Occupational Therapy Strategies

Some kids need extra practice and strategies to access the learning environment. Occupational Therapists have shown me a multitude of these tips to help with student learning. Here are some resources:

Strategy Links:

Parent-Teacher Intervention Checklists

Parent/ Teacher Checklist/ Screening:

Manuals:

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Tools and Screenings

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I recently found a site through res_uwmedicalcenter books in the Treatments That Work™ series that currently have resources available for download. I have used a few and wanted to take a chance and post it to the blog for future reference.

First Treatments That Work- Here

and

res_uwmedicalcenter

On these topics:

SCREENING & SURVEILLANCE –(SOURCE)

Home School Communication

Parents teacher meeting

Home school communication a great tool in working with challenging behavior. Parents often hold the keys to change.

Here are some examples:

Look at examples on pages 35-37

Principles and examples of home school communication from PENT: here

More examples of blank templates: here and here

Articles:

11 Rules for Better Parent-Teacher Teamwork

Sharing Data to Create Stronger Parent Partnerships

Visually readable progress reports

Simple:

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Source

To more involved:

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Daily Behavior Report Cards (DBRC)

Ongoing communication between home and school is an important component to behavior plans. DBRCs can be a very easy, efficient and helpful way of motivating students as well as informally monitoring behavioral improvement with intervention. Teacher behavior report cards can be designed to accomplish the following:

  •  Point out to the students behaviors that they need to learn (skill deficit).
  •  Provide a schedule of teacher attention/feedback for positive behaviors.
  •  Motivate students through reinforcing positive behavior that teachers want to increase, and providing consequences (e.g., a sad face) for negative behaviors they want to decrease.
  •  Increase home-school communication (increase accountability with additional opportunities for positive or negative consequences for behavior).
  •  Evaluate whether the intervention is working or not when used with other measures.

Source

Top Five Reasons to Engage Parents

1. Decades of research show when parents are involved students have:

  • – Higher grades, test scores, and graduation rates
  • – Better school attendance – Increased motivation, better self-esteem
  • – Lower rates of suspension
  • – Decreased use of drugs and alcohol
  • – Fewer instances of violent behavior

National Parent Teacher Association

2. Family participation in education is twice as predictive of students’ academic success as family socioeconomic status. Some of the more intensive programs had effects that were 10 times greater than other factors. Walberg (1984) in his review of 29 studies of school–parent programs.

3. School Benefits:

  • – Improves teacher morale
  • – Higher ratings of teachers by parents
  • – More support from families
  • – Higher student achievement
  • – Better reputations in the community

A New Generation of Evidence: The Family is Critical to Student Achievement, edited by Anne T. Henderson and Nancy Berla, Center for Law and Education, Washington, D.C., 1994 (third printing, 1996)

4. Parent involvement leads to feelings of ownership, resulting in increased support of schools. Davies, Don. (1988). Low Income Parents and the Schools: A Research Report and a Plan for Action. Equity and Choice 4,3 (Spring): 51-57. EJ 374 512.

5. Parents express a genuine and deep-seated desire to help their children succeed academically, regardless of differences in socioeconomic status, race, ethnicity, and cultural background. Mapp (1999)

Source

 

 

Talking with children using engagement and active listening

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As, I work with children I have noticed that some adults generally refrain from talking to children. I am a big proponent of encouraging adults to talk to kids and forge relationships when they can, the benefits of doing this are great for children in a variety  of ways.

  • Why do teachers talk with children? There are many excellent reasons, such as these:

    • • Children enjoy social conversations with adults.
    • • A few enticing words can encourage children to engage in a particular activity or behavior.
    • • Thought-provoking questions or using new words can extend children’s thinking and curiosity.
    • • Adults can directly answer children’s questions. A great deal of research supports the value of talking with young children.
    • • When adults purposefully talk more with children, children develop larger vocabularies (Hart & Risley, 1999; Hoff & Naigles, 2002).
    • • When children have larger vocabularies, they become better readers in middle childhood (Snow, Burns, & Griffin, 1998).
    • • When adults talk to children with longer, more complex words and sentences, children have higher IQ scores (Hart & Risley, 1999).

• When adults talk with children in a responsive and sensitive way, they encourage children’s social and emotional development (Ensor & Hughes, 2008; Harris, 2005). In general, talking with young children encourages development in many areas: spoken language, early literacy, cognitive development, social skills, and emotional maturity. Speaking with children in increasingly complex and responsive ways does this even better. Source

So what to do?

What Can Adults Do?

Adults can play a major role in children’s ability to identify, understand, and express emotions in a healthy way. The following strategies are key in fostering emotional literacy in young children:

Express Your Own Feelings. One way to help children learn to label their emotions is to have healthy emotional expression modeled for them by the adults in their lives. For example, a teacher who knocked over all the glitter can say, “Oh boy, is that frustrating. Oh well, I’d better take a deep breath and figure out how to clean it up.” Or a parent who just got word that she got a promotion at work can say, “Wow! I am so excited about this! I feel proud of myself for working so hard.” Parents, teachers, and child care providers can make a point to talk out loud about their feelings as they experience them throughout the day.

