Sunday, July 02, 2006

Case Examples for Institute

Case Examples:

1a. Elena – 1st grade

Elena is a sweet, sunny six-year-old first-grade student who has recently moved back into your district and your school from rural southern Mexico. Elena was born here in the United States – as was her older sister Adrianna – and she is a U.S. citizen – but struggles with immigration authorities have split the family. Here in the U.S., Elena lives with her mother Carmen – who works for the school district as a paraprofessional at the high school. In Mexico, Elena lives with her father Nicolás and her grandparents. Carmen has mentioned how difficult it has been on the girls to divide their time between countries, but feels that it is very important for the girls to stay close to their father and grandparents while they wait for their papers to be processed. She has also told you that in Mexico the girls attend a local school – but your district has never been able to get either records or a clear picture of the scope or sequence of curriculum there.
The teachers and students at your school know Elena well, since she was a student here for several months last year, during the fall. By all accounts, Elena was a delight for her kindergarten teacher, who described her as “always willing to help other students,” “a very thoughtful little girl,” and “she has very good English, even though I think she uses Spanish with her mother and sister at home.”
School begins, and through September and October, Elena’s first-grade teacher Kate reports that things are “going well,” and that “Elena knows all the letters of the alphabet,” and “can say most of the sounds each letter makes.” By November, however, Kate reports that Elena is falling a bit behind her peers in learning how to blend sounds together, and that “she seems to be struggling to sound out consonant/vowel combinations that most of her peers can say with ease.” After talking more with Kate about the specific struggles Elena is having, it becomes apparent that, although Elena does have some phonemic awareness skills, she doesn’t seem to have mastered the full range of English-language sounds each letter can make. Further, while Elena’s sight-word vocabulary is as good as (or better than) many of her peers (for example, she readily identifies words like “cat,” “dog,” and “mom”), she doesn’t seem to have a way to approach new words like “toe” or “slow.”
Kate mentions that some of Elena’s struggles match what she’s read about dyslexia, and is wondering aloud if she should make a referral for evaluation by the school psychologist.

1b. Ashley – 4th grade

Ashley, who is 9 years old and about to begin the fourth grade, was referred for a full evaluation by the school psychologist at the end of last year, after her third grade teacher watched her struggling and falling behind her peers.
During the initial data collection process, Ashley’s first and second grade teachers and classroom assistants reported that her phonemic awareness and decoding skills, while a bit delayed compared to her peers, have improved dramatically. She can now quickly and accurately decode unfamiliar, multisyllabic words in English, and her fluency in reading age-appropriate passages out loud to her teachers is excellent. However, Ashley’s comprehension of what she reads is very weak. While she can sometimes tell (or find in the text) the specific, factual details of a passage she has read aloud, she struggles with questions relating to inference, causality, or sequence.
Ashley’s third grade teacher, Dawn Parham, reports some concern that Ashley’s struggles with reading comprehension are “interfering with her learning in other areas, like math.” Dawn has seen Ashley struggling to isolate important details or sequences in story problems – and sometimes struggling to figure out what’s being asked in the first place.
“Her strategies for figuring out what’s happening in story problems are very weak,” classroom assistant Julie Greenwood notes; “…if there was one thing I’d recommend for her fourth grade teacher, it would be to work on that. She needs to develop ways to begin problems or passages she finds difficult, and persevere until something makes sense.”
Perhaps worse, Ashley seems to be noticing that she’s falling farther and farther behind her peers. Dawn and Julie heard Ashley referring to herself as ‘dumb’ or ‘stupid’ on a number of occasions, and were disappointed to see her behavior changing towards the end of the year. They note that while Ashley had usually been friendly with peers and considerate with teachers, she gradually stopped volunteering in class, and began to get into arguments with her friends more quickly than before. One argument, which seemed to be over something another student had said to Ashley during recess, was loud and disruptive enough that Ashley was sent to the principal, and her mother Sarah was called in for a conference.
At that conference, Sarah reported that Ashley “doesn’t seem to be as excited about school as before,” and added that “she sometimes doesn’t bring her book bag home.” Sarah worried aloud to the principal that Ashley’s older sister was also getting failing grades at the high school, and that she doesn’t want the same thing to happen to Ashley. She asked the school to provide whatever help they could, so that Ashley didn’t fall through the cracks…

