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AASSPPEERRGGEERRSSSSYYNNDDRROOMMEEFACT SHEET
Specific type of pervasive developmental disorder characterized by problems indevelopment of social skills and behavior.
CHARACTERISTICS
Cognitive:
Normal intelligence
Use words by age 2
Speech patterns may be different, speakrapidly
ADD
Obsessive Compulsive Disorder
High IQs Speech inaccuracies
Psychomotor:
Coordination difficulties
Normal fine and gross motor development
Clumsy
Af fective:
Difficulty interacting with peers
Tend to be loners
Display eccentric behaviors
depression
Frustration
Low self esteem
ETIOLOGY AND PROGNOSIS
Individuals with Aspergers Syndrome are high functioning and have very adaptive behaviors. Thereis limited if any social interaction amongst peers. By age 2 individuals with Aspergers have aninability to use single words or to speak in full sentences or phrases by age 3.
With early intervention individuals with Aspergers, although diagnosed as having autism at a youngage, respond well to specific teaching strategies.
ASSESSMENT SUGGESTIONS
TGMD2
Brockport Physical Fitness
Peabody
EFFECTIVE TEACHING STRATEGIES
Limit amount of stimulus in thegymnasium
Activities that encourage interaction
Positive reinforcement
Avoid large amount of down time
Provide direct instruction
Tactile directions
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RESOURCES
Direct parental contact
School Psychologist
Teacher interaction
Cross-disciplinary teaching
REFERENCES
American Academy of child and Adolescent psychiatry NO. 69 September, 1999
Block, Martin E., 1995, A teachers guide to including students with disabilities in regular physicaleducation. pgs. 27, 144-145
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AAUUTTIISSMMFACT SHEET
Autism is a brain disorder that impairs a persons abil ity to communicate, form relationships,socially interact, and respond appropriately within a given environment.
CHARACTERISTICS
May avoid eye contact
May seam deaf
May lack awareness of the existencefeelings of others
Can be physically aggressive or haveoutbursts when familiar environment ishanged
Can remain fixated on single activity or
object
May engage in strange actions such ashand flapping, rocking, or flicking objects
May lick toys/objects
May not show sensitivity to pain (burns,bruises)
May engage in self-mutilation, such as eyegouging
Impaired social interaction
Impaired verbal/non-verbal communication
Seeks sensory input (ex. Weighted vest)
Shows repetitive interests and activities,preoccupied with certain objects
Absence of imaginative activity
May withdraw from people
Abnormal response to external stimuli suchas sound and lights
May lack appropriate play
May be tactile defensive
May be sensitive to touch
CAUSE
Research continues to determine the causes of autism. These studies are looking at various parts of thebrain and how they function compared to a typical child. Scientists have come up with some hypothesis,which include the following:
Brain cells may migrate to the wrong place in the brain that could affect communication skills.(Parietal area of brain controls communication.)
Scientists have found impairments of the amygdala in autistic children. The area known as theamygdala helps regulate social and emotional behavior.
Research has found that individuals with autism may have high levels of the neurotransmitterserontonin. Since neurotransmitters are responsible for the passage of nerve impulses to the brain,these chemical differences could distort sensations in individuals with autism.
Research will continue as to the cause of autism that could someday lead to permanent treatment and
prevention procedures.
ETIOLOGY
Autism is a brain disorder that impairs a persons ability to communicate, form relationships, sociallyinteract, and respond appropriately within a given environment. Autistic symptoms must be presentbefore the age of 3. The disability can affect the individuals level of functioning in a variety of ways.Some autistic individuals may have severe cases in which they have mental retardation and seriouslanguage delays. Others may be high functioning individuals that can speak and are very intelligent.
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The symptoms of autisticindividuals can vary; however, most people with autism share problemsassociated with social, communication, motor, and sensory issues. Autism occurs in 5-15 per 10,000children. Boys are four times more likely to get autistic symptoms (National Dissemination Center forChildren with Disabilities, 2003).
