The Secrets of Service Delivery Grid for Autism IEP

How do you make a somewhat technical and dry post into an exciting one? Maybe if I say that knowing as much as possible about Service Delivery grids will make a huge difference in your understanding of your child's IEP, that would be exciting?


Is it working?.. Got it.


...Let me try again. What if I said that you will never again stare hopelessly at those three nearly identical tables, shrouded in mystery, filled with the tiny impenetrable patterns of numbers and x's and wonder how to decipher even a kernel of meaning out of them? You will just come, you will look, you will conquer.


Well, I hope this was better, because this is as good as I can do. Thank goodness I am a psychologist, because as a joke writer or a comedian, I would totally bomb.

 

Now, to the question.


"The Service Delivery section of the IEP has three grids – Grid A, Grid B, and Grid C. Why? What's the difference?"


I am so glad you've asked. Once, when I explained this to parents during a meeting, one of them said, "Wow, I've been confused about this for years, but now that Yulika has explained it so clearly, I finally understand!" I hope I can do the same for you.


Each grid has a distinct purpose. If you understand what it is and how to use it, your child’s IEP is going to serve him/her so much better. The common thread is that once a service is listed on any of the three service delivery grids, the school is mandated to implement it the way it is written. The school becomes legally accountable for the service. If in the team meeting someone says, “Of course, we will do X,” and then it does not happen, there is no accountability and you have no leverage. So, you want to get services on the grid for accountability, and also for the IEP to reflect the full extent of the services that your child is receiving. Additionally, if the school ever wants to modify a service that is on the grid, i.e. reduce or remove it, you have “stay put” rights that will keep it there while the dispute is being resolved. You do not have “stay put” rights to services that are not documented on the Service Delivery Grid.


So, let’s start from the beginning.


The purpose of each grid is stated right on the IEP, after the name of the grid. Most people just don’t notice.

 

Grid A is described as Consultation (Indirect Services to School Personnel and Parents), and that’s what it's for. I call it the most underused grid in the world. Its purpose is to set aside time for your child’s team to communicate with each other, and to provide consultation and training to you as a parent. This fun littlel grid can be used in the following ways:


  • Team members can have meetings to discuss your child’s progress. This is different from EP team meetings. Meetings that take place as consultations specified on Grid A are more used to coordinate, plan, exchange ideas, and help team members have a complete picture on what is going on with a child. Usually, it is a meeting of all or some special education professionals who are on the child’s team. Those can include special education teachers, aids/paras, speech and language pathologists (SLP), occupational therapists (OTs), Board Certified Behavioral Specialists (BCBAs), physical therapists (PTs), adaptive physical education (APE) teachers, assistive technology (AT) specialists etc., who participate. All the professionals providing related services and specialized instruction to your child could be present in these meetings. Parents do not attend.

  • Specific team members can have consultation time with each other. For example, if both an SLP and an OT are working with your child on self-regulation goal, then this consultation will give them time to coordinate and check in with each other.

  • Therapists and special education teachers working with your child can use consultation time to work with general education teachers and aids/paras to communicate to them what skills your child is working on, what language is being used and what strategies are being taught. In this way, use of the same skills, use of the same language and the same strategies can be used and supported in the classroom. -- Another focus of this type of consultation can focus on accommodations. Each professional can advise general education teachers on how to deliver instruction, materials and content to your child in a way that would accommodate his or her disability. It becomes especially important in middle and high school, when there are many teachers involved with the child. I often find that a child can be struggling in specific classes not because of the difficulties with content, but because a teacher does not understand what accommodations the student requires, even if they are spelled out in the IEP. These consultations, proactively used, could come in the shape of special education teacher reviewing the next week’s content with general education teacher and making recommendations on how to modify instruction, materials and content for your child. OT could help general education teacher accommodate sensory, motor and self-regulation issues; SLP could help with accommodating language and communication issues, and so forth. You do not need to have a consultation by every single person on the team, only by those whose input makes sense.

