Brother Urges Parents to Prepare Typical Siblings For the Future

“My sister helped shape the trajectory of my life!”

Phillip Clark adores his sister, Sarah.

“I was 4-years-old when she was born, and I knew she was different then. From a young age, I knew I would always protect her.”

Clark kept his promise. He even created a career path centered around Sarah and other individuals with disabilities.

Clark owns ENABLE Special Needs Planning, LLC, and works with families daily to get their financial, life, resource, and legal plans in order for their child with a disability.

Phillip with his parents, wife, and sister’s Sarah and Grace

“We often talked about future planning in our family. When I was going away to college, my parents sat me down and explained how they prepared for Sarah’s future. They said she would live with one of my cousins if my parents both passed on. I told them ‘absolutely not! Sarah and Grace (the youngest, typical sister) would live with me’.”

When Sarah was born 28-years-ago, doctors told her parents she would
never learn to read, among many other limitations. However, today, Sarah works as a second grade teacher’s aide, tutoring students in reading.

 

Clark credits Sarah’s success to his parent’s diligent planning early on. “They always focused on her abilities, and they always included my typical sister, Grace, and I in the decision-making process.”

Phillip Clark with his sisters, Sarah and Grace

In his professional experience, Clark has found that parents who didn’t plan are struggling as their child ages.

“Some of these parents are in their 60s, and their adult child is in their 40s. Many didn’t plan, and now there’s not much help for them. Most end up in government run day programs, because the parents can no longer care for them at home.”

His advice, start early and think abundantly about your child’s future. Include your typical children as early as possible in the future decision-making plans.

Clark is optimistic about the opportunities that individuals with special needs and their families currently have. He believes these opportunities will continue to grow as awareness continues to get stronger.

“The generation before Sarah was often institutionalized because people didn’t realize the profound impact that individuals with special needs could have on their families, communities, and businesses. Sarah’s generation was the first to widely stay at home with their parents; but the awareness and opportunities weren’t yet there for them to be fully included in all aspects of life. The next generation will have countless opportunities for inclusion, and parents need to be prepared for this new reality.”

Clarks says it’s not enough to plan financially. 

His personal journey allows him to understand the difference in planning  special needs families face, compared to typical families. He explains that every aspect of your family’s life and child’s life must be carefully considered.

It is important to plan financially, but equally important to create a Life Plan and a Resource Plan. He says you must make a Life Plan for your child that gives him or her every opportunity to live a purposeful, impactful life.

As for Sarah, Clark says she is busy leading a fulfilling and purpose-filled life, but he’s prepared to help her when she needs him.

Clark is a Special Needs Planning consultant licensed to serve families in every state. He provides Life, Resource, and Financial consulting services and referrals for Legal Planning. He also created a database of resources for special needs planning. See what services Clark can provide your family here.

Inclusion Evolution and it’s author did not received any services from Clark or Enable Special Needs Planning.

Not Dead Yet!

Imagine needing a life-saving kidney transplant, and being denied access to an organ transplant wait list.

This is the reality for some Americans living with a disability. They need a life-saving organ transplant, but doctors tell them they’re not a good candidate. Why? 

Often the reason is discrimination:

  1. Some doctors may refuse an organ transplant for individuals with disabilities that need help to follow post-transplant treatment plans (even if they have already secured post-op help).
  2. Some doctors may believe that individuals without a disability should have higher priority to organ transplant wait lists. 

But tell me, who gets to decide who’s life is more significant than another’s?! This is not only a right to life issue, but a civil right’s issue!

James Wellman is living this nightmare right now. The 26-year-old with Down syndrome is likely to die soon because he his kidneys are only functioning at 12%. Doctors won’t let him on an organ transplant wait list. His family is distraught. Watch his story below.

Ohio House Representative Niraj Antani

The American with Disabilities Act (ADA) provides broad protections against healthcare discrimination, but there’s no federal enforcement when it comes to organ transplant discrimination. Often their loved one with a disability dies while families try to find recourse through ADA.

That’s why states must step up to ensure people with disabilities are protected from discrimination.

I introduced possible legislation to my state legislator, and after agreeing it was needed he spent the summer drafting the bill. Ohio State Representative, Niraj Antani, plans to introduce the bill to prevent organ transplant discrimination in my state next week. You can view the draft bill here: Organ Transplant Waitlist Anti-Discrimination Bill

Only 5 states (California, Massachusetts, Maryland, Pennsylvania, and New Jersey) currently have organ transplant anti-discrimination laws. Three other states (Delaware, Kansas, Oregon) currently have a bill working it’s way through state legislatures. All of these bills are bipartisan.

With help from disability groups across my state, as well as doctors’ organizations, I hope we’re able to lead the charge against discrimination for our loved ones here in Ohio…

Because they’re #NOT DEAD YET!

If you’re interested in introducing an organ transplant anti-discrimination bill in your own state visit my “Advocacy” page under “Resources.” The NDSS created a toolkit for advocates with model legislation and other helpful resources on this topic.

I will post updates of our efforts here in Ohio as well.

