A child struggling with a bipolar disorder is often
highly gifted, but may have difficulty making transitions, and may
have co-morbid syndromes that make him or her distractible, inattentive,
anxious, or very perfectionistic. He or she may also be sleepy from
medications or may be having cognitive difficulties as a result
of them. Frequently, children with bipolar disorder have associated
learning disabilites and executive function deficits which make
it extremely difficult for them to organize and break things down
and accomplish complex tasks (we will discuss these executive function
deficits in more detail below).
All of these co-morbid conditions, medication issues,
known and unknown learning disabilities and organizational deficits
complicate a students acquisition of knowledge and adjustment
to academic demands.
When one also considers that these children have an
illness which causes their ability to focus and energy levels to
wax and wane (often according to the season) its not hard
for parents and educators to realize these children need special
accommodations in school.
In creating the type of education you want for your
son or daughter, you must keep in mind that although all the children
we are discussing here have bipolar disorder, each child is an individual
with different social, emotional, and academic strengths and weaknesses.
Therefore, their educational needs may vary from one season or school
year to the next.
The JBRF Educational Page is intended to help parents,
teachers and the educational team ease the strain for the child
struggling with these issues and to ensure a comfort level that
allows these students to learn, benefit, and excel in the academic
Section 504 Option Versus Eligibility
and Classification under the IDEA
Once your child has been diagnosed with a bipolar
disorder and perhaps a co-morbid condition such as ADHD or OCD and/or
learning disabilities of any kind, your child can become eligible
for accommodations in the academic environment. He or she is protected
by two federal laws: Section 504 of the Rehabilitation Act of 1973;
and the more powerful statute enacted in 1975 and reauthorized in
1997 known as the Individuals with Disabilities Education Act (IDEA).
Section 504 mandates that individuals with impairments
that substantially limit a major life activity, such as learning,
are entitled to academic adjustments and auxiliary aids and services,
so that courses, examinations, and services will be accessible to
them. Parents often ask why they should certify their child
under the IDEA instead of under Section 504.
A Section 504 is intended primarily for use in the
mainstream classroom. If a child needs minor accommodations such
as a bathroom pass because he or she has frequent urination as a
result of a drug such as lithium, or needs seating close to the
teacher so that he or she can pay better attention, then accommodations
under Section 504 may be adequate.
However, bipolar disorder is by nature an episodic
illness which may become acute at times. A student with this illness
typically needs more services outside the classroom and may need
accommodations such as time spent in a resource room, an aide, or
a later start to the school day (these accommodations will be explained
in the pages below). These more flexible, all-encompassing accommodations
are rarely available unless the student has an Individual Education
Plan provided by an IDEA classification. (The IDEA provides federal
funds to elementary and secondary schools for public education,
whereas no such funding supports a Section 504.)
In other words, accommodations under a Section 504
may work as an emergency measure while the IEP process is being
conducted (to help ease the stress on the child) but they are probably
not adequate for the majority of children with bipolar disorder
throughout the span of their time spent in school.
Under IDEA, schools are responsible for identifying
and evaluating students with disabilities who may need special education
and services. This federal law also requires schools to continue
providing services for the student as long as they are needed through
their K-12 schooling and up to age 22. The services are provided
through a plan or blueprint called an Individualized Education Programthe
Before the IEP can take place, however, the student
must be tested and found eligible for services. For your child to
qualify for special education under IDEA, it is not enough that
he has one of these disabilities. There must also be evidence that
your child's disability adversely affects his educational performance.
There are 13 categories under IDEA which entitle a
child to services and accommodations throughout the school day.
The two that most often apply to a child with a bipolar disorder
are other health impaired (OHI), or seriously
emotionally disturbed (SED). The SED classification may be
referred to in some states as emotionally disordered
(ED), behaviorally disturbed (BD), or some variant of these.
The phrase severely emotionally disturbed
may sound exceedingly ominous to parents, but in some states an
ED label may make it easier to access better services such as out
of district placements or a therapeutic day school or residential
school if this becomes necessary. If parents do accept this label,
they must be certain that the ED classification (and the IEP team)
does not place the child in an inappropriate placement with students
who have more delinquent behaviors.
