[music]

0:00:05.3 Vicki Brett.: Welcome to the Inclusive Education Project. I'm Vicki Brett.

0:00:08.9 Amanda Selogie.: I'm Amanda Selogie. We're two civil rights lawyers on a mission to change the conversation about education, civil rights, and modern activism.

0:00:19.3 Vicki Brett.: Each week we're gonna explore new topics which are going to educate and empower others.

0:00:26.0 Amanda Selogie.: And give them a platform to enact change in education and level the playing field. Welcome back for part two.

0:00:36.5 Vicki Brett.: With Dr. Dennis.

0:00:38.8 Dr. Dennis.: Hello, everyone. Nice to be back.

0:00:41.4 Amanda Selogie.: Last episode, we really focused on this idea of where is this school refusal or non-attendance coming from? Really looking at how do we identify the root cause. We talked a lot with Dr. Dennis about his new methods of evaluating students, which are just so important. We always should be thinking outside the box and thinking of new ways to support students. And so today we wanted to go deeper into talking about once we have this data, once we have this information, the next step of really analyzing this data and figuring out where do we go from here.

0:01:19.8 Vicki Brett.: So the parent has come to you, Dr. Dennis. The district has contracted with you, and we're coming to the IEP meeting. Hopefully everybody's done their homework and reviewed it, and then you're kind of going over it at that point. Are you providing... Are you adding to the bip? Are you providing a new type of plan for the team to be implementing or developing? How does that work?

0:01:42.7 Dr. Dennis.: That's a great question. Yeah. So I typically will revise the bip, and this new approach is such that I give myself permission to kind of break the normal boundaries of what you will see in a behavior intervention plan, where in many parts of the country, it's still considered to be non-compliant if that bip references anything like internal emotional states or environmental factors that are not consistent with the behavioral model. So, instead of continuing with a bip, what I typically recommend is something I call an AIP. So rather than a behavior intervention plan, it's an attendance intervention plan.

0:02:21.7 Dr. Dennis.: And it's another brief summary of everything that I've presented in my report under those three main paradigms, which I'm combining to kind of leverage better results and better interventions. So, the functions of the behavior are outlined, and then there's a typical bip-type component in that part of the AIP. And then there's a section corresponding to the second domain of data collection, which is the neuropsych section. And that's where there will be recommendations related to whether or not the student's presenting with normal executive function, whether that student's presenting with sensory disorders.

0:02:57.8 Dr. Dennis.: And I think on the last podcast we did together, it may have been Amanda who mentioned that the OT will be excused from a meeting because they're behavioral problems. But of course, the scope of practice for OTs has changed completely in the last 10 or 15 years from just looking at fine motor issues to looking at sensory needs as well. And most appropriately trained, they know. I'm amazed, particularly kids who are on the spectrum, how often the main issue, as it turns out, will be that the classroom is too noisy or that lunchtime is too noisy, or that the locker room when the student's supposed to be getting dressed out for PE is too noisy.

0:03:37.9 Dr. Dennis.: And that's not really considered in a lot of other approaches to data collection for school non-attendance. And, I've had cases where two or three specific sensory issues and almost nothing else out of the ordinary is what's keeping the student from getting out of the car in the morning. One example, I had a second grader who had decided that fire drills weren't going to happen only once a month. The second grader had decided that it could happen at any time. Even if it wasn't a real fire, the drills could happen at any time.

0:04:11.4 Vicki Brett.: At any time. Yeah.

0:04:12.5 Dr. Dennis.: And so began to perseverate on that and then was very concerned that any given day at school the fire bell would go off and he really didn't like the fire alarm. So, and that combined with an echoing effect in the multipurpose room, and then when they would go to enrichment class to music, there were certain instruments that he said made him feel like he was in pain. And so, once we accommodated for those settings and those experiences, the student just started going back to school and has been successful ever since. You typically wouldn't get that kind of data coordinated with the other data that's being collected when you're trying to inform interventions for attendance challenges.

0:04:55.7 Dr. Dennis.: So we go over that, and then the last area is where we collect a lot of data that helps us with that differentiation we were talking about in the last episode between school refusal and truancy. And for the most part, I mean they're combined types, but for the most part, if a student is presenting with high levels of anxiety, depression, if we're seeing panic attacks, if there's a lot of worry, and then of course, if there are already underlying disabilities associated with any of those, any clinic-based diagnoses that are associated with the educational determination of something like emotional disturbance or other health impairment or autism, that is probably what is contributing more to what's happening.

