My Son Is Going To College


Parent Advocate, Tracey Mayer will be offering up her writings to The Concussion Blog as a resource to the readers, especially the parents out there.  As time allows she (and possibly her son Drew) will be submitting posts for you to read.  I truly hope that everyone gets a chance to read about concussions from yet another perspective.  Thank you Tracey!

Drew was accepted into his first college of choice, Illinois State University –  the only school he wanted to apply to.  This is wonderful news.  We were all holding our breath with anticipation, after all, Drew’s freshman and sophomore year transcripts held quite a few C’s.

I called our school psychologist, hoping for some guidance on how to approach the college in regard to accommodations for Drew.  Unfortunately, she more or less told me that we are on our own, and I will have to contact the disabilities office at ISU and find out what services they offer.  I can’t say that I am surprised to hear that, although it is disappointing.

I am going to make that call tomorrow, and there are so many thoughts in my head.  How do I approach this?  How do I organize the information so it’s as clear as possible?  Do I even have the right or enough information?  Are they even going to understand what I’m talking about?  Or will they care?  College is very different from high school, so is extra time on tests going to be what he needs?  Will he need breaks on tests, tutoring, etc.?  Who will help us determine this?  So begins another search for answers and based upon my previous work, you can see where I might be a bit concerned.

When I applied for extended time on the ACT for Drew, this is what the letter from the College Board said – “Please provide a detailed description of your disability, including the frequency, duration and intensity of your CURRENT symptoms.  Detailed information from your teachers would be helpful.  It would be helpful to provide an updated neurological evaluation.  For medical disabilities, the documentation should show that a comprehensive assessment was conducted to arrive at the diagnosis and to determine the need for the requested accommodations(s).  Documentation should include a history, course of illness, summary of assessment procedures and evaluation instruments used to make the diagnosis, a narrative summary of the evaluation results, treatment and medication (past and current) as well as a rationale for each accommodation recommended by the evaluator.  A qualitative description of how your disability impacts your academic functioning, specifically its functional impact on your ability to take College Board tests, should be included.  Please include detailed descriptions from your teachers regarding your need for, consistent use of, and benefit from accommodations in school may prove helpful.  Please provide a written report and standard/scaled scores for all academic and cognitive subtests.”  I have a feeling the college will request something of the same nature, but it would help if I had something from a doctor.

Drew will be seeing his neurologist on Tuesday, but since I had to write the letter I needed from her to submit with the ACT application requesting additional time, I am not expecting her to offer much to the college.  I guess if I tell her exactly what I need like I did last time, and perhaps write the letter again for her to copy on her letterhead we might have something to work with, although I don’t even know what we should be asking for at this point.

The neuropsychologist who tested Drew after his injury told me she will not give me anything that states that the results of the neurocognitive testing performed on Drew may not be accurate since the testing is not written for concussed patients, and there are too many variables.  She outright said no, she will not do anything for us.

I have since learned of another pediatric neuropsychologist practice that appears to really fight on their patient’s behalf; so perhaps if I take Drew to see them they might be able to help us.  Of course, that would possibly require him having to go through extensive testing, which begs the question – what tests, and are they going to be consistent with his problems or end up being the same as the first time?  In the first testing the results didn’t show any significant deficiencies because it was not the right type of testing – utterly confusing.  It’s like going to the doctor complaining of a sore right ankle and having him or her x-ray your left shoulder and say everything looks fine.  How do I ask a doctor to test him based on the fact that intense focusing triggers migraines, particularly in math and science?  I also need to include the fact that he still forgets some things – we don’t see a specific pattern – sometimes he cannot remember the simplest of things at all: like what he ate for lunch or a kid’s name that he should know.

Drew has taken medicine, mainly to help him focus which helps, but we are trying to keep him off the meds because it shuts him down and makes him feel sick.   He now receives 50% more time on tests, which reduces the stress and helps prevent the headaches, but he doesn’t always need it –it depends on the class and the test.  So, we cannot show the difference between the test results with extra time and no extra time.  Or the tests with meds versus no meds – meds…..no meds…..regular time……extra time…….all of the above…..none of the above……is your head spinning yet?  Mine is.

One step at a time.  First call to ISU disabilities office tomorrow.  Deep breath.  I’ll keep you posted.

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15 thoughts on “My Son Is Going To College

  1. Don Brady, PhD, PsyD, NCSP, Licensed Psychologist October 17, 2011 / 10:12

    Ms. Mayer,

    Congrats to Drew on his accomplishment…and to you for your support.

    I Googled the ISU Disabilities office and found the below list of FAQs and available answers on their website. Assume you may have read them…but have included the questions within my response to also inform others of these type of issues and the availability of corresponding answers to various related questions.

