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PLUK News December 1998/January 1999 Volume 13 Number 5/6
	PLUK News is published by Parents, Let's Unite for Kids, a private nonprofit organization founded in 1984 by a group of parents of children with disabilities and chronic health problems. Subscriptions are free, however, we ask that subscribers contribute $15/year toward PLUK activities. PLUK News is available in alternative formats. Editor: Katharin A. Kelker Production: Roger Holt PLUK Office 516 N 32nd St Billings MT 59101-6003 800.222.7585 in MT; 406.255.0540 (voice/TT); 406.255.0523 (fax) E-mail: plukinfo@pluk.org
The contents of this newsletter were developed under a grant from the Department of Education. However, those contents do not necessarily represent the policy of the Department of Education and you should not assume endorsement by the Federal Government. Products and services described herein are not endorsed by PLUK, the U.S. Department of Education, or by the Federal Government.

Article Index

Racicot Asks for More Education Money Montana Parents Advocate Lawmakers May End Managed Care Warm Springs is Down-Sizing How to Give Testimony Federal Monitors to Visit in March 943 Children Insured by CHIP PLUK Produces New Video on the IEP! DD Programs Propose Expansion Voc Rehab Has Legislative Agenda New Funding for SPED But Still Problems SSI Cost of Living Adjustments New Federal Funding for IDEA Title XX Funds Cut Work Incentives Endorsed Federal Initiative to Hire More Teachers Supreme Court to Hear ADA Case School District Libel for Death What Are DD Services? Love Yourself: Tips for Stress Management

Five Ways to Say: I Love You! Ten Caring Ways to Connect with Children Full Esteem Ahead March is Disabilities Awareness Month ASK PLUK??? Parent Corner Parent Training Grants New Treatment for Tourette Syndrome DSM-IV ADHD in Preschoolers Medication Makes Difference in ADHD Ritalin has Low Addictive Potential NIH Symposium on ADHD New Tests to Identify LD Cyber-Kid Safety Content Area Reading Alternative Schools--A Good Choice? New Drug for JRA Classes on Increasing Learning Skills Prevalence of Fragile X Syndrome HONOR ROLL

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Racicot Asks for More Education Money

Governor Racicot's budget request to the 1999 Legislature includes an increase for K-12 BASE aid of $30.7 million, increasing the basic and per student entitlements by 3.5% per year for elementary districts and 1.5% per year for high schools, and increasing special education by 1.5% per year. The Governor's request also includes an increase of $1 million over the biennium for Improving Montana Schools, a continuation of the standards review project and the Montana Education Profile. The Governor's budget recommendation can be downloaded/viewed on the web at http://www.mt.gov/budget/2000_01_budget/index.htm.

Senate Majority Leader John Harp (R-Kalispell) introduced the governor's school funding plan in the 1999 Legislature, saying the bill would do something that is long overdue and get schools back on track with state funding and help ease the burden on local property taxpayers to fund schools. Governor Racicot told the Senate Education Committee that by almost every measure, our schools are succeeding in Montana. However, he said, many schools do not have any room left to cut their budgets and it is time for a major infusion of state funding to prevent harming the quality of the state's public education.

Educators and parents agreed with the Governor that more money is needed but argued for an even greater increase--preferably the $6 million more contained in House Bill 133, sponsored by Rep. Rosalie Buzzas (D-Missoula).

Both sides of the school funding debate agree that the legislature will no doubt select a funding increase somewhere between the two proposals.

The 1990s have been a decade of budget cuts for Montana schools. In Mineral County, for example, school children have left since a local lumber mill closed down and families moved out. To make up for the loss of school funding, the school libraries are open every other day, the home economics program has been eliminated, there are no paid playground attendants, and all employees are working under a pay freeze.

The school-funding debate surfaced other issues pertinent to the 1999 Legislature. Both Senator Harp and Eric Feaver of the Montana Education Association agreed that problems in paying for public education illustrate the need for a statewide sales tax. Harp and others noted the state now supplied roughly 63 percent of the overall public school funding. That is a 10 percent drop from a decade ago and much of the burden has shifted to local property taxpayers.

Montana Parents Advocate for Increases in State Funding of Special Education

On January 14, 1999, several parents of children in special education joined with educators and school administrators in asking the Education Subcommittee on Appropriations to recommend an increase in state funding for special education. Those testifying pointed out that the state per pupil expenditure for special education students has not increased since 1989. At one time, the state funded 90% of allowable costs in special education; now the state's portion is more like 65% of costs, leaving local taxpayers with the responsibility of picking up 25% or more that is not covered by state and federal contributions.

Governor Racicot's budget recommends increases in SPED funding for each year of the biennium, but State Superintendent of Public Education, Nancy Keenan, testified that more was needed, a total of $5.1 million or a 9% increase to meet the state's commitments to mandated special education services.

The Subcommittee voted to recommend the Governor's proposed increases plus an additional $3 million from the Tobacco Settlement dollars. If this proposal is successful in the Legislature, it will represent a significant infusion of state dollars into special education.

Lawmakers May End Managed Care

Steps are being taken in the 1999 Legislature which may bring an end to the state's five-year managed-care contract with Magellan Health Services for publicly funded treatment of the mentally ill. The Racicot Administration has been reluctant to drop the program, fearing that services without the contract would be even more chaotic and that the state might be sued by Magellan.

Despite the Administration's reluctance, the Joint Appropriations Subcommittee on Human Services voted 4-2 to request that the Legislature's lead attorney advise them on how to cancel the $400-million contract that provides mental health care for all Montanans on Medicaid and for about 5,000 other low-income people who have serious mental illnesses.

Sen. Mignon Waterman (D-Helena) made the motion to begin the process of disengaging from the program. She commented that the 20,000 poor, elderly and disabled people served by the contract are already losing services because Magellan refuses to pay claims.

The Western Montana Mental Health Center in Missoula, for example, has announced it must close for two weeks and lay off 400 of its 426 employees because Magellan owes the company $1.7 million in unpaid claims. The center borrowed $100,000 from its own insurance fund to meet its December payroll.

Warm Springs Is Down-Sizing

Montana State Hospital for the mentally ill at Warm Springs has begun downsizing its workforce. As of January 1, 1999, one work unit was closed, creating 23 lay offs.

These changes are the result of the patient census declining from 190 to 165. The census reflects patients being hospitalized for shorter periods, transferring to the Mental Health Nursing Care Center in Lewistown, and new community-base placement programs opening in Helena.

Plans call for further reductions in the hospital census, with an average daily population of 135 to be achieved by August 1999.

The census reductions have a domino effect that reduces revenue the hospital receives from the mental health managed care program and ultimately affects staffing. Legislative appropriations provide direct funding for about 25 percent of the hospital's operating budget. The remainder comes from the managed care program, based on the number of eligible people hospitalized. Under this plan, funding follows the patients from the hospital to the community. When the hospital census declines, so does hospital funding.

How to Give Testimony

If you are planning to testify in person at the Legislature this year, here are some suggestions for making your testimony more effective:

• When it is your turn to speak, go to the podium and speak into the microphone. Speak slowly and clearly. Don't be afraid. Remember, the people on the committee want to hear what you have to say so they can help you and others.
• Begin your talk by saying, "Madame Chair or Mister Chairman and members of the committee, my name is __________ and I live in _________.
• Tell the committee about your family member with a disability. Briefly give them your family member's history, then tell them about his/her needs. Remember, the committee members want to know about these needs so they can help. Don't be concerned if you become emotional. Everybody at this meeting realizes that it is not easy to talk about things that are personal and challenging.
• It may help to write your testimony out on a piece of paper. When you are finished speaking, give your paper to the committee secretary. It will then become part of the hearing's written record.
• Ask the committee to support some specific measure like service expansion, provider increase.
• Be sure to thank committee members for their past support and the future help they will give.

Committee Mailing Address: Capitol Station, Helena MT 59620

Message Center: 406-444-4800

TDD: 1-800-832-0283

Fax: 1-900-225-1600 ($.45/minute)

E-mail House Members: house@state.mt.us

E-mail Senate Members: senate@state.mt.us.

Federal Monitors to Visit Montana in March

During March, monitors from the U.S. Department of Education will be visiting Montana school districts to determine if the state is in compliance with the Individuals with Disabilities Education Act (IDEA). Every three years, a team from the Office of Special Education Programs (OSEP), conducts an on-site program approval review (PAR). The purpose of the review is to see if Montana is ensuring that all eligible students with disabilities have access to a free, appropriate public education (FAPE). During their visit, the federal monitors will visit public and private educational programs, review records and IEP's, and talk to educators, administrators, students, and parents. They will be particularly concerned about (a) whether a Child Find process is in place, (b) whether parents are involved in the special education process and whether they have been informed of their due process rights, (c) whether IEP's have been properly written and implemented, and (d) whether students with disabilities are receiving their education in the least restrictive environment.

Montana's Office of Public Instruction (OPI) is responsible for having on file with the federal government a State Plan which describes how Montana intends to implement IDEA. The State Plan is developed from the plans submitted to OPI from local schools districts and special education cooperatives. OPI is responsible for monitoring local school districts (called local education agencies or LEA's), and the federal government is, in turn, responsible for monitoring the Office of Public Instruction (called the state education agency or SEA).

When the federal monitors complete their on-site visit, they develop a written report of their findings which includes (a) areas of commendation recognizing aspects of the special education program in which the state is providing exemplary services, and (b) areas needing correction where the state is out of compliance with some aspect of special education law. OPI is then given an opportunity to respond to the report and develop a corrective action plan for the areas of deficit. OPI can negotiate with the Office of Special Education Programs until a final corrective action plan is agreed upon. This final plan for corrective action is a public document and parents can request copies.

Once an action plan is developed and agreed upon, OPI is responsible for making the required changes by taking corrective action to bring the state into full compliance with IDEA. OPI must make the corrections agreed upon or risk losing federal funding.

Parents Can Be Part of the Process

Parents of students receiving special education are intended to be a part of the monitoring process. The federal monitors are particularly interested in hearing from parents about how LEA's are implementing the procedures required in the special education process, but they will not be able to deal with individual cases. If you provide testimony to the monitors, your comments should relate directly to the law and how it is being implemented. Written or oral testimony should comment on how well your school district is doing any or all of the following things:

• Providing a free, appropriate public education (FAPE) for eligible students
• Informing parents of their due process rights
• Finding children and youth who are eligible for special education services
• Acting upon special education referrals in a timely fashion
• Conducting evaluations in a timely manner
• Completing multi-disciplinary evaluations
• Providing parents with written notice of proposed changes in identification, evaluation, placement or provision of free, appropriate public education (FAPE)
• Holding IEP meetings at a mutually agreed upon time and place
• Ensuring that evaluations, including vocational evaluations, were conducted by qualified personnel
• Informing parents of their right to an independent evaluation.

