You are the Early Childhood Special Education Coordinator for the school district in which Tia is enrolled. Tia is a 3 1/2 year old girl with a tracheostomy which was placed when she was 6 months and old and which her doctor has said will be permanent. She has Spina Bifida as well as the health issues due to the tracheostomy. She is verbal and scores right at her age for cognitive skills. Tia has some behavior concerns. When she doesn't get her way she can hold her breath until she has to be resuscitated. Therefore, oxygen and a bagger and her suctioning equipment must always be close. She often refuses to follow teacher instructions. She can walk with crutches. She sometimes uses a wheelchair.

Tia receives many services while at school and at home. The district provides transportation, speech therapy, physical and occupational therapy, a personal assistant in the classroom, tuition to a community preschool, an ECSE teacher and training to all staff working with Tia regarding her medical needs.

You usually participate in Tia's IEP meetings and have worked with the education team and the parents in order to coordinate some services and funding for equipment or services. The parents have approached you with questions about obtaining funding for a new type of valve for Tia's trach and for your support in getting more speech therapy for Tia so she can achieve the skills she needs to be successful with the valve.

The classroom teacher has asked you to attend a meeting concerning Tia.

You are not sure what is going to be discussed at the meeting, but you hope to find out more about the possibility of increasing her speech time without overburdening your speech pathologist. You are also wondering what this valve thing is and if the school has to pay for one more thing for this child.