In this episode, we discuss the importance of how a multidisciplinary evaluation can help to more fully inform your child's IEP placement and programming needs with guest speaker, Dr. Chris Bogart, owner and Co-Director of Sasco River Center LLC located in Fairfield County, CT.
Dr. Bogart is licensed clinical psychologist who has worked in both the private and public sectors for the past twenty-five years, Dr. Bogart works with children, adolescents and parents, conducting comprehensive psychoeducational and AD/HD evaluations as well as therapy services. He also provides program consultations to local schools, as well as supervision to doctoral students in psychology. Dr. Bogart serves as the Board President of the Board of Trustees of Smart Kids with Learning Disabilities; as a member of the Board of Trustees for New Canaan Country School; and as a member of the Advisory Board for the Center for Sexual Assault Crisis Counseling and Education.
Prior to co-founding the Sasco River Center, Dr. Bogart held various clinical positions including staff psychologist at the Beth Israel Medical Center in New York City and Director of Psychology at the Rockland Children’s Psychiatric Center in Orangeburg, New York. While serving as director, Dr. Bogart organized and administered an American Psychological Association approved externship training program for clinical psychology and social work graduate students. He supervised staff psychologists on children’s and adolescent inpatient units and he devised a hospital-wide behavior modification program for the children. Dr. Bogart has provided numerous classes, lectures and training programs on various topics such as parent education, executive functions assessment and coaching, psychological testing, and stress management. He has also conducted research studies in various areas including Attention Deficit Hyperactivity Disorder, Social Skills Training, and depression in children.
Dr. Bogart received his undergraduate training at Georgetown University and received his doctoral degree from The American University in 1986.
For more information, visit: https://sascoriver.com/
Welcome to the podcast. Let's talk sped law, a podcast dedicated to discussing special education rights of children with disabilities. I'm your host and special education attorney. Jeff forte. Now let's talk sped law.Speaker 2:
Hi everyone. And welcome to another episode of let's talk sped law. Uh, today we have , um , a very special guest on, and that is Dr. Chris Bogart, one of the founding owners and partners of SASCO river center here , um , here in Connecticut. And we're going to be talking about the important of multi-disciplinary evaluations and, and when they're needed, why they're needed , uh, you know, for the benefit of all of you that are listening , um, across the, across the country. Uh, I'd like to tell you a little bit about , uh, Dr. Bogart. Um, Dr. Bogart is a licensed clinical psychologist, and he's worked in both the private and public sectors for the past 25 years. And he works with children, adolescents, and parents. He has extensive experience conducting comprehensive psychoeducational evaluations , um, program consultations for both parents and for local school districts. Um, he supervises doctoral students in psychology. Um, and before today, I didn't know this, but he , um, got his doctorate degree at American university, which is where I went to law school. And his undergraduate training is at, was at Georgetown university. So Dr. Boulevard , thank you so much for being on the show today. I really look forward to our conversation. Welcome here.Speaker 3:
Thanks Jeff. It's really good to be here. Hello everybody.Speaker 2:
So, you know, first of all, let's, let's get your information out. So folks can know where to reach you and your multidisciplinary email@example.com . Um, now SASCO river is a fairly new reinvented , um, organization. Can you tell us a little bit about how SASCO river was kind of the merger of two , um, uh, you know, two therapeutic centers before it became SASCO river?Speaker 3:
Sure. So the, the history is that , um, I've actually been here in Fairfield County for about 30 years , uh, and for the first , uh, you know, 18 or so of that, I was in private practice. And what I discovered, you know, in private practice as a clinical psychologist, you know, there were a lot of areas that you can do a lot of great work, but you often are left in a position of feeling that you've only solved or helped a child or a family to a certain degree. And then you're reliant on other professionals, you know, sometimes a language pathologist because of a communication issue or an occupational therapist because of a sensory issue. Um, and so when I constantly found is that it was often hard to get that team to work in a coordinated fashion that even though we all, you know, wanted to be collaborative , uh, you know, finding the time to discuss the child or communicate with the parents always became a challenge. And so, as I got further into my private practice, I felt like, you know, that the model that would really work is to bring all of these people together under one roof and to work in a way that is much more holistic and comprehensive. And so , uh, you know, 12 years ago I founded a center called the South field center and , uh, we have our location