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TABLE OF CONTENTS- click on the title to access the article
ACT Therapy and Hexaflex
Imagine you are in a small rowboat heading north across calm waters. Then, a storm comes that batters the boat, causes it to get turned around and veer off course. What do you do? You could try to use your entire energy to fight the much stronger storm. You could give up and allow the storm to take you wherever it likes. Or, you could find the direction you want to move in, adjust your rudder and travel through the storm, sometimes climbing high waves, getting wet and bruised, but still, heading north.
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This is a metaphor commonly used by Acceptance and Commitment Therapy (ACT) practitioners to explain ACT, and specifically how the concept of Values is a key component of this therapeutic approach.
ACT therapy works by focusing on accepting life experiences as they come, without evaluating or trying to change them. It's a skill developed through mindfulness exercises that encourage you to build a new and more compassionate relationship with difficult experiences.
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HEXAFLEX is like a feelings compass and is used in ACT Therapy to help develop awareness. The 6 Hexaflex directions are;
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Contact with the Present Moment: This concept is based on mindfulness which is non-judgmental present moment awareness. Mindfulness based activities are used to help promote psychological flexibility.
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Acceptance: This is a active stance towards the present moment and whatever is going on, does not mean you have to like it but you will be open and willing to engage with it. Being open and willing to experience what shows up helps create psychological flexibility.
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Defusion: This is about understanding language and how we can get stuck in our thoughts which help reinforce our struggle. Defusion is about dropping the struggle with language and just being aware of it. Being present with emotions and thoughts and not being stuck in them helps increase psychological flexibility.
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Self As Context: This is about understanding that we are a collection of experiences. We all have a story that we carry around about ourselves and when we are to invested in that story we tend to miss other parts of ourselves that we can grow. Being able to understand that we do not have to hold that story too tight allows us to have more psychological flexibility.
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Committed Action: This is making the steps and the actually process of turning towards your chosen values-oriented life in the here and now. By turning towards and moving psychological flexibility is created.
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Values: This is about you and your chosen values. Values are your compass and your direction. Values are freely chosen. They are not based on shoulds or goals. Values are ongoing and infinite. Values are apparent in how we actively and intentionally life our lives. Using our values as a guide helps us reach psychological flexibility.
Epilepsy - Breaking Down Barriers
More than three million people in the U.S. - and over 65 million people worldwide - live with epilepsy. People with epilepsy have seizures - unexpected electrical "storms" in the brain.
Seizures impact their lives in many ways including creating barriers to employment and education and facing a sense of discrimination and isolation from their peers who donʼt understand what happens when they see a seizure occur.
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The Epilepsy Foundation promotes education and awareness about epilepsy. Our goal is to help everyone understand what a seizure looks like and what to do if they see someone having a seizure. The more everyone talks about epilepsy, the less people living with the condition have to fear discrimination, worry about receiving improper first aid, or keep their epilepsy hidden in the shadows.
We want all people with epilepsy to know the extent of treatment options to help control their seizures. While most people living with epilepsy are well controlled on their first anti-seizure medication, people who live with difficult to control seizures are not often aware of the latest treatment options. The Foundation encourages people with epilepsy to seek out epilepsy specialists to ensure they are taking advantage of the latest and greatest options to achieve freedom from seizures and freedom for side effects.
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The Foundation advocates for more attention and money to be dedicated to epilepsy research and the acceleration of new therapies. One-third of people living with epilepsy have seizures that cannot be controlled with current treatments, and all people living with epilepsy have the risk of a potential “breakthrough” seizure. The uncertainty of when and where the next seizure may occur has a dramatic impact on the lives of all people living with epilepsy and on their loved ones. We must encourage our leaders to focus on increasing funding for research toward better seizure treatments and a cure for epilepsy.
Insurance Coverage for Dependents Age 26 & Beyond
Continuing coverage after age 19 under private insurance. Normally, coverage for your eligible children ceases the end of the month in which they turn age 19. However, your dependent(s) by birth or legal adoption remain eligible through the end of the month in which the child turns age 26 or graduates, whichever comes first, if they are an unmarried student who is enrolled at least half time in an accredited educational institution and dependent on you for financial support.
If your enrolled dependent is a disabled child, coverage will continue as long as they were totally and permanently disabled before age 19, continue to be disabled and your coverage does not terminate for any other reason. Disabled children are those who are unable to earn a living because of a mental or physical impairment and must depend on their parents for support and maintenance. You must furnish proof of disability and proof of dependency.
Is Reevaluation Required Every Three Years?
