Parents are frustrated. Teachers are frustrated. Clinicians are frustrated. The problem? How can we get the "system" to respond to our needs? How can we get a grip on the huge array of services "out there" that are suppose to serve mentally learning handicapped children?

     This document attempts to answer that question, at least to a degree. The purpose of this document is to offer a framework for conceptualizing the process of pursuing services that in the end will in fact help you as a care provider secure the information necessary to help children.

     The ensuing discussion is broken down into three sections: (1) the Context; (2) the Problem; and (3) the Solution. The presentation relies on a metaphor, viewing the issue as a "service delivery exercise" played out in a sports stadium-like arena.

(Goto Section #2 now     Goto Section #3 now)

Section 1: The Context

Let's set the stage first and then look at it rather closely. Picture a huge stadium, complete with a very large seating capacity and huge green grassy field in the midst of that stadium.
     The stadium is called PL94-142 [PL105-17/ IDEA]. The purpose of the IDEA Stadium as a structure is to embrace, protect, and assist all the people allowed through the various entry gates and onto the restricted green "playing" field in the middle of the stadium.
     The entry gates are many and each entrance is well labeled: MR, LD, Autism, ADD/HD, ED, Rett's Disorder, Aphasia, Asperger's Syndrome, Stuttering, Expressive Language, Speech/ Language Impaired, PICA, Physically Impaired, Rumination, Tourette's Syndrome, Enuresis, Epilepsy, Visually Impaired, Multi-Handicapped....
     On approaching and then entering the stadium, a several eye-catching conventions capture our attention. (1) Every label/category/diagnostic category covered by federal law has its own entrance into the stadium, with each passage clearly marked. (2) Each label or category boasts its own statium section. (3) Those stadium sections are also clearly marked and brightly color-coded. (4) All around the IDEA Stadium are large flags that declare: "Let Each Become All (S)he is Capable of Being". Heck, it's all enough to make John Dewey -- American educator par excellence -- burst with pride that his teachings and counsel were not in vain.
     As caregivers and caretakers (however defined for the sake of brevity), you and I are thankfully allowed into the stadium. Eager to learn more, we make our way quickly toward the center of the huge field and find ourselves staggering a bit as we stare in total amazement at the vast number of huge gaudy banners vying for our attention atop this quite intimidating IDEA Stadium. So many banners indeed -- "Early Intervention." "Assessment." "Teamwork." " "Interdisciplinary." "Data Collection." "Differential Diagnosis." "Parent Conferencing." "Networking." "Followup." "Generalization." .... so much to try to understand! And yes, so little time. How do we harness all this information? How do we make it all work?
     The enormity of it all is overwhelming. The IDEA Stadium and all that it represents offers us insight, if only we will grasp it. Happily, as we and thousands of other care providers stand awestruck in the center of the Stadium pondering the sheer vastness of this protective womb-like stadium, a quiet sense of logic warmly emerges and wraps us in ever-growing confidence.

This IDEA Stadium sets the parameters or boundaries of the "special education context."
     True: there are few absolutes in life; nothing is 100%. There are no miracle "cures." Everything is relative and human effort is defined by the context in which events occur. Not surprisingly, given the clever layout of the stadium, the banners that rim the top of the IDEA Stadium help define that context. Blown to and fro in those rampant winds, the banners still manage to maintain their steely form as they exalt the many procedures which the federal regulations embrace and enforce within the special education context.
      The vastness of it all gives pause. Gazing at those "markers" far away atop the stadium, we take a moment to ponder the effort IDEA legislation has made over the years to assist those for whom we caring providers are responsible. Within this light of reason, the banners seem to imply a sense of order. Indeed, looking more closely now at the way those banners are laid out, we notice straightaway that the largest and by far the most brightly colored banner atop this protective stadium and thus

          clearly #1 is

           ASSESSMENT

The next largest banner displayed atop the stadium and thus

          clearly #2 is

               Interdisplinary Teamwork

The third largest banner fluttering further off to one side and a bit lower than the other two atop the stadium and thus

          clearly #3 is

                    Data Collection

The fourth largest banner is fluttering a bit further off to one side and lower still than the other two atop the stadium. It is

          clearly #4 is

                      Differential Diagnosis

Finally, there is a fifth banner waving in the wind, pleading for our attention. True, this banner is a bit smaller than the rest, but it still waves boldly in the win and forces us to reflect on its importance. This last banner is

          clearly #5 --

                             Follow-up

The logic of IDEA is inescapable; the procedures make sense:

     Assessment

          Interdisplinary Teamwork

               Data Collection

                    Differential Diagnosis

                         Follow-up ....

     Those banners are well-positioned indeed. And we aren't silly. We get the point straightaway; it's hard not to! First and foremost is the importance of Assessment. Then, IDEA is telling us that assessment is perhaps best served by enlisting a team to carry out that assessment. The team should consist of skilled professionals representing several disciplines. The information collected from this interdisplinary team assessment will result in a differential diagnosis of what -- if any -- the learning problem is. If indeed the child at issue is found on the basis of the data to have a learning problem, follow-up efforts on the part of the team or team leader in consultation with the care provider will suggest a variety of options to pursue to enlist services required. It makes sense. That is the purpose of the IDEA Stadium and all those regulations it encompasses and those bannered-procedures the IDEA Stadium embraces and supports (and enforces!). It makes sense -- well, almost.

(Beginning          Down to Solutions/Section #3)

Section 2: The Bull-horn Problem

So, how do we make "the system" work for us? As a parent, guardian, care provider -- how do we get all those banners to work for us? Our IDEA Stadium does its best to embrace us and protect our rights to FAPE (Free and Appropriate Free public school Education). The keyword, of course, is appropriate.
      How do we locate appropriate services so that our child will receive appropriate education? How do we translate the ideals of IDEA into a workable plan or program that will ensure that much-needed services are in fact delivered to the children we serve? After all, that is the the reason we showed up at the IDEA Stadium in the first place! We need answers. We want services. The problem is how to find those services....

     Try looking at the service-delivery problem this way: There are hundreds of thousands of individuals sitting dutifully in their designated seats in this vast stadium. Each person has a bull-horn, turned on, at full volume. There are graduate students. There are graduate students acting as mouthpieces for cutting-edge professors and researchers. There are, indeed, a few leading profs, a few productive researchers who have come on down from their proverbial Ivory Towers to join the real-life street-level struggle for change. In the stands there are also "opinion leaders" who may or may not have a clue what they are talking about, but nonetheless exercise their right to push one self-serving point of view or another. In the stands there are advocates of a "miracle" diet, a "proven" medical remedy, a "revolutionary communication approach," a new therapy or intervention that turns out to be old wine in new bottles...

      For better or worse, each person seated in the stands has a nametag -- yes, along with that poised bullhorn. The name-tags themselves are interesting, if tiresomely repetitious: "Behavioral approach." Psycho-dynamic approach." "Recovered autism." "Facilitative communication." "Chromosome-linked therapy." "Computer-based instruction" (yeah!). "Encounter this-group therapy." "Doman-Delecato." "Montessori." "Structured Tactics." "Diet-based soybean intervention." "Believe-in-me group" …. My god, we wonder, who's right? Surely not everyone has the "right" answer!

     So many people. So many instant experts. So many "proven" techniques. So many people trying to bullhorn their way to importance. So many mantras with so little data! And everyone seems so serious, so intent, so convincing, so ardent in their plea for us to give their approach, intervention, remedy, or cure a try. Amid it all, the stadium stands strong. Firm. The banners wave boldly. The structure remains solidly in place, rising above it all. Clearly it is up to us as logically thinking, care-providers to decide for ourselves where we will sit in this vast stadium. Amid the crushing din of blaring bullhorns, we resolve to keep in mind the five banners above us that point the way toward truth as we stroll around the arena, listening to the pitches and marveling at the zeal of it all...

