What is Available and Appropriate in the Continuum of Services?

For children with mild to moderate needs, the general education classroom may be appropriate, with modifications for the individual needs of the child. Service delivery in a general education classroom might include speech and occupational therapy with small groups of students in the room, academic modifications and behavioral goals by the special education teacher, and implementation of the goals and strategies by a paraprofessional or aide.

Some children with fragile X syndrome benefit more from small classroom settings and more intensive special education service. If a child attends a special education room for 50% or less of the day, he or she is considered to be in a "resource" room setting. Some speech-language pathologists and occupational therapists like to pull children out of their larger classes for a period of intense one-on-one work or small group intervention.  The occupational therapist might be able to use special equipment or provide calming time in a setting other than the regular classroom. Speech-language pathologists may role-play conversational strategies in small settings, with "assignments" back in the regular classroom. Reading or math might be taught in a resource room by a special education teacher.

If children are in a special education room for more than 50% of the day, the setting is called a "self-contained special education" class. Children might be grouped with others by disability level and might rejoin their regular education peers for such subjects as art, music, gym, and lunch. All of the children in a "self-contained" room would have IEP goals, and the teacher, aides, and therapists would work with the implementation of those individualized goals. Children with fragile X syndrome might be recommended to self-contained settings because of behavioral issues, intense academic needs, or lack of comprehension in the regular education classroom.

Sometimes self-contained rooms offered by a public school district are not in the neighborhood school, but rather in another within the district. The district might fund only one classroom for those with moderate mental impairments or social-emotional needs, and that classroom may not always be housed in the local, neighborhood school. The multidisciplinary team must always justify why such a setting is still in the "least restrictive environment" for a particular child.

Finally, children may be taught in separate, private schools. For some children with fragile X syndrome, the public school setting does not offer an "appropriate" educational setting. In order for a child to be placed in a private school, the IEP must state why neither the local public school nor the district level special education options are appropriate.

With any setting, placement decisions are discussed at the annual staffing, and more often if needed.  Placement at one level during a particular academic year does not mean that the child will always be in that placement type. Parents should visit settings that are offered as options, in order to be ready to advocate for the setting they believe is most appropriate for their child.

Gail Harris-Schmidt, Ph.D., CCC-SLP
Saint Xavier University
Chicago, Illinois

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