Label Children’s Feelings. As adults provide feeling names for children’s emotional expressions, a child’s feeling vocabulary grows. Throughout the day, adults can attend to children’s emotional moments and label feelings for the children. For example, as a child runs for a swing, another child reaches it and gets on. The first child begins to frown. The teacher approaches her and says, “You look a little disappointed about that swing.” Or a boy’s grandmother surprises him by picking him up at child care. The boy screams, “Grandma!” and runs up to hug her. The child care provider says, “Oh boy, you look so happy and surprised that your grandma is here!” As children’s feeling vocabulary develops, their ability to correctly identify feelings in themselves and others also progresses.

Play Games, Sing Songs, and Read Stories with New Feeling Words. Adults can enhance children’s feeling vocabularies by introducing games, songs, and storybooks featuring new feeling words. Teachers and other caregivers can adapt songs such as “If you’re happy and you know it” with verses such as “If you’re frustrated and you know it, take a breath”; “If you’re disappointed and you know it, tell a friend”; or “If you’re proud and you know it, say ‘I did it!’” The following are some examples of games young children can play.

• Adults can cut out pictures that represent various feeling faces and place them in a container that is passed around the circle as music plays. When the music stops, the child holding the container can select a picture designating an emotion and identify it, show how they look when they feel that way, or describe a time when he or she felt that way. To extend this fun activity, give the children handheld mirrors that they can use to look at their own feeling faces.

• Children can look through magazines to find various feeling faces. They can cut them out and make a feeling face collage. Adults can help the children label the different feeling faces.

• Children and adults can play “feeling face charades” by freezing a certain emotional expression and then letting others guess what the feeling is. To extend this activity, ask the children to think of a time that they felt that way.

• In the mornings, have children “check in” by selecting a feeling face that best represents their morning mood. At the end of the day, have children select again, and then talk about why their feeling changed or stayed the same.

• Finally, the teacher can put feeling face pictures around the room. Children can be given child-size magnifying glasses and told to walk around looking for different feeling faces. When they find one, they can label it and tell about a time they felt that way. With a little creativity, teachers and other caregivers can play, adapt, or develop new games, songs, and stories to teach feeling words.  Source

Active Listening has some good ideas for promoting good communication.

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Active Listening

The most common problem in communication is not listening! A Chinese symbol for “To Listen” is shown below.  It is wise beyond the art. The left side of the symbol represents an ear. The right side represents the individual- you. The eyes and undivided attention are next and finally there is the heart.

chineseletter

This symbol tells us that to listen we must use both ears, watch and maintain eye contact, give undivided attention, and finally be empathetic.  In other words we must engage in active listening!

Active listening is a skill taught to teachers and police officers, counselors, ministers, rabbis and priests. It is a skill we would all do better having learned, practiced. To begin being an active listener we must first understand the four rules of active listening.

The Four Rules of Active Listening

1. Seek to understand before you seek to be understood.

2. Be non judgmental

3. Give your undivided attention to the speaker

4. Use silence effectively

Let’s explore the rules of active listening.

1. Seek to understand before seeking to be understood. When we seek to understand rather than be understood, our modus operandi will be to listen. Often, when we enter into conversation, our goal is to be better understood. We can be better understood, if first we better understand. With age, maturity, and experience comes silence. It is most often a wise person who says little or nothing at the beginning of a conversation or listening experience. We need to remember to collect information before we disseminate it. We need to know it before we say it.
2. Be non judgmental. Empathetic listening demonstrates a high degree of emotional intelligence. There is a reason kids do not usually speak with adults about drugs, sex, and rock and roll. The kids already know what the adults have to say. Once a child knows your judgment, there is little reason to ask the question unless the intention is to argue. If we would speak to anyone about issues important to them, we need to avoid sharing our judgment until we have learned their judgment. This empathetic behavior is an indicator of emotional intelligence as described in Chapter 3.
  1. Give your undivided attention to the speaker.The Chinese symbol that we used to describe listening used the eyes and undivided attention. Absolutely important is dedicating your undivided attention to the speaker if you are to succeed as an active listener. Eye contact is less important. In most listening situations people use eye contact to affirm listening. The speaker maintains eye contact to be sure the listener or listeners are paying attention. From their body language the speaker can tell if he is speaking too softly or loudly, too quickly or slowly, or if the vocabulary or the language is inappropriate. Listeners can also send messages to speakers using body language. Applause is the reason many performers perform. Positive feedback is an endorphin releaser for the giver and the sender. Eye contact can be a form of positive feedback. BUT, eye contact can also be a form of aggression, of trying to show dominance, of forcing submissive behavior. All primates use eye contact to varying degrees. We should be careful how we use it when listening. If we want to provide undivided attention to a child, a better way to show your attention is to do a “walk and talk”.
  2. Use silence effectively.The final rule for active or empathic listening is to effectively use silence. To often a truly revealing moment is never brought to fruition because of an untimely interruption. Some of the finest police interrogators, counselors, teachers and parents learn more by maintaining silence than by asking questions. As an active or empathic listener, silence is a very valuable tool. DO NOT interrupt unless absolutely necessary. Silence can be painful. It is more painful for a speaker than for a listener. If someone is speaking, and we want them to continue talking, we do not interrupt. Rather, we do provide positive feedback using body language, eye contact, and non word sounds like “umh, huh”. Silence is indeed golden especially when used to gather information as a listener. Source

