Down Syndrome Center at UPMC Children’s Hospital of Pittsburgh

In this podcast Dr. Vellody answers a parent’s question about how to prepare for the transition from the birth to three programs into the school system. Down Syndrome Center Coordinator Sheila Cannon, an expert in the transition process, provides information and insight.

Released: 3/8/13


Dr. Vellody: Hello again, everyone, and welcome to the Down Syndrome Center podcast. As always, I am your host, Dr. Kishore Vellody. The response to the podcasts thus far has been tremendous. Please remember to let others who might be interested in the podcasts know about them. We have received several questions about Down syndrome at our e-mail address which is One question, I can answer quickly. Someone wondered who the children were on the main podcast picture. Well, that’s my brother and I when we were children. And if you’re wondering which one’s me, I’m the one with the big ears!

Well, today we are going to be answering another listener’s question. This listener was wondering about how best to prepare for the transition from the birth to three programs into the school system. Transition is always a challenge for patients and for the families so I thought we could explore that further today. Our center coordinator Sheila Cannon just happens to be an expert in the transition process. So, Sheila, thanks again for joining us for this podcast.

Ms. Cannon: Oh I’m happy to be here!

Dr. Vellody: Well great. Can you start us off by giving us your perspectives on transitions?

Ms. Cannon: I’d be happy to. Throughout our lives, we experience transitions. Some common transitions are going to kindergarten, graduating from high school, attending college, getting a job, marriage and family, then later in life, preparing for retirement. All of these transitions require some degree of planning and strategizing to ensure that the transition takes place smoothly.

Dr. Vellody: That’s great advice Sheila. Is there anything else specific that parents should know about when it comes to transitions in children with Down syndrome?

Ms. Cannon: Transitions for children with special needs, specifically children with Down syndrome, may feel as though they need more planning. Parents often report that certain transitions are more stressful. Moving from the birth to three program to preschool, then preschool to kindergarten can be full of angst. Depending on your child’s needs, the details involved in planning for a smooth transition may be overwhelming – but information and planning will certainly help to decrease your worries about your child in a new setting. You have already established strategies for transitions – remember when you planned for your child’s homecoming from the hospital? Think about the planning strategies you used then and use them as a reference point.

Today we will share information on transition to preschool services, which is still called early intervention services. In PA, these early intervention preschool programs are usually provided by the Intermediate Units rather than the school districts. Your service coordinator will help you figure out which agency provides the preschool services in your area.

Dr. Vellody: Thanks, Sheila. It really is great that we have such excellent birth to three early intervention programs in Pennsylvania. The service coordinators can be a real help during this transition process. Well, I’ll tell you one thing that families often comment on is that there are so many terms that they have to sort through when it comes to transitions into the school system. Can you help us sort out this alphabet soup?

Ms. Cannon: I’d be happy to. There are definitely new terms to become familiar with during this new transition – Terms such as IEP (individualized education program); IU (intermediate unit in PA); LRE (least restrictive environment). So what do these letters, these terms mean? An IEP is the document that is used to assess, plan, provide and monitor services for your child preschool to 21 years of age. This document tends to be child focused with the team including teachers, therapists with the parent’s consent. The IEP contains goals/objectives/therapy plans/other services the child many need such as transportation. The LRE or least restrictive environment pertains to the placement – where your child will receive preschool services. The LRE is the school placement where the child would have been educated if he/she did not have special learning needs. LRE also includes the supports necessary for the child to be successfully educated with peers. This should always be the starting point in discussing an educational placement. The IU is the Intermediate Unit in PA – and there are many located throughout the state. The IU provides preschool programs and other specialized programs to meet the needs of students throughout PA.

Dr. Vellody: There certainly are a lot of new terms for our families to learn during this process so thanks for going through them for us. All right, well, let me ask you this. When should parents start planning this transition?

Ms. Cannon: Transition for preschool should occur sometime after the child’s second birthday, certainly depending on your child’s needs. Your service coordinator will give you information on preschool programs. Programs for preschoolers can include: regular neighborhood preschool programs, special education preschool programs, and these are run by the Intermediate Unit; the child’s home; community settings; private schools etc. The IEP Team must choose a placement that is appropriate for the child and it is in the Least Restrictive Environment (LRE) You may have an opportunity to visit the programs – but don’t be surprised if it is difficult to see or envision your child in that classroom. Most of the children will be older and have had the experience of knowing the rules of the classroom by the time you observe.

Dr. Vellody: Well that makes sense. Sheila, could you address if there are any specific questions that parents should ask during this transition?

Ms. Cannon: Sure. Parents should make a list of questions that pertain to their child’s needs. Certainly your child’s needs will determine the IEP but all children should have opportunities to learn together – meaning children with and without special learning needs should be in the same learning environment. Here are some questions that might help you with planning for this transition – will there be children w/o special needs in the class? What is the percentage of children who attend from the community? Will therapies be provided at this location? Certainly ask which therapies are pertinent to your child’s needs. If your child needs help with toileting, ask how the staff implements the toileting program. Is the equipment (chairs/tables/toys etc) a suitable size for your child? How long is the day? How many days per week? Will your child take a school bus or be transported by you? Will your child need an aide for safety or behavioral reasons? What behavioral strategies will be implemented to help my child meet his/her educational goals?

When you and the team have selected the best placement for your child – certainly after the IEP has been developed – ask if you can visit the program again. If possible, take pictures of the classroom, the building, and some familiar landmarks along the route to the school. Take a picture of your child smiling with his/her backpack. Help your child to connect via pictures to this new place. You can make a story board of this new journey using the pictures in sequence.

Talk with other parents who have experienced transition to preschool. We all learn new ways of decreasing this stressful time – you may have already developed your own strategies and can pass them along to others.

Dr. Vellody: I couldn’t agree more, Sheila. One of our parents sent in a question about whether a specific person like an advocate should be present during the preschool transition. What are your thoughts about that?

Ms. Cannon: Well, for most IEP/LRE development for preschool, an advocate may not be necessary. There are a lot of supports in place, families and their children are moving from the IFSP to a preschool program, there is a lot of support there. However, there are times when a family has a lot of difficulty finding a preschool program or the supports that are necessary to help their child. At that time an advocate may be helpful for both the IEP team and the family to help figure this all out. In western PA, you can contact two agencies that specialize in educational advocacy. The first would be ACHIEVA and their website is The other is The Peal Center. Their information is

Dr. Vellody: Those are some helpful websites. So Sheila, are there any final comments or advice that you would like to leave with our families?

Ms. Cannon: Well, I’d like to say to families to remember to enjoy this new experience with your child. We all hope that this new school experience will be perfect – but changes do occur either with staff or program locations or the needs of your child may change. There are ways to work out those bumps in the educational road. The IEP can always be reopened and plans can be changed to more effectively educate your child.

If you have more questions or you want more in depth information on IEP/LRE and preschool programs please go to the Educational Law Center website, or you can write to us at

Dr. Vellody: I’ll second that, Sheila. The whole reason our Center exists is to help people in our area through the different stages of their child’s life. Please don’t hesitate to contact us with any questions about this transition process or any other question you may have. Who knows, your question may well be a future podcast topic! But that does wrap up this podcast. Sheila, thanks for sharing your knowledge on the preschool transition with us today. I know that this information is timely as IEPs are being created as we speak! To our listeners, I’d like to thank you again for listening. We hope you are enjoying these podcasts and finding the information helpful. Don’t forget to subscribe to the podcast through iTunes so you don’t miss an episode! I’d like to thank our listener who suggested this podcast topic today. If any of you have any other podcast topic suggestions, please send us your request to We’ll talk with you again soon. Bye bye.

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