chapter9

FOR a number of students, schoolwide and classwide interventions are not enough, even with the provision of small-group and some individual instruction. Some students may be receiving a number of accommodations from a teacher who is differentiating the content, process, and product, while integrating instruction of social and emotional curricula. A number of students will still need a more detailed analysis of their social, emotional, and behavioral needs, followed by an individual plan. Therefore, this chapter is about how plans are developed to meet an individual child’s social, emotional, and behavioral needs.

The best start to an effective individual behavior plan is excellent teaching, where children show learning through products that can be analyzed by the MDT. Individual plans will be used in concert with the schoolwide and classwide interventions that we discussed in Chapter 4, but the individual plan will be more uniquely tailored to meet a child’s specific needs.

The foundation for all successful plans is a comprehensive evaluation, as we discussed in Chapter 6. So, if you are teaching or parenting a child with challenging behavior, and would like to develop a school plan, first assure that evaluations are complete, consider all of the child’s needs, and compile baseline data to inform the development of a plan. Designing and implementing an individual student plan can be a multifaceted problem-solving process, time consuming, and revealing. It may require the involvement of specialists, both within and outside of the school district, and it always requires the expertise of parents.

If a child’s individual program or plan is written appropriately, she is much more likely to be successful in school. She is being successful if she is accessing the curriculum, making meaningful progress, and receiving benefit from her program. The major question is: What type of plan is right for any specific child?

• How can a beneficial and meaningful Individualized Education Program (IEP) be developed?

Whether your child has an IEP, BIP, 504 Plan, or other informal plan, there are three factors important to its development:

• teaching skills from the curriculum, including a social skills and behavior curriculum; and

Although there are many interrelated factors that influence how effective a plan can be to improving school success, the most important aspect of developing an individual plan is its meaningfulness to the child. Depending on the age and developmental level of the child, she should be involved with, agree to, and participate in developing and carrying out the individual plan. Individual student plans should:

• include scientifically based, or at least evidence-based, positive behavior supports, methods, and interventions;

• assure instruction for emotional, behavioral, or social skills is based on a curriculum;

• be at the child’s instructional level—not too easy and not too difficult.

Tool 9.1 can be used in multidisciplinary meetings by parents and educators to assure all elements of the plan have been considered. The framework of the individual student plan includes great instruction, schoolwide and classwide behavior management and change quality indicators from Chapter 4, and an MDT’s perspective that the child’s behavior requires problem solving. In other words, a successful individual plan to address behavior should be informed by the topics covered so far in this book.

The first type of formal plan we will discuss is the Individualized Education Program (or Plan, depending on the language used in your district), commonly called the IEP. The IEP is developed within 30 days after the multidisciplinary team has decided that the child is eligible for a plan under IDEA. We are discussing the IEP first because it is the most well-defined plan and contains many aspects commonly considered by the 504 Plan. Also, the IEP contains specific requirements that should be used as a template for other types of plans.

The MDT, including the parent, develops a school success plan, including an IEP. The MDT, through the development of the IEP, decides which services, accommodations, goals, and placement the child will receive for all parts of the IEP. Tool 9.2 includes a checklist for parents to consider when taking part in the MDT’s development of the individual student plan.

The IEP is a document that spells out everything a child needs because of his educational disability or emotional behavioral disorder. There are 10 legally required parts of the IEP as defined by Weinfeld and Davis (2008), and shown in Figure 13. Each part interacts with the others, and together, delivers a beneficial, meaningful education to a child with a disability.

Part 1 of the IEP: Identifying information. This section includes the child’s name, address, and contact information for the parents. It usually contains an identification number and identifies the child’s disability.

Part 2 of the IEP: Present levels of academic achievement and functional performance. This foundational part of the IEP documents a child’s strengths, his needs, and areas that are affected by his emotional or behavior disability. Parents who want to speak the school district lingo may use the acronym PLOP (present level of performance) to describe this part of the IEP. The PLOP of the IEP is like the foundation for the house (the IEP) that is about to be built. Each area that affects a child such as regulation skills, communication skills, social skills, reading skills, following directions, peer relations, organization skills, or other areas identified by evaluations are included in the PLOP. This part, therefore, starts the threads in the IEP—from identification of needs, to recommendations for a program, service, or type of instruction—that will be woven through the different sections to ultimately recommend a school placement and services. Parents and educators should be sure each area of need or concern is listed, so that later in the IEP, the child’s needs are considered for each area in the PLOP that affects educational performance.

