Preparing for an Educational & Vocational Future after a TBI

1. Preparing for an Educational & Vocational Future after a TBI www.cincinnatichildrens.org

2. DisclosureSharon Ramey, MSWMarcie Mendelsohn, BSENo Disclosures

3. Discussion of Educational/ Vocational Transition High School Post High School

4. What do we do? Transition Clinic Assist young adults (age 16 and over) with brain injuries, chronic illnesses and disabilities to generate a plan that addresses: • Educational Goals • Vocational/Training Programs • Employment Goals

5. Why are we doing this? Employment and Disability Just over 1/3 of people ages 18-64 with disabilities are employed compared to more than ¾ of those without disabilities. 2004 National Organization on Disability/Harris Survey of Americans with Disabilities

6. People with disabilities are less likely to have completed high school than are those without disabilities. 2004 National Organization on Disability/Harris Survey of Americans with Disabilities

7. Who do we work with? • Patients 16 years old or older. • Must have chronic illness or disability.

8. How are individuals referred to us? Patients are referred by a CCHMC physician or healthcare provider

9. What is Transition? • Transition is alifelong process, not an event • Multifaceted, active process. • Attends to the medical, psychosocial, educational and vocational needs. • Involves adolescents as they move from child-oriented to adult-oriented lifestyles and systems. • The adolescent and family must be involved in the decision process. • Families look toward independence. • Coordination of services and providers is essential.

10. Creating an Employment Vision for the Future: Age 6-11 • Teach self-care and basic grooming. • Encourage the child to accept himself. • Teach personal safety. • Talk about dreams and aspirations. • Promote leisure activities. • Encourage and support friendships and social opportunities. Paving the Road. LYS

11. Help decision-making by giving structured choices. • Help the child learn to solve problems. • Let the child learn the consequences of their • behavior. • Assign chores appropriate for the ability level. • Ask “What will you want to do when you grow up? • Avoid the “sympathy card”. • Paving the Road. LYS

12. Creating an Employment Vision for the Future: Age 12-18 • Continue development of typical self-help skills as well as skills related to special health care needs. • Help develop a realistic vision for the future. • Continue to encourage hobbies, leisure and social activities. • Continue to assign progressively more difficult family chores. • Identify strengths and weaknesses. • Explore job opportunities. Paving the Road. LYS.

13. Encourage work and/or volunteer activities in the community. • Provide opportunities to manage money. • Encourage participation with peers separate from family. • Explore and understand adult service options. • Place child’s name on appropriate waiting lists. • Begin to plan for living independently.

14. Creating an Employment Vision for the Future: Young Adult • Develop self-determination skills. • Explore adult education opportunities and training. • Learn about eligibility for services. • Set up a personal bank account. • Plan for living independently. • Join community clubs, interest groups, support groups. • Learn to cook, clean, wash clothes.

15. Assist the family and patient to look at the chronic illness or disability from multiple points of view and determine what the patient “should do”. Specialized Testing

16. Neuropsych Testing • In-house testing • 1 year post injury • Up to date testing based on individual progress • Re-testing recommended during transition years

17. High School

18. High School Education • IDEA/504/IEP • Private Schools • Charter Schools • Home Schooling • Deferred Graduation • College

19. Individuals with Disabilities Education Act (IDEA ) The Individuals with Disabilities Education Act (IDEA), is the landmark special education legislation that requires states to provide special education and related services to children and youth with disabilities, age 3 through age 21. CCHMC Special Needs Directory

20. 504 Plan • Comes from the Rehabilitation Act of 1973 • The child may receive accommodations and modifications even if he or she does not qualify for special education. American Partnership for Eosinophilic Disorders www.apfed.org/downloads/IEP_and_ 504.pdf

21. IEP • What is an IEP? • IEP stands for Individualized Education Program (IEP). • The IEP is a written document that describes the educational plan for a student with a disability. • IEP talks about your disability, what skills you need to learn, what you'll do in school this year, what services your school will provide, and where your learning will take place. http://www.ldonline.org/article/5944

22. Progress Meetings vs. IEP Meetings Last two years should be having progress meetings, along with your yearly IEP meeting

23. What should you be discussing? Self Advocacy Independence Medical care issues Deferred Graduation Work-study/life skills Employment Tours (colleges, vocational programs) Referrals

24. IEPTransition to Adulthood School Years vs. Real World • School: Meet IEP Goals and Accommodations • Real World: Employer Expectations and Self Advocacy • Be Clear about Goal! • Work or Academics?