Since every state has different laws and ways of classifying
students, it may be best to speak with an educational consultant
or educational attorney before setting out on this journey. To locate
a trained advocate or attorney see the Resource section provided
Initiating the IEP Process
A child cannot receive services until a full evaluation
is completed and the child has qualified as disabled under the IDEA.
A parent should request an evaluation in writing after having first
talked with the special education director and guidance counsellor
to find out how their system initiates the process. In many states,
the parents are asked to sign a consent form which makes their child
a focus of concern. Once the process begins the child
will be observed in the classroom, and a number of standardized
tests that assess IQ, academic strengths and weaknesses, and language
and communication abilities will be administered. Various psychological
assessment tests may be administered as well. Additionally, an observation
by a qualified person (such as the school psychologist) must be
made as part of the assessment to qualify and place a student in
an ED program.
All the testing will be done by the school system
at no expense to the parents. However, parents may bring their own
independent assessments to the meeting. Doing so allows a parent
to handpick an experienced tester who will do more in-depth testing
and supply a very specific report. Since the IEP is the critical
document from which all services and progress benchmarks flow, the
quality and comprehensiveness of the baseline assessments cannot
be underestimated. The professional most qualified to provide this
kind of focused assessment is a neuropsychologistfor all the
reasons we are about to discuss.
The Neuropsychological Testing
of a Child with Bipolar Disorder
Not only do the symptoms of a mood disorder impact
a childs ability to learn, but evidence is emerging that learning
disabilities, attentional problems, and deficits in the area known
as executive functions are a significantly associated feature of
early-onset bipolar disorder.
A learning disability is assumed to be present when
a child has a discrepancy between his or her ability and his or
her achievement. This is typically documented when a student has
a normal or high IQ, but is still two years behind his or classmates
in academic learning. U.S. Public Law states that learning-disabled
individuals are: Those who have a disorder in one or more
of the basic psychological processes involved in understanding or
in using language, spoken or written, which disorder may manifest
itself in imperfect ability to listen, think, speak, read, write,
spell, or do mathematical calculations.
These are broad and rather non-inclusive definitions
of learning disabilities which address mostly verbal disabilities
and which fail to take into account the non-language domains and
area of executive functions. A specific learning disability is a
breakdown in one particular task area, whereas executive function
deficits cut across many domains and impact all arenas of lifeboth
academic and non-academic. Executive function deficits affect the
students ability to organize, strategize, and plan, among
other things. It is highly likely that deficits in the area of executive
functions will not be apparent until schoolwork gets more complicated,
requires more independent work, and more planning and strategizing.
Therefore, unless a child is tested and identified as experiencing
these deficits, the snowballing effect of problems in this area
may not become apparent until middle school or early high school.
If the child shuts down and refuses to do school work at this point,
parents and therapists will look to medication failure and the thriving
of hormones before thinking that it may be silent executive
Therefore, children with bipolar disorder should be
tested with a comprehensive battery of intelligence, academic, neuropsychological,
and psychological tests. These tests identify area of strength and
weakness and do much to explain present difficulties and warn of
future difficulties as the academic work-load becomes more demanding
and intense in the higher grades. The findings of these tests will
guide remediation efforts, and are critical when developing the
Individual Education Planthe IEP.
Who Should Test and How Do You Find The Tester?
Children with bipolar disorder should be tested by
a child neuropsychologist. This is a professional who has specific
training and supervised experience in the assessment and treatment
of patients with brain disorders, and disorders of the central nervous
system. A neuropsychologist typically has a doctorate in psychology
and two years of postdoctoral training within a neurological or
neurosurgical setting (one year in a general setting; one in a childrens
unit). These professionals are licensed by the state.
To find a neuropsychologist, speak with your child
psychiatrist, pediatrician, or pediatric neurologist. Other health
professionals, such as occupational therapists, physiotherapists,
speech pathologists and special educators may also make referrals.