• Strengths: Kids with challenging behaviors often are creative, and this section of the PLOP can be used to identify a child’s interests or abilities, both those related to school and those related to future goals. It also can recognize a child’s giftedness and show under what circumstances a child shines. For example, this section might read, “Louis attends to tasks better when the environmental distractions are limited. When he has at least one break each half hour and opportunities to talk with the teacher privately when he’s having problems with his peers, he is able to remain on task to complete 85% of his writing assignments.”

• Parental concerns: Parents can write this section before the meeting to help the team understand their concerns. These can include answers to questions like, “What could the school do to help my child succeed?” “What would I like to see in place for my child’s counseling needs?” or “What is a specific program I’d like my child to be part of?” For example, this section might read, “We think Kenny needs a smaller classroom setting where there is a counselor on site all of the time. Kenny needs an intensive reading program because his behaviors get worse when he is frustrated with his reading problems.”

• Academic needs, including study skills: Study skill problems are usual for children with challenging behaviors, no matter the age. Study skills can be learned, and should be included if needed in the PLOP section. Executive functioning, attention, and other regulation difficulties can contribute to the behavior and academic failure of students. Remember that classroom performance does not have to be related only to poor reading, writing, and math skills—organization, attention, and memory can affect a child’s academic performance as well. For example, this section may read, “Shelly has difficulty organizing her writing, coming up with ideas for writing prompts, editing her writing, and typing final drafts. She gets frustrated and will rip up her paper or refuse to write at least one time per each daily 90-minute language arts block.”

• Instructional level: Educators who teach kids with challenging behaviors often do not use classroom or individual strategies, including adjusting the instructional level of materials (Penno, Frank, & Wacker, 2000). A large number of behavior problems could be avoided if the teacher understood the child’s instruction grade level and used materials that were adjusted to the child’s instructional levels (Gettinger & Seibert, 2002). A task or materials at the child’s level of frustration should not be used. Independent-level materials should be used for independent practices, leisure or enjoyment, when new material is being introduced, or for repetition or reminders. For example, the PLOP section, under reading, may state, “When new information is being introduced, provide independent-level reading material for Jordan, at no higher than the 4.5 grade readability level, to prevent frustration.”

• Functional and classroom performance: There are times when kids with challenging behaviors are capable of performing the grade-level academic demand, but because of challenging behaviors, the child may have a performance deficit. This performance deficit can be identified when the team conducts a thorough and correct FBA and includes the parents. Part of the analysis of behavior should include whether the behavior is due to a skill deficit or a performance deficit. This “can’t do” versus “won’t do” question is part of the FBA (see Chapter 7). For example, the PLOP section, under math, may read, “Desiree can recite the steps to solving problems, but when under real or perceived stress, she may not use her problem-solving skills. This affects her educationally because time is needed outside the classroom for her to regain a calm demeanor and successfully generate solutions to the problem.”

• Results of current evaluation: If you remember the formal and informal evaluation discussion we had in Chapter 6, you will know the types of data sources that should be used to document the results of both formal and informal testing, including classroom-based information. Specialists’ reports and recommendations can be included here. The same data tools used to monitor progress can be listed in this part of the IEP to form baseline functioning against which future goals will be measured. Data from informal assessment can be individualized, detailed, and informative. However, continued teacher training and parent training is needed. For example, under the “Social Skills” section of present levels of academic achievement and functional performance, Sherri’s scores were:

Part 3 of the IEP: Transition. Starting at age 16, and earlier if the team determines necessary, the IEP will state what services a student needs to live independently, go to college, go to a trade or training program, or otherwise participate in their postsecondary outcomes. This part also is critical because it identifies which agencies may support the child as an adult, and links the child and parent with multiple community supports. Figure 14 shows the various transition services included in this part of the IEP.

Part 4 of the IEP: Outcome, assessment, and curriculum. For most students, the regular or general curriculum will be used, even if the child’s behaviors affect learning. For most children, the goal at the end of high school will be a diploma. Some states have various forms of a diploma, sometimes called a modified or tiered diploma. A very small number of students will need an alternate, functional life skills curriculum, and will be removed from the requirement to take standardized state tests. Some states have different curricula and requirements for teaching children who are highly gifted. It is critical that the right and appropriate curriculum is selected. The cornerstone of the child’s plan will be instruction, and curriculum is required for effective instruction. This section of the IEP, therefore, can include consideration of the appropriate instruction for behavioral or social skills.

