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CHCIC512A: Plan the inclusion of children with additional needs

Identify children with additional needs

Contents

Investigate child’s behaviour and expressed emotions to identify an additional need 3

Negative labels 4

Putting people first 4

Why refer to an impairment at all? 5

Why do children have additional needs? 7

Language and communication difficulties 7

Children who have a difference in their cognitive development 14

Children with differences in their physical development 18

Social norms 25

Health needs 29

Observe the particular child, identify and document needs for additional care and use to develop a plan of inclusion 32

Discuss concerns with others to develop a clear understanding of a particular child’s needs and use this information to plan 38

Information about a child’s background and situation 38

Identify the cultural and language background and migration experiences of the child 43

Ways in which children’s family backgrounds are diverse 43

Diploma of Children’s Services: CHCIC512A: Reader LO 9369 © NSW DET 2010

Investigate child’s behaviour and expressed emotions to identify an additional need

When you are working with children and families in children’s services, you will come across children from diverse backgrounds. How will you identify these children’s needs? How will you support those children with additional needs?

As educators, we work with children whose needs are diverse.

You will now learn to develop your understanding of additional needs and how as early childhood educators we can identify children’s additional needs by:

• observing children’s behaviour • sharing of information with families and professionals.

Firstly, what is an additional need?

Activity 1

Activity 2

Activity 3

Diploma of Children’s Services: CHCIC512A: Reader LO 9369© NSW DET 2010

Negative labelsThe term ‘additional need’ has developed as a preferred term when talking about individuals who require additional support to participate within an environment. Over the last century, we have labelled individuals with additional needs as being ‘disabled’, ‘special’, ‘handicapped’, ‘slow’, ‘mentally retarded’ and ‘spastic’.

Say each of these labels (‘handicapped’, ‘spastic’ and so on) to yourself. Close your eyes. What do you imagine when you say those words? Perhaps, doodle a picture of what you imagine. Is it a positive image or picture?

Such stereotypical language encourages us not only to take pity on a person but also to focus on what they cannot do.

Putting people firstAs our society becomes increasingly diverse and with the implications of anti-discrimination legislation, attitudes and values are changing. People with additional needs are viewed as valued members of the community who make great contributions to our society.

Think about some famous people in our society who have made a difference. Did any of these people have an additional need during their lives?

Consider Cathy Freeman who has inspired many sports people to achieve their dreams. She has overcome adversity that is faced by young Aboriginal people in a non-Aboriginal culture. Also consider Louise Sauvage, the gold-medal-winning wheelchair athlete who has shown us that ability is the key—not disability. She can turn the wheels on her chair faster than most of us can run. Eminent scientist and writer Stephen Hawkings has motor neurone disease and needs a ventilator, feeding tube and personal assistants.

With diversity comes difference and, with the acceptance of difference, we are now encouraged to look at a person’s abilities rather than disabilities.

So when we are referring to a child with an additional need, we always refer to the child first. For example, we do not say, ‘the Down syndrome girl Dora’. We would say: ‘Dora, the girl with Down syndrome’—thus emphasising the child rather than the additional need. If Dora’s disability has nothing to do with what we are talking about, just use her name, ‘Dora’. What does it matter that she has Down syndrome?

The term ‘impairment’ is also now widely used to describe a condition that affects a person’s ability to function. However, if you are not sure of what term to use for any particular disability—and whether a particular term is appropriate—try to find out from an association of people with that disability. Take your cue from them.


Sometimes there may be more than one appropriate term used for a person with a disability. Let’s take the term ‘deaf’. Often rather than saying a person is deaf, we would refer to that person as having a hearing impairment—the way that the impairment affects the person is the additional need. However, people in the deaf community would use the term ‘deaf’ or ‘Deaf’ as opposed to ‘hearing impairment’.

Remember that sometimes usage of terms may change. Sometimes what used to be ‘acceptable’ or at least widely used is no longer so. It is a very good idea to keep abreast with any changes to the way terms are used—and, as we have mentioned, to take our cues from the community with the disability.

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Why refer to an impairment at all?When we say, ‘The slow girl, Susan’, we are making two errors. Firstly, the word ‘slow’ comes across as negative, insensitive and value-laden—it’s a word that judges. Secondly, by saying ‘That slow girl, Susan’, we are putting the disability first and the individual last. It much better to say, ‘Susan, the girl with the intellectual disability’—here we are putting the individual first.

However, why not just ‘Susan’? Should we even mention the child’s disability at all? Remember, even when we put the person first and the disability later, we must be careful to say this only when it’s relevant or important to the context of the discussion.

Implications of labelling a childThere has been much debate and concern over the use of categorical labels to describe and define a disability. On the one hand, when we use labels, it makes it easier for us to bring about consistency in communication regarding disabilities. Also, sometimes, we might label a child because we think that will enable us to better understand the child’s behaviour and physical differences. Sometimes we might think that a label will help us work out the person’s needs and what programs and support services to plan for them.

On the other hand, we must be always aware that labels reinforce certain attitudes—attitudes that stigmatise, isolate and stereotype individuals with learning, behavioural or physical differences.

When a child with a disability behaves in a certain way, we immediately say that the behaviour is typical of children with that particular disability. We do not try to first understand what the child’s needs may be and what he or she may be


feeling. The child is not perceived as an individual with individual needs and feelings—but as a ‘type’.

We are also attaching a certain value to the individual—we are saying that the individual is a sum total of their disability. The person is not the disability—the person has the disability. We are not taking into account that the person has other attributes—personality, likes and dislikes, hopes and aspirations, feelings and so on. In other words, we dehumanise the person by labelling them. We perceive them as caricatures—not as human beings with feelings.

With negative and stereotypical attitudes come barriers as well as certain expectations (eg ‘that child cannot do that’). In other words, we have certain expectations (or predictions) of the child’s ability and behaviour—and we are saying that the child is capable of only some things and can never be capable of others. We are also discounting the possibility that the child can develop and change. We are expecting the child to be a certain way—always. Remember that people tend to live up—or down—to expectations. As educators, we must not allow labels to destroy the hopes and aspirations of children with a disability. Instead, we must encourage and support them in what they are interested in doing.

With labelling, we are also not taking into account that sometimes incorrect diagnosis can occur. A little girl I knew was demonstrating, at two years of age, regression in physical ability. After many medical tests, she was diagnosed and labelled with van der Knaap syndrome, a debilitating syndrome where the white matter in the brain degenerates, leading to regression across all developmental areas and eventually an early death.

Imagine the implications if this was your child or if this child attended your service. How would you have felt working with her?

At five, however, this little girl was displaying typical development. The doctors were amazed and have now reassessed her, concluding that she does not have van der Knaap syndrome.

So have our expectations for this child changed? Definitely. Incorrect diagnosis is just another reason why we shouldn’t label a child. Who knows what the future holds for the child? We do not want to limit a child.

Why do we label children?We label children so that they can be eligible for funding and support based on their additional need. This allows children appropriate access to service and support in an equitable way.

All children have additional needs of some kind. It is very easy to see with some children what their additional needs are. With others, it is not so simple. All


children have additional needs (so do all adults). However, what you will find is that some children will require more support than others to have their needs met.

All children, regardless of their additional need, need to feel safe and secure in an environment that supports their growth and development. By providing an appropriate environment, we are recognising and responding to each child’s additional needs.

Why do children have additional needs?Children’s additional needs may arise from:

• language and communication difficulties• cognitive differences • physical differences• sensory impairments• social and emotional differences• health needs• family circumstances and need.

Language and communication difficultiesCommunication is the process of exchanging information between participants. Speech and language are part of communication.

Language is made up of:

• expressive language, ie when we express thoughts, needs and feelings • receptive language, ie when we perceive, interpret and respond to

language.

Speech refers to a child’s ability to produce speech and sounds.

The development of speech and language may be limited in the ways listed below.

The child may:

• not talk at all• babble using long strings of sounds (‘jargon aphasia’)• gesture or grunt to communicate• have difficulty structuring sentences (eg ‘Me have that no’)


• have difficulty producing sounds and speaking clearly so that they can be understood

• have difficulty understanding language.

Many factors and problems can occur when speech and language skills are developing.

• The child might not have an incentive to talk if educators constantly anticipate and fulfil the child’s needs (eg educators may respond to the child’s gesturing and pointing so the child does not see any need to speak).