0:05:40.7 Dr. Dennis.: And so that can be more rightly or accurately called school refusal versus truancy. Now, if the student is presenting with very high levels of externalizing behavior, he's pretty chill in most situations and just seems to be mostly disengaged or bored, or maybe there are high levels of novelty seeking because there are attentional issues. And so combined with the impulse control and the wanting to introduce exciting stimuli just to be able to feel right, feel normal, to maintain that baseline level, they might get a charge from not going to school and just going to the skate park instead. But again, the really important point is, and we talked about this last time, that does not give the team permission...

0:06:24.9 Vicki Brett.: Oh, no sympathy. Yeah.

0:06:26.5 Dr. Dennis.: I'm doing this thing where I'm wiping my hands together. Not our problem. Yeah, you can't just officially be mad and then move on. You've got to figure out a way to hook the student back in for a successful school experience. And then, the other things we add is in, there are these different features or areas of the comparison. If it seems like the parents are aware that the student is staying home, sometimes facilitating them to stay home, and that's oftentimes school refusal versus truancy. Especially among older students, the young person will actively hide the absences from the parents, so it comes as a surprise.

0:07:05.4 Dr. Dennis.: In terms of location, usually school refusal, the child doesn't want to leave the home. In fact, I've got a case I'm working with right now where it's part of a larger profile related to agoraphobia and fear of just even leaving the house. The student won't go to school, won't go to the mall, won't go to Denny's, won't do anything, and it was allowed to get worse. And so at this point, not going to school is something that's going to need to be addressed at some point, but just being able to step out the front door, take the dog for a walk is something that we're shooting for.

0:07:38.8 Dr. Dennis.: And then classic truancy cases, again, particularly with older students, they may be cruising out and about, hanging out with other peers who are skipping school that day and not necessarily at home. And then in terms of the functional motivation, this is where some of the FBA data helps, is school refusal is typically about escaping aversive stimuli. So, if you're not going to school, the function of not going to school is to escape bullying, maybe tests, maybe there's social phobia and something that is closely connected with adolescence.

0:08:16.2 Dr. Dennis.: Because as we enter adolescence, we begin to engage in something called the imaginal audience, and that's where we assume that everybody's thinking about us and looking at us when really no one cares, frankly. But the young person in sixth, seventh, eighth grade believes that they are just constantly on display, and the intensity of that makes it hard to go to school. And then, oftentimes there is separation anxiety with younger students. In that case, it's essentially a fear response rather than an operant response for those B.F. Skinner nerds out there.

0:08:53.8 Dr. Dennis.: So it's really just there's a paired fear with being at school and not with mom, versus anticipating all the horrible things that can happen at school and then not wanting to go to school, which tends to be operant, which means that you've got to train that up. Oftentimes a few pretty bad things have to happen at school before that student is scared to go. And then the contrast is in truancy, you see the classic characteristics. You see defiance, that's what we were talking about, the seeking of external rewards, like flipping that skateboard, just one more 180-degree rotation and you're gonna feel great about yourself.

0:09:32.8 Dr. Dennis.: And then we also will start to see in some small percentage of students, typically around 3% to 5%, the kind of rebellious behavior that is not developmentally appropriate. It's not about differentiation from the parents. It's oftentimes related to something that fortunately everyone is taking seriously now: underlying trauma or adverse childhood experiences, or ACEs. And most professionals now make sure to include an ACE analysis, which I actually do under both the second and third domains, under both the neuropsych and the cognitive for this reason.

0:10:10.1 Dr. Dennis.: We know now that negative experiences at a point in your life when you are not prepared to deal with them will actually rewire the brain. So that's squarely in the neuropsych department. Right. But we also know that it can contribute to some of these other cognitive experiences, some of these other social-emotional experiences like school refusal and the anxiety and the depression, or truancy, the rebellious behavior.

0:10:35.3 Vicki Brett.: And I think that you are so eloquent at describing all of the different scenarios with your experience and with your work in the school districts and with so many students over the years. I mean, I feel like sometimes districts throw their hands up as if they've never seen a kid like this ever, right? Or it's just teen angst or whatever. And it is really based in being able to really see what is happening, not putting your spin on it, right, not putting this like, it's a teen thing, whatever, or they just miss mom, or whatever. It's deeper than that.

0:11:14.6 Vicki Brett.: And to be able to have all of those categories, I was like, yes, I have a kid right now that's in that category. The autism sensory dysregulation and then emotional dysregulation and then shame spiral. And that team in particular, we've had... We will have six IEP meetings and it's only mid-March, right? And we did not find out until... We didn't even find out at an IEP meeting. The child eventually told a second grader that they were able to opt out of music. We didn't know that that was happening, that he was having a sensory kind of dysregulation that was happening in music.