Part 5 of the IEP: Annual goals. Annual goals are required for every area that affects a child in which he needs specialized instruction. Specialized teaching that is adapted to meet a child’s unique needs can be needed in any area, not only academics. Goals for instruction should be: good for the child, observable, attainable, logical, and scientifically sound. Also, goals should include four components (called CBET): a condition statement, behavior, evaluation methods, and timeframe. Here’s an example of a good CBET goal:

Condition: Given social skills instruction in an evidence-based curriculum and role play,

Evaluation Methods: As evidenced by a positive tone of voice, language, and volume, Joseph should give feedback or make requests each class period. Mastery is 9 of 10 periods with no prompting, based on the teacher and student rating per day, or 90% of checklist completed for each time he makes a comment, with interval recording two times a week.

Reading this goal, it is clear that the student is working on making comments to others. It also is clear that the mastery of the goal can occur after role-play and practice. This, the condition statement, can be used to drive an intervention. The mastery criteria include a checklist, with interval recording of data per week. Or, the mastery criteria can include the use of a tracking system for the targeted behavior.

Condition: Given a separate space in an adjoining classroom, cool-down time of up to 20 minutes, and verbal problem-solving with staff,
Behavior: Jillian will select and follow steps from graphic organizer for one solution to the problem.
Evaluation Methods: Within 10 minutes of returning to classroom, Jillian will follow all steps 4 out of 5 times, as indicated on a checklist that matches the graphic organizer.
Timeline: By the end of the month.

It is clear from this goal that Jillian needs to work on taking a break before reacting, and that to meet the goal, she will follow through on steps after problem solving with a favorite staff member. The goal also makes it clear that teachers should use a graphic organizer and checklist as visual cues. Graphic organizers and checklists can be used to measure progress over time, help the child visualize expectations, communicate with parents, and provide a multisensory way of problem solving. The goals can inform the teaching of the skill, including the activities that will be used to measure progress. Most of all, however, the goals tell the parents and staff what behaviors to expect, and what data sources will used to monitor and evaluate progress.

Part 6: Accommodation, modification, supplementary aides, and services. What is good teaching to some is considered accommodation for others. In some classrooms and schools, all students receive extended time and ability to retake tests, while in other schools, extra time or ability to retake tests may be a testing accommodation. In the tools at the end of the chapter, the reader will find a reproducible resource that is designed to guide the selection of accommodation for both the classroom and for tests. Accommodations that are used in testing also should be used in the classroom. While considering accommodations in the context of the IEP, the reader also should consider that the same type and amount of accommodation can be recommended through the 504 Plan, discussed later in this chapter, or other plans developed by the school district. Tool 9.3 includes some ideas for accommodations in the classroom.

There are substantial differences between accommodation and modification. Accommodations do not change the curriculum, while modifications do change the amount, type, or nature of the curriculum. Accommodations should not necessarily change how a child is graded, but a modification may change the way a child is graded. When a child with EBD requires a different social or emotional curriculum such as instruction in social skills, this may be considered a modification to supplement the typical curriculum, or this may be considered an additional service, for example.

• testing accommodations that do not change the content being tested, but support students in showing their knowledge of the content.

• identification of different grading practices to address the change of content;

• a change in what the child is learning, or how she is assessed in the adjusted curriculum.

The definition of supplementary aides and services is broad and varies from child to child. IDEA notes that supplementary aides should be provided in regular education classes and in both extracurricular and nonacademic settings. Examples of supplementary aides and services include:

• services needed for the child to progress in the curriculum, such as tutoring; and

• services that are different from related services as described in the next section.

There is an almost infinite list of supplementary aides and services needed by a child with a disability to meaningfully access the curriculum and make substantial progress.

Part 7 of the IEP: Related services. Related services are services a child needs to benefit from her special education program, including specially designed instruction to meet her unique needs. On the left side of Table 5, the named related service is listed. Some of these services use paraprofessionals or assistants. The IEP, through the decisions of the MDT, can specify the title and professional qualifications needed for the child to have FAPE.

