Bridging The Educational Evaluation-to-Classroom Gap

About This Episode

NYC Special Education Attorney Adam Dayan talks with guest Dr. David Salsberg, a licensed Clinical Neuropsychologist and the Director of Pediatric Assessment, Learning, and Support (PALS), a multidisciplinary group practice in Manhattan specializing in conducting neuropsychological and educational evaluations for children. They discuss how to implement educational evaluation recommendations from a neuropsychological evaluation in a classroom setting, the collaboration required among school staff, and how to measure success.

Special Education Attorney Adam Dayan talks with guest Dr. David Salsberg

During the episode, Dr. Salsberg shares

• valuable insights about understanding how a child learns,

• implementing “out-of-the-box” strategies, and

• a road map to a child’s school for implementing educational recommendations that will benefit the child.

(LISTEN) The Curious Incident Podcast Episode 15: Bridging The Educational Evaluation-to-Classroom Gap

Transcript Below

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Do you have questions about your child's education? Call Special Education Attorney Adam Dayan at the Law Offices of Adam Dayan: (646) 866-7157 and request a consultation with our New York attorneys today.

Transcript

Speaker 1: This is Curious Incident, a podcast for special needs families and your window into the world of special education. Special needs parenting can be challenging and we want to make it easier by providing you with the resources you need to help your child. Let's delve deep into the world of learning differently with your host, special education attorney Adam Dayan.

Adam Dayan: I am honored to present my next guest on this podcast, Dr. David Salsberg. Dr. Salsberg is a licensed clinical neuropsychologist in Manhattan, an adjunct clinical assistant professor of neuropsychology at Weill Cornell Medical College, and a clinical instructor at the NYU School of Medicine. Dr. Salsberg is the director of Pediatric Assessment Learning and Support, known as PALS, a multidisciplinary group practice in Manhattan. In addition to therapy and treatment, his practice specializes in conducting neuropsychological and educational evaluations for children, as well as school consultation and advocacy. Dr. Salsberg serves on numerous professional advisory boards, including Daniel's Music Foundation, The Meeting House, and The IDEAL School, which is a private school in Manhattan committed to an inclusion model of education. David, welcome to the show.

Dr. David Salsberg: Thank you for having me.

Adam Dayan: It's great to have you here. So tell me a little bit more about you. What makes your approach or outlook unique given your particular background, skills, and experiences?

Dr. David Salsberg: So I've been doing this for quite a long time. Thankfully, I really love what I do. I think I come to it from a lot of different perspectives. I grew up in New York City a long time ago, when the public schools that were near where I lived were not great. My father was a special ed teacher in New York City Department of Education, so I had a lot of internal experience from him and his friends. But I went to private school in Manhattan, thankfully, thank God, on a full financial scholarship. So from an education perspective, I got to see a wide range, special education from my father, how private schools handled or didn't handle such things, friends in public school, and my own learning experience. So going into this field, which I decided very early on, I think I was 15 when I decided this, which I guess is another story which maybe we'll get to, I really felt a passion for working with children and helping children in need, originally thinking I would just go into it for therapy as most psychologists think. And I fell in love with being able to dive into a child in the family's lives and really do some detective work and figure out how they learn, how to help them, and how to advocate for that. So throughout my career and training, I worked with a wide variety of children and families, very complex cases, and it just forced me to think outside the box in terms of how to approach testing, evaluations, and advocacy for children.

Adam Dayan: I really like what you said about detective work because it's not always apparent, right? Sometimes it takes some digging to figure out what's going on with the child.

Dr. David Salsberg: Yeah. And that's really what a neuropsych evaluation should be. It really shouldn't be a canned assessment. It shouldn't have a preconceived notion of what we're going to find or not find, or what we're going to recommend. So it's taking a lot of different data points, much from testing, a lot from collateral information from parents, from teachers, from direct observation. And again, coming from the majority of my career over 20 years, I was at a hospital where I trained, I did my pre-doctoral internship, my post-doctoral fellowship, and ended up becoming the associate director of pediatric neuropsychology at NYU Medical Center.

And there, worked with children from every walk of life. Unfortunately, medical issues, cancer, strokes, car accidents don't discriminate for one population versus another. And I was forced to figure out how to dive into these families' lives, often during the most traumatic time of their lives, and help figure out how to evaluate children who've now suffered a tremendous disability or who've grown up with disability and how to integrate them or reintegrate them into perhaps a world that's changed for them and really forced me to think very broadly about everything and creatively, which is, I don't know if I'm typically a creative person, but I had to be in this and I just fell in love with it.

Adam Dayan: So I think I've told you this, ever since I entered this field as a legal practitioner 13 years ago, you've been considered the gold standard in your field. And I know you'll deny it, but it's true. Why do you think that is the case? And is there anything that you do differently than other neuropsychologists in the evaluation process?

Dr. David Salsberg: Yeah, I'm humbled by that and I don't agree. I don't know, I think the gold standard in evaluation is flexibility, and that's, I guess, what maybe I bring to it, which I don't know every neuropsychologist would agree with that approach. So everything that we do as evaluators is very manualized, it's very normative. Otherwise, we can't really score things if we don't test the way we're supposed to test. However, some degree of that, and again, really the hospital experience showed me what are we really measuring if a child is having a seizure while we're testing them or falling asleep, or so angry and upset that they're not looking at the blocks that we're asking them to assemble, do I just go with that score and keep going because my schedule says I have two hours to test this child and I have to finish it? No, that's ridiculous.