Possible Areas of Concern / Accommodations

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General Areas of Concern
 Assignments / Homework:

·         Frequent work breaks

·         Allow use of computer or technology to complete assignments

·         Allow projects / written assignments to be presented orally or on tape

·         Allow projects to presented through demonstration pictures and / or models

·         Extended time to complete assigned work

·         Shorten or chunk assignments / work periods

·         Simplify complex directions

·         Break long assignments into manageable chunks

·         Assist student in setting short-term goals

·         Pair written instructions with oral instructions

·         Develop private signal so that student can let teacher know if repetition of instruction is needed

·         Check homework daily

·         Reduce amount of homework

·         Limit homework to specified # of minutes / night

·         Permit re-submitted assignments

·         Grade written work on content, not spelling, handwriting, or mechanics

·         Adapt assignments to minimize writing (e.g. circle, cross out, etc.)

·         Provide study skills training / learning strategies

·         Reduce the reading level of assignments

·         Use self-monitoring devices (checklists, visual aids, etc.)

·         Provide distributed review and drill

 

 Attention:

·         Provide cognitive behavioral feedback:  positive feedback for attention to task with frequency based on what student can currently do

·         Short-term reinforcers that provide feedback (happy face, check mark, star, in-class rewards) or long –term (accumulated points to exchange for positive reinforcement at school or home)

·         Plan academic instruction for student’s peak attention time

·         Allow student to stand at times during seatwork

·         Require active responses in instruction (e.g. talking, moving, organizing, work at whiteboard or slate, interacting with computer, etc.)

·         Provide short break between assignments

·         Give child substitute verbal or motor responses to make while waiting

·         Provide fidget object for manual activity (eg. Koosh ball, clay, worry beads, etc.)

·         Teacher proximity

·         Preferential seating

·         Positive feedback / reward for short periods of waiting

·         Increase novelty to gain / sustain attention

·         Alternate high and low interest tasks

·         Increase choice of tasks

·         Place student first in line or avoid lines altogether

·         Build in opportunities for movement

·         Teach compensatory strategies for organization

·         Provide increased supervision during unstructured times (e.g. recess, transitions, field trips, etc.)

·         Home-school communication procedures / strategies

·         Non-verbal cues between teacher / student for behavior monitoring

·         Highlight important or required information

·         Student checklists for self-monitoring

·         Adapt student’s work area to help screen out distractions

·         Grade for content, not neatness, spelling, mechanics

·         Avoid withholding physical activity as negative reinforcer

 

Classroom Environment and Seating:

·         Predictable daily routines

·         Schedule changes addressed ahead of time

·         Consistent and clear expectations / procedures / boundaries set for classroom behavior

·         Work alternates short, concentrated periods with breaks

·         Minimize visual or auditory distractions

·         Small group instruction

·         Team teaching

·         Identify teaching-style / student match (e.g. structured, nurturing, etc.)

·         Preferential seating (near teacher, near study buddy, front of classroom, etc.)

·         Allow personal space around desk

·         Allow legitimate movement

·         Use study carrel or partitions at independent work times

Learner Needs / Behavior:

·         Allow for short breaks between assignments

·         Allow student more time to pass in the hallway

·         Allow student time out of seat to run errands, etc.

·         Cue student to stay on task (non-verbal signal)

·         Implement a behavior management system

·         Use visual depictions of expected procedures

·         Clear, simple, consistent classroom rules and procedures

·         Point out positive behaviors

·         Provide positive reinforcement

·         Set defined limits

·         Use self-monitoring strategies

·         Provide behavioral feedback frequently (written, non-verbal signal, etc.)

·         Ignore minor, inappropriate behavior

·         Increase immediacy or rewards or consequences

·         Supervise closely during transition times

·         Call on only when student has followed classroom procedure (raising hand, waiting to be called on, etc.)

·         Establish behavior contract with specified goals (2-3 at most), student input on goals as appropriate

·         Prudent use of negative consequences

·         Provide immediate feedback for both appropriate and inappropriate behaviors

·         Avoid lecturing or criticism

·         Implement home-school communication system

·         Communicate with student in writing if behavior is intended to engage verbal interaction

·         Provide opportunities for student to show responsibility for classroom tasks (e.g. straighten classroom shelves, water plants, etc.)