Table 5

Related Services and Their Purposes

Related Service	General Purposes
Speech or language pathology (See http://www. asha. org)	For identification, diagnosis, or appraisal of communication disorders. For treatment or counseling for communication disorders. For pragmatic, or social, language disorders. For listening, following directions, or expressing oneself. For prevention of communication disorders.
Transportation	For travel to and from school, usually door to door.
Audiology services (http://www. asha. org)	For hearing loss or deafness.
Interpreting services	For transcription, signing for children who are deaf or hard of hearing, technological transcription, and special transcription for children who are deaf and blind.
Psychological services	For development of positive behavior supports and strategies, counseling, consultation, assessment, and training.
Physical therapy (http://www. apta. org)	For gross motor and other motor problems. For physical movement and activity.
Occupational therapy (http://www. aota. org)	For functional independence, through skills provided by a qualified occupational therapist. For preventing or limiting impairment of functional activities.
Transition services	For a coordinated set of activities to develop achievement and functional performance, to allow the child movement from school to postschool activities.
Travel training	For students with cognitive disabilities, who need instruction in awareness of the environment and how to get from place to place in the school or community.
Recreation; therapeutic recreation	For leisure skills assessment, leisure education, therapeutic recreation services, or recreation programs and services.
Early identification and assessment	For assurance that a plan to identify a child’s disability is found and addressed as early as possible.
Social work services (http://www. socialworkers. org)	For counseling or other mental health direct or indirect services. Services provided by a licensed or otherwise qualified social worker.
School health services	For medication at school, collaboration with prescribing doctor, medical monitoring, or monitoring of medication effect in classroom, when nurse or other health professional is a required member of an MDT. Can be delivered by a nurse or other qualified personnel.
Counseling services	For guidance counseling, social skills counseling, or other counseling. Provided by social workers, guidance counselors, psychologists, or otherwise qualified professionals.
Rehabilitation counseling	For restoring, remediating, or rehabilitating a skill lost by a disability, event, or condition.
Parent counseling and training	For helping parents understand the child’s special needs, for instruction for parents about developmental (what is normal?) skills, and for skills the parents need to support the implementation of the IEP.
Orientation and mobility services	For students who are usually blind or visually impaired who need a special service to be oriented in the school or community, or help getting around the school, community, or job settings.
Medical services (http://www.ama-assn.org)	For evaluation of medical needs. Inserting, mapping, repairing, or managing a surgically implanted device is not included. Must be done by a medical professional, who is part of the MDT.
Vision services	For low vision, visual impairments, vision conditions, and blindness.

On the right side of Table 5, general purposes of the related service providers are listed. Before agreeing to provide related services, the MDT will conduct an evaluation and recommend the service, usually after developing appropriate goals. When there is a professional organization that has different licensing criteria, the website is listed under the name of the service.

This list is not meant to be exhaustive; it is based on the listing of related services in IDEA. The listed services must be specified and provided as specified in the IEP.

Part 8 of the IEP: Consideration of special factors, including the BIP. The considerations of special factors part of the IEP must consider a child’s need for Braille, communication needs, assistive technology devices and services, and the child’s native language. Relevant to challenging behavior, this section requires the MDT to develop a BIP, and consider the need for FBA. In the tools section of this chapter, a number of accommodations, which also may be put into the BIP, are listed, and can be used by parents, students, and educators. A BIP should provide for “positive behavior supports and strategies” (IDEA, 2004, p. 46683), and overall, IDEA calls for research-based, quality, peer-reviewed interventions and methods.

Behavioral intervention plan (BIP). The BIP must be based on a sound FBA. If the whole team, including the parent, has not engaged in the problem-solving process involved in the FBA as described in Chapter 7, a BIP should not be developed. A good BIP will answer the 5 W questions—who, what, when, where, why—and the 2 H questions—how, and how long, as summarized below:

• When and by when?: What days of the week, dates, or time periods will the “what” occur?

• Where?: Will the child be removed from the classroom to receive the service, and if so, to where?

• Why?: Which goals are being addressed by the intervention? Why is the intervention being considered?

• How?: How will the intervention be delivered? What are the components of the intervention and how is instruction delivered?

• How long?: How long will the sessions last, for what duration? What date will the interventions be reviewed? What date will the interventions end, and how will we know their effect?

For whom should the BIP be developed? A BIP should be considered by the MDT any time a behavior interferes with a child’s learning or his peers’ learning. At any of the nine stages of the special education process, whether a child is eligible for special education or whether there are milder concerns from the classroom teacher, a BIP can be developed.