PROGNOSIS
Autism is a very challenging disability to solve because of many unknown factors. Since there is no curefor autism, proper procedures such as therapy must be taken to help these individuals handle theirproblems. With proper therapy sessions, autistic individuals can improve their modes of communicationand socialization to live very productive independent lifestyles in society. Autistic children with IQ scoresof 70 and above normally can live and work more productive independent lifestyles within society (GaleEncyclopedia of Psychology, 2001).
Autism symptoms vary from mild to severe. The prognosis for these individuals depends on the severityof their disability and the level of therapy they receive. Most autistic individuals will have some sort ofimpairment of their senses throughout life. These could include: smell, taste, vision, hearing, and sensoryissues. Autistic individuals are often labeled incorrectly as loners because of their inability to sociallyinteract. Approximately 33% of children with autism will eventually develop epilepsy. The highest risk iswith children that have severe cognitive impairments and motor deficits (Turkinson, 1999).
Autistic individuals can live very active lifestyles. They are very capable of performing most physicalactivities. This will depend on the severity of the disability. Also, an active lifestyle is more likely to helpthese individuals with weight control, muscular endurance, muscular strength, cardiovascular endurance,self-esteem, and self-confidence.
IMPLICATIONS FOR PHYSICAL EDUCATION
In the community, may need 1:1 supervision for child
Use a PECS book (Picture Exchange Communication System) to allow non-verbal student choices ofphysical activities.
Provide an initial screening process to determine students physical strengths and weaknesses. Thiswill help in writing IEP objectives and goals.
Establish routines and smooth transitions throughout the lesson
Modify equipment so that the student can be successful, yet challenged.
Provide balls that will provide sensory output during activities. (ie: Knobby balls)
Videotapes can be useful for autistic children who can follow visual cues.
ASSESSMENT SUGGESTIONS
STANDARDIZED ASSESSMENTS
BROCKPORT PHYSICAL FITNESSTEST:This is a criterion-referenced test that measures physical fitness
levels for students between 10-17 years old. . It includes tests for body composition, muscularstrength, muscular endurance, speed, power, flexibility, coordination, and cardiovascular endurance.This test could be used for an individual with autism if there were a concern with their fitness levels.
BRUININKS-OSERETSKYTEST OF MOTOR PROFICIENCY:This is a norm-referenced test that measures anindividuals speed, agility, fine motor, hand-eye coordination, and strength for disabled studentsbetween 4.5-14.5 years old.
TGMD-2: This test provides criteria for different locomotor and object control skills for ages 3-10.
ICAN:This criterion and content test is for disabled children who are ambulatory. The test measuresmotor and play skills and recreation skills.
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MOTOR ACTIVITIESTRAINING PROGRAM:SPECIAL OLYMPICS SPORTS SKILL PROGRAM: This content-referenced test is for severe handicaps of any age. The test measures striking, kicking, aquatics, andmobility.
OHIO STATE UNIVERSITY SCALE OF INTRA GROSS MOTOR ASSESSMENT: This content and criterionreferenced test measure basic locomotor skills, balance, object-control, gymnastics, health relatedfitness and sport skills for disabled individuals between 2.5-14 years old.
PHYSICAL BEST: This criterion and norm based test could be used for severe cases of autisticindividuals. This test measures aerobic capacity, body composition, flexibility, upper and lower bodystrength and endurance for children between 5-17 years old.
FITNESSGRAM: This criterion-referenced test (level of mastery) tests an individuals overallwellness. This includes: body composition, cardiovascular endurance, muscular strength andendurance, and flexibility.
AUTHENTIC ASSESSMENTS
RUBRICS: A rubric is a authentic assessment tool which can be used for assessing students withdisabilities. In the rubric, there are various sets to each progression which have a scoring criteria andlevel of achievement. These progressions can be used to assess any locomotor and object-control
skills. This type of assessment will tell exactly where the individual lies in terms of skill/healthdevelopment.
Types of rubrics:1. Holistic rubric: Addresses a skill without task analyzing. This rubric is usually used for older
population who are at the mastery level for that particular skill.2. Analytic rubric: Breaks down a skill to meet the needs of someone working on mastering a
skill. Usually addresses younger population.3. Individual rubric: This rubric is used to meet the individual need of a child. This can be used
to address someone with a disability whose needs must be met in a small class setting. Thisis an excellent procedure to use to meet a childs IEP goals/objectives.
