Danielle Chelette's Portfolio · Web viewOral hygiene is difficult for this group of students and...
Transcript of Danielle Chelette's Portfolio · Web viewOral hygiene is difficult for this group of students and...
Amber Burks
Danielle Chelette
Special Needs Oral Health Program- Part 1
Needs Assessment
A. General data
1. Description of Site
Groves Elementary is located at 3901 Cleveland Groves, Texas 77619. Groves
Elementary was built in 1948 as a junior high school and it originally served
students grades 7-9. In the 1970’s this school was changed from a Jr. High school
to an elementary school currently serving students in the 4th and 5th grades. The
2008-2009 school years marked the sixtieth anniversary of the building. This
school is within the Port Neches-Groves Independent school district, and is
governed by the elected members of the school board. The function and role of
this site is to provide education to 4th and 5th grade students. The mission of
Groves Elementary is “we believe that all students can learn, the mission of the
staff of Groves Elementary is to provide continuity of the teaching process, a
challenge for all students to excel academically, a positive school climate for
learning, and a caring atmosphere through which we can offer the best possible
educational opportunities”(1). This school is funded by the state government.
The life skills classroom they do have a fundraiser once a month selling baked
potatoes to the teachers at Groves Elementary. The money from the fundraiser
is used by the students in the class to do community based instructional
activities such as going to a restaurant or to the movies. (1, 2)
2. Description of Target Population
The target population consists of twelve students’, 6 students in the life skills
classroom and 6 students in the adaptive behavior unit. The ages range from
nine to twelve. These students may have an intellectual and developmental
disability and/or emotionally disturbed. In the adaptive behavior unit, all of the
students live in a single parent home. The enrollment requirements are based on
the doctor’s diagnosis, and could include Down’s syndrome, mental retardation,
and autism. (2, 3, 4)
3. Description of Staff Population
The teacher over the life skills department has 2 paraprofessionals to help assist
with the students. In a separate classroom is the director of the adaptive
behavior unit and has 1 paraprofessional to help assist with the students. The
responsibilities of the instructors in the life skills department are to conduct
academic lessons, develop independent living skills, and socially appropriate
behavior. The responsibilities of the instructors in the adaptive behavior unit are
very similar to the life skills department but, they also work on anger
management. The teacher of the life skills department has a bachelor’s degree in
education with some graduate hours, and has been teaching for thirteen years.
The director of the adaptive behavior unit has a bachelor’s degree in education
and in math. This instructor also has an EC/EC certification with some graduate
hours, and has been teaching for twenty-three years. (2, 3)
4. Description of Services Provided
The principal of Groves Elementary and the teachers in both life skills
department and the adaptive behavior unit all have the capability to coordinate
activities. For the life skills department, the teacher likes to bring the students
out to eat, to the grocery store, and to the bank. Part of the students’ curriculum
is to learn how to order food, and how to act in a social setting. The activities are
designed and implemented for the students. The students go to class from 8:30
a.m. to 3:30 p.m., Monday through Friday. The life skills department coordinates
a potato sale the last Thursday of every month. They also take a trip the Tuesday
before the potato sale to the grocery store to gather supplies for the sale. The
adaptive behavior unit uses an incentives program, they work to reach a certain
amount of Accelerated Reader (AR) points, and they are rewarded with a
bowling trip. In the future, the life skills department plans to attend the Young
Men’s Business League (YMBL) rodeo youth day next month. This is a community
event for the students and the events coordinator reserves a day for special
needs students to attend. The life skills classroom schedule is as follows:
breakfast, restroom, office jobs, work (math, spelling), snack, restroom, PE/work,
recess, lunch, restroom, quiet time, work, snack, restroom, and to prepare for
dismissal. The adaptive behavior schedule is as follows: 8:30-9:15 reading, 9:15-
11:00 math, 11:00-11:30 lunch, 11:30-12:00 language arts, 12:00-1:15 science
(inclusion with other students), 1:15-2:15 PE/music (alternates), and 2:15-3:30
history/writing. (2, 3, 4) At this location the water is fluoridated at 0.80 mg/L. (5)
B. Information Related to Dental Health
There have been no previous dental services provided to this target group in the
past. The director of adaptive behavior unit was involved with an oral health
program before being hired on at Groves Elementary, but is unaware of the