• Siblings may speak for the child.• The child may have a hearing problem which may be caused by recurring

ear infections or glue ear (otitis media). When there is a hearing loss, sound development can be adversely affected and the child may not be able to hear certain sounds.

• The child may have difficulty understanding language and therefore expressive language is delayed.

• The child may have difficulties feeding—an indication of low muscle tone in the oral region.

• The child may have a medically diagnosed condition (eg developmental delay, cerebral palsy, cleft palate).

• The child may have experienced difficulties at birth or may have been sick after birth (eg lack of oxygen, premature birth, chronic illness).

For some children, speech may not be possible as they have a condition such as cerebral palsy, autism or a severe physical disability. For these children, an alternative method of communication is necessary.

Alternative methods of communicationBelow are some of the more common systems of communication used in disability work. There are many more systems used by communication specialists.

ObjectsThe objects may be real (ie objects that represent or are associated with an activity) or miniature versions.

PhotographsClear photographs of real objects, people or events which may be mounted on a board or in a book or wallet.


Computerised pictographs—COMPIC and BOARDMAKERCOMPIC and BOARDMAKER are computerised published systems of symbols which represent objects, words or ideas. They can be purchased as a software package where the symbols can be printed in varying sizes and colours. Each symbol is usually accompanied by the object or idea represented. A board, book or wallet is used to display the pictures.

Pictographs using sounds and symbolsThis was developed by the Spastic Centre of NSW for children who have cerebral palsy, who understand and respond to language but who cannot communicate with speech. It is a conceptual system consisting of a communication board made up of the symbols, letters of the alphabet, numbers and words that the individual knows and is able to use, and a personalised symbol-to-word dictionary.

Alphabet/word/sentenceThis is a display of printed letters, words, sentences or combinations. The arrangement may be varied to suit an individual’s needs, as may the size and type of printing.

Australasian Signed EnglishDeveloped for hearing-impaired students, this is a system of hand and body movements that are used to represent English. Manual signs and finger spelling are used to mirror the structure and meaning of spoken English. The manual signs and finger spelling are used in conjunction with spoken words. (It would be useful for you to try and access the Dictionary of Australasian Signs and gain some familiarity with the scope of this system.)

MakatonThe Makaton is an essential or core vocabulary that uses words, signs and/or pictographs. It was developed to aid in progressing people with communication impairment from simple concepts to more complex ones.

This is not a system per se but the basis of Makaton language programs used throughout the world with people with communication impairments. The vocabulary is graded into levels so it can be taught in sequence. This is somewhat limited by the lack of word-to-symbol translation—limited to concepts. The concepts are not bound by the rules of grammar.


Australian Sign Language (Auslan)Auslan is a system of visual language—with gestures (signs, body movements, facial expression, gesture, mime and finger spelling). It’s used by the Australian Deaf community as their primary language. It has its own structured word order, grammar and vocabulary—it’s quite different from English.

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Types of speech and language problemsSome children have a difficult time trying to produce speech and language. How do we know whether the language and speech of the children in our service is normal? Assessment by a speech therapist or speech pathologist will tell us whether a child’s language and speech development is age-appropriate.

Remember that diagnosis of a child’s additional need cannot be made by early childhood educators as we are not specialists in this field. If you are concerned about a child’s development and would like to broach the subject with the child’s parents or guardians, speak to your director about it.

You might notice that a child’s speech and language development is obviously behind that of other children of the same age. Generally we become concerned if we are not able to understand about half of the speech of most two-year-olds. With most three-year-olds, we should be able to understand a lot of what is being said (about 75%). By the time the child reaches four, we might be a bit concerned if we cannot quite understand more or less everything the child says. As early childhood educators, we can plan and support a child’s additional needs with appropriate provisions.

SpeechBelow are examples of speech problems. Remember that sometimes the causes are not known.

• The child still leaves out the last sounds in words at three or three-and-a-half years of age (phonological impairment).

• The child cannot make particular speech sounds (articulation impairment). The reasons might include ‘tongue-tie’, cleft palate or an abnormality in the functions of nerves and muscles involved in speech production.

• The child has great difficulty moving their mouth and tongue to produce speech. The child might say the same word in a different way each time they try to say the word. This is one of the characteristics of what’s known as dyspraxia. Remember, however, that not all children with unclear speech have dyspraxia.

• The child stutters (stammers).


LanguageYou might come across a child in your service who has difficulty either understanding when others speak or using language to express their ideas. Their language ability, in other words, is not what you would expect of a child of their age and cognitive ability, especially if the child is not deprived of exposure to language.

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Caregiving strategies for children with speech or language difficultiesWhen working with children who have communication difficulties, it is important that we work alongside parents and other professionals such as speech pathologists, special education teachers and specialists.

The following strategies may assist and support the child with communication difficulties within an early childhood environment.

Be prepared

• Learn about the child’s interests so we as caregivers have a shared knowledge of what children may attempt to talk about.

• Learn Makaton and use this with the child. This promotes expressive language-reducing frustration and provides the child with an immediate form of communication.

• Find out as much as you can from the child’s speech therapist and family about how you can support the child at the service.

Model with good speech

• Simplify language and speak clearly. It is easier to understand and imitate shorter sentences. Cut out unnecessary words and use only important words that carry meaning. For example, instead of saying ‘It’s time for us to have our lunch’, you could just say ‘Lunchtime now’.

• Model sentences that are one or two words longer than what the child is currently using, eg if the child says ‘Tap on’, you could respond by saying ‘Yes, let’s turn on the tap’. Also use lots of repetition when talking.

Explore language through books and rhymes

• Look at pictures in books and talk about them and make up simple stories about them.

• Share books regularly with children and read stories that are repetitious and predictable, eg The Very Busy Spider by Eric Carle.


• Enhance story-telling with props such as felt boards and puppets and encourage children to retell their own stories using props.

• Provide experiences for children to explore language (rhythm and patterns of speech) through simple rhymes and songs. Encourage children to retell the rhymes in their own words.

• Sing with the child. Singing provides opportunities for children to practise language in a safe and non-threatening way.

Literature is a powerful tool for language development

Communicate through games• Play a guessing game with the child by describing an object and asking the

child to guess what it is, eg ‘It has branches and grows outside’ (a tree) or ‘We keep it in the freezer. It is cold. It is sweet. We put it on a cone, sometimes. I like the chocolate flavour’ (ice-cream).

• Play ‘I spy with my little eye...’.• Communicate using a variety of media• Communicate with the child using a variety of forms such as picture cues,

signing, gestures or words.• Label the room with words and pictures and use visual timetables to

support children’s learning of what comes next.• Make a scrapbook of the child’s favourite or familiar things by cutting out

magazine pictures. Group them into categories, such as things to wear, things to ride on, things to eat, things for dessert, fruits and things to play with. Encourage the child to point at each picture and name them. Count the items pictured in the book together with the children.

Reinforce the child’s attempts at speech• Do not directly correct children’s speech errors, and certainly not in front

of other people. Instead, model the incorrect word back to the child in a natural way (as part of the conversation), eg if the child says ‘I want a wowwy’, you could say ‘You want a lolly. OK, let’s get a lolly.’

• Build on what the child says, eg if the child says, ‘Juice’, you can say: ‘Yes, Ali, I have juice. I have orange juice. I have pineapple juice. Do you want pineapple juice?’


• Use baby talk only if it will help convey the message and only if the baby word is accompanied by the adult word, eg if the child says ‘Mum-mum time’, you can say, ‘Yes, Liam, it is mum-mum time—it is lunchtime.’

• Show that you understand what the child has said by fulfilling the request (if that is appropriate).

• When the child starts a conversation, give your full attention whenever possible. Also make sure that you have the child’s attention before you speak.

• Be patient and allow time for the child to tell you things. Pause after speaking. This gives the child a chance to continue the conversation..

• Help the child understand and answer questions that are of interest to the child. You could, for example, begin by asking closed questions such as: ‘Shall we sing now, Mayom?’ and ‘Joseph, do you like ice-cream?’ Later, you can ask open-ended questions, eg ‘How is the apple juice, Caylan?’ and the child might say ‘Nice’.