OSEP Hearings--Dates, Times and Locations

Monday, March 8

MetNet--Missoula/Kalispell - Part C - 6:00-7:30 pm

Missoula - Part B - 7:45-9:30 pm

U of M , Gallagher Building

Corner of Arthur & Eddy, Rm 104

Child Care: CDC Respite House (728-2746)

 

Kalispell - Part B - 7:45-9:30 pm

Flathead Valley Community College

777Grandview Dr

Learning Resource Center, Rm 120

Child Care: CDC (755-2425)

 

Hardin - 7:00-9:00 pm

Big Horn County Public Library

419 N Custer

Part B--Library, Board Room

Part C--Library, Third Floor

Child Care: STEP (665-2436)

Tuesday, March 9

Helena - 6:30-8:30 pm

Colonial Inn

2301 Colonial Drive

Part C--Meadowlark Room

Part B--Montana Room

Child Care: Governor's Room (443-7370)

 

Billings - 6:00-8:00 pm

Sheraton

27 N 27th St

Part B--Wood Room

Part C--Granite

Child Care: Hague &Ikerman Rooms (247-3817)

Wednesday, March 10

MetNet--Great Falls/Havre - Part C - 6:00-7:30 pm

Great Falls - Part B - 7:45-9:30 pm

College of Technology

2100 16th Ave S, Rm 147

Child Care: Quality Life Concepts (452-9531)

 

Havre: Part B - 7:45-9:30 pm

MSU-Northern

300 11th St West

Hegener Science Center, Rm 202

Child Care: Quality Life Concepts (452-9531)

MetNet: Miles City/Glasgow - Part C - 5:30-6:30 pm

Miles City: Part B - 6:45-8:00 pm

Miles Community College

2715 Dickenson St, Rm 106

Child Care: DEAP at MCC, Rm 107 (232-6034)

 

Glasgow: Part B - 6:45-8:00 pm

Francis Mahon Deaconess Hospital, 621 3rd St S

Child Care: Hi-Line Home Programs (228-9431)

Accommodations

Any individual who will need accommodations for a disability (interpreting services, assistive listening, etc.) in order to participate in a meeting should call one of the following individuals:

For Special Education (Part B), call Carrie Shinkle at 406/444-5661.

For Early Intervention (Part C), call Jan Spiegle Stinger at 406/444-4181.

943 Children Insured by CHIP

There are 943 more insured children in Montana after a pilot program for the uninsured reached its capacity in late January.

The program received more than 1,500 applications from parents wanting to enroll their children. Children's Health Insurance Program (CHIP) is targeted at poor working Montana families who cannot afford health insurance, but make too much money to qualify for Medicaid. For example, a family of four with income of $2,056 or less per month is eligible.

The 943 children, picked on a first-come basis, will receive health insurance for one year at a cost of $210,000.

In Montana, the CHIP Pilot Program will pay monthly health insurance premiums for 943 children age 18 or younger who live in low-income families. Some parents will share the cost of their children's health care through an annual enrollment fee and a co-payment for services used.

CHIP benefits include physician and mid-level practitioner services; inpatient and outpatient hospital services; routine sports and employment physicals; surgical and anesthesia services; prescription drugs; inpatient, outpatient, and residential mental health and substance treatment services; and vision and hearing exams.

The Governor's Office and DPHHS are asking the 1999 Legislature to expand CHIP to provide health insurance for 10,184 Montana children. CHIP, created by federal legislation in 1997, calls for an 80-20 percent match of federal to state funding. The $2.9 million of state general fund money being sought would bring a federal match of $11.7 million.

Census information indicates that about 14,500 Montana children would qualify for CHIP. Uninsured children have a significantly increased risk for preventable health problems and many turn to expensive emergency room care when they are ill.

For more information about CHIP, contact Mary Noel, CHIP Program Officer at 406-444-6971.

PLUK Produces New Video on the IEP!

Thanks to the Developmental Disabilities Planning and Advisory Council (DDPAC) PLUK has produced a new 17 minute video "Goals for Success: Writing IEPs That Work!". The video is available through the TRIC/PLUK Library, or may be purchased for $15.

DD Programs Propose Expansion

The Developmental Disabilities Program is proposing an $18 million expansion of services to be funded through the Federal Home and Community Based Services Waiver. This means that if this proposal is successful, it will not cost the State any new money. There is a downside, however. Many of the nonprofit providers of service indicate that they cannot consider expanding services unless they also receive an increase in provider rates. According to Wally Melcher, lobbyist for the DD system, the problem is a little bit like building a new story on a building that has a crumbling foundation. Expansion, in and of itself, does not improve a service provider's financial health if that provider's current services are already underfunded. The Governor's budget contains a 1% increase in provider rates for each year of the biennium. Providers have explained that at least a 2% increase is needed.

A public hearing on Developmental Disabilities Program funding was held Friday, February 12 in the DPHHS Auditorium in Helena. Those who wish to provide written testimony should contact the Human Services Appropriations Subcommittee. Members of the committee include:

• Rep. Betty Lou Kasten (R-Brockway), Chair
• Sen. Chuck Swysgood (R-Dillon), Vice Chair
• Sen. Bob Keenan (R-Bigfork)
• Rep. John Cobb (R-Augusta)
• Rep. Beverly Barnhart (D-Bozeman)
• Sen. Mignon Waterman (D-Helena).

Voc Rehab Has Legislative Agenda

The Vocational Rehabilitation Program has a short list of budget requests that will affect VR services. These include:

• A 1% provider rate increase. This rate increase will help rehabilitation programs keep up with cost of living adjustments. The total cost of this request is $1,657,925.
• Increased funding for tuition costs. The Montana university system will be raising its tuition by approximately 4% each year of the upcoming biennium. VR is requesting funds to keep pace with the cost of tuition so that VR can maintain students in university and vo-tech settings. The biennial total cost for this request is $398,267.
• VR case load increase. VR is requesting increases in its caseload benefits budget to provide for two new positions within VR, one in Helena and one in Billings. This increase in personnel is intended to address additional referral demands. The request also covers an increase in caseload budget to address increased referrals. The total request is $484,725.

Public testimony for the Vocational Rehabilitation Program was held Thursday, February 11. Written comments should be sent to the Human Services Appropriations Subcommittee at Capitol Station, Helena MT 59620.

New Funding for SPED But Still Problems

While special education programs received an unexpected $500 million increase in federal funding, the Individuals with Disabilities Education Act (IDEA) barely escaped many attempts to amend discipline provisions in the law that would make it easier for schools to expel students with disabilities. The huge federal budget bill also includes a requirement that the U.S. Department of Education publish IDEA regulations by December 1, 1998. That deadline has come and gone, and still there are no published regulations. Another provision of the budget bill requires the General Accounting Office to conduct a study of IDEA's impact on the ability of local schools to maintain safe environments that promote learning. The report from GAO is due to Congress by March 1, 1999, and may or may not recommend changes in IDEA.

SSI Cost of Living Adjustments

A cost of living adjustment (COLA) was provided for recipients of Social Security SSI program effective January 1, 1999. The increase is $6.00 per month for an individual and $10.00 for a couple.

Montana DPHHS is passing this increase on to individuals who are recipients of state supplemental payments. The state supplemental payment rates remain the same but the base monthly SSI payment is increased in the following ways by the COLA:

Living Arrangement - Individual/Couple

Personal Care Facility - $594/$944

Group Home - $594/$944

Child and Adult Foster Care - $552/$861

Transitional Living - $526/$808

The Social Security Administration automatically made all increases for those recipients on the rolls in November and December 1998.

New Federal Funding for IDEA

The recent federal budget agreement signed in October 1998 appropriated more than $4.1 billion for IDEA in FY 99 (1999-2000), a $500 million increase over FY 98. This budget agreement received strong support from Republicans because of a provision which allows some reduction of local tax burden for special education.

Under the federal law, when appropriations for basic state special education grants exceed $4.1 billion nationally, local school districts may use up to 20 percent of the increase to reduce the local cost of IDEA. Advocates for special education point out, however, that reducing the costs school districts bear for providing special education and related services to students with disabilities may be a start in the right direction, but this measure is only a "token" gesture. Texas special education attorney, Jose Martin, provides this simple illustration:

If the total budget for providing special education services in a local district is $1,000 and local funds account for $200 of the total budget, then if the federal government provides an additional $100 in funding, the local district can reduce its total share by $20. Thus, the local district would provide $180 instead of $200.

Other forms of Financial Relief

Congress provided other forms of financial relief in the IDEA Amendments of 1997. The new law:

• Relaxes maintenance-of-effort requirements, thereby allowing school districts to reduce spending levels when high-cost special education students leave the school district, after onetime expenditures, and upon the departure of special education personnel.
• Permanently caps state administrative and other activities at the rate of inflation or an appropriations increase, whichever is smaller, so that more funds will flow to local school districts. In Montana, this provision makes no difference because the state has always passed through the bulk of federal funds.
• Eliminates required automatic, comprehensive triennial evaluations at estimated savings of $765 million nationwide each year at the local level.
• Requires each state to offer mediation as a way to resolve disputes between school districts and parents quickly, resulting in lower attorneys' fees costs. Again, this provision will have little impact in Montana because very few cases go to due process, and Montana has always had a mediation process.

Republicans have advocated full funding of the federal IDEA share (40% of the cost) and reduced financial requirements in order to negate the need for federal involvement in other education issues, such as school construction and teacher hiring--items which have been on the national agenda for Democrats.

Title XX Funds Cut

A major portion of the Developmental Disabilities budget in Montana is made up of federal Title XX Social Service Block Grant dollars. This money comes to the state from Congress to be used in a variety of social service programs at the state's discretion. Most states use this money to fund a wide variety of social service programs; however, in Montana the decision was made by the Legislative Fiscal Analyst to put all of this money in the Developmental Disabilities budget. This decision was made so that these dollars could be conveniently tracked in one budget rather than spread out throughout a variety of programs.

For a number of years having Title XX funding in the DD budget has been highly beneficial to DD programs and not a problem. This began to change a few years ago when Congress decided to make cuts in the Title XX grant, shifting this money into other federal programs.

Recently, the Disability Services Division of Montana state government received word that Congress had made another cut in Title XX when it passed its 1999 budget in mid-November. This cut immediately took approximately $1.1 million out of Montana's 1999 developmental disabilities budget for this fiscal year. To make matters worse, sources in Washington D.C. are telling Montana to expect cuts amounting to approximately 17% in each of the next two years. Specifically, this would amount to $2,093,081 in Fiscal Year 2000 and $3,026,043 in Fiscal Year 2001 for a total reduction of $5,119,124 for the biennium. Obviously, this would leave a huge hole in the Developmental Disabilities budget.

So far, a number of individuals and organizations have been encouraging Laurie Ekanger, the Director of the Department of Public Health and Human Services (DPHHS), to mitigate the impact of the Title XX reductions by spreading them out over the entire DPHHS department. Letters have also been sent to Governor Racicot asking that he insure that Developmental Disabilities not have to absorb these cuts alone.