IDEA does not require a BIP, unless a child is being repeatedly suspended from school or removed from the classroom because of behavior. IDEA does, however, require that the child’s behavior needs are met by interventions and strategies, when the behaviors are interfering with a child’s learning or his peers’ learning. It would be a mistake to conclude that the BIP (developed as a result of an FBA) is not required by IDEA in situations where discipline is not a concern. The law specifically mentions the BIP and FBA in its discipline sections, but FBA and analysis of a child’s response to a BIP can and should be part of the whole evaluation process. The FBA and BIP can be useful tools for evaluation of a child in all areas of suspected disability, and to fully understand the nature of a child’s needs (Von Ravensburg, 2006–2008). Nonetheless, Congress says that it makes “good sense” for an FBA and BIP to be developed for a child who needs it to receive a FAPE (IDEA, 2004, p. 46683).

A BIP should be written in a form and mode that the parent can understand, and should become a part of the child’s existing IEP or 504 Plan, if one exists. A BIP also can stand alone, however, if the school chooses to use it with a child who is not yet eligible for the IEP or 504 Plan.

What does the BIP contain? Although there is no mandated format for the plan, there are widely understood best practices that should be followed when developing a BIP. A BIP should describe the following (IDEA, 2004):

• What materials and/or resources are needed and whether these are available within existing resources.

• Roles and responsibilities with respect to intervention implementation (i.e., who will be responsible for running the intervention, preparing materials, etc.).

• The intervention schedule (i.e., how often, for how long, and at what times in the day?) and context (i.e., where, and with whom?).

• How the intervention and its outcomes will be monitored (i.e., what measures, by whom, and on what schedule?) and analyzed (i.e., compared to what criterion?).

Part 9 of the IEP: Extended school year and extended school day services. In times that schools are not in session, students with disabilities may need extended school year (ESY) services, so that a break in school does not cause the student to regress, or prevent the child from retaining skills or acquiring skills in the future. States have different requirements for the criteria for eligibility for ESY services, but the state requirements cannot limit the services globally defined by IDEA. There have been many legal actions related to ESY (Kraft, 2000). Some of the earliest cases involve students with emotional disturbance, where parents have successfully advocated that the standard (180 day) school year is not enough to adequately address a child’s needs. In fact, in many states, one factor that makes a child eligible for ESY services is the child’s interfering behaviors. Other factors include the nature and severity of the child’s disability, regression risk with a break from school, emerging skills that must be continued or will be lost, whether the IEP goals relate to critical life skills, or general special circumstances. Table 6 shows the IDEA requirements for ESY services (Florida State Department of Education, 2002; IDEA, 2004).

Table 6

IDEA Requirements for ESY Services

ESY Services Should Be:	ESY Services Should Not Be:
Individually determined	The same for all students
Determined by the MDT to provide FAPE	Limiting to any disability category
Provided in the least restrictive environment (LRE)	Only in the summertime

Part 10 of the IEP: Placement in the least restrictive setting. In an ideal world, all students with learning or behavioral differences would be with their peers in neighborhood schools. In this ideal world every student would be able to have an individualized education and schools would be flexible enough to create a personalized learning environment for all. Unfortunately, most schools create programs for the general population—for the majority of students who are assumed to learn well in a large-group setting. Not all students benefit from this group-oriented process. Some students will only progress if their individual needs are considered and very intensive services are provided in a very intensive setting. For example, a student who becomes highly distracted or anxious in large groups might need a smaller environment with reduced distraction to be able to concentrate. Similarly, a student who has frequent outbursts or has trouble utilizing language to communicate his or her needs might need more frequent decoding by an adult or positive interaction with a teacher.

The majority of children and youth with emotional and behavioral difficulties are educated in their neighborhood schools (Newman, Wagner, Cameto, & Knokey, 2009). Greater than 80% of students with EBD are served in general education classes with a mix of specialized instruction and related services like counseling, psychological services, speech and language therapy, and crisis intervention services. Students whose behavior becomes unmanageable in the comprehensive school are removed to alternative settings, private therapeutic day programs, and in rare instances (less than 5% of students with EBD), residential treatment centers.

