Category: Education

My child does not want to go to school

Children walking to school
Children walking to school

As a doctor for children, I often talk to parents about school refusal. There are many reasons  why children do not want to go to school and the reasons change with age.

Here I summarize a list for the most common causes of school refusal. Some are typical for age and some require help and support.

Separation anxiety. Children who become very sad and worry when their parents leave. It can start at 6-7 months of age. Peaks at age 15-18 months. Most children cry when parents leave, but can calm fast and they are happy to see their parents at pick up time. Children who cannot calm down, refuse to play with other kids, may need help.

Light bulbWhat parents can do;

  • Talk to your children about school in simple words “its School time, play time”.
  • Remind them of things they like to do at school.
  • Use rewards. A reward can be a fun activity that you do together.

Performance Anxiety. Definition: Children who escape certain class activities. Examples are; reading in front of the class or being called on to answer questions.

Light bulbWhat parents can do;

  • Talk to teachers, they will give important information about how your children are doing in the classroom.
  • Work with the teachers to make a plan, for example; allow time for them to raise hand or practice reading before the class starts.
  • Use stars reward system for “reading out loud”.
  • Tell them you are happy with their hard work, even if they were not successful.

Learning Disability (LD). Definition: difficulties with school academics. Difficulties can be in; reading, writing, math or in more than one topic.

Light bulbWhat parents can do;

ADHD. Definition: It is a medical condition that makes it difficult to listen and pay attention. It is due to changes in the brain chemicals. ADHD is more noticed when children move to higher grades. Children with ADHD can be misunderstood. As a result, making friends can be hard.

Light bulbWhat parents can do;

  • Talk with the teachers. Ask if your children act same at home and school?
  • Talk to your doctor. ADHD is very common and can be treated with medications and some additional help at home and school.
  • Schools can help and support children with ADHD. Know your rights, students with ADHD

Bullying. Definition: when a person or a group repeatedly harm someone. It can be; physical, calling out names or using the social network to post bad things.

Light bulbWhat parents can do;

  • Ask Children if they ever get hurt in school or called names.
  • Ask the school counselor and the teacher to help you find out more if you have any reason to think about your children being bullied.
  • Get children help through therapist, share with your school and your doctor.


Depression. Definition: low mood and loss of interest in fun activities. It is more common among older children/teenagers. Depressed children can be irritable or angry not sad. It is important to notice any other changes to your children mood and behaviors at home.

Light bulbWhat parents can do;

  • Talk to the school counselor, your doctor or someone in your community to help you with resources.
  • Always look for expert help.


ABA Therapy

child pointing at a chartHello, my name is Felisha Thomas and I work as a behavior therapist in a public school.

Therapists and teachers use ABA to help work with children.  ABA stands for Applied Behavioral Analyst.  This means the science of behavior.  ABA is not just for children with autism.  ABA is used to help all children with their behaviors.

Therapists and teachers learn ABA in school.  They learn about the 3 ABCs of behavior.

  • Antecedent: what are they doing before the behavior?
  • Behavior: what are they doing?
  • Consequence: what are they doing after the behavior?

Therapists and teachers use ABA for lots of things.

Help children make better choices throughout the day.

  • Help children who are sad.
  • Help children who are mad.
  • Play with children at the playground.
  • Keep children safe.
  • Help children follow directions in class.
  • Help teach children the rules.
  • Help children learn the class lessons.

Therapists and teachers go other places outside of school to help children too.

  • We go to museums.
  • We go to zoos.
  • We go to parks.
  • We go to the pool.
  • We try to help children anytime there is a need.

Therapists and teachers are friendly.  We let children know that we are their friends who like to help.

For more information on ABA therapy, see ABA in Classroom Settings.

A Beginners Course About Disabilities

My disability is one part of who i am.
Leading change in society Copyright 2015 Marines

My name is Scott Janz. I advocate for social fairness.

What is the plan?

My job focuses on disabilities in the community .

Disabilities are part of culture. What is a disability? A college course on disabilities can help. A beginner course could cover the following.

Carry out Plan

Areas of focus:

Why does this matter?

To create hope for change. Disabilities are rising in society. We have future leaders in colleges. We need to excite them to lead change. People with disabilities have rights. We should help them reach those rights. We need to advocate for change in the public.  I would like the public to learn more about disabilities. Everyone has a voice.

The Discipline Gap: How Children with Disabilities Are at a Loss in the Classroom

Discipline is part of growing up. But many kids with disabilities are disciplined in the wrong Children's colorful alphabet blocksway. This can hurt a child in the long run.

