Tag: Featured

Everything You Need to Know About IEPs and 504s

 (for Children and Teens with ADHD)

Navigating the ins and outs of getting help for your child in school can be overwhelming, especially when it feels like everyone is speaking a language you’re not familiar with! This week, I’ll help demystify two very different avenues of accessing school support for your child or teen – I’ll share  everything you need to know about IEP and 504 plans for children and teens with ADHD. You’ll be able to advocate for them more effectively and they’ll be able to manage classes and homework with more ease and success.  

 

Many kids with ADHD struggle in school–not just with accessing what they know when they need to use it but also with co-occurring learning disabilities that occur about 70% of the time.  There are several paths that lead to the provision of an Individualized Education Plan (IEP) or Section 504 Service Agreement (504 SA) for your child, but they all start with one thing – concern that your child may need additional support to be successful in school, and a psychoeducational or multi-disciplinary team evaluation to determine why they are struggling.  Your child’s school might request to initiate this evaluation, you might request an evaluation, or you might provide the school with documentation of your child’s existing disability or neurodivergence…there are many different scenarios in which a student can be referred to determine eligibility. 

 

Where to begin the process

Ultimately, everyone wants to ensure that if your child does need modifications or accommodations due to neurodivergence, they receive tools and strategies to be successful at school. This process often starts with a team meeting (that you or your school team typically have to formally request) to discuss concerns that can

 lead to a psychoeducational evaluation, functional behavioral assessment or recommendation to meet with your primary care provider. If your child already has a diagnosis of ADHD and/or an evaluation that you obtained privately, then this meeting will most likely discuss the information that you already have, and any impact on school performance. Either way, you and the school team will discuss what’s going on and the team will decide whether a school based evaluation is appropriate to determine if your child is eligible under IDEA for an IEP or Section 504. If so, then they will develop a plan that outlines what, how, and where any needed supports or accommodations will be provided.  

Now that we’ve laid out how to begin, let’s talk about the basics of an IEP and 504, what each of them is (and is not), and who they are appropriate for. In order to do this, I will be using the word ‘disability’ here when referring to ADHD instead of ‘difference’ because school based services are only provided based on the determination of a disability. 

Individualized Education Plans–IEPs

An IEP – “Individualized Education Plan”  is a legal document that outlines what supports and services your child will receive as a result of being found eligible for special education under a qualifying disability category.  Federal law under IDEA guarantees a free and appropriate education to all students. IDEA is about facilitating academic achievement and progress. IEPs are just one component of what falls under the umbrella of “Special Education” for children ages 3 through 21 in schools.  They offer a road map for teachers, support staff, related service providers, parents, and other team members to follow.  

The Details of an IEP

An IEP can only be drafted after the school has conducted a psychoeducational evaluation (or you bring one that the district accepts), shared the findings with you, and all participants agree that the student is eligible for special education under a qualifying disability category. The named disability has to be found to negatively impact their educational performance so that the student needs specialized support and services to make progress educationally. While disability categories can vary from state to state, federal law under the Individuals with Disabilities Education Act (IDEA, Part B) identifies thirteen categories of disability, including: Other Health Impairment, Specific Learning Disability, Traumatic Brain Injury, Orthopedic Impairment, Hearing Impairment, Emotional Disturbance, Autism, Speech/Language Impairment, etc. 

An IEP is characterized by the modifications that are deemed necessary to make the curriculum more accessible for the student to be successful. These are changes to what is taught or expected, through specialized instruction or the provision of related services (behavior supports, PT/OT, Speech, etc.).  An IEP means that the student has been found eligible for Special Education. 

ADHD and IEPs

Under IDEA, ADHD is considered an “Other Health Impairment.” The psychoeducational evaluation by the school cannot diagnose ADHD per se but will indicate that a child has the symptoms or behaviors commonly seen in attention disorders. This means that you will have to take the report back to your primary care provider or a licensed therapist for a formal diagnosis or clinical/medical follow-up. It’s a complicated process but worth it in the end to get services at school. 