    Suggest you and Drew find out the specific criterion and what is needed for documentation directly from the disabilities Office staff when you contact the ISU office. From gleaning the material on the website, it appears a student, 18 years of age or older, should be involved in informing the disability office staff of his/her presenting issues.

    Keep in mind that documentation has previously been obtained of the exisitence of a disability. for your son. This previous documentation should be a plus re advocating for assistance with a disability at the college level.

    ============================================

    Student FAQs [ obtained from ISU website ]

    Disability Concerns provides the following answers to commonly asked questions that students may have about our services.

    •What are the most important factors for a student with a disability to succeed in college?

    •What are some strategies I can use to advocate for myself?

    •I was in a special education class (IDEA) or had a 504 Plan in high school. Am I automatically entitled to the same services that I received in high school?

    •May I meet with someone from Disability Services when I am on campus for a tour or interview?

    •Should I self-identify that I have a disability during the admission process?

    •Are there separate admission standards for students with disabilities?

    •Will it prejudice my case, or help my case, to inform Admissions that I have a disability?

    •If I am a student with a disability, will Disability Concerns seek me out to provide services like my counselors did in high school?

    •What role can my parents have in helping me request accommodations from Disability Concerns?

    •What documents does the University need to assess eligibility for accommodations based on a disability?

    •Who is responsible for paying for documentation to verify my disability?

    •When and where do I send my disability documentation?

    •If I am receiving accommodations at another college or university will I automatically receive accommodations at Illinois State University?

    •What should I do if I have never received accommodations and suspect I have a disability?

    •How do I apply for services?

    •If I become a client of Disability Concerns will it show up on my academic record?

    •I suspect I have a learning disability. Can Disability Services conduct the assessment to provide a diagnosis?

    •What reasonable academic accommodations are available for students?

    •What if I need changes in my accommodations?

    •What if I’m not able to maintain a full time course load because of my disability?

    •Do I need to submit a new request and documentation every year?

    •How do I communicate my accommodation needs to professors if I am eligible?

    •Is my disability information shared with my professors?

    •I’m a Division of Rehabilitation Services (DRS) customer. Is there anything special I should know?

    •Do you have interpreters?

    •What is the process for obtaining a housing accommodation?

    •Do you have designated parking for persons with disabilities?

    •Does Disability Concerns convert course materials into an alternative format?

    •Is tutoring provided specifically for students with disabilities?

    •Are accommodations retroactive?

    ——————————————————————————–

    • Tracey Mayer October 17, 2011 / 14:02

      Hi, Dr. Brady

      I did take a look at the website prior to calling the disabilities office. Thank you for posting the Q&A on here.

      Drew’s situation is a tricky one because if we choose the psycho-educational route, it will require strong supporting evidence. His neuro-psych test results did not show any significant deficiencies because the testing he received was not consistent with his symptoms/complaints. Therefore, we don’t have a strong case with that. His 504 plan was initiated in November, 2010, so we are coming up on just one year of him having extra time on his exams, which is also not a strong track record, particularly since he does not require extra time on every exam.

      During his freshman and sophomore years, Drew’s teachers gave him a great deal of flexibility, however since there was no formal plan in place, nothing was tracked or recorded. The C’s he received should have been F’s, based on true results, but we cannot “prove” that. We can go to the new neuro-psych doctor and request testing that is appropriate for measuring his ability to focus and process material, as well as longer-term memory, and those results could be helpful for a psycho-educational case.

      On the other hand, we can focus on his medical condition of chronic migraines as his primary disability. His neurologist will have to complete a medical letter that outlines his medical condition, along with the recommended accommodations. Once the letter is completed, Drew would call the disabilities office and complete a request of services form over the phone. They would ask him some questions and a committee would review his case. If approved, Drew would visit the disabilities office to become a new client. If refused, we would have to try a psycho-educational approach.

      We don’t know what accommodations he will need because the college setting will be quite different from high school, and he will not have the flexibility he has with his current teachers. He may find that he will need a note taker to reduce the intensity of having to absorb the huge volumes of material during lectures and such. He may find that he will want to test independently, outside of the classroom, and he will want to make sure that if he misses a class and/or an exam due to a migraine he won’t be punished.

      I would feel a whole lot better if I knew that his neurologist had a good pulse on this, but she doesn’t. When Drew sees her tomorrow, I am going to have to walk her through this process and tell her exactly what he needs from her to support his medical condition. Hopefully, that will be enough for approval, and then Drew will have to monitor and modify his accommodations, as needed, once he begins school.

      Warm Regards,
      Tracey

      • Christine Tressel August 20, 2015 / 09:49

        Hi Tracey,
        I’m trying to get in touch with you regarding a story we are working on. Could you please give me a call.
        I’m with a Chicago TV station.
        Christine 312-750-7058

  2. Tracey Mayer October 17, 2011 / 14:32

    Dear, Dr. Brady

    I did visit the ISU website before calling the disabilities office. Thank you for posting the Q&A.