Kids that go against teachers or struggle with classmates are called naughty. This is worse for kids of color with disabilities. One in 4 black boys and 1 in 5 black girls are sent home from school. This is much more often than white kids.

When schools are lax with Individual Education Plans (IEP), disciplining kids with disabilities turns out to be harder.

Next steps:

  • Know your rights! Parents should know how kids’ IEP’s will be used.
  • Teachers must be taught. When teachers are not aware of kids’ needs, everyone is at a loss.
  • Schools should be graded on how well they follow IEPs

All kids should get a fair chance. Kids with disabilities should get to thrive. Raising them with respect is key.


Lewis, K. R. (2015, July 24). Why do schools over-discipline children with disabilities? The Atlantic. Retrieved from The Atlantic

My Child with a Disability Keeps Getting Suspended or Recommended for Expulsion. (2014, November). Retrieved from Disability Rights California Nov 2014, Pub. #5563-01

What you need to know about IDEA 2004: Suspending children from school. (2012, March 22). Retrieved October 28, 2016, from Wrights Law, October 28, 2016, from Wrights Law

Using Tablets to Talk!

Picture of school-aged girl sitting at table using tablet.Communication

There are some children who have difficulty talking. Using a tablet can help.  Finding the right tablet for each child is not easy. A specialist, called a Speech Language Pathologist (SLP), is like a doctor. A SLP meets with the child and watches the child playing. The SLP also speaks to the child. The SLP enables the child to play with different tablets. The purpose is to see which tablet the child likes to use the most. The SLP then asks the child to do a few tasks. The difficulty of the task levels go up to match the level of the child’s understanding. The
SLP has questions for parents as well. The SLP wants to understand how parents and their children talk to each other at home.
Once the SLP finishes meeting with the child, the SLP will write a report. Parents will receive a copy. If parents want to get a tablet for their child, parents and the SLP will work with each other for at least a month. They watch the child using the tablet at school, and then at home. The purpose is to see if the new tablet is really helpful for the child. Parents will take some data to share with the SLP.
Once a child has the right matching tablet, it is important for the parents to know how to use it. Training for parents is important. Parents need to know how to help their children. Many are afraid of allowing their children to use tablets. They worry their children will become dependent on a tablet and not vocalize any more.
For more information, contact Massachusetts Advocates for Children.

Language Rights at IEP Meetings

Red apple on stack of three books. Blackboard in background.

Do you know about Individual Education Plans (IEP)?  Many parents that move to America from other countries do not know what an IEP is. They might be invited to a meeting at the school and not understand why. The letter may be written in English. The language they speak might not be English. These parents might not know what the meeting is about.

Did you know that you have the right to written information in your own language at IEP meetings? You also have the right to have letters sent to you in your language. You also have the right to have language help at the IEP meeting.  The language helpers should be specially trained.

Many parents do not know about language rights. The Federal government has laws about this. If a program gets money from the federal government, they must follow language rights rules. One of these rules is called Americans with Disabilities Act, Section 504, chapter 151B.  It says that the school should provide language help to people that need it.

I have gone with many Vietnamese parents to IEP meetings in Boston.  School staff often do not follow language rules. I have seen many parents have trouble. It is important that parents know their rights.


After School

What do you do after school?child playing a video game

Deciding what to do after a long day at school can be difficult for any child or young adult.  Do you do your homework, hang out with friends, watch TV or play video games? Parents are often very involved in making sure their children have something to do.  Questions about activities for after school become even more difficult when you have a child or young adult with a disability.  Parents have to consider the supports that are needed in order to make sure their child has a structured and supervised afternoon. While some parents are home when their children get home from school in the early afternoon, many parents are working. Most families these days rely on two incomes to support their household.  Therefore, parents must look for supports from the school or community for after school care.

Unfortunately, finding after school programs poses several barriers for families with children with disabilities.  For one, many after school programs are for younger children. This is a major challenge for families with transitioning young adults who still require a supervised and supported afternoon.  Not only are these programs for younger children, but they are for children that do not have disabilities and high needs for support.  Generally, the after school programs have an adult to child ratio that cannot support young adults or children who cannot be independent.  Another barrier for after school programs is that they usually are not free. The expense for after school care is another challenge for families to figure out a structured afternoon.