  • Consultation time can also be used for one professional to train other professionals. -- One example of when that is needed is when child is using Augmentative and Alternative Communication system or device. There has to be a staff member, usually SLP, who takes responsibility for setting up and updating the system or device, for training everyone on the team and the parents to use it, and for continued supervision and data collection on the use of AAC system or device, so that the system/device and its use can be adjusted as needed. -- For a child who has positive behavioral supports or Behavioral Support Plan (BSP) as an accommodation, another example would be a consultation by a BCBA. BCBA needs that consultation time to collect baseline data to develop the plan, to train everyone working with the child on it, to set up data collection, to supervise its implementation, to monitor its effectiveness and update it as needed.

  • Grid A can also be used to set up home-based ABA services in the form of training provided to parents. Sometimes there can be home-based consultations on this grid by OT to help parents meet child’s sensory needs at home. These usually are time-limited, i.e. provided over a period of several weeks to help set everything up, with follow up meetings at school to check in on how things are working and provide additional consultation and suggestions.

  • Because Grid A explicitly includes consultation to parents, it can be used to set up home-school communication. This communication can be in the form of “clinic meetings”. This is not a formal name, but it is often used. These are meetings between you, the parents, and any school clinician with whom you want to consult, either one at a time or as a group. This is not an IEP team meeting. This is a meeting in which you can see your child’s work samples, hear updates on the learning of skills, get suggestions on how to support your child’s progress at home, and also bring any information about how your child is doing at home and with private providers that would be helpful to the school team. These meetings usually occur every 6-8 weeks and can last anywhere between 30 mins to an hour, depending on how many people are present. --Home-school communication on this grid can also be in the form of phone calls between you and the school staff that you want to exchange information with. -- The way I approach home-school communication is this: if you can request it in a team meeting and have it happen without it being listed on the Grid A, that is fine. As long as the communication is happening, there is no special need to document it. However, if your child’s team has committed to this type of consultation but you are having a hard time getting meetings scheduled or getting emails/phone calls back, you should ask for it to be included on the Grid A. Once it is included, the school is mandated to do it.



A word of wisdom: I often see IEPs with impressively comprehensive services on Grids B and C, and without a single consultation on Grid A. Even if your team assures you that they “talk to each other all the time,” make sure you request the formal consultation times. It will help those working with your child set aside dedicated time for coordinating, and it will make the school legally accountable for making it happen.

 

Grid B is easy peasy. It is for Special Education and Related Services that take place in a general education classroom. Whoever works with your child comes into the classroom and provides the service without your child having to go anywhere. This format is known as a “push-in.”


Grid B specifies direct services, meaning they are provided to your child rather than to team members, teachers or parents. Services can be delivered individually, in a dyad or in a group. You always need to ask what the format will be because it is not always obvious from the way the grid is written. Sometimes, when service, such as, for example, speech and language therapy, is delivered in the group format, parents might worry that it is not individualized enough for their child, or that child will not be able focus on instruction as well. If you have reasons to feel strongly about it, group size can be documented on the grid itself or in the Additional Information section. You can specify individual session, a dyad, or a group, and a size of the group can be specified as well (for example, “no more than 4 children”).


"Push-in" can be used for several reasons:


  • Specific skills being worked on can only be taught in the classroom. For example, if your child is learning how to participate in the large circle appropriately or, for older children, how to participate in small academic groups, this can only be done in the classroom. If your child is in inclusion and receives ABA services in naturalistic teaching (NT) format, that natural setting is the general education classroom.

  • Generalization of skills (i.e. transferring skill learning from one person/setting to another person/setting)– if your child works with therapists outside of the classroom, they can also come in to help your child practice those same skills in real life situations. For example, if your child is learning to take turns, after your child has developed that skill in 1:1 situation with therapist, the therapist can come and help your child take turns during play with his or her classmates.

  • Minimizing transitions – many children do not do well with transitions and being able to work with therapists right in the classroom is easier and sometimes make work possible without triggering behavioral issues.

  • Emphasis on inclusion – some schools have strong emphasis on inclusion and all services are delivered in the classroom. It works for many children, but if it does not work for your child, you need to discuss that with your team and decide if an adjustment can be made or if your child requires a different placement.