Remember, you are looking for someone who does more than psychoeducational
A comprehensive battery of tests can easily require
eight hours of direct consultation, as well as additional hours
for reviewing records, data analysis, and the preparation of a written
report. The cost for such an assessment will run in the range of
$2,400-$3,000. Some insurance companies may reimburse a portion
of the fees, but many do not. Its a good idea to call your
insurance company for preauthorization.
The schools assessment will not be a complete
neuropsychological evaluation since most school psychologists are
not licensed to administer and interpret the neuropsychological
battery of tests. Some schools may accept the test results that
you bring them and be heartened that a seasoned professional has
pinpointed areas of difficulty. However, the IDEA does not require
them to accept your professionals findings. In the event the
team does not consider the findings in an independent or outside
assessment, you have the right to present your findings in a due
process hearing. In such a case you will want to consult with a
qualified education advocate or attorney. (See Mediation
and Due Process below.)
The Battery of Tests:
A suggested battery of tests (including the battery
that examines the domain of executive functions and that should
be given to all children and adolescents with bipolar disorder)
is listed and discussed in depth in The Bipolar Child, Revised
Edition. For the purposes of this article, we will focus only
on the executive function deficits that so many children with bipolar
disorder are now suspected of having.
What Are Executive Functions?
The pre-frontal cortex and the frontal lobes which
are (just in front of the motor strip), are the areas of the brain
that coordinate speech, reasoning, problem solving, strategizing,
working memory, attention, self-control, intention, motor sequencing,
and other processes central to higher functioning. When all is well,
an individual can plan, strategize, break a plan down into smaller
tasks in order to aim for a goal, assess if the strategy is working
or not and be flexible enough to change it (shift set),
bring working memory to bear, and sustain attention and see the
project through to the finish.
by Jackie Aher
for the Bipolar Child,
Revised Edition, 2002
Research is showing that children with
attention-deficit disorder with hyperactivity, as well as those
with Tourettes syndrome, have deficits in the frontal lobes.
It is now suspected that many children with bipolar disorder also
have problems in the frontal lobes. When the prefrontal systems
dont work correctly, there is a major impact on the ability
to pay attention, inhibit impulses, devise plans, carry them through,
and alter them if needed.
The child with glitches in this area will appear distractible,
impulsive and restless, and disorganized (things will be lost or
forgotten; rooms will be a mess). The problem or problems in the
domain of executive functioning, governed by the frontal lobes may
account for the co-morbidity between ADHD and bipolar disorder,
Tourettes syndrome and Oppositional Defiant Disorder.
Working memory is often confusing to people who understand
short-term memory and long-term memory. An excellent definition
of working memory is provided by Dr. Leslie E. Packer: When
you hold new information in mind while you retrieve past information
to apply to it, you are using your working memory. If I ask you
a question, you keep the question in mind as you mentally search
through your memory files or folders to pull out the
information you are looking for. But what if memorys filing
system is a disorganized mess? Youd know that the information
was in there but it would take you longer to find it
and you may not always find it in time.
Working memory, then, involves the ability to hold
data in short-term memory while manipulating it toward problem solving
or sequencing it in a logical order.
Research studies using functional magnetic resonance
imaging (fMRI) have examined working memory and found that as memory
load grows heavier, activity increases in the front area of the
brain. A key part of the prefrontal cortex and certain other brain
areas stay active, impressing researchers that these areas are involved
in the active maintenance of information in working memory.
Bipolar children also seem to have problems with working
memory. This is not surprising since they seem to have some problem
in the prefrontal cortex of the brain.
Executive functions also affect motor skills as the
motor strip begins the frontal lobes. (If you think of the placement
of a headband on the hair, imagine the motor strip there, and everything
in front of it the frontal cortex. The prefrontal cortex is the
layer of tissue just behind the forehead).
Almost all tasksby definitioninvolve not
only analysis, planning, monitoring, and adjustment of strategy,
but also images and ideas which must be translated into sequenced
motor acts. It is not uncommon for these children to have difficulties
with fine motor skills (handwriting) and motor outflow (initiating
action in space). This is the child who may appear lazy, unmotivated,
and hopelessly disorganized. As one very bright boy put it: Remote
controls were made for people like me.