Give the child a reason to communicateChildren need reasons to communicate. We use language for a variety of reasons: to gain attention, to express ideas, to request assistance. If children are not communicated with or given choices or their needs are always met, they will have no reason to communicate. Below are some reasons for encouraging children to communicate.

• Be interested in the child. Encourage the child to talk about things the child does, sees, feels, knows and likes. Talk to the child about what they are doing. Comment on objects that are within the child’s immediate environment.

• Place a desirable toy or object out of reach so that a child has to request your assistance.

• Encourage the child to say the word (if this is appropriate) rather than point or grunt. If the child is pointing to a toy, for example, you could, as you reach for it, say, ‘What is this called, Brian?’ or you could inject some fun into it by saying ‘Is this a truck, Brian?’ (when it’s obviously not a truck but a car). However, don’t withhold the toy if the child does not respond or name the toy—instead you could say ‘Oh, it's a car, isn’t it?’ (as if you have suddenly realised what it is).

• Set up obstacles that require the child to ask for help, eg give a child a pencil that is broken or a container where the lid is too tight to open.

• Sabotage experiences in a fun way. Don’t provide enough materials for the child to complete the experience. The child will have to request additional materials.

• Withdraw an activity a child is enjoying in a fun way, eg stop pushing a child on a swing and wait for them to ask for more.


• Provide situations where the child is expected to make a choice, eg by offering a child a choice between an apple and a banana at snack time.

Helping a child understand instructionsIt is important in the development of speech and language that children understand what we want them to do.

• Always make sure there is eye contact.• Get down to the child’s level.• Emphasise key words in the direction.• Use gestures or pointing if the child does not understand so this will add

prompt to the direction.• If a child still has difficulty understanding what you are wanting, use

photos or show the child. This will assist the child to understand what is happening in their environment.

• Give a child practice with words for spatial relationships (first, middle and last, right and left). Also use words for opposites (up and down, on and off).

• Keep instructions short and simple. Begin with one-step directions, eg ‘Raj, give me the book please.’ Then build towards two- and three-step directions, eg ‘Raj, go to the bookshelf. Pick a book. Bring the book to me.’

Other support strategies• Do not put the child in a situation where they will have to speak or

practise sounds in front of a big group. • Be aware of any social difficulties the child might be experiencing (eg

other children might be teasing the child or the child might be having difficulty with making friends).

• Design activities that will enable the child to confidently participate. Practice of sounds, for example, need to be on a one-to-one basis.

Children who have a difference in their cognitive development

Cognitive differenceChildren who have differences in their cognitive skills are often unable to receive and process information. Many children with a cognitive difference are frequently overwhelmed and are unable to make sense of what is happening around them.


Cognitive difference could be due to a genetic or congenital abnormality, a trauma or an environmental factor.

A child who has a cognitive difference is often tested and labelled with an IQ (intelligence quotient) score. An IQ test gives a numerical score. The average IQ is 100. It is not compulsory for a child to have an IQ test, but once again having a label provides a significant difference in access to funding and service.

The intellectual impairment is identified according to the degree of difference in cognitive ability. The degree of difference is classified as being mild, moderate, severe or profound. This is based upon a child’s IQ score:

• mild cognitive delay: IQ score of 50–55 to 70• moderate cognitive delay: IQ score of 35–40 to 50–55• severe cognitive delay: IQ score of 20–25 to 35–40• profound cognitive delay: IQ score below 20–25.

Genetic or congenital conditions can lead to a cognitive difference but we need to remember that all children are unique and because they may have a label such as Down syndrome or fragile X doesn’t necessarily mean that they would have differences in their cognitive ability or would be intellectually impaired.

Down syndromeDown syndrome is a condition which results from a disorder affecting chromosome number 21. In a person with Down syndrome, the 21st chromosome contains additional genetic material. There are three types of Down syndrome, the most common being trisomy 21. The other types are mosaicism and translocation.

The physical characteristics of a child with Down syndrome may include a broad flat face, a thick tongue and small nose, a short broad neck, rounded ears, short stature and heart defects. The child may have impairments in their physical, cognitive, social and emotional development. To find out more about Down syndrome visit the following website: www.dsansw.org.au

Fragile XFragile X is an inherited condition that is a genetic abnormality in which the mother is a carrier (fragile X is carried in the X chromosome which children receive from their mothers). Characteristics of fragile X include a long face, large ears, flat feet, poor muscle tone and hyper-extensible joints. A child with fragile X may demonstrate autistic type behaviours, be hyperactive and have some intellectual impairment. To find out more about fragile X visit the following website: www.fragilex.org.au


Other genetic conditionsOther genetic or congenital conditions you may come across when working with children with cognitive differences could include Angleman syndrome, Rett syndrome, Prader-Willi syndrome, Tourette syndrome and phenylketonia.

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Effect of environmental factors on cognitive developmentEnvironmental factors also influence a child’s cognitive ability. The environment in which a child is nurtured can be supportive or detrimental to the child’s growth and development. Delays in children’s development can be related to:

• a lack of opportunity to learn and practise new skills• the child’s exposure to chemicals • damage from drugs in utero such as foetal alcohol syndrome.

Working in early childhood we are well aware that the first three years in a child’s life are the most important and determine the child’s future learning potential.

Trauma can have a significant impact upon a child’s cognitive ability. Children who have experienced extreme events such as shaken baby syndrome or encephalitis often have irreversible damage to the brain. I once worked with a child who, as a young baby, was shaken and physically abused. At two years, this child could not see. She had limited movement and just laid lifeless, as if gazing into space. This made me feel extremely sad—the child’s potential was limited by an act that could have been avoided.

Use of the term developmental delayChildren who cannot be given specific diagnoses are often labelled as having a developmental delay. A developmental delay may be in one specific area of development such as cognitive, physical or language. Global developmental delay is across two or more developmental areas, eg language and cognitive.

GiftednessWhen we identify differences in cognitive ability we also need to consider the child with above-average intelligence. A child is labelled gifted when the child has a level of intelligence or creative ability that is significantly above age and stage expectations.

Children who are gifted may demonstrate some of the following characteristics:


• masters new skills with speed and accuracy• is attentive and alert• uses a large vocabulary of words• meets developmental milestones early—significantly before peers• is able to follow complex directions • asks lots of questions.

Gifted children also need additional support

A child who is gifted will require additional support within the early childhood environment to have their needs met. Additional support may be required to meet needs of boredom, over excitabilities, heightened sensitivity, frustration, perfectionism and to develop friendships. To find out more information about giftedness, visit the following website: www.nswagtc.org.au

Caregiving strategies for a child with a cognitive difference

• Model to children; allow children to copy one step at a time.• Break tasks into smaller steps and scaffold children’s learning. Work out

what you want the child to do and break the task into small, achievable steps. This will allow the child to achieve success.

• Use repetition and practice. It is important that the child be given opportunities to practise skills in a variety of settings at home, at preschool, playgroup and early intervention.

• Always use the child’s interests as a basis for learning.• Use positive reinforcement, giving lots of meaningful verbal

encouragement.• Give the child opportunities to experience success; ensure that

experiences that are provided are at an appropriate achievable level for the child.

• Provide structure and consistent routine for children so that with practice they can develop an understanding of what is happening during the day.

• Give the children lots of visuals to support them within the early childhood environment. Implement visual cues and visual aides to assist the child’s understanding.


Caregiving strategies for a child who is gifted• Provide opportunities for the child so they are mentally challenged. • Plan experiences based upon children’s strengths and interests.• Provide an environment that is safe, secure and supportive for the child. • Use an appropriate level of language when communicating with the child.• Talk about feelings with the child—eg ‘You might feel annoyed or

frustrated when John tells you that the colour is blue when it is aqua’.• Support the child to make friendships. It may be appropriate sometimes

to group the child with older children who have similar interests.

Children with differences in their physical development All children have differences in their physical abilities. Some children are extremely active and physically competent in all that they do while other children are awkward and clumsy and prefer to avoid physical activity.

Sometimes physical competence is achieved as a result of a lot of opportunities for physical activity. For example, a child living on a farm may spend the weekends chasing sheep, swimming in the river and climbing trees. This child’s physical ability would more likely be refined and the child would be extremely competent in gross motor ability compared to a child who lives in the inner city and spends most of his time indoors playing computer games. However, the child who plays computer games may have enhanced fine motor skills. In other words, children sometimes have physical differences that relate to opportunity and experience. Therefore we need to ensure that children have the time and space that will enable them to be challenged to explore and practise new skills.