The Developmental Disabilities Program (DDP) had hoped to do an $18 million service expansion to address services needed by over 400 individuals on waiting lists. It has been suggested by Laurie Ekanger and others that DDP could use the $18 million currently earmarked for expansion to offset the reductions in Title XX funding. The difficulty with this solution is that the 400 plus people on the waiting lists for services would receive nothing and DDP would end up being unduly impacted by a funding problem that should not be theirs alone. Another problem is that even if DD were forced to use the General Fund money that would have gone into the service expansion ($4,729,566 of General Fund dollars), it would still be $389,558 short of handling the entire Title XX cut.

What DDP and advocates for developmental disabilities services would like to see is (1) preservation of the DD Service Expansion initiative, and (2) the funding cuts addressed by some other means.

Work Incentives Endorsed

In January President Clinton and Vice President Gore unveiled a new initiative to improve economic opportunities for Americans with disabilities. The initiative that was introduced on January 13, 1999, will remove significant barriers to work for people with disabilities. This 3-part budget initiative, which invests over $2 billion over 5 years, includes:

• Full funding of the Work Incentive Improvement Act in the President's budget, which will be introduced as a bipartisan effort by Senators Jeffords, Kennedy, Roth, and Moynihan;
• Health care--particularly prescription drugs and personal assistance is essential for people with disabilities.
• Expand states' ability to provide a Medicaid buy-in to people with disabilities who return to work.
• Expand Medicare coverage, for the first time, for people with disabilities who return to work.
• Create a new Medicaid buy-in demonstration to help people with specific physical or mental impairments that are not yet severe enough to qualify for health care assistance, but can be reasonably expected to lead to a severe disability in the absence of medical treatment.
• Modernize the employment services system by creating a ticket that will enable SSI or SSDI beneficiaries to go to any of a number of public or private providers for vocational rehabilitation.
• Create a Work Incentive Grant Program to provide benefits planning and assistance, facilitate access to information about work incentives, and better integrate services to people with disabilities working or returning to work.
• Provide a $1,000 tax credit for work-related expenses for people with disabilities.
• Provide workers with significant disabilities with an annual $1,000 tax credit to help cover the formal and informal costs that are associated with employment, such as special transportation and technology.
• Improve access to assistive technology. This new initiative would accelerate the development and adoption of information and communications technologies that can improve the quality of life for people with disabilities and enhance their ability to participate in the workplace.

The initiative would also:

• Help make the Federal government a model user of assistive technology;
• Support new and expanded state loan programs to make assistive technology more affordable for Americans with disabilities; and
• Invest in research and development and technology transfer.

With these new proposals, the Administration will have taken action on every recommendation made in the report of the President's Task Force on the Employment of Adults with Disabilities, which the Vice President accepted in December 1998. Justin Dart, one of the foremost leaders of the disability advocacy movement, stated in response to the President's proposal: "The Clinton-Gore Administration has a long history of supporting the disability community. This policy initiative is one of the boldest since the landmark passage of the ADA."

Federal Initiative Allows States to Hire More Teachers

School districts will be able to hire more than 30,000 new teachers in the 1999-2000 school year under the omnibus spending bill President Clinton signed in October. The bill provides a $1.2 billion down payment on Clinton's goal of hiring 100,000 new teachers over the next seven years. The funds included in the fiscal year 1999 appropriations bill will help local school districts hire new teachers in an effort to reduce to 18 the number of pupils per teacher in grades 1-3.

While states will have control over their hiring decisions, Republicans are encouraging local districts to give a priority to special education teachers. Eighty percent of the funds will be distributed within the states on the basis of child poverty, while 20 percent will be based on school enrollment. Local districts can use the funds to hire teachers in grades 1-3 based on their needs, with up to 15 percent available for teacher testing and training. Districts that already have class sizes of 18 students or fewer in grades 1-3 can use the funds to further reduce those class sizes, shrink class sizes in other grades, or carry out activities to improve teacher quality. It is estimated that Montana school districts will be able to hire about 145 additional teachers.

Supreme Court to Hear ADA Case

The U.S. Supreme Court has agreed to decide whether some people with mental disabilities must be given a chance at group homes or other community-based programs rather than being placed in institutions.

Lower courts said Georgia had to provide that opportunity, a requirement 22 other states, including Montana, have contended would have "catastrophic effects" on their treasuries.

The justices voted to clarify the scope of the Americans with Disabilities Act, best known for requiring accessibility to public buildings. A decision is expected by July 1999.

Georgia officials say the federal law does not require community placement if appropriate treatment also can be provided in a state institution "rather than in an integrated community-based program."

In this particular Georgia case, two individuals formerly housed in a psychiatric hospital claimed that the Americans with Disabilities Act requires their care be provided "in the most integrated setting appropriate" to their needs.

Both were placed in community-based programs after filing their lawsuit, but lower courts kept the case alive and ruled that the state had discriminated against them.

The 11th U.S. Circuit Court of Appeals ruled in April 1998 that Georgia cannot escape its ADA responsibilities just because it may have to spend more money to do so.

Led by Florida, 22 states said in a friend-of-the-court brief that the appeals court's rationale, if used elsewhere, would make any state a target of such lawsuits. The other states signing that brief were Alabama, California, Colorado, Delaware, Hawaii, Louisiana, Maryland, Michigan, Mississippi, MONTANA, Nebraska, Nevada, New Hampshire, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah , West Virginia, and Wyoming.

The precise question before the U.S. Supreme Court is:

Whether the public services portion of the federal Americans with Disabilities Act compels the state to provide treatment and habilitation for mentally disabled persons in a community placement, when appropriate treatment and habilitation can also be provided to them in a State mental institution.

The case turns on the meaning of the "integration mandate" in Title II of the ADA. The mandate provides that:

A public entity shall administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities.

This past October, Montana's Attorney General Joe Mazurek joined 21 other state attorney generals in a friend-of-the court (amicus curiae) brief asking the U.S. Supreme Court to hear the appeal in the Georgia case. In that brief, the State of Montana, through its Attorney General, asked the U.S. Supreme Court to set aside the integration regulation and hold that the ADA does not impose a duty to provide treatment in the most integrated setting appropriate to the person's needs. The State of Montana asked the Court to make it the law of the land that the ADA does not require a State to provide community services to institutionalized individuals when a person's treating professional finds that community placement is appropriate for the individual.

Montana also asked the Court to declare the ADA unconstitutional and set it aside in its entirety, but the Supreme Court has said that it will not decide that issue at this time, in this case. Even though this issue will not be considered by the Supreme Court at this time, it is significant to note that Montana has gone on record as supporting the notion that the entire Americans with Disabilities Act is unconstitutional and therefore an invalid law.

Montana Has a Similar Case

Montana is currently engaged in a significant law suit that relates to this ADA Case. The Montana Advocacy Program on behalf of individuals who are institutionalized at the Montana Developmental Center and Eastmont is arguing in a law suit that individuals who are institutionalized, but who have been identified as appropriate for community-based services, have the right to a community placement. The suit points out that individuals living in the institution have been unfairly discriminated against since there are individuals with similar profiles and needs already living in the community successfully. The determination of who receives community-based services and who does not is based on an arbitrary rationing system because the state has not provided enough funding to offer community-based services to all who need them.

Montana advocates for deinstitutionalization were outraged that Montana signed on to the friends-of-the court brief in the Georgia case without consulting with disability groups in the state. People upset with this decision have been lobbying the Governor (444-3111; 444-5529-fax) and Attorney General Joe Mazurek (444-2026; 444-3549-fax), urging them to reconsider this public position which runs counter to the history in Montana of support for community-based placements.

School District Libel for Death

The Tenth Circuit Court of Appeals has held that school officials may be sued under 42 USC 1983 where a teenager with a history of psychological problems killed himself after being suspended from school and sent home alone. In this case, the student allegedly told a school counselor, "Maybe I'd be better off dead." School officials then suspended him for threatening a teacher and dropped him off at his house where they knew he had access to guns without checking to see if his parents were home. According to the court, school officials "put (the student) at proximate harm by suspending him from school, which caused him to become distraught and threaten violence, and then taking him to his home and leaving him alone with access to firearms..in conscious disregard of the risk of suicide." Armijo v. Wagon Mound Public Schools, No. 97-2150 (10th Cir. Oct. 28, 1998).

What are Developmental Disabilities Services?

Parents whose children are newly diagnosed as having developmental delays may be unaware that the State of Montana provides services to assist them and their children. These services, which are funded through a combination of state general fund dollars and federal monies, are available throughout Montana for free for any eligible individual or family. The services are, however, "rationed" on the basis of the government funds available; that is, an individual or family may be deemed eligible for service but not receive the service immediately because there are no funded openings at that time. The individual or family may be placed on a waiting list until an opening occurs for the service requested.

To be eligible for developmental disabilities services, the individual must meet the criteria for the following definition:

Developmentally disabilities refers to having disabilities attributable to mental retardation, cerebral palsy, epilepsy, autism, or any other neurologically handicapping condition closely related to mental retardation and requiring treatment similar to that required by mentally retarded individuals. The disability must originate before the person reaches 18, it must continue or be expected to continue indefinitely, and it must constitute a substantial handicap to the individual.

The Developmental Disabilities System is administered through the Developmental Disabilities Program (DDP), a division of the Department of Public Health and Human Services in state government. In general, DDP does not provide direct services. Instead the program contracts with individual private and nonprofit corporations to provide services at the community level. They may be contacted at:

Dept of Public Health and Human Services

Developmental Disabilities Program

111 Sanders

Helena MT 59620

406-444-2995

Community-Based System

The Developmental Disabilities Program was created in 1978 by the Montana State Legislature as an alternative to institutional care. The purpose of the system is:

...to provide quality community-based services in the least restrictive environment which promotes the principle of normalization for citizens who are developmentally disabled.

From the beginning, the Legislature determined that services for individuals with developmental disabilities would be provided in local communities by nonprofit corporations under the leadership of locally-recruited Boards of Directors. These individual nonprofits would contract with the state to provide support services for families and children and residential and work opportunities for adults with developmental disabilities. Local boards would be responsible for the day-to-day operation of services and the state would provide funding, technical assistance, and quality assurance monitoring.

The creation of community-based services throughout Montana allowed for rapid deinstitutionalization and the movement of hundreds of individuals from the state institution for the mentally retarded, Montana Developmental Center in Boulder, to community-based programs. Since the late seventies, infants and children with developmental disabilities have not been placed in the institution; instead they have remained in their natural homes and been cared for by their families (or foster families) with the support, when appropriate, of state-funded programs.