So I think that being able to dig deeper past maybe the child's first initial response, making sure they're looking at the choices before they answer. And again, this came from children who have neurological injury that they couldn't see half of their field of vision, or lose an arm or an appendage, so had to be flexible about how we were testing. So I think being able to dive in to find their strengths and their abilities despite the issues of disability that they're bringing to the table. I always say that I could probably teach anyone, probably a high school student, to test for weaknesses with someone with a disability. It's easy, and it's not that helpful to see what someone can't do, really finding and testing the strengths, which might mean using a different test. Standard IQ test might not tell us anything. Maybe there's a non-verbal test of intelligence or different ways to assess someone's strength. So that's what I'm more interested in. So I balance that by, my goal in testing is to figure out what the child's ability, strengths, potential are for the child, for their family, for figuring out how to use those strengths to help them. But at the same time, really digging deep so that we have a broader picture of the weaknesses with definitive roadmap to follow, that it should be applied. It's a big pet peeve of mine to see a report by any practitioner, which ends with just reporting what the issues are, maybe coming with a label and diagnosis because they found it on a page in the diagnostic manual without a holistic picture and more importantly, without a blueprint or an action plan that someone can follow. If I see a report that ends with, "These results should be discussed at the IEP meeting," or the recommendation is the family should contact the school district and initiate an IEP so that the committee on special education should start the process to help them, it makes smoke come out of my ears.

It's like going to your internist and them saying, "This is what you have. I'm not really that familiar with the medicines, so maybe just go at Walgreens and ask around." It just doesn't make any sense to me. So finding the goals, digging to every part of the weakness is the detective work. And then really knowing the schools, if you don't know the schools in this field, you should not be practicing. Maybe that's a little bit bold for me to say, but again, the analogy is a doctor that doesn't know what medicines to prescribe.

Adam Dayan: Yeah, well, so a lot to say in response to that. I mean, the listeners can't see us, but I'm rolling my eyes and shaking my head because you see that pretty often with the school district evaluations, that they don't include a blueprint or roadmap. There's no recommendations. It just leaves it to the team to determine what's appropriate. And parents are relying on those evaluations to understand what's being recommended programmatically for their children. So an evaluation that doesn't include a blueprint is really not so helpful.

The other thing that I think you hit on which is very important for us in my office who are helping families navigate the legal process is, and we see this often, that parents come to us and we identify the need for a neuropsychological evaluation, and we're looking for people who are able to tailor it to their specific student. And there are some evaluators who have a certain approach to testing or think that you can't test this age or they don't really have experience with this particular issue, but it's important to focus in on those nuances and understand the whole child, as you said, very articulately. What are some examples of recommendations you might make in one of your reports to be implemented in a child's classroom setting?

Dr. David Salsberg: I think the first part is, what is the classroom setting? Again, another frustrating part of some of the CSE processes are making recommendations that don't really speak to what the placement's going to be. So my first goal is always on figuring out what the type of class is for this child. In New York City, it's typically general education or general education with supports or an inclusion, or what's called the ICT, integrated co-teaching class, or special ed classes that are within the community school. Then there's District 75 and private schools. So the first goal is to figure out what kind of classroom, is the school that they're in going to work, and how do we make it work better if it hasn't worked up until that point, and how collaborative the team will be, and what resources the school has.

So to make recommendations, and again, it's not canned, it's not every child with an attention issue or a learning disability should be in an ICT class. It really depends, and it depends on the school. So some ICT integrated classes in certain schools are run very well and have great teams, and most of them do have great teams and great teachers, but if there's already 12 students in that class that are rambunctious and have different set of problems, it might not be the right place for a very shy, anxious child with learning issues. Who is going to get overwhelmed by that? So really, there's a lot of different parts that are looked at. So the first goal is to figure out what the class is and then what accommodations can be made within the class and what remediation needs to happen. Is it a learning disability that can respond to the remediation of an integrated co-teaching class?

Adam Dayan: Let's define those terms. What do you mean when you say accommodations and remediation?

Dr. David Salsberg: Sure. So when we, let's say, find a child with a learning disability, dyslexia, having trouble cracking the code of reading, decoding fluently at an early age, especially if you catch it early, the main goal is to remediate to help that child learn phonics and to crack the code of reading so that they can be successful. If that unfortunately sometimes is not diagnosed or recognized till much later on and or the child has had remediation and has sort of hit some walls, simultaneously to remediating, we have to accommodate. So for instance, having a child in fifth grade who's really struggling with the decoding of reading because they never really cracked the code, spending a lot of time, resources and frustration on phonics and blends, you might not get as far with that globally. Might be important to do that in some context.

But at the same time, the child is capable of keeping up with the social studies in science and English curriculum, maybe we accommodate it by them getting an audiobook. Those are the differences between remediation and accommodation. And we're usually trying to thread the needle between both of them so that we don't frustrate the child. Some of that can happen within a class. Some of it has to happen outside of school. We often give specific recommendations besides the school to the family. So for instance, notorious, and I think not popular with a lot of educators, when I have a child who is presenting with dyslexia, is also self-conscious and maybe anxious about it understandably, and every day they're going home because the teachers say, "You read to your parents 20 minutes a day, make sure that they do that," these families understandably really want that to happen because they know they're struggling, I often tell them to stop because it's so frustrating for the child to read aloud to their parents, the two most important people in their lives.