 

Section 504 Service Agreement – 504 Plans

A “504 Plan” or “Section 504 Service Agreement” is a civil rights law that refers to

Section 504 of the US Rehabilitation Act of 1973.  It is a legal document that outlines what accommodations your child needs to ensure equitable access in their schooling.  

A 504 SA can only be drafted after the school has conducted an evaluation or reviewed one that you have provided and discussed the findings with you. All participants agree that the student has a disability that limits their functioning in one or more “major life areas” and qualifies for protection as a result.  ​​These functions include such things as self-care, performing manual tasks, walking, seeing, speaking, breathing, learning, working, eating, lifting, bending, reading, concentrating, thinking, communicating, and more. 

504 Plans Level the Playing Field

A 504 is characterized by the accommodations that are necessary for the student to access the curriculum. It is designed to “level the playing field”. 504’s eliminate barriers to allow students with disabilities to access the same activities and programs as their non-disabled peers. It offers protection to persons with disabilities from discrimination based on their disability. Again, within this definition, ADHD qualifies as a disability. 

Students – at any level – who attend a school program that receives federal funding can be eligible for protection under a 504 Service Agreement. They require accommodations to access the General Education setting.  This means a student who is enrolled in preschool, elementary, secondary, postsecondary, vocational, or adult education can qualify, regardless of age. 

 

With the technical information about IEPs and 504 plans out of the way, let’s look at some common misconceptions and the real truths. 

Myths vs. Facts about IEP AND 504 Plans

MYTH:  My child was diagnosed with ADHD by her psychiatrist/family doctor/specialist, she should have an IEP. 

FACT: She should have an IEP only if progress at her grade level is negatively impacted by her ADHD symptoms. 

A common misconception that many parents have is that a diagnosis of ADHD, “dyslexia” (or a specific learning disability), ASD, Anxiety, etc., made by a medical professional, means that their child automatically needs Special Education programming and an IEP.  This is only true when there is an educational impact because the symptoms of that diagnosis make learning at grade level difficult for the student. 

If she is learning at grade level, but needs accommodations like extra time on tests, verbal directions, etc., to address symptoms of ADHD, then a 504 SA could be appropriate. 

 

MYTH: Our son’s outside executive functioning coach thinks he has ADHD and maybe dyslexia. She thinks the school should diagnose him.  

FACT:  A school cannot diagnose a student with ADHD or diagnose dyslexia. For a clinical or medical diagnosis, you should follow up with a primary care provider or licensed therapist. But, if the school were to do an evaluation and also find him eligible under IDEA, he would have educational eligibility under “Specific Learning Disability” and “Other Health Impairment”, and an IEP could be drafted. Remember that in schools, ADHD is considered an “Other Health Impairment”, and dyslexia is considered a “Specific Learning Disability”. The reality is that the same diagnoses a child receives from an outside clinical/medical professional exist in schools but may be categorized or called something different. No wonder parents get confused!

 

When considering whether an IEP or 504 SA may be appropriate for your child at school, here are 5 key takeaways:

 Key Takeaways

  1. An IEP makes mandatory adjustments and modifications, a 504 SA affords access and makes some accommodations. 
  2. Not all students with neurodivergence need special education!
  3. Clinical and medical diagnoses and educational disabilities are often two different versions of the same language.
  4. A school-based evaluation determines eligibility for special education or a 504 SA. 
  5. Going through the process of determining what types of services are best for your child can be very confusing. Get the support you need by talking with your primary care provider, licensed therapists, special education advocates or knowledgeable coaches.

Overcoming ADHD Brain Fog

Dear Dr. Saline:

I’m a 30 year-old AuDHDer who would love your input. I pride myself on my ability to focus and concentrate on what needs to be done. I’m achievement-oriented and used to be able to blaze through a to-do list. Lately though, brain fog has been hitting me hard. It’s been a period of very high stress. I find myself struggling to make sense of things people say which I would previously decode with ease. I’m hoping this is temporary but it’s embarrassing. What can I do? 

