Education

PPS, Parents At Odds Over Providing Autism Therapy In Classrooms

By Rob Manning (OPB)
Portland, Ore. Jan. 23, 2018 2 p.m.

Tatianna Terdal’s son is exceptionally bright — and has special needs as a kid on the autism spectrum.

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He’s in the place that educators and parents tend to prefer: a regular classroom. But his behavior can distract his teacher and classmates. And Terdal said he’s clever enough to use his outbursts to get what he wants: to be left alone, to read.

Related: Navigating Life On Campus When You're On The Autism Spectrum

"All he has to do is be disruptive in class and both his teacher and his para-educator will give him a bunch of books, set him in the corner, and he'll be there reading all day," she said. "The teacher is happy because he's not disruptive, the class is silent, [my son] is happy because he's able to read all day. But it's not in his best interest, and he is not learning anything new."

Public schools are required to work to meet the individual needs of children who need special or additional supports, and school support systems have evolved to include plenty of services that aren't traditionally academic in nature. Special education is about finding the right individual fit, within the school's resources.

Anna Lawler also has a son on the autism spectrum who is bright — bright enough to qualify for Portland's ACCESS Academy for talented and gifted students. Lawler thought she had the right fit for her son a few years ago. After Oregon lawmakers mandated that health insurers cover an autism therapy called Applied Behavior Analysis, or ABA, Portland Public Schools allowed therapists into schools.

Lawler said that approach worked well for her child.

"The teacher was so thankful for that, and so was the administration," she said. 

ABA is a system intended to improve a range of skills and behaviors, from social interaction to academics to motor skills. Therapists start by setting goals and creating incentives to motivate kids to work on skill development.

They focus their teaching on the goals, often by emphasizing repeated practice. Along the way, therapists are expected to carefully document progress and problems their patients encounter.

Portland special ed attorney Diane Wiscarson said ABA works because it's proactive, rather than reactive, like many methods used in public schools.

“If somebody hits another student, then there’s going to be a consequence; they might be suspended, right?" Wiscarson said. "But ABA seeks to look where those areas of deficit and weakness are before they become a problem.”

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Related: A School District Dilemma: How To Transform, While Rebuilding Trust

But recently, Portland Public leaders reduced the therapists' access from 10 or more hours a week to two. The district also limited therapists to observation and data collection, rather than direct interaction with students.

The Lawlers and Terdals are among about 20 Portland families whose insurance was funding ABA therapists in local public schools.

A few of those families are considering taking their kids out of their local Portland school. The Lawlers and Terdals are trying another approach: They've filed a legal complaint against the district under the Individuals with Disabilities Education Act, contending their children are being denied the free and appropriate education guaranteed by law. They contend that denying ABA is akin to not providing medicine to a medically fragile child.

Portland’s special education director, Robert Cantwell, said the better analogy is speech therapy.

"No private speech therapists provide their services directly to students in the school setting," Cantwell said. "We just see those two types of work as distinct and separate.”

Cantwell said Portland Public Schools has six trained coaches and many teachers and para-educators working in schools to help students on the autism spectrum.

Oregon has more than 9,000 students on the autism spectrum in its public schools, and they represent one of the fastest-growing disability groups in the state. Serving Portland's roughly 800 students with autism fits a similar pattern for all kids with special needs, according to the PPS director.

"Our charge is to figure out what the learning needs are of each of our students in this district, and figure out how to meet those needs," Cantwell said. "And I think we do that really well."

The families point out PPS staff aren't certified in ABA. But autism coaches like Jennifer Caslavka contend the district draws from the same well of successful strategies as ABA therapists. Repeated practice, setting goals and documenting progress are part of what teachers and para-educators are trained to do, too.

"Generally, our work is driven by these 27 evidence-based practices that the National Development Center developed in 2014. We really drive our work to coach and train — and a lot of those fall under the ABA methodology," Caslavka said.

The proper role for outside therapists — whether they're doing speech therapy, ABA or intervening on other difficulties — is to consult and share information, according to PPS autism coach Rebecca Baker.  

"I think that having that whole picture of the child and understanding them across all settings is beneficial," she said. 

But the families, led by the Lawlers and Terdals, argue the cash-strapped school district is denying an expert resource it doesn't have to pay for.

“Why would you fight this?” asked Brian Lawler, Anna Lawler's husband.

Related: Oregon Continues Spending To Revive Career Education Programs

As a federal employee, Brian Lawler said he understands bureaucracies have their limitations, but he doesn't understand why the school district would balk when parents are paying.

PPS officials say they sympathize with the parents — and acknowledge that some individual teachers might agree that the therapists coming to class helped students.

But district leaders say they worry about other families, especially those without insurance. Parent Paul Terdal helped write Oregon's ABA law. His answer to Portland Public? Bill Medicaid.

"They could literally be getting millions of dollars of extra funding if they do this the right way," he said. 

But billing Medicaid is complicated and costly. And there's another problem: The district says lower-income children receiving special education for autism are less likely to have a medical diagnosis and therefore can't access insurance-covered therapists.

Bottom line, district officials worry that if outside therapy is allowed on campus, the cost will come out of the schools' budget, at some point. District funding for ABA therapy is part of the parents' legal complaint.

Parents contend the district might've avoided the litigation, and potential financial risk, had officials sat down with them to discuss their issues. Portland Public Schools recently agreed to mediation, raising the possibility of finding agreement in classrooms rather than a courtroom.

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