results of the program. As part of a preventative measure, the life skills
department incorporates brushing in their daily schedule, either in the morning
or after lunch. They also make this part of their learning curriculum. At the
beginning of the school year the life skills department sends out a school supply
list which does include toothbrushes and toothpaste. The staff has great
knowledge and awareness of dental health. (2, 3, 4)
C. Dental Health Status
1. Dental Caries- The dental caries rate of Texas children in the 3rd grade was
seventy-three point three percent out of three thousand eight hundred sixty-
four students. The children in our target group are at a higher risk for caries
because of their cognitive, sensory, or physical conditions. Also, this target
population has more untreated caries. (6,7)
2. Periodontal Disease- This target group has a poorer periodontal status and has
fewer remaining teeth due to their condition and lack of oral hygiene routine. (7)
3. Oral Hygiene- Because of their disabilities, they have great limitations when it
comes to their oral hygiene and lack of skills. Oral hygiene is difficult for this
group of students and their oral hygiene status is general, moderate to low
grade. (7)
4. Malocclusion- Certain conditions do cause malocclusion such as Down’s
syndrome and cerebral palsy. (7)
5. Oral Cancer- Not relevant
6. Utilization of Dental Services- In the Oral Health Needs Survey of 2009 from the
Michigan Department of Community Health, the utilization of dental services of
special needs children was listed from that state. Dentists were asked to
estimate how many special needs patients were treated in their office. In a year
eighteen point eight three percent were treated. Forty point six two percent of
the dentists in the survey stated that they treated less than five children with
disabilities in 2009. Only about ten percent of the dentist surveyed stated that
they treated more than thirty children in a year with disabilities. (10)
7. Additional information- Out of the 6 students in the special needs class the
majority is white with 1 Hispanic, 2 students have a reduced lunch, 1 student
has a free lunch, and 2 students live in a single parent home. In the adaptive
behavior unit the majority is white with one Hispanic, 4 out of the 6 students
have free or reduced lunch, and all of the students live in a single parent home.
Some special needs students eat non-food items, and occasionally you can smell
it on their breath. The director of the adaptive behavioral unit explains the
students are not consistent with brushing, and you can smell it on their breath in
the morning. (2,3)
Goal-Improve the oral health of the 4th and 5th grade special needs children at Groves
elementary through an educational program.
Objective - Increase the dental health knowledge of the students by 15% using the pre
and post-test
Objective - Decrease plaque and oral debris by 15% using plaque score
Objective - Increase their oral health and skills by passing a toothbrush evaluation
Objective : Increase their knowledge of healthy foods by getting 50% correct matches on
the nutrition game board
Rational
Oral Health Services for Children and Adolescents with Special Health Care Needs is a
second edition resource guide. This resource guide starts off with an introduction describing the
purpose of this guide and the need for oral health care among children and adolescents with
special needs. The National Maternal and Child Oral Health Resource Center (OHCR) developed
this resource guide. The first part of this guide provides peer reviewed articles over specific
diseases such as barriers to dental care for children with Autism, access to dental care needs for
children with special needs, and nutrition and oral health considerations in children with special
needs. The second part includes guides, brochures, reports, and fact sheets. The third and last
section includes lists for professional associations that are used for resources. Our target group
is composed of several different developmental disabilities and this resource guide gives us
information on each condition. This resource guide also provides past national, state, and local
special needs oral health programs and how they were conducted. (8)
Promoting the Oral Health of Children with Special Health Care Needs- In Support of the
National Agenda covers several different topics such as medical home, insurance coverage,
screening, organization of services, family involvement, and transition to adulthood. The
medical home is where families and health care providers work together to recognize special
health care needs, provide continuous care, and coordinate with other services and other
health care professionals. For families who cannot afford dental care, this article wants to
increase access to care for special needs patients by programs such as Medicaid to provide
reimbursement opportunities. They strive for insurance companies to support special needs
clinics. Screenings are intended for infants and young children to be identified with special
needs conditions early to ensure they receive the correct care to prevent oral health diseases.
