New York City Department of Education, Impartial Hearing Decision

FINDINGS OF FACT AND DECISION

Case Number:

Student’s Name:

Date of Birth:

District:

Hearing Requested By: Parent

Date of Hearing: July 11, 2012

August 2, 2012

Actual Record Close Date: August 15, 2012

Hearing Officer: Dora M. Lassinger, Esq.

NAMES AND TITLES OF PERSONS WHO APPEARED ON JULY 11, 2012

Director-Educational Advocacy Services — Parents

Parent/Mother — Parents

Parent/Father — Parents

Administrator- (via telephone) — Parents

District Representative-CSE — DOE

Special Education Teacher Assigned-CSE (via telephone) — DOE

Unit Coordinator- (via telephone) — DOE

NAMES AND TITLES OF PERSONS WHO APPEARED ON AUGUST 2, 2012

Parent Advocate — Parents

Parents

Parents

Director-RFTSLC — Parents

Teacher (via telephone) — Parents

Occupational Therapist — Parents

CSE- Representative — DOE

Mrs. ., the mother of ., by her advocates, , requested an impartial hearing on May 15, 2012 seeking funding for her unilateral placement of (“ ”) for the 2011/2012 school year. I was designated to hear this matter on May 17, 2012 pursuant to 20 U.S.C. Section 1415(f)(1). An impartial hearing was held on July 11 and August 2, 2012. The compliance date was extended on one occasion, to August 29, 2012, due to the unavailability of witnesses, and the extensive testimony and issues. The final compliance date is August 29, 2012. (IHO Ex. II).

. (DOE Ex. 1). His classification is not in dispute. (Par. Ex. A). On April 14, 2011, the Committee on Special Education (“CSE”) met to review . A school psychologist, the parent, , a special education teacher who also served as the District Representative, , the associate director at , a special education classroom teacher from RFTS , two parent advocates, and a parent member participated in the meeting. (DOE Ex 1, p. 2).

It was reported that and significant . The IEP describes his present academic performance and learning characteristics as follows:

“According to the classroom teacher,^[1] learned to recognize 20 sounds. Reportedly, he knows all of the letters. He can identify 5-10 sight words. He shows interest in reading and typing on the computer. According to the teacher “he does not have comprehension skills”. knows numbers 1-10. He is working on number 11-20 and one to one correspondence. He can’t add.

He does not understand more/less concept.”

It was noted that according to teacher estimates, his decoding skills were at a and all of his other academic skills (reading and listening comprehension, writing, computation and problem solving) were at a . It was further noted that he required a small, structured academic environment, therapy, for communication, repetition and redirection. (Id. p. 3).

With respect to his performance, it was noted that experiences related to changes in routine or transition times; that he has and self- , and that when . His teacher reported . The CSE concluded that with instruction, and recommended a ), which was attached to the IEP. (Id. at 4, 20). I t was noted that he requires positive reinforcement of , close supervision, short/high interest activities and a visual schedule. (Id. at 4). The behaviors reported to interfere with reinforcement of , when . The CSE recommended a paraprofessional as a support. (Id. at 19, 20). According to Ms. , the behaviors described in the were obtained from school participants in the conference. did not provide its written behavior plan, stating that it is applicable only in the setting of that school. (Tr. pp. 17-18).

In the description of his management needs, it was noted that requires (“ ”), ”) and a . It was noted that he has . (Id. at 5). The IEP includes academic goals for development of the ability to strengthen sound/symbol relationships, develop sight word vocabulary; demonstrate proficiency in the use of numerals 1 to 30; develop phonetic analysis skills; demonstrate improved comprehension skills; improve expressive writing skills; and function more successfully in the classroom. All of the academic goals include detailed short-term objectives. Methods of measurement are listed as class activities and teacher/provider observations; (Id. at 6, 7, 8, 15, 16). The IEP also includes goals for improving the ability to use sensory information and fine/visual motor skills; increase play skills and with detailed short term objectives . Methods of measurement are listed as class activities and teacher/provider observations (Id. at 9-10). The IEP includes four goals for therapy (ST), including a goal for increasing oral motor and feeding skills. All of the ST goals include short-term objectives. The method of measurement is class activities and performance assessment task. (Id. at 11, 12, 13). Finally, the IEP includes physical therapy goals of increased postural control and lower extremity strength, and increased coordination. These goals do not include short-term objectives. The method of measurement is class activities and teacher/provider observation. (Id. at 14).