2. Olivia – kindergarten

Olivia is a shy, five year old soon-to-be-kindergarten student with spina bifida and hydrocephaly with a surgically placed shunt who has some paralysis on her left side. She uses a push wheelchair for mobility, uses some spoken English to communicate, and needs some physical assistance getting into and out of her chair, and with toileting and dressing. She has not attended formal pre-school prior to kindergarten, but has met some other students occasionally when her mother, Lydia – who is single and who has no other children or nearby family members – was able to get respite care. Lydia reports that she has applied through a number of agencies for help getting Olivia an electric wheelchair, but has to this point been unsuccessful.
Olivia’s physician has indicated some concern – privately – to school officials over her language development, since she has not had much opportunity to play with other children over the years. He further indicates that Olivia is starting to demonstrate some amount of nystagmus – uncontrolled shaking of the eye – that may be impacting her vision.
When asked, discreetly, about Olivia’s alphabet recognition or experience with books, Lydia reports that she has been “just too overwhelmed with the basics” to do much bedtime reading with her, though she adds that “I talk to her all the time, tell her stories… tell her what I’m doing. All the time. And I let her watch Sesame Street, which she loves… she’s always laughing and giggling along to that.”
After Olivia registers for school in August, a rather rushed evaluation from the school psychologist indicates that Olivia, though initially withdrawn and reluctant to participate, quickly established good rapport with the tester, and seemed to make genuine efforts at success. However, she showed a good deal of trouble following directions during the testing, and her vocabulary seemed limited to a very few descriptors beyond ‘yes,’ ‘no,’ and ‘that.’ Olivia smiled and occasionally giggled at the feedback and praise she received during the testing session, but the psychologist reported that “…ultimately I don’t feel that this testing was indicative of Olivia’s true capabilities, given the struggles we both faced with communication.” He recommends a re-evaluation in six months, after Olivia has been engaged at school in a ‘typical’ kindergarten class.
There are four kindergarten classes at Olivia’s school in which she might be included, and as you make a list of her needs, you start to wonder which of them might serve her best, and how you might support her in the classroom. Perhaps the largest issue is the teachers; none of them has had a student with spina bifida or any significant mobility impairment before. One teacher mentions that she’s had a student on crutches once, and that the other students “were darlings, all wanting to help out.” Though they all seem willing to have Olivia in class, they agree that they’d like “as much training as the district can give, and support in the classroom for her special needs.” They all seem worried about how to go about including a student who is significantly different from the other students in the class.

3. Marcus – 7th grade

Marcus is an enthusiastic, gifted 7th grader who attends a neighborhood middle school that offers “academic enrichment” programming after school, but which does not have any formalized gifted programming. Marcus is extremely energetic, and loves the newly formalized sports opportunities his middle school offers. He’s been a member of the football team, the baseball team, the cross-country team, and most recently, the basketball team. His coaches have described Marcus as a “non-stop kid,” and at the same time, “sort of annoying.” He was kicked off the basketball team two weeks into the season, for what his coach Bill Jackson described as “ignoring my whole program. He wouldn’t practice like the other kids, he wouldn’t drill… he’d always want to run around and play pick-up games… he just wasn’t a team player. Just shoot, run, shoot – me-first kind of basketball…”
Perhaps worse than getting kicked off the basketball team, Marcus has also been struggling with his schoolwork for the past two years, as the expectations for homework and classwork have increased. His frequent small mistakes on homework, and his inattention to details such as due dates and headings on papers have earned him increasingly lower grades through the course of the school year. Often he hasn’t been turning in his homework at all, and the work he does turn in is often so messy and incomplete that his teachers want him to re-do it.
“Marcus is a mess,” reports his math teacher Tammy Pelli. “I think he means well, and he’s smart! But he’s just so disorganized. Have you seen his backpack? It’s a total black hole. He even stayed after school for an hour last week with me, punching holes in all his papers, and putting together a math binder. But this week? He left his binder on a shelf at the back of my room – and it’s got papers from Language Arts, history, life science, and even P.E. hanging out of it. And he turned in exactly one of this week’s four assignments!”
Marcus’s history teacher chimes in: “Marcus needs to shape up, or he’s in for trouble. He’s not in elementary school anymore, and I know that high school teachers won’t put up with any of the things he does in class. It’s like he’s nine years old sometimes! He bothers the other students, always tapping his pens on his desk or talking out in class; he butts in on discussions we’re having without raising his hand… I mean, sometimes he has some really insightful things to say, but he drives me crazy! It’s like he’s got to be either talking, or moving, or both! I don’t know, maybe he’s got some sort of internal motor set at about a hundred miles an hour or something...”
Marcus’s mother and father have both been in to see his teachers and the principal of the school on several occasions. His mother, looking a bit frazzled, confirms that Marcus is non-stop at home, and has been that way since early childhood. She indicates that Marcus was identified and served successfully by the gifted program at his elementary school since the first grade, where he was already reading at a third grade level. She says “…he picks things up real quick. He’s always been that way.” She adds that the school, and the family doctor, made a diagnosis of ADHD last year, when he started failing classes – and that Marcus had tried a course of Adderall for a few months – but that it made him “sick to his stomach, and he didn’t feel like himself, so we stopped.” Marcus’s father adds that “I don’t really like the idea of medicating my boy anyway. He needs to learn how to behave in school, in normal situations… and he’ll never learn that if we just give him drugs. Is he supposed to take those for the rest of his life? He just needs to grow up.”