0:11:40.3 Vicki Brett.: And the opting out, there was no plan. Opt out was just him being at the back of the class. Well, now at this point, he's rolling around. He's trying to regulate his body when these loud noises are happening. And, we had no idea until, guess what, he had a huge meltdown, and then a chair was thrown or this was broken, and then it resulted in a suspension. And so we have now... I feel like the glass has been tipped over, right? You can't put that water back in that glass. And all those signs were there.

0:12:26.5 Vicki Brett.: And it is so important, and it blows my mind that, you know, oh, well, an FBA is non-compliant if we're kind of looking at this. But that's what I like about how you still put a magnifying glass on these things, because that is important, knowing if the child is triggered. And I know, Amanda, you've had a case that you've talked about where it was like we were taking the child out for OT during art. And that was the only thing that was getting her to school was art. And Amanda came in and she was like, so when are we taking her out for OT? Oh, well, during art. Huh? So then maybe this is the... It just blows my mind.

0:13:01.0 Amanda Selogie.: Well, even teams failing to take that step to say, let's think about this for a second. Let's use our logical brains, that even someone who's not a professional could see that like, maybe this isn't the best thing to do. But I think so many teams get wrapped up in their own little thing. Each member has these blinders on, like we talked about before, and they're not really working together. And whether it's because they don't have the understanding that they need to be collaborating all together or they're so overworked, overloaded that there's not a single other minute in the day, whatever the case may be.

0:13:33.8 Amanda Selogie.: And then, we're just like, oh well, until it gets to the point like, nobody does anything until it gets to this explosive point. And it's either, well, it's the child's fault, or if it's a younger kiddo, it's the parent's fault, because the parent's allowing... I had that in an IEP meeting the other day where they tried to question the parent's parenting on like, they wouldn't even bring the kid to...

0:13:57.9 Amanda Selogie.: Like, I'm sorry, I don't know. I am a parent myself whose kid goes to school, and I can tell you that on days when he's sick, I'm like, are you kidding me? Yes, I want the best for my child, but I want them to go to school. I have stuff to do, right? So even on the concept of a parent is just willy-nilly saying, I'm gonna keep my child at school, there's no parent doing that.

0:14:19.1 Vicki Brett.: I mean, I'd love for you to try to get a four, five, six-year-old to do anything. Like...

0:14:25.3 Amanda Selogie.: Exactly.

0:14:26.0 Vicki Brett.: Okay, do it.

0:14:27.0 Dr. Dennis.: Yeah. And also, many educators are trained to avoid contemplating individual differences, which is rough on kids with special needs. We're kind of trained, and I was, myself when I trained as a gen ed teacher and then a special ed teacher and then a resource specialist, we kind of treat all the kids the same, like they have the same needs, which is diametrically opposed to the whole notion, the whole philosophy of specialized needs, right? So there's absolutely a lot of that. Part of it is we have these brain biases, and one of the most powerful, and this is hardwired and evolved, and we all have this between our ears, is something called cognitive efficiency.

0:15:09.8 Dr. Dennis.: And that's where we want to take a problem, and no matter how complicated it is, we want to simplify it, even if it means oversimplifying it so that we don't actually understand it, and then our plan to solve it doesn't have much chance of succeeding. And so, when you see that kid rolling around in the back of the room during a music lesson it's a... First of all, we want to think that it is something that is going to go away. It's something that wasn't there before and it's here now, and it's just gonna magically go away. And unfortunately, that's typically not the case. But that's our first default is, this is not something that I'm gonna have to address.

0:15:48.9 Dr. Dennis.: That's what's so frustrating about the example I think I've given to Vicki in the past, which is that when you have psychiatrists and pediatricians and child neurologists putting kids on home hospital before they even really need it... Now, some kids need home hospital, and I've put plenty of kids on home hospital instruction when there was no way they were going to come to school for whatever reason. But what I often see is an otherwise responsible professional just basically wanting to kick the problem down the road by saying, oh, she's afraid to go to school? Well, let's have her stay home.

0:16:26.8 Dr. Dennis.: And then, that lack of momentum just gets worse and worse and worse, and then it's very difficult to lower the threshold enough to get that student back on campus. Sort of the last thing we do when we look at all of that through the data analysis process is we come back to that big question that I posed in the last episode, which is: Is this a performance deficit or a skills deficit? Is it a won't do or a can't do? And if it seems like it's a can't do, it seems like it's not social maladjustment or antisocial behavior, just problems with compliance or with rules, then it's internalized and it's school refusal.

0:17:29.8 Dr. Dennis.: If it's the opposite of all those things, if it's a choice to not do work or go to school, and then we see that characteristic sort of oppositional or defiant behavior with adults, then we know it's probably something more like truancy. And unfortunately, when that happens, we talked a little bit about schools kind of being stuck in the ways that they handle problems and maybe not being as insightful or creative as we want them to be. I mean, once something's labeled as truancy, it tends to go down a very dark path because then it becomes a legal thing, and then the assistant district attorney gets involved, and then it becomes wholly punitive and it doesn't feel like support anymore.