Parents can read about the problems that executive
function deficits can cause for a student at school at http://www.schoolbehavior.com/conditions_edf.htm.
There are some excellent tips for educators and parents on how to
better organize the child or adolescent. We particularly liked the
picture of the backpack and its being labelled Another black
hole in space where papers and books disappear never to be seen
How to Prepare for the IEP
The maximum amount of time allowed to pass between
the parents request and/or agreement to conduct the evaluation
to the IEP development differs from state to state, but most regulations
cite a time line somewhere between fifty and 120 days. (Note: In
some states the meeting at which the IEP is written is called by
the somewhat misleading phrase Admission, Review Dismissal meetingthe
Whatever its called in your state, you will
have a lot to prepare so that the meeting is productive and so that
the school personnel understand the necessity of the accommodations.
Being prepared will also ensure that the IEP is well written.
Parents must be prepared to educate the school team,
develop a resource binder, rehearse the meeting beforehand, and
decide who will be at the meeting with them (the child psychiatrist,
an advocate, an educational lawyer?).
Any written materials about early-onset bipolar disorder
that you want the special education team at school to review (perhaps
this article, and the FAQ from this site http://www.jbrf.org
-- click on About Juvenile
Bipolar Disorder) should be sent about two weeks before
the scheduled meeting so that the IEP team will have time to digest
the materials and better understand how to write the IEP. Few could
skim and grasp the implications of this illness and construct an
IEP in the hour or two allotted to the process without prior knowledge
about the students challenges and illness.
Preparing the Binder
The three-ring binder should carry a picture of your
child on the front, his or her name and grade on the spine, and
be divided into sections inside. These should include:
1. Important contacts and telephone
2. Reports or letters from the
professionals working with your child. An example would be letters
from the psychiatrist or therapist with any recommendations they
have for your child's education.
3.Results you have from private
assessments such as the neuropsychological testing. These test
results should support your childs need for an IDEA classification.
4.The complete list of accommodations
from this article.
5. The sample
IEP from The Bipolar Child website. This sample IEP will help
you with your input at the IEP meeting.
chart from this article is a visual aide to help the IEP team
better understand how to interpret disruptive behaviors and recommend
how to develop interventions which will reduce these unruly behaviors.
7.Examples of your childs
work which exemplify areas of difficulty and areas of giftedness.
8. A copy of Jennifer Bolleros
beautifully written and reasoned article called Playing
Hearts, Not Poker available at the Harbor
House Press Law site. No parent should leave home for an IEP
meeting without reading or re-reading this article.
Educating the Team About Accommodations That Will
Benefit Your Child
Since a parent usually understands the illness and
the side effects of the medications better than anyone, he or she
should be ready to spell out a list of symptoms and medication side
effects and proposed modifications in the academic schedule to accommodate
the childs difficulties and to make the school day more productive
and comfortable for the student.
Hopefully, by the time the education team sits down
to write the IEP, the parents can provide the independent neuropsychological
assessment which can pinpoint any specific learning disabilities,
learning styles, and possible weaknesses in the domains of executive
functions. (This neuropsychologists report should make recommendations
for the academic arena and these recommendations should be addressed
in the IEP also.)
We thought it would be helpful to divide the modifications
into categories where parents and educators could see at a glance
which symptoms the student has and which accommodations will have
to be incorporated into the IEP. Four categories the IEP team should
consider when developing an appropriate IEP for a student with a
mood disorder are:
I. Symptoms caused by the mood
II. Side effects of the medications
used to treat the condition
III. Attention and organizational
IV. Specific learning disabilities
to view all the symptoms and accommodations)
Constructing the IEP
The Individualized Education Plan, constructed by
the school team, is a written statement of the goals, objectives,
and services that will be provided to assist a child with exceptional
educational needs. A well-written IEP will incorporate long term
goals and very specific measurable objectives accompanied by a timetable
in which those objectives will be met. Federal law mandates that
an IEP include seven required parts:
1. A statement of the childs
present level of performance.
