Surviving Your Child's Multidisciplinary Evaluation

As the parent of a child with learning and neurological disabilities, I know how overwhelming and confusing it can be to prepare for meetings, evaluations, and doctor's appointments. In the beginning, it is easy to feel "outmatched" - as though the 'experts' have all the answers and you're 'just' the parent waiting for the verdict on your child. With a little time, research, and life experience, however - you also can become an 'expert' on this process.

If your child qualifies for the system and begins receiving services, at some point there will be at least one multidisciplinary evaluation (MDE) which will evaluate and assess several areas of your child's growth and development (such as cognitive, language, social, adaptive, and physical skills). The MDE usually involves at least two therapists with different specialties depending upon the initial screening process (the first phone call where they ask you a lot of questions about your child) and possibly a child psychologist or a special ed teacher. This MDE would happen before services begin to determine your child's needs, and also during the process to assess your child's progress and to prepare for transitioning your child to the next phase of his/her education. The MDE for ages 3 to 5 determines what your child's needs are, and which therapy services or future educational placement will best meet your child's needs.

I have experienced a few of these evaluations and assessments, and they have not been easy or simple to get through, but there are some ways to make them go more smoothly, answer more questions 'up front', and to make the experiences less stressful for your child. In this article I will give a few suggestions help you plan for your child's MDE, and give some ideas on what to expect and how to prepare for it.

Assuming that your child has already been in an early intervention program (EIP) or a similar agency to treat delays and/or disabilities from infancy to age 3, you probably will have collected quite a few session reports (from therapy sessions), doctor's assessments (from doctor's evaluations), and/or developmental evaluations from associated agencies. If you are still in the process of beginning these services, I strongly recommend that you start a file (or a file box) for your child - to place every session report, progress report, evaluation, and assessment into this file for your child. It may seem like a bunch of meaningless paperwork or medical jargon, but it will all be useful, necessary and important when the MDEs come around.

When the MDE has been scheduled by the agency, they will notify you by postal mail of the date, and assuming the date is okay with you, it is time to start preparing. Ask your child's therapists if they would be willing to write up a progress report on your child - generally a one-page assessment of the treatments your child is receiving, your child's strengths and weaknesses, what the therapist sees as influencing factors in your child's progress, and what the therapist feels is your child's prognosis with continued therapy.

Gather these progress reports, any remarkable session notes (i.e., if a diagnosis is suspected or given, any regression accounts, any notable progress, any other comments that might be useful), any evaluation reports, any assessments -- have a few copies made of all paperwork, and gather one set of everything to give to the evaluators. This should go with your child's file, and should add to the overall picture of your child's development, growth, and individual needs as a child and a student.

It is likely that the agency may already have their own copies on file of some of these reports - give them their set anyway. If nothing else, your preparation tells them that you are an involved parent, you are prepared, and that you've 'done your homework'. Sometimes you are treated with more respect this way -- sometimes it just lets them know that you are a parent to be reckoned with and that you are an equal and important member of the team that will decide your child's near future. You are both!

If you have other children, most likely they will not be permitted to attend the MDE, since it is focused exclusively on your child with special needs. When you learn the date of the MDE, try to contact a family member, friend, or a babysitter as soon as possible to make other arrangements for your other children -- including for care after the MDE is finished. You and your child will both probably need some "decompression" time after it's over, and it may be in the best interests of your other children if they're otherwise occupied with friends or family.

The day of the MDE, if it is not scheduled at your home or day care (the 3 to 5 MDE will most likely be scheduled at the agency) -- be sure to leave earlier than you feel necessary, especially if you're not sure where you're going. Allow at least an extra 30 minutes to get there, due to traffic, bad directions, difficulty parking or a longer walking distance (if from public transportation or difficulty parking). If you get there too early, use the opportunity to look around, perhaps talk to other parents if they are also waiting for their MDE, and allow your child to acclimate to the environment and relax a little. Don't forget that this is stressful for your child as well.

Depending on your child's needs, pack accordingly. For example, my child is known to have "diaper troubles", so I always need to have two extra sets of clothing, extra diapers and wipes, bags for the diapers, and some "munchies" and some juice or bottled water. I have to pack carefully because my child cannot drink milk (allergic or intolerant), and due to her sensory problems, she's a very picky eater. I also bring certain "fidget toys" with me to help calm her down if she's starts getting over-stimulated, overwhelmed, or just shuts down completely. I bring some brushes for calming her if she needs it.

Some agencies may have a policy of "no outside food or beverages" - check on this if your child has food allergies or sensory issues that interfere with your child eating or drinking 'typical' snacks. I brought my child's favorite snacks and a juice, not only in case she was hungry or thirsty, but as a measure of comfort and familiarity - something from home in the midst of a strange place and with strange people handing her toys and asking her questions.

The MDE may take a few hours - they often say 1-1/2 hours, but I've never been part of an MDE lasting less than 2-1/2 hours. They ask a lot of questions, they do a lot of tests, and every time I thought they were winding down ... out came another round of questions! If you notice that your child's eyes are glazing over or that your child is demonstrating behavior that you know means "I've had enough," don't be afraid to speak up and let the evaluators know that they need to finish soon. You know your child, they don't. They're doing their jobs, but they work with hundreds of kids - you are your child's best advocate, and your child's most important advocate.

Depending upon which agency is conducting the MDE, you probably will not receive the results that day. You can ask the evaluators if they can give you an idea of what their initial findings are. They may share some thoughts, or tell you that they share your concerns (which is what happened with me). They should give you a time frame in which to expect a report, and they should also give you written information on what to do if you receive the report and disagree with their assessment. There is an established procedure to follow if you wish to file a grievance or disagree with the assessment and ask for another opinion, and they should give this procedure to you in writing. Everything with child welfare agencies must be conducted according to government laws and regulations, and they must follow them.

At the end of the MDE, they should give you information regarding the name and contact information for your child's Services Coordinator (the person in charge of managing your child's services through the agency and provider agencies), with instructions to call your SC if you have any questions.

After the MDE is over, I strongly recommend taking your child home or to a playground or another place where your child can relax, eat, play, or do whatever he/she wants to unwind. The MDE tends to be intense, exhausting, and a strain on both of you -- because it's long and it covers so many areas of development. So plan to keep the rest of the day open if possible -- don't schedule doctor's visits, school activities, or other events requiring thought and attention unless you know it's something your child will definitely enjoy even after an exhausting appointment.

For you as the parent, it may take some time to process everything that happened and to come up with a "bottom line" of how things went. Talk to your family and friends, or talk to other parents of children with special needs. Talk about your experiences, what frustrated you, what you liked, what your questions are. Talking about these things helps us to put things in perspective, and reminds us that evaluators are not "God", that we are an equal and important part of the process, and that if we don't like the outcome or disagree with their findings, we have a right to respectfully disagree and pursue more options. We as parents and guardians are guaranteed certain rights of due process by law, but we need to exercise our rights with respect and a reasonable attitude.

The whole process of special education does become less overwhelming with time and experience, but in the beginning, it can feel like climbing a mountain for the first time. A good resource to check for information and help regarding special education law and process, and parental rights and resources, can be found at the Parent Education Network at http://www.parentednet.org/. This site is a Pennsylvania resource, but it contains many links and portals to assistance in other states, and I have found it to be an invaluable source of free information. Many of their publications are free, and they'll mail them to you if you request them. They can also be reached by phone (toll free) at 1-800-522-5827 (V/TTY). Also ask your child's pediatrician for resources and referrals.

This article is not all-inclusive nor exhaustive, but it may be useful in helping you to prepare for an experience that most special needs children will go through in order to be considered eligible for services they need.