The term physical disability describes a person who is limited in their mobility. This could be due to a person being orthopedically impaired or impaired due to health.

Physical disabilities impact on children’s independence to complete tasks and participate fully in programs. Physical disabilities result in movement difficulties to some extent and are classified by the severity of the impairment into mild, moderate or severe.

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Types of physical disabilities The most common physical disabilities include cerebral palsy and spina bifida. Other physical disabilities you may come across could include:


• muscular dystrophy—www.mda.org.au• osteogenesis imperfecta—www.oiaustralia.org• paraplegia and

quadriplegia—http://www.paraquad-nsw.asn.au/page.asp?partid=1

Use the relevant websites to explore these conditions.

Spina bifidaSpina bifida is a congenital condition that occurs before birth. Spina bifida is when the neural tube fails to close on the baby’s back; the bones of the spine are not completely fused. As a result, the spinal cord and the protective sac that surrounds the cord may protrude through an open part of the spine.

Symptoms associated with spina bifida vary depending on the position of the opening along the spine and how much of the spinal cord or protective sac protrudes through the backbone. If only the sac protrudes, the condition is less severe than if the cord itself and the associated nerves protrude and are damaged. The condition is less severe when the opening is higher along the back.

If you would like to find out more about spina bifida, go to the following websites:

www.asbha.org.au

www.northcott.org.au

Cerebral palsyCerebral palsy is a term used to describe a group of chronic conditions affecting the body’s movements, muscle coordination, muscle tone and posture. There are a variety of forms of cerebral palsy.

Cerebral palsy is caused by damage to one or more specific areas of the brain which usually occurs during foetal development, during birth and during infancy. The extent of the damage to the brain determines the degree of tension or resistance to movement (muscle tone) which can be mild to severe and may also result in other debilitating conditions such as sensory impairments, communication impairments, learning problems, seizures, ADHD, vision impairments, and hearing and intellectual impairments.

If you would like to find out more about cerebral palsy, visit the following websites:

www.northcott.com.au

www.tscnsw.org.au

http://www.thespasticcentre.org.au/


Children with multiple disabilitiesSome children have multiple disabilities. This would mean that a child may have severe physical disabilities as well as delays in other areas such as cognitive or language development. These children often also have health problems associated with their conditions. Health problems could include being unwell, epilepsy or illnesses associated with their physical disability, eg a child with cerebral palsy may have difficulty expelling air from their lungs and may need to have excess fluid drained daily.

Caregiving strategies for children with physical differencesIt is important to work cooperatively as a team with all who are involved in supporting the child. This will include parents and other professionals such as physiotherapists, occupational therapists, special educators and medical specialists. It may also include resource specialists from the Spastic Centre, the Northcott Society and Paraquad NSW.

Some caregiving strategies:

• Ensure you are competent using appropriate lifting, handling and positioning techniques.

• Ensure the environment is friendly for the child and promotes active participation for the child.

• Learn how to use equipment such as wheelchairs, walkers, standing frames and seats.

• Offer appropriate stimulating materials, equipment and experiences for the child. It is important to adequately reflect the child’s level of development when planning.

• Provide developmentally appropriate activities and experiences with challenges as well as opportunities for success.

• Encourage a positive self-image and high self-esteem. Always emphasise the child’s uniqueness and ability.

• Ensure that children are actively involved in experiences and not left as observers.

• Help children express emotions such as frustration.• Encourage social interaction between the child and all children at the

service.• Establish trust and meaningful relationships with the child so that the

child feels safe and secure within the environment.• Never talk about the child in front of the child or in front of other children.


Children who have differences in their sensory abilitySenses are the parts of the body that send important messages to the brain about the world around us. Our senses include our sight, our ability to smell, taste, hear and feel through touch. A sensory impairment can be described as our senses not functioning as they were meant to. Children who have differences in their sensory ability may have a hearing impairment, a visual impairment or may be tactile-defensive (ie, resistant to any form of contact on his skin).

Close your eyes and type your name backwards. How did you go? What would it be like to have a sensory impairment?

Visual impairmentA visual impairment is the limitation in one or more functions of the eye or vision system. There are various types of vision impairments so it is important that you understand each child’s individual impairment.

There are different eye conditions that create different problems for children. They include:

• congenital blindness—this means that a person is born with no eyesight. This could be due to complications during pregnancy or at birth. Hereditary blindness is transmitted genetically.

• blindness which occurs due to an accident, tumour, infection or disease• nearsightedness—where a person can see things up close but has

difficulty seeing things at a distance• farsightedness—where distance vision is good but there is difficulty seeing

up close• astigmatism—this may occur alongside nearsightedness or farsightedness.

A person with astigmatism has blurred vision. The cornea is of an irregular shape—it is oval like a football when it should be spherical like a basketball, causing light to focus on two points in the back of the eye instead of one point—hence the blurred vision. Sometimes the cause is not the irregularly shaped cornea but the irregularly shaped lens (behind the cornea).

• colour blindness—a vision impairment that is genetic and impairs a person’s ability to distinguish between colours.

To find out more about visual impairment, look at the Royal Blind Society’s website: www.rbs.com.au

There are many variations in vision. Do you have 20/20 vision?

Learning needs of children with visual impairmentChildren need good vision to explore their environments and to learn about the world in which they live. How do you learn? For those of us who can see, we can


learn by seeing things being demonstrated or by observing. People who have a visual impairment depend on other styles of learning such as auditory learning. It is up to us to provide environments that are conducive to children’s styles of learning.

Indicators that a child may have vision impairment may include:

• one or both eyes have a persistent discharge• a turned eye or a shaking or wondering eye• the child frequently rubs their eyes• the child squints when looking at objects• extreme sensitivity to light or glare• tilting or the head when looking at objects• holding books or objects extremely close to the eyes or sits close to

objects• the child loses the place when reading• difficulty seeing things at a distance or at close range• complaints of headaches or sore eyes, double vision or blurred vision.

Hearing impairmentHearing loss is an impairment of the ability to receive sound. There are two types of hearing impairment:

• sensory neural hearing loss • conductive hearing loss.

Sensory neural hearing loss is permanent and is mostly associated with nerve damage. Hearing aids may assist some children with sensory neural hearing loss. Other children may communicate through signing. In Australia Auslan is the language of the Deaf community.

Conductive hearing loss occurs when there is interference with the sound entering the ear. The loss can be permanent or temporary.

One type of temporary conductive hearing loss is otitis media or 'glue ear' which is an infection of the middle ear. There is a build-up of fluid within the ear resulting in a blockage in the Eustachian tube—thus fluid cannot escape. Children with otitis media will sometimes have grommets inserted into their ears to drain the excess fluid.

Some other types of conductive hearing loss are a result of excess wax, ear malformations and fluid behind the ear. These can also be treated with surgery or with the use of hearing aids.

Indicators that a child may have a hearing impairment:

• The child may suffer frequent coughs, colds or throat infections.


• The child may have recurring ear infections and a history of ear problems.• The child’s ear may appear to be blocked, and the child may snore and

breathe through their mouth.• The child may be irritable or may pull at his or her ears.• The child may appear to daydream.• The child may prefer to go close to the speaker and watch the speaker’s

face intently.• The child may not hear when they are being called and may

misunderstand or be slow in responding.• The child may give inappropriate answers when asked a question.• The child may be inattentive and restless.• The child may be withdrawn and may not play with other children.• The child may have poor concentration and may become tired easily.• The child’s speech may be unusually soft or loud or indistinct.• The child may have little or no speech.

For more information on hearing impairment, the following websites may be useful:

www.ridbc.org.au

www.aad.org.au

Caregiving strategies for a child with a sensory differenceChildren with sensory impairments often use other senses to compensate for impairments. It is important that early childhood educators ensure that they provide an environment that supports the child’s full participation in the program.

The strategies listed below may assist you but it is also important to access specialists with expert knowledge of sensory impairments.

