more on transparency: CSE meetings, second opinion and fair use

Another CSE meeting recently, another issue with transparency. Professionals can sometimes disagree, which is bound to happen because children's performance is subject to variability. When test performance varies across different tests that are supposed to measure the same construct both professionals should be open and concerned enough to try to explore and understand the difference between test scores.

I have never had a problem releasing raw test data to occupational therapy colleagues. I understand that there are issues with randomly releasing test materials and manuals to the general public, but most people agree that in the case of 'second opinions' it is not objectionable for a professional to release raw data to another similarly credentialed professional upon request and upon consent from the family. The materials pass directly between professionals, and should never involve parents, lawyers, etc. unless there is some court order to do so.

Today a (non-OT) professional didn't want to release raw data to one of their colleagues, citing confidentiality issues. Patient confidentiality is not the guiding issue with raw data release - trade secret and copyright law is. Obviously they were more interested in finding excuses to avoid sharing information than they were in helping the child.

In sum, it represented obstruction. The professional finally stated that they would be willing to have a face to face meeting with whoever would provide the second opinion, but my hopes for that are slim because we haven't been able to convince them to even contact the professional for a phone consult.

Generally when we discuss terms like "agenda-setting," "obstruction," and "control" in the same sentence we are referring to politics. It concerns me when an agenda for a CSE or 504 meeting is so tightly controlled that it precludes the team members from bringing up concerns. Additionally, in my recent meeting when I raised the issue of writing competency for a seventh grade student there was little interest in considering the concern; rather, there was an attack on my 'credential' to comment on a student's writing. The committee was willing to allow me to comment on writing legibility, but not on writing organization or process.

What is an occupational therapist's purview? I told them that I am a licensed professional who looks at a child's functional performance in their environment. Does that make me an English teacher - of course not. But does it mean that as a professional I may have observations or information for the team to consider - I would think so. This particular child has serious difficulties with visual organization, making it very difficult to coherently construct sentences - and all this is on top of legibility and spacing concerns. So for you OTs out there - next time you do a school inservice and all you talk about is how to HOLD THE PENCIL, please consider that you may be educating your teams incompletely and they may not come to understand OT as a profession that has the ability to provide broader recommendations than pencil grips and slant boards.

Sad news: before the meeting I am willing to bet that those educators could have been heard saying, "Parents aren't involved enough" or "We aren't holding kids to the proper standards." I hear teachers say this every day. So why does the story change when we enter a CSE meeting? Suddenly we take an involved parent and define them as an overbearing parent who expects too much. Then they make statements about how a child is functioning "just like" all of the other kids in the class. When it counts the most, accountability and standards really go flying out the window.

Instead the committee got fed a test result that directly contradicts the result of the outside professional, the meeting agenda gets controlled, there is a refusal to share the raw data, attempts to discuss it are shot down with attacks against credentials, and ultimately the child receives less than what they should receive. Special education, when it is at its worst, can he horribly broken.

Not all is lost: many districts really do things the proper way. But it is so disappointing when they don't.

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