Thanks!

Crystal

Dear Crystal-

Brain fog can certainly be disorienting, confusing and even a bit scary for folks with and without ADHD or autism. Brain fog refers to a group of symptoms that impact how you function cognitively–your thinking, your recall and your concentration. It can also reflect difficulty with making decisions, mental fatigue, slower response time and uncertainty. While we don’t know what causes brain fog exactly, research shows that it’s associated with chronic fatigue syndrome, long COVID, chemotherapy, autoimmune conditions or depression. But, brain fog is not a medical condition so you can’t be diagnosed with it. It’s more like a set of symptoms that arise when something else is going on and you are not thinking as clearly as you could.

As you have shared, the symptoms of brain fog can make it difficult for people to engage in conversations, perform routine daily tasks and follow instructions. Plus, brain fog differs from person to person, particularly women. In fact, it disproportionately affects women because of hormonal changes related to menstruation and menopause. For folks with ADHD who already struggle with focus, memory and organization, stress can bring on brain fog by overwhelming weaker executive functioning skills. 

Develop coping strategies for daily stress

Of course, living with ADHD and AuDHD means living with a baseline of stress that neurotypical adults don’t have to deal with. The consistent inconsistency of being neurodivergent leads to being unclear– if you will follow through on things, if you will arrive on time, and if people will like you. You may freeze in the moment, unsure of what to say or do. Perhaps you lose your train of thought more often and get distracted more easily. Or, maybe you interrupt others or say something awkward without knowing it. This is especially tough in the middle of social situations, peer interactions or important work meetings.

Rely on coping strategies

Crystal, it seems like you’ve developed some useful coping tools to help you make sense of what others are saying to you and respond effectively. I can’t even imagine how frustrating it is for you to deal with this disorienting brain fog. And, let’s be honest, everybody spaces out sometimes. Yes, this may happen more intensely and more often for folks living with ADHD due to how their brains are wired. You are not alone in your embarrassment when this occurs. But, being upset with yourself for something that you cannot control only increases your stress and worsens the very brain fog that is troubling you in the first place.

It seems that  the question you are asking is, “How do I navigate these moments with more ease and less self-criticism?” I think your first step to lower your stress. I am a big fan of being authentic. Authenticity means being transparent and non-defensive when you miss a comment in a conversation or do something that you later regret. Self-care, exercise and self-compassion are all ways to reduce the tension in your life and hopefully the brain fog too. Try these  strategies to lower your stress.

4 techniques to manage brain fog in your life:  

1. Reduce stress by focusing on one task at a time: In today’s busy, constantly connected world, we live with too much to do and not enough time to reset. When we take a walk while talking on our phone or scroll while eating lunch, we don’t actually give ourselves the true break that we really need. We shred our time into distracted chunks instead of having space to exhale and regroup. When we multitask, we stress our brains and exhaust ourselves. Opt for single tasking as often as possible. You may not be able to eliminate all media multitasking habits but, with single tasking, you’ll feel more productive and less stressed.

2. Get enough sleep:Nothing weakens our coping abilities like a lack of sleep. Many people with ADHD struggle with sleep issues. Typically, folks wrestle with three aspects of sleep: falling asleep, staying asleep and waking up. It can be tough to turn off your mind. Perhaps you experience racing thoughts, intrusive worries or a fitful night of sleep marked by “tossing and turning” throughout the night.

Some people sleep so deeply that they struggle to get up in the morning, requiring numerous alarm clocks or physical reminders. Think about your sleep needs: how much, when and what helps you relax. Practice consistent sleep habits by going to bed and waking up at the same times and staying off screens for at least thirty minutes before you nod off.