2. A statement of the goals and objectives.
3. A statement of special education services to be provided (including
location, duration, and frequency of services).
4. A statement of the extent to which the child will participate
in regular education.
5. The date the special educational services are to begin and
the expected ending date.
6. The criteria for determining if the objectives are being met.
7. A statement of transition services needed.
The IEP goals should be written for all academic areas
of need (math, reading, writing, etc) and for any school-related
areas of need (such as attendance, school behavior, self-help, social,
emotional, etc.) The language should be very specific.
In addition to the written goals, the document should
answer the following questions:
- What services are to be provided?
- Who will provide the services?:
Specialists, teachers, aides?
- Which teaching methods will
- Where will services be provided:
regular classroom, resource room, and/or special education classroom?
Will it be one-on-one? With a small group?
- How often will the services
- How long will each session be?
- When will the services begin?
To view a model of an IEP written specifically for
a student with bipolar disorder, go to The Bipolar Child website:
The goals of the IEP should be monitored and reviewed
every nine weeks to determine if progress is being made. Parents
may request more frequent feedback. Additionally, parents may request
an IEP meeting at any time to review progress and to request needed
Though the school is required by law to conduct a
triennial review (every three years) where the student will be retested,
this is generally too long to wait to determine if the students
academic weaknesses are being remediated. We advise parents to have
an annual, independent evaluation in early spring so that a meeting
can be called and the results of any evaluations can be shared with
the IEP team. This will ensure that the appropriate program, goals,
and objectives are in place for the next school year. Some states
and school districts require and regularly provide annual reviews.
Annual reviews do not require a complete neuropsychological
evaluation. Instead, they focus on troublesome areas that are being
remediated in school or with private tutors. Do not assume your
child will tell you (or be able to identify) that he or she is having
a problem or that the work is too difficult. Instead, they become
Masters of Defense and develop the attitude Who gives?
Also, understand what grade level means.
If a dyslexic student has a verbal IQ of 138 and her reading is
at grade level, assume that this is a near-tragic scenario.
Any child doing work three standard deviations below his or her
cognitive ability (no matter what the learning disability) is a
child in trouble. Some schools may not recognize this or wish to
point it out to parents as they fear a due process hearing.
What If the School is
Non-Compliant with the IEP?
An IEP may be beautifully written with the best of
intentions but a parent may begin to notice that the mandated services
are not being provided, or are being provided inconsistently. This
may occur when mainstream teachers ignore the modifications and/or
accommodations set down in the students IEP. The parent has
not only to question this, but must document it as well. The parents
first course of action is to remind the school in writing that they
are required to follow the IEP. The more documentation that a parent
has, the better the case that he or she will be able to advocate
for the child if corrections are not made and the situation heads
to mediation or due process. (Hearing officers do not like to see
that schools are out of compliance with an IEP so a parent needs
to document carefully.)
Any omission of an accommodation or a service should
be noted in a log by the parent, and a letter detailing this omission
should be sent to the special education teacher with copies to the
school administrator and program manager at the district level.
If the matter is handled over the telephone, a letter should be
written as a follow-up to confirm the content of the discussion
that says: This is to follow up in writing what we discussed
on the telephone today
If matters do not improve with dialogue and follow-up
documentation, a parent should contact his or her states Protection
and Advocacy group. This is a nationwide network that, among other
things, devotes considerable resources to ensuring full access to
inclusive educational programs. A phone call or letter from the
Protection and Advocacy group requesting accommodations or that
accommodations already in place be complied with, or the presence
of one of the P&A personnel at an IEP meeting almost always
ensures things happening.
To find the Protection and Advocacy group in your
state, call the National Association of Protection and Advocacy
Inc. at 203-408-9514; or visit their web site at http://www.protectionandadvocacy.com
and click on P & As/CAPS.
If matters still do not get resolved, the IDEA includes
rules of procedure for resolving such complaints. These rules include
mediation, due process hearings, and appeals to the state or federal
courts. (See the section on Mediation and Due Process Hearings below.)