Why do that, and even if the parent has a doctorate in teaching reading, I would still say, "Okay, they shouldn't be the mediator. Let's figure out who should be and how to remediate that." And let a parent read to their child because who better than a parent to help them love a story? We often see children who are understanding or interested in stories that are way above their pay scale as readers. So we might say remediation in this context, in this school with this teacher, with this SET, special ed teachers, support services or tutor, but not with the parent. And let the parent sort of instill the love of a story which the tutors can't necessarily do as easily while a child is learning. So we're always thinking of all of these different possibilities that work for that specific child. The canned recommendations, like the knee-jerk child with attention issue, they should sit in the front of the class. There typically aren't fronts of classes anymore, the way most classrooms aren't specifically lined up. And for a lot of children, being in the front of class is actually worse. We really have to look at the child. For instance, we have had children who've had neurological injuries and strokes. I remember going to one of the schools for one of those children and they were sitting in the front, and I point out that the child had what's called a visual and field cut. So they couldn't see anything on the whole right side of their field. And here, they were sitting in the front so that the teacher and everything was in their right field division, wouldn't see anything. So really trying to make the recommendations for that child and then really seeing how the response of the school is and the teachers and the resources that a school has. And sometimes it requires a change of class placement or even school.

Adam Dayan: You mentioned love of a story. Would you agree that a lot of the recommendations that you're making are to help foster a love of learning in the kids that you're seeing? Because in our practice, we see that so often, that kids are becoming dejected and dispirited and hopeless because they're struggling and their self-confidence is plummeting and they're feeling awkward socially, and they're losing that love of learning. They want to avoid it. So would you agree that part of it is putting these supports and services in place so that they can continue developing that love of learning?

Dr. David Salsberg: Without a doubt, and self-esteem is always the most important part of our assessment and recommendations, and speaks to evaluating and diagnosing and making recommendations as early as possible before things get to that point, which is hard because a lot of children fall through the cracks for a variety of reasons. So yeah, and then playing catch up with reading, playing catch up with writing, playing catch up with math is a lot more doable than playing catch up with self-esteem and how you see yourself as a student, that is much more difficult.

Adam Dayan: Okay. So as far as recommendations, we've talked about classroom setting, we've talked about accommodations and remediation. Any other types of recommendations that you think our listeners should be familiar with?

Dr. David Salsberg: Well, I mean, listen, I think since the listeners are primarily parents, I'm sure this is a broken record on this and other podcast, any parent with special needs, just trust your instinct, trust your guts in terms of ask the questions, get as much information as you can. In any evaluation process, it should be a very collaborative process. So it shouldn't just be a label or a description that feels so foreign to the child you know. You should get a lot more insight, but ask all the questions, put the evaluator's feet to the fire. And there are many times where despite all my efforts, it might take longer for the child to show us what they got, and we come out of an evaluation or two sessions and I need to re-look at it from what parents are asking or reporting and we'll give them the benefit of the doubt.

I always say we typically make three appointments for most children that can go through an evaluation process. Sometimes it becomes honestly eight or 10 or 12, whatever's needed. So really, it should be collaboration between the parent and the evaluator, the child and the evaluator, and the school. So the recommendations then go from there. Again, what do we recommend at school? Should there be outside tutoring? What are the implications of that? What other therapies should be considered? I'm not in any way, shape or form a lawyer, nor do I play one on TV, but I do really try as much as possible to help present what the options are in terms of advocacy and what can be done, or what can be done but we can't really make the argument to the school to do it, and we might have to go outside and or refer to an attorney that is going to fight for their rights.

Adam Dayan: Okay. I think this is a really good segue. You're talking about collaboration, and we're here to talk about bridging the gap between the evaluation and testing process and the classroom. So what does it mean to bridge the gap between a neuropsychological evaluation and a child's classroom setting? And how is the evaluation supposed to relate to the classroom?

Dr. David Salsberg: So it's supposed to relate very much so to the classroom. Again, the classroom and the school is our pharmacy. So we have to make recommendations on dosages and different medicines and be flexible enough and have zero ego in this to rethink it. And I always want the teacher's input so they might see things very differently. And hopefully we can get to a point where we're helping each other see the perspectives. A lot of children mask things at school and they might not know that it's taking them four hours to do homework that should only take them a half an hour, and the parents are helping them. So the recommendations, which are in writing, should form some basis of a blueprint to follow. But we're always more excited and willing to meet with schools and have back and forth and a lot of some trial and error.

Sometimes we will either stop an evaluation or pause an evaluation and say, "Hey, listen, you know what? This is looking like ADHD," let's say, "and these are some things we should do about it. Let's try that and come back in three months and see how that responds," or the learning issue, or I'm with a child with autism, this kind of intervention that hasn't been tried before, we really think can move the needle. So let's pause on the evaluation, let's try this, let's revisit, and our recommendations might be different. So as much as possible, with our neuropsychs, we try not to just come in and come out in just three appointments, one month, we're done and wash our hands of it. It's bad analogy, but in some ways it's sort of like getting a new car. If you need some tune-ups and some checking in or looking at the instructions again, we're typically involved with parents and families at the minimum for a year and sometimes for a couple of decades that we've been following children.

