Special Education and Nursing
Definitions
RTI (Response to Intervention)
The purpose of RTI is to ensure success of all students, and provide early
assistance to students who are experiencing academic and/or behavioral challenges.
RTI guides the SAT in developing a plan to support students in becoming successful in
the general education setting. It supports the teachers to develop successful strategies
and interventions to use with all students.
Tier IA
All students are Tier IA students-they are enrolled in classes at the appropriate
level and have teachers that use best practices and core curricula. Teachers fill our
classroom profiles at the beginning of the year. Teachers document how each of their
students is progressing and communicates with parents. If a student appears to not be
making adequate progress, the teacher is challenged to determine what factors may be
barriers to learning. Tier IB indicates the teacher’s development of a classroom
intervention plan (CIP) and a student academic improvement plan (AIP)-progress is
measured over the next 4-6 weeks and the process is shared with the parents. If the
issues are behavioral or health-related in nature, the student is referred to the Health
and Wellness team for consideration and recommendations. For behaviors, a functional
behavioral assessment (FBA) may be completed and a behavioral intervention plan
(BIP) can be developed and implemented. For health related issues, an individualized
health plan (IHP) is developed and implemented. In both situations, if the student is
showing growth and achievement he/she can remain in Tier IB indefinitely. However, if
interventions are not showing improvement, a request to go to SAT is submitted.
SAT Team (Student Assistance Team)-Each school site has a SAT whereby
concerned teachers and/or parents may request a meeting regarding a student’s
academic progress issues. The team is usually chaired by an appointed staff member
and is comprised of the student’s teacher, counselor, nurse*, assistant principal, etc.
SAT Process-The teacher or parent may request a SAT meeting when there are
concerns regarding a student’s progress after implementation of Tier I interventions
have been made. The SAT chairperson convenes a meeting with the concerned parties
and reviews the student’s progress, the interventions implemented and responses to
those interventions. (See below SAT Meeting)
SAT-Health Record Review-As part of the SAT process, the sponsor teacher requests
the school nurse to review the student’s health record which includes the latest results
of hearing and vision, any pertinent known health concerns and medications currently
taken.
Tier II – SAT Meeting-An initial meeting includes discussion of the concerns,
interventions attempted and response, and then discussion regarding ideas to support
student success. A plan of action is designed and documented-this is called the SAT
Intervention Plan. Two additional review meetings are held at designated intervals.
Following the second meeting, the determination to return the student to Tier IB, retain
the student in Tier II with continued interventions or refer to the Diagnostician is made.
Once the diagnostician determines that the student should be tested for special
education and the parents have been notified, the School Nurse is asked to
complete the Initial Health History and Assessment.
504 Accommodation Plan-Section 504 is a federal civil rights law under the
Rehabilitation Act of 1973. The law protects individuals with disabilities from
discrimination. In the school setting, the law prohibits discrimination on the basis of
disability from all school programs and activities in both public and private schools that
receive direct or indirect federal funding. Students may qualify if they have a mental or
physical disability that substantially limits one or more major life activities and
significantly affects the student’s education.
SAT and 504-The SAT team serves as the starting point for consideration for a 504
plan. Decisions are made according to eligibility criteria by the SAT/504 team at the
school site.
Special Education
Diagnostician/Evaluation Specialist-Specially trained teacher who administers a
battery of tests to the student to determine/evaluate Special Education eligibility.
Diagnosticians test and analyze test results making recommendations for a student plan
of action for academic success.
Initial Evaluation-For Nursing, the Initial Evaluation relates to the initial testing of a
student for diagnostic evaluation. The School Nurse completes the Initial Health History
with the parent/guardian, performs a limited physical assessment and determines the
need for medical referral or additional medical information that would aid in the
educational diagnostic process. The school nurse completes the Nursing Summary
Form for Special Education and submits to the requesting Diagnostician with
recommendations for referral if needed.