3. Exercise regularly: I cannot emphasize enough how much exercise helps with clear thinking. The endorphins that are released during exercise enhance focus and increase your overall sense of well-being. Moving your body has been found to improve motivation, build energy and reduce confusion. The Centers for Disease Control (CDC) recommends that adults engage in at 150 minutes per week of moderate-intensity activity such as brisk walking, running, biking, etc. Of course, eating well helps your overall health too. So the next time that you are feeling brain fog descend, try to move your body and see what happens.

4. Chunk your activities and write things down: Instead of relying on hyperfocus, try breaking tasks down into 30-45 minute work blocks. You want to give your brain time to reset and rest a bit throughout the day rather than go intooverdrive and burnout. It can be tough for a lot of people who like to hunker down and plow through a set of projects. But overworking like this uses up the natural glucose fuel in the brain and then relies on cortisol. You wind up creating stress that doesn’t need to be there. Trying to remember everything also adds pressure. Give yourself a break and write things down. This also reduces stress and gives you the visual cues you need to be productive and stay focused.

Aim for reducing brain fog not eliminating it

Learning how to schedule adequate down time to integrate and process information, asking for someone to repeat what they said without self-criticism and taking care of yourself with good sleep, nutrition and exercise habits will reduce your overwhelm and your shame. Remember, brain fog is not your fault; you didn’t choose this. Instead, just explain what’s going on to someone when it is happening and move on. You’ve got this!

Surviving Back To School: A Neurodivergent Parent’s Guide

As thoughts begin to turn from planning picnics and BBQ’s to planning school lunches, our parental priorities shift from “summer fun” to “get it done.”  The back-to-school transition helps set the stage for a successful school year. It is a great opportunity to help equip kids with the tools they’ll need for a smooth start. But for parents and caregivers of neurodivergent students, this time of year can feel especially overwhelming, as it is so much more than just pencils and pens that our students need.  In fact, parents of children who have learning and thinking differences are more likely than other parents to say they feel stressed (39% vs. 28%, respectively), unprepared (19% vs. 12%), scared (17% vs. 9%), and/or lonely (10% vs. 3%) when it comes to back-to-school season. This week, I’ll share practical tips for how you can survive and thrive during this back-to-school season.

Adjust Expectations

As the parent or caregiver of a student with unique learning needs, you know that being flexible is essential. Why not give yourself that same space (and grace) to be able to NOT do it all, and remain flexible with what you’d like to accomplish? Setting too many goals at once – “I’ll arrange playdates every weekend,”  “We will eat breakfast as a family every day,” or “I’ll volunteer 5 hours in the classroom” – can feel overwhelming to both you AND your child.

Families living with ADHD can be especially sensitive to changes in routines. When new tasks are thrown into existing ones, confusion and frustration often come along for the ride. This year, consider viewing back-to-school tasks through the lens of what is truly important to your family’s needs. Instead of one long “to-do” list to slog through, focus on one or two things that are truly important for your family right now.  By limiting your goals and adjusting your expectations, you’ll minimize pressure on everybody and reduce family stress.  

Start Preparations Now with Low-Key Conversations

Now is a great time to begin easy conversations about returning to school – asking what your child is most excited about doing or seeing when they go back, what foods they look forward to in their lunchbox, who they’ll high-five first, etc. These are no-pressure conversations that signal change is afoot. Start with “Tell me what you know about….” this new grade or this new school. You’ll get a sense of their level of understanding and be better prepared to meet them where they are.

By pairing these conversations with visual cues at home such as a countdown calendar, displaying photos of familiar school staff and classmates, meeting their teacher or walking the hallways of a new school, you’ll help make going “back to school” seem less frightening and more familiar.  These conversations are just as important with college age students so set aside some time to start now! 