Lesson Presentation:

·         Allow students to tape lessons or lectures for replay

·         Break long presentations into short segments

·         Emphasize multi-sensory teaching:  auditory, visual, tactile-kinesthetic

·         Emphasize critical information / key concepts

·         Include a variety of activities during each lesson

·         Pair students to check work

·         Pre-teach vocabulary (front-load)

·         Peer note-taker

·         Peer tutor

·         Provide visual aides

·         Provide written outline or other written material

·         Written steps / checklist for multiple step directions

·         Frequent checks for understanding / comprehension

·         Have student repeat directions to teacher or peer

·         Provide key points in writing / visually / as well as in auditory format

·         Use advanced organizers / study guides

·         Computer assisted instruction

·         Use of manipulatives

·         Specialized curriculum

 Organization:

·         Extra set of texts at home

·         Assign volunteer homework buddy

·         Assignment notebook with home / school connection

·         Adult / peer to review assignment notebook and materials before leaving for home

·         Organizational aids such as outlines, graphic organizers, checklists

·         Photographs or visual aids that depict what desk, book bag, folders, etc.  should like in an organized manner

·         Colored folders

·         Color and physical / spatial organizers

 Socialization and Social Skills:

·         Provide recess / lunch opportunities with friend in structure setting

·         Provide lunch buddies

·         Establish social behavior goals and reward program

·         Establish social stories for areas that are difficult for the student

·         Non-verbal prompts to remind of appropriate social behavior

·         Avoid placing student in situations that have a pattern of being difficult for him / her

·         Provide social skills training (school-related skills, friendship skills, dealing with feelings, alternatives to aggression, dealing with anxiety / stress, etc.)

Testing:

·         Allow extra time

·         Allow open book tests

·         Give test orally

·         Take home tests

·         Adjusted setting for test-taking (small group or individual)

·         Provide written outline of main points prior to test

·         Untimed

·         Give extended time if necessary

·         Break test into shorter chunks and testing periods

·         Identify whether test will assess abilities or disabilities

·         Grade test for content, not handwriting, spelling, or mechanics

·         Give frequent short quizzes, rather than long exams

·         Allow outlines or notes during quiz / test

 

Specific Areas of Disability
Allergies

Example:  The student has severe allergic reactions to certain pollens and / or foods.  For purposes of this example the condition substantially limits the major life activity of breathing and may interfere with the students’ ability to get to school or participate once there.

Possible accommodations and services:

·         Avoid allergy –causing substances: soap, weeds, pollen, food

·         In-service necessary persons:  dietary staff, peers, coaches, etc.

·         Allow time for shots / clinic appointments

·         Use of air purifiers

·         Adapt physical education curriculum during high pollen time

·         Improve room ventilation (e.g. when remodeling has occurred and materials may cause reaction)

·         Develop health care and / or emergency plans

·         Address pets / animals in the classroom

·         Involve school health consultant in school related health issues

·         Train for proper dispensing, monitoring, and distribution of medications and monitoring for side effects

·         Address pets / animals in the classroom

Arthritis

Example:  A student with severe arthritis may have persistent pain, tenderness or swelling in one or more joints.  A student experiencing arthritic pain may require a modified physical education program.   For purposes of this example, the condition substantially limits the major life activity of learning.

Possible accommodations and services:

·         Provide a rest period during the day

·         Accommodate for absences for doctors’ appointments

·         Provide assistive devices for writing (e.g. pencil grips, non-skid surface, typewriter / computer, etc.)

·         Adapt physical education

·         Administer medication following health protocol

·         Train staff for proper dispensing, monitoring, and distribution of medications, monitor for side effects

·         Arrange for assistance carrying materials and supplies (e.g. books, lunch tray, etc.)

·         Implement movement plan to avoid stiffness

·         Provide seating accommodations

·         Allow extra time between classes

·         Provide locker assistance

·         Provide modified eating utensils

·         Develop health and emergency plans

·         Provide for accommodations for writing tasks:  a note taker, copies of notes, computer or tape recorder, etc.)

·         Make available access to wheelchair / ramps and school van / bus for transportation

·         Provide time for massage or exercise

·         Adjust recess time and activities

·         Provide peer support groups

·         Instructional aide supports

·         Record lectures / presentations

·         Padded chairs / comfortable seating

·         Adjust attendance policy

·         Altered school day

·         Extra set of books for home

·         Warmer room and seating near heat source

·         Allow student to respond orally for assignments, tests, etc.

·         Awareness program for staff and students

·         Monitor special dietary considerations

·         Involve school nurse in health protocols and decision making

·         Provide post-secondary or vocational transition planning

 

Asthma

Example:  A student has been diagnosed as having severe asthma.   The doctor has advised the student not to participate in physical activity outdoors.  For purposes of this example, the disability limits the major life activity of breathing.

Possible accommodations and services:

·         Adapt activity level for recess, physical education, etc.

·         Provide inhalant therapy assistance

·         Train staff/student for proper dispensing, monitoring, and distribution of medication, monitor for side-effects

·         Remove allergens (e.g. hairspray, lotions, perfumes, paint, latex, etc.)

·         Accommodate medical absences

·         Adapt curriculum expectations as appropriate (e.g. science, physical educations, etc.)