 

 

How to Spend ABLE Account Money

We opened an ABLE account for our 4-year-old son, Troy, this past spring. Ultimately, Troy will decide how to spend this money when he becomes an adult, and his spending options are far-reaching.

The sky is the limit for possible ways to spend money from an ABLE account. 

The Achieve a Better Life Experience (ABLE) Act states that money can be spent on any “qualified disability expense,” and that term is defined very broadly. As long as the beneficiary is eligible, the account can be used to offset the cost of any disability-related expense. This doesn’t just mean medical expenses.

“The ABLE account should be used to maintain or improve a person’s life, well-being, or independence,” explains Chris Rodriguez, Public Policy Director for the National Disability Institute. Categories that these expenses could fall under include:

Education (tuition, books, tutoring)

Housing (rent, mortgage, property tax, funds used for housing expenses will NOT impact SSI  so long as the funds are disbursed from the account in the same month in which the housing expense is paid)

Transportation (Uber, taxi, car payment, bus)

Employment training and support (job coach, continuing education, certification,Interview prep and resume development, Transportation to employment)

Assistive technology and personal support services (cook, housekeeper, iPhone, Dragon Dictation)

health, prevention and wellness (yoga, ballroom dance, medical bills)

financial management

legal fees

expenses for oversight and monitoring

basic living expenses

funeral and burial expenses

The ABLE Act explicitly states that the account is designed to SUPPLEMENT Medicaid supports, not replaces these services. “ABLE can cover gaps in services and supports and, for some people, enable them to maintain Medicaid coverage while possibly saving for future expenses,” says Rodriguez.

ABLE Account holders do not need pre-approval to spend the funds, and many ABLE programs provide pre-paid debt cards to get the money instantly.

Rodriguez says you do need to keep an informal record of what is spent. “Keep track of your receipts of all purchases and record how each expense meets the definition of a ‘Qualified Disability Expense’ in case you’re audited by the IRS,” explains Rodriguez. He says the explanation only needs to be a sentence or two, and if the account holder uses a debit card it will likely keep electronic receipts for you.

Here’s an example of how you can record the Qualified Disability Expense:

Expense: Uber

Cost: $25

How this qualifies as a Qualified Disability Expense: Troy uses Uber to get to work on snowy days, because public transportation is sometimes slow. Without Uber Troy may not get to work on time. Employment and transportation improve Troy’s independence.

Misuse of ABLE Funds

Rodriguez says there are two ways to misuse an ABLE account, potentially threatening the account holder’s eligibility for federal means testing.

  1. Opening more than one ABLE account. “There’s a 10% penalty and income taxation on ABLE funds if it’s found that a person has more than one account. It will also threaten their SSI benefits,” Rodriguez explains.
  2. Spending money on something other than a Qualified Disability Expense. “The same penalty applies if the IRS finds that the ABLE funds have been used on non-QDE.” Rodriguez says the funds can indirectly benefit someone other than the account holder, but the account holder should be the primary person benefitting from all expenses.

If you’re interested in comparing different state ABLE programs go here. To learn more about the myths of ABLE accounts click here. And if you want to learn more about ABLE go here

 

Evie’s Sleep Story

The Following is Evie’s Sleep Treatment Story as Told By Her Mom, Jen Alge: 

Read about new research that links sleep issues with cognitive, memory, language, and behavior issues HERE.

I could write a book about this. Evie’s had 7 sleep studies. Her first was at 11 months, because they were trying to rule out pulmonary pressure issues before doing heart surgery. She had mild apnea then.

We did another sleep study before her first set of tubes and they found she had severe sleep apnea. They put tubes in and took the adenoids out. She still had severe apnea. They then did the tonsils along with a tear duct probe and another set of tubes. Then her apnea was moderate so the tonsils helped a bit.

Then we did a simi MRI to get a better read on her airway. That helped the docs a ton. I highly recommend that procedure. But that showed us just how obstructed her airway is so that’s when we started the CPAP (Central Positive Air Pressure). Due to her tiny facial structure and age (she started this when she was 4) it took a while to find the right mask and pressure that she would tolerate.

Doing a sleep study to titrate the machine was the most challenging sleep study- keeping a canula in with a CPAP is rough. So they gave her ambien to get that result. Then after several months of her only wearing the CPAP for 2 hours we did another sleep study and this time with a time-released melatonin. That did the trick.

So Evie takes a pill like a champ every night along with her nasal steroid and allergy meds to open her airway. After we got her pressure where it works best and a full face mask, she wears her CPAP an average of 7 hours a night. Now, she’s on a pressure of 11, and the full face mask isn’t the best option because when she moves the seal breaks pretty easy. So we’re not at the finish line yet. But the docs are happy with her use and they want to kick us out of the upper airway clinic.

I’m holding on because, yes, she does wear it on average 7 hours a night, but that’s only because I’m in her room 5-8 times a night at least putting the mask back on. She lets me put it back on, but man is this lack of sleep going to get old someday soon. And I’ve definitely considered other options like orthodontic pieces and the surgeries they really wanted to do when she wasn’t wearing her CPAP more than 2 hours.