A student’s educational needs can change over time, the regulations that implement the IDEA require that a student be reevaluated every three years unless the parent and the school agree that such a reevaluation is unnecessary. [34 C.F.R. § 300.303(b)(2)] A reevaluation can occur more frequently, but not more than once a year, unless the parent and the school agree otherwise. [34 C.F.R. § 300.303(b)(1)] This does not mean that a school is required to conduct additional assessments if the IEP team, in conducting its review of existing data, determines that no additional data are needed to determine whether the child continues to have a qualifying disability and continues to need special education and related services; the educational needs of the child; or whether the child has an additional category of disability. Said another way, additional assessments every three years are not necessarily required, but a reevaluation every three years is required. [See 34 C.F.R. § 300.305].
Every three years, the Muli-disciplinary Evaluation Team (MET) should convene to conduct current evaluations of a student's skills and deficits. This is valuable information for the entire team and provides a great measurement of skill development. Many times, staff or parents may say they don't want to bother with the MET because the student is still eligible for services in school. While it may be true that the student remains educationally eligible for special education services, please consider requesting the testing to see if gains have been made in goal areas and if any new deficits have developed.
What is Music Therapy?
Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program (AMTA, 2005).
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Why Music Therapy for Individuals with ASD?
People of all ages, cultures, socioeconomic backgrounds, and degrees of abilities respond to aspects of music in daily life. The engaging nature and accessibility of music often elicits positive responses of individuals with ASD (Kern, 2014). Researchers have discussed advanced music memory, responsiveness, and aptitudes within this population; more recent studies show that individuals with ASD may have a heightened musical aptitude and sensitivity to musical elements, yet similar skills of music perception as compared to typically developing peers (Heaton, 2005). While only a small number of individuals with ASD are musical savants (Treffert, 2012), all clients can benefit from music therapy interventions.
What is the Focus of Music Therapy Interventions for Individuals with ASD?
Music therapy interventions focus on enhancing social, communicative, motor/sensory, emotional, and academic/cognitive functioning, or music skills in individuals with ASD. Music therapy services are based on each client’s individual abilities, noting preferences, needs, the family’s values, beliefs, and priorities. Music therapists work in partnership with clients, families, and teams.
The music therapy assessment process is designed to gain an understanding of the individual’s current level of functioning while engaging in a variety of intentional and developmentally sound music experiences. The music therapy intervention plan is based on the assessment outcomes. It integrates a variety of ASD-specific evidence-based strategies (e.g., prompting, reinforcement, picture schedule) and music therapy techniques (e.g., singing/ vocalization, instrument play, movement/ dance, musical improvisation, songwriting/ composition, listening to music, or computer-based music activities). These strategies and techniques support clients in practicing identified and targeted skills. Music therapy sessions provide familiarity, consistency, structure, and predictability – characteristics that support the learning style of individuals with ASD. Music therapists document clients’ responses and conduct ongoing evaluation of progress towards the achievement of goals while making recommendations for generalization and future intervention options. These measures and suggestions may assist the individual with ASD, family, and team to appreciate success while empowering clients to maximize their functioning in all aspects of their lives (Kern & Humpal, 2012).
Is Music Therapy Evidenced Based for Individuals with ASD?
Yes! A new 2020 report from the “National Clearinghouse on Autism Evidence and Practice” lists music therapy as evidence-based practice for children and teens under music-mediated interventions. This includes music therapy, which occurs in a therapeutic relationship with a trained music therapist, in addition to the planned use of songs, melodic intonation, and/or rhythm to support the learning or performance of target behaviors and skills in varied contexts.
How is Music Therapy utilized at PARClife?
We currently offer group music therapy by a Board Certified Music Therapist for our teens/tweens, young adults, Saturday sessions and Summer camp. Our Music Therapist, Rita Douglas, brings additional insights into the therapeutic relationship through parenting a son with ASD and other health challenges. As part of the PARClife team, Rita reinforces learner individual and group treatment goals using music on an ongoing basis. She enjoys developing therapeutic relationships with each learner, and loves to generate smiles and fun!
IRS Notice 2014-7: Tax-Free Pay for Personal Care Services Through Medicaid Waivers
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People who serve as CLS or Home Health providers and live with a disabled person who receives either the Michigan Children’s Waiver or disabled adults who receive the HCBS waiver Medicaid home and community based services) do not have to pay taxes on that income.
Many families who live with and work for their child as CLS staff (for those on the childrens waiver) and as Home Health and CLS providers for disabled adults on the HCBS waiver do not know this and may be erroneously paying taxes on that income (thinking about some of the adult siblings who also work for their disabled sibling as CLS). Theirs does not alert you that you've made an error and will tax your income if you don't highlight as not taxable per the guiding tax laws.