Ms. prepared a “Contact Sheet” with notes regarding the CSE meeting held on April 14, 2011. In it, she noted that all academic levels and goals were reviewed with the parent and school. She further noted that the parent’s request for home services for were ruled out as his needs can be appropriately met with the recommended program. She wrote that the “program recommendation was discussed and agreed upon”. (DOE Ex. 3).

The CSE recommended placement in a special class in a specialized school ( ), with related services of ST (4 x 60 individually, and once in a group of , for sixty minutes); and (5 x 30 individually); (3 x 30 individually) and a full-time ). (DOE Ex. 1, p. 19).

On June 4, 2011, the CSE sent the parent a Final Notice of Recommendation recommending placement for in a special class in specialized school ( ), with a , and all of the related services recommended in his IEP. (DOE Ex. 2).

, the unit coordinator at the recommended site, testified that the site has five classes with a staffing ratio of . (Tr. p. 42). The school serves students in grades kindergarten through fifth grade. (Tr. p. 43). All of the teachers have Master’s Degrees in special education and are certified in special education. (Tr. p. 77). Had attended the recommended placement, he would have been placed in the class of in September 2011. (Tr. p. 44). During the summer months, would have attended the same site, but would not have had the same teacher, as two sites combine during the summer months. (Tr. pp. 46, 69-70). Nevertheless, a seat would have been available for in July 2011, in a 6:1:1 class, with other students within a two year age range. (Tr. pp. 45-46, 70). His one-toone paraprofessional would also have been provided. (Tr. p. 51). She testified that related services were provided through a combination of in school and outside providers (paid pursuant to Related Services Authorizations (“RSA’s”). At a minimum, ’s , , and half of his ST services would have been provided at school. As to any services which were not provided at school, he would have been issued an RSA. (Tr. p. 51). During the summer months, he would more likely have received all of his therapies at school, as more therapists are available. (Tr. pp. 70-71).

In September 2011, the class included four students with varying language abilities (non-verbal, limited language and verbal). (Tr. p. 52). Reviewing ’s academic levels, Ms. testified that he would have been placed with other children performing at his level. (Tr. p. 66).

would be provided his , as recommended in his IEP; and would also have access to other within the classroom. (Tr. pp. 53-54). She testified that another student in the school has a , that the would know how to use it, and would show the staff how to use it. (Tr. pp. 55-56). She testified that in September, the classroom teacher would conduct a . (“FBA”) Up until that time, the school would work from the BIP in the IEP. (Tr. pp. 75-76). To address , the school uses positive reinforcement (allowing students to perform a desired activity) to reinforce ; and avoidance of situations that trigger negative behaviors. (Tr. pp. 67-68).

OT would be provided in a therapy room equipped with mats, a swing and big balls. A separate OT office is also available for working on fine motor skills. (Tr. p. 57). Paraprofessionals receive training for two days before school starts, and on other days when the students are not present. (Tr. p. 58).

The school day begins with a fifty minute “get ready to learn” program, which includes yoga. (Tr. p. 58). Breakfast and lunch are instructional; and are provided in the classroom. The program utilizes ABA techniques, throughout the day, with one period of discrete trials (provided individually), which could last from 20 to 50 minutes. (Tr. p 59, 77-78).^[2] During discrete trials, the students work on academic, interpersonal and communication skills, as determined by the ABLLS. (Tr. pp. 78-79).

Students are assessed three times during the year, using the ABLLS, to measure progress. (T p. 63). The parents could receive assistance from the , in addressing the at home. The parent coordinator provides assistance regarding accessing services outside of school, including a home attendant. (Tr. pp. 65-66).

Mrs. mother, testified that prior to attending RFTS, received and attended the . (Tr. pp. 213-214). He started attending when he was approximately three or four years old. (Tr. p. 215).