Schools can be a great resource for families with children and young adults with disabilities, but often close the doors after the school day is over.  Schools need to rethink how the value of after-school activities could be used to help children and young adults work on many of the social, emotional, leisure and everyday-life skills. With additional supports after school, we could see many gains in student success during the school day.  Resources and staff time would be a limitation for schools to implement after school programs. However, community organizations that support individuals with disabilities could collaborate with schools to create after-school programs that would address a huge gap in the system of care. It’s time for schools and organizations to think outside of the box and partner with families to meet student needs.

Self-determination for Youth with disabilities

Alarm clock displaying timeExpectations for Youth with Disabilities

As a Transition Specialist, I attend a lot of meetings with families to help plan for future opportunities for young adults with disabilities. I love meeting with families to think through how to help young adults have a meaningful life after high school. I see potential in all young adults. Sadly, families and schools often help young adults too much. That limits skill development. An important skill for young adults to develop is making their own decisions.  When they make more of their own decisions, they realize the importance of responsibility.

Do Accommodations help?

I find many accommodations are necessary for young adults to learn to be independent. On the other hand, I also find accommodations can limit a young adult’s growth at times. One example I often see is that young adults with disabilities often have more flexibility when it comes to being on time or attending classes. This is an example of a special rule most young adults with disabilities do not truly need. It teaches them a bad lesson around responsibility.

Why should we push youth with disabilities to follow the same rules?

Accommodations that allow young adults to play by a different set of rules sends the wrong message. That does not prepare young adults for life after high school.  In the world of work, employers are often not as forgiving when it comes to being late for work, or not showing up at all. During the transition years of high school, it is important to teach independence and responsibility.  These are the most important skills that students will need in college, employment, or other community involvement. Most of the students I have worked with hope for at least one or more of these activities when we talk about future goals.

How can we help youth with disabilities be more prepared?

We need to put more effort and thought into teaching lessons, around responsibility and independence, to young adults with disabilities.  Massachusetts has a goal for all young adults with disabilities to transition into the community, and to have a meaningful life that, if possible, includes working. Responsibility is one of the main skills that can help young adults make this goal a reality.  I work with families and schools to practice self-determination for young adults with disabilities. Self-determination is a strategy that encourages independence and choice-making, which can lead to more responsibility and a more-fulfilling adult life.  We need to make sure we provide all necessary supports to help young adults with disabilities reach their full potential, but not teach those who are able that

Communicating With People Who Use AAC

Image of an AAC screen
Image of an AAC screen

“In this country we are justly proud of the freedom of speech, that we can say what we want. But I think there is an even more basic freedom than the freedom of speech and that is the freedom to speak.” Stephen Hawking

What is AAC ?
As a speech-language pathologist, I have had the pleasure of working with many children and adults whose developmental disorders or traumatic brain injuries have rendered them without a voice. As a result, many communicate with the support of Augmentative Alternative Communication (AAC) systems. AAC is a way to enhance and support communication in people whose existing speech is not functional. AAC can be:

•    High-Tech

  •     iPads;
  •     DynaVox;
  •     Tobii Eye Tracking; or

•    Low-Tech

  •     DynaWrite
  •     voice output; or

•     No-Tech

  •     picture books;
  •     alphabet system

Communication Partners
I worked with Jen*, a former patient of mine who used a communication book with words organized in numbered columns and rows. Jen was a fast user. I was a fast learner. I pointed to each column and row. She would raise her eyebrows to say yes or wiggle her lips to say no. We would eventually land on the target word (“Column 6, Row 2, Word: Hi”). Just as there are communication breakdowns in a speaking conversation, there are those in a conversation using AAC too. There were times when I moved through the columns or rows too quickly, and completely missed Jen’s signal. She would get frustrated. Or, maybe she was tired that day and her ambiguous raised eyebrows looked more like a muscle twitch. I would get frustrated. No matter how many breakdowns or how long it took, we had an endless amount of patience for one another. We were communication partners. We wanted to hear what the other had to say.
*Name has been changed

“And he’s Dopey…He never talks”
Too often I have opened a patient’s file and read ancient medical reports saying, “Patient was unable to respond to my testing questions…Patient is diagnosed with Mental Retardation”. Fortunately, we have come a long way from those archaic testing methods! We know that even though an individual cannot speak, it does not mean that s/he does not THINK (contrary to the classic fairy tale). Across my work, I have had the honor of meeting smart people, who just happen to also be AAC users. They have written books, presented at conferences and produced short films. AAC users have a lot to share with us as long as we are patient and willing to listen.

