By: Rajapillai Pillai, MD, PhD, and Jacqueline M. Branch, MD, FAAP
As a parent, you know your child best. If you have concerns about how your child talks, acts, moves, plays or learns, don't wait to raise them. Acting early can make a huge difference in your child's success in school and life.
What is early intervention?
For babies and young children, this may mean getting
early intervention services and supports for developmental delays or disabilities. Starting at age 3, a child's developmental services transition from early intervention to the school system. This process can feel overwhelming, especially for children with
special health care needs and developmental disabilities.
Sometimes, we discover that a child needs services and support after they start school.
Parents and caregivers have a lot of influence. You can advocate for your child and help them get the support they need. We hope that the following information will help make the process easier.
What's the difference between an IEP and a 504 plan?
The Individuals with Disabilities Education Act (IDEA) requires that all individuals can obtain a free and appropriate education. The Individualized Education Program (IEP) and 504 plan help ensure that all children are able to receive this, regardless of physical or mental disability.
An IEP is a formal plan that involves specialized instruction, supportive services and measurable goals. These goals are reviewed on a yearly basis, and regular progress reports are required. For example, specialized instruction may include a smaller classroom size or classroom accommodations. Supportive services may include speech/language therapy, physical therapy, occupational therapy, specialized transportation or mental health counseling.
A 504 plan provides educational accommodations to students who have a physical or mental impairment that substantially limits a major life activity such as eating, sleeping, standing, lifting, concentrating or communicating. This does not necessarily include regular progress reports or reviews of goals. But a 504 plan may include increased time on exams, breaks during physical education, reduced length of assignments or unlimited bathroom access. Basically, the purpose of a 504 plan is to remove barriers to learning and ensure equal access for all students in school.
Know Your Support Structures:
IEPs and 504 Plans Explained
Individualized Education Program (IEP)
Requires measured annual goals with progress reports.
Must include post-secondary transition services.
Requires the child to fit one of 13 categories of conditions requiring extra support.
Has formal, measurable goals.
Requires accommodations to assist free appropriate public education.
Requires the school to address health needs of children at risk for severe disease (including severe COVID).
Can incorporate a health plan to help prevent transmission of disease to vulnerable children (e.g., sanitizing equipment, avoiding shared toys or tools).
For children who need special support but not necessarily specialized instruction.
Requires the child to have a record of a physical or mental impairment substantially limiting one or more major life activities.
Provides accommodations beyond kindergarten through 12th-grade education at the post-secondary level.
Every child who receives
special education services must have a written document known as an IEP. It outlines your child's goals, education, services and other resources that the school district will provide.
Special education: how your pediatrician can help your child get services they need
Parents who feel their child might benefit from special education services should request an IEP evaluation in writing. Your pediatrician can help draft a letter of this request. Parents should work with personnel from their child's early intervention program to help with this transition. You can begin this process when your child turns 2 years old.
The IEP is written after a formal evaluation by the school. During the evaluation, current performance levels are established and documented. To be eligible for special education services, your child must meet the criteria for one of 13 eligibility categories, and the disability must adversely affect their educational performance.
Every IEP should have several key pieces of information, including:
Your child's current levels of performance
Measurable goals for the school year
When reports about your child's progress will be provided
How well your child is able to function in school
How your child will be included with peers with typical development
How your child will be assessed on statewide and district-wide tests
The IEP should include dates when services will begin, locations and how long they will last. The IEP should also discuss what will be done when your child's needs change. It also may outline whether your child gets related services, such as special transportation,
occupational therapy or counseling. If your child also qualifies for services when school is not in session, the IEP should include which interventions they will receive.
The IEP is written by a team made up of:
The First IEP or 504 meeting: tips for parents
The first IEP or 504 Plan meeting can be an emotional time for parents and school staff. Before the meeting, look over education laws and what interventions may be offered based on your child's needs.
A meeting to discuss the IEP must be held within 30 days after a school determines that a child needs special education services. Parents may invite anyone to this meeting, including personnel such as an advocate or the child's case manager from the early intervention program. The IEP is evaluated at least every year to determine whether goals are being met and may be adjusted if your child's needs change.
What if your child's IEP or 504 plan isn't working?
Regular progress reviews are required as part of a child's IEP. If you feel that their plan is not working, a good first step is often to speak to their teacher and support staff directly to make sure all parts of the IEP are being followed appropriately. You also have the right to request a formal meeting to review their IEP.
A 504 plan does not provide the same process to formally review a child's progress. But many of the same steps can be taken. Parents and caregivers can discuss their child's education and behavior with their teachers, therapists, school nurse and 504 coordinator. You can also request a meeting, though the school is not legally required to convene as they are for an IEP.
Your child's pediatrician is another good resource to ask for advice or to write a letter of support. The pediatrician does not decide what accommodations a child receives. But their input can help give the IEP or 504 team a better understanding of your child's condition.
How to request or adjust an IEP or 504 Plan
To request services:
Find out who your school's IEP or 504 coordinator is.
Submit a formal written request to the coordinator. Be specific about your concerns! Include any documentation that may support your child's needs and include the date. You may need to follow up on this request.
Discuss with your pediatrician for advice and specific recommendations. Pediatricians can help advocate for the needs of your child, including a letter of support in certain cases, though the plan will ultimately be at the discretion of the school.
To adjust an IEP or 504 Plan:
First, discuss with your child's teacher to make sure the plan is being followed.
For an IEP, you can bring up your concerns and request a change when reviewing the plan's goals. Or submit a formal request asking for a re-evaluation or change in plan. Again, be specific!
For a 504 Plan you can also request a meeting with your child's teacher or 504 coordinator or request a team meeting, though the school is not required to meet as they are with an IEP.
The process of advocating for your child to obtain and maintain an IEP or a 504 plan can feel stressful or even scary. But there are many supports and useful resources to help parents navigate the process. If you feel overwhelmed, a friend, another parent or your pediatrician or another health care professional can be a good source of perspective and advice. You are not alone in this process.
About Dr. Pillai
Rajapillai Pillai, MD, PhD, is a member of the American Academy of Pediatrics Council on Children With Disabilities as the Section on Pediatric Trainees Liaison. He is completing residency in Neurodevelopmental Disabilities at Boston Children’s Hospital. His clinical and research interests include mental health in nonverbal individuals and severe emotional dysregulation.
About Dr. Branch
Jacqueline Branch, MD, FAAP, is a Developmental Behavioral Pediatrician at Akron Children’s Hospital in Ohio. She is a member of the American Academy of Pediatrics Council on Children With Disabilities. Prior to attending medical school, she completed her Master of Science in Special Education and Elementary Education at Canisius College in Buffalo, New York. In her current practice she serves as the Developmental Behavioral Pediatrician in the School Success Clinic.