0:17:45.5 Dr. Dennis.: What I try to do with my recommendations, so even if the student seems to be in some control of his or her behavior, try some things that will make that student more likely to comply. And little things, again, can make a huge difference. One powerful approach is just providing a little bit of control or a little bit of choice over what's going to happen. Being able to choose what classes to go to, being able to decide what order to complete assignments—this is the kind of thing that's been traditionally effective with both young people on the spectrum and young people with emotional disturbance. And, it can be hugely helpful for kids who have kind of checked out of the school experience.

0:18:31.0 Vicki Brett.: And in the grand scheme of things, that being able to just make a choice on your own for that child is everything. And, it seems like a very easy thing a district could offer, right? Is like, how do we want the class...

0:18:46.5 Dr. Dennis.: There's maybe 30 years of research on this that it immediately lowers the affective filter. So, if you're anxious or worried about what's going to happen, and there are schools of thought that even the most significant forms of truancy may, at the end of the day, be based in worry or fear because you've had experiences with adults that you trusted who let you down. So when Mrs. Smith tells you to finish your math packet, you've had this experience with other adults who told you to do stuff that didn't turn out well, and your automatic set point is, no, because I'm worried that this is going to end badly. Is that really defiance, or is that really just another form of internalized worry?

0:19:29.8 Vicki Brett.: Right. I love that. I love that.

0:19:31.3 Dr. Dennis.: And we see that that's significantly worse with young people who have experienced a significant number of ACEs during important developmental periods. Back to the trauma, those adverse childhood experiences.

0:19:44.8 Vicki Brett.: In, I don't know how many times we say in IEP meetings, the child is not safe. They do not feel safe, right, based on these experiences or community violence or whatnot that they've been exposed to. And, we all know when you're in a heightened state, right, when the adrenaline is pumping and it's that fear that kicks in and it's flight or freeze or fawn or whatever they say now, you can sit up there and do your teaching, but that child, it's not hitting them at all.

0:20:15.2 Dr. Dennis.: We've made so much progress, and teachers in terms of their training and the in-services and the workshops they go to, we've made so much progress in terms of understanding that limbic hijack and that heightened state of arousal. And, staff and parents have been taking mindfulness seriously, meditation, deliberative breathing. And so we know how to do that. Yet we rarely take the time to prompt the students to do it, right? Because we're too busy at home and we're too busy in the classroom. And so, some of the tools are out there, and there's an awareness that's so much better now than just a few years ago, but still, it's kind of a time crunch.

0:20:56.6 Dr. Dennis.: You're running around in the house or you're rushing through the curriculum for geometry, and you don't feel like you've got the time to spend five minutes at the beginning of class, if there's going to be a high-stakes exam, doing a little bit of breathing, right? Even though there are some kids who would do better on the test, and there are some kids where if you did that regularly, they wouldn't be home that day. Right? They would actually be in the classroom taking the test.

0:21:22.3 Vicki Brett.: Yeah. Yeah. Oh, Dr. Dennis, we could talk to you forever. We really could.

0:21:26.9 Dr. Dennis.: I could talk to you guys forever too. All right, let's do it. Let me use the restroom and then I'll come back and then we'll talk forever.

0:21:35.2 Vicki Brett.: I mean, the [0:21:35.5] ____ you do is extremely helpful to not only the child, the families, but even in helping us advocate for our kiddos. And so we are just so, so grateful to you for your expertise and your passion for this area. And you might come on a third time. We'll figure out what. I think we want to talk about our own cases.

0:21:56.6 Dr. Dennis.: I don't think you're gonna be able to stop me.

0:21:58.4 Vicki Brett.: Oh, good. Oh, wonderful, wonderful. Listeners, if you have any questions, please let us know. And Dr. Dennis, if people wanted to reach out to you, what's the best way that they could do that?

0:22:07.6 Dr. Dennis.: So probably the best way is to access my website. I can give that right now. So it's doctor.dennis, so like doctor dennis with a period between the doctor and the dennis, @back@school, just like the name of the agency.net.

0:22:30.7 Vicki Brett.: Wonderful. I mean, I'm sure you have wonderful resources on your website as well.

0:22:35.6 Dr. Dennis.: Yeah, I think there's some worthwhile stuff there.

0:22:37.8 Vicki Brett.: Yeah. Yeah. And so please, listeners, check them out. If you have any questions for us, obviously, DMs are always open and we will talk to you soon.

0:22:47.1 Amanda Selogie.: Bye.

[music]