For a child with a visual impairment:

• Identify yourself—don’t assume the child can tell it is you from your voice.• Use the tone of your voice to give extra information.• Introduce everyone who is present. We could model to children to say,

‘Hello, it’s Jessi-Lee’ when they enter play areas.• Speak naturally and clearly.• Use everyday words.• Avoid statements such as ‘See how nice the water looks’. Instead, you

might say, ‘Feel the water’. For obvious reasons, do not say things such as ‘Look!’, ‘See’ and ‘Watch’.

• Accompany all actions with short, descriptive statements.• When reading stories, pass around objects associated with the story (eg

toy animals, flowers or pieces of fruit).• Use mats to define play areas.


• Ensure there is good lighting. Reduce glare.• Use contrasting colours that make it easier for the child to see (eg black

and white puzzles). Be aware that some colour combinations may be difficult to see for someone with a visual impairment.

• Provide a safe indoor and outdoor environment (eg paint the front edge of steps with a white strip to make them easier to see).

• Help the child to become familiar with the outdoor and indoor environments.

• For a child with a hearing impairment• Before talking to the child, direct the child’s attention to you and your

voice.• Have the light on your face and not in the child’s eyes.• Face the child when talking to them.• Don’t exaggerate your speech or lip patterns. Speak in a strong, normal

voice.• Don’t obscure your face: make sure it is visible to the child and provide

non-verbal cues such as facial expressions and gestures.• Support children’s methods of communication. Become competent in

managing hearing aids and other specialist devices such as FM systems, loop systems and Easy Listener.

• Read stories that are inclusive of children with hearing impairments. Suggested titles include: Arabella: The smallest girl in the world by Mem Fox and I’m Deaf and It’s Okay by Lorraine Aseltine, Evelyn Mueller and Nancy Tait (focuses on the feelings and needs of a boy with hearing impairment and how people learn to respond to his needs).

• Attend training sessions and gather information on hearing impairments.• Reduce noise within the environment (eg carpet on the floor and curtains

on windows can reduce noise conduction).

Children who have differences in their social and emotional developmentWhat is meant by social and emotional development?

Social development is the development of our ability to interact and communicate with others. Our emotional development relates to our feelings.

Social normsSocially there are many differences between us. Some people like to be social butterflies; they prefer to be constantly with other people going out and meeting and making new friends. Others prefer to have time to themselves—to reflect and to be alone. This is all part of our own unique personality and this is what makes us different.


It’s great to be different and to acknowledge difference; but within our society, we are also expected to comply with social norms and expectations. For example, you would most likely say ‘thank you’ if someone opened the door for you and you wouldn’t hold your hands over your ears and squeal on a crowded bus. These behaviours would not be socially appropriate.

When I was studying at university we had to complete a task that involved catching a train into the city with a brown paper bag over our heads. One person was given the task of placing the bag over their head while the rest of us observed people’s reactions. One thing we did discover was that it wasn’t socially appropriate to catch a train with a brown paper bag over your head. Other train commuters became concerned, shaking their heads, pointing and gasping and even a few asked the paper bag wearer if they were alright. We clearly identified that within a society we have social norms and if you step outside those norms, concern is given about your wellbeing.

Children who have differences in their social and emotional development may demonstrate a variety of behaviours that are inappropriate for the situation—for example, a child who sits silently rocking in a corner every day while other children play or a child who always screams inconsolably whenever she is moved away from a particular toy.

Inappropriate social behaviour may include persistent crying, being withdrawn, being destructive, shyness, insecurity, being frustrated, being unhappy, not cooperating, irritability and not having friends.

A child might demonstrate these behaviours every now and again. This does not mean that the child has a social or emotional difference as we all have different times in our lives when we require different amounts of support for our social and emotional wellbeing. However, some children have a greater need in the development of their social and emotional abilities. This may be due to genetics or environmental conditioning. What do you think?

Think about your family or people you are close to. Are there similarities and differences in your social and emotional makeup?

I know I am a sulker when I get upset. I like to be alone and secretly hope for condolence. I've just noticed recently that my daughter demonstrates the same behaviour when she becomes upset. Is this genetic or environmental, I wonder?

Autism spectrum disorderAutism spectrum disorder is a term used to describe a range of conditions that affects a person’s ability to process information. The term encompasses Asperger’s syndrome. Autism spectrum disorder affects approximately one in 1000 Australians, with four times as many males affected than females. Autism is


present at birth but is not often diagnosed until a child is around two to three years old. There is no specific test to diagnose autism spectrum disorder. In Australia, diagnosis is collaboratively made by specialists, parents and teachers.

Children with an autistic spectrum disorder have difficulty with social, emotional and communication skills. They are also likely to have an intellectual delay. They are delayed in expressive and receptive language and display unusual behaviour patterns. Patterns of behaviour include:

• impaired social skills • little or no eye contact• little facial expression• little gesturing• insisting on sameness, eg the same cup, plate, seat, etc• impaired speech or lack of speech• impaired understanding of what is happening around them• a lack of empathy• an inability to form friendships • repetitive and unusual play, eg lines up toys, plates and pillows• taking words literally, eg the expression ‘pull up your socks’ creates great

confusion and anxiety for the child wearing no socks• absorption in special interests, eg Thomas the tank engine• clumsy movements• limited imagination, eg doesn’t realise that a fork could also be used to

stir a coffee• no interest in other children • unusual body movements such as flapping or walking on tiptoes• sensory sensitivities to sound, touch, taste or smell.

If you would like to find out more about autistic spectrum disorder, the following websites may be useful:

www.autismnsw.com.au

www.autism-resources.com

www.suelarkey.com

Asperger’s syndromeThe child with Asperger’s syndrome—which is often described as the less severe form of autism—often has expressive language but has difficulty in social relationships and interaction. A diagnosis is made often around school age—ie five to six years of age. These children often have intelligence that falls in the average or above-average ranges and sometimes within the gifted range.


Attention deficit disorderChildren with a diagnosis of attention deficit disorder (ADD) or attention deficit disorder with hyperactivity (ADHD or AD/HD) may demonstrate an inability to concentrate or remain on task to a degree that is considered inappropriate for the child’s age and stage of development.

However, just because a child is overactive and loud doesn’t necessarily mean that he or she has ADD or ADHD. It is a disorder that is often diagnosed in early childhood and can be managed well with treatment that may include medication, diet modification and behaviour management strategies.

The characteristics of ADD or ADHD include:

• impulsitivity• lack of concentration• difficulty organising oneself• easily distracted• excessive physical activity• poor social skills—including having difficulty with turn-taking.

To find out more about ADD and ADHD, visit the following websites:

www.chadd.org

www.add.org

www.disability.vic.gov

www.healthnsite.gov.au

Mental illnessMental illness can be defined as a disease of the mind. It affects the way people cope with life. In our community, many individuals suffer from mental illness and lead full and active lives.

Mental illness is becoming increasingly prevalent during childhood. When working in early childhood, you may observe differences in children’s mental health.

There are several mental illnesses that can affect a child. These include anxiety disorders, schizophrenia, mood disorders and eating disorders. Disorders must be diagnosed by professionals in consultation with parents and teachers. Professionals consider signs and symptoms in relation to the child’s developmental level and the child’s physical and social environment.

Symptoms of a mental health disorder may include:

• difficulties with concentration


• withdrawal• illness• unpleasant thoughts• aggression• hostile behaviour• anger towards others.

Most people can manage differences in their mental health with medication, education and therapy.

To find out additional information about mental health and illnesses, visit the following websites:

www.headroom.net.au

http://www.nimh.nih.gov/

Caregiving strategies for children with differences in their social and emotional developmentChildren with social and emotional differences need to feel safe and secure to participate in the early childhood environment. As early childhood educators, we can offer support to children through implementing appropriate strategies that have been developed in collaboration with parents, teachers and specialists. We can provide an environment that supports the child’s full participation in the program.

The following strategies may assist you to support a child with a social or emotional need.

• Model and directly teach appropriate social behaviours, eg say ‘Stop’ if we don’t that, or show someone that you are listening when they are talking (eyes up, looking and sitting still).

• Provide a secure and supportive environment that has an appropriate level of structure for the child.

• Provide experiences that give the child independence and choice and allow the child to achieve success.

• Use the child’s interests as a basis for planning. For example, if we want a child to play alongside other children and if the child’s interest is farm animals, you could have a provision for a small group of children which included farm animals in the water trough with grass, hay and leaves. This may encourage the child to play alongside peers.

