Why are Children Referred to RP?
There are different ways to address the question. One is to look at the most common reasons for admission to residential facilities. Another is to understand the legal basis for why school districts make this decision.
Reasons for admission to residential facilities (according to a study done by Abt Associates, 2008). Review this list and note if any apply to your child.
- the complexity and severity of their child’s condition
- safety and other needs for 24-hour structured treatment
- challenges in accessing appropriate outpatient care for the child and themselves
- preference for all aspects of treatment and education within one system
- destructive acts in the community
- self-injury or other danger to one’s self
- inability to function in daily activities
- physical aggression, assault, or danger to others
This study also reported the children’s diagnoses at admission:
- mood disorders (such as depression, anxiety, bipolar 91%)
- impulse control/attention problems (91%)
- aggression/oppositionality (90%)
- post-traumatic stress disorder (84%)
- learning disabilities (76%)
- substance abuse (70%)
- psychosis (63%)
- communication disorders (48%)
- autism spectrum disorder (ASD; 40%)
- eating disorders (34%)
- sleep disorders (27%; note that the sum of percentages exceeds 100% because some children have more than one condition).
The legal reason for residential placement referrals by public schools is that the child’s IEP Team agrees that they cannot provide FAPE to the child. This can be difficult for schools to conclude, especially given their legal requirement to educate children in the Least Restrictive Environment (LRE). Sometimes a private day placement with increased home-based support will be tried first, before referring to residential. The school district is only obligated to provide residential services when they are required for educational reasons. For children who have serious mental health challenges and involvement with the Department of Mental Health (DMH), sometimes the residential placement and referral will come from DMH. For other children, DMH will pay residential costs while the public school district will pay for the day school costs.
How do I know if a Residential Placement (RP) is right for my child?
No two children or families are alike, and there is no right time to consider a decision about residential placement. This is a highly personal decision. Many factors should be weighed, including all of the pros and cons of residential placement, as well as the pros and cons of keeping a child at home. This list should be generated not only for the child, but for other family members as well. Being aware of what the child and other family members have to gain and lose with all available options can be helpful in deciding what is and is not tolerable. Some families decide they cannot bear the pain of being separated from their child, and others decide they can no longer manage daily injuries at home due to the child’s self-injury and aggression toward others.
Looking at the data on reasons children are referred for residential placement is one way to help parents sort through this difficult decision-making process. Parents may also come to believe that their child deserves the best chance to learn and live life to their fullest potential – even if this is at a residential school. It may take years of grappling with this option for parents to feel comfortable or ready for it.