Students with emotional or behavioral challenges may need accommodation in the general education environment in order to make progress academically and socially. Or, students with EBD may require a placement in a setting that is removed from the general classroom. Services delivered through a continuum of services are not only required by IDEA (see Section 300.115 of the legislation), but they are necessary to serve kids with challenging behaviors in the neighborhood school. Figure 15 shows a continuum of placements that may be considered by schools. Unfortunately, most districts are set up so that a child who needs a smaller setting must be placed in another school to meet his unique needs. Although different options for placement may have benefits, the MDT is required to consider potential harmful effects of a placement. The following sections discuss the various placement options for students with EBD and also detail the promises and the potential pitfalls of each option.

The standard for removing a child from the general education setting to the special education setting, where all students have educational disabilities, is unique to each child. A child whose needs cannot be met through services and accommodation may be removed from the general classroom; some students may require a special school placement. Some students absolutely require removal from the general education setting to special education or a residential setting. Many of the special education settings in the school systems do not serve the needs of all students with behavior or conduct problems, so decisions must be made per individual child, with understanding of the resources, methods, philosophies, and procedures of the school district.

General education environments. In recent years, parents, professionals, and policy makers have attempted to better include students with all learning, cognitive, physical, and behavioral differences in their neighborhood schools and in typical classrooms. The law mandates that students be educated in the least restrictive environment (LRE) available and many states have quickly moved to eliminate separate classrooms for students with disabilities. For example, some school districts have declared themselves an all-inclusive school district and plan to individualize for students with disabilities and differences within each general education school building. Additionally, with the advent of movements such as Response to Intervention (RtI), interventions should be tried and recorded in general education as soon as a need is detected.

Promises. Including all students in one system has many benefits. First and foremost, one public system for all helps ensure the civil rights of people with differences. In other words, students with disabilities are exposed to the same learning options and opportunities as other students and are not relegated to trailers, basements, or a second-class parallel system. In general education, all students are exposed to the county’s curriculum and have the opportunity to excel. Inclusive environments also help students with differences make friends and feel like typical members of society.

Responsible inclusion demands that school systems prepare staff to accommodate and modify instruction to meet the needs of students with differences and use data to track the progress of students who are learning in a larger group setting. Programs that successfully include students with disabilities in general education have excellent coteaching between a general education teacher and a special education teacher, have a data collection and evaluation system that can help track the progress of students so that all know when more intensive instruction or intervention is needed, and provide intensive remediation services when needed.

Potential pitfalls. Although the concept of inclusion is a correct one, the practice of inclusion has a series of potential pitfalls. When staff are untrained to meet the needs of diverse learners and are expected to still maintain large classrooms, students with challenges often have their needs unmet. Students with behavioral challenges spend a great deal of time in isolation or away from the general education class. In these circumstances they are away from the general education environment and are with assistants or administrators who may or may not be trained in education or in special education. Untrained personnel tend to rely on punishment and exclusion rather than develop individual plans. Students with behavioral challenges rarely have friends and often are marginalized socially without purposeful intervention by teachers and administrators. Just being exposed to their general education peers is not enough. In fact, at the high school level more students with behavioral challenges are dropping out (Newman et al., 2009).

Special programs or self-contained classrooms. Students receiving intensive special education and related services were historically taught in self-contained classes in which only students with disabilities were served. These children traveled together as a group to lunch and to their elective classes. This type of programming exists today only for students with the most severe disabilities. The majority of children with disabilities who are served in public schools spend some percentage of their school day with nondisabled students. Some students require the consistency, routine, and managed sensory environment of small classrooms to be successful. Students who require a full day of special education and related service are placed in separate wings or standalone buildings. A child may receive 100% of his education with other children with disabilities or may receive part of his daily education in the special education setting.

Promises. Perhaps the biggest benefit for special classes is the amount of staff attention and support given to each individual student. Because of the small class size, teachers and school staff can be more flexible in meeting academic and social goals and can modify instruction more easily. In addition, special classes also can allow a break from a more traditional approach to learning in order to meet the unique mental health needs of students.

Potential pitfalls. Unfortunately, special classes that only serve students with disabilities also have some potential problems. In a specialized school or a self-contained classroom, the staff often are not focused first on academics and can oversimplify lessons and “water” down the general education content. Sometimes students with disabilities are not receiving the same exposure to grade-level content as other students. Although this is not true of all specialized settings, many school systems are trying to downsize self-contained classrooms.

Residential treatment centers or therapeutic boarding schools. Approximately 3%–5% of children with EBD are placed in residential treatment centers. A residential treatment center is a facility that provides 24-hour care for children. They may be locked or unlocked. Students are placed in these facilities in one of four ways:

• The local school system, through an IEP team process, determines that the child requires 24-hour instruction in order to make progress on the IEP.