in Darien, Connecticut, and the South field center was , uh, you know, a group of professionals multidisciplinary , uh , made up of psychologists, psychiatrists, language pathologists , uh, um, educators and our work was predominantly with kids with , uh , learning or emotional challenges, working with them and their schools , uh, working with them and their parents , uh , to hopefully stabilize and move them towards their best development. As we got further into things, we realized that we were missing a big component. We were missing that sensory motor development piece. And I started working with , um, a woman named Melissa Khan , who is the owner and founder of sensory kids. And the two of us had a very similar way of thinking about things in terms of , uh, really very often needing that integrated approach to children. And so , uh , the two of us began collaborating. We ended up opening up a center together in Wilton and then decided that it was going well. So we decided to more formally a partner and we opened up the SASCO river center back , uh , January of last year, January of 2020. We opened up the SESCO river center and we now have locations in , uh , Wilton Darien and Stanford. Um, we've got about 60 plus professionals that cover all of those areas of psychology, psychiatry, occupational therapy, speech, and language, education, nutrition , uh, all of those different pieces. And we , uh, uh, even though if a person comes to me and I'm their primary person that they're working with, I've got the benefit of these other 60 professionals that I can turn to for input support, sometimes form a multidisciplinary team , uh , to be able to provide a more comprehensive and holistic way of dealing with the child.Speaker 2:
Right. I mean, it's just, it's just amazing for the folks that don't have the visual, cause we're an audio podcast mean I'm on the SASCO river center website right now and just the breadth and scope and the resumes of the staff that you have is , is really second to none. And, you know, you really underscored it that when you're needing to take that multi-disciplinary approach with all of the subspecialties , it's really great to have it kind of all under one , um, under one roof where you could all really talk about how to further advance the child's , uh , you know , needs and address them appropriately. Um, you know, one question though, right? That we often kind of get it from from the parent's perspective as well. So that's what the school team's there for, right? The school team arguably is the multi-disciplinary team of , uh , of a child's IEP. And so in that regard, a parent may get , um, you know , pushback, if they're requesting that the multidisciplinary approach be taken elsewhere to either be, you know , uh , uh, you know, parent funded or mutually agreeable evaluation based funded. And can you talk about that, that space and that discussion where if a parent is feeling that they want to get a second look with a multidisciplinary team, how, when does it arise? Um, you know, how does the referral come and can you walk, can you walk parents through that process a bit?Speaker 3:
Sure. Yeah. And that's it , that's a great point in terms of, you know, what a school district has is they do have , uh , the bulk of those professionals , uh, under one roof and , uh , the bulk of those professionals who can , uh, you know, create a, an individualized education plan that covers , uh , all of the main learning needs, as well as the related services like occupational therapy and speech and language here . Here's the thing I would say. And I would say this, you know , I have a , I have a very good relationship with pretty much all of the districts in the area and have done a lot of work with the districts , uh , supporting their teams , uh, helping to work on kids who are, you know , having some complex challenges to be able to move them forward appropriately. And I would say this, if, if you know, one of these special ed directors was on this call and say the same thing, I'd say the difference between the way we approach cases and the way it happens in district is that just by the nature of a school and what they're delivering in terms of their services, there, there is a , in some ways, just almost more of a attendancy or even a need for some of these different professionals to work a little bit more within their individual discipline. And so even though they meet as a PPT, you know, our planning and placement team to come together and form an integrated IEP, an individualized education plan, even though they are working as a team, when you get the reports from these different disciplines, they're they're individual reports. So the language pathologist is looking at it as a language pathologist and looking at the speech and communication issues. The OT is looking at the fine motor and the sensory piece, the psychologist is looking at the cognitive and the emotional piece, the special educator is looking at the academic piece. And so they're all looking at this kind of in their own individualized view. And then they try to blend it after the fact to pull it together. Our approach is a little bit different. Our approach kind of goes at it from a different direction that the evaluation, when we decide to do a multidisciplinary evaluation from the beginning of the