OTHER ASSESSMENT IDEAS MOTOR DEVELOPMENT CHECKLIST: This is a progressive checklist for locomotor and object-control
skills. Each skill is broken down from simplest to most difficult. As the student performs the assignedtask, teacher will observe physical movement and check off the components of the skill that wereaccomplished.
RECOMMENDED ACTIVITIES
Any activity that requires vigorous activity and will improve their overall fitness levels. (flexibility,cardiovascular endurance, strength, muscular endurance)
Walking/Hiking
Bike riding (Type of bike will depend on ability/balance levels)
Swimming: An excellent low impact activity that can benefit student in a variety of health-related
ways Activities that require the use of their senses. Autistic children like deep pressure that helps them
relax. Weighted backpacks/vest can help provide this deep pressure.
Find out the students physical activity interests.
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CONTRAINDICATED ACTIVITIES
Having class in a loud and/or bright environment; providing too much stimuli within the environment.(ie: Over stimulating with too much noise/equipment (Block et al, 2003).
Activities that require a lot of contact.
Spending too much time on a single activity and not providing enough choices (Block et al., 2003).
EFFECTIVE TEACHING STRATEGIES
Pre-school-Secondary
Use teaching stations
Change activities regularly
Eliminate different distractions
Keep directions short and age-appropriate.(Limit prompts)
Use sensory stimulation to increaseattention span
Use smooth transitions
Instruct in an environment were noise,smells, lights will not interfere with learning.
Teach in less stimulating environment.
Provide students with ear plugs/cotton ballsin noisier environment.
Keep motivational music at low level.
Establish predictable routines within lessons
Create high structured environment which isorganized and predictable
Warm-up, Activity, Closure Stations
Use visual aids during activities
Use vigorous aerobic exercises to keepstudent on task
Use a consistent behavior modificationprogram
Provide lots of practice time/repetitions.
Show enthusiasm when teaching.
Preschool-Elementary
Use sticker chart as a reward system Teach students basic locomotor and objectcontrol skills.
Middle School - Secondary
Provide reward system that allows studentsthe opportunity to participate in enjoyableactivity.
Teach students lead-up activities for team,individual, and cooperative activities.
Have child perform task and draw parts of a
picture (face) every time task is completed
Use a peer tutor to assist child in learning.
Teach students lifelong activities that can beused for the rest of their lives. Allow choiceswhen setting up the curriculum so they canchoose an activity that is of interest to them.
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Positive Behavior Management Strategies
Set realistic goals and expectations
Increase amount of activity time, whiledecreasing instructional and transitionperiods
Check for basic understanding to make surestudents know expectations
Provide a structured environment withappropriate routines
Challenge the students to keep themmotivated
Provide a reward system for good attitudesand behavior
Provide non-verbal feedback andencouragement with high 5s and cheering
Be consistent and fair with your rules andconsequences
Use proximity control if a problem is arising
Get to know the students and show interesttoward them outside of the physicaleducation environment.
Create a positive and enthusiasticenvironment for everyone
Provide vigorous activities to help studentsremain on task.
RESOURCES
Teachers and Parents:
Web sites: P.E. Central Project Inspire PE Links4U California Physical Education Resources www.nichcy.org www.educationworld.com www.ncpad.org www.nimh.gov http://members.aol.com www.asd.k12.ak.us
http://ncperd.usf.edu www.americanfitness.net (Physical Best) www.educationworld.com
Journals: Palaestra Teaching Elementary Physical Education J OPERD Strategies Adapted Physical Activity Quarterly
Books: Principles and Methods of Adapted Physical Education and Recreation Including Students with Disabilities in General Physical Education Inclusive Games
Organizations : AAHPERD - www.aahperd.org
Sport: Special Olympics - www.specialolypics.org Empire State Games for the Physically Challenged - www.empirestategames.org/physical Disabled Sport USA - www.dsusa.org
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DDEEPPRREESSSSIIOONNAANNDDEEMMOOTTIIOONNAALLDDIISSTTUURRBBAANNCCEEFACT SHEET
DepressionA feeling of low self -esteem that adversely affects the students behavior , educat ion, and social
relationships
Emotional DisturbanceAn inabi li ty to learn, bui ld relationships, and maintain happ iness over a period of time that
negatively affects academic performance
CHARACTERISTICS
Depressed mood most of the day, nearlyevery day
Markedly diminished interest or pleasurein almost all activities most of the day,nearly every day
Significant weight loss/gain Feelings of helplessness and
hopelessness.
