Innovative and therapeutic school for students with neurological differences - The Monarch Institute

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• Part2

The Monarch School, cornerstone program of the Monarch Institute, was founded in 1997 as one of Houston's first therapeutic schools in order to meet a critical and urgent need to serve students with neurological differences. Part of the mission of the Monarch School and its parent Institute is to provide global leadership in developing innovative and therapeutic learning environments for students with neurological differences, which include Autism Spectrum Disorder, Attention Deficit Disorder, Learning Disabilities, Tourette's Syndrome, Mood Disorders (Bipolar Disorder, Depression), Anxiety, seizure disorders and other neurological differences.

Some important characteristics of The Monarch Institute include (a) a learner centered approach that meets learners "where they are," (b) a developmental model of four core goal areas (self-regulation and self-awareness, executive functions, relationship development, and academic competence), and (c) the use of an ecological model as a concrete metaphor for belongingness within a natural system. Programs sponsored by the Institute include The Monarch School, Diagnostic Clinic, Therapy Services, Training Center, Replication, and Transition Services. Several of these programs have received awards for their innovative and distinguished support for students with neurological differences. (http://www.monarchinstitute.org/about-us/awards)

In this report I will spotlight each service based on their website (http://www.monarchinstitute.org/) and the interview with Bryant Shaw, Ph.D., Director of the Diagnostic Clinic at the Monarch Institute. Before introducing each service, I'll provide information related to the students, staff, and campus facility at the Monarch Institute.

A. Enrollment

The Monarch School enrolls about 150 students from early childhood through 12th grade, and also serves some graduate and postgraduate students in conjunction with the Institute's Transition Services program. After the completion of the expansion of their facility, their enrollment is projected to approach 250. Some relevant characteristics of the students being served follow:

(1) Gender, Age

Interviewer: Could you please tell me about demographics of your clients?

Dr. Shaw: In our day school, we have about 130 students right now and I believe about 75% of them are male. Our enrolled student population does to some degree reflect the community trend toward a preponderance of boys being affected by neurodevelopmental disorders from childhood. We also have a growing cohort of young girls as well. In terms of functional levels too, we have people at all functional levels - male and female.

Interviewer: You have growing cohorts of female students in your school. Interesting!

Dr. Shaw: I haven't looked at the trends statistically but we see more and more girls - I can't say at this time whether or not this is reflected as a growing percentage of our student body. I'm not sure but it seems at a surface level to reflect a growing female presence here.

Interviewer: Very interesting. How about the age range of your students?

Dr. Shaw: To my knowledge, the youngest student we've ever had was 3 years old. Our oldest current student is in their early 30s, as we have a graduate or postgraduate program that allows for internship and continued work on executive functions. Also, we offer transitional living support if that's needed as well. So our young adult population is another growing segment of our service population.

Interviewer: If parents are interested in sending their child who is under 3 years old, you're not ready to accept? Or is there a reason behind why you don't take students under age 3?

Dr. Shaw: Typically, what we find is that below that age it is difficult to determine whether the children are going to be a match for what we have to offer from a neuro developmental standpoint. They're generally going to require one to one support to engage and to do the pre-academic learning pieces that are typical at that age. From our perspective, it often makes more sense to see those people outpatient through our therapy services rather than engage them in a daily school program. We often route very young children to engage with our therapists as an outpatient. Then when we feel like they're developmentally matured enough to take advantage of a little broader environment then we'll invite them to apply.

(2) Socio-Economic Status

Interviewer: Yes, that makes sense. What about the socio-economic status of your students? Do you provide any scholarships?

Dr. Shaw: Well, I think we have to start answering that question by saying that we have a great deal of diversity reflected in our population here despite the fact that it can be expensive to come to school here or to access our therapy or clinical services, for example. That does not at all indicate that everyone who's accessing our services is wealthy. As I mentioned previously, some of our families pull together as an extended family to be able to afford the tuition here. We offer tuition support to all of our students if they qualify. We have a third-party reviewer that determines the degree to which the family should be able to pay. We use that to decide how much of an award should be given, and awards can run as high as 30% or so of tuition costs.

Interviewer: If I remember correctly from your website, sometimes parents can use their medical insurances for some of the programs or therapies?

Dr. Shaw: We're insurance friendly is the best way to answer that question. Everything that we do is fee for service which means that we have to ask for the monies upfront rather than wait to be reimbursed maybe by someone's insurance company. As a private, non-for-profit organization, we don't have the fee structures or the external funding mechanisms in place to allow us to have more freedom there. Plus the added burden of chasing down insurance money would mean even more expenditures on our part to make sure that that money got captured. Since we have licensed and billable clinicians scattered throughout all of our programs, all of the contacts that are potentially insurance reimbursable are recorded and the appropriate documentation is maintained confidentially. If parents request it, we can provide them with a quarterly statement of all those contacts that they may then submit to their insurer to try to capture some of their money back. We give all the diagnostic and service codes that are appropriate and, for example, here in the clinic, if we're going to do an assessment of someone we'll do all the precertification process et cetera but when it comes to the issue of the payment itself, we don't accept the insurance assignment because our need to have cash on hand for operating expenses.

(3) Geographical Location

Interviewer: How about your students' geographic location? Are they mostly coming from the Houston area or from other areas also?

Dr. Shaw: This little map (points to a world map) shows you all the countries that are colored orange and these represent all the places that people have come here from to ask for an evaluation through our clinic. To a large degree, that also reflects people who come here and applied to go to school here because there are psychological testing requirements involved with the admissions process and we often do that testing here.

Interviewer: Do some of your clients come from overseas?

Dr. Shaw: Many of these families have an oil and gas company connection, and some of these companies are heavily invested in the welfare of their children of their employees and they support enrollment in a place like Monarch fairly readily. In other cases, we're just talking about people who got on the internet and were really inspired by reading about our educational philosophy, and perhaps might have a cousin who lives here that they can come to visit and so they come and check us out and if they determine that it's feasible then sometimes, they'll move here thereafter.

(4) Race and Ethnicity

Interviewer: May I ask about the race and ethnicity of your clients?

Dr. Shaw: About 70% or so of our students are Caucasian right now and then it's fairly evenly split among people that are Asian or eastern Asian, African or African-American or Hispanic.

Interviewer: For any who are coming non-English speakers, do you provide ESL? Or is English competency a requirement?

Dr. Shaw: That's a complex question because we're dealing with kids who are language disordered, many of them are and often, they're also coming to us very young from families that are at least partially bilingual. So sometimes we admit kids when we have lots of questions about that but we want to be sure we can communicate fully with the family. What does the child's real world language development look like? For example, we recently admitted a very young child who didn't have a lot of functional language. His parents aren't very fluent English speakers so we're still examining the impact of receiving school-based support in one language and using a different language at home. We all feel reasonably confident that immersion in an English speaking environment is okay for many children of bilingual or ESL families, especially when people in that environment are aware of how to work with you if you're language impaired.

Courtesy: The Monarch Institute for Neurological Differences

(5) Diagnosis of the Students

Interviewer: What percentage of your students has autism?

Dr. Shaw: It's about 70% and the younger the students are, the higher that percentage is. Among our very youngest children almost all of them have autism spectrum disorder.

Interviewer: Are your clients mostly high functioning? By looking at your website, problem solving skills is required for being accepted into your program. So most of your students are high functioning, right?

Dr. Shaw: We're looking for a spark of engagement. We don't want that to be perfect so that there's nothing to work on, though. We don't necessarily have cognitive functioning requirements per se but we are looking for someone who can take what we have to offer and make use of it. In that respect, we're looking for kids that are engageable and responsive to some degree, or we think we can shape that over time. We're also looking for students who have some memory functioning that they can access so that they can hang onto what we're teaching.

Interviewer: If you think a student is not a good match for your school, do you recommend them to go to a different school? Do you give other options to his parents?

Dr. Shaw: Yes. We're always striving to give good answers and sometimes the question is "help me find a good school for my child" or "is your school right for my child." I'm not just going to answer that by saying, "No. It isn't." We're going to try to give you a complete answer so that you get something from the process that helps you determine the next move that is in the child's best interest. If that means having to think outside the box, we'll do that and we do have to stretch a lot.

As you might imagine with our growing reputation for innovation, we don't necessarily get the easiest cases or easiest kids. It's often pretty complex landscape so we get called on to think outside the box a great deal.

B. Staff

At The Monarch School program, the student-faculty ratio is very low. At the highest level of student support, there is one teacher for every two students, and chances are there is at least one additional adult on hand such as a therapist. The Monarch School has multi-disciplinary teams consisting of a range of professions, including professional educators, clinical/applied psychology professionals, social workers, certified DIR®/Floortime™ therapists, neurologic music therapists, educational specialists, and speech therapists. All of the faculty are degreed and experienced in child development and in teaching students with diverse learning patterns; many have advanced degrees in education and special education.

Interviewer: How many staff work at your institution?

Dr. Shaw: I have that written down. Let me look at it. We have 72 full time faculty and 15 part-time faculty.

Every year, we have 350 volunteers and a lot of that is direct program support too. Now that's not just the school that's across the entire institute which includes the day school, the clinic, and the transition services including all the houses and apartments. We have faculty and administrative personnel, but also engage with a host of professionals from other disciplines.

Interviewer: Do your teachers go to teacher training?

Dr. Shaw: I can speak to what we do for the month of August. When all the public school teachers are on vacation, our full complement of professional educators come to school for training. We call our teachers "professional educators" because they're not just teachers - they have to be therapists too and they have training in interacting with students in therapeutic ways. We spend the entire month of August doing in-service related training on topics relevant to working with these kids, including topics such as "mental disorders of childhood" and the like.

What we're trying to do there is just to make sure that anyone of us can answer parent or professional questions about what happens here and anyone of us can act as a therapeutic agent of change for our kids without having to call a professional to provide extra services for them.

C. Campus Facility

The Monarch Institute is located on an 11 acre site in Northwest Houston. To accomplish the school's mission and therapeutic practices, the campus has a unique people- and environmentally-friendly design. In fact, one of the buildings, The Chrysalis building is the first energy LEED® Gold certified and "Designed to Earn the ENERGY STAR®" certified special education school building in the United States. Some unique features of the environmentally-friendly facility are:

• At this time, one ancillary building has been constructed for practicing development in the Four Core Goal areas. The Living Building Challenge Studio Classroom was built to compete in an international architectural competition aimed at promoting off-the-grid, green, sustainable buildings. This outdoor science pavilion provides many learning opportunities (e.g., learning about energy harvesting, solar energy, compost toileting, etc.).


Courtesy: The Monarch Institute for Neurological Differences

• A pond for water retention and for studying biological sciences was also built into the landscape.
• A large terrace garden for the planting of native Texas grasses and plants, food production, water retention, water recycling, beautification, and botanical instruction is under development and construction.
• A crushed granite walking trail and multiple fitness stations were built to provide a framework for use of physical exercise as a coping mechanism.