• The local school system may partner with another agency to provide residential placement. Agencies such as the Department of Social Services, Department of Juvenile Justice, or the local mental health department agrees to pay for the residential component of the program.

• The child is court-ordered into residential treatment. In this case, the local department of juvenile justice is usually responsible for funding and managing the child’s placement.

• Parents/guardians may elect to privately place their children in a residential treatment center.

Residential treatment centers are departmentalized institutions of care that provide intensive, structured programming 24 hours per day, 7 days per week, and 365 days per year. The quality of these programs varies widely. Within 24 hours of admission, an Individualized Treatment Plan (ITP) may be developed. Children are assigned to treatment teams consisting of a psychiatrist, licensed social worker, and nursing, residential, and education staff. The constellation of staffing will vary from facility to facility. This team monitors the student’s progress on a frequent basis. Staff to student ratio rarely exceeds four students to one staff member. Two staff are assigned to each classroom. Programs are therapy-integrated, which means that individual and group therapy occur during the school day and all staff is trained regarding the use of therapeutic language, positive behavior supports, and behavior management techniques, including the judicious use of passive physical and chemical restraint, if necessary.

Promises. Programs that serve children with EBD can be therapeutic for students and their families. Healing takes time and is invisible. Creative programming and opportunities to participate in the community are important features of any program that works with children with EBD. Staff who are prepared to work specifically with students with behavioral challenges can look beyond the behavior to the child underneath. Through relationship and consistency, residential treatment centers can reach the most troubled children through an all-encompassing intervention approach. Some programs offer therapeutic horseback riding, outdoor adventure programming, therapeutic recreation, and community service experiences in addition to excellent teaching. Residential treatment centers also use positive behavior supports and sophisticated clinical interventions to give students opportunities to be normal and escape from patterns of problem solving that have not been productive.

Potential pitfalls. The residential treatment center industry has been highly scrutinized over the past 15 years. Parents agree to have their children placed in these facilities during times of great stress; they are relieved to have their children in a contained environment and to take a break from the daily stress and conflict that accompany children and families who are in crisis. Nationally, there have been many problems associated with residential treatment center care. Serious student and staff injuries, poorly managed medication administration, and poor quality custodial care are some of the issues plaguing the industry. In order for a residential treatment center to receive federal funding, it must be approved by the Joint Commission (formerly known as the Joint Commission for the Accreditation of Healthcare Organizations or JCAHO). School programs affiliated with residential treatment centers are approved by the state department of education within the state that they are located. These entities require intense compliance regarding a multitude of regulations. They do not provide quality assurance monitoring. Each entity has rigorous compliance standards. Complaints and findings of investigations are available to the public under the Freedom of Information Act.

Section 504 is so named because it relates to the 504th Section of the Rehabilitation Act of 1973. Both a 504 Plan and an IEP should assure that a child is receiving a free appropriate public education. There can be many other similarities between IEPs and 504 Plans (see Figure 16). This is because there are no set requirements for what the 504 Plan should contain. The 504 Plan can contain any of the above-described parts of the IEP. The tools at the end of this chapter on possible accommodations can be used for ideas when developing the 504 Plan. What goes into the 504 Plan is up to the MDT. The scope of evidence-based methods or accommodations possible in the 504 Plan includes:

An individual student plan can take the form of an Individualized Education Plan, 504 Plan, or informal plan created by the school. A Behavior Intervention Plan should accompany these, as we have discussed in this chapter. In the upcoming chapters, we discuss how all aspects of the individual child must be considered, including biological and neurological factors. In the development of an effective plan for school success, the MDT should consider the factors explored in the next three chapters—brain factors, biological factors, and medical factors—so the child is seen as a whole person and all of his needs are met for school success.

Parents and educators work together toward common goals when components of student plans are well defined and documented. This worksheet can be used before, during, or after MDT meetings to structure questions, discussion, and sharing of information. The first column lists the elements required in an individual student plan. The middle column should be used to document those aspects of the student’s plan, and the last column is used to keep track of things to do before, during, and after the MDT meeting.

Place a check mark next to the items you as a parent have considered, and circle those to discuss with a school-based professional or other expert:

Am I asking for services first, without understanding the process that drives the agreement for services, or without the team first recognizing the need in that area?

Am I aware of my rights for consent, that my input does not automatically “trump” the other members of the MDT?