They provide organizational services and they try to make them family-centered and easily
reachable. This article states that family members of special needs patients play a major role in
the child’s health care needs. Overall, this article is stating the need for development of special
needs oral health care programs. The national goal that was stated in Healthy People 2010:
National Health Promotion and Disease Prevention Objectives is to “increase the proportion of
states and territories that have service systems for children with or at risk for chronic and
disabling conditions as required by Public Law 101-239”(9). (9)
In 2009, the state of Michigan designed an Oral Health Needs Survey stating a need for
dentists to provide more dental care to special needs patients. This survey suggested that
dentist do not want to provide care for special needs patients because of their low insurance
rates and how they are time consuming and not bringing in a profit when these particular
patients are seen in the dental office. This survey wants to develop new ideas to enable more
dentists to provide care to this target group. Surveys were sent out to different dentists to
provide information about what facility they work in and what insurances they accept. Overall,
this study proved that dental health care professionals need to dedicate more time and training
to these special needs patients giving them more opportunities for dental treatment. (10)
Program Design
A. Activities
This project is aimed at educating 4th and 5th grade special needs students at Groves
Elementary. Throughout the program we will provide oral health education, instruction,
and emphasize the importance of oral health. We will have a total of 4 sessions, with
one session each week. The sessions will be as follows:
1. Session 1 (week 1)
a. The role of the dental hygienists and teeth
Introduction of general information related to the anatomy of the oral cavity and
the importance of keeping your natural teeth
1. Pre-test- Overall class discussion
2. Discuss how many teeth are in a deciduous dentition
3. Discuss how many teeth are in permanent dentition
4. Discuss the importance of keeping natural teeth
5. Discuss the role of an RDH
6. Read The Tooth Book by Dr. Seuss
7. Students will create a mouth model made out of construction paper, glue,
and marshmallows
2. Session 2 (week 2)
a. Plaque
Introduction of plaque and the effects it has on the oral cavity
1. Discuss plaque, what it is composed of (bacteria, germs)
2. Discuss how it is the cause of cavities
3. Discuss the importance of brushing
4. Discuss a proper brushing technique (Fones Method)
5. Hand out toothbrushes to each student
6. Demonstrate proper brushing technique
7. Have students practice brushing in their own mouth
8. Help students and modify brushing methods
9. Apply disclosing solution to students
10. Show students spots missed in mouth
11. Coloring activity
3. Session 3 (week 3)
a. Caries and Fluoride
Introduction of the caries process and ways to prevent them from forming
1. Discuss the caries process
2. Discuss the role of fluoride in preventing caries
3. Demonstration with eggs, fluoride, and vinegar
4. Coloring activity
4. Session 4 (week 4)
a. Nutrition
1. Discuss healthy snacks for the oral cavity
2. Discuss unhealthy snacks for the oral cavity
3. Reiterate sugars role in the caries process from the foods mentioned
4. Magnet game involving identifying healthy foods vs. unhealthy foods
5. Enjoy healthy snack time with the students
6. Hand out post-test to each student- Overall class discussion
B. Constraints and Alternative Strategies
1. Constraint: There may be a short attention span from the students in the classroom
due to their intellectual disabilities and their knowledge towards oral health.
Alternative: 1. Keep the presentation short, clear, and concise. 2. The presentation
needs to be enjoyable and include all senses including hearing, seeing, touching, and
tasting to keep their attention. 3. Involve the students in the presentation and keep
their interest.
2. Constraint: The students may have difficulty understanding information presented
due to their intellectual disabilities.
Alternative: 1. We need to provide the most basic form of oral hygiene education
and instruction. 2. Make sure the students are aware they can ask questions
throughout the presentation.
3. Constraint: School attendance may be an issue in this department because
occasionally they are absent from school.
Alternative: 1. Send a letter home advertising our oral health program including the
dates of each lesson to encourage the students to attend school on those particular
dates. 2. Ask the teachers to remind the students the day before and encourage
their presence.
4. Constraint: There may be a lack of parental involvement due to their busy lifestyle
and work schedule.
Alternative: 1. Send a letter home requesting their attendance to one or all of the
program dates. 2. Inform the parents/guardians’ of their role in their child’s oral
health, and stress that their involvement is crucial to the success of our program.
C. Resources
The following resources will be required for implementation of the program:
1. Personnel: Program planners (Amber and Danielle)
2. Supplies:
a. Youth toothbrushes (15), toothpaste (15)- provided by LIT DH
b. Gloves, disclosing solution, cotton swabs, paper napkins, cups, tongue
depressors- provided by program planners
c. Glue, scissors, crayons, pencils-provided by the students at Groves Elementary
3. Audiovisual aids: illustrations:
a. The Tooth Book by Dr. Seuss, typodont, pink and red construction paper,
marshmallows, eggs, anti-cavity mouth rinse with fluoride, 3 containers, vinegar,
healthy snacks-provided by program planners
b. magnet game- provided by LIT DH
4. Evaluation material:
a. Pre-test-T/F Overall class discussion
b. Post-test- T/F Overall class discussion
c. Plaque index sheets
d. Director evaluation
5. Supplements
a. Program plan written lesson plan- provided by program planners
D. Budget:
The estimated cost for the dental health program is as follows:
1. Toothbrush and toothpaste 0.00
2. Paper napkins and cups 0.00
3. Gloves 9.00
4. Cotton swabs and tongue depressors 9.00
5. Disclosing solution 5.00
6. Construction paper 3.00
7. Eggs 4.00
8. Fluoride mouth rinse 5.00
9. Vinegar 3.00
10. Containers 7.00
11. Healthy snacks 8.00
12. Marshmallows 4.00
Total $57.00
E. Timetable
There will be 4 sessions spanning a 4 week period of time. The projected weeks of
implementation will be scheduled as follows:
Session 1: Tuesday March 18, 2014 from 2:15-2:45
Session 2: Friday April 4, 2014 from 2:15-3
Session 3: Tuesday April 8, 2014 from 2:15-2:45
Session 4: Tuesday April 15, 2014 from 2:15-2:15
Evaluation
A. Formative evaluation:
1. For week 1, we will evaluate their dental knowledge over teeth and the role of a
dental hygienist.
2. For week 2, we will evaluate each student’s effectiveness of removing plaque by
taking a plaque score. Also, review the students’ knowledge of teeth and the role
of a dental hygienist that was discussed in the previous lesson.
3. For week 3, we will evaluate their knowledge of caries and fluoride. Also, we will
review each student’s effectiveness of removing plaque by taking a plaque score.
4. For week 4, we will evaluate their knowledge of healthy snacks. Also, we will
review their knowledge of caries and fluoride and any material that they may be
struggling with. After results of the post test, we will review any subject matter
they struggled with.
b. Summative evaluation:
1. Increase the dental health knowledge of the students by 15% using the pre
and post-test.
2. Decrease plaque and oral debris by 15% using plaque score.
3. Increase their oral health and skills by passing a toothbrush evaluation at the
end of the oral health program.
4. Increase their knowledge of healthy foods by getting 50% correct matches on
the nutrition game board.
References
1. Port Neches-Groves Independent School District. (2014). Our Schools Mission Statement and History. Retrieved from http://png.groveses.schoolfusion.us/?sessionid=9cf2a1d0438b7d67c4033449b1474e4b&t
2. (J. Fecowycz, personal communication, February 11, 2014).3. (D. Windhorst, personal communication, February 11, 2014).4. (B. Chelette, personal communication, February 11, 2014).5. Centers for Disease Control and Prevention. (2008). My Water’s Fluoride. Retrieved
from http://apps.nccd.cdc.gov/MWF/PWSDetailV.asp?PWSID=1230012&State=TX&StartPg=1&EndPg=20&County=Jefferson&PWSName=&Filter=0&PWS_ID=&State_ID=TX&SortBy=1&StateName=Texas
6. Centers for Disease Control and Prevention. (2007-2008). Caries Experience. Retrieved from http://apps.nccd.cdc.gov/nohss/IndicatorV.asp?Indicator=2
7. Boyce, R., & Shah, B. (2012). Trends in Periodontal Status and Dental Caries Among Specific Treatment Populations. The Brooklyn Hospital Center Journal of Health Sciences, 3. Retrieved from http://www.tbh.org/journal/story_print.php?story_id=214
8. Bertness J, Holt K, eds. 2011. Oral Health Services for Children and Adolescents with Special Health Care Needs: A Resource Guide (2nd ed.). Washington, DC: National Maternal and Child Oral Health Resource Center.
9. Maternal and Child Health Bureau, Health Resources and Services Administration. Achieving and Measuring Success: A National Agenda for Children with Special Health Care Needs. [Website]http://mchb.hrsa.gov/programs/specialneeds/measuresuccess.htm.
10. Michigan Department of Community health/ Michigan Oral Health Coalition. (2009). Oral Health Needs Survey 2009 Technical Report. Retrieved from www.mohc.org
11. (R. Tornwall, personal communication, March 4, 2014).
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