4. Ben – 11th grade

Ben is a tall, extremely bright 11th grade student who was diagnosed with severe emotional disturbance back in middle school. Ben was referred for evaluation by his mother after a series of incidents at home and at school that culminated in his running away for three days. Though there is sparse information from Ben’s mother about the referral, his teachers reported at the time that he could be “up and down, sometimes in the same class,” but that he was “a good kid: he has friends, and is well-liked.” They also report that Ben is “incredibly creative – he draws all the time, all over his notes and often up and down his arms.”
Back in middle school, which was organized in a collection of small ‘houses,” Ben’s IEP team decided that he really just needed accommodations in his classes for some of the behaviors that were getting him in trouble, so they allowed him to take ‘time-outs’ when he needed them, and they set up a check-in system, in which he had to see his house leader every morning when he got to school, and every afternoon when he left. There is also a note in Ben’s IEP folder indicating that some flexibility was granted in Ben’s grades after he missed an excessive number of days in class during the winter of 8th grade. Ben’s eighth grade exam scores were at or near the top of his class, across the board.
After the move to high school, Ben’s 9th and 10th grade teachers report that he “typically has weeks and months where he’s a model student,” but then also report “…periods where he either stops coming to class, or where he’s so withdrawn he might as well not be here.” Ben earned credits for only about half his classes during his freshman and sophomore years, but managed to score in the top decile on the state mathematics exam in 9th grade, and won a creative writing award from his 10th grade English teacher.
All of Ben’s current 11th grade teachers report awareness of his diagnosis of “emotional disturbance,” but also say that they’re not really sure how it impacts what they’re supposed to do with him in class. One teacher reports that when Ben “seems depressed or agitated in class,” she gives him extra days to turn in his homework. Most report that they’ve had to send him out of the room for inappropriate or aggressive behavior towards peers, and that he seems isolated from most of the other students.
Ben’s homeroom teacher, Brian, sees Ben from 7:55-8:00 each morning before first period. Brian reports that some days this year, Ben has shown up at school and “seemed extremely depressed, maybe like he was on drugs or something.” and on other days has acted “hyper and challenging to his peers and to me.”
During the last few weeks, Ben has also missed a great deal of school, and is starting to fail his classes again. His teachers have, over the past month, referred him to the principal for skipping class, for ‘talking back,’ for “nonparticipation,’ for ‘rude and sarcastic comments,’ and finally for smashing the glass in a doorway between halls. This last incident got Ben fourteen stitches in his left hand, and got him a three day out-of-school suspension. His teachers are starting to mention to the special education department, and to the principal, that they’re uncomfortable having him in class.
“He’s so unpredictable,” says his science teacher. “At this point, for me, it’s a safety issue. I just don’t know if I can trust him in chemistry lab when he doesn’t listen to me… he acts like he’s in his own little world sometimes. He does all these little annoying things to his classmates, and when they tell him to quit it, he either sulks or blows up on them. I wonder if maybe he ought to be in another class, with a bit more supervision.”

