Trying to Mainstream

According to CDC estimates, as many as one in 31 children have autism, and one in ten or 11 have ADHD. Another 20 percent have learning disabilities. That’s a lot of children who can’t get their needs met in a typical classroom setting.

Esti Schiffmiller, the mother of four neurodivergent children and the founder of the advocacy group Family First Inclusion Revolution, lays out the typical trajectory of a child with a disability. “You’ll often get a child in playgroup who seems immature or delayed, and maybe a PT or OT will be called in,” she says. “Some children are put in a center-based special ed program until they turn five, but after that, they must be placed in a regular school.”

Going from an early childhood classroom to a Kindergarten one is a big jump — especially for kids who are struggling. That’s often when the red flags appear: maybe the child is easily overwhelmed or anxious, seems unable to make any friends, or can’t academically cut it. “By Pre-1A or first grade, these delays no longer seem ‘cute.’ The school will usually push for an evaluation for ASD or ADHD, suggest medications, and put a para into place. In better-funded schools, there may be social skills groups and counseling,” Esti says.

Once an official diagnosis is made, several options are available. There’s public school, which is well-funded in New York and typically offers high-quality programs for neurodivergent kids; special ed school (Jewish or public); or homeschooling. Since none of these options are particularly appealing — or practical — for frum parents, “a high percentage of frum kids with challenges are mainstreamed,” says Esti. They enter regular yeshivah with supports, meaning extra academic help and/or a para.

“For these children, the pace of the regular academic treadmill is too fast, so the para’s role is to keep the child from falling off,” says Esti. “Unfortunately, extra supports like a para often aren’t enough to ensure they succeed.” If mainstreaming doesn’t work, parents are back to square one: public school, special ed school, or homeschooling.

The Big Debate: Push In vs. Pull Out

“I regularly consult with parents of kids who have special needs,” says Mrs. Suri Pierce*, who runs her own BCBA agency in an East Coast community. “The extreme cases — kids with Down syndrome or who are extremely autistic — are actually easier because it’s a clear-cut case of special needs. You don’t ever expect them to mainstream. The path forward for kids who are only slightly atypical — like high-level autism or learning disabilities — is much harder to navigate. These kids aren’t typical enough to make it at mainstream schools, and they’re not ‘special needs-y’ enough to be in a special school.”

Even if there’s a straightforward targeted therapy that can help the child, when and how should the support be given? That question lies at the heart of a big debate among special ed experts: Is it better to “push in” to the classroom with a para who can ideally support the child in real-time in a discreet way? Or “pull out” a child from the normal classroom setting on a regular basis to get specialized educational help? At some mainstream schools, there might also be an option to “pull out” a child to a secondary track, where teachers are trained to meet the needs of the lower-skilled students.

There are pros and cons to each approach. “If you ‘pull out,’ for example, the student will miss subjects and classroom learning, which sometimes leads to him falling further behind,” says Mrs. Pierce. “How do you expect a child to keep up in Chumash when every other day he misses the lesson?”

As a parent, you can push hard to schedule everything right so the child only misses Chumash once a week and a tutor makes up whatever he missed. But it’s almost impossible to make that happen on a regular basis, with fluctuating school schedules and tutors who have their own set hours and who are likely working with multiple students who have equally complicated schedules.

On the other hand, a distinct advantage of getting “pulled out” is that the child is working with a true professional who is providing targeted academic or behavioral support. “Unfortunately, most paras aren’t as effective, unless they’re really good, which isn’t often the case,” says Mrs. Pierce. “They’re simply not as trained as true professionals.”

And professionalism matters here — a lot. “People in my field like to say, ‘If you’ve seen one kid with autism… you’ve seen one kid with autism,’” says Dr. Malky Zacharowicz, Psy.D., who specializes in evaluating children for ASD. “The spectrum is so broad that it encompasses nonverbal children who stim and yell as well as Asperger’s-type children who are brilliant but socially delayed, so you really have to know your subject to be able to effectively help a child with targeted therapy.”

Pulling out a child into a lower-skill-level track isn’t available at every school, but even when it is, parents don’t always take advantage of this option. “Ten years ago, I was serving as a special education coordinator for a girls’ junior high school in Brooklyn,” shares Mrs. Edelstein*. “We created a new model for the school: instead of individual girls being pulled out to get extra support in the resource room, we started the year with different tracked skills classes. We worked hard to create the classes in a way that there wouldn’t be a stigma — in fact, it was less of a stigma because no one was being pulled out.