Feeling useless.
Self-hatred, constant questioning ofthoughts and actions, an overwhelmingneed for reassurance.
Being vulnerable and "over-sensitive".
Feeling guilty.
Self harm.
Difficulty with getting off to sleep or feelingtired more then usual
Agitation and restlessness.
Finding it impossible to concentrate forany length of time, forgetfulness.
A sense of unreality.
Physical aches and pains, sometimes withthe fear that you are seriously ill.
Suicidal tendencies
Loss of appetite
Decline in participation of everydayactivities
A loss of energy and motivation, thatmakes even the simplest tasks ordecisions seem difficult.
CAUSE
Major life changes
Traumatic event
Death in the family
End of a relationship
Failure to meet expectations
Family problems divorce, separation,abuse
Loss of employment their employmentor parental employment
Financial problems
ETIOLOGY AND PROGNOSIS
Biological Factors
Genetic Factors
Psycho-social Factors
Imbalance in neurotransmitters
Varies depending on cause and treatmentused.
Must be evaluated according to recoveryfrom incident and reoccurrence
74% recovery for children after 1 year
92% recovery for children after 2 years
70% of children have reoccurrence within5 years
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IMPLICATIONS FOR PHYSICAL EDUCATION
Student might have a developmental delay
Lack of confidence could lead to inactivity
Student might not be social and have poor teamwork habits
The student could be overweight or have an eating problem resulting in low energy levels
Not able to focus on activity due to short attention span
Does not feel like doing activity, loss of interest
ASSESSMENT SUGGESTIONS
Use authentic assessment
Dont have students perform skills test in front of other students
Grade on effort and knowledge along with skill.
Do assessment more then once in case the student is having a badday
RECOMMENDED ACTIVITIES
Do skills that will bring success
Have enjoyable activities for that individual
Let them be the leader or the person that is IT
Exercise continuous activities such as running, walking, biking, swimming
Stress Management techniques
CONTRAINDICATED ACTIVITIES
De-emphasize competition Do not pit the students against each other
Test in separate areas or during game play (authentic), not in front of all of the students
EFFECTIVE TEACHING STRATEGIES
Structure the class for success Do not set a student up for failure
Establish class rules that are stated positively Do not be negative
Have a set routine - not different class outline each time
Organize and plan class for active participation by all; little waiting time
Show same attention to all students Dont play favorites
Base grades on different aspects of the class Not just skill level
Use teamwork skills to help with socializing and taking eyes off of individual students
POSITIVE BEHAVIOR MANAGEMENT
Reward appropriate behavior
Enforce fair and humane consequences for inappropriate behavior
Provide students with a safe space to be alone so that they can develop skills to control theirbehavior
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RESOURCES
Teacher: Familiarize themselves with the National SED (Serious Emotional Disturbances) The Relationship of Self-Esteem and Depression In Adolescence:
http://www.help4teachers.com/depression.htm Lessons for Living: http://www.lessons4living.com Stress Management: http://stress.about.com/ Mastering Stress: http://www.psywww.com/mtsite/smpage.html Teacher Notes: http://ecdc.tamucc.edu/HELP/depression/teachernotes.html
Parent: The Depression Resource Center: http://www.healingwell.com/depression/ Have a Hearts Depression Resource: http://www.have-a-heart.com/ National Mental Health Association: http://www.nmha.org/ What to do when a friend is depressed: http://www.hoptechno.com/book34.htm Depression Chat: http://www.depressionchat.com/ Parents Guide: http://ecdc.tamucc.edu/HELP/depression/parentguide.html
Sport: Exercise Against Depression: http://www.physsportsmed.com/issues/1998/10Oct/artal.htm
REFERENCES
http://www.montana.edu/wwwebm/Depression.htm
http://www.hp.ufl.edu/~jjohnson/1
http://www.bipolarhome.org/understanding.html
http://www7.twu.edu/~f_huettig/fact_sheets/Emotdis.htm
http://ecdc.tamucc.edu/HELP/default.html
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DOWN SYNDROMEFACT SHEET
Down syndrome, also called Trisomy 21 is the most common cause of mental retardation andmalformation in a newborn.
