Reflections and Connections: Standards Based Grading and A1c's

This week, I had the opportunity to attend the AMLE conference- a conference for middle level educators. The theme of the conference was THRIVE.  Those that know me, know that sometimes my self-diagnosed ADHD kicks in and my mind is like the book, If You Give a Mouse a Cookie.  Eventually, like the mouse, I do end up back on track but in the mean time, I sometimes manage to have a few good insights and make some obscure connections.   This is an example of one of those times!

Standards Based Grading (SBG) can be defined as measuring student achievement based on well defined course objectives.  As Rick Wormeli states,  "It is about measuring what the student knows, not the route it took to get there."  With SBG,  teachers and students need to be constantly examining what we know and where we need to go in our course.  We need to make goals to reach our target and then change those goals based on the evidence, not the extra credit.  Our evidence is the students' work.  It is what they produce daily.  As simple as a quick question, "Why did you chose to do this?" to more complex projects involving application of skills,  we are measuring the distance to the goal.  We call this "formative assessment."  We use this information to drive our decision making.   I have heard many times over the course of this last year and the course of this conference that the "targets should be visible."  Never have I heard that the target should be easy to reach.

At this point, you are wondering why on Earth she is writing about school in a diabetes blog.  Just like the mouse asking for a straw for his milk, bear with me as this will connect.  The A1c measures the average blood sugar over a period of time.  It is the target for control.  We always see that target, but it is not always easy to reach.   Like grades in school, we look at the numbers, we look at our practices and we set goals and make changes to achieve mastery.  I watch my children poke their fingers up to 10 times a day to measure their blood sugars; formative assessment.  This information drives our decision making.

In both SBG and diabetes management, we can't just roll the dice and hope for the best.  That would not be fair to anyone involved.  Instead, we take what we know, based on evidence, and we make informed decisions.  In both cases, we should never lower our target or our expectations.   I live with three children and who fight a battle for their lives daily.  If I told one of them that she didn't have to check her blood sugar today because she worked so hard at it yesterday or because her room was clean, I would be doing her a tremendous disservice.  Lowering her  target to this level would be the equivalent of saying, "Today, your life is less important."  We do, however, very often need to change our route, add some steps, or sometimes even turn around and start all over.  Along the way we meet frustration, we meet success, we get bumps and we get bruises.  Shouldn't it be the same with education?  To me, allowing a box of tissue or a parent signature to count as "extra credit"  is the equivalent of saying, "Today, your life, your education, has less value."  In either case, settling for a "C" is not an option.  I want mastery or better!

SBG is best practice, it's what's good for the kids.  From experience, I can tell you that I was more than a little nervous about this school year; new job, new grading system, new team.  Now, one quarter complete, I can't believe how fast it has gone, how much I have learned and how valuable SBG is to the educational system. It makes school "real" and evidence based.  Yes, there are glitches in the technology.  True, not everyday is easy nor is every person happy.  Absolutely, I have to work hard and make some changes to lesson plans I have used in the past.  Is it worth it?  Without a doubt.  Student-led conferences turned into a formative assessment for me this year.  Listening to my students talk about their learning allowed me another opportunity to reflect on my teaching.   I realized that many times in the past, I had settled for something because I was using an arbitrary measuring tool and never asking the tough questions.  I was cheating my students.  The same can be said for diabetes management.  I will admit there are days that I don't want to ask the tough questions of my kids.  There are days that I want to give them a "day off" because I, like them, just don't want to do battle anymore .  But is that fair?  Rick Wormeli says over and over, "Fair isn't always equal."  Fair isn't always easy, either.   Helen Keller states, "We couldn't be brave or patient if there were only joys in the world."  I would assert that without challenges, we could never THRIVE.  Do you see that?   Like the mouse, we have come full circle, right back to that cookie!  Conferences like AMLE and JDRFCC, are opportunities to connect with like minded people: they demonstrate the power of people committed to progress and positive change.  That reminds me of a team...