Am I assuming that the recommendations from evaluation reports, especially reports that I paid for, will be incorporated into the program?

Do I understand the information in evaluations prior to meeting with the school team, or am I expecting services before evaluations are complete?

Am I reading and understanding the paperwork that is used in the school meetings and afterschool meetings?

Am I continually interacting with teachers and all staff and involved with my child’s school and classroom? Am I avoiding meeting with the team only once per year?

Have I requested data, and do I understand how data will be collected? Am I keeping a portfolio or running record of my concerns?

Do I avoid being either being “best friends” or “worst enemies” with the MDT members (making it personal)?

Do I need help understanding the process for developing a plan? Are there people with special knowledge of my child who I can bring to the meetings where plans are developed? Can I arrange for the private therapist or doctor to participate in the school meetings and document recommendations in written reports?

• Read aloud; indicate full text or partial text. Include use of technology that reads aloud

• Give preferential seating: front, near teacher, away from noisy machines, away from distracting peers, near study buddy

• Adjust workload: fewer problems, more practice problems, more enrichment, eliminate or reduce homework, specify time to work on homework

• Allow alternate product such as oral presentation of an essay, PowerPoint presentation, web-based product, illustrations

• Adapt assignment to minimize writing (e.g., circle, cross out, write above line)

• Adjusted notetaking, use alternate forms for notes (e.g., fill in the blank, circle)

• Specify if effort is graded; whether student graded compared with himself, peers, or both; and how a parent should understand the grading

Myth	Truth
The regular classroom setting is appropriate for all students.	Each student should be considered individually for placement in a setting removed from the regular or general classroom.
Behavior contracts and level systems are behavior change methods.	Behavior contracts and level systems have limited success rates.
The IEP is a living, breathing document that can be changed at any time.	The IEP can be changed without a meeting if the parent and school provide written consent. If a child needs a service, and that need is shown through evaluation, the service should be listed in the IEP and how often the service will be provided, how long, and by who must be clearly understood.
Removal from the general classroom setting should only be done when accommodations and modification in the regular classroom do not meet student needs.	Counseling, staff training, and other professional development for regular classroom teachers is not available at all schools.
A child has to fail before receiving an individual plan.	Response to Intervention problem solving should be used to intervene early, so a child can respond to evidence-based methods.

Test or Tool	Score	Description
Test of Pragmatic Language	79	Low, well below average. (Average is 90–109)
Social Mapping	1 out of 15 interactions were initiated by Sherri	Below age expectation. Average for class is 11/15.
Pragmatics Profile of Clinical Evaluation of Language Fundamentals	88 Criterion Score	Below criterion. 142 or greater indicates no concern.
Social Competence Scale	T Score of 50	Average. Scores between 30 and 60 are average.

Individual Plans Should:	Documentation:	To-Do:
Be based on proper evaluation of behavior, including FBA	List date of evaluations used, and description:	To-do list and who is responsible:
Include scientifically based, or at least evidence-based, positive behavior supports, methods, and interventions	List evidence basis or scientifically based research, including name of intervention and description: List strategies, and under what conditions strategies are effective: List methods and instructional methods:	Follow up and to-do list, including persons responsible:
Be multimodal, both proactive and reactive	Proactive interventions and strategies: Reactive interventions and strategies:	To-do and who:
Include specific present levels of performance	Strengths: Needs:	To-do list and follow up:
Assure instruction for emotional and behavioral skills or social skills is based on a curriculum	Name the curricula here, including websites to the curricula, usually available at the state or district websites: Include social skills curricula or emotional and behavioral skills curricula:	To-do or notes:
Define goals, along with or in conjunction with the IEP goals, if any	Refer to IEP goals: If no IEP, write goals:	Draft goals here:
Be individualized Involve parents	Parent involvement? Best way to communicate?	Notes:
Incorporate how progress will be monitored, and include data collection tools	See Chapter 6 for a list of formal and informal evaluation tools.	Notes or to-do:
Include meaningful accommodations	See Tool 9.3 for suggestions and ideas.	List accommodations or refer to 504 Plan or IEP:
Consider necessary related or supplementary services, including assistive technology	Related services: Supplementary aides and services, if any: Assistive technology, if any:	Notes and to-do:
Be meaningful to the child and include parents	List how the child will be involved in the development and implementation of the plan: If appropriate, list child’s future goals, after school:	Notes: