Today on the podcast, we welcome back Tracey Ellis from International Diagnostic Solutions (IDS) to discuss the impact this past pandemic year has had on families, parents, teachers, and students with learning needs. Tracey predicts there will be large uptake in student referrals for assessment and evaluation since so many of our kids spent the year behind a computer screen, making it more difficult for their teachers and specialists to be able to identify possible red flags.


Tracey Ellis is the CEO and founder of International Diagnostic Solutions, a company providing online special needs services and therapy to families and schools around the world through a telehealth model. Tracey started IDS over a decade ago as the first online special education team to support families abroad. 

As an occupational therapist by training and with a background in public health and special education, Tracey recognized early on that using online delivery of support and resources could mean that children could have access to experts, treatment, and assessment no matter where they lived. As a champion for inclusion, Tracey has worked hard in these 10 years to provide schools with the resources and training to make sure that all children participate and all children succeed.


Transcribed by Kanako Suwa

[ Introduction music plays ]

Welcome to the SENIA Happy Hour, where you get 1 hour of learning in less than thirty minutes.

Lori: Hey everyone. Today on the podcast, we welcome back Tracy Ellis from International Diagnostic Solutions, or ISD,  to discuss the impact this past pandemic year has had on families, parents, teachers, and students with learning needs. Tracy predicts there will be a large uptake in student referrals for assessment and evaluation since so many of our kids spent the year behind a computer screen, making it much more difficult for their teachers and specialists to be able to identify possible red flags.  I learned so much from today ‘s show and I hope you will too. So now… onto the show.

 Hi Tracy and welcome back to the podcast!

Tracy:  Hello, how are you, Lori?

Lori: I ‘m doing great. I will tell everyone that once again the stars have aligned and there is more construction going on outside my house today during the podcast… I swear it doesn’t happen unless I’m doing a podcast! So if people hear beeping and crunching and all that good stuff, you know that’s what’s happening. So, we met about a year ago on this podcast to discuss your company, International Diagnostic Solutions and your telehealth model of support. Today, we thought we would talk more about the impact this past pandemic year has had on families, parents, teachers, and most of all, our students with learning needs.  Does that sound good to you?

Tracy:  That sounds fantastic! 

Lori: Alright so I’ve got tons of questions for you”¦

Tracy: Fire on when you ‘re ready!

Lori: Okay, so we ‘ve heard that a lot of parents felt that their child was really struggling this year but due to the online learning environment. they didn’t get flagged for an assessment. So how would you characterize this past year in terms of kids getting identified as needing support?

Tracy: Well that’s a really really good question and you know I guess I could start by saying in a, in what would we would consider a typical year, we see the same kind of trends where the beginning of the year, kids come in and around October or November, we start to see that we’re getting referrals. Kids are getting flagged for struggling in the classroom and struggling with the new school year. This year, you know, teachers, um, struggle to really be able to observe like they normally would in their classroom. There’s so much that goes on when, when you’re in a classroom transitioning from subject to subject, recess, back into the classroom to lunch and there’s so many opportunities that teachers have to really observe kids in person. 

And you know, I think everyone did a really great job adapting to the online format and really finding ways to serve kids differently and make sure that they’re getting the academic and educational support they need. But let’s face it, if you have, what I called the Brady Bunch window, where you’re a teacher and now instead of just, you know, you can see and observe a little bit better with two people on a screen. But when you have 20 kids and you’re seeing the small little windows and you might be able to see that they’re there but as an occupational therapist by training, I kind of look at it like well, I can’t really see a lot of what’s going on below the shoulders, for example. I can’t really observe how they are approaching a task, how or where their paper is placed, what’s going on with their hands and feet, what’s their posture like,  and those are the kinds of things, even seeing how kids are going through the school bumping into each other, whether those transitions kind of bring out different behaviors that might not be as functional for a regular classroom still in attendance. 

So, I feel as though it was hard for teachers to identify kids who might have normally been flagged as needing an evaluation or needing a screening. So what we’ve started seeing, as normally we would get all these referrals for evaluations in October or November, we started to see them trickling in at the end of the year because it took longer to identify some of those issues. But what we know is that there are so many kids who fell under the radar. For example, if you ‘re, if you see a child that’s looking back at you in the screen and you think “oh, they ‘re doing a great job attending to me, they don’t seem distracted at all,” but they could really be looking at the lights on your ceiling, or the picture behind your back, or they might be actually trying to see.. Oh, look at Johnny. I wonder if Johnny ‘s in his living room or family room. You know? There are so many things kids might be looking at and we see them looking at the screen but it doesn’t mean that they’re really absorbing and listening to what’s, the educational materials being delivered.

So, I think we’re going to see a huge wave of kids in, in the fall who are behind that we couldn’t necessarily tell online. And so, we’re going to have this issue where there are going to be a lot of kids with needs, on top of the regular kids, that we would see and I think it’s, it’s something that we really like… I’m trying to raise the alarms to school to say, you know a lot of kids were missed and families might not have known also in the beginning because they just see, “okay my child’s online and they seem to be attending school” but by the end of the year, I think a lot of parents were able to identify the fact that their kids didn’t make the progress they needed to make. 

Lori: Sure, I mean, that makes so much sense. Going along with that, a lot of families moved and teachers moved and signing on from places that were not even near their school, from different countries in the middle of the night… I’ve had that experience myself, teaching at like 2 in the morning and in general, there just seem to be fewer resources available since it wasn’t as easy to access evaluation and treatment services that might have been in place during in-person schooling or with regular school stuff. Have you heard from many schools that staffing and availability of their local resources impacted their ability to get kids evaluated and supported?

Tracy: Oh, absolutely. So first of all, if you think about what school would have looked like, even not that all schools had a lot of resources in house, there were schools that might have had speech therapy and OT, and maybe it was someone local who came in to support one day a week. We’ve even heard of people in the past that had models that someone would fly-in even like once a month”¦ But with the pandemic, so many people shifted. Teachers, like you said, were teaching from different locations. Maybe a local psychologist that schools could have referred to in the past wasn’t seeing people in person. Or maybe the kid that was attending that school was no longer really local but they were signing in from someplace else. 

So it’s almost like you took what was, what was this like… everything in place in a box and you just shook it up and so people connected with those resources, some of the things might have fallen out. So if you might have had a speech therapist in the program, and let’s say, because of the employer of a spouse, maybe they ended up leaving and so now all the sudden, that school that used to be able to say we have the speech therapist, they didn’t have them there anymore. And that person wasn’t able to sign on and do it online or wasn’t comfortable with it. We had a lot of schools too, in the previous year, they might have had staffing allocated for  inclusion and learning support staff but because they didn’t know what this past school year would look like and how many kids were actually returning, it was harder for them to say, “actually, yeah, we do need those extra learning support staff”, because schools, really let’s face it, when it comes to anything in our world of special education and learning support, schools typically over… they don’t over staff. They usually staff with what they think their needs are going to be. 

And that presented a huge problem because if schools didn’t know which kids were coming back or if they didn’t think they would need to support them in the same way because let’s say, they, you know, the kids that needed maybe somebody really in person and a low student staff ratio now all of a sudden those… they didn’t need those people or didn ‘t have them available. So you have this situation where even if a teacher was able to stay, “wow, that student really needs to be evaluated”, they were faced with the problem of “oh actually they’re signing in from Canada, we don’t know who’s local there” or you know, there.. There are even issues of of licensing, country to country, so people weren’t necessarily as familiar with the online resources available for things like testing. But it was really tough because schools were trying to support but a lot of those local resources, there were lots of psychologists for example, who, even though they were still there, they didn’t have access to the tools for testing. But they weren’t even willing to do some of that in person testing even if the people were still there and it was because of covid restrictions so it ‘s understandable… but it just meant that people wouldn’t have the support they needed so teachers, I think, were also a little bit more hesitant to refer because they didn’t know how to without having the normal resources that they’ve gotten used to. Again, it’s not like this is all been even over time, with all of our support, so psych, OT… it’s not like everyone’s known where all the resources were to begin with. 

Lori: That ‘s a great point”¦ So what do you think this means for students who might have just gone through an entire school year without the support they needed or without being evaluated for that support? 

Tracy: So, for the students, I think we ‘re gonna see that there’s a huge need; it ‘s kind of two-pronged because we’ve got… what are the schools going to see and surprise, surprise, they’re going to see almost double the caseload because they didn’t or weren’t able to address a lot of these issues but kids are really going to be in a bad situation. So if in a normal year, let’s say, in a normal classroom in September or October, a teacher identifies five kids or even three, right? What we’re looking at is… 3 kids were supposed to have been identified in September of last year too and then over the course of the year, there’s another three or four more so if you’re looking at.. you had seven kids that missed out last year and now you have over the course of this year, 7 more kids. I put it in math, because it isn’t…  when people understand the numbers, so if we had a classroom where we had again five, five kids starting out the year for therapy, normally by the end of the year we have about 10 so schools are going to have to understand that those numbers are doubled. So if they were struggling to cover and get assessments for plans in place, meetings with families, all of those things that really are time-consuming”¦

Lori:  Oh yeah, it takes so much time… I was just thinking how just one student, it might take, you know, months to get the whole process under way, and”¦ 

Tracy: Exactly! So for example, we do our evaluations and we get them turned around in two weeks, and that means as a teacher and a family can have the information they need to get started right away but if you’re using some other local providers who say “well, you’ll be able.. we can schedule you in about five weeks, and then we usually takes 4 weeks to get the test done”, so now that students not even going to have a written evaluation for 9 weeks. And that’s if.. that’s if if all goes well with scheduling. So, someone starting in September or October, you’re going to be looking at”¦ now we are in December by the time we can get a meeting and everyone together but then there’s the break and the coming back and things are a little bit crazy in January”¦ So by the time that students actually getting support during, maybe February, March. And what that means is they almost missed another whole school year because by the time they start to get some momentum, it’s the end of the school year. They’ve got spring break and then end of the school year and that teacher also is likely going to have double what she had. And then so I’m trying to really not only make sure their parents become a stronger part of the team here, because if you know that your child… if you have questions about whether your child made enough progress, then that’s probably meaning they didn’t, and at the very least you should get them evaluated. 

So my whole push right now is trying to get people to do it early, you know. I know that… I know that summer is, is when everyone wants to be on vacation but I think we have to look at this year as… it was an anomaly and it’s not going to be a typical summer if families and parents want their kids to be prepped and ready to, to make up for lost time this coming year. But also for teachers, if you don’t identify this now, you’re”¦ you’re kind of choosing to go in blind in September and September is already tough enough for the new school year and with everyone coming back, it’s going to be a little bit, you know, more chaotic too this year in person coming back, systems have to get going again”¦. I think, I think if teachers and administrators can look at this year a little bit differently and say let’s, let ‘s look at at least identifying kids… but to parents, I would say, do everything in your power to get your child evaluated over the summer so that when you walk into school this year you can say, you know what I don’t want my child waiting till February, we went out and we got what we needed so that we could be, you know, ready to go and and you know just ready to make some progress.

Lori: Yeah. I think that ‘s a really smart action for families to take. Again just this year, right, like it’s… it’s just such an anomaly and if they need to advocate for their kiddo, then they need to. But I like what you said about schools doing it as well. So you’re recommending that schools take the time that they need this summer to recognize who those kids might be or at least plan, maybe they don’t know who those kids are just because of the different restrictions that happened with Zoom and all the different platforms, but to be ready, maybe.

Tracy: Yeah I think I think…it is the… on the part of parents and teachers, you know, when you have a hunch. A lot of times, we don’t get that many kids who have been sent to us for testing who didn’t need it. You know, with some of our US based working schools, it’s a natural process like they’re screening and assessing and they end up not needing it, but with the international program, if a child is coming up on the radar, that means that they really needed some kind of assessment and then potentially some intervention. So if you even had a hunch, I really think that for the parents, don’t just say “well I’m not sure, I’m not a teacher so I don’t know”¦”, I would just say, “you know what, go get it done so that you know”. 

Now, for schools, the difference is teachers probably know which kids, they have a hunch, and teachers are smart like that. Again, I think some people might not have felt that they could refer in the same way or they didn’t want them, you know, where is a big flag because it takes a while, I’m not really sure, you know, Zoom is so awkward, I don’t know if they needed something.. But I would say now’s the time to make a list and prioritize. It’s just like triaging so if you know, if it if you can say, okay look, these are the kids that I…my, my, my little feelers were going up for, so there’s these five kids. But I’m… I would say, I would rank order them and if you have five, then contact those parents, just saying, you know what, we really want your child to be ready to go next year and while they made it through the year and things are okay, we just have”¦ we have some concerns so we think it would be great if you could get, try to get evaluated and see if you could get some information and a plan so we can get a good plan in place for the start of the school year. Most times, you know which parents are going to do that. You know which ones are actually going to follow through over the summer or which ones might say, you know what, I think would be better if we waited until the school year. 

And that’s fine too, because you say, at least you have your list and now you know who is going to be first, second, third when we start that testing in, in the fall. And I think it’s important too, because there is going to be volume and schools might not have had the resources, so either they need to start making partnerships with their local providers that they have used before and say, okay we know we’re going to have a lot more, are you prepared to take them in? And you know, x number of evaluations or referrals. What we do, especially what we ‘re doing with our schools this year, is we’re saying, hey let’s see if we can get kids on an evaluation schedule over the summer but if not, we’re also working with schools to say, okay, we have a speech therapist who is going to be dedicated to testing at your program. We have a psychologist who’s going to be dedicated to testing at your program, for the month of September or the month of October, so let’s get on a kind of.. Um.. um”¦ put into play a process where you know maybe three kids are getting evaluated whether it’s each week or you’re doing 2 a day but let’s get them done quickly. 

Because the longer a teacher has to have kids in her classroom that don’t have a plan in place, she’s or he is not going to be struggling to figure out how to meet their needs. So, on top of having double the number of kids that might be struggling, they’re sitting there pulling their hair out because they don’t have a map for how to help that child right away. And so I think, if you want to help your.. your teachers to feel supported, you give them the resources they need and instead of making them all spend the entire year scheduling meetings with parents and you know having to”¦ drip drip drip over the course of the year, and let’s face it, teachers want to see their kids make progress. And if they don’t have the ability to do that because they’re not given the resources, which would be good evaluations and a good plan, if they don’t have a plan that the parents are also in tune with and in agreement with and supported, then the poor teachers are going to be struggling all year. 

So instead, make a plan, find a partnership, and find someone who’s going to save you this amount of time and say let’s get this amount or number of evaluations done. And one of the reasons that’s really important too, is because just like teachers when you want to get, like the best teachers for your program, the likelihood of you finding the best teachers once you get into September or October is not that likely. Because they’re already in”¦ in programs. So it’s no different in our therapy world, our speech therapists and OTs and the social workers, they all want to know what their caseload is or what their workload is for the year coming into September. So if you decide to wait and say I will figure it out once we see how many kids are in here, you know, you’re not going to be able to find someone who can do 5 to 10 evaluations so quickly. You ‘re gonna get someone who says, “well, with my schedule, I can only do like one a month, maybe 2″.  That ‘s gonna put you behind. 

Lori: Sure is. Huh”¦ *laughs* it ‘s, given, it ‘s given… given certainly a lot of food for thought and  something I’m sure most of us just haven’t really thought so much about just because most teachers as you say they ‘re in the thick of things so thank you for that I think, is what I ‘m trying to say.

Tracy: I think, um, you know sometimes we don’t want to think well, first, about summer time but”¦ we don’t want to think about the fact that there’s going to be that… there ‘s going to be some of those challenges moving forward. But I think from a leadership perspective, if you really want to have a successful return to in-person learning, the best thing that you can do is.. is predict, right, you don’t you don’t just go into the school saying,  “well we’ll see how many kids”.  We have a plan, and we have a lot of kids who are going to be in need, and so setting up that plan in advance is the best way to give your teachers the resources they need. 

It’s the best way to let parents know, hey, you know we think that there could be some issues. And you make a partnership with the parents, so for parents that you know will actually go out and get the evaluations, partner with them now and say this is what we need and so they can also start helping to look for resources. So again, whether they know someone local, or let’s say they come to us and say we need these done over the summer… Triage is important. Having a plan in place too. Some schools, what we’ll do is when they know that kids are going to get pulled on certain days, like Mondays and Wednesdays are speech evaluation days.  And making sure too, that teachers and other staff know that hey, you know there’s going to be people looking for information from you on a student whether it’s questionnaires and things like that so that evaluations can be well-informed.

Teachers are also thinking, that’s a lot of extra work for teachers as well so plan ahead, so they… they don’t come to you in in mid-October saying we have so much work on our”¦ we can’t even”¦ we can’t even focus during the school day because we’re doing meetings, doing questionnaires, with all of these other things so I think even”¦ even finding ways to encourage teachers, whether it’s perks or bonuses to give them for the extra time they take in this whole process but definitely developing partnerships in having a scheduled plan in place is the best way to get this through this. 

And also making sure too, when you do find providers, some will do a month or longer to get to writing a report. And I think it’s important that with the providers the schools use, you have an agreement, this is what I need reports to look like.  Maybe they can do them all in the same format so teachers also aren’t getting 15 different types of evaluations written 15 different ways. If a teacher knows the speech therapist doing the evaluations because they’ve just worked with 5 of their kids, it’s a great way to have communication and banter back and forth to really understand and share information. And I think developing that, that’s a partnership as well and it’s a real way the teachers feel like”¦ oh well it’s kind of like we have a speech therapist right here, and they work with us all the time and then reports look like this same for psychology and  it just works better because you did a really good kind of working machine. 

Lori: Yes. Brilliant. Thank you. Well, finally, Tracy, changing gears completely”¦  your organization has decided to sponsor SENIA yet again for the 2021-2022 school year and you guys are gold level sponsors. First of all, thanks so much for that because it’s due to sponsorship such as yours that we’re able to offer our participants a significantly reduced price for our amazing conferences that we have. Second, can you tell us why you chose to sponsor us again? 