• Be consistent and make the child’s routine predictable. You could implement a visual timetable to support the child’s movements between experiences.

• Be aware of the child’s concentration and attention span and plan experiences according to this.


http://www.headroom.net.au/

• Practise skills in small doses frequently and break complex skills into simpler skills to aid learning.

• Be prepared to repeat tasks to assist in the child’s concept development. • Children may require hand-on-hand support with specific tasks such as

opening and closing scissors. This support will build pathways in the child’s brain and assist the child to manage the task in future.

• Model communication skills and use communication that is appropriate for the child. Speak clearly and use fewer words, or support speech with signs.

• Establish eye contact when communicating.• Use objects and actions to support your communication.• Establish trust with the child and help to make the centre a safe place.• Be positive, warm, accepting and encouraging to the child.• Be consistent and reliable in your management of the child’s behaviour

and establish clear behavioural limits.• Positively reinforce appropriate behaviour.

Health needs Many children have health problems that impact on their development. It is up to the early childhood educator to acknowledge differences in children’s health and to implement appropriate strategies to support the child in the early childhood environment.

Asthma, allergy and anaphylaxisAsthma, allergy and anaphylaxis are life-threatening conditions.

Asthma is an incurable respiratory disease where airways narrow, thus inhibiting a person’s breathing. The symptoms of an asthma attack may include rapid, shallow breathing, wheezing and coughing. Asthma is often triggered by exercise, illness, stress, the climate or allergy (eg pollen, dust and certain foods). Asthma can be managed and treated with medication and education.

An allergy is sensitivity to a substance which causes the body to react to it. Allergies are extremely serious as they can cause an anaphylactic reaction. Symptoms of an anaphylactic reaction include tingling or swelling of the lips, throat or tongue, severe itching of the skin, vomiting, pain, heart failure and unconsciousness.

A person who is having an anaphylactic reaction needs to be treated with adrenaline and taken to hospital. Children with severe allergies often carry epinephrine (adrenaline injector), popularly known by the brand name EpiPen®,


which can be administered by a trained caregiver. An ambulance needs to be called.

Prevention is the key for anaphylaxis. We need to ensure that children’s allergies are identified and appropriate strategies for control are implemented within the early childhood service.

To find out more about asthma and allergies, visit the following website: www.chw.edu.au

DiabetesChildren are diagnosed with Type 1 diabetes when their pancreas is unable to make enough of the insulin required in the body to convert the sugars we eat into energy. The sugar stays in the blood—this causes the blood sugar level to become abnormally high. When this occurs the child becomes extremely unwell—symptoms may include weight loss, tiredness, being unwell, dehydration, excessive thirst and excessive urination. Treatment for children with diabetes includes giving insulin through injections, implementing a healthy eating plan, exercise and the monitoring of blood glucose levels.

To find out more about diabetes, visit the following website: www.diabetesaustralia.com.au

EpilepsyThis is a condition that can affect people at any stage of their lives. Epilepsy in children is a very serious condition which requires consistent monitoring by health professionals.

Epilepsy is a condition where there are repeated periods of distorted electrical activity in the brain. There are a variety of symptoms, depending on which part of the brain is involved. Symptoms include seizures of varying degrees, daydreaming and/or being confused or dazed. If you encounter a child having an epileptic seizure, call an ambulance and administer appropriate first aid. To find out more about epilepsy, visit the following website: www.epilepsy.org.au

Chronic illnessChronic illness can impair children’s development in many ways depending on what part of the body is affected. The child may have difficulty preforming tasks associated with daily living and may not be able to complete tasks they were once able to do. Chronic illness places enormous stress on a child and on their families. As early childhood educators we need to be available to provide support for the child and family.


The following children’s hospital websites give information on how we can support children and their families who are suffering from chronic illness.

www.chw.edu.au/

www.sch.edu.au

Caregiving strategies to support a child with a health needChildren who are suffering from illnesses and who have health needs require caregivers who can offer support, who are caring, empathetic and understanding. It is important that caregivers are familiar with the condition and that they provide accurate information to parents.

Some caregiving strategies:

• Be available to talk to parents and educators.• Be resourceful—eg arrange for guest speakers or support groups to visit

the service.• Ensure you have accurate, up-to-date information about the condition.• Seek support from professionals for the family and caregivers.• Set up the environment so it meets the needs of the child (eg calm and

relaxing).• Read stories to all children about sickness and hospitals.• Encourage all children to ask questions and to talk about how they feel in

relation to their friend’s illness.• Provide play experiences where the children can express their feelings, eg

dramatic play.

Activity 9


Observe the particular child, identify and document needs for additional care and use to develop a plan of inclusion

How do we identify children with additional needs? Some additional needs are visible while others cannot be seen. You have just completed study about different types of additional needs and as you can see there is not an easy method to identify a child’s additional need. Identification of children’s needs must occur in collaboration with educators, teachers, parents, families, specialists and professionals. Identification of need can only be made after appropriate observation of the child in relation to what is known about typical child development. Diagnosis of a child’s additional need cannot be made by early childhood educators as we are not specialists in this field. However, we can plan and support a child’s additional needs with appropriate provisions.

Maslow’s hierarchy of needs

Maslow's hierarchy of needs

In this element of study we refer to Maslow’s hierarchy of needs as a tool to demonstrate the needs that all children have. It also assists us to support children’s additional needs.


Maslow’s hierarchy demonstrates that all children have needs which must be met for the child to develop to their potential. The hierarchy of needs clearly demonstrates that we must have our lower needs met first before level 5 needs can be met.

Level 1: The need for essential body requirements—food, water, shelter and warmth

We need to ensure that all children have:

• appropriate clothing to protect them from the weather• somewhere to rest • appropriate food and drink to keep their bodies healthy so that they grow

and develop.

Level 2: The need for physical safety, security and protection

We need to ensure that we provide a safe environment for all children. This includes the physical safety of the environment and the protection of all children.

Level 3: The need for love attention, closeness to others and the need to belong

We need to ensure that meaningful relationships are developed with children. Children need to be loved and to have attachment to others. A child needs to feel safe, secure and supported to grow and learn within an environment.

Level 4: The need to feel valued by others, to be accepted and appreciated, to be worthy and to have status (self-esteem)

We need to ensure that children know that they are valued and appreciated by us. Children need to belong and be told that they are a significant part of the service. We need to enhance and promote children’s self-esteem. We want children to feel confident and have opportunities to achieve success.

Level 5: The need to realise one’s potential (self-actualisation)

We need to ensure that children have opportunities to learn new things and develop towards their potential.

Case study: SharniSharni is four years and four months old and is an only child. She attends the Curran’s Children’s Centre two days a week for half a day each time.

Sharni, at 18 months, had meningitis. She has epileptic seizures, for which she is seeing a paediatrician. No other diagnosis has been made. The professionals working with Sharni include the centre staff, early intervention centre staff, an occupational therapist and the Spastic Centre.


Sharni gets extremely distressed when Mum and/or Dad leave, spending much of the day crying. She is not interacting with other children and does not initiate any communication with educators or children. While at the centre, Sharni takes little interest in the things around her and she will occasionally mouth objects. Sharni is not mobile.

Using Maslow’s hierarchy of needs as a guide, let us identify areas where Sharni may require additional support. We should also consider what additional information we would like to know to clearly identify additional support required by Sharni.

Level 1: The need for essential body requirements; food, water, shelter and warmth

Sharni’s needs:

Sharni would require additional support with mobility, toileting, feeding and dressing. We would need to consider her movement within the environment and her physical positioning at experiences so that she can observe and have opportunities to explore provisions. Sharni would require assistance with eating and we would need to determine appropriate foods, eg soft foods, finger foods, likes and dislikes.

Questions we will need answers to:

• How is Sharni able to move around within the environment? • Does Sharni require modified equipment?• How can Sharni participate fully in the program?• What additional care needs are required to support the toileting process?• What support is required with feeding? Are there special foods?

Level 2: The need for physical safety, security and protection

Sharni’s needs:

Sharni would require additional support to ensure her physical safety within the service. Sharni would require protection in regard to movement within the service. For personal safety in the management of epilepsy, staff would require training to deal appropriately with a seizure.