Those surgeries are 3 in total: 1. Cutting the back of her tongue and pulling out some tissue. 2. Cutting away her lingual tonsils at the back of her throat (this is a risky procedure with a long recovery due to the risk of her throat swelling and closing up- lots of steroids) 3. The insertion of a screw under her chin with a string tied to her tongue to keep it forward. Evie’s problem is not the tongue, the throat or the width or length of her mouth- it is all three. So only all three procedures would solve it. Oh and all three procedures only have a 60% success rate so she’ll likely still need a CPAP. 🙂

I’ve notice no behavior changes since the treatment. Evie’s always been a smarty pants and she talks all day long so I can’t credit the CPAP for any changes there. I will say she is getting more air and isn’t gasping for breath or snoring with the cpap on so that’s a relief. The behavior changes might be more long term given her age.

Worth More Than a Test Score

Want to really make a parent of a student with Down syndrome cringe? Bring up assessments, especially IQ testing. Sitting around a table, outnumbered by school professionals, describing in detail how your child doesn’t measure up. I’ve been through it (albeit, not IQ scores) and Troy is only in preschool!

Why is this being done and what can be done about it?

It’s understandable that schools must use some sort of assessment to decide eligibility for special education services. The key word here is “services.” Special education is not a place, but a service!

I repeat, federal law does not define disability services as a special education classroom, but instead a “free and appropriate education” in the “least restrictive environment.”

But many school district use IQ testing and other assessments to systematically segregate students.

The school district I taught in called it “tracking.” Supporters of tracking or ability-grouping say it allows students to learn at their own level, and prevents teachers from having to teach many different abilities in one classroom. I argue that the costs to students in the low-level, or special education classroom, negates the benefits to the students in the advanced classes.

Instead, why not follow federal law and court precedent that calls for inclusion with needed supports in the general education classroom? Why not execute a true “Individualized” Education Plan (IEP), instead of systematically creating “places” for groups of students to be served. If a student is best served in a separate room so be it, BUT it should not be an assumed, systematic practice solely based on the student’s test score or disability.

New Approaches to Assessing the Strengths and Weaknesses of Students with Down Syndrome:

“It’s misleading to take that one score and portray the entirety of that child. May be that child functions well when you do non-verbal skills. Parents should make it clear during the testing that the teacher should sit down and understand both your child’s strengths and weaknesses,” says Dr. Jamie Edgin of the University of Arizona.

For the past decade, Professor Edgin has been researching better ways to assess students with Down syndrome. Her team is currently working on two types of cognitive test batteries. The Arizona Cognitive Test Battery is for students 7-years-old and older, and a newer iPad assessments for preschoolers (some of whom are completely non-verbal) called the Arizona Memory Assessment for Preschoolers. Unlike IQ tests, that are a global assessment with a cut off score, Edgin’s set of tests assesses multiple domains of strengths and weaknesses.

UC David MIND Institute is testing adults with Down syndrome

Another method being developed at the UC Davis MIND Institute breaks down scores below the IQ cutoff (the most common IQ tests are not able to measure cognitive ability below a certain level).  “A child placed in a new special education classroom may be given the Stanford-Binet IQ test and obtain a floored score showing no variation in performance, which would give the impression that he is simply low functioning and has no real cognitive strengths or weaknesses,” says David Hessl, UC Davis professor of psychiatry and behavioral sciences and the study’s senior author. “But if our scoring method is used, you are likely to find that particular verbal skills are relatively better, or there are unique visual spatial strengths, and that might help you to better serve his needs.”

The problem is neither of these new methods to test students with Down syndrome are widely available in school districts across the country. “You have to function within the way the school system works. These batteries haven’t been around long enough, and tested enough students to be widely accepted,” Dr. Edgin argues.

So, what do we as parents do when our child’s school wants to use a traditional IQ test?

3 Alternatives to Traditional IQ Testing of Students with Down Syndrome:

  1. Refuse: IQ Testing is NOT required for Special Education services, so many parents refuse the test.  Even when a school district argues that a designation of “intellectual disability” cannot be used without an IQ score, parents have gotten around the pesky assessment. Usually by using the “Other Health Impairment” designation instead. Both ID and OHI should be measured by a wide range of assessments and observations, not necessarily IQ scores. Before your child turns 18-years-old, find out what your state requires for eligibility to adult services. Some states require an IQ score to receive these services.
  2. Request a Better Test: Professor Edgin says it’s worth asking for a Differential Abilities Scale, which gives a wide range of scores with strengths and weakness. If your school refuses, and you have the financial ability, an outside assessment may be worth your child’s time.
  3. Advocate: Ask what test is being given and how the scores will be used. It’s your right to know which assessment your child will be given, and what impact it will have on their education. Never sign an IEP or assessment form without understanding the implications of test results. Another good tip: ask for the test results before the IEP meeting. That way you can leave your emotional response to the test results at home, and better advocate for your child at the meeting. Also, ensure that strengths and areas for improvement are a focus of any conversation.

Know that your child is worth more than one test score. Know your child’s rights, and don’t be afraid to advocate!