Tracy: Well, first of all, we love SENIA and as a”¦ as an organization that really provides the support of whether it ‘s valuation, it ‘s treatment, even just consultation and kind of coaching to teachers and especially for programs that don’t have a lot of the resources, we just found SENIA feels like a home to us in… in terms of networking and, and connecting with people. We’ve gone to a lot of conferences over the years and we just felt like there’s just like mindedness with SENIA, and we are able when, when we’re sharing information, we feel like it’s really being shared and used. We feel like people come to us looking for answers as well and so would it ‘s like SENIA just kind of spread this net around the”¦ around the world, global domination, and uplifts everyone within the inclusion environment or to those trying to bring that kind of mindset to their school. And so we just feel like, wow, the the mission of SENIA and the people involved, I just feel like it”¦ it’s driving this process so much faster. 

So we started doing telehealth, an online support in 2009 so we’ve been doing this for 12 years now  and we feel like, since, since we first met SENIA and when we first went to the first conference in Hong Kong 2, 3 years ago now.. Now I can’t remember”¦ the growth, the growth of the organization has been so dramatic that we’re seeing programs popping up everywhere where they’re actually bringing resources in education and inclusion back in. So I feel like what we were trying to do as a small organization providing therapies and evaluations to get people that mindset to change and understand that inclusion isn’t hard, it’s just shifting of how you do something, I feel like SENIA has”¦ it’s like you came in and just like shine the light on it. The global creep has been gigantic, and so we feel like it’s almost a privilege for us to be connected with you because the work you guys have done is fantastic. 

Lori: Thanks and I love that. The global creep. That’ll be our nickname from now on… but for our listeners who were tuning in for the first time or they don’t know so much about in your ideas,  can you just give a”¦ your 30-second elevator pitch about what you do and how, how you can provide evaluations for our students overseas even though you’re located in the States? 

Tracy:  Sure. We’ve been doing it for 12 years so before everyone went online in this way, and so we, we feel like it’s it’s just second nature for us to be able to see and identify and work with kids through the online medium. We provide evaluations, treatment, as I said, coaching… A lot of families that had to, to bring education back home, needed some support as well, we’ve been there for all aspects. And if we, we also do it in a way that’s relevant for families in school, so we have bilingual provider so whether it’s you know Korean, Italian, Spanish, no matter what the language is we wanna make sure that kids are evaluated in a way that’s meaningful to them, that is meaningful to the parents, culturally and language appropriate. 

And what we’ve done is also worked with companies to, to get their evaluation tools validated and push them to get validation for tools so that people can be evaluated online around the world. So what we try to do is make sure that for schools that don’t have resources they can partner with us to be a resource in their school like their Special Education team even though we’re at a distance. And when schools programs grow and they have the capacity to bring someone in full-time, then we we can just step back but we, we really, I think help to be a great bridge for programs needing resources but they don’t have them immediately available. 

And for parents, one of the things that’s really great is when they have a therapist in one location and then they move 2 years later, we go with them so we make sure that their plans go with them. They have the same provider, especially when you’re talking about counseling, it’s a great thing to have a consistent provider. We help schools and we help with the transition from school to school so we do all the evaluations online with psychology, occupational therapy, speech therapy, you name it. We ‘re able to do and we have the provider’s on everyone’s time zones and like I said, different languages, cultural backgrounds”¦ we kind of pull it all together because our job is to make sure that we’re supporting families no matter where they are in the world and no matter what the programmer local resources are. 

Lori: Great! And at our conference, we will have, you will have your own booth,  virtual booth, and you can set up a visit with our participants. And so I’m encouraging all our participants to go and meet Tracy and Katie at the, at the conference and greet them in person! 

Tracy: And we ‘d also love to hear from people in advance what they want to hear. That to me, is the most important sometimes when we project what we think people want to hear but in reality, it ‘s something different. So I encourage parents and teachers to go to our website, which is idsalliance.com and go to contact us and feel free to share thoughts, questions, um, areas that you ‘d like to hear more about, because we ‘re always ready to go and dig in. We have a lot of people on our team that do research at universities and colleges so we ‘re happy to make sure that we ‘re making the, the, experience meaningful at the conference. 

Lori: That ‘s perfect. Well, thank you Tracy for your time today, and happy summer! 

Tracy: Same to you, same to you! Thanks again. 

Thanks for stopping in to SENIA Happy Hour, don ‘t forget to head over to SENIAinternational.org/podcasts and check out our show notes from the discussion today. We at SENIA hope you ‘re enjoying these podcasts. There ‘s so much to explore and we ‘re at the very beginning. So feel free to drop us a note and let us know what you ‘d like to hear more about during your next SENIA Happy Hour. Until then”¦ Cheers!