·         Develop health and emergency plans

·         Have peers available to carry materials to and from classes (e.g. lunch tray, books, etc.)

·         Make health care needs known to appropriate staff

·         Place student in most easily controlled environment

·         Provide indoor space for before and / or after school activities

·         Provide rest periods

Bipolar Disorder or Mood Disorder – NOS (not otherwise specified)

Example:  The student was diagnosed as having a bipolar disorder, however the severity (frequency, intensity, duration considerations) of the condition did not qualify the student for Special Education support under IDEA.  A properly convened 504 team determined that the condition did significantly impair the major life activity of learning and designed a 504 accommodation plan for the student.

Possible accommodations and services:

·         Break down assignments into manageable parts with clear, simple directions, given one at a time

·         Plan advanced preparation for transition

·         Monitor clarity of understanding and alertness

·         Provide extra time on tests, class work, and homework if needed

·         Strategies in place for unpredictable mood swings

·         Provide appropriate staff training for mood swings

·         Create awareness by staff of potential victimization from other students

·         Allow most difficult subjects at times when student is most alert

·         Implement a crisis intervention plan for extreme cases where students is out of control and may do something impulsive or dangerous

·         Provide positive praise and redirection

·         Reports any suicidal comments to counselor / psychologist immediately

·         Consider home instruction for times when the student’s mood disorder make it impossible for him / her to attend school for an extended period

·         Adjusted passing time

 

Cancer (or other long-term medical concerns)

Example:  A student with a long-term medical problem may require special accommodations.  A condition, such as cancer, may substantially limit the major life activities of learning and caring for oneself (e.g. a student with cancer may need a class schedule that allow for rest and recuperation following chemotherapy or other treatment).

Possible accommodations and services:

·         Adjust attendance policy

·         Limit number of classes taken; accommodate scheduling needs

·         Hospital-bound instruction (this is sometimes arranged through the hospital)

·         Home-bound instruction

·         Take whatever steps necessary to accommodate student involvement in extracurricular activities if they are otherwise qualified

·         Adjust activity level and expectations in classes based on physical limitations; don’t require activities that are physically taxing

·         Train for proper dispensing, monitoring, and distribution of medications, monitor for side effects

·         Provide appropriate assistive technology

·         Provide a private rest area

·         Adjusted school day

·         Send additional sets of texts and assignments to hospital schools

·         Adjust schedule to include rest breaks

·         Tape lessons, adjust expectations for homework and assessment

·         Provide counseling; peer support

·         Adapt physical education

·         Provide access to school health services

·         Provide awareness training for  staff and students as appropriate

·         Develop health care emergency plan

·         Peer tutor

·         Student buddy for participation in sports

·         Initiate a free pass system from the classroom

·         Ongoing home / school communication plan

·         Notify family of communicable diseases at school

·         Designate a person in school to function as liaison with parents as a means of updating changing health status

·         Adjusted passing time

 Cerebral Palsy

Example:  The student has serious difficulties with fine and gross motor skills, although cognitive skills are within the average to above average range.  A wheelchair is used for mobility.  For purposes of this example, the condition substantially limits the major life activity of walking.

Possible accommodations and services:

·         Assistive technology devices

·         Arrange for use of ramps and elevators

·         Allow for extra time between classes

·         Assistance with carrying books, materials, lunch tray, etc.

·         Adapt physical education curriculum

·         Provide for physical therapy as appropriate

·         Train for proper dispensing, monitoring, and distribution of medications, monitor for side effects

·         Adapt eating utensils

·         Transportation

·         Initiate a health care plan that also addresses emergency situations

·         Paraprofessional support (e.g. trained in the specific needs of this student – feeding, transporting, etc.)

·         Adapted assignments

·         Educate peers / staff with family permission

·         Ensure accessibility to all programs during the school day as well as extracurricular activities

·         Ensure that bathroom facilities, sinks, water fountains are accessible

·         Adjusted passing time

 

 Chronic Infectious Diseases (i.e. Acquired Immune Deficiency Syndrome – AIDS, etc.)

Example:  The student frequently misses school and does not have the strength to attend a full day.  For purposes of this example, the student has a record of a disability which substantially limits the major life activity of learning.

Possible accommodations and services:

·         Review district policies regarding communicable diseases

·         In-service staff (and students as appropriate) regarding the disease, how it is transmitted, how it is treated (consult appropriate district policies)

·         In-service staff regarding confidentiality issues

·         Train for proper dispensing, monitoring, and distribution of medications, monitor for side effects

·         Adjust attendance policies, school day, and / or schedule

·         Provide rest periods

·         Adapt Physical Education curriculum

·         Establish routine communication with health professionals, school nurse, and home

·         Develop health care and emergency plan

·         Train appropriate school staff on medical / emergency protocol

·         Provide 2-way audio / video link between home and classroom via computer

·         Home–bound instruction

·         Adapt assignments and tests

·         Provide an extra set of textbooks for home

·         Provide transportation to and from school

·         Tape books or provide a personal reader

·         Participation in a support group

·         Videotape classroom lessons

·         Promote the most supportive, least restrictive classroom environment.