DD Services for Infants, Toddlers

Children from birth up to age three with developmental delays are eligible for DD services and these services are an entitlement. Criteria for entry into the Infant and Toddler Early Program under Part C of the Individuals with Disabilities Education Act (IDEA) include the following:

1. Has a diagnosed physical or mental condition that has a high probability of resulting in developmental delay (e.g. sensory impairments, inborn errors of metabolism, microcephaly, fetal alcohol syndrome, epilepsy, Down syndrome or other chromosomal abnormalities), even though the delay may not exist at the time of diagnosis;
2. Is experiencing developmental delays, as measured by appropriate diagnostic instruments and procedures in one or more of the following areas:
   1. Cognitive delay;
   2. Physical development, including vision and hearing;
   3. Speech and language development;
   4. Social and emotional development;
   5. Self-help skills.

The criteria to be used in Montana for determining a child's eligibility as a result of developmental delay include:

1. A minimum of 50% delay in any one of the above developmental areas; or
2. A 25% delay in two or more of the above areas.

Informed clinical opinion may be used in determining eligibility for services under Part C if there are no standardized measures, or the standardized measures and procedures available are not appropriate for a given age or developmental level.

Part C services are mandated services. All eligible children must be provided the services.

DD Services for Children and Youth

DD services for children under the age of 18 are designed to support families and prevent placement of children in institutional settings. The following is the range of services available to children and families: (a) case management, (b) education and training, (c) respite care, and (d) family-designed wraparound services. The state also funds some children's group homes for children and youth who cannot be served in family settings.

Administration of the DD System

For the purposes of administration of DD services, the State of Montana has been divided into five administrative regions, each supervised by Regional Managers in Glasgow, Great Falls, Billings, Helena, and Missoula. Children's services are provided by seven main service agencies located in Miles City (DEAP), Glasgow (Hi-Line Home Programs), Billings (STEP and ECI), Great Falls (Quality Life Concepts), Helena (Family Outreach), and Missoula (Comprehensive Developmental Center). Adult services are provided by a wide variety of corporations throughout the state.

To begin the process of entering services, individuals should contact the state office of Developmental Disabilities Programs or the appropriate Regional Manager for a particular area.

Family Policy Developed

In Montana, the service system for children and adults with developmental disabilities has always been supportive of family involvement in planning and decision-making. Recently, the Strategic Planning Across Montana (SPAM), a work group representing families of children and adults with developmental disabilities plus service providers and state agency personnel, met and drafted a Family Involvement Policy for the Developmental Disabilities Program. The group also developed a set of recommendations for the DDP service system aimed at making the policy "visible" and "sustainable."

The following is the draft language for the Family Involvement Policy:

The Developmental Disabilities Program is committed to the continuing relationship of families in their delivery of services to individuals with disabilities. To this end, maintenance of family ties is strongly encouraged when a family member enters out-of-home services such as foster home, community group home, supported living, or developmental center/institutional placement. When the out-of-home placement involves a minor, all parental/family responsibilities should remain the same as if the child remained in the natural home. When the placement involves an adult, family members are encouraged to remain involved in the life and support of the individual. All contractors of services with the Developmental Disabilities Program are encouraged to develop policies and practices consistent with this Policy.

Draft Recommendations

1. Assure that family members of individuals with disabilities are members of all work groups, policy making committees, or other groups which impact DDP policy and services.
2. Include the Family Involvement Policy in all DDP Public Awareness materials/publications, brochures, posters, booklets, webpage, information, etc.
3. Include the Family Involvement Policy at the bottom of all letters of notice to families/individuals/guardians regarding eligibility for DDP services.
4. Include the Family Involvement Policy in the letters which notify families/guardians of IFSP and IP meetings.
5. Encourage DDP Contractors to include DDP's Family Involvement Policy or their agency's Family Involvement Policy in all their public awareness and informational materials.
6. Assure that the Family Involvement Policy Work Group assumes responsibility each year for a session or workshop at the Annual DD Conference affirming, explaining, and providing technical assistance on implementing DDP's Family Involvement Policy across all DDP-funded services.
7. Assure that DDP's Comprehensive Evaluations acknowledge each Contractor's efforts in the area of promoting/sustaining Family Involvement.
8. Request that DDP's Family Involvement Policy be "boxed and published" at least quarterly, in the PLUK Newsletter and the Quality Matters newsletter.

To comment on the Family Involvement Policy, contact Jan Spiegle Stinger at DDP/DPHHS, Box 4210, 111 N. Sanders, Helena MT 59604. The members of the Family Involvement Policy Work Group are Charlie Trott, Rob Tallon, Millie Kindle, Alicia Pichette, Florence Massey, Vince Benjamin, and Greg Olsen.

Love Yourself: Tips for Stress Management

• Learn to recognize when your body is tense. When tense, take a moment to shake muscles out.
• Begin some form of relaxation exercises such as progressive relaxation, deep breathing, or yoga. Start by doing them at least 10 minutes per day. Ultimately, you should perform the exercises for 10 minutes in the morning and 10 minutes in the afternoon or evening.
• Be wary of your negative thoughts and try to reframe them into positive ones.
• Learn to identify and communicate your true feelings more assertively.
• Practice time management.
• Set aside time for activities with family or friends.
• Consider change as an opportunity.
• Look for what you can resolve and control rather than what you cannot.
• Change problems into goals and seek solutions.
• Develop your friendships more deeply.
• Commit to developing your spiritual life.
• Exercise when and where you can.
• Examine your health habits and determine which ones are moving you away from good health. Substitute healthy habits for unhealthy ones.
• Respond; don't react.

Five Ways to Say: I Love You!

1. Specific "I Love Yous": When you want to say a simple "I love you," instead tell your child something very specific that you love about him or her, for a much more memorable effect.

2. The Morning Question: Ask your child when you wake up in the morning, "How would you like to be loved today?" You might be surprised by the answers you receive.

3. Expressions of Love: Read a story or poem out loud, or play a special song, and ask your child to listen very carefully to each word. When you are finished, let him or her know that the words and melody express sentiments that you feel about your child that cannot be put into words easily.

4. Artistic "I Love Yous": Create your own poem, painting, story, or song in honor of your love for your child. Present it to your child at an unexpected moment.

5. Loving Questions: Ask yourself on a regular basis, "What is one way that I can express my love to my child that he or she would enjoy?"

Ten Caring Ways to Connect with Children Each Day

1. Compassion: Honor all of your feelings and listen with empathy to each other.

2. Clear Communication: Express your emotions simply and speak from the heart.

3. Creativity: Try new things, be playful and invite the unexpected.

4. Consistency: Do what you say and say what you mean each day.

5. Challenge: Approach problems with positive expectancy and learn from the challenges.

6. Cheerfulness: Embrace the day with lightheartedness and learn to enjoy life.

7. Confidence: Trust and believe in your own talents and in the abilities of others.

8. Calmness: Breathe and live from a calm center within yourself each day.

9. Clear Agreements: Create clear agreements and rules that everyone understands and feels good about.

10. Commitment: Be committed to being true to yourself and honest with others each day.

Source: Loomans, D. (1994). Full Esteem Ahead. Tiburon CA: H.J. Kramer.

Full Esteem Ahead By Diane Loomans

To feel the joy

And embrace the sorrow,

To live for today

And believe in tomorrow.

To laugh more laughter

And cry more tears,

To feel the feelings

And face the fears.

To have the strength to hold on

And the wisdom to let go,

To trust in the ebb

And move with the flow.

To have great vision

And be a dreamer by day,

To have the courage to be real

In each and every way.

To dare to rise

And to risk the fall,

To reach out to life

And connect with it all.

This is to have lived a life of full esteem.

Disability Awareness Month: Prepare for March

March is Disability Awareness Month in Montana. Now in its fifth year, this statewide recognition of disability issues has come to be an important event for educating the general public about disabilities and ways to overcome the effects of various impairments. Several types of events have become traditional: (a) poster contest and distribution of winning posters, (b) emphasis on the Disability Awareness Curriculum (People Like Us) in schools, (c) Disability Film Festivals, (d) People Like Us Parades, (e) disability awareness displays and fairs, and (f) proclamations by county commissioners, mayors and city councils. Disability awareness activities have generally been arranged by local parent committees. For a packet describing how to prepare for Disability Awareness Month, contact PLUK at 800-222-7585 or 406/255-0540.

The 1999 Disability Awareness Poster

The Developmental Disabilities Planning and Advisory Council is conducting the Fifth Annual Poster Contest to create the statewide poster for Disabilities Awareness Month in March 1999. This year's contest participants are asked to think about ways that people with and without disabilities are the same and design a poster that helps to illustrate the theme, "More the Same Than Different."

The winners of each category will be brought to Helena in March for an awards presentation. The overall winner will be selected from these finalists. Prizes are being provided by the Montana Association for Independent Disabilities Services (MAIDS) and the Montana Power/Entech Foundation.

Copies of the overall winning poster are made available for display during March. For more information, call Robin at 800-337-9942.

Disability Awareness Curriculum

During March, several school districts have made a point of using Montana's disability awareness curriculum, People Like Us. The curriculum includes simulation activities which allow participants to experience the effects of various disabilities on their ability to perform daily tasks. People Like Us curriculum has units designed for students in the first, fourth, seventh and tenth grades&endash;Curiosity, Challenge, Cooperation, and Commitment. The curriculum focuses on the growth of students in their awareness and understanding of individual differences and in their understanding of themselves. The unit contains 15 lessons, each of which (a) covers one theme, (b) could stand alone as a set of learning activities and objectives, (c) has a consistent format, (d) provides explicit directions for the teacher implementing the curriculum, and (e) requires from 30 to 60 minutes of presentation time. Copies of the curriculum can be borrowed from the PLUK Library (406/657-2055; 800-222-7585) or are free of charge from the Office of Public Instruction (406/444-0037 or 406/444-5661)

Video Festival

In many Montana communities during the month of March, local video stores have been very willing to feature videos that depict disabilities. Some possible videos might be: My Left Foot, Rain Man, Dead Poets' Society, What's Eating Gilbert Grape, Bill (Mickey Rooney), Scent of a Woman, Lorenzo's Oil, Awakenings, Children of a Lesser God, The Piano, Of Mice and Men, One Flew Over the Cuckoo's Nest, The Waterdance, Born on the Fourth of July, Coming Home, Charlie, Flowers for Algernon, Birdy, Elephant Man, Mask, Gaby, The Miracle Worker, Forest Gump. This is an easy activity to set up and potentially has great benefits for public awareness.

Parades

Disability Awareness Parades feature costumed figures, people with and without disabilities marching together, carrying signs with positive disability awareness statements. Parades have also been organized in some individual schools and Head Start programs. Parades get lots of people involved and provide another opportunity to display positive views of inclusion of people with disabilities.

Displays

Libraries, community centers, schools, banks, and grocery stores have offered to display information about disabilities and services available in the community for people with disabilities. Good items for displays include: factsheets about disabilities, disability awareness curriculum, the Disability Awareness Month poster, and children's books with characters who have disabilities.

Proclamations

City Councils and County Commissioners in many Montana communities officially declare March as Disability Awareness Month. In order to have this done, it is important to contact the Council or Commissioners and get on their agenda for early March. Copies of sample proclamations are available from the PLUK office.

ASK PLUK???

The following questions are recent inquiries received by PLUK staff.