25. Get Velcro Shoes!!!

26. Differences between Public School and Private School • Private school children with disabilities do not have an individual right to receive some or all of the special education and related services that the child would receive if enrolled in a public school. • Public Schools are required by law to provide services. • Typically, Private Schools are not aware of transition services available.

27. Home Schooling • Dramatic increase in the number of students with disabilities and chronic illnesses who are being home schooled. • MUST be set up through local school district or state in order to be valid. • Rules vary from state to state

28. Charter Schools • State-funded public schools that operate outside of the traditional public school system. • Fewer rules and regulations to follow in such areas as curriculum, grade levels and length of school year. • They must follow all state and federal laws related to special education, including IDEA and Section 504. CCHMC Special Needs Directory, http://www.cincinnatichildrens.org/svc/alpha/c/special-needs/resources/education/private-schools.htm

29. Deferred Graduation • Can receive services until they reach age 22 as long as the students have the required high school credits • They can "walk through" graduation with the rest of their class but defer receiving their diploma until they complete transition classes, job training programs or vocational school. This should be part of the IEP transition plan. • The advantage to the student is the continued support for a free appropriate public education, special education and related services. These protections will not be provided after graduation. • **Requirements differ from state to state.

30. Deferred Graduation OPTIONS Vocational School Transition Program Individualized Program (1-3 years) Can accept diploma anytime/academics are completed

31. Kent State University Research 1999 Students with disabilities and chronic illnesses who completed vocational training programs are nine times more likely to report being employed. Bob Baer

32. College (Preparing the High School student for College) • Senior Year • Evaluate IEP goals • Make sure that student is prepared to enter college • Self Advocacy • ACT/SAT • Placement Test (2 year colleges) • FAFSA (Must be completed for admission to college) • Referral to BVR • Testing • College Tours

33. College Disability Services • Each college/university has an office • Eligibility Criteria: • Application • Professional documentation of disability • List of HS accommodations • HS transcript

34. ACT/SAT Accommodations School must fill out paperwork to get accommodations Some accommodations include: scribe extended time breaking up the testing days separate testing room

35. Placement Test Every 2 year college requires taking an placement test to help you and your advisor to choose classes that meet your educational needs.

36. College Tours • What are your needs? • housing • transportation (on and off campus) • Accessible room • Think reasonable for yourself • What works best for you?

37. Post High School

38. College-2 year • Placement Test required • Developmental classes • Smaller classes • Smaller campus

39. College-4 year • ACT/SAT required • Larger classes • Larger campus

40. Office of Disability ServicesRequested Information • Current documentation from Health Care provider • Clearly state the diagnoses • Explain the limitations • Historical information • Medications and Treatments • Recommendations for accommodations Southern M et al. 2007

41. College • Why is it important to declare yourself to disability services?

42. Current documentation Clearly state the diagnoses Explain the limitations Gross Motor Mobility Accessibility (dorm room, class room) Transportation Dexterity/Fine motor Attention/Learning Social/Psychological Historical information School IEP Most recent testing Previous services Medications and Treatments Potential impact in educational setting Recommendations for accommodations Physical/structural issues Learning issues Note takers Books on tape Proofreader Scribe Extended time on tests Individual room for tests Tutoring Office of Disability ServicesRequested Information

43. In college, if the student doesn’t ask for help, they are not going to get help. And they must declare themselves to the Disability Services Office before the first day of class in order to receive accommodations throughout the year. Waiting until the day of the test won’t work. Self Advocacy

44. In College: Accommodations-YES Modifications-NO

45. Lessons Learned: College www.heath.gwu.edu/index.htm National Clearinghouse on Postsecondary Education for Individuals with Disabilities www.thinkcollege.net Searchable database postsecondary education programs that support youth with intellectual disabilities www.ed.gov/about/offices/list/ocr/transition.html US Dept of Education Office for Civil Rights

46. GED Almost twice as many students with disabilities and chronic illnesses drop out as compared to students without disabilities. Such students are less likely to ever return to school and are more likely to be unemployed. National Council on Disabilities, 2000.

47. GED Issues • Must be 18 years of age or have school superintendent signature (varies by state) • Program Location • Pre-GED test • Difficulty of test • Diploma jobs vs. non-diploma job (hospitals require GED or High school diploma)

48. Community Resources/Agencies Rehabilitation Services Commission (RSC) Bureau of Vocational Rehabilitation (BVR) BVR=WORK must have barrier to employment *name varies from state to state*

49. BVR • Funding source • Contract with agencies to provide services • Individualized Program

50. What are some things BVR can do to assist? • Assessments/Evaluations • Educational Evaluation • Community Based Assessment • Job Shadowing • This process is to evaluate each individual’s skills and interests.