Functional Behavioral Assessments
and Behavior Intervention Plans
While many children with bipolar disorder dont
act out in school (but save their pent up frustration and upset
for home and mother), some do. The school may try to discipline,
suspend, or expel the student due to unruly or oppositional behaviors
without understanding that many of the behaviors are a result of
the students condition. If you or the child psychiatrist believe
that these behaviors are sequellae of bipolar symptoms, you should
request that the school conduct a Functional Behavioral Analysis
(an FBA). Based on the findings of the FBA, the school must write
a Behavior Intervention Plan (BIP) into the IEP. This is now mandated
The FBA/BIP Process
The FBA (Functional Behavioral Analysis) is a formal
assessment which can identify problem behaviors a student is exhibiting,
where they are having them, when they are having them, and with
whom they are having them. The data is analyzed and a Behavioral
Intervention Plan is developed which provides goals to replace problem
behaviors with positive behaviors.
Only trained professionals such as psychologists or
special education teachers with specialized training are qualified
to conduct a Functional Behavioral Analysis. We cannot stress strongly
enough that parents need to investigate the level of experience
of the people assigned to conduct the FBA. If it becomes obvious
that experienced professionals are not available, then the parents
are going to have to insist that the school district bring in such
professionals from the outside. Otherwise school districts will
continue developing BIPs which are inherently flawed and subject
The data from the FBA is used by the BIP team (school
psychologist, teachers, support teachers and any other professionals
who work with the child) to develop an appropriate intervention
plan that will:
- Describe the behavior
- Determine the functions of behavior
- Develop interventions that will
replace untoward behaviors with new behaviors.
- Develop a timeline for reviewing
The school will implement the plan and, over time,
evaluate the outcomes as outlined in the plan.
It is important when observing a child with bipolar
disorder to differentiate between behaviors that can be modified,
and symptoms of the illness. For example a child may be refusing
to work because he is overwhelmed by the stimulation in the room,
does not understand the assignment, and/or feels lethargic from
the meds and/or the illness (or a combination of these factors).
Therefore, he is simply not able to perform to the teachers
expectations at that time, as opposed to being defiant to earn the
respect of his peers, or some other outcome (known as a function)
of the behavior.
It may be necessary for the team to receive training
in childhood bipolar disorder before the team is able to create
an effective and appropriate Behavioral Intervention Plan--one intended
to identify the antecedents of the problem behaviors and modify
them with positive behaviors.
The Behavior Intervention Plan should:
- Identify the antecedents to
the problem behavior
- Focus on positive supports
- Teach replacement behaviors
- Manipulate antecedents
- Manipulate consequences
- Change curriculum or instruction
- Monitor and evaluate effectiveness
and modify if necessary
Some examples of these interventions are:
| Child refuses to do classwork
|| -Lethargic from meds
-Overwhelmed by the assignment
| -Allow student to work on a creative or interesting
- Have an aide work one-on-one with the child.
- Reduce the length of the assignment.
- Allow the child to work in a study carrel.
|Child interacts inappropriately
|| Inability to read social cues
||School offers social skills taught by school
pschologist or school social worker
|Child pushes other children
|| Sensory Integration Issues
|| Student stands at the back of the line an arms
length in line away from other children
For more information about FBAs and BIPs, contact
the Center for Effective Collaboration and Practice. This is a national
organization that helps students with emotional and behavioral problems
in school. Go to http://cecp.air.org/fba/default.htm
Two other helpful sites are:
Where Can The Students Needs Best be Accommodated?
Because federal guidelines call for placing any child
with a disability in the least restrictive environment, most
public schools begin providing services in the regular classroom.
If the child continues to struggle or does not make progress in
the general education classroom, the team may decide (with the parents
agreement) to place the child in a self-contained classroom within
the public school setting. Here the class size will be reduced and
there will be more accountability to the individual student. There
are typically one or two special education teachers and a trained
aide or two working with the student in the self-contained classroom.