Set a Positive Course with Collaboration

Setting a positive course for this year depends on collaborating with your son or daughter to establish clear goals and useful strategies. Kids with ADHD spend a lot of time listening to what they could do differently from caring adults, friends,

coaches, etc. By including some of their opinions in whatever program you create, you increase their buy-in. When they feel like their ideas matter, these kids are far more likely to cooperate. So, start this school year with a calm, honest family conversation.This chat sets the tone for how you will work together to make it a success.

Take the Time to Reflect First

Before you sit down with your son or daughter, consider your responses to these questions: 

  • What do you hope for your child or teen this year?
  • What went well last year and why?
  • Can you identify any behaviors or decisions that made a positive difference? 
  • What were some of the challenges? What improved them?

When you’re ready for your conversation, ask them similar questions. Offer some of your reflections and see if you can agree on some goals for this fall. Write these down and, together, choose one to start with.  It can be fun to treat this as a “time capsule” too: make a copy and place it in an envelope to be opened at the end of the semester. Then you can review how things actually worked out–the successes and the challenges.- kept in an envelope until the end of the year (or month, semester, etc.), then reviewed together and discussed.  

Practice time management skills now

Many children who are neurodivergent struggle with time and get frustrated.This makes morning routines tricky and causes conflict.

It’s harder for them to feel time, plan for things accordingly and then actually do them. They tend to overestimate how long a task will take and how much effort it entails. Then they feel overwhelmed, procrastinate or avoid it altogether. Or, they underestimate how long a task will take and the effort involved. Then they leave things until the last minute, rush to complete them and feel very stressed in the process.

Use Backwards Design to Teach Time and Planning Skills

When planning school schedules, practice using backwards design with your child to help them plan – in reverse – for where they want to be (or want to have done) in the future.  This means working backwards  by starting with the end goal and allocating time accordingly.  Sit down in advance and review what needs to be accomplished and how long things actually take.

“You have to be at school by 7:30. It takes  twenty minutes to ride your bike, lock it up and get to homeroom so that puts you at 7:10. Before that, you want to eat breakfast (ten minutes), go to the bathroom, brush your teeth and get dressed (fifteen minutes) which puts you at 6:55 am. Then you have to wake up. Usually you hit the snooze button once or twice which lasts another fifteen minutes. So that means you have to set my alarm for 6:40 if everything goes perfectly. Maybe we should set it earlier for this week, just in case.”

Backwards design benefits kids by teaching them how to estimate time, develop the ability to sequence events and improve planning and prioritizing. 

Notice the Positive to Raise Self-esteem

Parents of neurodivergent children are 2.4 x’s more likely to experience challenges related to their mental health than their parent peers, making self care strategies an essential component of your back-to-school parenting toolkit.  Equally important, however, is to extend these practices to neurodivergent learners with ADHD. They benefit from explicit support and instruction in identifying and incorporating positive events in their day that nurture self-esteem.

Spend a few minutes at the end of the day and check in with your child, asking “What are two things that went well today? What were your favorite times of the day?” Many kids with ADHD tend towards negative mindsets marked by internal self-criticism and judgment. Shifting their thinking not only nurtures growth mindsets but also self-care. By noticing what is working, they start to feel more confident and courageous. Set aside a time to review two highs and one low of the day. Often dinner is a good place to do this. One of my clients calls this talking about “the happy and the crappy;” for another it’s “the rose and the thorn.” 

Your Self-Care Makes Family Life Stronger

Noticing the positive applies to you too. Self-care goals or guidelines for this year bc when parents are stressed kids pick it up and act out.  As adults, we tend to think acts of self care look like bubble baths, a piece of chocolate, reading a book, etc. But setting boundaries, keeping organized, and lowering the pressure of unrealistic expectations also provide much needed relief.  Before tending to your child, start this school year off on the right foot by reflecting on your capacity, your limits and treating yourself with compassion. Then you can show up and guide your child towards thriving once classes begin.

  Ready, Set…LET’S GO!