evaluation to the end of the evaluation, it's done in an integrated fashion. So the team gets together before we even jump into the evaluation and talks about what components need to be a part of this. And would it make sense for the psychologist to observe the child in the sensory gym to see how the child's reacting to that situation or the , uh, you know, the person doing the educational piece would be working with the language pathologists in concert so that we're looking at phonemic awareness and we're looking at rapid naming skills in concert. And so, so from the very beginning and at different steps of the process, all along the way to the final report, that's an integrated report it's done in an integrated fashion so that you don't come to the end of it and say, you know, Oh, well, I think that the issue is all of these sensory pieces and the kid needs, you know, 30 sensory sessions over the next two months. Oh, and I know I'm the language pathologist, and I think the kid needs this. I think, you know, and you don't end up with recommendations that are all of these individualized pieces. It's meant to be blended together with the prioritization of, we need to address this first, and then we can get onto this and then we can get under this. And it's done in a more integrated fashion from the get-go so that the results are blended. The recommendations are blended, and the parents guided through the next steps in a way that doesn't feel quite as overwhelming to them.Speaker 2:
Right. Right. And, you know, to , to sprinkle some of the law in this, under the individuals with disabilities education act , uh, the definition of multi-disciplinary that the legal definition is it means the involvement are two or more separate disciplines or professions with respect to the evaluation of a child and the assessment of the child and the family. And it may include one or more individuals was qualified in one or more disciplines or professions. And you know, what you're talking about on the, on the clinical side is literally mirroring what, what , uh, you know, th the legal definition under the Ida is , um, you know, one question though that we often will get is , uh, you know, what level of deficits does a child, you know, typically need to present with, in order to even start to have the discussion of requiring a multi, a multi-professional multi-disciplinary type of evaluation. Um, and what do you find from the clinical side and your experience with you and your team? What does the student presenting with that will often , uh , qualify a child to get a multi-disciplinary approach to evaluation?Speaker 3:
So, so the , the , the multidisciplinary evaluation is, is really meant to be for those students who really have a very complex presentation in terms of , uh, you know , uh , potential involvement across multiple domains, where, you know, there's, there's clear difficulties in the language development, potentially difficulties in the , uh, motoric sensory area , uh, possible impact from how they process information. So there may be attentional issues or executive function, function issues. It's, it's meant to be really reserved for those kids who more often than not have already gone through some individual evaluations. And there may be , uh , you know, some , um, you know, differential diagnoses, you know, maybe this kid might be a child who's on the spectrum, or maybe this is a child who has attentional issues with a learning disability, but we're not exactly sure, you know, is it truly a learning disability, or is it really an attentional issue? And so the kid is not focusing well enough to learn the material, you know? And so you get to this place very often in an evaluation process , uh , with either the school or , uh , with pediatrician or with some other outside entity where they're scratching their heads and saying, we're not sure what's driving the train here. We , we, we have theories. We have, you know, potential multiple diagnoses that's going in here, but we just can't seem to figure it out. And so that multidisciplinary evaluation is meant to be , um, you know, driven, you know , really directed towards those more complex cases. Now that the , the other side to this there, Jeff , that we do quite a bit of probably, you know, for all the multi-disciplinary evaluations, we do, you know, eight or 10 other individual, but the way that we approach this is that even if the person is coming to me as a clinical psychologist for a comprehensive evaluation, and I'm looking at , uh, you know, overall verbal abilities, cognitive skills, visual processing , uh, language development, you know, I'm, I'm the person doing all of that evaluation piece as part of a comp comprehensive psychoeducational evaluation. What I will do on a consistent basis is as I'm going through the analysis of data, I'll go down the hallway to my language pathologists and say, Hey, look at this data, what does it say to you? Or I'll go to the OT and say, this is what I'm seeing, you know, what do you think? Or, you know, Hey, I'm going to be testing this child at 10 o'clock. Can you, you know, can you , uh, sit in for a part of it so that we can have a little bit of other piece ? And so a lot of times we will be doing a comprehensive psychoeducational evaluation, but we'll still involve another person to take a peek at it to add a little bit of depth to that. So, so we've got the multi-disciplinary evaluations that might be made up of a psychologist and occupational therapist and a language pathologist coming together all to test an integrated result. Or we may have a comprehensive psychoeducational . That's my signature, my license on it, but still has the input from those other professionals.Speaker 2:
Right. Right. So that's a , that's a great way of putting it , uh, Dr. Bogart and, you know, for , so for parents that are still processing this right. And they're, they're understanding all of this , um, you know, a multi-disciplinary about isn't necessarily for, you know, for everyone. Um, but, but a parent should be thinking that they may be wanting to ask for one, when there has been, for example, multiple disability, eligibility categories within an IEP that have changed year over year, or the child's disability continues to evolve and change to a detriment , uh, you know, year over year as the child grows , um, versus , uh, seeking, you know, kind of like a more traditional psychoeducational evaluation or psychological or neuro psych . And the recommendations could include things like a follow-up with OT, a follow-up with PT, follow-up with SLP. Um, I think it's good to explain kind of the two differences with that, because, you know, if a child is just simply having a speech and language impairment, that's a significant impairment, but might not necessarily qualify them in and of itself for a full multi-disciplinary , um, assessment. Right.Speaker 3:
Right. Exactly. Yeah. And, and we do loads and loads of those kinds of evaluations, where it's really one clinician with one specialization, that's doing a very deep dive into that area. But as , as I said , I would say most of our evaluations are, you know, even if it's a deep dive by a language pathologist they're popping in, popping in my office to say, what else might be going on here at a cognitive level or a , you know , what other pieces of my potentially missing that I should look at here. So, you know, the, the advantage to, to working in, you know, with , uh , a center like ours, and, and I'm not trying to be here to say, we're the only one around there's other centers that do this types of this type of stuff. But the advantage to that type of a multidisciplinary philosophy is that, you know, you're getting the benefit of multiple eyes. Even if there's one person that's kind of your primary clinician, that's doing that deeper dive. Right.Speaker 2:
Right. Right. Now, let , let's kind of talk a little bit about , um, the role of the evaluator in the context of , um, uh , you know , uh , a dispute, if you will, or a disagreement between the parent team, I'll call it versus the child school team. And really, you know, the empowerment that a independent or mutually agreeable evaluator plays in the role to more fully informed the child's IEP, you know , um, uh , oftentimes evaluators are , are pulled in where there is that dispute. And how do you, how do you go about , um, more fully informing what the child's needs are , uh, when you're kind of put into that situation?Speaker 3:
Yeah , it's a , it's a , uh, in, in many ways it's a little tight rope that you need to walk because the most important driving force that , uh, that really motivates all of the clinicians. I know that I work with certainly as my motivating force. And it's also, you know , uh , your motivating force as a special education attorney, and it's also the parents motivating for us . And it's the school's motivating for us , which is the idea of, we want to do what's best for this child, whatever this child's true needs are, is what should drive wherever we end up. And so that's what we would, that's what we say. And that's what everybody involved in this would say. But the reality is that a lot of times people have their own, you know , perspective on , on what that, that, you know , what that needs should be and what that, you know, how that should be filled, the way that we have this over the years, I've been both working as a independent practitioner, as well as a part of this multidisciplinary practice. The way I've navigated that is upfront with anybody I'm intersecting with, if the superintendent of schools contacts me or a special ed director, contacts me where a special ed attorney contacts me or a parent contacts me. What I say very much up front is please understand that we will be doing this analysis in a, you know , in a very independent fashion, meaning we're going to be doing a lot of work with your child to delve into all the different layers of what might be impacting them. We will get information from the school, we'll get information from any outside providers, a pediatrician or outside tutors or things like that. We're going to pull all of this information together, but our report is going to be truly based on what our data is telling us in the context of this student's history. And our recommendations are going to be based on that. And you might not like what those recommendations are, because it might not be fulfilling what, the way you see things where the , the, the direction you want things to take. And that is, you know , we , we will present this, we'll present our rationale for it. We'll present the data that backs it up. We'll , you know, we will layer this within the science that we operate under and, you know, and anybody who contacts me after it and says, you know, could you possibly rewrite this or say it this way? Or, you know, put it in this language, we're going to say, no, this is what our , this is what my license tells me. I need to do. This is what my ethics tells me I need to do. And that's , that's, you know, what I can really say with pride is 30 years into my profession. I don't think that there has been a time that , uh, either a school or a parent or a special ed attorney or anybody has gotten back to me and said, you know , you know, I feel like you were biased in this situation. Right ,Speaker 2:
Right , right. You know, and I , I really applaud you and your entire team for that. Um, you know, often on the parent attorney side, right. You know, lawyers are storytellers, right. And we can tell the story, but we can't necessarily create the story. And , um , you have to find your client as they are so to speak. And oftentimes, you know, I give an analogy to my , my parents, you know, you don't want to take your child to get any particular tests with their pediatrician and tell the pediatrician, Oh, and by the way, I want the results to be this, right. That's not to the benefit of your child. Right . Um, instead you want a pediatrician, that's going to say, listen, here's what your child has. And here are my recommendations because that's the authenticity of, of the practice. So , uh, you know, that fortunately not everyone follows that in your footsteps doctor, but , um, but it's , it's great that, that, that SASCO obviously SESCO river does. Um, so where, where are we now with COVID right. So we, for example, are we able to conduct multidisciplinary evaluations given our pandemic right now? Um, and if so, how and what parts are able to be remote? What parts are not, w what are kind of the best practices that have been developed regarding this as a response to the pandemic?Speaker 3:
So , uh, that , that's a , uh , a changing answer probably every day, but , uh , but here's where, where we have gotten to, and it's actually fairly comprehensive what we're able to do at this point. Um, you know, if you go back to March, April, may basically all testing shut down, because it was felt to be , uh, you know, too risky, too close to the clients . So they , that what we developed going into June, and we've kind of continually , uh, alternate as the needs presented itself as is we created with the back , you know, with the guidance of the American psychological association and , uh, uh , test publishers and study that we created a , um, a battery of tests that is considered to be scientifically valid, much of which can be administered , uh, over zoom. But what we do is we bring the student to the center and we have a testing room that's set up , uh, uh, with , uh , sound quality controlled for, and the environment sterilized. And, you know , the student has the student room and the psychologist has the psychologist room where if it's the language pathologist or whoever it is, has their own room. And we're able to administer , um, you know, a lot of the different instruments in a remote way, just like we're talking today , uh, but still be in the same location. So if the student's having a hard time, I'm there to help them to, you know, address whatever the issue is, fixed technology, as necessary as time has progressed. What we've been able to do as well is set up different areas that are areas that have , uh, you know , uh, highly advanced , uh, HEPA air filtration systems and have like a plexiglass barrier . So that now what we have in addition to doing some of the stuff in a remote type setup, we're now able to be in the same room and able , uh, you know, with a socially distanced , uh, situation and with the, the barrier and the proper air filtration, we're able to do a lot of stuff face-to-face, but with, you know , with a , a , a barrier between us so that I can now see the student's mouth move , uh, or I can hear exactly what's going on, or I can administer certain stuff where I can watch much more closely exactly how the students are progressing through some of the tasks that I'm providing. And so , uh , well , we've moved to , uh , through our different iterations that are getting us closer and closer and closer to being able to do things the way we were prior to the pandemic. Um, and , uh, all of this has been guided by what the science says is, is valid. Um, and there are still a couple of instruments that we're not able to do able to do, but , uh, but it doesn't block us from being able to do a very comprehensive analysis. Um, you know, we were even, we've, we've moved back into doing sensory evaluations in a sensory gym, but we also have , um, a system set up where the sensory gym can be fully sterilized. We've got this aerosol sterilization things, so that in between students going in there and swinging on the swings and moving through some of the structures, everything is able to be , uh, uh, aerosol clear cleansed and wiped down and things like that. And , and , uh, you know, the students wearing a mask, the occupational therapist has a mask on, so you can do it in a socially distanced way. The, the gyms are, you know , uh, 800 square feet of open space with high ceilings, with good filtration. So, you know, we'd been operating , uh, back in that capacity since June. Um, and we've , we've tested now, you know , uh , well over a hundred students, I don't know the exact number, but, you know, a very large number of students and happy to say that , uh , we've had zero , uh, issues with any sort of contagion, anything passed from one person to another Pat person. So everything is working.Speaker 2:
That's great. That's great. Um, as a follow-up , how, how are you finding , uh, the , uh, school districts regarding, you know, when, when you and your team have to go into district to either do a in-person , uh, you know , student observation, are, are you finding that , um, number one, are you being allowed to, or is it more where you can zoom in, so to speak remotely or a combination of the two?Speaker 3:
Yeah, so the , this old districts in our area , um, are out allowing outside , uh , folks to come in and observe or attend meetings in inside the school. Uh, you know , for obvious reasons, they're, they're obviously protecting the environment and limiting exposure , um, what they would , most of them have done. And I can't say a hundred percent, but most of them have done is allowed us to do zoom observations. Um, you know, of, of the student, they have to do it obviously in a way that is protecting the confidentiality of the other students and things like that. But , but we've been able to get those snapshots , uh, you know, within, within the classroom, we've done a lot more of , um, having , uh , you know, in the past we would always get input from the team. Now we get even a lot more input . So , you know, very often we're scheduling a , you know, a full hour with all the different members of the team to have a discussion about what they're all seeing from their different perspective. You know, whereas before we might get that in writing as a rating scale, we still get the rating scales done, but we might've just gotten that kind of on a form . Now we're actually having these kinds of meetings with the different members of the team , um, the private schools, interestingly. So it needs varies according to private schools. I , I, you know , I know you're more focused on the public schools and public education law and somebody that, but , uh , private schools vary . We have some private schools that are allowing us to come in and do observations , uh, where they don't, they're usually allowing this through the video technology.Speaker 2:
Great. Great. Um, and how are your, how are your clinics, you know , going in response to COVID? I know that, you know, a lot of , um, uh, parents really enjoy having their children go to afterschool , uh , day clinics and , um, you know, how, how has that been in response to COVID?Speaker 3:
Yeah , so, you know, whenever you, whenever we're able to successfully and therapeutically deliver the service via , uh , you know , remote technology, we're doing that. So we're doing a lot of teletherapy with kids. Uh, you know, generally that's a lot more successful with the teenagers and young adults that we work with. Uh, you know, parent meetings, we do , uh, almost a hundred percent through zoom technology at this point, but there are a lot of younger kids that don't do so well in that sort of a setting. And so I'm starting back in may when the weather was nicer and study that we started doing a lot of outdoor therapy. So we would meet a child at a park or, you know, meet them on the grounds of our center. And we would go for walks or throw football back and forth, and we would have therapy outside. We did a lot of occupational therapy at various playgrounds and , uh, really used outside as much as possible on a day like today, where it's , uh , 15 degrees and windy and cold and stuff like that. Um, what we are able to do is , uh , we've got , um, a number of, you know, in our bearing location, we've got five rooms set up, each of which is a minimum of 300 square feet. And some of them are about 500 square feet that are much larger. Again, we put in a high-end filtration systems , um, and we're meeting in these rooms at a good social distance , uh , but able to conduct most of our services. And , and I mentioned before what we're doing for the sensory OT evaluations, where we have the ability to sterilize between patients. So we're doing occupational therapy. It's not as efficient or as easy as it was a year ago before a pandemic, but , uh, but we're getting it done. SoSpeaker 2:
That's great. That's great. Well, Dr. Bogart, thank you. Thank you so much for being on the show. Um, you know , uh, th the importance of multi-disciplinary evaluations, I really think is something that's continuing to be at the forefront. And , um, especially for students that are needing them, and it's important for parents to know about them. So I want to thank you for , for really opening up and sharing your expertise about this for the benefit of , uh, for the parents that are listening.Speaker 3:
That's great. Thank you, Jeff, for inviting me. It's always great to talk to you.Speaker 2:
Thanks. All right, everyone. Well, thank you so much for listening to another episode of let's talk sped law, by the way, we now have over $7,000 .Speaker 1:
So I want to thank the audience for listening to me in every week. They to look for another episode, thank you and take care.