• What are safe handling techniques when moving Sharni?• Are there environmental triggers that set off seizures?• What first aid is required when Sharni has a seizure?• Is medication required during the day? • What are the side effects of medication?• How can we provide a safe environment for Sharni?

Level 3: The need for love, attention, closeness to others and a need to belong


Sharni’s needs:

Sharni would require support in the development of her social and emotional needs. Sharni requires additional support to develop a sense of belonging. She needs to be provided with opportunities to be close to others and to develop relationships and attachments with peers and staff.


• How can we support Sharni’s transition to the service to minimise distress?

• What are Sharni's interests?• How can we ensure Sharni is physically able to participate fully in the

program?• How can we provide Sharni with opportunities to interact with peers?• How does Sharni communicate her needs and wants?

Level 4: The need to feel valued by others, to be accepted, appreciated, to be worthy and to have status (self-esteem)

Sharni’s needs:

Sharni needs support to feel part of the service for her to develop relationships with adults and peers and to be seen as a valuable member of the group. She needs to be able to see herself in a positive light, to develop a sense of self and to have opportunities to become competent and develop her independence.


• What opportunities can we provide for Sharni to experience success?• How can we use Sharni's interests to promote play with peers?• How can we educate children and staff about Sharni’s condition?

Level 5: The need to realise one’s potential (self-actualisation)

Sharni’s needs:

Sharni requires additional support to participate in experiences that are developmentally appropriate for her age and stage of development. Experiences that support her growth and development and provide opportunities for success will enhance her satisfaction of self and will encourage her to aspire to new things.


• What additional support is required within the service to ensure provisions are conducive to Sharni’s growth and development?

• How can the service access up-to-date information to support future opportunities for Sharni?


Information from observationsHow do we gain information about the whole child in the early childhood environment? We observe.

To gain information about the child’s interests, strengths and needs we observe children: the more we observe the more we learn.

Observations are ongoing and they are crucial to successfully plan for the child. The various techniques and methods of observation we use in children’s services include anecdotal records, diary records and time samples, running records, checklists, photographs and video.

Types of observations and situationsTo gain an overall picture of the child, we should include a variety of different types of observations in varied contexts and environments.

When observing in a wide variety of situations, you need to ensure that they are familiar to the child. You will find that most children will react differently in unfamiliar situations, eg during tests. To give you an example, my daughter in Kindergarten was given a test of 56 sight words. At the bottom of the sheet the teacher recorded a score of 14/56. I asked her to read the words to me while we were sitting at our kitchen table one night after school. She got 28/56. This was a more than significant improvement. Why do you think this might have been? I personally wonder about the testing situation. Was it in a crowded classroom with lots of distractions, or was it in an unfamiliar room with an unfamiliar person? Also the question must be asked about the relevance these words have to the child—this, however, is a whole different debate! Needless to say, when a child improves her performance to such an extent, there is very likely a good reason. Consider this if you ever put a child in a testing situation. When we are observing children, we really want to get a comprehensive and accurate picture of the child.

The following points need to be considered when observing children with additional needs.

• Observations are easier when you have a good understanding of child development.

• Never make assumptions about the child’s needs based on a label.• Always gather information and observe each child (not their condition) to

determine individual needs.• Observe children in a wide variety of situations that are familiar to the

child. Avoid testing the children.• Observe all areas of development and focus on the particular interests of

the child.• Observe each skill on several occasions.• Make sure the observer is accurate and objective.


• Consult with other relevant people, especially family members and professionals.

Once we have observed the child, we are then able to collate information collected and formulate a child profile. A chid profile identifies a child’s interests, strengths, emerging skills and needs. Once again it is very important you consult with parents during this process.


Discuss concerns with others to develop a clear understanding of a particular child’s needs and use this information to plan

To fully understand individual children and to identify their additional needs, we need to know them and have a relationship with them. Children are unique individuals who respond and behave differently in different environments.

I once came across a four-year-old child who would not speak while she was at the service, not one word. We were extremely concerned about this child’s language development but after consultation with her family, we learnt she was a chatterbox at home. Our focus was no longer her language development. We needed to make this child feel safe and secure within the environment so that she would feel comfortable to speak.

This situation demonstrates that to truly understand a child, we must have knowledge of the children in all their environments. To do this, we must get to know the person who knows the child best and who observes this child in many environments. This person is usually the child’s parents or primary caregiver.

Information about a child’s background and situationTo gain the whole picture of the child we need to find out about their background and current situation. Once again, discussion with the primary caregiver is the most appropriate source for this information.

Information gained from a parent may include:

• medical history • special care needs• specialists who the child visits• the child’s interests • other activities the child participates in during the week• the family situation


• number of siblings and people living at the home.

The child’s file and enrolment form at the service can also provide valuable information about the child’s background.

Consulting with parents and primary caregiversParents are the best source of information about their own children. When parents first visit the service to ask about the placement of their child they will usually talk with the co-ordinator or director. In this conversation, the co-ordinator will usually find out some basic information about the child. This information itself may be sufficient to indicate the child has additional needs.

There will be times however, when you have not been provided with information about the child’s additional need, and this only becomes evident after they have already joined your group. There are a number of reasons why parents might avoid mentioning their child’s additional need:

• parents who have children with developmental delays or behavioural challenges may have already experienced so much rejection that they are afraid to be honest with you

• parents may be afraid that if there is something ‘wrong’ with their child, they will not be accepted into the service

• parents may see their personal circumstances as none of your business • parents may not be aware themselves that their child is different in any

way to other children • parents may be in a state of ‘denial’, and rationalise their child’s

additional need by suggesting that all children are different, and their child will soon ‘catch up’ or learn to behave like other children

• parents may feel that they will be blamed for their child’s additional need, and that they will be identified as ‘failures’ as parents

• parents may feel ashamed that their child has an additional need

When you have not been provided with sufficient information to help you plan for the child’s additional need, you may feel as if you have been ‘thrown in the deep end’. It is not surprising if that makes you feel resentful, or even angry, but it is important to try to identify how the parent must be feeling. It can be a very painful experience for parents when they begin to realise that their child’s development is different to that of other children. It is not unusual for parents to initially deny any possible difference. This ‘denial’ may persist over time. If parents are in a state of denial and you persist in describing the difference, the parents will often react defensively, and either ignore what you are saying or respond angrily because you are trying to destroy the illusions they have about their child. It may take some parents a long time to move beyond this stage and be ready to communicate with you about their child’s needs. It is important to be supportive, accepting and understanding no matter what stage a parent is at, sometimes they


just need time, other times they may never accept the situation. Avoid judging the parent, we will never know the journey they have walked or are walking, even if similar experiences have happened to you, there are always differences.

Whereas some parents may initially try to cope with their child’s additional need by denying it, other parents may feel frightened. They may feel ashamed that there is something ‘wrong’ with their child. When communicating your concerns to these parents, you must always provide reassurance that difference is not ‘wrong’ and being different is not something that we should be ashamed about. Rather, we should welcome opportunities to be different, and to be with people who are different. Parents will also need reassurance that they are valued as parents; that their expertise in relation to their children is needed, and that you can be equal partners in providing the best opportunities for their child.

Of course, not all parents will avoid mentioning their child’s additional need. There are many parents who have moved beyond the initial feelings of shock, denial, sadness, and grief that they may have experienced when their child’s additional need was first identified. They will be quite honest and open about their child’s needs, and will be very willing to work with you. It is still important to remember however, that parenting a child with an additional need can be very difficult, and can impact on the whole family. Parents will often be under a lot of stress, as they try to provide physical care for the child, juggle appointments with therapists, and care for other members of the family. They also may be feeling anxious or guilty about placing their child in care. Keep in mind that:

• The parents may have goals and aspirations for their child that you do not think are achievable. This does not mean they are in ‘denial’ – they are simply looking toward a positive future.

• Parents may become ‘emotional’ at times. This does not mean that they are not coping – they are simply showing their feelings.

• Parents may disagree with the way you are working with their child, or ask you to explain why you do things a certain way. They are not being difficult or critical—they simply want what is best for their child.

Activity 10

My Blonde Haired Blue Eyed Boy

A very memorable day, the eleventh day of May.Not only was my son born but it was also Mother’s Day.

He was quickly placed in my arms where we cried tears of joy,I could hardly believe I had given birth to a Blonde Haired Blue Eyed Boy.