Speaker 1: If you like what you are hearing, please let us know by subscribing to the Curious Incident podcast and letting other special needs parents know about it too. If you have thoughts, questions, comments, or would like to suggest ideas for a future episode, we'd love to hear it. So email your feedback to podcast@dayanlawfirm.com.

Adam Dayan: So let's talk a little bit more about those situations where either you've completed the testing process and now you're keeping in touch over the course of the year, or you've started the testing and you want to test it out as you mentioned for a few months and see how it's going. What sort of information are you gathering? I know you mentioned speaking with the teachers, right? What sort of input are you getting from them? Is it conversational and anecdotal? Are you looking at reports? What else are you considering?

Dr. David Salsberg: All the above. It really depends on the teacher, it depends on the school and the report cards and what they actually send home, and is there enough information. Often, and it's not because we don't trust a teacher, but we just want to sometimes see for ourselves, we'll often do school observations or periodic school observations. In my practice, at least, my evaluations almost always have at least two of us, sometimes three, just to get different perspectives. So for instance, most evaluations will have me and another doctor, because children establish rapport differently. One of us might go to a school visit, so obviously we're not recognized if the child had other behavioral issues or maybe a child on the autism spectrum who would benefit from someone with a degree, a BCBA or ABA therapist, or a SEIT. We have those in our office too, and it may be more collaborative just to really, like I said, get everything out of them.

So the monitoring is the same as we might have a parent coach work with a family and circle back to us, or speak to a teacher or do an observation, and like I said, sometimes take a whole different path. Listen, this is what we tried. The school followed everything. They're giving the child, they're in an inclusion class, they're getting SETS or special ed teacher support services. On top of that, they're getting counseling, they're getting all of these things. And here we are from November to April, and the needle hasn't moved and we can retest things. We can look at academics, is usually how we track the academic progress and or we're seeing the toll it's taking on the child. So it's great that they're reading better, but they're crying every day being pulled out or working with a tutor, and it's just taking a toll on their self-esteem. So these are all different data points that we're constantly monitoring.

Adam Dayan: What's the parents' roles in bridging the gap between the neuropsychological evaluation and the implementation in the classroom or at home?

Dr. David Salsberg: Well, if we do our job right or we have to redo it again and again, we need to help the parents understand their child's learning pattern and what they can and can't ask for, or what they can and can't expect in such certain situations. And then it's advocacy, which is hard. It's very hard in some bureaucratic environments to even have more than just parent-teacher conference twice a year. So being your child's advocate is our most important job as parents, and that's really what we try to give them all the tools and understanding to implement that.

Adam Dayan: I just want to emphasize the piece you mentioned earlier about school observations. I mean, you get a different impression of a student observing them in the classroom than you would in a one-to-one testing situation. And in our practice, if we are referring a family out to get a neuropsychological, that's one of the criteria that we emphasize to them. You really want an evaluator who is willing to conduct that classroom observation, so you get that perspective.

Dr. David Salsberg: This was one of the reasons that I eventually had to leave the hospital, is because the hospital bureaucracy would frown upon things that aren't billed, like going to a school visit or participating in IEP or an impartial hearing. And then it just felt that this was not the way children should be evaluated.

Adam Dayan: Talk a little bit more about how your recommendations are meant to be used in the classroom, and do you find that teachers typically follow your recommendations with fidelity?

Dr. David Salsberg: It's so variable. I wish I could say yes, they all follow it exactly. A lot of times it's really doing education with the teachers on what the issues are. And I think the best teachers are the ones who don't get defensive and see this as a collaborative process. And I get it, some of them can be wonderful, amazing educators, but they have 30 other kids to worry about. And the child you're evaluating, from our perspective, they're the squeakiest wheel, but they very well might not be the squeakiest wheel in that classroom. So really just getting their buy-in and seeing themselves as the most valuable potential team member.

I guess what's most frustrating is that sometimes we get into these positions where the teacher knows what they should be doing, but their hands are tied. Or an administrator or a CSE person at an IEP kind of knows what should be happening, but some supervisors, although they can't do it or they don't have the time or resources, and I feel for them. And that's got to be frustrating for any of those people involved. So I mean, we try as much as possible to avail ourselves to do in-services and just help in any way that we can.

Adam Dayan: Mm-hmm. It occurred to me while you were speaking that your dad wanted you in the classroom, and in a sense, you're in the classroom.

Dr. David Salsberg: Yeah, I think one of the most, I don't know, I guess stuck in my mind, evaluations as a child in the hospital who suffered a stroke on the left side of her brain in class. I think it was either third grade, I think second or third grade. And it happened in front of everyone. She was in the hospital for a long time, the left side of her brain controlled speech, she wasn't able to speak, she had what's called aphasia. Her right dominant hand, she couldn't use. She had this what's called hemiparesis, and here we were again, getting close to getting her back to school and the school couldn't have been more interested and collaborative in wanting to do everything bend over backwards. And in that discussion also came across how traumatic this was for the school and the classroom and the kids who were spreading rumors, whether this is contagious or not, or I heard it was something she ate at lunch.

So we actually ended up doing an in-service for the staff, for the kids as much as we could, teach them about strokes and what happened, that age seven or eight or nine, I don't remember. And then we, not only for the teachers, but for the kids too, had them understand what this disability looks like. So we had them play charades, how frustrating it is if you can't come up with the words to get your point across. We had them all write with their non-dominant hand. And it's just an example of having to think outside the box. There's no manual for doing this. I never did anything like that before. But it involved the communication, the involvement of the family, but really the openness and collaboration of the school, and child integrated and did great.