The video below, the article from Arc, and the explanation on steps to take if you have overpaid are outlined below. Families can have up to three years to request refunds for overpayments.
IRS Notice 2014-7: Tax-Free Pay for Personal Care Services Through Medicaid Waivers
How to get a refund:
If you paid taxes on income earned through Community Living Supports (CLS) and home health services for a disabled person you live with in Michigan, you may be eligible for a refund or tax exclusion under IRS Notice 2014-7. This IRS guidance states that certain Medicaid waiver payments for providing in-home care to a qualified individual may be excluded from gross income for federal tax purposes. Here’s what you should do:
1. Determine Eligibility for the Tax Exclusion
• Qualifying Payments: Check whether your payments were made under a state Medicaid Home and Community-Based Services (HCBS) waiver or children's waiver.
• Live-in Requirement: You must live with the disabled individual for the payments to be tax-exempt.
• Employment Type: The exclusion applies regardless of whether you are classified as an employee or independent provider by the funding agency.
2. Review Your Tax Returns (Current & Past Years)
• If you already paid taxes on this income, you may be able to amend your tax returns for prior years (up to 3 years from the original filing deadline) to claim a refund.
• Look at IRS Form 1040 and confirm if this income was reported as taxable in previous years.
3. File an Amended Return (If Necessary)
• If you included these payments as taxable income, you can file IRS Form 1040-X (Amended U.S. Individual Income Tax Return) to remove the taxable portion and request a refund.
• You may also need to submit a statement explaining that your income qualifies under IRS Notice 2014-7 and attach any supporting documents.
4. Adjust Future Tax Filings
• For Current & Future Tax Years: Ensure that qualifying Medicaid waiver payments are excluded from your taxable income on your federal tax return.
• If your employer issues a W-2, they may still include these payments in Box 1 (Wages, Tips, Other Compensation)—but you should exclude it when filing your tax return.
5. State Tax Considerations (Michigan)
• Michigan generally follows federal taxable income, so if you exclude the income federally, it may also be non-taxable at the state level.
• Confirm with the Michigan Department of Treasury or a tax professional to ensure compliance.
6. Seek Professional Assistance (If Needed)
If you’re unsure how to handle the amendment, consider consulting a tax professional with experience with Medicaid waiver payments and IRS Notice 2014-7.
You may also call the IRS Taxpayer Assistance Center or visit a local Volunteer Income Tax Assistance (VITA) site for help. If you paid taxes on income earned through Community Living Supports (CLS) and home health services for a disabled person you live with in Michigan, you may be eligible for a refund or tax exclusion under IRS Notice 2014-7. This IRS guidance states that certain Medicaid waiver payments for providing in-home care to a qualified individual may be excluded from gross income for federal tax purposes. Here’s what you should do:
1. Determine Eligibility for the Tax Exclusion
• Qualifying Payments: Check whether your payments were made under a state Medicaid Home and Community-Based Services (HCBS) waiver or similar program.
• Live-in Requirement: You must live with the disabled individual for the payments to be tax-exempt.
• Employment Type: The exclusion applies regardless of whether you are classified as an employee or independent provider by the funding agency.
2. Review Your Tax Returns (Current & Past Years)
• If you already paid taxes on this income, you may be able to amend your tax returns for prior years (up to 3 years from the original filing deadline) to claim a refund.
• Look at IRS Form 1040 and confirm if this income was reported as taxable in previous years.
3. File an Amended Return (If Necessary)
• If you included these payments as taxable income, you can file IRS Form 1040-X (Amended U.S. Individual Income Tax Return) to remove the taxable portion and request a refund.
• You may also need to submit a statement explaining that your income qualifies under IRS Notice 2014-7 and attach any supporting documents.
4. Adjust Future Tax Filings
• For Current & Future Tax Years: Ensure that qualifying Medicaid waiver payments are excluded from your taxable income on your federal tax return.
• If your employer issues a W-2, they may still include these payments in Box 1 (Wages, Tips, Other Compensation)—but you should exclude it when filing your tax return.
5. State Tax Considerations (Michigan)
• Michigan generally follows federal taxable income, so if you exclude the income federally, it may also be non-taxable at the state level.
• Confirm with the Michigan Department of Treasury or a tax professional to ensure compliance.
6. Seek Professional Assistance (If Needed)
• If you’re unsure how to handle the amendment, consider consulting a tax professional who has experience with Medicaid waiver payments and IRS Notice 2014-7.
• You may also call the IRS Taxpayer Assistance Center or visit a local Volunteer Income Tax Assistance (VITA) site for help.