Cystic Fibrosis

Example:  The student has an extensive medical history, which includes the diagnosis of cystic fibrosis.  He has significant difficulty breathing and will be absent often due to respiratory infection.  For purposes of this example, learning and breathing are the major life activities that are substantially impaired.

Possible accommodations and services:

·         Train for proper dispensing, monitoring, and distribution of medications, monitor for side effects

·         Health care plan for management of acute and chronic phases

·         Establish routine communication with health professionals, school nurse, and home

·         Adjust attendance policies, school day, and / or schedule

·         Educate peers / staff with family permission

·         Home-bound instruction

·         Adapted assignments / tests

·         Tutoring

·         Support group

·         Adapt Physical Education curriculum

·         Allow for rest periods

·         Transportation

Deaf  / Hearing Impairment

Example:  A student was diagnosed with a substantial hearing impairment at an early age, which resulted in hearing loss and a mild speech impediment.   He compensates through both lip reading and sign language.  Academic abilities test in the average range.  For purposes of this example, hearing is the major life activity that is substantially impaired.

Possible accommodations and services:

·         Allow for written directions / instructions in addition to oral presentation

·         Ensure delivery of instruction facing the student to allow lip reading

·         Provide visual information as primary mode of instruction

·         Allow for provision of interpreter services during school day or school events

·         Install acoustical tile, carpeting

·         Seat in a location with minimal background noise

·         Provide paper / pencil / slate / technology to write or draw responses or requests

·         Facilitate acquisition of TDDs and related assistive technology

·         Allow for extra time between classes

·         Provide post-secondary or vocational transition planning

Diabetes

Example:  A sixth grade student with Type I Diabetes requires numerous accommodations to maintain optimal blood sugar, even though he is quite independent in managing the disease.  For purposes of this example, he is substantially limited in the major life activity of caring for oneself.

Possible accommodations and services:

·         Assistance with and privacy for blood glucose monitoring or insulin injections

·         Snacks / meals when and wherever necessary

·         Free access to water and bathroom

·         Full participation in any extra-curricular programs

·         Scheduling physical education around meal times

·         Allowances for increased absences

·         Health care plan for management of condition in the school setting and in emergencies

·         Educate staff to signs / symptoms of insulin reaction / hypoglycemia (e.g. hunger, shakiness, sweatiness, change in face color, disorientation, drowsiness, etc.)

·         Provide assistance to walk to the clinic if the student is feeling poorly

·         Create an emergency signal with office to alert health personnel when they need to come to the child

·         Train for proper dispensing, monitoring, and distribution of medications, monitor for side effects

·         Establish routine communication with health professionals, school nurse, and home

·         Store equipment and documentation in a readily accessible location for student, family, and school nurse or health secretary

Emotionally Disturbed

Example:  An emotionally disturbed student may need an adjusted class schedule or assignments due to allow for regular counseling or therapy.  For purposes of this example, the condition substantially limits the individual’s major life activity of learning.

Possible accommodations and services:

·         Train for proper dispensing, monitoring, and distribution of medications, monitor for side effects

·         Maintain weekly / daily journals for self-recording of behavior

·         Establish home-school communication system

·         Schedule periodic meetings with school, family, and treatment specialists

·         Provide carry-over of treatment plans into school setting

·         Assist with inter-agency referrals

·         Behavior management programs

·         Frequent positive feedback

·         Develop student behavior contracts

·         Develop visual cues and non-verbal signals for feedback

·         Teach specific procedures and behavioral expectations

·         Counseling, social skills instruction

·         Adapt schedule

·         Schedule shorter work / study periods according to attention span capabilities

·         Provide post-secondary or vocational transition planning

Encopresis / Enuresis

Example:  A student urinates or defecates in clothing, not because of physical incontinence but a needed behavior change (e.g. toilet training, bowel / bladder retraining, etc.)  For purposes of this example, the student is substantially limited in the major bodily function of bowel and / or bladder functioning and the major life activity of caring for oneself.

Possible accommodations and services:

·         Create a specific plan for instances of soiling, including:  student goes to specific location for clean-up and change of clothing, plan for soiled clothing, parent contact, etc.

·         Maintain clean change of clothing at school in the clinic or alternate location

·         Record events to attempt to determine consistent triggers of behavior

·         Establish home, school, medical personnel communication

·         Support bowel / bladder retraining program that is recommended by physician

·         Schedule time for student to use the restroom

 

Epilepsy (other seizure disorder)

Example:  The student is on medication for seizure activity, but experiences several petit mal seizures each month.  This condition substantially limits the major life activity of learning.

Possible accommodations and services:

·         Consistent school, home, medical personnel communication

·         Documentation procedure to record and communicate characteristics of each seizure

·         Train for proper dispensing, monitoring, and distribution of medications, monitor for side effects

·         Train staff and peers as appropriate

·         Develop health plan and emergency protocol

·         Anticipate process should a seizure occur:  Move seating / clear space during seizure, do not insert objects into student’s mouth during seizure, administer no fluids if student is unconscious, turn unconscious student on side to avoid aspiration, provide rest time, accommodate return to academic demands following seizure, etc.