“We had fantastic teachers and a fantastic curriculum lined up, but first we had to call parents to get them on board,” Mrs. Edelstein remembers. “Some parents refused, saying: ‘It’s a stigma, why would I do that to my daughter? Just let her be in class. I don’t want her to be seen as different.’ It was disappointing because we’d worked hard to find a way to help these girls develop their skills in a consistent way from teachers who could really support them.”

Fast forward three years: When that first group of girls — the ones who had gone through the skills track for sixth, seventh, and eighth grade — applied for high school, they were mostly able to join the regular classes. This, unfortunately, was not the case for the girls who stuck it out in the mainstream track.

The stigma issue also comes up with “pushing in,” especially when there’s only one child in the class with a para. But these days, it’s become increasingly common to have multiple paras in a single classroom. “Sometimes I have two paras, myself, and an assistant in a class of sixteen kids. We trip over each other!” says Avital, a lower elementary school teacher. Etty, a seasoned para, has been in classrooms with seven paras for 15 children — plus the teacher and an assistant.

There’s a good reason why paras have become so popular. Imagine having an exclusive classroom assistant and educational advocate focusing all their attention on helping your child succeed? A para means your child can get full-time, real-time, individualized support. And there are real success stories. In the best cases, students can typically drop the para after a year or two and become fully mainstreamed.

Unfortunately, it doesn’t always pan out that way.

An Honest Look at Paras

Many of the issues that come up with paras are rooted in the fact that they’re not highly trained professionals. In fact, only a high school diploma and a brief course by an agency are required for the job, making it an attractive option for young people.

“Paras are paid around $35 to $38 per hour, which is much better than what many teacher’s assistants make, and the work is generally not so difficult,” says Chana, the clinical director of an agency for special needs children in Brooklyn. “Men can make even more, like $50 an hour, because there’s a tremendous shortage of male paras.”

The success of a para has much to do with the quality of her training, her own motivation, and perhaps most importantly, how much supervision she receives.

In the best-case scenario, you have solid training, high motivation, and excellent supervision. Leah, for example, was trained by an agency with a comprehensive 40-hour course. “Most of my training happened on the job and through interacting with a BCBA (a Board-Certified Behavior Analyst) who was overseeing me. My BCBA came in to observe once a week and she helped me implement techniques and goals.”

Leah currently works with a boy named Moishie. “I sit near him to help with issues like sitting still and focusing, and I used a rewards chart to motivate him. During social times like lunch or recess, I try to guide him to engage with other children and respond appropriately. If another kid asks me, ‘Why do you always sit with Moishie?’ I’ll tell him, ‘Why don’t you ask Moishie?’ Sometimes I’ll prompt Moishie: ‘Look, Chaim is talking to you, you should answer him.’ These kids find it easier to participate in games if an adult is around, so I’ll join games to get Moishie started.”

Over the years, Leah has learned to make herself useful to the teacher when her assigned child isn’t in need of her. It’s a win-win situation: “The teacher appreciates the help, and the child feels better, too, because it looks like I’m there helping everybody, not just him,” Leah says. “He doesn’t feel singled out.”

Devorah, an occupational therapist, has been both a provider and receiver of special needs services. Her now-12-year-old son, who is on the spectrum, has received support from a para since he was four years old. “I’ve had such mixed experiences,” she says. “In first grade, my son had a para who was just amazing. She loved her work, and she loved my son. She was very hands-on; they would play games, go to the playground, and work on social skills.

“I’ve also had some terrible paras,” she continues. “There was the para who took every issue straight to the principal — a woman who lacked specialized training and had so much else on her plate — instead of consulting with her BCBA, who had real expertise in autism. Another para constantly took my son out of the classroom, which created two problems. First, he couldn’t keep up with the pace of the class, so he started falling further behind. Second, the rebbi wouldn’t agree to keep my son at the front of the class — where it would be easier for him to stay focused — because it was too disruptive when the para took him out, yet again.”

If a para is, well, para-lyzed for lack of guidance, she may end up sitting in a classroom doing very little. “My daughter who is fresh out of high school just became a para,” Bina says. “But her training was minimal, and these kids are very complex! It’s been six months, and her BCBA supervisor has only shown up once in six months. My daughter can’t work on goals or skills with the child she was assigned because she’s getting no guidance or training.”

