will be given
Daily.

What the agreed targets are
Sensory stressors are minimised as far as possible to reduce ds?s anxiety levels.


?How progress and success will be measured
?????????????????

[claw2]

That's great news!

Seems pretty good actually for an IEP.

One thing that leaps straight out at me 'sensory stressors are minimised as far as possible to reduce ds's anxiety levels. How will they measure his anxiety level? Some strategies he could be asked to rate his anxiety level 1-10 after each lesson?

'Provide regular opportunities throughout the day for ?heavy work? (proprioceptive input) and respite (outdoor or sensory room)' how regular is regular opportunities?

'Ds will be given an opt out clause' What is the opt out clause exactly? how does he go about opting out?

'Access to sensory room' when? how? is he expected to ask? how will he or they know when he needs it?

'Golden mile' again when? how?

'Who will give the help' OT, when? how?

'How often' Daily when? how often?

It will measured by how successful the intervention actually is ie his anxiety is reduced, so the question is how will they measure his anxiety?

When he uses his lunch pass, when he uses his opt out clause etc, etc and his anxiety is reduced.

[claw2]

Also not liking the 'network of adults' who exactly is responsible for what?

[claw2]

Also if they have an OT why isn't she/he involved in setting IEP targets?

Why isn't she/he observing your ds in school on a regular basis to see how successful the intervention is?

and how often is the IEP reviewed?

[popgoestheweezel]

Thanks claw, the OT is not yet involved but is going to be accessed through Camhs at ed psychs suggestion today, we will have to wait some time before the visit I am sure! So as yet cannot be more specific about what involvement they may have.
Network of adults has been identified as ct and two TAs but I think there needs to be a lunchtime person on there too.
The idea of asking ds to rate his anxiety levels is great, I have found a questionnaire thing called 'good and bad things about school' which we could use, then do again after a month or so.
This is still a first draft at the moment so all your points about specificity can be incorporated. There has to be some flexibility built in though as with PDA ds has to be offered the choice and remain in control of what he does and when he does it :)
Also, this is the one relating to sensory issues. We have used the same format for transitions and dealing with new experiences/changes to routine.
We have another meeting in the diary for beg of next term already so more plans to be made then.

[claw2]

It all sounds very promising and if school are taking it seriously.

OT accessed through CAMHS? ive never heard of that, they are literally two very separate services, although I have heard of CAMHS themselves dealing with sensory issues. Or do they just mean CAMHS make a referral?

What I mean by network of adults, if that person isn't named specifically for being responsible for x,y and z, will they know its their responsibility or think that someone else is responsible and nothing gets done.

I understand about the flexibility and choices for your ds, it just seems they are placing a lot of the responsibility on your ds to know how to. I suppose my point was rather more about how will he know to use the strategies or access them, or will he in fact use them when overwhelmed?

My ds for example the problem was he wouldn't ask for help when he needed it, so he was given a 'help' card to use. He didn't use the card, but to school this meant success, as he didn't need any help now!

He was also given a 'pass' for when he was feeling overwhelmed in the playground, that allowed him to go inside and get away from the situation. Again never used, and again instead of this being a failure, to school this equalled great progress as he hadn't used the card which must mean he isn't feeling overwhelmed!

Another 'for ds to express his worries about school with confidence', never expressed any worries, which meant he didn't have any, rather than he still didn't have the confidence or ability to express his worries!

So they classed failure as success!

When feeling overwhelmed or sensory overload would your ds be able to ask to use the sensory room for example? Would he even know why or if he was feeling overwhelmed and that the sensory room might help him at that time?

[popgoestheweezel]

Their plan is to have an extra member of staff in the classroom all the time who will be able to support ds. At the moment the class teacher is doing her best but it takes her away from the rest of the class too much. That person will be responsible for monitoring ds and watching for signs of stress. Also will be sitting by him at carpet times etc to help
Out if needed.
I think we need to track progress by rating his going in/coming out of school attitude everyday and also asking him to rate his experience in school. Maybe not daily, but perhaps at the start of term and then same questions again a month or so later???

[claw2]

Sorry Pop, haven't been on, had a very busy weekend.

If the TA is going to monitor stress and is new and I assume doesn't know your ds very well, maybe the signs of stress should be listed in the IEP and exactly what she is expected to do when/if she does see any, will she recorded them etc?

Personally I would be asking ds to rate his stress levels at the end of each lesson or activity to start with for a couple of reasons firstly ds wouldn't be able to remember his stress levels if asked to rate them at the end of each day, week, month, it would be more a how do I feel right now. Secondly if you can see when he is most stressed, you can see where more/less help or strategies are needed and triggers etc

Maybe you could do both ie TA and your ds monitor stress, especially if school are not noticing his stress levels. For example with my ds school would say he was happy and showing no signs, ds would say exactly the opposite. So some signs of stress can be very subtle or hard to pick up on to the untrained eye.

[claw2]

I would add monitoring his stress levels is the key, as this is how it will be determined if the intervention has been a success and the target met.

[popgoestheweezel]

Sorry I missed your reply there!
Yes, signs of stress need to be identified. I have made a form to be filled out periodically throughout the day (8 times) where ds and then us at home or his teacher/TA at school can rate his level from 1-10, 1 being totally stressed and 10 being happy and engaged. I will put notes on the form describing stressed behaviours. I'm hoping this will be easy to implement for school.

[claw2]

Sounds perfect!

Would also add keeping a home/school book might be helpful. With ds the rating doesn't go too well, he either doesn't realise that he is stressed at the time or he tells school whatever he thinks they want to hear (probably due to it being badly implemented ie ds having to explain his rating and ds not being able to explain or recognise why he felt stressed)

Maybe you could ask for your ds not to be questioned about his rating to start with and just see what pattern develops.

For ds if he rated below a 5, he was asked to explain why, so he just stopped rating below 5, so he didn't have to answer!

Which defeated the whole rating thing which was put in place because he couldn't express himself grr!

[popgoestheweezel]

Good advice, thanks. We can trial it and see how it goes. I will get a home/school diary sorted too, we've had them before but ct didn't bother to write in it so it wasn't much help. The only prob with it is that we can't put in how he was on his way to school (usually super-stressed part of day)- unless we write it up when we arrive? Maybe that would work.
Luckily he's pretty much an open book in terms of his feelings, he says when he feels angry he 'just HAS to let it out'- not much chance of anybody not getting how he feels- even complete strangers walking down the street are in no doubt!