Adam Dayan: So what suggestions do you have for parents who have just completed a neuropsychological evaluation and now are trying to make sure it gets applied properly inside the classroom?

Dr. David Salsberg: Use the evaluator as much as possible to attend a meeting or to elaborate or to make themselves at least available to the team members. Often we're available, but the IEP team may not even reach out or just go through the motions, cut and paste everything we put in there, but not necessarily agree with our recommendations. So again, it's really advocating, making sure that you as a parent understand the ins and outs. And I think one of the hard things for me to communicate to parents much as we try is we're not going anywhere. Circle back to us and let us know what's working, what else we can help with, and what they're listening to or not, or do we really need to rethink things? And then knowing your rights as a parent and exploring what those options might be in different schools or different interventions, those are all key. And listening to podcasts like this.

Adam Dayan: Absolutely. Thank you for that plug. How would you define success in terms of bridging the gap between evaluation and classroom?

Dr. David Salsberg: A happy child, movement in a direction that wasn't there before, confidence, less tears, better self-esteem. And in the evaluation process, I think a lot of people think there's a real difference between neuropsych and psych, and they're not. They should be integrating the both. So having a child who's improving with their learning, but like I said, is working so hard that they're not having a social life or feeling terrible about how different they are, we need to look at every part of that. So the success is with those things working better and moving on a better trajectory instead of steps back. And it's difficult with kids, especially with learning and all of these different things because we're trying to fix the plane while it's flying. So yeah, we can get the child to improve, let's say their reading or the math, but now all of a sudden the next unit's harder. So it is a lot to attack and to keep attacking because the treadmill keeps getting faster and faster.

Adam Dayan: And I think this relates to what you said earlier about the holistic child, all parts of the child, academic, social, emotional. It's the whole package.

Dr. David Salsberg: Yep.

Adam Dayan: And when you were talking about happy child, when you're feeling badly about yourself and your brain is just telling you, "I'm terrible, I can't do this, I'm not competent," it gets in the way of everything. You can't absorb the information or the skills or whatever's coming your way in. So getting a student to that place where they're feeling good about themself makes a big difference. Do you agree?

Dr. David Salsberg: Absolutely.

Adam Dayan: What are the keys to achieving this success that we've been discussing?

Dr. David Salsberg: Good assessments, digging deep, trusting your gut, looking further than what you might be hearing if it doesn't click for you, knowing your rights as a parent, knowing what you can avail yourself of with professionals, with advocating in different school environments. Those are the keys to all of this. And for working with a neuropsychologist or therapists, whoever, just being able to really put their feet to the fire in terms of making sure that you are getting what you want in terms of understanding. It may not always be what you want to hear, which is also there and complicated. Always feel like a collaboration.

Adam Dayan: All right. So you just talked a little bit about collaboration between parent and school. We talked earlier about collaboration between neuropsychologists and school. Let's talk a little bit more about your expectations for collaboration in the school among the staff and providers. How do you see that process? What needs to happen for that to be successful so that the recommendations in your report are getting implemented properly in the classroom and school setting?

Dr. David Salsberg: It starts for the most basic first, be it a team meeting or an IEP meeting, are they defensive? Are they listening? Are they changing some things? Sometimes they'll report all of this, but nothing will change on an IEP for instance. And again, I think it's really just, are they seeing this as a burden or are they seeing this as a challenge in why they became an educator? And do they have the resources or are they open to explore how to get the resources? Often we're helping schools understand, "Hey, it's okay that you don't have this provider, but guess what? You can get what's called a related service authorization so that they can get it outside." "Oh, I didn't know that." Or, "It's okay that you don't have this. There are schools you could send the child to, a private school, where you can investigate those." All of these different things, it really starts with an openness from the school personnel and then seeing that the needle is moving on social, emotional learning, confidence, and all of that.

Adam Dayan: And I think for our listeners who live in New York City, I think it's important for them to understand the extent to which the New York City Department of Education is inundated and short on resources compared to the number of students. It's the biggest school district in the country. There's about 200,000 special needs students in the New York City public school system. And the teams sometimes just don't have the resources to tailor every meeting to the student and make sure that every child is getting what they need.

So, advocating and knowing your rights and being in a position where you can put in place what needs to be put in place if the school district is not fulfilling their role in the way you describe. And I've spoken with colleagues outside of New York City who deal with other school districts, and it's sometimes a very different conversation. The team is very open and looking for ways to collaborate with the parent and the school, and that's the way it's meant to work. But New York City is not always in a position to do that, and parents need to be prepared, as you mentioned, to take things into their own hands when necessary.

Dr. David Salsberg: Right, absolutely.

Speaker 1: If you like what you are hearing, please let us know by subscribing to our podcast and letting others know about it too. If you have thoughts, questions, comments, or would like to suggest ideas for a future episode, we'd love to hear it. So email your feedback to podcast@dayanlawfirm.com.

Adam Dayan: How would you assess whether the recommendations made in your report are being followed properly and if they're having the intended effect on the student?

