Letter from Dr. Ansel

LEARNING DIFFERENCES & DEVELOPMENTAL VARIATION

Letter from Dr. Ansel to the state Dept. of Education:


2 May, 1999

Special Education Regulations
Mass. Department of Education
350 Main St., 5th fl.
Malden MA 02148-5023

Ladies and Gentlemen:

I am a Developmental Pediatrician practicing in Massachusetts for almost 12 years. My private patients include children with a wide range of disabilities – from the severe (Mental Retardation, Cerebral Palsy, Autism) to the relatively mild (Learning Disability, Depression) and everything in-between. In my role attending at Children’s Hospital in Boston, I help direct a multidisciplinary clinic assessing Middle & High School students with learning, attention, and behavior problems. I am writing to voice my strong opposition to the DOE’s proposed changes in Massachusetts Special Education (SPED) regulations.

While there is no doubt current practices in this state regarding SPED are flawed, and in need of reform, the proposed changes fail to address many of the most glaring problems – at least as seen from any point of view other than a school administrator’s. While they may save money, they will increase the burden of parenting a child with special needs, decrease the number of Massachusetts children being well served, and not resolve any of the inequities of the current system. I would respectfully submit that any attempt at SPED reform in the Commonwealth ought to include the following features:

1.) SPED law was not originally written or intended for many of the kinds of children it has come to be applied to. We should establish separate & distinct procedures, standards, and guidelines (and perhaps laws) for dealing with milder dysfunctions (e.g. LD, ADHD, Emotional Disturbances) vs. more severe handicaps and disorders (e.g. Mental Retardation, Cerebral Palsy, Autism, Down Syndrome, Blindness, Psychosis). One size does not fit all.

2.) We shouldn’t just “tighten up” eligibility criteria, they need to be made more specific and standardized without requiring undue labeling or pigeonholing of children. If we do that, however, we should simultaneously eliminate the conflict-of-interest created by the current system of placing the functions of evaluation/needs-determination and service delivery in the same hands. We should do away with school evaluations altogether in favor of a network of private, state accredited (and state regulated so they adhere to state criteria) evaluation centers separate from the public schools. Schools would be freed of testing, but have the sole responsibility for fulfilling the recommendations made by these centers. This by itself would eliminate most of the demand for 2nd opinions and independent evaluations.

3.) Our current system seems designed to confuse the issues of “what does this child need” vs. “who is going to pay for it”. Many disputes are really about the latter, but are debated in the language of the former. We need to establish separate funding sources for special vs. regular education so that the two are not in competition and so that schools can fulfill the needs of special children without worry of detracting from their other missions. We also need a frank and thorough public discussion of who ought to pay for what. We must establish more transparent, understandable rules about which things are to be paid for through SPED funding, what things health insurance ought to be mandated to cover, and when (if ever) certain things must default to the financial responsibility of parents.

The proposed regulation changes fail to substantially address any of the above three issues. They would force labeling of many children in order to obtain services, deny services to many needy others unable to “fit” into an approved pigeonhole, all the while creating at least the impression of a reduction in “due process” by imposing significant barriers to second opinions. The current situation of distributing the most resources to the “squeakiest wheels” rather than the most needy kids would not be much changed. I hope the DOE will rethink this proposal, and perhaps work with the state legislature and professionals dealing with special needs children in many capacities/venues around the state to craft a more thoughtful, comprehensive, and compassionate reform.

Sincerely,

 

David A. Ansel, M.D., F.A.A.P.

Associate Director, Young Adult Team
Children’s Hospital – Boston

Clinical Instructor in Pediatrics
Harvard Medical School & Boston University School of Medicine.

Founder & President
Children’s Medical Office of North Andover, P.C.