·         Arrange a buddy system or adult assistance, especially during field trips

·         Alternative recess, adapt physical activities

·         Accommodate for make-up work or class time missed

·         Observe for consistent triggers of seizure activity (e.g. smells, bright light, perfume, hair spray, etc.)

·         Provide post-secondary or vocational transition planning

 

Learning Disabilities (non-specific)

Example:  The student has a learning disability that impacts her ability to read.  She has more difficulty with word decoding and spelling than comprehension.  Completing reading tasks is difficult and slow.  She does not qualify for Special Education services, but there is ample evaluative evidence that she is substantially limited in the major life activity of learning.

Possible accommodations and services:

·         Provide reading materials that cover course context at a lower readability level

·         Extended time on tests

·         Arrange for volunteer readers

·         Provide information regarding accessing books on tape and other materials Allow access to spell checkers and / or word processing

·         Oral directions in addition to written

·         Frequent checks for understanding

·         Visual or non-verbal signals cues to check for understanding

·         Clearly sequenced instruction

·         Visual graphs / charts / organizers / diagrams to support instruction

·         Provision of computer access

·         Tests read aloud to student

·         Computer access

·         Direct instruction of time-management / organizational skills

·         Direct instruction of coping skills / strategies

·         Support in helping student recognize areas of strength and how to capitalize on them

·         Support in use of strategies to assist memory and problem-solving

·         Multi-sensory instructional methods / differentiated instruction specific to this student

·         Provide post-secondary or vocational transition planning

Orthopedically Impaired

Example:  The student has limited mobility and uses a wheelchair.  For purposes of this example, the student is substantially limited in the major life activity of walking.

Possible accommodations and services:

·         Develop a health care and emergency plan

·         Adaptive physical education program

·         Physical therapy at school

·         Provide extra between class periods

·         Supply a set of textbooks for home

·         Provide a copy of class notes from peer

·         Plan for and practice emergency exits from school building

·         Ensure accessibility of facilities / pathways / programs / school events

·         Assistance carrying materials, lunch trays, etc.

·         Provide post-secondary or vocational transition planning

Special Health Care Needs

Example:  The student has a special health care problem that requires clean intermittent catheterization twice each day during the school day.  For purposes of this example this condition substantially limiting in the major life activity of caring for oneself.

·         Provide trained personnel to perform special medical procedures.  Train for proper dispensing, monitoring, and distribution of medications, monitor for side effects

·         Provide student with private location and time to perform procedures if independent

·         Involve school nurse, family, school staff, and medical personnel in regular communication

·         Preferential seating

·         Adapt recess, physical education, transportation

·         Develop health care and emergency plans

·         Adapt attendance policy

·         Adapt homework / instruction for class time missed for medical reasons

·         Homebound instruction

Tourette’s Syndrome

Example:  The student exhibits tics and some inappropriate gestures and sounds.  For purposes of this example, the condition is substantially limiting in the major life activities of learning and caring for oneself.

Possible accommodations and services:

·         Provide student with a means of catching up on missed assignments

·         Pair with a peer for studying

·         Educate staff / peers about associated outbursts, tics, gestures with family permission

·         Arrange for frequent home / school /medical personnel communication

·         Train for proper dispensing, monitoring, and distribution of medications, monitor for side effects

·         Implement a behavior management program if indicated

·         Use visual or non-verbal signals to cue student about behaviors (positive and negative)

·         Provide supervision for transition activities, during agitated periods

·         Provide alternative / larger work-space area or appropriate space for the child

·         Direct instruction of compensatory strategies

·         Adapt assignments if indicated

·         Provide post-secondary or vocational transition planning

Traumatic Brain Injury

Example:  The student sustained a brain injury in an automobile accident.  Many academic and motor skills have been seriously affected by the injury.  The student does not qualify for Special Education services.  The condition is substantially limiting to the major life activities of learning and performing manual tasks.

Possible accommodations and services:

·         Adjusted school day

·         Adjust assignments and homework

·         Provided tutoring

·         Furnish memory / organizational aids

·         Provide alternative testing

·         Arrange an emergency plan / health protocol

·         Monitor for seizure activity

·         In-service staff and peers with student / parent permission

·         Monitor for fatigue / mental exhaustion

·         Provide frequent breaks during periods of intense concentration

·         Provide strategies and assistance with organizing / sequencing tasks

·         Provide post-secondary or vocational transition planning

Visual Impairment

Example:  A student has a progressive medical disorder, which results in increasing loss of visual acuity.  He now requires both enhanced lighting and enlarged print materials in order to read.  For purposes of this example, the condition is substantially limiting in the major life activity of seeing.

Possible accommodations and services:

·         Preferential seating

·         Adaptations to physical environment (e.g. consistent room arrangement, removal of obstacles, etc.)

·         Copies of text / reading materials for adaptation (e.g. enlarged type, etc.)