5. Brian – 9th grade

Brian is an bright young man who is about to enter the 9th grade. He has been in and out of the public schools in town over the years, and has for the past year and a half been homeschooled by his mother Pamela; the district has been providing an at-home tutor twice weekly to provide some academic support. Brian was diagnosed with Asperger’s Disorder two years ago – after a relatively disastrous 7th grade, during which his mother pulled him out of middle school, while threatening to sue the district for failing to diagnose the Asperger’s, and for not providing appropriate accommodations. Brian has a clear love for all things computer-related – particularly Apple-related – and interestingly, runs his own software beta-testing company out of his bedroom, from which he earns enough to keep buying the latest hardware on the market.
Brian’s struggles with social interactions seem to be at the root of why he’s been in and out of the public schools over the years. Pamela cheerfully describes Brian as ‘a little weird,’ and perhaps the same could fairly be said of Pamela herself. They both appear a bit physically disheveled, and do not make eye contact when they speak to people; Brian often misses the main point of conversations, and does not read body or facial language well. Brian rarely acknowledges other people around him, and tends to speak in monologues; he often appears impatient when other people speak. This has gotten him in trouble at school, when he has ignored teachers in class, or has openly described their lessons as ‘stupid’ or ‘irrelevant.’
Pamela is wary of the school district’s intentions with respect to Brian’s education, and feels as if the district has done everything in its power over the years to either ignore her or to provide a bare minimum of services. Pam does say that she was quite happy with the past year, when she homeschooled Brian’s English, P.E., and social studies classes under contract to the district (Pamela is herself a certified music teacher), and Brian was bused to school for three half-days per week for computer, advanced math, and orchestra classes. A district tutor visited Pamela and Brian twice weekly last year. The original intent was to help support Brian’s reading and writing skill development – but the tutor has reported that mostly Pamela had him editing and correction Brian’s homework.
Pamela is concerned that Brian will be ‘lost’ in high school, and wants to continue the current setup of a majority-homeschool schedule at least through freshman year. It is tough to know what Brian wants, as Pamela has so far not allowed him to attend IEP meetings. There is some concern among teachers at school that Brian’s mother, while well-intentioned, has not been a very rigorous English teacher at home, and that his disrupted schooling and weak reading and writing skills are putting him at high risk of school failure across subject areas.
Complicating things is that Brian has recently undergone part of his three-year re-evaluation with the district psychologist; testing indicates that, while Brian’s IQ appears to be above-average, Brian’s achievement scores in written expression, spelling, and reading comprehension are lower than would be expected. The psychologist adds that Brian did not seem terribly motivated to complete the achievement testing, and hurried through the reading and writing tasks without checking his work at all.
The high school would like to honor the family’s wishes in designing an appropriate educational environment for the upcoming year, but isn’t sure exactly what the ‘best’ or most appropriate environment for Brian might be…

6. Morgan – 5th grade

Morgan is a short, active fifth grade student who was diagnosed with mild mental retardation in the second grade, after an initial early diagnosis of developmental delay. While she has not shown many of the physical manifestations of mental retardation – for example, she is well-coordinated, and rode her bike without training wheels at an early age – she demonstrates significant verbal communication delays, and has had an inordinate amount of difficulty learning and understanding social rules and problem-solving skills.
Morgan has been included in regular classes at school full-time since she was five, and as a result is well-known (if not particularly well-liked) by her peers. Her relationships with her classmates have changed over time. Early on, Morgan was somewhat protected and accepted by her peers, who acknowledged her differences; over the last two years, however, she has faced increasing differentiation and isolation. Some of her peers have expressed frustration at the difficulty Morgan has had in understanding new materials or following complex directions; a few have even suggested that she ‘really doesn’t belong’ in class anymore. While it’s not completely clear why this has happened, Morgan’s fourth and fifth grade teachers both mentioned that they ‘didn’t feel well-equipped’ to teach Morgan, and both largely deferred to the judgment of the classroom aides the school has assigned to Morgan when making instructional decisions.
Morgan’s mother Theresa expresses concern that ‘…she just doesn’t seem happy with school anymore.’ She adds that Morgan has recently been gaining weight, has stopped riding her bike in the driveway, and doesn’t come home and run around outside like she used to – but instead often takes a nap after school or watches television for hours. Theresa adds that she’s a bit sad that Morgan seems to have very few friends from school, and that she only sees her play with other children at church on Sundays, where she often plays with much younger children.
Morgan’s academics are a source of concern. While Morgan did reasonably well in the early grades, where a large amount of time was spent on art projects, physical activity, and other creative endeavors, her ability to ‘keep up’ has markedly dropped off. For example, Morgan learned to decode words quite well during the second and third grades – but last year and this year’s focus on comprehension have not gone so well. Morgan has also struggled with a new classroom emphasis on written production, where she is far behind her peers, and a recently increased expectation of uninterrupted seatwork. She seems less willing to try new challenges, complains more often than she used to, and seems fidgety or openly noncompliant when her teachers attempt to sit with her one-on-one.
At Morgan’s annual IEP meeting in November of her fifth grade year, Theresa and Morgan’s teachers agree that there are two overarching concerns for Morgan at school. First, she is struggling to make and keep friends. Second, she is struggling to make progress in reading and writing, which is holding her back in most other academic areas as well. The team further identifies inclusion in a regular class as a priority for the family – although Morgan’s primary teacher is a bit less than convinced that a full inclusion approach is Morgan’s best option. They all want to come up with strategies for supporting Morgan’s social and academic learning over this year, and then into middle school in the year beyond.