Depending on the student and the special ed program, the child may
be mainstreamed into regular education classes for some
academic subjects and for elective periods such as music, art, gym,
The time may come, however, when it becomes clear
that a small, therapeutic program in a private or public school
would be a more appropriate placement for the student. When a students
illness negatively impacts his or her learning and no progress is
being made academically, socially and/or emotionally, the parents
and school team should begin to discuss a therapeutic day school.
This is a separate school, usually with a small number of students,
a small class size (six to eight children), in a classroom with
a trained special education teacher and a trained aide. The child
receives academic instruction along with group therapy, individual
therapy, social skills classes, and art and music therapies.
Some schools will make recommendations of therapeutic
day schools, but some will tell parents only about programs that
are inexpensive for the school district and which may serve more
as a warehousing situation than an appropriate place for education.
Nor will all communities have any kind of therapeutic day schoolgood
In these situations, parents will want to contact
an educational consultant (and may have to secure the services of
an educational attorney). The Independent Educational Consultant
Association has a list of reputable consultants in all areas of
the country. Go to http://www.iecaonline.com
or call 703-591-4860 to obtain names and phone numbers. Educational
consultants are trained experts who possess comprehensive knowledge
of placement options. Many consultants specialize in crisis-intervention
and have extensive experience advising families with children who
have emotional and behavioral difficulties. This expertise is used
to advise you on the most suitable placement for your child.
Parents can also contact their Department of Educations
Special Education Division. Most states list their approved therapeutic
day schools so you can at least get started. Go to: http://www.ed.gov/Programs/bastmp/SDSE.htm
Therapeutic Boarding Schools
and Residential Treatment Centers
Therapeutic boarding schools are generally middle
schools, and high schools that have comprehensive therapies for
the students and a program to help them with self-esteem and problem
behaviors. Some of them are character building schools,
and all have individual philosophies.
At this time most of the therapeutic boarding schools
do not have a medical plan for bipolar disorder, and do not provide
psychiatrists on staff. If you want your child to attend a therapeutic
boarding school he or she needs to be stable enough to attend school
with therapy support, while maintaining a relationship with an outside
psychiatrist. Additionally, some schools do not wish to administer
Residential Treatment Centers
Sometimes the school that best meets the childs
needs just doesnt exist anywhere near the childs home,
or the child may become too unstable to stay at home and attend
school. It may become painfully obvious that a change in environment
with a twenty-four-hour peer group and nonparental authority figures
may help the child blossom and mature in a safe environment. Maybe
they are a danger to themselves or to others and they need to be
in a setting that can monitor their illness, as well as provide
them with tools to understand and deal with their illness.
Residential Treatment Centers (RTCs) are medical facilities.
They have psychiatrists and nurses on staff. They administer medications,
make medication adjustments, and provide therapy and schooling.
They are required to follow a students IEP.
Residential schools can cost anywhere from $56,000
to over $125,00 per year. A school district may pay part or most
of the fee of such a placement, but typically only after a due process
Parents should definitely seek the help of a professional
consultant and the child psychiatrist should be involved with the
search process. Websites that are particularly helpful are: Family
Light --also known as Bridge to Understanding http://www.bridgetounderstanding.com;
(check under special education); and Ron Woodburys Struggling
The American Association of Childrens Residential Centers
Mediation and Due Process
Some parents will need to go to mediation or due process
to achieve the proper educational accommodations or educational
setting for their children; and this is where the relationship between
school and parents enters the legal arena and the relationship becomes
adversarial. It is not recommended that parents go through this
process alone, so parents will need to procure the services of an
experienced educational attorney.
The decision to pursue due process is a very serious
one as the costs--financial and emotional--to the parents can be
enormous. To explore the pros and cons in full, first read the education
chapter of The Bipolar Child, Revised Edition, especially
pages 307-310; and be prepared to spend multiple hours at http://www.wrightslaw.com
--the gold standard of the rights of special needs students.
