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Another pandemic side effect: did early intervention miss a lot of kids?
Students are showing up for school with disabilities that normally would have been caught and addressed before kindergarten.
Anecdotally, I’ve witnessed and heard of lots of students showing up to kindergarten with disabilities that will likely require special education services – and should have been assessed and addressed in early intervention.
At our son Ben’s 12 month appointment, the pediatrician asked a lot of questions about his development: Was he eating different solid foods? How many words did he know? Ben (or “smush,” as I call him) crawled around the office while the doctor interrogated us. At one point, she noticed him crawling on just one leg. “Does he always crawl that way?” she asked. We heard the concern in her voice. She ended up recommending he be screened for “Early Intervention.” An occupational therapist should evaluate his “asymmetrical crawling” and determine if he needed therapy, she said.
Alarm bells went off – our son has a disability? But then I reminded myself: in Philadelphia, this is how the system should work. In Pennsylvania, “Early Intervention” refers to services and supports for eligible children from birth to age 5. “Eligible” typically means a child has some sort of atypical physical or cognitive development. In Philadelphia, there are two systems: one that services children from birth to age 3, and another that services children age 3 to 5 — the age they typically begin kindergarten. While the pandemic likely prevented some students in both groups from being identified for early intervention, it’s the latter group — students age 3+ when the pandemic started — who are beginning kindergarten this year.
Typically, doctors and daycare/preschool centers make referrals to Early Intervention providers. An organization, Elwyn, then screens, determines eligibility, develops individualized plans, and provides services for three to five year old’s in Philadelphia. Disabilities can range from speech issues and cognitive delays to autism and emotional disturbances.
So why might these have been missed for students just now entering kindergarten? Consider how many children didn’t attend daycares or missed in-person doctor visits in the last 18 months. Some of the above-named disabilities can be difficult to diagnose over Zoom or Google Meet, meaning parents themselves would have to diagnose and seek out intervention services for their children.
Even if they did that, they likely faced an additional barrier: providing the interventions themselves. Many providers were closed for in-person services. Indeed, when we did our sessions with Ben’s occupational therapist, I became the occupational therapist. I had to take time off from work and move our 12-month-old through stair climbing exercises and other physical feats. It was challenging work that required job flexibility – something many parents don’t have.
It’s no surprise, then, that other principals and I have anecdotally seen an uptick in the number of students arriving to kindergarten classes with atypical behaviors and skill deficits that normally would have triggered special education services via early intervention.
Some of these disabilities aren’t so prohibitive that children can’t make progress in the large classes of the general education environment. But some are. I’ve witnessed first-hand students whose cognitive, social, and emotional skills are so atypical that they really struggle in those large class setting (our kindergartens can have up to 30 students).
Couple that with the overall lack of socialization opportunities and classroom exposure that young students have had over the last 18 months, and our early elementary teachers, school psychologists, and special education teachers really have their work cut out for them this year.
Fortunately, I feel more equipped than ever to address these pressing needs. For the first time ever, I have a full-time school psychologist working at my school. Just this past week she observed, on our recommendation, a kindergarten student who displayed some atypical behaviors. She collected some data, immediately requested we send home a “permission to evaluate” the child, and began evaluating him within days of our initial concern. In previous years, it might have taken weeks or even months to even gather the required data to send the permission form home.
Not every school is so fortunate to have a full-time psychologist or really skilled special education team. And educational evaluations are time-intensive, sometimes requiring several days’ worth of testing (in short chunks) and more time to analyze data, make a diagnosis, and then write an individualized educational plan (IEP) or find a more suitable placement, like a fully-inclusive autistic support classroom. The whole process can take weeks.
For the children whose deficits aren’t so severe, the general education teachers can certainly help them make progress. For others with more severe deficits, being in such a large class without the individual attention they need can really set them back and exacerbate their conditions – and make it hard for teachers to teach the other 20+ students. And in a year like this, every additional challenge feels like the straw that might break our backs.
In late June, the CDC released a report noting that early cancer screenings for breast and cervical cancer were down over 80% in April 2020 compared to previous years. More research will need to be done to confirm what I’m seeing on the ground. In the meantime, we’ll pore over academic screeners to make sure every student gets what they need.