Dr. David Salsberg: Again, first and foremost, do they actually listen and document or implement? Sometimes we'll talk to families about, especially recently, this post-COVID era of schools having a lot of resources to put in an extra reading help and all of these catch up things that they got federal money for. We'll sometimes say, "Okay, that sounds good, but is that person a special educator? And it's very nice and their heart's in the right place, but you know what? I really want that on his or her IEP because otherwise it's not really enforceable." So really being able to see what actually gets put on paper and what gets implemented.

And then typically, we'll see a child for an update if there are still levels of concerns or curiosity about their improvement. Terrible businessman in that I love not to have repeat business. So if I don't have repeat business, it means we set them off in the right direction with the right educators, with the right plan. God bless, invite me to bar mitzvah or college graduation, or call me later for an internship or a job, and I'm thrilled. So that's our gold standard in terms of being able to give the child and their family the right launching pad. But in the meantime, anywhere along the way, assessing progress or not also at crucial junctures like the transition to middle school, transition to high school, transition to college, those are times where the progress needs to be monitored even a little bit more carefully, unless everything's going great, which is great.

Adam Dayan: We may have touched on this a little bit, but talk a little bit more about how you view the IEP team's role in bridging the gap.

Dr. David Salsberg: The New York City system is very different than anywhere else, especially at very crucial period of time that we see a lot of children, which is this transition into school, from preschool to kindergarten. So that process in New York City is-

Adam Dayan: Known as the Turning Five process or Turning Five review.

Dr. David Salsberg: Correct. Right. In my feeling, is a lot broken in the way it's just organized. So that CSE, IEP team may or may not have ever observed the child. There's typically no requirement for that child to have an evaluation. Obviously if they've seen us, there's some evaluation that we can give them, but it's not always the school that your child would go to, nor is there any guarantee that this IEP... In fact, there's a guarantee that this IEP team will not tell you what school your child is going to. And they might make a placement recommendation that sounds good, but push comes to shove, sometimes I'll ask the IEP team, "Oh, that sounds good. It's not really my experience, but have you ever been in a District 75 class of six?" And the answer often is no. And it's just as an example. Sometimes there are.

But even then, even if every star aligns that they know every program and have been in every program, they'll admit at that meeting, "We have no idea where your child's going to get placed." It goes to a placement officer, which just is really, really hard. So the IEP team should be really involved and know the ins and outs of the child and of what is actually being put on paper and what will be implemented. But it's all separate silos. So when your child is already at a school and it's the in-house school that's doing the follow-up IEP team meetings, then at least you're in a little bit better setting and situation potentially as long as, again, the collaboration and openness and flexibility is there on both sides. Parents too. So that makes it really hard. Whereas if you're in a suburban district somewhere else, you're meeting with the players, you're meeting with typically often a CSE chair or certainly the people who know the elementary schools and who will be the therapist that your child will see and have done more due diligence or an evaluation.

Adam Dayan: You're definitely right about the silos, and it's very separate in New York City, the placement recommendations coming from a separate placement office. And it's not uncommon for parents to have the experience that a certain program is recommended on the IEP, let's call it, at District 75 6:1, and then they go to the school that they get from the placement office, and that school doesn't have the program. So that communication that you would expect to see and that you do see in some other school districts doesn't always happen in New York City.

Dr. David Salsberg: Right.

Adam Dayan: I understand your practice provides more services than just neuropsychological testing. So can you discuss what other services you provide?

Dr. David Salsberg: Yeah. I think COVID kind of forced this out of me. I think for most of my career, I avoided starting other services. I referred to every type of therapist imaginable, have built many people's practices and been very happy because I find people I trust and I hand them a family that I want them to get help with to these providers. And I always felt, if I had that in house, it would feel like, I don't know, icky, that, "Hey, I think you need this," and, "Hey, I give this." So I didn't really want to feel like that or be in that position. But COVID really pushed every envelope. It pushed the envelope of a lot of these practitioners were out of work, or were looking for work. A lot of families could not access services in their home. A lot of people were not working with kids in their home, and these were kids that could not get anything accomplished remotely that would be for their special needs.

So we started with hiring one of my favorite parent coaches and BCBAs and realized, "Well, you know what? Not only do parents not present that I'm recommending them, they actually really appreciate that we're a team who collaborates and talks, and they don't have to start looking around to other people and reestablishing trust." So as of right now, we have parent coaches, private SEIT. So if a child needs shadowing at a school, either through an order where they get approved for having this or they're doing this privately for a period of time to get over a hump, we have BCBAs, people who do ABA, applied behavior analysis, who will go to schools, go to people's homes, and do that individual work. And we have a host of tutors and executive functioning coaches who work very closely with families. And we're doing the neuropsych instead of, I was going to say faxing, emailing it to a different practitioner.

Adam Dayan: What's that? I don't know.

Dr. David Salsberg: We talk about it, and we sometimes have the coach come into a feedback with us or be part of the evaluation process, and we give other recommendations too. And if it's logistically, a lot of what we do is not in network and insurance. And if a family needs to go in network, we'll find the providers that are in network. So it just is a much more holistic approach to the families and it's really been a value for everyone. I think that there are times where I think families might have come back for a reassessment or an updated consultation with me. I don't need them to, if I have a provider that's working with them and we can talk and say, "Listen, you know what? So-and-so is following your child and we're seeing the growth. They've been in touch with the school and this is what we're seeing." So it's just a much more full service approach.