Q: Recently our son was suspended from school for the rest of the school year. This whole process took place so quickly that we were overwhelmed and unable to cope with the implications of what was happening. Our son has learning disabilities and was in special education from third through sixth grade. When he entered middle school in the seventh grade, he was tested and found to be at grade level in all areas so he was exited from special education. He struggled academically throughout seventh grade and ended up failing his four core subjects. We tried to get him back into special education but our pleas were ignored. In eighth grade, our son started getting into trouble for being the class clown. Very quickly, he had enough offenses that he reached a step in the discipline program that called for suspension. At the hearing on suspension, we tried to explain that our son needed academic help and his behavior was related to his feelings of failure in the classroom. Our "defense" was ignored. In less than 30 minutes, our son was suspended. Now he is sitting at home trying to do correspondence courses on his own while we are at work. Is there anything we can do about this situation? We are heart sick and at a loss.

A: Suspension of students, particularly at the middle school level, is becoming more and more common, not just in Montana but all across the nation. This "crackdown" can be attributed, in part, to a desire on the part of school officials to ensure a safe learning environment, free of disruptions.

Because your son was exited from special education, he became what is called an "unclassified student"; that is, a student who has no particular protection from school discipline procedures. Students who are in special education do have protections against suspension and expulsion if it can be demonstrated that their misbehaviors are related to their disabilities.

With "unclassified" students, there are some potential protections which may apply to your son. You may claim that your child should have received some special consideration if one of the following conditions is true:

• You as parents had formally expressed concern to district personnel that your child needed special education.
• The behavior or academic performance of your child demonstrated the need for special education.
• You had requested an evaluation of your child.
• Your child's teachers had expressed concerns about behavior or academic performance to special education personnel.

These provisions may apply to your case because you tried to have your son reinstated in special education because of his poor academic performance. If any of your requests were made in writing and you retained a copy of that request, you can use this information to make the case that you tried to have your child evaluated for special education.

At this point, what you need to do is make an appointment with the school principal and lay out the facts of your son's situation from your point of view. Bring with you any copies of written requests for help or teacher comments that indicated your son was in trouble academically. Give the principal a letter in which you state two things: (1) you are formally requesting that your child be evaluated for special education, and (2) you want a manifestation hearing to take place to determine if your son's behavior which caused the suspension could be attributed to his disability. If you are not satisfied with the response of the principal, then make your request to the superintendent.

If school district officials are not responsive, then you can make a complaint to the Office of Public Instruction, Legal Services in Helena.

Q: Our son is a sophomore in high school. After much hassle, we were able to get him tested by the school this year, and he was identified for special education as a student with a learning disability in written expression. He is in a learning strategies class now which is helping him a lot. His grades have gone up and his spirits are soaring. We are so grateful for this improvement, but one problem remains. English is his hardest subject and the teacher he has for this class is inflexible. She has a seating chart for her room which places our son in the back row. Our son's IEP clearly states that he needs preferential seating and should be close to the teacher in order to aid him in paying attention. Even though this teacher was at the IEP meeting and signed the IEP, she refuses to make this minor change. She says our son "daydreams" and he is old enough to be more self disciplined. What can we do?

A: If it says in your child's IEP that he is to receive preferential seating, then he must be given this accommodation. This individual teacher cannot decide to do something different for her own reasons.

Make an appointment with the principal of your son's school. Bring a copy of the IEP. Explain the problem and ask the principal to handle the situation in a tactful manner. If there is an option to move your child to a different English teacher's classroom, this might be the best solution to the problem. You cannot, however, demand such a change. All that you can expect is that the district will honor what is written in the IEP.

Q: Last spring we asked at our eight year-old daughter's IEP meeting we requested that she be evaluated for assistive technology. We think that she would benefit from using word processing because her handwriting is so laborious and illegible. We have a computer at home and she loves using it to study for spelling tests. It is now almost a year later and there has been no assistive technology evaluation. Are there any rules governing how quickly an evaluation should be conducted?

A: IDEA itself is not specific about how much time a school district has to complete an evaluation. The law requires that evaluations occur in a reasonable amount of time, usually interpreted to mean 4-6 weeks. For AT evaluations in particular, recent court cases have indicated that AT assessments like all other special education evaluations should be done in a timely manner --Austin Indep. Sch. Dist., 25 IDELR 875 (Tex. SEA 1997).

Waiting almost a year for an evaluation certainly does not seem to meet the requirement for timely evaluations. At this point, you should file a complaint with the Office of Public Instruction. You may also want to consider getting an independent assistive technology evaluation at the school district's expense.

Q: Our 16 year-old daughter has severe, multiple disabilities--cognitive delay, cerebral palsy--, but she is ambulatory and quite capable of managing self help skills. Her biggest problem is communication. She can say a few words but her speech is very hard to understand, except by those who know her well. We are very concerned about what the future holds for her after high school if she doesn't master some form of effective communication. Her school program is not addressing communication. Basically, she is repeating the same activities she has been doing for years . What should we do?

A: The concerns you raise are really transition issues. Your daughter's IEP should include a page which describes the skills she needs to learn in order to make a successful transition from high school into adult support services. In your daughter's case, a key issue in the transition portion of the IEP should be communication skills. There are a number of options that could be tried--using a picture wallet, or a portable electronic communication device, for example.

It is very important that your daughter's IEP transition page be completely filled out with the level of detail necessary to describe how the goals and objectives in the IEP will assist her in making a successful transition. If your daughter's current IEP is not this specific, ask for an IEP meeting to develop a more thorough transition page. If you need help in thinking about what should go on that page, contact your local PLUK representative.

Also, you should think very seriously about how long your daughter will take to learn the skills described on the transition page. Be sure that it is clear that you expect your child to graduate from high school on the basis of having accomplished her transition goals and objectives. It may take her longer than four years to reach her goals so her graduation date may be delayed a year or two.

Q: Our son is an excellent junior high student who achieves good grades and is active in school extracurricular programs. He does have a Section 504 plan because of a chronic health condition (a muscle disorder) that causes him to have diminished strength. All of the students at his school are encouraged to use the Internet to complete school research projects. Access to the Internet is provided in the school library. The problem for our son is that he cannot use the keyboard on the library computer effectively. We have asked that he be evaluated to determine what kind of access would work for him, but we have been told by the librarian and the principal that the school does not have to accommodate our son further because he is only a 504 student and not in special education. Is this true?

A: No. For students with disabilities not receiving services under the special education law, but covered under Section 504, a student's need for assistive technology is considered as part of determining the appropriate educational and related services that will be provided to meet the individual educational needs of that student as adequately as the needs of students who are not disabled. If all the students in your son's school are supposed to be using the Internet, and your son cannot use the Internet due to his physical disabilities, your son should be provided appropriate accommodations. Your son cannot be denied access to the educational opportunity of using the Internet--an opportunity made available to all other students. The district is responsible for evaluating your son and providing him with appropriate access.

Parent Corner

Items of interest to parents

Rent Assistance

The Department of Housing and Urban Development will distribute nearly $130 million in new federal housing vouchers to help low-income people with disabilities pay rent. The vouchers are meant to subsidize rent in the private marketplace so low-income people with disabilities do not spend more than 30 percent of their income in rent. HUD will distribute the money through local housing authorities in more than 200 communities. For more information, contact your local Housing Authority.

Transition Information

The Social Security Administration has an information package for those who work with young people with disabilities. Called "Graduating to Independence," the materials aim to help parents, teachers, counselors, and others who assist young people with disabilities. The multimedia package, including written materials, two computer software disks and a video, is distributed to special education teachers and administrators, advocacy organizations and Social Security offices.

The package provides information on how Social Security and Supplemental Security Income (SSI) can help young people with disabilities achieve their employment goals.

Parents, teachers or organizations can order the kit by contacting Graduating to Independence, Social Security Administration, 545 Altmeyer Building, 6401 Security Boulevard, Baltimore Maryland 21235.

Finding the IDEA Regulations

IDEA '97 regulations will probably not be published until after February 15, 1999. These regulations are expected to provide guidance in how to implement the changes in the federal special education law that occurred with the most recent reauthorization by Congress.

When the new IDEA regulations are released, they can be accessed in the following ways:

• At the Federal Register World Wide Web site on the day of release at http://www.access.gpo.gov/nara
• On the U.S. Department of Education's web site within a few days of release at http://www.ed.gov/legislation/FedRegister/finrule?index.html
• On the IDEA '97 web site within 3-4 days of release at http://www.ed.gov/offices/OSERS/IDEA. An information sheet detailing the ways that customers can obtain copies of the regulations will be posted on the Web along with the regulations hotline at the IDEA '97 Web site.

To receive copies of the regulations by mail--

• Telephone EDPUBS toll-free at 1-877-433-7827 or 1-877-576-7734 (TTY/TTD) to request one free copy. Copies will not be available until 1-2 weeks after the regulations have been released.
• Telephone the Government printing Office (GPO) to order one or more copies ($8.00 each) at 202-512-1800; write to Government Printing Office, Superintendent of Documents, PO Box 37195-7954, Pittsburgh PA 15250; or call 202-512-0132 or check http://www.access.gpo.gov/su_docs/sale/abkst001.html for the GPO bookstore nearest you.
• Telephone 202-512-1530 for the closest Federal Depository Library or check their Web site at http://www.access.gpo.gov/su_docs/dpos/adpos003.html.

Customer Service

Financial eligibility guidelines for Montana Community Partner's non-Medicaid Program will change effective March 1, 1999. Only those individuals whose income is at or below 150% of poverty will be eligible for Mental Health Access Plan (MHAP) services.

If your gross annual income is at 150% of the federal poverty guidelines or below, you will be eligible for participation in the non-Medicaid Program. Your income cannot be greater than the income shown in the following table:

Number in Family/Annual Income for 150% of Poverty
1 Person/$12,075
2 People/$16,275
3 People/$20,475
4 People/$24,674

Members whose income is from 151-200% of federal poverty guidelines will lose their non-Medicaid eligibility effective March 1, 1999.

With these changes, there will not be a co-payment for pharmacy or any other mental health services for the non-Medicaid program.

If you have questions about Montana Community Partners and its services, call 1-888-599-2233. Montana Community Partners is the managed care system for providing mental health services to low income children and adults.

Legislative Presence for OPI

The Office of Public Instruction has been given office space in Room 106 of the Capitol for the legislative session. OPI staff members Joe Lamson and Catherine Love will be located at the Capitol. In addition, Dan Stonington is working as a legislative intern for OPI. These staff members can be reached by telephone at 444-7095 and 444-7094 and by fax at 444-7093.

Math Learning Disabilities

Dr. Catherine Garnett of Hunter College provides information on the different types of math learning problems that LD children may have. You can locate this information at: http://www.ldonline.org/ld_indepth/math_skills/garnett.html.