Josh was equal to his peers with his sit, crawl, walk and mime.The best thing he had going for him was he knew how to have a good time.It was when he was a little older, I picked up his lack of speech.


Then it suddenly dawned on me he couldn’t tell me when things were out of reach.It was soon suggested we could get help at Early Intervention.

Where soon after arrival he was put under close observation.I was extremely pleased with the attention that he got.

They couldn’t tell me what was wrong but guaranteed him a spot.We went to see a paediatrician, who observed Josh and offered a toy.

All I could wonder is there something wrong with my Blonde Haired Blue Eyed Boy.

We gave a detailed history. I was impressed with the way Josh did act.But now looking back the paediatrician must have known what was fact.

Off to Sydney we did go as suggested by the doctor.Josh needed to be seen by a social worker, psychologist and professor.

It was a scary time for all, and I was feeling glum.But it suddenly occurred to me, Josh had just learnt to say Mum.

We went to the assessment and was feeling positive in many ways.It started with background, history and how Josh spends his days.

Then came the observation and testing behind a one way screen.That’s when it started sinking in, the behaviour that was seen.

Finally we were called to have a final chat,Among all the professional staff, I was somewhat lost in that.

Things were a little hazy; I can’t remember what was said.I straightened up and listened, when the word autism was read.

So finally we got a diagnosis, they said mild Autism.Often described by others as a world looking through a prism.

Things are falling into place now as I play by Josh’s side.My Blonde Haired Blue Eyed Boy, he’s just locked inside.

We don’t know what the future holds for our little man.Except that we will love him and do all that we can.

Josh needs understanding from everyone and all.As he goes through life it is us whom he will call.

I often walk around and think and then wonder, why me?Then it all comes clear why God may have chosen us three.

He can be very intelligent; he has the ability to have fun.But I can’t express in words the love I have for my son.

So even though I am still shocked as I observe Josh during play.He is the same Blonde Haired Blue Eyed Boy, born on Mother’s Day.

[Lorelle ,8th April 2000, day after diagnosis]


Consultation with othersWhen working with children with additional needs you need to ensure you develop an accurate picture of the child. It is important to seek information from the family members. These are the people will have the greatest knowledge of the abilities, strengths and needs of the child.

You may need, however, to look further than just Mum and/or Dad. It will depend on each child’s individual circumstances, but often others in the family will have as much or more information than Mum or Dad. They might have a very different perspective of the child and their behaviour, skills and abilities. Grandma, who has been looking after the child since soon after birth full time, will be able to give lots of valuable input. It is essential that you seek parental permission before interviewing anyone else in regard to the child.

A child diagnosed with an additional need at birth may already have a number of professionals and specialists working closely with both the child and family. These specialists and professionals need to be involved when developing a program for the child.

Professionals that could be contacted with parental permission may include early intervention teachers, speech pathologists, occupational therapists, physiotherapists, psychologists, doctors, paediatricians and other medical specialists.

Specialist agencies are experts on specific conditions. You could contact agencies such as Early Intervention programs, the Autistic Association, the Down Syndrome Association, the Spastic Centre and your local SUPS program. This again must only be done with parental permission.

Activity 11

Communicating with othersIt is important to discuss your observations with other staff members within your service. When comparing observations with other staff members we occasionally get a very different picture of the same child. Educators and children interact in different ways together and therefore responses can also be very different.

Communicating with others is an important part of providing an inclusive environment. However, we need to remember that it is up to the parents to decide who you may contact. Always make sure you have written permission and that you are respectful in your communications.

Activity 12


Identify the cultural and language background and migration experiences of the child

In children’s services we work with many children and families who come from diverse backgrounds. Think about the people who live in your street. Alternatively, consider the people in your town, suburb or region. There are many similarities and differences. In an area people may live in very different housing and have varied occupations. There may be different family types e.g. extended families, elderly couples, foster families, single people, married couples with children, de-facto relationships and same-sex partners.

Families are of varying sizes. There would be a variety of ethnic/cultural backgrounds and religions. Families will also have different dietary preferences or allergies.

Imagine if we placed these people together. The common factor would be that we all live in the same few streets in the one community. However, there are many differences, making us a diverse group of individuals.

Ways in which children’s family backgrounds are diverseIn early childhood services we need to be aware of diversity and identify additional needs that children may have due to their family background.

A child’s background may be different because:

• they were born overseas• their parents were born overseas• they arrived in Australia as a refugee• they may have lived in abusive environments or could currently be at risk

of abuse• they may have experienced trauma• their family belongs to a cultural or religious group that has different

practices and beliefs to the majority of families at the centre.


Inclusive programOur program should be inclusive and reflective of our local community. We need to ensure we are supportive of all children and work towards meeting each child’s individual needs. When working with a child who has differences in their family background, it is important that we work with specialist agencies to provide appropriate support. Specialist agencies may include Inclusion Support Agencies, ethnic workers’ pool, multicultural resource centres, Department of Community Services and other local, state and federal agencies.

Strategies to identify the background of the childIt is helpful to identify:

• the nationality/culture/tribe of the parents • the languages they speak and those spoken by others who may live with

them • the languages the child speaks• cultural practices and beliefs of the family• the migration experiences of the family and child

This information can be obtained through:

• questions on the enrolment form• the enrolment and orientation process• informal conversations when getting to know the parents

InclusionWould you believe that less than 40 years ago children with disabilities were institutionalised? We excluded children with disabilities. They were locked away in institutions and often disowned and forgotten about by some families.

I recently heard the story of a friend who discovered she had an aunt the day the aunt passed away (at 52 years of age). Her family had failed to ever mention that her father had a sister who was born with an intellectual disability and institutionalised at three years of age.

Up to the 1970s, families were told that an institution would be the best and most appropriate place for their child. An Australian book Annie’s Coming Out written by Rosemary Crossely and Annie McDonald gives a great insight to the life of children who were institutionalised in Australia in the 1960s. The book and video are available in TAFE libraries where you can access them.

In the 1970s, the majority of children with disabilities attended segregated special schools—such as Beverley Park Special School for children with physical


disabilities at Campbelltown and the North Rocks Deaf and Blind School. Currently, these schools provide education and support to children (and their families) with a high support need who are unable to be supported in a mainstream school environment.

In the 1980s, we begin to see a move towards inclusive environments. Children were provided more access to mainstream schools with support units. Special Education Units became attached to local primary schools and the beginnings of mainstreaming of children with additional needs occurred.

Today education is continuing to move towards inclusion.

Inclusion is supported by state and federal governments. They have realised that segregation does not benefit communities. Legislation now promotes inclusion.

The relevant state and federal legislation includes:

• NSW Anti-discrimination Act (1977)• Commonwealth Disability Discrimination Act (1992)• NSW Disability Services Act (1993).

Legislation states that:

• people with disabilities have the same rights as all people within the larger community

• services must be provided to all Australians• people with disabilities should be able to participate in making decisions• services should enable people to reach their full potential• it is unlawful to discriminate against people based on their disability.

To gain an understanding of each Act, visit the following websites:

www.legislation.nsw.gov.au

www.hreoc.gov.au

What is inclusion?Inclusion is providing equal opportunity to all participants. It is the acceptance of all children, irrespective of their abilities. Inclusion is a commitment to meet the needs of the child to the best ability of the service in the most appropriate way. It demonstrates a respect for diversity and acceptance of all. An inclusive early childhood environment is one that meets the individual needs of all children.

In early childhood environments, we can support inclusion by providing an appropriate service to all children. To do this, we develop an understanding of our children and identify their interests, strengths and additional needs.

Activity 13


Integration and mainstreamingWhen working in early childhood environments and school settings, you may come across terms in regards to inclusion of children into environments. Terms you may hear could include integration and mainstreaming.

Integration and mainstreaming are practices that include children, but don’t be mistaken—they do not reflect an inclusive environment. An inclusive environment is one where all children’s needs are catered for, regardless of differences.

Integration is the placement of children with additional needs into a regular setting. However, children are seen as being different but are accepted in the setting. Support is provided to assist the child to ‘fit in’ to the centre. Mainstreaming is the placement of children with additional needs into a regular setting with no support to meet their additional needs. Children participate alongside peers with minimal support.


CLIPS Word Template - TAFE NSW · Web viewThis was developed by the Spastic Centre of NSW for...

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