A common complaint about paras is that they spend much of their class time looking at their phones. It does happen sometimes — and there are reasons for it. “Sometimes a teacher will complain to me that she has six therapists in the classroom because all the mothers pushed in,” says Mrs. Pierce. “When there are too many people crowding a classroom and not everyone knows what they’re doing, the paras check out and start using their phones.”

Tedium is another reason: “My daughter became a para and she was dead bored,” one mother shares. “She was sitting next to the kid the whole time but he didn’t really need that much help, so she just sat there.” Etty can empathize: “If a kid is doing well, following in class and not acting up, the para doesn’t have much to do except sit there in case there’s an issue. I had some kids like that. I read a lot of Tehillim when I was unoccupied, or I’d find ways to help the teacher.”

Even if your child’s para is excellent, it’s still not always a perfect solution. While a good para will try to be as unobtrusive as possible, sitting discreetly off to the side, the other kids all know she is there — and for which kid. “It may help the teacher by having a para to keep the child in line,” says Bina. “But the child doesn’t feel like a full member of the class. He knows he’s the para’s charge.” And that knowledge alone can cause self-esteem issues.

Relying on a para year after year can also foster a slew of problems, from disruption to dependency. “My son’s para tries to help him with socialization and keep him on task, and there’s a place for that,” says Tova. “But I see it can become a crutch when the child starts to depend on the para to help him socialize, focus, and stay on track.”

Zahava, a mother of a child with ASD, has seen children become too dependent on their paras. “One day my para didn’t show up, and my 11-year-old son said, ‘Oh, so I don’t have to daven.’ I told him, ‘You’re going to be bar mitzvah in a couple of years. You won’t be able to have a para with you during your bar mitzvah!’”

The goal for paras, ideally, is to prepare the child to function on his own. “As time goes by, I try to slowly withdraw my support to promote independence,” says Leah. “I’ll tell the child, ‘You start playing with the other kids; I’ll come join you in five minutes.’”

“There should always be a fading-out process,” Etty agrees. “A para sits next to a child at first, then moves to the back as he does better. Many cases don’t need help after two years.”

If a child needs a para for longer than that, it might be time to consider another route. “If the only way a child can survive in a school is with a para — if the gap is too wide — then maybe the parents and school should reassess,” says Zahava.

Devorah agrees. “Using a para in a mainstream school is just putting a Band-Aid on the problem. Most of them really need a special class that fits their needs.” Her son ultimately ended up transferring to a Jewish special ed school, where he spent two years in a program for children on the spectrum before changing to a school geared for students with language processing issues.

A Good Match

Let’s say your child is required to have a para, or, after much deliberation, you decide that it’s better to “push in” with a para than “pull out.” What can you do to ensure that your child is paired with an excellent para?

“The para thing is very tricky,” says Mrs. Pierce. “Your child isn’t going to get helped unless you have a good para with solid supervision working for a strong agency. The same applies to everything in life: if you don’t have a good cleaning lady, for instance, she’s not going to clean well. So, you need to get involved and advocate. Don’t just say, ‘it’s the school’s job to hire a good para,’ and don’t waste your time complaining if the para is bad. Take action.”

In most cases, the school is the one who officially hires the paras via an agency. “But every school is different. Sometimes it’s the parent’s job,” says Mrs. Pierce. Either way, it’s worth researching the agency that the school uses (or asking for a recommendation if you’re doing the hiring) because every agency runs things differently.

“Your BCBA agency should be very involved,” ‘says Mrs. Pierce. “At my agency, we see our job as being a team leader between the school and the home — coordinating everything so the therapy is consistent. For example, you can have the Title 1 reading specialist saying one thing and the principal saying another. You need strong communication so everyone is on the same page.”

In most cases, you cannot handpick your child’s para. But you can advocate if you see the para isn’t a good fit. “As a rule of thumb, a good para is one who knows how to be super discreet, who knows when to step in without drawing attention to the child. You want someone who doesn’t obviously single out the kid, so he’s still getting the support he needs without the embarrassment,” says Mrs. Pierce. “What matters most is the para’s will to succeed, their ability to master the tools for success, and the right chemistry with the child.”

What are clear red flags? “If there isn’t good communication with the para, if you don’t agree on what the right approach is, and if the para is shy and doesn’t know how to advocate for the kid in the classroom,” says Mrs. Pierce.

If the para and the child don’t seem to be a good match, ask for a change. “It’s never one-size-fits-all,” Dr. Zacharowicz says.