Back to School

School starts next week.  I seem to have blocked this from my mind and all of a sudden here it is!  So, today I have been making lists.  School supplies, D supplies for school, Gluten free snacks for TJ, touch base with school nurse, forms to dietitian, update health plan...you get the picture. 

We have been pretty lucky, I think, with our school experiences.  Thinking back to Tylie, her daycare provider  and preschool teachers were right at the hospital with us learning to count carbs and treat highs and lows.  When she started kindergarten, there was no school nurse, but we met with school staff and created a health plan that worked.  At that time we were still mixing "cloudy" and "clear" and she did not get a shot at lunch time.  Wow- we have come a long way!  We did have some struggles with Taya.  She told me- way after the fact- that the teachers at the daycare she went to before kindergarten would make her eat all by herself.  They said she ate too slow and they couldn't keep track of it in the big group.  She hated going to this center.  But, we always thought it was because she went there alone, without any of her siblings.  It wasn't until recently that she even told me about this memory!  If I had known I would have pulled her out of there so fast.  I still drive by there and want to march in and ask what they were thinking!  She told me of teachers that made her walk up and down the hall in an effort to lower her blood sugar.  She has always been so secretive about having diabetes and these two stories showed me why.  She is slowly working her way through this and having an insulin pump has really helped her to be more compliant.  This is not to say she doesn't struggle but we see progress.  While Taya likes to pretend she doesn't have diabetes, Tylie has been known to use it to her advantage.  Her 5th grade teacher told me once that Tylie was always low at music time.  Well, after some investigation it seems she didn't really like music.  But she really liked spending time in the classroom with her teacher!  But, overall, their experience was good, particularly in elementary school.  The teachers were open and willing to meet.  I came into the classrooms and talked with the kids.  It still breaks my heart when I hear the bad experiences that others have had. 

When TJ was diagnosed he was still at the daycare the girls had attended and T was more than willing to learn how to give shots and get a refresher on fingerpokes.  He also attended a preschool.  There they had not previously had any children with diabetes but the director had gestational diabetes with her last pregnancy and agreed to give him his shot at lunch time.  For kindergarten he attended the same school the girls had but now there was a nurse!  Wow- is she amazing!  She is as irritatingly organized as I am so she double checks everything.  I love it!  When he was also diagnosed with Celiac she contacted the school district dietitian and helped us create a plan so he could eat lunch at school most days of the week.  This year she is as excited as I am about no shots but I have no doubt she will monitor him with his pump just as stringently. 

They have all had their back to school appointments so basals and bolus' have been tweaked.  Now I will work on updating health plans and packing tubs of snacks to take to the class open houses next week. I still will worry if their blood sugar got checked before lunch or if they remembered to bolus or if the teacher remembered to grab TJ's juice boxes for the field trip.  But, I am thankful for the support we have and the plans in place.   The big girls are lucky enough to have their parents teach in the buildings they go to school in so we will go shopping for a stash of snacks for there as well.  Actually, I kind of enjoy the times they have to come to my room because their blood sugar is low.  They usually bring a friend and you can learn a lot about them they don't normally share! 

My goal for this school year are for the big girls to consistently remember to check at lunch time and in the busy mornings.  It is difficult with teenagers because if I remind them, they are annoyed that I am treating them like babies. However, if I don't they "forget."  I don't think that battle will really end, but my hope is that they get to a point where they don't need me to remind them.  Taya actually has a pretty cool plan.  She has a spare meter she put at the end of her bed with a note to herself saying, "Check!" with an arrow pointing down.  It will be the first thing she sees when she wakes up and the last thing she sees when she goes to bed.  Tylie also makes lists.  They have both made huge gains in this area so I am really hoping for the best A1c's ever at their next appointment.  As for TJ, my biggest worry is actually school parties and snacks and more related to gluten than to insulin.  And I will write more about that later!