In services and still feel like something isn't working

Picture a Tuesday. A school team runs a plan with 14 goals. That afternoon a clinic runs a different plan with its own goals. On Thursday a speech therapist works on a third set. None of the three reports mention the other two, and the only person who has read all three is the parent standing in the kitchen at 6:00 pm trying to remember which plan said what.

This is for the family that already got through the hard part. You got the services. You fought for the hours. And now you have a question you may not feel allowed to ask out loud: is this working?

Who is running your child's team?

Someone has to run the team, and unless you decide otherwise, that someone is you. Your child may be getting services from three systems with three sets of rules: school (the IEP), the clinic (the treatment plan your insurer authorizes), and home and community supports (the waiver service plan). They do not share a database, a calendar or a definition of progress.

Many families have six people serving the child and zero tables where those six people sit. You are the only place their advice meets.

Your job description is shorter than you think. Ask every provider the same four questions: What are you working on? How do we know it's working? Who is responsible for each piece? What changes if it's not? Keep one set of papers, and decide in the end whether a plan is worth continuing. You do not have to be the clinician.

Read the IEP with a pen

Federal law spells out what an IEP must include: present levels of academic and functional performance, measurable annual goals, how and when progress will be measured and reported, the services with their frequency, location and duration, and accommodations. Those words are your checklist.

A good goal names a skill, a condition, a measure and a date. If two reasonable people could disagree about whether a goal was met, it was too vague. Watch for "services as needed," and for what is missing, like a safety section for a child who wanders. Find the line that says when progress reports come, and circle it.

Your rights in the IEP meeting

• You are a member of the team, and you or the school can invite others with knowledge of your child, like their speech therapist or behavior analyst.
• The meeting has to be at a mutually agreed time and place. If the time offered is impossible, ask for another.
• Ask for the draft ahead of time. You can ask to pause or continue another day.
• Before you sign, ask what the signature means: attendance or agreement.
• Send a one page parent concern letter a week ahead: what is going well, what worries me, what I would like the team to consider, and what I need from this meeting. Ask that it be attached.
• Send a same-day follow-up email listing what you understood was decided.
• If the school says no and nothing is in writing, ask for prior written notice.

When the answer is no

If the school says no, IDEA gives you a ladder, and you do not have to start at the top. The first rung is simply asking in writing. If insurance says no, a denial letter has a clock on it that starts the day it arrives, so find the deadline first.

When nothing is wrong and it still is not working

Sometimes services are happening, no one is unreasonable, and your child is not changing. Track numbers for every goal, ask the clinic for the plan, the data and the end, and walk the checks in the episode before deciding what to change.

And ask your child. If your child communicates in other ways, watch: do they go to the clinic door willingly? Do hard days cluster around a person, a time or a place? A child who consistently resists a service is giving you information. It always means somebody should look.

Put it on a calendar

• The annual IEP meeting, with a reminder six weeks earlier, and the three year reevaluation.
• The end of your clinic authorization, with a reminder 30 days before.
• Insurance open enrollment, Medicaid renewal dates, and a call every six months to confirm you are still on every waitlist with current contact information.
• A 90 day review: what did we say we were working on, how do we know, and what changes?

Ashleigh Dominguez, MS, BCBA, is licensed in North Carolina, Georgia, and Iowa. This article is general education based on the episode. It is not clinical, legal, or treatment advice for your child or your state. Corrections and sources are listed in the YouTube description.