Back to school will be a breeze for you and your child with neurodivergence when it includes collaborative conversations, time for community support, opportunities to practice time management, setting realistic expectations, and room for personal growth and positive reinforcement.  Help your child or teen navigate this shift back to school by easing them into the changes ahead with the tips above, and you’ll feel ready to tackle this time of year together! 

 

How 3 Useful Changes Can Make Positive Differences in Your Life

HOW 3 USEFUL CHANGES CAN MAKE POSITIVE DIFFERENCES IN YOUR LIFE

Proactive change is a fascinating thing. It’s the type of change you seek when you desire a shift in your life. You might have identified an area you want to improve, a behavior you want to stop, or a wish you want to manifest. You are ready for a transformation but may feel overwhelmed with where to begin or what to focus on. Change is possible through desire, small steps, and support.

This week, I attended the educationally stimulating ICD Virtual Conference, “Shining a Spotlight on ADHD.” There were three terrific speakers- Melanie Sobocinski, PhD, PCC, Sharon Saline, Psy.D, and Ari Tuckman, PsyD, MBA. They shared a wealth of information. I’m focusing on three ideas I learned about change that I thought would be especially helpful.

Read the article! Oh, So Organized

Are Your Kid’s Meltdowns a Sign of Rejection Sensitive Dysphoria?

Are Your Kid’s Meltdowns a Sign of Rejection Sensitive Dysphoria?

If you’ve noticed that your child is exhibiting sudden emotional outbursts, crying, or even aggressive behavior when they feel rejected or criticized—often leading to social isolation—it’s possible that they are affected by Rejection Sensitive Dysphoria (RSD).

Rejection Sensitive Dsyphoria is an emotional sensitivity and emotional pain triggered by the perception—not necessarily the reality—of being rejected, teased, or criticized by important people in one’s life. It is often a symptom of ADHD, but can also present as a stand alone condition. Read the article!

ADHD and The Imposter Syndrome: Fighting the Feeling that You Are Never Enough

ADHD and The Imposter Syndrome: Fighting the Feeling that You Are Never Enough

Does this scenario resonate with you? THEM: What a bang-up job you did in the meeting today! So smart the way you handled that. YOU: Oh, it was just luck that I happened to have that info. TO YOURSELF: (Wow, dodged another bullet. One of these days they are going to find out how much I actually stink at this.)

Read the article!

The Unspoken Truths of Postpartum Depression: Help for Women With and Without ADHD

“The Unspoken Truths of Postpartum Depression: Help for Women With and Without ADHD” [Video Replay & Podcast #470]

Pregnancy and childbirth are life-altering events, and it is not uncommon for postpartum mood disturbances to impact the mental health of new mothers. Studies suggest that ADHD increases the risk for experiencing postpartum mood disorders (PPMD), a form of postpartum depression (PPD), which are often triggered by dramatic hormonal fluctuations, inadequate sleep, and the new and relentless demands of caring for an infant. Postpartum symptoms may also exacerbate ADHD symptoms in some women and can impact the wellbeing of the entire family.

Listen here!

ADDitude

I-Team: What’s leading to ADHD drug shortage?

I-Team: What’s leading to ADHD drug shortage?

A sharp increase in ADHD diagnoses during the pandemic has led to a nationwide medication shortage that is impacting families here in western Massachusetts. The shortage is forcing pharmacists to get creative with dosing and parents to scramble while kids are trying desperately to keep it together. The 22News I-Team looked into what’s causing the shortage and how families are coping. The ADHD medication shortage means moms, like Lauren Harris of South Hadley, are spending a lot more time on the phone and in the car finding the ADHD medication her kids need became like a second job.

Watch here!

Eight Tips to Make Halloween a Treat for Your Child with ADHD

Eight Tips to Make Halloween a Treat for Your Child with ADHD

Halloween can be tough for children with ADHD — and their parents. There is so much stimulation, unknowns, safety rules, unexpected transitions and waaayyyy too much sugar candy. How can you help your child enjoy the holiday without meltdowns or having to have the fun curtailed?

Read here!