Project Eye-to Eye

Jonathan Mooney, who has dyslexia, and David Cole, who has attention deficit hyperactivity disorder, have designed Project Eye-to-Eye which pairs college students who have learned to manage their learning disabilities with elementary students who are enduring a similar struggle. Learn more about this innovative project at: http://www.ldonline.org/whats_new/project_eyetoeye.html.

Legislative Information

Information regarding the 1999 Montana Legislative Session can be found at the following address: http://laws.leg.state.mt.us/law/plsql/LAW0200W$.Startup.

Absorbent Underpants

Kimberly-Clark has introduced a product that is helpful for children who are not yet fully potty-trained. Goodnites are absorbent underpants that are pulled on and off just like underwear. They come in sizes to fit children 45 to 125 pounds. Goodnites can be worn both day and night. A new extra-large size is being developed.

Understanding Motor Dysfunction

Some children with learning disabilities display mild problems with motor functioning: lack of coordination, difficulty with fine motor tasks, problems with organizing motor tasks. Dr. Mel Levine, director of the Center for Development and Learning at the University of North Carolina School of Medicine, provides insight for assisting children with poor gross and fine motor performance. You can find this information at: http://www.ldonline.org/ld_indepth/parenting/motor_levine.html.

CEC Conference Coming Up

This year's Council for Exceptional Children Conference will be held in Missoula on March 24, 25 and 26. The CDC Respite House will be available for use by parents who are attending the conference. CEC will pay the costs for respite care during the day and evening sessions. Parents needing respite care are asked to contact Brent at the respite house (406-728-2746). For more information about the conference itself, contact Dale Lambert at dlambert@lewistown.k12.mt.us.

Grant Monies Available

Falling Through the Cracks, Inc., a private not-for-profit organization, has a limited amount of funds available to assist children and adults with developmental disabilities who live in Region III (south central Montana). The grant funds are intended to address emergency needs of individuals on a onetime/short term basis.

Consumers, parents, service providers, and case managers can apply for the grant funds as long as the potential recipient meets the following criteria: (1) is DD eligible, (2) resides in the eleven county Region III Area, and (3) submits an Application Form.

A committee will review requests and attempt to address needs by suggesting possible resources to the applicant. Assistance may or may not be in the form of direct funds being awarded if other alternatives are available. Further, due to limited resources, grant funds may be awarded on a loan basis in which the recipient may be required to pay back the loan over an agreed upon period of time.

To receive an application, contact Rita Schilling at 406-245-6323.

Have You Received a Progress Report?

IDEA '97 requires that parents receive a progress report on their child's progress toward IEP goals and objectives. These progress reports are supposed to be provided as often as other students would be receiving report cards (e.g., quarterly). If you have not received a progress report, contact your child's special education teacher and ask for one. Note: A regular report card that does not address the IEP is not sufficient to meet this requirement of IDEA '97.

FDA for Kids

The Food and Drug Administration has developed a home page for children on its Web site. Children aged 9-12 years can learn more about the agency through activities like a medicine cabinet word find, a food safety quiz, and an interactive human skeleton. The site can be accessed at http://www.fda.gov/oc/opacom/kids/.

Young Cancer Survivors

Childhood cancer survivors can find help in "Outlook: Life Beyond Childhood Cancer," a new internet site sponsored by the University of Wisconsin. Visitors to http://www.outlook-life.org/ will find detailed information on health concerns, insurance and financial matters, and school and job issues. Visitors are also invited to share personal stories, poems, and thoughts.

Learn about Medications

The Child Psychopharmacology Information Service maintains a computerized database of 13,000 references relating to the use of psychiatric medications in children and adolescents. The service will provide computer-printed bibliographies and single copies of articles on any topic relating children's psychopharmacology. They also publish two information guides: Obsessive Compulsive Disorder in Children and Adolescents and Attention-Deficit Hyperactivty Disorder in Children. These guides sell for $4.50. To order, call 608-827-2390.

The Information Service also publishes a quarterly newsletter called Just the Facts. It is full of the latest information on medications used with children and adolescents. It is available by subscription for $15.00 per year. To subscribe, call 608-263-6171.

Orton Gillingham System on Disk

The Lexia Learning Systems company has developed software that implements the Orton Gillingham system for teaching reading skills to individuals who are dyslexic. The Assess A & B reading tests help identify strengths and weaknesses in decoding and their reports help teachers focus their instruction, organize reading groups and assign software modules. Phonics Based Reading and Reading S.O.S. are used by LD students to develop phonological awareness, understand sound-symbol correspondence and develop their decoding skills. For more information, visit the Lexia web site at http://www.lexialearning.com.

AlphaSmart Online

AlphaSmarts are small, portable word processors that are convenient for students to use in the classroom for all types of word processing. AlphaSmart operates a web site store at http://www.alphasmart.com. Browsing or purchases can occur 7 days a week, 24 hours a day at this safe and secure online store.

MetNet Broadcast on Managing Behavior

The Rural Institute on Disabilities will be hosting a day-long statewide interactive video conference on positive behavioral supports on the MetNet system on June 11. Anyone who wishes to attend may do so at no cost. The training will be suitable for consumers, family members, and service providers. Two national experts on positive behavior management, Joe Schiappacasse from Colorado Developmental Disability Services, and Joan Sweeney, a behavior consultant from Charleston, South Carolina, will share their expertise and respond to questions from the statewide audience.

A video tape of the MetNet session will be available at cost (about $6.00). This tape may be useful for inservice training or home viewing. For more information, contact Cary Griffin at the Rural Institute (243-2454).

E-mail Congress

If you have access to e-mail, it can be an easy method to voice your opinions to Montana's Congressional delegation. Here are the e-mail addresses for our Senators and Representative:

Senator Max Baucus

Web address: http://www.senate.gov/~baucus/

e-mail: max@baucus.senate.gov

 

Senator Conrad Burns

Web address: http://www.senate.gov/~burns/

e-mail: conrad_burns@burns.senate.gov

 

Representative Rick Hill

Web address: http://www.house.gov/hill/

e-mail: Rick.Hill@mail.house.gov

Practical Genetics for the New Millennium

On May 21-22, 1999, Shodair Hospital will be sponsoring a Medical Genetics Conference for health care professionals. For more information contact: Medical Genetics at Shodair 1-800-447-6614, ext. 7532; e-mail: mtgene@initco.net or Special Health Services (DPHHS at 406-444-3622.

Children at Risk Conference

The Children at Risk Conference will be held on March 10-13, 1999. The featured speaker will be Dr. Ira Chasnoff who will discuss "Understanding the Drug Exposed Child." The conference is sponsored by the College of Professional Studies and Lifelong Learning at MSU-Billings and March of Dimes. For more information, call 406-657-2203.

Partners for Learning

The U.S. Department of Education has issued "Partners for Learning: Preparing Teachers to Involve Families," a free kit with video, CD ROM, and print materials for educators and community leaders to help teachers and parents work together to improve their children's education. Call 1-800-USA-LEARN to request a free kit.

Anxiety Disorders Conference

On March 4 and 5 in the Mary Alice Fortin Health Conference Center of Deaconess Hospital in Billings there will be an Anxiety Disorders Conference discussing such conditions as Obsessive Compulsive Disorders and Post Traumatic Stress Disorder. For more information, contact Jennifer Donovan, PO Box 219, Billings MT 59103.

Parent Training Grants

PLUK has received an additional $7,000 for parent training grants from the Office of Public Instruction. This money is to be used to help individual parents take advantage of training opportunities that may help them understand their child's disability better. This additional grant money will need to be used by June 30, 1999 so please submit applications as soon as possible. To receive an application, please contact the PLUK office in Billings at 255-0540 or 1-800-222-7585 (toll free).

New Treatment for Tourette Syndrome

Paul Sanberg and his colleagues recently reported in The Lancet , a British medical journal, that nicotine significantly reduces the symptoms of Tourette syndrome (TS). These same researchers also are reporting that mecamylamine, a drug that blocks the action of nicotine, also causes remarkable improvement in many individuals with TS.

The researchers tested mecamylamine, a blood pressure drug withdrawn from the market in 1977 due to low usage, on 13 people with TS (four adults and nine children). According to Sanberg et al., 11 of the 13 exhibited significantly fewer motor and vocal tics during treatment. People in the study also reported an improvement in mood, in particular, decreased irritability and aggression. In addition the children taking mecamylamine appeared to function better socially and in school.

It seems odd that a drug that blocks nicotine's action would have effects similar to nicotine's. Researcher John Rosecrans speculates that the two substances affect different sites, thus causing the same effect through different pathways. It appears that both substances may desensitize acetylcholine receptors or stabilize dopamine-releasing cells in the brain.

Sanberg says that, unlike other drugs used to treat Tourette syndrome, mecamylamine appears to have few side effects. At the low dosage used in this study (an average of 2.5 mg/day), the only side effects seen were low blood pressure and constipation.

The researchers are now organizing a placebo-controlled study of mecamylamine's effects on Tourette syndrome, to be conducted at ten medical centers in the United States. Results of the study will be published in 1999. In addition, the researchers plan to investigate the drug's effectiveness as treatment for attention deficit hyperactivity disorder, obsessive compulsive disorder, and other neuropsychiatric disorders.

Nicotine and Other Disorders

John Rosecrans reports that researchers are actively investigating the use of nicotine for a variety of psychiatric conditions. Among the studies he cites:

• One research group found that nonsmoking individuals with depression showed short-term improvements in mood when given nicotine patches. The subjects also showed increases in REM (rapid eye movement) sleep, which is often reduced in depressed individuals.
• Noting that people with attention deficit hyperactivity disorder (ADHD) are much more likely to smoke than other people, researchers gave nicotine patches to smokers and nonsmokers with ADHD. Both groups showed improved scores on the Clinical Global Impressions scale during treatment.
• Researchers report that when schizophrenic patients are given nicotine via a patch or gum, they can process auditory or visual stimuli in a manner more similar to nondisabled people.

Rosecrans reports that research in his laboratory with rats has indicated that nicotine has an unusual quality: it tends to have a 'normalizing' effect on behavior. Highly aroused rats tend to calm down, while under-aroused rats tend to be stimulated. He suggests that many smokers may use tobacco not because it is addictive, but because they are self-medicating psychiatric symptoms.

Sources: Sanberg, P.R. Shytle, R.D., & Silver, A.A. (August 29, 1998). Treatment of Tourette's syndrome with mecamylamine, Lancet 352 (9129), 705-706.

Rosecrans, J. (July 6, 1998). Nicotine: helping those who help themselves? Address John Rosecrans, Dept. of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond VA 23298.

DSM-IV ADHD in Preschoolers

DSM-IV criteria can be used to diagnose preschool-age children with attention-deficit hyperactivity disorder.

It used to be assumed that children under the age of 6 could not be diagnosed as having ADHD because the symptoms were too vague in young children. However, in a study of 126 children aged 4-6 years meeting DSM-IV criteria for attention-deficit hyperactivity disorder (ADHD) and 126 controls, behavioral evaluation by self-assessment and parent and teacher observation correlated with DSM-IV diagnoses for ADHD, even after controlling for other conditions and potentially confounding factors like age and intelligence.