Adam Dayan: I respect that you're finding multifaceted ways of meeting the family's needs. We're doing the same within our legal practice. In what scenarios might a student benefit from receiving these other services you offer?

Dr. David Salsberg: So there are a lot of times where a child has not been given or have access to some of these services in their school, or there's no mechanism to get an executive functioning coach for the child. We can get them sets or resource room in a group, but this child needs individuals, so we can really tailor make the recommendations. So be it a child who needs executive functioning help or a child who needs 15 hours of a ABA therapist to work on social skills, activities of daily living, parents that need help in the home instead of just going to an outpatient office or even remotely working with someone once a week, that someone's actually with them and addressing things in motion. So any of these behavioral parenting or educational executive functioning needs.

Adam Dayan: So let's talk about the role of you and your team if the bridging the gap process has not gone successfully. In what ways do you continue to be involved in the student's education?

Dr. David Salsberg: In any way that if parent needs and wants and reaches out, so that will often be the initial advocacy and following up on the report and standing by it. And standing by it sometimes means going all the way to encouraging a family to look at different school options. The advocacy for that sometimes leads to litigation and impartial hearings. And if I believe in what I did and said, I better be able to stand up to it and be cross-examined and go to a court-like proceeding in order to make that happen. So that, I think, is a big part of what you asked before in terms of the practice and what, I guess, we do. We go all the way if needed. I think that leads Department of Ed personnel and lawyers who cross-examine me to always think that I recommend private school for everyone, which is so far from the truth. I have many more kids, exponentially more kids in public school than I do private, but they only see me going to a hearing when it's not working.

So that is a big part. Not every psychologist, neuropsychologist, or professional feels comfortable testifying. I do, and there's a couple of us that do, and a couple of people I've trained that do. But there's people I've been training or have supervisor collaboratively worked with for years who still don't love that process. But it's crucial, right? You have to stand by what you're advocating for sometimes in order to make sure it happens. So that's sort of taking it all the way to the distance.

Adam Dayan: That's definitely true. And I mentioned earlier that one of the important criteria we look for in evaluators is that they're willing to do classroom observations. Another important criteria is that they're experienced and skilled with testifying at impartial hearings. Because if they've done an excellent report and evaluation but they can't speak to a hearing officer about the testing they conducted, the recommendations they made and why a certain program is or isn't appropriate for the student, then it's not much value as far as the legal case is concerned.

So we talked about when they're working with some of the providers within your practice, they don't have to do updated testing so often because you can confer with the professionals. What if that isn't the case and they've come to you for an evaluation? How often should the recommendations in your report be reviewed to consider whether they're still appropriate based on the student's needs?

Dr. David Salsberg: So I usually tell parents, at any point that there are concerns or not seeing progress, at any point that a potential shift in schools might even just want to be explored, it's New York City, so educationally and clinically, it would make sense for me to say to a parent, "You know what, call me at the end of the year in June, let's see if it's working and then we can look at other schools." Well, if we need to look at other schools, there will be no other schools sometimes for that child. So sometimes we're working on parallel paths where we say, "Listen, we're going to try these things. I think that there's a good shot that this could work at public school. But just in case, so we don't get to that point and not have another school option or intervention option, let's try this and then circle back and see where the growth is."

So sometimes it's within that same year if there's something really new and big that we've diagnosed or intervening on. And otherwise we say, again, whenever they're curious for progress or want more data points. Because a lot of times you get teacher report cards or subjective measurements or even things that look objective, where child got 80% of these questions right that doesn't tell me anything normative, nor is it comparing apples to apples in terms of actual trajectory and growth. So if they feel like they need more of that, otherwise any transition time.

So certainly, if we're seeing a second-grader or third-grader, we will say, "Listen, touch base with us if everything's going great." At least circle back may not be for an evaluation unless needed. But given these learning issues, we might want to check in at the end of fourth grade so we could talk about middle school or the transition to middle, transition to high school, transition to college. Those are the times that we would certainly want to hear from a family or assess something. Otherwise, this child is supposed to have an evaluation every three years or triennial. And we'll talk about the pros and cons of doing that through the district or through us or both. So at the very least, if a child is continuing to get special ed services, we would expect to at least have some touchpoints every three years at the most.

Adam Dayan: David, how does your approach to bridging the gap differ for kids going into post-secondary transition programs?

Dr. David Salsberg: Honestly, not that different. The same approach is holistic. And at those older ages, I think as a child gets older, depending on what their trajectory has been and disability, probably get more focused on prioritizing and what are practical recommendations more and more as it applies to where they are, which is always what I'm recommending. But for instance, at some point it's not always just a transition. At some point, I might say, again, not always so popular to a family with a child, let's say, who has a tremendous math disability, at some point I might just say, "We have these smartphones and there's an app for that. Let's stop torturing the child on that." And if a child has even more issues, we need to make sure that let's work towards as independent as they can be. Geometry isn't so helpful, nor is algebra, nor is it always necessary. But balancing checkbooks and using an app or a credit card and budgeting and banking, those things are super important.

So the transition into more independence and adulthood I feel is really lacking in terms of the educational model. There's, again, a lot of different silos, not a lot of communication and planning. I think one of the things that I try and do at every level, and I think again maybe what differentiates or has in the past differentiated, I spent a lot of time visiting places and visiting schools and seeing programs and educating myself and then re-looking at it. If I haven't been to a school in a few years, it's hard for me to recommend it. If it's a new transition program or a residential or a day program, I'm constantly trying to educate myself so I can give families the best advice that I can.