“Sometimes, people ask me: whose responsibility is it to make sure the child gets a proper education — the parents or the school?” Mrs. Pierce shares. “The answer is that it’s a thousand percent both. Unfortunately, there are so many disaster stories where the school and parents can’t get on the same page. Parents get frustrated because schools don’t always have resources. It’s true: they sometimes don’t have the bandwidth to handle your atypical child. But there are also beautiful stories where they work together and the child succeeds, sometimes beyond expectations. It requires an attitude of responsibility.

“At the end of the day,” continues Mrs. Pierce. “Every parent should pray to find the right shaliach to help their child thrive and shine.”

How The Para System Started

W

hen did paras become mainstream? And how is it normal to have seven paras in a single classroom? The answer requires a little history lesson.

“About ten years ago, laws were put in place that said insurance companies must cover medical care for children with an ASD diagnosis,” explains Chana, a BCBA who is currently the clinical director of an agency for special needs children in Brooklyn. “What that means in practice is that these children must receive a type of therapy known as ABA (Applied Behavioral Analysis).”

Insurance companies intended for ABA therapy to take place at home, but this doesn’t work for frum families for two reasons: 1) frum schools don’t typically offer the resources and supports that are provided during school hours by public schools and 2) teaching social skills works better when a child is actually in a social situation like school. Hence, many frum families opt to receive ABA services in a school setting.

According to Dr. Zacharowicz, the social parts of the school day, such as lunch and recess, are when you need paras the most because kids on the spectrum are vulnerable to bullying or ostracism. “The social piece is an extension of chinuch. It’s just as much of an opportunity for learning as academics,” she says. “That’s when you really need extra eyes and ears, and boots on the ground, so parents should work with the schools to obtain these extra resources.”

Etty points out that kids with severe ADHD need paras to handle a regular classroom. “They’re too impulsive, too agitated, even when they’re on medication,” she says. “They often lack social skills — they don’t pay attention to what the other child is saying, or don’t focus on the ball during a game. ABA therapy in the classroom can help them stay on track.”

Moreover, regular teachers are simply not trained to deal with kids on the spectrum or who have other disabilities. “With ASD, for instance, you have to focus on the cause of a behavior, not the outcome. My son could be triggered by a noise like another kid tapping his pen on a chair,” Devorah says. “Once he was supposed to tear a page out of his notebook, but it ripped, which for him was catastrophic, so he put it in the garbage. The teacher yelled, ‘Chutzpah!’ But if you yell at him, you won’t get anywhere. The teacher didn’t know how to de-escalate the situation. The school ended up calling me to take my son home.”

For a while, it was relatively easy to access funding for paras in the school setting. “The insurance companies mostly looked away, and since the agencies were getting reimbursed for services, everyone was happy,” Chana says. Of course, not every agency would accept every insurance, and even then, some insurances refused to fund paras in schools.

As more and more children received ASD and ADHD diagnoses, however, insurance companies balked at the expense and began to withdraw funding. “If a child was getting services in school, they’d tell parents to go to the Department of Education and ask for services,” Chana says. “But yeshivos are not part of the Department of Education, so parents would receive no services unless they paid out of pocket. Insurances did continue coverage for after-school and camp.”

Chana says that it is possible to get services from the DOE in New York, but it’s a drawn-out, complicated process. “You have to make a case that your child’s yeshivah is the right place for him — the only place — and he just needs support,” she says. “In some cases they will agree to send a para. But it takes time and perseverance.”

Unfortunately, there has also been some abuse of the system. “There are parents who procure an ASD diagnosis in order to get their child a para for free,” says Esti Schiffmiller. But this carries long-term consequences. As Bina points out, “Being diagnosed as on the spectrum goes on a child’s medical records. You can later try to have it changed, claiming misdiagnosis, but it stays in the Medicaid records forever.”

She adds that the New York OPWDD (Office for People with Developmental Disabilities) provides generous funding to families of children with disabilities like ASD. These families are given paras, funding for recreation and classes, even equipment like swing sets. It can add up to many thousands of dollars a year.

“I know parents who were given sixteen hours of help from a para per week,” says Baruch, whose son is on the spectrum and benefits from just a few hours of support per week. “They primarily used it as babysitting for their child and the other children. When there’s abuse, the people who are truly in need lose out.”

But the government has gotten stricter, according to Miri*, a BCBA who runs her own agency. “There were agencies billing for services, especially during Covid, when nothing was happening,” she said. “Now our agencies are subject to frequent audits. It’s good to keep everyone honest, because otherwise the kids who really need services might not get them.”

(Originally featured in Family First, Issue 985)