To locate an educational attorney, go to http://www.abanet.org
Homebound instruction is considered a general
education placement, but it is considered the most restrictive
placement because it removes the student from the mainstream and
peers. However, it is frequently used for a student who is too symptomatic,
or too emotionally fragile to attend school in the school building.
It is considered a temporary placement until the student is able
to return to school or until a more appropriate placement can be
Parents need to know that a doctors order
must accompany the request for home instruction. An IEP meeting
will determine how often the tutors for each subject will come to
the house to provide instruction and lessons for the student. Some
school districts require a doctors therapy or treatment plan
to accompany any application for homebound instruction.
If an appropriate learning situation is not available
in your geographic region, and if the stresses of schoolany
kind of schoolare making it difficult for the child to function,
or to recover from an episode or hospitalization, some parents may
want to consider the option of homeschooling.
Homeschooling was viewed, not too long ago, as very
counterculture, or something that people did solely because of religious
beliefs. As outcomes of homeschooling were measured, however, and
the homeschooled children often tested two years ahead of their
in-schooled peers, homeschooling has become more generally accepted.
All 50 states allow for it as long as the parent completes the necessary
paperwork with the states department of education. To locate
your states DOE, go to http://ucasdweb.iu5.org/Learner%20Links/stdpted
Thanks to advances in technology, homeschooling can
be done richly and effectively on computers with CD-Rom curricula
or even over the Internet. This mode of learning may be particularly
beneficial for a bipolar child because it focuses learning and helps
students with attentional problems. One such curriculum, Switched-On
Schoolhouse, is an advanced multimedia-based learning environment
that incorporates video clips, sound files, animations, computer
games, drills and tests. With earphones, a parent can homeschool
The student works at his or her own pace and if a
hospitalization should interrupt learning, the student doesnt
miss the work but just picks up where he or she left off.
Switched-On Schoolhouse has curricula for grades 3-12,
but it is a Christian curriculum with some religious content woven
sporadically throughout the text. If this is an issue, a similar
secular program is available from Pathway Publishers and is called
Odyssey Ware (see homeschooling web sites below).
The availability of special education services for
homeschooled children varies from state-to-state. Some states may
consider a homeschooled student to be enrolled part-time in the
local district; in this case, the district would continue to provide
full or partial services under an IEP. Other states classify homeschooling
as private schooling, so the student is not entitled to an IEP.
(However, the student may qualify for a services plan. See http://www.ideapractices.org/law/briefs/brief10.php
for a description of the law when parents place their child in a
You will need to research the practices and options
in your state and local
district. Start with your state's Department of Education. The following
link may help you determine the current status of special ed services
homeschoolers in different states: http://www.hslda.org/search.asp.
To further explore the prospect of homeschooling,
or to take a look at programs that may help a child catch up when
work is missed, take a look at the following web sites:
--Official web site of Practical Homeschooling Magazine,
Listing of homeschooling organizations in your area, Home Life Catalogue,
-- The Home School Legal Defense Association
Interesting discussion forums for parents who are or are thinking
-- Switched-On Schoolhouse s CD-Rom Curricula and other Alpha
(Odyssey Ware CD-ROM curricula, the secular version of Switched-On
-- On-line accredited schooling from Alpha Omega Publishers (interactive
schooling with teachers, counsellors and support staff)
To read the story of two parents and the school they
founded to serve the needs of children with bipolar disorder and
their families using a CD-Rom curriculum that makes such a school
economically feasible, go to http://bipolarchild.com/newsletters/0110.html.
Any questions you have regarding your childs
education can be asked of and discussed with the JBRF educational
team and other parents and educators who visit this site simply
by clicking on the Educational Forum. We look forward to your visit and to getting
to know you.
Mary Jane Hatton and Sandi Norelli, Co-Directors,
the JBRF Educational Team
and Accomodations >
This article was written by Janice Papolos (co-author
of The Bipolar Child, Revised Edition), Mary Jane Hatton, and Sandi
Norelli, (co-directors of the JBRF Educational Team), Christine
E. Garcia, M.Ed., and Anne Marie Smith, M.Ed.
Copyright © 2002. All Rights Reserved.