Adam Dayan: Right. That's smart. I think what you said before is so true. Really, for education in general, for any student, tailoring it to the practical realities of what they're going to need to use it for. And it reminded me of this book I once read, I think it was called the Saber-Tooth Curriculum. It was basically about how education lags. We are teaching things that once were relevant but may not be relevant anymore. And I think what you're saying is, especially for special needs kids, putting emphasis on what do they need and what tools are they going to need to be able to function in the real world.

Dr. David Salsberg: Yeah. And I think often I'm in a position where I might talk to families about putting perspective even on the diagnosis or the pathology. So for instance, if I have a child who is really struggling in school and has a diagnosis of attention-deficit hyperactivity disorder, might have some behavioral issues, might really have difficulties with classes and performance and getting things in, but has other areas of passion, and the parents get so overwhelmed by where they are right now, I basically help try and take a step back and say, "Describing your child, they're super interested in X, Y, and Z to an extent where they don't even want to budge from it and they know the ins and outs of it. All the other stuff, they don't care about, and that's where the trouble is. And it's very hard for them to pay attention, very hard for them to stay focused on that, except for when it's something interesting to them." That's a successful adult.

We find our passion. I often will see children who I feel are much better wired for college or grad school or vocation than they are for fourth grade. So there's a lot to see of where to put the priorities and also sometimes put into perspective that what we pathologize often in childhood can sometimes not be as much of an issue later on or comes out in a different way. Even social issues, there are children who march to their own beat, who are maybe idiosyncratic or more atypical or even on the autism spectrum. Doesn't mean they're not going to find their niche later on and their group. But yeah, it is hard. Middle school is hard for anyone, let alone someone with some of these issues.

So as we look toward transition programs, I really, again, try to start from strength and look for individual's interests and needs, and also what's practical honestly. I'm loath to make recommendations that really would just be financially or logistically difficult for a family. A parent lives so far away from a program that's needed. I don't know that commuting three hours is a net benefit for, even though I think this program is good, let's take a step back from it and see, see if that means your child will never have a play date, or after school program, I don't know that this is best. So we really try and look at all the different things, and certainly as they transition into adulthood and more independence.

Speaker 1: You are listening to Curious Incident, a podcast for special needs parents, with your host, special education lawyer Adam Dayan. If you like what you are hearing, please like and subscribe.

Adam Dayan: All right, before we conclude, I have to ask, what fuels your passion? Why do you do what you do? What drives you to get out of bed and go to work every day?

Dr. David Salsberg: I love what I do when everything aligns, which I hope is more often than not, where I can help see, or my team can help see a child differently, help a family and an educational system see them differently, and give concrete ways of changing that trajectory. There's nothing like it in the world. I mean, there are times where we make a diagnosis or an intervention, sometimes where it even changes school, often if that's what we're advocating for, we might get it all paid for. All of these different things can absolutely shift the trajectory of this person's life. It's not always recognized or they may not understand that a different evaluation may not have seen things this way and it all works, but that's fine. I'm just happy that kids is what drives this. Not seeing a kid suffer and knowing what that looks like is what gets me up every morning. And I used to, especially when working at the hospital, and I've had a lot of patients who never recovered, many who've actually passed away, and I think I can still, after 30 years of doing this, probably, I think I can remember every single family, still in touch with a lot of them, families who either remained with significant disabilities and or passed away, I'm still in touch. And people would always ask me, "How the hell do you do this?" I'd say, "I don't know, how the hell you don't?" Because yeah, you see and have experienced horrible trauma and things that are just unimaginable to happen to children, but at the same time, you see the strength and resilience of kids and their families that fuels you and makes the other things sad and hard. But again, like I said before, who am I to not put myself out there if they are? Adam Dayan: What's one interesting fact about you? Dr. David Salsberg: Yeah, there's nothing. Sorry.

Adam Dayan: All right. So where can our listeners get more information about you?

Dr. David Salsberg: I guess the website's easiest, which is NY PALS or New York PALS, PALS stands for Pediatric Assessment Learning and Support. So, nypals.com.

Adam Dayan: All right, David, I've admired you for a long time. I really respect what you do. I have a new appreciation for what drives you, especially in light of everything that you shared with us here today. I'm inspired and looking forward to going back to my job with a new sense of excitement given the important work that we do. I think you've given some great information to our listeners about bridging the gap between the evaluation and the classroom. And I want to thank you so much for being here with me today.

Dr. David Salsberg: My pleasure. Thank you for everything you do.

Speaker 1: Thanks for listening to Curious Incident, a podcast for special needs families. Don't forget to subscribe for a new episode every month. For more resources and helpful information, check out our website and blog at dayanlawfirm.com.

This podcast provides general information which is not intended to and does not constitute legal advice. You should not rely on this information for any purpose. For legal counsel, you should consult with an attorney to discuss your specific circumstances. Your listening to this podcast does not create an attorney-client relationship between you and the Law Offices of Adam Dayan, PLLC. No attorney-client relationship is established unless a retainer agreement has been executed between the client and the Law Offices of Adam Dayan. This podcast may constitute attorney advertising. Prior results do not guarantee a similar outcome. Any guest featured or resources mentioned on this podcast are for information purposes and are not endorsed by the Law Offices of Adam Dayan, PLLC.