3 Helpful Tips When Communicating With an AAC User
1.    Remember to Pause. As I have discussed throughout this blog, patience is important, especially when communicating with AAC users. Be sure to provide enough pause time to allow the AAC user to respond to your question or comment.
2.    Face the Speaker. There is more to communication than speech alone. We communicate with our ENTIRE body, using facial cues, hand gestures and body movements. Make sure to face the AAC user while s/he is speaking so that you incorporate all those non-verbal cues and gain a better understanding of his/her message.
3.    Reduce the Use of Questions. There is a sense of pressure to be the one to ask the questions and maintain the conversation. However, questions tend to demand the AAC user to talk and can make the conversation one-sided. Instead, you can elicit a conversation by making comments.

Suggested Resources
•    I Raise My Eyes to Say Yes, by Ruth Sienkiewicz-Mercer and Steven B. Kaplan
•    The Diving Bell and the Butterfly, by Jean-Dominique Bauby (there is a movie too!)
•    Radiolab- Mr. Bliss:
•    Praactical AAC Blog:
•    Augmentative Communication Program at Boston Children’s Hospital Facebook Page:

Music Therapy 101

Mom smiling with toddler boy with Down Syndrome smiling and clapping on her lapMusic is a powerful way to connect people. Did you know that it also helps people of all ages achieve their personal goals every day? I first heard about music therapy from a teacher at my summer arts camp. I mentioned that I wanted to be a music teacher because I wanted to help people with music. She asked me, “Have you heard of music therapy?” At that moment, I knew exactly what I wanted to do for my life’s work.


Music was a healing force long before music therapy was a defined field. Going back to the days of David playing his harp for Saul, music can heal, soothe, connect, comfort and excite people all around the world. Beginning after World Wars I and II, musicians visited hospitals to bring music to the veterans. It was there that the future of music therapy began. Formal college programs started to train music therapists to meet the increasing needs of the returning war veterans in the 1940’s. As Ronna Kaplan noted, “Doctors and nurses noticed patients’ positive and emotional responses to music” (Kaplan, 2011). To learn more about the history of music therapy, visit the American Music Therapy Association

And Today

There are over 6,000 music therapists certified by the Certification Board for Music Therapists. Today, Board Certified Music Therapists (MT-BC) around the country work with a variety of people, including:

• Mothers preparing for childbirth and in labor and delivery
• Infants in NICU
• Young children
• Children and adults with disabilities
• Children and adults with mental health needs
• Adults looking for increased insight and social connections
• Older adults to increase health and wellness
• Elders with Alzheimer’s, dementia or other age related conditions
• Individuals of all ages at the end of life

Music Therapy…
Gives children with special needs fun ways to develop their skills in a creative space
Supports adults with disabilities by using music as a way to connect to others in formal and informal ways
Invites older adults to participate and share in meaningful verbal and non-verbal music making
Where can I find a music therapist?

Board Certified Music Therapists can be found working in
• Public and private schools
• Hospitals
• Long term care and skilled nursing facilities
• Assisted living facilities
• Music therapy clinics
• In-patient and out-patient mental health centers
• Hospice programs
• Community centers
• Recreation programs
• Early intervention and 0-3 programs
• Children’s library programs

Music is not one size fits all!

You can’t just hit play on a CD player or an ipod and enjoy the effects of music therapy. Music therapy demands responses from a music therapist. He or she must carefully choose the music and instruments in the moment to help meet the person’s goals. Music therapy uses music to increase connections, develop new skills and reach one’s full potential.

The music and instruments change because of the people involved. Everything is adapted to meet the client’s needs. No matter what the music sounds like, music therapists use music to work towards very specific goals.

What are the Benefits of Music Therapy?
Music therapy creates new conversations and can help people connect without the need for words. Music therapy can help many people from young to old, by:
• Enhancing quality of life
• Developing new skills
• Reducing stress or loneliness
• Encouraging teamwork and new solutions
Clive Robbins, a leader in the music therapy field once said, “Almost all children respond to music. Music is an open-sesame, and if you can use it carefully and appropriately, you can reach into that child’s potential for development.” Although he worked mostly with children, as a music therapist, I can truthfully say that music serves as an open sesame for all people.

When used thoughtfully and with an understanding and commitment to personal growth, music can transform lives. Music develops early childhood skills, and helps people transition at the end of life. Either way, music opens doors to new understandings, new solutions and personal development.

For more information, visit
The American Music Therapy Association
The Certification Board for Music Therapists

What Is Music Therapy? Ronna Kaplan, M.A. (n.d.). Retrieved October 11, 2014, from
American Music Therapy Association, American Music Therapy Association (AMTA). (n.d.). Retrieved October 11, 2014, from