·         Modified writing tools (e.g. dark felt tip pens, dark lined writing paper, desktop slantboard, etc.)

·         Slate and stylus

·         Braille accommodations (e.g. Perkins Brailler, textbooks, materials, tests, in Braille, etc.)

·         Raised lines on writing paper

·         Low vision devices including magnifiers, monocular glass, closed-circuit TV

·         Books on tape

·         Oral, instead of written tests

·         Tactile maps

·         Computer with enlarged print screen / adaptations

·         Speech synthesize for input and output

·         Screen reading device

·         Optical Character Recognition System Scanner

Adapted from: **www.advancingmilestones.com

** Puget Sound, ESD, Office of Special Services, November, 2002

Cutting/ Non-Suicidal Self-Injury (NSSI)

Non-suicidal self-injury (NSSI) is defined as deliberately injuring oneself without suicidal intent. The most common form of NSSI is self-cutting, but other forms include burning, scratching, hitting, intentionally preventing wounds from healing, and other similar behaviors. Tattoos and body piercings are not considered NSSI, unless they are created with the specific intention to self-harm. NSSI is often inflicted on the hands, wrists, stomach, or thighs, but it can occur anywhere on the body.

Rates of NSSI are highest among adolescents and young adults. Although estimates vary, approximately 12%-24% of adolescents and young adults have self-injured, and 6%-8% report current, chronic self-injury. Some individuals continue to engage in these behaviors well into adulthood, especially when they do not receive treatment. Source

Risk Factors

  • Knowledge that friends or acquaintances are cutting
  • Difficulty expressing feelings
  • Extreme emotional reactions to minor occurrences (anger or sorrow)
  • Stressful family events (divorce, death, conflict)
  • Loss of a friend, boyfriend/girlfriend, or social status
  • Negative body image
  • Lack of coping skills
  • Depression

Signs

  • Wearing long sleeves during warm weather
  • Wearing thick wristbands that are never removed
  • Unexplained marks on body
  • Secretive or elusive behavior
  • Spending lengthy periods of time alone
  • Items that could be used for cutting (knives, scissors, safety pins, razors) are missing

What should you do?
If you become aware that your child is engaging in self-injurious acts, remember that it is fairly common. Though it is often frightening for parents, the majority of teens who cut themselves do not intend to inflict serious injury or cause death. If the injury appears to pose potential medical risks, contact emergency medical services immediately. If the injury doesn’t appear to pose immediate medical risks, remain calm and nonjudgmental, contact your child’s pediatrician to discuss the concerns, and ask for a referral to a trained mental health professional who has experience in this area. Source

Overview for school staff:

Educators & Self Injury How to recognize, understand, and respond to nonsuicidal self-injury.

Quick reference protocol in steps to intervene at school.  Helps remind staff of steps in intervening with a student who has been cutting.

Parent Notification Form– Please involve parents by informing them by phone prior to sending the form home this parent notification.

Parent Fact Sheet– to go home with Parent Notification Form.

Suicide Risk Assessment Summary Sheet  This is a very good tool.

Safety Contract for Adolescents

Further reading:

Non-Suicidal Self-Injury in Schools: Developing & Implementing School Protocol

PPT Self-Injury Interventions for School Psychologists

Why Teenagers Cut, and How to Help

Need help for self-harm?

If you’re not sure where to turn, call the S.A.F.E. Alternatives information line in the U.S. at (800) 366-8288 for referrals and support for cutting and self-harm. For helplines in other countries, see Resources and References below.

In the middle of a crisis?

If you’re feeling suicidal and need help right now, call the National Suicide Prevention Lifeline in the U.S. at (800) 273-8255. For a suicide helpline outside the U.S., visit Befrienders Worldwide.

Margaret Wheatley and the “The Six Circle Model”

A few years back I learned about Margaret Wheatley and her work around, “The Six Circle Model”. In a nut shell it is the structures of work and its interplay with the culture, communication, and relationships within that structure.

Tehama Schools Concise Synopsis

Margaret J. Wheatley (commonly Meg Wheatley) (born 1941) is an American writer and management consultant who studies organizational behavior. Her approach includes systems thinking, theories of change, chaos theory, leadership and the learning organization: particularly its capacity to self-organize. Her work is often compared to that of Donella Meadows and Dee Hock. She describes her work as opposing “highly controlled mechanistic systems” that only create robotic behaviors.

In any organization you must find a blend of melding above and below the green line. I think that in my work when we have been faced with a problem, considering what might be missing on the “The Six Circle Model” has really helped our teams better reset on a path to better practices.

At this time in our history, we are in great need of processes that can help us weave ourselves back together. We’ve lost confidence in our great human capabilities, partly because mechanistic organizational processes have separated and divided us, and made us fearful and distrusting of one another. We need processes to help us reweave connections, to discover shared interests, to listen to one another’s stories and dreams. We need processes that take advantage of our natural ability to network, to communicate when something is meaningful to us. We need processes that invite us to participate, that honor our creativity and commitment to the organization. – Margaret Wheatley