By Pamela P. Siller, MD
There is a common misconception that if a child attends a yeshiva, he is not eligible to receive services from the Department of Education (DOE) within the five boroughs of New York City. As a psychiatrist who provides services for the DOE, I have been able to provide assessments in yeshivas, as well as in public schools.
Consider the following scenario:
Jacob is a nine-year-old boy who attends a yeshiva in Queens. Although he has been acting out for several years, his behaviors have become more aggressive following the divorce of his parents. His disruptive behaviors were initially confined to the home. However, for the last two months, he has been lashing out in anger at his peers and teachers. Parents have been angrily calling the principal demanding action, as their children have been pushed, pinched, bitten or kicked. Additionally, Jacob has begun to run out of the school building. He has been in and out of therapy for three years, with no noticeable improvement. He has been on different medication trials, but his improvements are sporadic, and he decompensates when his home life becomes chaotic. At this time, Jacob is unable to stay in school for more than two hours at a time without his parents being called to pick him up. His yeshiva has asked his parents to pay out of pocket for a “shadow,” or he will not be allowed back into school.
Although many parents do take this route, there are other options. Unfortunately, many parents are unaware of the services provided by the Department of Education (DOE), and/or how to access them. If deemed appropriate, the DOE will pay for a 1:1 para-professional to alleviate safety concerns, regardless of the school a child is in. Elopement, aggression and self-injury are all safety concerns. Additionally, if needed, occupational, physical, and speech therapies can all be provided free of charge. At times, social skills groups and/or play therapy may be warranted.
Accessing Services
The first step in accessing these services involves contacting the CSE – Committee on Special Education. A meeting must be scheduled, and all providers, clinicians in the school, and parents may attend. If an outside provider cannot be available in person, a phone conference can usually be arranged. If it is determined that the child meets the criteria for special education, an IEP (Individualized Education Program) is then formulated.
How should a parent request a CSE meeting?
- Always make a request for a CSE meeting in a letter addressed to the CSE chairperson
- Notify school district in writing if you intend to bring an attorney to the meeting
- A parent member will attend the CSE meeting unless the parent of the child declines a parent member in writing
The IEP
The criteria for special education includes what is called the Two Tier Test: (a) a child with mental retardation, hearing impairments, speech or language impairments, visual impairments, serious emotional disturbance, orthopedic impairments, autism, traumatic brain injury, other health impairments (includes ADD), or specific learning disabilities (includes dyslexia), and (b) who, by reason of the disability, requires special education and related services.
The IEP is a written statement for a child with a disability that describes special education programming and related services designed to meet the unique needs of the child.
The IEP must include: a statement of the child’s present levels of academic achievement and functional progress; measurable annual goals that are designed to enable the child to make progress in the general education curriculum; a description of how the child’s progress will be measured; measurable post-secondary school goals.
How should a parent prepare for and participate in a CSE meeting?
- Prepare a meeting agenda with the three most important things that you hope to accomplish
- Spirit of collaboration
- Listen to all CSE members
- Assert yourself and redirect members to the purpose of the meeting outlined in the meeting agenda
- Remember, the parent is a member of the CSE and must be afforded meaningful participation.
At times, further testing is needed to determine the exact nature of the child’s difficulty, and/or rule in/out the presence of a mood disorder, autism, or ADHD (Attention Deficit Hyperactivity Disorder). To this end, the DOE may pay for a psychiatric evaluation, a neuropsychological evaluation, or an occupational, physical and/or speech therapy evaluation. The evaluator may come to the child’s school, or they may ask you to bring him/her to their private office. If you are not in agreement with the recommendations or findings of the CSE, you are entitled to an Impartial Due Process Hearing which allows for parents and school district to bring a dispute in front of an Impartial Hearing Officer (IHO) for adjudication.
As a provider for the DOE, I am flooded with requests for psychiatric evaluations. At the time of the assessment, I will interview the child, speak with his parents, school psychologist and/or guidance counselor. Based on the above, I will make recommendations which are felt to benefit the child. If a learning disability or other diagnosis is in question, I may recommend a neuropsychological evaluation or further testing. I will also reiterate the need for a 1:1 if there is a safety concern, as described above.
As Jacob in the above scenario was seen in my private practice for medication management, a new psychiatric evaluation was not needed. I was able to participate by telephone in the emergency CSE meeting which was held less than a month after it was requested. The DOE is now paying for a 1:1 to assist with focus, and frustration tolerance. He no longer attempts to elope from the school. When agitated, the 1:1 will take him for a walk until he can safety rejoin his class.
If your child is struggling in school or is having difficulty mastering age-appropriate milestones or activities of daily living, do not hesitate to speak with his/her guidance counselor or school psychologist. Additionally, consult with his/her outside mental health providers if needed, or request a consultation. You can also speak with the CSE directly, and/or request a meeting to discuss your concerns, so that additional services may be implemented.
Pamela P. Siller, MD is a board-certified child, adolescent and adult psychiatrist who provides medication management as well as individual and family therapy to children and adults. She maintains a private practice in Great Neck, New York. Dr. Siller is also the director of child and adolescent psychiatry at the Interborough Developmental and Consultation Center in Brooklyn. She is an assistant professor of psychiatry at New York Medical College. Dr. Siller can be reached at 917-841-0663.