She testified that she attended the April 14, 2011 CSE review, and that she agreed that a class with a staffing ratio of was appropriate for . When she received the final notice of recommendation, she went to visit the recommended site. (Tr. p. 217). She was told that there was no classroom in July and that the school year started in September. In addition, the classroom she observed did not have picture schedules for the individual children. She testified that needs this so that he knows what’s coming up next, because his anxiety levels are so high. (Tr. p. 218). In addition, she was told that the therapy provider was not PROMPT certified, and that feeding therapy was not available. She was also told that all of the children go into a lunch room. Ms. testified that needs someone to help him with . (Tr. pp. 219-220).^[3] She later testified that she does not recall a discussion regarding the children, eating in the classroom; and that she just saw children of in the lunchroom. She does not recall if those children were identified as being in . (Tr. p. 227). ’s teacher, who accompanied Ms. . to the recommended school, felt that Hayim needed more one-to-one direction. (Tr. pp. 219-221).

On June 15, 2011, the Mr. . wrote a letter to the CSE rejecting the recommended site because “the placement is not appropriate for ”. The letter does not specify the parent’s objections to the IEP or the recommended site. The parent stated his intent to enroll the child and seek reimbursement at an impartial hearing. (Par. Ex. C-1). In a subsequent letter dated July 28, 2011, the parent set forth the following specific objections to the recommended site: that the teachers are not trained in the ; that the other students are verbal and not in need of a high tech device; that none of the students had a and were engaged in self stimulating behaviors without any redirection to task; that seemed disorganized; that the speech therapists are not PROMPT certified and that the school is not able to meet all of the student’s mandates. (Par. Ex. D). Mrs. D. testified that she made the site visit sometime in June 2011. (Tr. p. 234). She was told that would not be grouped with the children that she observed. (Tr. pp. 235-236). She was informed that the classroom would attend in the summer had not yet been formed. (Tr. pp. 239-240).

On September 1, 2011, the parents signed a contract enrolling for the 2011-2012 school year with a tuition of $93,000. (Par. Ex. E ). As of the hearing date, the parents had paid the tuition in full. (Par. Ex. F1).

On May 15, 2012, the parent requested an impartial hearing. In her hearing request, she stated that she agreed with the description of ’s academic and social/emotional management needs, as described in the April 14, 2011 IEP, but that she disagreed with his annual goals. She wrote that the teachers at the recommended site are not familiar with recommended for ; that the other students in the class were not similar in functioning to , that the related service mandate could not be met at the recommended site; and that the crisis management paraprofessional would not be a special education teacher or related service provider which was of great concern. She wrote that the behavioral plan developed for is insufficient. (Par. Ex. A).

Mrs. . testified that during the 2011-2012 school year. progressed from eating only pizza to eating vegetables, chicken, ground beef and cheeses. A feeding therapist worked with him to expand his diet. (Tr. pp. 222-223).^[4] She also noticed an improvement in his receptive language. (Tr. pp. 224-225).

, director for , testified that she has a Master’s degree in special education, an advanced certificate in school administration and supervision, and has performed coursework in (“ ”). She is a certified special education teacher. (Tr. pp. 84-85). is a school that services children with disorders ag ed to . (Tr. pp. 87-88). The school uses an (“ ”) model. (Tr. p. 89).

During the 2011-2012 school year, had 19 students, initially. (Tr. p. 89). The school had four classes, with no more than five children, one lead teacher, one speech and language pathologist and four teachers. (Tr. pp. 88, 90). All of the students receive ST, OT and music therapy. (Tr. p. 88). Instruction is provided individually; however group instruction is provided which incorporates the student’s individualized academic goals. (Tr. pp. 140-141).

She described as a young boy who enjoys various activities and has a lot of motivation. He has good receptive language but was deficient in his . His and reduce his anxiety level. (Tr. pp. 92-94). At the start of the 20111-2012 school year, his social skills were emerging. His fluctuated throughout the year. (Tr. pp. 95-96).

Ms. testified that in July 2011, the school had a specialist from the School come into to consult regarding , and . He in response to demands; or sometimes “out of the blue”. When attempts were made to , he would respond with . was reinforced for low levels of the , which was initially effective. (Tr. pp. 97-100, 127-128). Over time, however, the started to increase again, and the school is working to reduce them. (Tr. pp. 128-129).

In preparation for the April 14, 2011 CSE review, Ms. provided all progress reports, which includes the . During the meeting, she also described his behaviors; and how the school addresses them. (Tr. p. 105). did not provide the CSE with its written behavioral plan, because it is designed for use in a setting with a teacher to student ratio, based upon the environment at . (Tr. p. 131).

Since July 2011, has progressed in expanding the foods he would eat. He went from eating five foods to about forty different foods from various groups. (Tr. pp. 114115). The school allows the parent to come to the school to work with the teachers and therapists. The school has also sent therapists to her home to help him generalize skills. (Tr. p. 116). Ms. could not state how frequently this occurred. (Tr. p. 118).

, a certified special education teacher with a background in , testified that she became ’s lead teacher in March 2012. (Tr. pp. 157-159, 163). The classroom consists of five students, Ms. and five other teachers who have at least a Bachelor’s Degree. Ms. supervises the other teachers and reviews their data and program books. (Tr. pp. 159161).

When Ms. began working with , he participated in individual and group activities. His . When staff addressed the behavior, he had difficulty handling the redirection. Up until May, the without a really specific plan. In May 2012, , and he was exposing his genitals in a group setting. This behavior made it difficult for him to acquire a new skills or to participate in a group; and when redirected, he . The school had phone consults with the neurologist that is working with and . (Tr. pp. 165-166).

, but he uses his . (Tr. p. 167). enjoys group activities. (Tr. p. 168). He receives ST five times per week. ST is also pushed into the classroom. also receives

OT. The teachers work closely with the to address his ability to regulate his body, incorporating . (Tr. pp. 169).

eats lunch in the classroom or in his individual area, depending upon his level. He has a specialized feeding protocol to introduce him to new foods and increase is tolerance to trying new foods. (Tr. p. 170). She testified that since March 2012, has acquired some new skills in his receptive language and his ability to ; however his with his ability to learn new skills. (Tr. p. 174, 184). She testified that is appropriate for because it offers individualized instruction and a group setting. The consistency of the program decreases his and allows him to learn new skills. (Tr. p. 174).

, a licensed occupational therapist, testified that she provided , during the 20112012 schoo l year, in collaboration with another therapist. (Tr. pp. 202-204). She testified that at receives daily for 45 minutes to an hour, individually. (Tr. p. 207). During the 2011--2012 school year, improved his , including his balance and ability to use both sides of his body by doing jumping jacks; riding his bike without training wheels for 10 feet; and catching a ball. His skills also improved. With respect to his fine motor skills, he has more control with his pencil and can draw shapes upon request. (Tr. pp. 208-209). While he did not receive PT at targeted his gross motor skills and postural control. (Tr. p. 209)

, a certified , testified that she became the director of speech and language services at RFTS on April 16, 2012. She began working with at that point; and more intensely at the end of May 2012, when she became his exclusive provider. (Tr. pp. 187-189). They worked on following directions, expanding vocabulary, repairing communication breakdowns, being able to respond to and formulate questions and making his needs and wants known in a socially appropriate manner. (Tr. p. 189). When a communication breakdown occurred, was guided toward using his voice output device (VOCA)5, or an alternative means such as a static board or pictures. (Tr. p. 190). She testified that around transitional times; manifested in an increased pitch in his voice, striking a teacher, flapping and exposing himself. (Tr. p. 195). She testified that the team has met to develop a BIP to deal with those , and that it has been effective. (Tr. p. 196). She later testified that while is able to convey his basic needs, his and there has been inconsistent regression in goals that were achieved. (Tr. p. 199).

Findings of Fact, Conclusions of Law and Order

The school district bears the burden of proving the appropriateness of the recommended program. Education Law 4404(1). The school district must comply with the procedural requirements of the Individual with Disabilities Education Act. (IDEA), and the IEP developed through its CSE must be reasonably calculated to enable the student to receive educational benefits. (Board of Educ. v. Rowley, 458 U.S. 176 [1982]. A Board of The communication device was provided by the DOE. (Tr. p. 200). Education may be required to pay for educational services obtained for a child by the child’s parents, if the services offered by be Board Of Education were inadequate or inappropriate, the services selected by the parents were appropriate, and equitable considerations support the parents’ claim. (School Committee of the Town of Burlington v. Department of Education, Massachusetts, 471 U. S. 359 (1985). The fact that the facility selected by the parents to provide special education services to the child is not approved as a school for children with Florence disabilities does not preclude an award of reimbursement. (Florence School District Four et al. v. Carter by Carter , to 510 US. (1993).