Thankfully, we caregivers/caretakers have come to the IDEA Stadium at least partially prepared for the onslaught of service delivery "alternatives." We know, for example, that there is good reason why those blaring come-to-me electronic mouthpieces are aptly called bullhorns! We know there is a process and a well-founded set of procedures can help us, but only if we will listen to "reason." To learn and to succeed, we surely must act responsibly -- if we expect the system to work for us. True: Everyone in the stands has a right to be heard. And we have an equal right not to listen. Or better yet, we should listen mostly to those who make the most sense. And those who make the most sense are those who embrace the laws, the regs, and the procedures that form the super-structure of this magnificent IDEA Stadium.

We want the system to work for us?! It ain't easy if we ain't listenin'!

(Beginning       Up to Bullhorns/section #2 )

Section 3: The Practical Solution

How do we make "the system" work for us?

     If you visit the section of the IDEA Stadium that reflects and underscores those five banners waving in full glory above the Stadium, at least one practical solution stands above and beyond the din. At least the following set of procedures become obvious.
      Step 1. Conduct two independent, multi-disciplinary assessments leading to a differential diagnosis. The multi-discipline team would include whatever the federal regs suggest, and perhaps additional members as well. Start with the professionals who know the child best (parent, pediatrician) and work from there. Perhaps also included on the team might be a dietician, behavioral psychologist, speech/language therapist, child development expert, social worker (who has knowledge of various agencies/ facilities in your area), well-known special education teacher, and so on.
      The two assessment procedures would involve of course separate team members hopefully unknown to one another and unaware that the other assessment has been or will be conducted.
      Step 2. Obtain a differential diagnosis. And one possible outcome/differential diagnosis might be "no problem." Or the differential diagnosis might find, "need for attention." Or, "simple growing pains." Or, "need for contingency contracting."
     Indeed, it may well be that after everything is said and done, "Johnny just needs a big cheeseburger and a big hug and heaps of big smiles and tons of social praise; he's just having a few growing pains right now."
     If you came to my seat at the stadium, I would not be all that keen to conclude anything "bad" or "special" or whatever until the assessments had been conducted and the differential diagnoses made. But I would be quite quick to suggest that you be quite prepared to accept that perhaps nothing is particularly awry and that the teams might even go so far as to suggest you wait a year.
     At any rate, you would leave the area of the stadium well aware that two independent

multi-disciplinary

assessments should be conducted leading to

differential diagnosis that might conclude that nothing is wrong

just as convincingly as any conclusion that something is "wrong."

     Step 3. Expore intervention paths -- the logical result of the two differential independently determined differential diagnoses. Each team on its own would suggest a "remedial plan of action", if warranted, based on the information collected and discussions held. The care provider will be given a set of very specific suggestions: Educational, Behavioral, Social, Psychological, Leisurely …. and so on. Depending on the extent to which the two independent diagnoses concur, the care provider will end up with a portfolio of specific recommendations on where to go when you leave the IDEA Stadium.

     Step 4. Network! Make the most of the information collected during the Intervention Planning step. Discover what's available locally. Ascertain rights and recourse in case something goes awry at some future point. Keep abreast of the research literature. Learn to know!

     Exiting....Where one stands depends on where one sits in IDEA Stadium. Seated in the stands is a vast amalgam of graduate students, experts, practitioners, writers, consultants, doctors, therapists, and …. -- all of them bullhorn-driven advocates of hundreds of therapies, interventions, schemes, get-well-quickly fixes.
         As we leave the Stadium, we leave feeling better about it all. We have a framework within which to understand the rights and remedies protecting special education. We have learned about a practical approach to problem-solving which federal law embraces and supports. We know a whole lot more about the importance of being informed about what the published research offers to those who care -- and what interdisciplinary teams have found works and does not work. And yes, as we leave the Stadium, we have learned one other lesson as well: If we fail to "get the job done," we might want to consider pointing fingers at the mirror rather than at others. There is a lot "out there" just waiting to assist us. Time to get at it.