Melmark Carolinas is a private school serving students with autism, intellectual and other developmental disabilities who exhibit severe challenging behaviors. Prior to enrollment at MCS, students were unable to make progress in other educational settings and were often hospitalized, homebound, or placed on a modified (i.e., shortened) school day, where they accessed as few as one to three hours of instruction per week due to their challenging behaviors. They were often excluded from other supports for which they would otherwise be eligible, including insurance-funded applied behavior analysis services or respite care.
Leadership at Melmark knew the transition would be particularly challenging for its students who already faced so many challenges. In order to best support them and their families, Melmark’s response had to be more robust than most other schools. The organization’s core commitments proved to be guiding principles throughout the COVID-19 pandemic: compassionate care, evidence-based practices, highly skilled workforce, and integrity in everything we do, ensuring best outcomes for all students.
The first step in continuing to provide high quality special education services was to develop individualized remote learning plans for all students that also demonstrated compassion. Families faced unanticipated obstacles to facilitate instruction, as most of Melmark’s students exhibited developmental and/or behavior challenges preventing them from participating in remote learning independently. Considering the capacity of the families to assist with instructional delivery ensured Melmark staff’s best efforts would not be lost.
The Melmark team immediately met to begin planning utilizing evidence-based practices. Educators combed through each student’s individualized education program (IEP) and lesson plans to draft a framework for how to continue educating each student in this new environment created by COVID-19. Melmark Carolinas staff worked with each family to create an individualized remote learning plan. These plans included: adapted instructional techniques and modified lesson plans so they could be delivered remotely, the creation and distribution of new materials, purchasing and delivering technology for families without internet access and/or technology capable of video conferencing, training for families, and even meal delivery for those unable to access the food assistance for which they were eligible. Melmark had to be creative, as many of its instructional techniques were not possible over video. For instance, when teaching a new skill, a physical or gesture prompt may traditionally be incorporated, but those cannot always be delivered remotely. Melmark staff modified instructional plans to incorporate technology and in-home resources to the extent that families could support.
Highly Skilled Workforce
Some Melmark students were successful with remote plans. They continued to progress on IEP goals as they worked through lessons with their teachers. Unfortunately, even with all these supports, many students did not make the progress to which they are entitled (Endrew). For instance, one student, a 20-year old man with severe autism, was unable to follow gesture or model prompts or attend to a screen. When his family attempted to have him engage in instruction, he would often engage in severe aggressive and self-injurious behavior, presenting a safety risk. Another high school student would elope or become highly aggressive when he was not allowed to use technology in the way he desired. Melmark’s highly skilled workforce quickly realized that any model of remote learning was not beneficial or safe for many of the students Melmark serves. Education teams met repeatedly to discuss how to best support their most complex students.
Integrity in Everything We Do
Time and time again, the Melmark team came back to its core commitment of ensuring integrity in everything we do by providing evidence-based practices. Some students just were not able to maintain or grow skills remotely and demonstrated a critical need for in-person instruction. MCS quickly took the steps necessary to re-open as soon as it was safely possible. This was no easy task given the preparations required by a virus spread through airborne transmission, constantly evolving guidance, and widespread supply shortages.
Staff exhibited a level of resourcefulness that had not been asked of them before. For instance, guidance from health departments was just being developed and there were no systematic plans for how to operate a school. By scouring resources from federal, state and local health departments, Melmark leadership discovered preliminary guidance for educational, healthcare and childcare settings. By triangulating between these sources, a systematic guide to reopen and operate during a pandemic was developed. In a time of scarcity, new supply lines ensured securing enough protective equipment, including N95/KN95 masks and eye protection for all Melmark staff and disinfectant to keep facilities clean. Evidence-based lesson plans designed to teach students mask toleration upon return were developed. Classroom groupings and layouts were reconfigured for the entire school. All these measures ensured best practices regarding COVID-19 mitigation.
Ensuring Best Outcomes
In June of 2020, Melmark was ready to resume in-person instruction. As calls were made to families and school districts, there was a myriad of responses. Some were surprised, some had questions, but most were excited. Several long conversations with families and school districts addressed questions about why Melmark was returning to in-person instruction so soon. The why was easy: the organization’s commitment to ensuring best outcomes for its students. There was universal agreement on this point.
There were also many questions about how Melmark would ensure a safe reopening. Procedures were detailed step-by-step, describing COVID-19 prevention, mitigation, and response plans. Families were also offered to keep their loved ones on a remote learning plan. As families assessed the risks and learned about Melmark’s preparation over the previous months, families and school districts once again universally agreed: returning to in-person services greatly offset the risk of skill loss and increases in challenging behaviors for Melmark students.
Since resuming in-person programs, Melmark’s most complex students began to benefit from their educational services once again. Our student who was unable to respond to model prompts or attend to a screen began progressing once again. While at school, he could receive the evidence-based instruction he required — including access to tangible materials and physical prompts — to make progress with critical language and learning skills. The high school student, now able to come to school on a daily basis, saw immediate improvement at home as well. His rates of elopement and frequency of behavior incidents immediately decreased.
Melmark did not go through 2020 and into 2021 without challenges. Adhering to COVID-19 protocols all day, every day brought new meaning to its commitment of integrity in everything we do. Some students resisted mask toleration at times, but through consistence and positive reinforcement, they were able to steadily increase the amount of time they wore them. Students and staff alike adjusted to social interactions from across the room as opposed to around a table. Learning opportunities on the white board increased while those requiring handheld cards and closely shared collaboration spaces decreased. Students and staff who developed COVID-19 symptoms required isolation and testing. Those exposed to COVID-19 outside of school required quarantine and a return to remote instruction for a short time. The small percentage of students and staff who contracted COVID-19 prompted contact tracing and notification to families that their child, due to possible exposure, would return to remote learning while they monitored for symptoms. During these times, Melmark’s robust preparation allowed quick and efficient staff response and successful mitigation practices.
As Melmark initially laid out plans to expand to the Carolinas, leadership never anticipated having to factor in a pandemic and certainly could not have predicted all the adjustments needed along the way. With the organization’s core commitments of compassionate care, evidence-based practices, highly skilled workforce, and integrity in everything we do as guiding principles, Melmark Carolinas has remained focused on being mission first for every individual, every day.