An appropriate educational program begins with an IEP that accurately reflects the results of evaluations to identify the student’s needs, establishes annual goals related to those needs and provides for the use of appropriate special education services. Application of a Student with a Disability, Appeal No. 11-162 (citations omitted). The appropriate education mandated by the IDEA does not require states to “maximize the potential of handicapped children”. Walczak v. Florida Union Free School District, 142 F. 3d 119 (2d Cir. 1998) (citing Rowley). An appropriate public education under IDEA is one that is “likely to produce progress, not regression”. Id. (citing Cypress-Fairbanks Indep. Sch. Dist. v. Michael F., 118 F. 3d 245, 248 (3d Cir. 1997).

An IEP must include a statement of measurable annual goals, including academic and functional goals designed to meet the student’s needs that result from the student’s disability and to enable the student to be involved in and make progress in the general education curriculum. Application of the Board of Education, Appeal No. 11-007, p. 21 (citing 8 NYCRR 200.4[d][2][iii]).

In evaluating whether a school district has complied with the procedural requirements of the IDEA, a hearing officer may find that a child did not receive a FAPE only if the procedural inadequacies (I) impeded the child’s right to a free and appropriate public education, (II) significantly impeded the parents’ opportunity to participate in the decision making process regarding the provision of a free and appropriate education, or (III) caused a deprivation of educational benefits. 20 U.S.C. Sec. 1415(f) (3) (e) (ii). Whether the goals and short-term objectives included in an IEP are appropriate is an initial procedural inquiry. M.H. and E.K. v New York City Department of Education, 59 IDELR 62 (2d Cir. 2012). Behavior Intervention Plan

The parent agreed with the description of , as set forth in the , but argued that the plan was insufficient, and could not be implemented by a paraprofessional. I find that the was appropriately developed, at the CSE review, based upon the information provided by staff and the parent. The staff at testified that its own written was specific to that site; and was, therefore, not shared with the CSE.

Inasmuch as at the time of the meeting, it was reasonable for the school staff to wait until he attended the recommended site before performing a Functional Behavioral Assessment. See Application of Student with a Disability, Appeal No. 11-032. Ms. testified that up until the time that the recommended site was able to perform an assessment of , the school would work from the in the IEP, addressing through positive reinforcement of ; and that . I further find that it was reasonable for the CSE to expect that a full-time crisis management paraprofessional who received training from the school could implement the , under the supervision of a certified, special education teacher.

To the extent that the did not comply with applicable regulations, I find that this did not constitute a denial of FAPE, where the interfering behaviors were accurately described, and the child was provided with a aide. See M.W. v. NYCDOE, 59 IDELR (E.D.N.Y .2012); C.F. v. NYCDOE 57 IDELR 255 (S.D.N.Y. 2011). Appropriateness of IEP Goals and Short-Term Objectives

The parent does not dispute the description of ’s needs, but states in the hearing request that the annual goals are inappropriate and inconsistent with his current levels of functioning as discussed during the IEP meeting. (Par. Ex. A, p. 2). The IEP includes academic goals for development of the ability to strengthen sound/symbol relationships, develop sight word vocabulary; demonstrate proficiency in the use of numerals 1 to 30; develop phonetic analysis skills; demonstrate improved comprehension skills; improve expressive writing skills; and function more successfully in the classroom. The IEP also includes goals for improving the ability to use sensory information and fine/visual motor skills; increase play skills and pragmatic skills. The IEP includes four goals for , including a goal for increasing oral motor and feeding skills. Finally, the IEP includes physical therapy goals of increased postural control and lower extremity strength, and increased coordination. I find that the IEP goals are appropriate, and consistent with ’s needs, as described in the IEP.

None of the parent’s witnesses testified that the goals contained in the April 14, 2011 IEP were inappropriate, or that they could not have been implemented in the recommended site. Nor was there any testimony that any disagreement with the goals was expressed at the IEP meeting or in subsequent correspondence to the CSE. Appropriateness of Recommended Site

The parent objected to the recommended site stating that staff was not trained in use of the Dynavox; (2) none of the students had a and students were engaged in ; (3) the other children were verbal and did not require a high tech device and (4) that the related services mandates could not be met at the school.

I credit Ms. ’s testimony that the would know how to use the , and would show the staff how to use it. I also credit her testimony that meals would be instructional, and would take place in the classroom. ’s IEP includes a goal for expanding his food repertoire. The record indicates that ’s and academic levels were within the range of the other students in the class. While Ms. testified that the school might only be able to fulfill half of mandate, she testified that the balance would be provided through an RSA. There was nothing to indicate that would not benefit from receiving part of his outside of school. Finally, the fact that other students did not have a , and were is not relevant to the appropriateness of , which included a and a to implement it.