    Drew’s situation is a tricky one. If we take a psycho-educational approach, we need strong supporting evidence. The neuro-psych testing that Drew took 3 months post injury and again one year later did not show any significant deficiencies because the tests he was given were not consistent with his symptoms/complaints. Therefore, he does not have a strong case. As well, his 504 plan was implemented in November, 2011, so we are not even at the one year point yet, which does not give a long track record to study. During his freshman and sophomore years, Drew’s teachers gave him a lot of flexibility, but since he was not on a formal plan nothing was documented. His C’s would have been F’s, based on true results. So, we don’t have strong neuro-psych support, and we don’t have strong support from the school or teachers.

    On the other hand, we can try a medical approach based on his condition of chronic migraines. His neurologist will have to compose a medical letter stating his diagnosis and recommended accommodations. I wish she had a better pulse on this, but she doesn’t, which means I will have to tell her exactly what to write…..again. Once the letter is completed, Drew will call the disabilities office and complete a request for services form over the phone. A committee will then review all of the information and approve or reject the request. If approved, Drew will visit the disabilities office to become a new client. If rejected, we will have to take a psycho-educational approach, which would involve more testing…..the proper testing, hopefully.

    It’s tough because the college setting is very different than high school. Drew may not know exactly what he needs until he begins school and gets a feel for it. He may need a note taker to reduce the intensity of having to absorb huge amounts of material during lectures. He may want to test independently – outside of the classroom. He will have to be allowed to miss class and/or an exam due to a migraine without repercussions.

    We will start with the medical letter and see see what happens. The good thing is that there is plenty of time, in the event this takes several attempts. Something tells me it will 🙂

    Warm Regards,
    Tracey

  3. Don Brady, PhD, PsyD, NCSP, Licensed Psychologist October 18, 2011 / 00:43

    Dear Ms. Meyer,

    I have faith that you and Drew will succeed thru your knowledge, wisdom and perseverance.

    From my perspective, some of your above statements reflect an ongoing and significant debate existing in medicine and psychology re conducting a valid and reliable concussion assessment.

    Three fundamental issues/questions that emerge from this debate follows:

    1-What constitutes a thorough concussion assessment and incorporates the science and art of medicine/psychology?

    2- Is a valid and reliable assessment of concussions possible at this time?

    3- What is the role of the clinician’s judgment in this assessment process?

    Below you will find some excerpts of writings by Flo Brady and/or me which briefly expand on these three questions. These excerpts also cite several prominent 1900’s pioneers in the area of concussions.

    Furthermore, it is my clinical viewpoint that neurocognitive screenings are insufficient to effectively evaluate a concussed brain…if the screenings do not thoroughly evaluate possible cognitive, physical and emotional effects of a concussion.

    =======================================================================
    Excerpts:

    1- Strauss and Savitsky (1934) are credited with coining the phrase postconcussion syndrome (Evans, 1994), and they posited that not only may a concussion occur without a loss of consciousness, but that it has an organic basis. In their extensive 63-page review of the topic, they emphasized the importance of documenting clinical observations and of not quickly attributing vague or unusual findings to functional/psychological origins. The value of the clinical judgment was also highlighted in the following statement: “Results of tests and exact quotients cannot take the place of the opinion of an experienced clinician” (p. 912).

    ============================================================================

    2- The uniqueness and subtleties of each concussion warrants an exploratory process that analyzes presenting concussion symptoms with an investigative clinical judgment. Therefore, this methodical and investigative process requires the inclusion of approaches that utilize the science and art of medicine (A. Joachimpillai, personal communication, September 15, 2003; Meeuiwisse, 2002). The utilization of a logical and investigative clinical judgment process is a core component of the concussion evaluation and the return-to-play assessment process since it has been clearly pointed out that many of the current neurocognitive and neuroimaging instrumentations and evaluation techniques are generally not sensitive enough in assessing and detecting mild brain injury (Bleiburg et al., 1998; Damasio,1994; Lovell, 1998). This lack of sensitive test instrumentation also acknowledges the limitations of a scientific methodology that only utilizes concrete, and thus observable, data as the sole valid and reliable data for drawing conclusions.
    ===========================================================================

    3- In an extensive review of research pertaining to mild brain injury, Reitan & Wolfson (2000) strongly cautioned that many researchers who have examined mild brain injury have typically not employed comprehensive neuropsychological test batteries in their methodology. The authors perceive this as a major flaw in evaluating the impact of mild brain injury, because they firmly believe that standard neuropsychological test batteries have frequently been shown to be sensitive to both focal and diffuse brain damage. They also pointed out that researchers typically have limited their assessment and focus due to
    a premature presumption that neuropsychological impairment is limited to a rather narrow range of deficits, and that a restricted range of tests is all that is required for adequate neuropsychological assessment. Our clinical experience suggests that mild brain injury produces diversified and even widespread neuropsychological losses in some patients (p.97).

