Q&A with Desiree Q. Luong, M.S., TMHP
Recently we spoke with developmental behavioral specialist, Desiree Q. Luong, about the current system of government agencies and public schools that oversee services for children with developmental delays. She answered questions for us about one of the most challenging transitions for young children: when a child turns 3 years old and those services become the responsibility of the school districts.
Q: Why would a child’s coverage and services change at age 3? (What’s the difference between Part B of IDEA and Part C of IDEA?)
A: The Individuals with Disabilities Education Act (IDEA) is a federal law that ensures services for children with disabilities, throughout the nation. Part C of IDEA is known as “early intervention,” and serves children—from birth up to 3 years of age—who are at risk of a developmental delay. Part B of IDEA, known as “special education services,” serves children with a disability from age 3 up to 21 years of age.
Part C and B require that all children receive an individualized plan to help them make progress. In Part C, the plan is called the Individualized Family Service Plan (IFSP), and focuses on the needs of both the child and family. In Part B, the plan is called the Individualized Education Plan, focusing on the needs of the child, to allow the child to participate in the general education curriculum, to the maximum extent possible.
Q: Do you know of any states with a similar Regional Center setup, like California’s?
A: Every state has a similar lead, umbrella agency serving people with developmental disabilities. Like California, there are some states with regional centers serving as local resources to connect individuals with developmental disabilities (and their families) to services and supports. In most states, there are lead agencies or centers with policies and procedures to ensure a smooth transition from early intervention services under Part C of IDEA to special education services under Part B of IDEA.
Q: How would you sum up the difference in how a regional center works with kids who face delays, and how the school district approaches therapy/working with kids?
A: One of the biggest noted changes when a child and family transitions from early intervention to school district services is moving from a family-centered approach to a child-focused approach, respectively. While early intervention addresses childrens’ overall development, and goals and outcomes, based on developmental deficits and family priorities and concerns, special education focuses on providing children with an education. The IFSP offers learning opportunities that take place in a child’s natural environment (e.g., park, library, home, etc.), during everyday routines and activities; an IEP contains goals and objectives regarding how to meet the needs of a child in contrived and formal environments limited to school.
Q: Are there cases in which the regional center is still involved with a case, instead of handing it over entirely to the school district?
A: To some extent, yes. To qualify for regional center services, the center provides a diagnostic and eligibility assessment, and then offers a range of programs based on test results. In California, when a child transitions from Part C to Part B of IDEA, regional centers might offer service coordination for individuals from ages 3 up to 22, to fill gaps that are not provided by the school, medical insurance, or other services available; regional centers cannot duplicate services that are provided by another source, such as psychiatry (covered by medical insurance). A child’s individualized needs are outlined in an Individual Program Plan (IPP) that is reviewed every one to three years. The IPP is tailored to each individual and situation; therefore, two children with the same diagnosis may receive a broad variety of services.
Q: What should a person do to prepare, insurance-wise, for the transition?
A: When a child qualifies for early intervention services (Early Start in California), public or private insurance is first accessed to pay for medically necessary services, such as speech and language, physical, and occupational therapies. Regional Centers in California are prohibited from funding a service that is available from private insurance or a health care service plan. However, if insurance companies fund fewer sessions than the IFSP recommendations, or insurance-based services are exhausted before a child exits early intervention, parents should contact the child’s service coordinator to review options.
For families wishing to access medical-based services after a child graduates from early intervention, it’s advisable to seek a prescription for recommended service from a pediatrician as soon as possible, to avoid disruption or breaks in services. Sometimes it is necessary to be on a waitlist for recommended services, so it helps to start that as soon as possible. In my experience, children with a medical diagnosis of autism are waitlisted for at least six months after their insurance/diagnostic evaluation; for there to be continued therapy for a child with autism, a diagnostic assessment should take place well before a child turns 2 ½ years of age. However, if an early intervention program also offers insurance-based programs (e.g., ABA services), a child on the autism spectrum would likely stay with the same agency and receive a smooth continuation of care.
Q: What are the biggest adaptations kids face during this transition? For children in home-based programs, the switch to a class must be huge.
A: Imagine starting a new job, or finding yourself in a new country and culture for the first time. It might be scary to think about how you’d fit in and how you’d adjust to new people, schedules, and settings. Or you might be someone who’s inspired by change, and can handle new situations better than some. For children, it is no different. Some children adapt faster and better than others who might have separation anxiety, do not like change, or are immersed in an environment that is not fully supportive of their needs. Because children respond differently to a new environment, there isn’t an all-encompassing “challenge” for every child transitioning from home-based services to school-based services. However, knowing some of what to expect might ease both parents and children’s anxiety during the transition phase.
Here are a few tips to ease your child into a new environment:
- Use developmentally appropriate ways to let your child know about the change (e.g., read a social story or book, talk or roleplay it out, etc.)
- Replicate the school schedule and traditions, at home (e.g., free play, circle time, washing hands, snack time, etc.)
- Introduce your child to new people often, setting up play dates in different environments, enrolling your child in half-day or full-day camps, and going to the library for “circle time.” When children have the opportunity to experience different conditions, they start to learn how to cope with different emotions deriving from stressful and overwhelming situations, as well as exciting and joyful experiences.
- Practice going to school before the first official day. Pack a backpack, drive to the school, and play outside of the school. If possible, tour the school and specifically, his own classroom, so that your child gets familiar with the surroundings before it’s full of kids and noise, and your child has to be anywhere on time.
- Play “school” during early intervention!