Week Eleven

Molly and Ian have worked hard over the last several years to support and help Thomas, and now 16 years of age, Thomas is doing well in high school. He currently attends the local public high school and is mostly in a self-contained class for children with Autism. The only mainstream class he has is PE, and this has proven to be the most difficult time of the day but still relatively manageable.  

Middle school, however, was another story. Thomas had managed to develop some friendly relationships with other children, although his limitations meant that, rather than coming to understand social cues in an intuitive manner, he had to very specifically be taught and coached as to what to say with friends and when. He entered middle school having had some positive experiences with two other kids at the Mathews Center, but Molly and Ian had to stop sending him there as the cost became prohibitive. It was shortly after ending with the Mathews Center that Thomas entered middle school. The first year went OK, but there were little signs that Thomas might have a rough time in middle school: even though the 5^th grade team at the elementary school had prepared teachers and administrators for Thomas and his specific needs, a new assistant principal had not been prepared for him and was not as understanding of Thomas’ disability as others in the school system had been. Thomas became frustrated at one point in the middle of his sixth grade year and ran out of his classroom. When he did, he was unable to avoid running into another student who was in the hallway at the time. The student fell and bumped her head. The assistant principal, who was in charge of discipline at the school, felt like Thomas’ behavior was intentional. Most everyone else involved, particularly the classroom teacher, knew Thomas and felt differently. Although Molly and Ian had been seeing a small change in Thomas’ behavior at home, they knew that he was not the kind of child who would intentionally hurt a peer. Still, the assistant principal held firm and suspended Thomas for 10 days.  

A manifestation determination was held, and, after a heated discussion, it was decided that Thomas’ behavior was a result of his disability. After 10 days, Thomas was able to return to school, but his attitude was quite different. This was the beginning of ongoing behavioral difficulties at the school that were a marked shift for Thomas in his experience of school. Finally, toward the end of his eighth grade year, the psychiatrist tried another type of medication which seemed to be effective for Thomas, and he was more able to manage himself throughout the school day. It wasn’t until moving to the high school, however, that Thomas finally felt safe and comfortable again in a school.

Now at age 16, Thomas is doing well on his IEP goals and is on track to graduate with an IEP diploma.

* Using Brofenbrenner’s ecological systems model, with what influences did Thomas have to contend in middle school?

* In your group’s opinion, what circumstances led to Molly and Ian’s resilience in the face of the challenges Thomas has presented as a child with ASD? Describe the factors that likely led to such resilience – be sure to consider what you can ascertain of Molly and Ian’s general level of functioning including what you perceive to be their overall psychological well-being.

* From the standpoint of the school and the IEP, what is transition? Describe at least 3 transition goals for Thomas. When would the IEP team have started to consider and include these?

* What is a manifestation determination meeting? Why does it occur? What are the possible ramifications of the meeting?

* What domain of development was likely a factor in Thomas’ differing experience in 7^th and 8^th grade? In other words, what was going on for Thomas that perhaps led to a change in the effectiveness of his medication?

* What happens when Thomas turns 18? For which services will he still be eligible? What kind of public assistance can he receive? How will he support himself? Be sure to look into SSI and disability – is he eligible when he turns 18? Is he eligible now, at 16?   

Week Ten

Week Ten is courtesy of the Wendy Marianna group!

When Thomas was around 9 years old, he began recognizing his strength and acting out in increasingly violent ways. Ian and Molly decided to take him to see a child psychiatrist in the area.  The goals listed in Thomas’s IEP were harder to achieve than originally expected; by bringing him to a psychiatrist Molly and Ian hoped to gain another professional opinion of what to do. The child psychiatrist recommended various behavioral intervention strategies and put Thomas on Olanzapine, an antipsychotic medication used to treat children with Autism.  

Thomas is now 12 years old. Over the past three years, Molly and Ian have watched Thomas grow in many areas, especially the more challenging areas such as expressive language and stress management. One of Thomas’s original goals was to use verbal communication to express his desires. At age 12 he has begun regularly using phrases such as, “Thomas needs the bathroom,” or, “Thomas wants noodles (or other food he is requesting).”

Ian and Molly began working longer hours during the week to earn some extra income. Although they were originally apprehensive about what to do with Thomas, a parent in their support group set them up with the Matthew’s Center. Thomas was able to receive after school care until 6 pm. Another area that Thomas has grown in is with his social world.  Thomas has made two friends at the Matthew’s Center, Primrose and Katniss, two girls with Asperger Syndrome. The trio has helped each other use more verbal communication and imaginary play, but work still needs to be done.  Ian and Molly have recently attended Thomas’s IEP meeting to update his goals.  The most significant progress the team hopes to see in Thomas is in the social area because middle school focuses more on group projects, athletics, programs, and other opportunities for young children to work together. If Thomas is able to participate more easily in any of these realms he will have achieved the goal for this year and will be better prepared to enter high school in the future.

Week Nine

Thomas is now 7 years of age, and the last few years seem to have gone by quickly for Molly and Ian. Thomas has shown some improvement in his language skills, but he is still far from typical in terms of his development. At home, he uses the PECS system which seems to help to keep him from becoming frustrated in communicating his needs.

In spite of considering a visit to a child psychiatrist, Molly and Ian have not taken Thomas to see anyone of this sort. Thomas continues his occupational therapy with a community-based provider, something that is helpful given the kind of therapy he receives during the school day. Molly and Ian continue to be concerned about Thomas' behaviors in the home, and they are considering requesting assistance through a local community agency. They have both been participating in couples counseling for the last year, something that has helped them to deal with the stresses of raising a child like Thomas and to ensure that their relationship stays strong. The stress has been overwhelming at times, particularly as Thomas has gotten bigger and is harder to contain when he tantrums. Molly is worried about what will happen as Thomas grows - will she be able to handle his outbursts?

* How often is Thomas likely to receive OT services in a typical public school system in Virginia? What about speech/language services? 

* Write 3 goals that are likely in Thomas' IEP at age 7. Include 3-4 objectives for each of the goals.

* What kinds of community-based services exist for children like Thomas? What kind of insurance would Thomas need to have in order to receive such services?

Week Eight

Spring Break

Week Seven

Individual assignment