    The medical evaluation component of a brain injury assessment is also highly suspect since typical medical assessment methods (i.e., neurology exam, EEG, brain-imaging techniques) utilized in determining adverse effects of mild brain injury are rather gross and insensitive, and thus false conclusions may be derived which report no neurological deficits were sustained (p.43).
    A similar perspective pertaining to false conclusions was shared by McClelland (1996) when he cautioned, “…the absence of evidence is not evidence of absence” (p. 566). This view was reiterated by Gronwall (1991), who stated, “…it is impossible to prove the null hypothesis. Failure to show a deficit does not prove that no deficit exists, and the neuropsychologist has a responsibility to make sure that appropriate tests for assessment are selected” (p. 257).

  4. Tracey Mayer October 18, 2011 / 11:30

    Hi, Dr. Brady

    If you are wondering why there are two similar replies above, it is because my first response to you did not post so I re-typed it from memory since I didn’t save a copy 🙂

    Your points are all very well noted. I also think neurocognitive tests are not an accurate measurement for a concussed brain. Unfortunately, that is what is required when taking a psycho-educational approach to applying for accommodations. If Drew is refused accommodations based on his medical condition, I am going to have to use everything I can get my hands on prove his case from another point-of-view.

    I am going to give a copy of your excerpts to his neurologist today when we see her. I will push her to take a more active role in helping to prove that Drew deserves accommodations.

    Warm Regards,
    Tracey

    • Don Brady, PhD, PsyD, NCSP, Licensed Psychologist October 19, 2011 / 00:38

      Dear Tracey ,

      Some clarity from me along with a request for consideration …

      Reitan & Wolfson have advocated for a comprehensive neuropsychological assessment for an mTBI as any component of the brain and brain function may be injured. Again what constitutes a comprehensive eval may vary among professionals.

      Neurocognitve screenings are more limited in scope & may only evaluate suspected areas of possible brain function/dysfunction.

      In general, and based on my training and experience, screenings are not as comprehensive as an assessment.

      ====================================================

      If it is ok with Drew and you, I would be curious as to knowing ALL the tests and subtests along with any other methods for gathering info/data that were used to neuropsychologically evaluate Drew.

      I do not wish to know any of the specific scores or other interpretive data info…just the names of each assessment/screening tool employed to complete the evaluation..

      Thank you both for your consideration.

      • Tracey Mayer October 19, 2011 / 17:06

        Hi, Dr. Brady

        I would be happy to send you a list of the tests and subtests, etc. that were used to evaluate Drew. Please provide me with your email address. Once you have reviewed it, I would like to continue our conversation on here so others are privy to the information.

        Thank you so much for your interest and support. It means a great deal.

        Tracey

      • Don Brady, PhD, PsyD, NCSP, Licensed Psychologist October 20, 2011 / 00:44

        Dear Tracey,

        Assuming the sending of the info is ok with Drew, please email the list of all assessment procedures to don@donbrady.com.

  5. John Gonoude October 18, 2011 / 12:20

    Tracey,

    Congratulations! So happy to hear this for Drew, as I am sure it is an absolute relief and sign of progress in his recovery. I wish nothing but good things to come for you and your son, and hope that Drew enjoys the opportunity of the collegiate experience. As always, I am always available if Drew ever needs someone to talk to, for I have sat where he is at right now.

    Again, great to hear.

    • Tracey Mayer October 18, 2011 / 13:48

      Hi, John!
      Thanks for your kind words. I will let Drew know that you are available to talk with him – I think that would be nice 🙂

      Tracey

  6. Michael Hopper October 18, 2011 / 14:00

    Tracey,

    Feel free to contact me as well. I can put you in touch with a couple of athletic trainers at ISU. They have a Graduate Athletic Training Program and a couple of them have focuses in concussions. I’m not sure how much help they’ll be, but let me know..

    hopsweb(AT)gmail.com

  7. Tracey Mayer October 18, 2011 / 14:29

    Thank you, Michael!

    • Dustin Fink October 18, 2011 / 19:43

      Tracey,

      When I sent out the tweet regarding your last post I included the Daily Newspaper of ISU, the Daily Vidette, and they replied by retweeting it… Needless to say they should be aware of your intentions on campus! Glad we can help, and hope that if anyone else seeks this support we are all right here…

  8. Tracey Mayer October 18, 2011 / 20:06

    Dustin, that is fantastic! What a wonderful feeling to have such amazing support.

    Thank you! Thank you! Thank you!!!

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