Children who met DSM-IV criteria for any of the three ADHD subtypes (combined, hyperactivity-impulsivity, and inattentive) exhibited functional impairment in several areas, such as social skills, self-control, and academic achievement, compared with controls.

Source: Lahey, B. (1998). Journal of the American Academy of Child and Adolescent Psychiatry, 37 (7): 695-702.

Medication Makes the Difference in Children with ADHD

An important new study shows that psychosocial therapy made no difference in treating ADHD, even when used in conjunction with drugs.

In the largest multicenter, multimodal study of attention-deficit hyperactivity disorder ever conducted, medication convincingly outperformed intensive behavioral interventions in children with moderately severe cases of ADHD.

Surprisingly, when children received both medication and intensive psychosocial therapy, nondrug approaches offered no measurable additional benefit in the Multimodal Treatment Study of ADHD sponsored by the National Institute of Mental Health and the Department of Education.

Results of the 14-month trial were presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry.

Medication was found to be superior to psychosocial treatment in three major areas: ADHD symptoms, aggression and oppositional-defiant disorder symptoms, and social functioning--the latter in terms of ratings of peers.

In this study, 579 children aged 7-9 were randomly assigned to one of four groups:

• Medication Only. Most children received methylphenidate (Ritalin), adjusted to their individual needs in response to monthly assessments by the parent, teacher, and prescribing physician and taken in three daily doses 7 days a week.
  Other stimulants such as dextroamphetamine (Dexadrine) or pemoline (Cylert) were used in some children, and some nonresponders were switched to antidepressants such as imipramine or nortriptyline.
  Parental guidance and support was provided during monthly medication recheck visits.
• Psychobehavioral Treatment Only. This intensive program included 30 training sessions for parents, a summer camp aimed at improving children's social and learning skills, daily behavior report cards, 8 weeks of teacher training sessions, and an in-school paraprofessional who spent 12 weeks with each child in class helping him or her stay on task.
• Combined Treatment. A combination group received both medication therapy and the intense psychobehavioral program.
• Control Group. Following assessment of the children by study coordinators, parents could seek community care for their children. Roughly two-thirds of children in this group received medication but still fared poorly in virtually every category.

On measure after measure, a pattern of results emerged: Medication alone and medication plus psychosocial treatment results were nearly identical, and both were significantly superior to psychosocial treatment alone or community treatment.

These results held true across a variety of differences in ethnicity and socioeconomic status across the sites in the study.

A key point in the study was the care with which medications were monitored and adjusted as needed. This point became particularly clear because two-thirds of the children receiving ADHD care from community sources received medication but did a lot worse.

Commonly in the community, a prescription is written for 3-6 months and there is not input from the teacher or parents. Physicians do not receive adequate feedback on the effects of the medications, and parents sometimes take their children off the medication without allowing for adjustments that may be needed.

The bottom line is that medication is effective, but it has to be monitored carefully and adjusted systematically.

Boys, who made up 80% of the study subjects, and girls responded practically identically to various study interventions.

Small differences in response were seen only among two subsets of children: those children who had anxiety disorder and those from low-income, single-parent families. In both cases, such children appeared to benefit most when psychosocial interventions were combined with medication therapy.

The investigators said much more data from the study remain to be analyzed, including information on whether ADHD drugs affect children's growth and whether academic interventions may be needed to supplement the effects of medications.

Study sites included: State University of New York at Buffalo; Duke University in Durham, North Carolina; New York State Psychiatric Institute in New York City; University of California, Berkeley; and University of California, Irvine.

Ritalin has Low Addictive Potential

New information on Ritalin sheds light on why individuals taking therapeutic dosages of the drug rarely abuse it or become addicted.

In a study at the Brookhaven National Laboratory in New York, researchers found that the drug is taken into the brain much more slowly than other, highly addictive drugs with the same mechanism of action.

This may explain why individuals do not experience a "high" from taking oral Ritalin and therefore do not develop an addiction.

The researchers found that it takes Ritalin about 60 minutes to reach peak concentration in the brain of a baboon, and they believe it takes about that long in the human brain.

Cocaine and amphetamine, which respectively take 5 and 9 minutes to reach peak concentrations in the human brain, target dopamine transporters, as does Ritalin.

In what they describe as the first study to measure the levels of dopamine transporter blockade reached after therapeutic doses of oral Ritalin, the investigators tested the drug in seven healthy subjects (average age 24 years).

The investigators gave subjects doses of Ritalin corresponding to those used for treating attention-deficit hyperactivity disorder symptoms.

Only one subject reported experiencing a moderate "high" for one of the Ritalin doses; all other subjects reported experiencing a minimal high or no high at all, even at Ritalin doses that blocked more than 60% of the dopamine transporters.

At a National Institutes of Health consensus development conference on attention-deficit hyperactivity disorder, research was cited supporting low levels of Ritalin abuse among high school students.

Data from the Monitoring the Future study indicate that the number of adolescents using Ritalin without a physician's order has decreased 35% since 1985. Studies indicated that most teens who take Ritalin without a physician's order do not do so to get high. It is more commonly used by teens who want to feel energized or lose weight or as a study aid.

There is, however, a small subgroup of polysubstance-abusing teenagers who may take it for its stimulant effect in terms of feeling euphoric.

The production of Ritalin has increased 500% between 1991 and 1997, and the United States alone produces and consumes about 90% of the world's Ritalin.

States with Highest Use of Ritalin (1997)

State - Grams Used Per 10,000 Population
Delaware - 373
Virginia - 350
Michigan - 334
New Hampshire - 332
Iowa - 329
Montana - 317
South Dakota - 307
Wisconsin - 303
Ohio - 298
Minnesota - 294
Note: U.S. average = 223 grams per 10,000 population. Hawaii, Alaska, and California have the lowest use (114 g, 119 g, 129 g, respectively).

Source: Drug Enforcement Agency

NIH Symposium on ADD

In late November 1998, the National Institutes of Health organized a conference in Washington DC to discuss the diagnosis and treatment of attention deficit hyperactivity disorder (ADHD). Currently, ADHD may be diagnosed if a child presents with six out of nine indicators of inattention or six out of nine indicators of hyperactivty/impulsivity, if the symptoms have been present for more than six months and have also been present since before the age of seven years, create impairment in two or more settings and are not due to any other condition. Children diagnosed with ADHD are often treated with medications, such as Ritalin, and are considered to be at very high risk of developing other problems if they remain undiagnosed and untreated.

Proponents of the diagnosis of ADHD state there is validity in the diagnosis of ADHD and that the diagnosis can be made reliably using well-tested diagnostic interview methods. Evidence supporting the validity of ADHD includes the predictable course of ADHD over time, studies in different cultures that reveal similar characteristics for the disorder, and the fact that ADHD has been shown to have a strong genetic component. However, there is no single procedure or objective test that can be routinely used to determine whether or not a child or adult has ADHD so a careful evaluation relying on information collected from multiple sources is required.

Those questioning the diagnosis of ADHD are concerned about the validity of a single syndrome of ADHD, stating that children currently diagnosed with ADHD are a very heterogeneous population consisting of very different children with many different profiles. However, it seems that most agree that children with these behavioral profiles should receive help if they are experiencing significant problems in functioning. Opponents do not necessarily disapprove of using medication to help the children function better. Some of these opponents of the diagnosis state that it is more useful to look at each child's specific profile, including temperament and other factors such as learning problems, and design appropriate, individualized interventions.

In any case, the conference concluded without agreement on any changes to the currently accepted diagnostic criteria for ADHD.

New Tests May Identify Learning Disabilities

One of the frustrations for parents of children with learning disabilities is that the current academic testing procedures that are used in identifying a child for special education simply test a child's general aptitude with an IQ test and compare that score with the child's achievement in various subject areas. If there is a significant gap between the child's potential and actual achievement, the child can be identified for support services through special education.

Unfortunately such a gap cannot be detected as soon as a child enters school. The school must wait until a psychologist can get a valid IQ score and the child has compiled an achievement record. Meanwhile, the typical child with a learning disability will have spent two to three years frustrated and failing in school.

Recent research in the field of learning disabilities has been aimed at finding better ways to assess whether or not a child has a learning disability and what the nature of that disability might be. Virginia Berninger is the principal investigator of a University of Washington research center, launched in 1995, that focuses on specific reading disorder, or dyslexia. Under Dr. Berninger's leadership, researchers have determined that dyslexia stems from processing problems in the brain. For example, in dyslexia, there appear to be three "markers" that children may show:

• Difficulty breaking down words into their component sounds. The child may not be able to tell how many syllables are in a given word or how many smaller sounds are in a syllable.
• Difficulty understanding that two letters can be combined into a single sound (such as "sh" or "ng"). A child with dyslexia may try to sound out a written word letter by letter and not recognize the result.
• Difficulty naming familiar written symbols rapidly and automatically. Faced with cards containing familiar symbols such as letters or colors, a child with dyslexia will often hesitate or stumble when trying to come up with their names.

Using a series of tests authored by Berninger, school psychologists can uncover reading problems related to three markers of dyslexia and these determinations can be made early in the child's schooling before the child has experienced too much failure in the reading process.

Given the obvious advantages of early diagnosis and intervention, why don't schools use tests like Beringer's instead of relying on the IQ/achievement gap? School districts are bound by special education law which has established the discrepancy between potential and performance as the standard for determining whether a child is eligible for special education as a learning disabled student. Since this is the legal standard, school officials are understandably reluctant to use other standards which are not sanctioned in law.

Also, another part of the problem, is simply lack of knowledge. Researchers and educators often do not move in the same circles, so cutting-edge techniques may not make it into the schools. In an effort to bridge that gap, Dr. Berninger has written a book entitled Process Assessment of the Learner: Guides for Intervention that was published in October 1998 and is intended for teachers and school psychologists.

Research into the origins and diagnosis of dyslexia is ongoing. Some promising research avenues include genetics (e.g., patterns of dyslexia in families), and proton echoplanar spectroscopy imagining (PEPSI). With PEPSI, subjects are placed in a magnetic resonance scanner running software that measures areas of brain activation.

When images of the brains dyslexic individuals are compared to those of children without dyslexia, researchers are finding that there is more brain activation in the children with dyslexia during the same language tasks. This finding suggest that individuals with dyslexia use more metabolic energy to do the same task. Berninger and other researchers are hoping that one day genetic and brain research will discover a way to use a blood test to identify children at high risk to develop dyslexia.

In the meantime, the intervention a child with dyslexia requires is still educational, not medical. A quarter century and more of research indicates that a child with dyslexia requires direct, explicit instruction in what has been called the "alphabet principle". The alphabet principle means that there is a systematic connection between particular sounds and letters or letter groups. Because all children come to school having mastered an oral language, reading and writing is a matter of translating what is basically auditory into a visual medium. This is phonics, but with two additions. First, it is not enough to teach the sounds of individual letters. In English, many of the basic sounds are formed by two-letter groups, so children learning to read need to learn these groups as units. Second, phonics is often taught through the use of rules, but research shows such verbalizations do little to fix the sound-letter connection in memory and may even get in the way.