The DOE proved that the recommended site could implement Hayim’s IEP, effective July 2011. See T.Y. v .New York City Department of Education, 584 F. 3d 412 (2d Cir. 2009).

For all of the foregoing reasons, I find that the DOE satisfied its burden of proving that it provided with a FAPE, and the parent’s request for tuition reimbursement is denied. Dated: August 28, 2012

__________________________________

DORA M. LASSINGER, ESQ.

Impartial Hearing Officer DML:jj

PLEASE TAKE NOTICE

Within 35 days of the date of this decision, the parent and/or the New York City Department of Education has a right to appeal the decision to the State Review Officer of the New York State Education Department under Section 4404 of the Education Law and the Individuals with Disabilities Education Act.

“The notice of intention to seek review shall be served upon the school district not less than 10 days before service of a copy of the petition for review upon such school district, and within 25 days from the date of the decision sought to be reviewed. The petition for review shall be served upon the school district within 35 days from the date of the decision sought to be reviewed. If the decision has been served by mail upon petitioner, the date of mailing and the four days subsequent thereto shall be excluded in computing the 25- or 35-day period.”

(8NYCRR279.2[b]) Failure to file the notice of intention to seek review is a waiver of the right to appeal this decision.

Directions and sample forms for filing an appeal are included with this decision. Directions and forms can also be found in the Office of State Review website: www.sro.nysed.gov/appeals.htm.

DOCUMENTATION ENTERED INTO THE RECORD

PARENT

A Impartial Hearing Request, 5/15/12, 5 pp. B Mission Statement and School Description, Undated, 3 pp. C Ten-Day Notice, 6/15/11, 2 pp. D Reply to Final Notice, 7/28/11, 5 pp. E General Admission Form, 9/1/11, 5 pp. F School Affidavit, 6/27/12, 1 p. G Attendance Record, 6/27/12, 1 p. H Classroom Profile, 2011-2012, 1 p. I 's Individual Schedule, 2011-2012, 1 p. J School Calendar, 2011-2012, 2 pp. K Classroom Teachers, 2011-2012, 1 p. L IEP, Reach for the Stars, 2011-2012, 18 pp. M Annual Evaluation, 5/4/11, 8 pp. N Goals, 2011-2012, 7 pp. O Progress Report, 12/16/11, 12 pp. P Educational Progress Report, 12/12/11, 3 pp. Q . Goals, 6/24/11, 5 pp. R . Evaluation, 6/24/11, 8 pp. S ABLLS, Various Years, 3 pp. T ABLLS, 6/27/12, 7 pp. (ID Only) U 's Sensory Motor Diet, 2011-2012, 1 p. V VB-APP Master Score Form, 11/3/11, 1 p. (ID Only) W Proof of Payment, Various Dates, 3 pp. X Provisional Charter, 6/21/05, 2 pp.

DEPARTMENT OF EDUCATION

1 IEP, 4/14/11, 20 pp. 2 Final Notice of Recommendation, 6/4/11, 1 p. 3 Contact Sheet, 4/2011, 1 p.

IMPARTIAL HEARING OFFICER

I Pre-Hearing Conference summary, 6/25/12, 1 p. II Case FollowUp Sheet, 7/10/12, 1 p.

Footnotes

[1] The IEP refers to Hayim as “ ”. His parent clarified that the correct spelling of his first name is “Hayim”. (Tr. p. 13).

[2] During the summer months, the program includes techniques throughout the day; but no discrete trials. The students take three trips during the summer. (Tr. pp. 81-82).

[3] Although Mrs. . testified at the hearing regarding ’s for therapy; the transcript does not clearly reflect this. Although the word “ ” appears once on p. 219 (line 5); subsequent references to certification or therapy appear as “- - ” where the word was used. (See Tr. pp. 219, 228-230). During the hearing, after I noted that the issue of training was not raised in the hearing request, the parent’s advocate stated that it was not an issue for hearing. (Tr. p. 230).

[4] In a report dated June 8, 2011 (less than two months after the disputed CSE review), a pathologist at reported that had expanded his food repertoire to include fruits, vegetables, hamburgers and hotdogs. He was able to self-feed during mealtimes. (Par. Ex. M6).