Re-Evaluation-For Nursing, the Re-evaluation relates to the 3-year re-evaluation of the
student in Special Education. The School Nurse completes the Nursing Assessment
and Health History Review. The Nursing Summary Form for Special Education is
completed with current information/findings or referrals and submitted to the requesting
Head Special Education Teacher or Sponsor Teacher.
IEP-The Individualized Education Plan is the formal plan developed for the student
based on findings of the diagnostician and teacher and parent recommendation. The
IEP determines which subjects require additional support through the Special Education
program, inclusion in regular classroom education as well as the need for related
services such as Speech and Language, OT, PT, Adaptive PE, and School Health.
When the student has significant health issues that impacts his education or that require
nursing services at school, the School Nurse should be present for the IEP meeting to
make recommendations for school health services time needed on the IEP, to explain
the health issues and how they impact education, and to serve as a resource to nonhealth staff in determining the student’s needs in the educational setting.
Sponsor Teacher-Special Education classroom teacher or regular education teacher
for a student.
IEP Specialist –staff person designated to complete the IEP on the TIENET software;
act as a knowledgeable resource for the components of the IEP.
Head Special Education Teacher- school site teacher responsible for the coordination
of the school’s special education program and student evaluations and/ or reevaluations.
PSS (Program Site Specialist)- administrator-in some cases an assistant principalwho coordinates the Special Education Programs for a selected group of schools.
Multi-DisciplinaryTeam (MDT) /Eligibility Determination Team (EDT)- The team
comprised of diagnosticians that reviews and determines the outcome for Special
Education Testing.
School Health Services/Time on IEP- The amount of time the IEP team at the site
determines to be appropriate for the provision of health care of a student. Service time
may be direct face-to-face services (i.e. med administration, g-tube feedings,
assessment/monitoring, student education, suctioning, etc.) or indirect (i.e. creating the
IHP, communication with parent/physician, coordination of services, referrals, staff
education, etc.) Service time is measured in minutes or hours per day, week, month or
semester. *Only direct (face-to-face) service time is billable*
Intensive Support Program (ISP)-Special classrooms designed to meet the
challenges of students with multiple developmental delays and special health needs.
Typically, these students are mentally challenged and require assistance in the activities
of daily living. Some of these students will require g-tube feedings and meds, tracheal
suctioning, toileting, feeding, etc. Additionally, some of these students will come from
group homes due to the high level of care required.
Behavioral Intervention Program (BIP) (including behavior intervention plan;
functional behavior assessment)- BIP is a term used by the district for the overall
programs housed at specific school sites and/or for the behavior intervention plan
designed to help the student control their behaviors while focusing on academic
success. The programs are designed to work with those students experiencing severe
emotional disorders and mental illness manifesting difficult behaviors. Schools that are
not designated BIP’s do have classrooms devoted to those students who have difficulty
controlling behavior but are not to the point of extreme concern and can be managed
with individual behavioral intervention plans and trained staff.
Medically Fragile- This term typically defines those students who have been identified
by the Center for Developmentally Delayed/Disabled who are considered high risk and
require nursing care in the home and/or in the schools. These students require
advanced technology to sustain life, are at high risk for infection and hospitalization and
are developmentally delayed.
Medically Complex- The medically fragile student is considered medically complex, but
there are those students who have chronic health conditions but do not benefit from the
Medically Fragile Program such as students with spina bifida and requiring nursing
interventions such as catheterization or perhaps the student with endstage cancer who
might require flushing of their ports or surveillance for infection etc. or the newly
diagnosed student with Type I diabetes who requires constant intervention.
Chronic Conditions- Those students with long term health issues that require
medication or treatments to keep their condition under control but could easily have
exacerbation and require additional intervention at school-asthma, diabetes, seizures,
etc.
Emotionally Disturbed- as it relates, to education, is an eligibility for Special Education
and not made on a psychiatric diagnosis. School psychologists determine the eligibility
based on specific characteristics that are exhibited over a long period of time and to a
marked degree that it adversely affects a child’s educational performance. While a
psychiatric diagnosis is not imperative, it helps to support the eligibility. For more in
depth explanation, go to http://cecp/air.org/resources/2oth/eligchar.asp