To address both problems, Berninger's research group developed "talking letters." Children are given a card that has the vowel sounds on one side and the consonant sounds on the other. Next to each letter or letter group is a picture of an object. Its word contains the target sound--a ring next to "ng," a can of oil next to "oi," and so forth. Using the card, children learn to connect the sound of a word they know with a letter or letter group; the expectation is that with practice the connection will become automatic.

Because the sound/symbol connections are so difficult for children with dyslexia to make, Dr. Beringer recommends that children with dyslexia receive continuous reading programs throughout their school years.

Cyber-Kid Safety

When using computers, children may face a variety of "adult" problems.

To maintain healthy computer use for children and adults, be sure to consider the following for all users:

• Proper seating. Children may require a booster seat to see the screen properly.
• Keyboarding. Proper positioning of hands and wrists is the same for adults and youngsters, as is the potential repetitive stress injuries.
• Vision. Prolonged computer use can draw attention to or aggravate vision problems.

At the same time, the computer may also be the solution to some problems affecting a child's school performance, including motor control and visual perception. One way to evaluate and address such problems is through occupational therapy.

Occupational therapy for children experiencing learning problems is available in schools through the federal Individuals with Disabilities Education Act. Occupational therapy is also a covered service in many insurance plans.

For more information, or to locate an occupational therapist in your community, call the American Occupational Therapy Association at 1-800-668-8255, or visit the website at http://www.aota.org.

Source: The American Occupational Therapy Association, Inc.

Content Area Reading

Many children with learning disabilities are able to learn the basics of reading but continue to struggle with reading comprehension. A new book series by Curriculum Associates is designed to help students understand and remember the content of what they are reading.

Think About begins with very simple words and concepts and then presents those words and concepts in progressively complex contexts as the student's ability grows. The Think About program is appropriate for use in primary grades, Title 1 and ESL programs, as well as mainstream emergent-reading classrooms.

The 45 titles in the Think About program focus on three specific content areas and support national standards in math, science or social studies. All titles help in the development of early literacy skills--comparisons and contrasts, the ability to make observations and inference, drawing conclusions, word recognition and sequencing. Currently there are three stages within each of the three content areas, with five titles per stage.

These books progress in stages with stage 1 providing very simple nonfiction language and topics. Text evolves from words to phrases to sentences within Stage 1, offering students a continued challenge as they master reading. The books provide one-to-one text/art matches for direct visual clues.

Stage 2 books are also nonfiction and extend the language and concepts into more complex settings. The text ranges from simple to more complex sentences, with an emphasis on critical thinking.

The books in Stage 3 are fiction and include a pair of consistent characters within each content area. This helps prepare children to read more advanced series books. Students will also find language from the previous stages used in fictional settings to help them distinguish between real and make believe. Dialogue is introduced and sentences become more complex to further students' reading ability.

For more information, contact Curriculum Associates, Inc., 153 Rangeway Rd., P.O. Box 2001, North Billerica MA 08162-0901; 800-225-0248; Fax: 978-663-0521; cainfo@curriculumassociates.com;

http://www.curriculumassociates.com.

Alternative Schools--A Good Choice?

The child is out of control. He or she no longer listens to parents or teachers, may engage in drug or alcohol abuse, may even be violent. Or maybe not. Maybe the child just cannot make it in a regular school. Or the child is just exhibiting normal adolescent rebelliousness, but parents can't cope with the behavior. A student who falls into any of the above situations could be a candidate for an alternative school.

With the rising expulsion rate, more children and youth in treatment centers; more frequent school violence; and parents who are desperate to save children who are lost to the world of drugs, gangs, or violence, alternative schools--public or private--are a booming enterprise.

And with new mandates in the Individuals with Disabilities Education Act (IDEA) 1997, which say schools must provide alternative educational placements for dangerous students with disabilities, the alternative school option is likely to continue its phenomenal growth.

Though many larger school districts offer alternative schools affiliated with the public school system, some states are turning to privately run alternative schools to serve their students who are expelled from or just do not fit into the public school system.

While the call for alternative schools has grown dramatically in the past few years, regulations governing them have not. Alternative schools run the gamut from well-run, credentialed institutions of learning to holding tanks for students that offer little in the way of academic or counseling services to poorly structured survival or boot camps that could actually damage students.

Currently, the number of students with disabilities placed in alternative schools remains fairly small--about 15-20 percent of alternative school populations. Most students with disabilities in these settings have learning disabilities, and some are identified as emotionally disturbed. However, staff in these schools say that many of their students have emotional disorders but have not been labeled as ED. Also, some alternative schools report that they have a high number of students who are gifted and having difficulty coping with the constraints of a regular school.

As a matter of law, students with disabilities who are placed in public school affiliated settings must receive appropriate special education services, but that may not be the case in non-public alternative schools. If the school is not accredited, it may not have a special education teacher on staff, may ignore IEPs, and fail to provide other services students may need.

Public Alternative Schools

Across the nation, public schools have developed some exemplary models of alternative schools. Though these schools serve both special and general education students, at least one special educator is usually employed to serve the students with disabilities. In some districts, if a student with a disability is placed in a residential or hospital setting, the school sends the special educator to the site.

Generally, the classes are small, and instruction can range from traditional classroom instruction to a type of independent study course in which the teacher, or special educator if the student has a disability, develops the course of study and the students work through the program on computers.

In addition to academics, these schools often offer individual and group counseling, drug counseling and treatment if needed, and family therapy. Some also provide job training, employment assistance and job counseling.

Structure vs. Flexibility

The area in which there is wide disagreement concerns that of structure vs. flexibility. Though some schools maintain that their students need a lot of structure and are very strict concerning rules, regulations and even dress codes, others give students more flexibility in areas they do not consider of true importance, such as tucked in shirt tails.

Flexibility in scheduling may be another component of public alternative schools. For example, in Arizona, students can get academic classes in the evening or on weekends or even through teleteaching. The alternative high school in Billings, Montana, offers courses on a trimester basis. In this way, a student can take more courses during a school year and graduate from high school sooner or make up credits more readily. In the Billings program, students can also go to school part time and work part time. In some instances, school credit is offered for working in community businesses.

Another critical goal of public alternative schools is to get the student back to the general education setting. Often this is accomplished by helping the student make the transition in a series of steps--as the student maintains success in the most restrictive environment, he or she is moved to a less restrictive alternative school and then to the home school.

In other districts, students may graduate or receive their GED from a less restrictive alternative school.

The success rate in public alternative schools varies. In some, students would be successful if they could continue at the alternative school but have difficulty when they return to their home school. Others, such as the Des Moines alternative school system, have a high success rate--approximately 76 percent of the students in the program return to their school and complete their educational programming.

Interest in Alternative Education Growing in Montana

Educators, parents, and students are expressing growing interest in educational alternatives, especially for high school students. Many adolescents do not seem to fit into the standard program of small comprehensive high schools which are the norm in Montana. Some students are expressing a need for more sophisticated vocational training than can be offered in their smaller high school; others yearn for more flexibility in how high school graduation is achieved. Still others would like to make use of technology to tap into specialized coursework that cannot be offered in a public school for just one or two students. Gail Gray, Assistant Superintendent of Public Instruction, has convened a task force to look at alternative school options. Those interested in finding out about options for alternative education in Montana can contact Ms. Gray at 1300 Eleventh Av., Helena 59620-2501.

New Drug for JRA

The Food and Drug Administration is now reviewing pediatric data on etanercept, a novel treatment for rheumatoid arthritis (RA) approved in November 1998 for use in adults with moderate to severe RA who do not respond adequately to methotrexate or other antirheumatic drugs. Entanercept, marketed as enbrel, inactivates tumor necrosis factor (TNF), one of the cytokines involved in the inflammatory process responsible for RA symptoms and joint damage. In studies of 54 children aged 4-17 with moderate to severe JRA who could not tolerate or did not respond to methotrexate, 76% improved after 3 months of using etanercept. The FDA is now considering approval for use of etanercept in children aged 4-17.

Classes on Increasing Your Learning Skills Offered at the Montana Center

The Montana Center on Disabilities is offering strategy sessions for high school students and adults taught by Gail White, a specialist in teaching learning strategies. Each session teaches practical, hands-on techniques for improving test taking, writing, and memory skills. Cost is $20 per session and registration is limited to 10 participants per session. The schedule of sessions is:

March 2 & 4, 5:30-7:30pm

April 6 & 8, 5:30-7:30pm

For more information contact the Montana Center on Disabilities at 657-2312 or 1-888-866-3822.

Prevalence of Fragile X Syndrome Appears to Be Declining

Fragile X, the most common inherited cause of mental retardation, may be on the wane. Medical reports are showing fewer new cases of Fragile X Syndrome and recently published estimates of the prevalence of the syndrome have been revised downward from 1 in 1,000 to 1 in 4,000 males.

This apparent downward trend is probably due to several factors working in concert, including the nationwide effort to perform DNA testing for Fragile X syndrome in all individuals having mental retardation with no apparent cause along with the availability of prenatal diagnosis and the option of pregnancy termination.

Additionally, genetic counseling of carriers and relatives of affected individuals has undoubtedly resulted in a substantial number of reproductive decisions not to have children. Also, some permutation carriers who have elected to delay having children may have had the parenting decision taken out of their hands since premature ovarian failure is associated with being a premutation carrier.

HONOR ROLL

The following educators have earned a place on the PLUK Honor Roll for their exemplary service to children with special needs. These individuals have been nominated for honor roll status because they have gone the extra mile for a student or students who needed special help to do well in school. Below each name is a quote from the letters of nomination.

George Day, Billings Skyview High School, Guidance Counselor

"George makes a personal connection with everyone he meets and leaves a warm and friendly feeling behind. Following up and following through are two of George's strengths. ..George has attended meetings off campus to follow my daughters case, he has organized meetings with her teachers, and contacts us regularly with options and updates. George's interest in our daughter's development, safety and education is delivered with a caring attitude that builds our trust and our daughter's self image."

Paul Johnson, Principal, Big Sky High School, Missoula

"Mr. Johnson clearly cares about all the students in his school. He sets a great personal example by treating students with disabilities with respect and compassion. Mr. Johnson makes certain that students with disabilities receive the services they need, not because he has to, but because he wants to. Paul Johnson is the kind of administrator I'd like to see in every public school."

If you know of an educator who deserves to be on the Honor Roll, send your nomination to PLUK, 516 N 32nd St, Billings MT 59101. Those recognized on the Honor Roll have their names published in PLUK News and receive an Honor Roll certificate and a personal thank you note from PLUK.

End of the PLUK NEWS December 1998/January 1999

Copyright © 1999 Parents, Let's Unite for Kids, all rights reserved.