CHARACTERISTICS
Psychomotor
Possible difficulty in walking Severe motor delays will put individual at a disadvantage Balance deficits limit motor skills Poor muscle tone Hyperflexibility Heart conditions could affect activity and fitness levels through out lifetime.
Cognitive
Delayed mental or social skillsAf fective
Stubbornness and refusal to talk when not fully understanding what is expected of them or whentrying to gain control over their lives Will talk to one-self in an uncomfortable or confusing situation
CAUSE
Down Syndrome, also called Trisomy 21, is caused by an error in cell division called non-disjunction. Anaccident in cell development results in 47 instead of the usual 46. The extra chromosome, number 21, ispresent in all or most of Down Syndrome individuals cells. This extra 21st chromosome has an impact onpsychomotor, cognitive and language development. Two other types of chromosomal abnormalities,mosaicism and translocation, are implicated but to a much lesser extent.
ETIOLOGY AND PROGNOSIS
Down Syndrome is the most common cause of mental retardation and malformation in a newborn. Itoccurs because of the presence of an extra chromosome, number 21, which has an effect on thepsychomotor, cognitive and language development. Some physical characteristics Down Syndromeindividuals display are being short in stature, having short fingers, toes, limbs and neck. They also displaydistinct facial features including small skull, slanting, almond shaped eyes, flat-bridged nose and smalloral cavity which can make tongue look large and protruding. Individuals with Down Syndrome have atendency to be overweight. Future conditions for individuals with Down Syndrome include; an inability toever reach normal growth development, possibility of poor hearing, heart conditions that will affect activityand fitness levels through life, and a faster aging process with a tendency to develop diseases of aginglike Alzheimers at an early age. Also, individuals with Down Syndrome are affected by certain eyedisorders including Strabismus (crossed eyes), which affects tracking skills and binocular vision throughout life.
IMPLICATIONS FOR PHYSICAL EDUCATION
Some important things that may affect a students performance in P.E. include:
visual problems
mild to moderate hearing loss
possible cardiovascular irregularities
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In addition, some individuals with Down Syndrome have Atlantoaxial Instability(AAI), a condition wherethere is increased mobility between the first and second cervical vertebrae, allowing the vertebrae to slipout of alignment easily, causing damage to the spinal cord. Because there are no symptoms of AAI, it isimportant for individuals with Down Syndrome to have X-rays taken. Copies of these X-rays should begiven to the school before any participation in physical activities.(www7.twu.edu/~f_huettig/Fact_Sheets/down.htm)
ASSESSMENT SUGGESTIONS
BASIC MOTOR ABILITYTESTS REVISED (BMAT-R): This test is used in children ages 4-12 to evaluatemotor responses such as; eye-hand coordination, finger dexterity, hand speed, flexibility, leg power,agility, static balance, arm strength and eye-foot coordination (Test can be obtained by writing to thefollowing address: Motor Thearpy, 2nd Ed., C,V. Mosby Co., St. Louis, MO 63141).
BROCKPORT PHYSICAL FITNESSTEST: For use in students ages 10-17. Test measures 3 components ofhealth related physical fitness; aerobic functioning, body composition and musculoskeletal function.(www.humankinetics.com)
PEABODY DEVELOPMENTAL MOTOR SCALES: Tests motor abilities, early movement milestones andfundamental movement skills in children ages birth- 6 years 11 months. Test helps to determine if achild is delayed in skill development, determine if there is a need for intervention and plan theprogram and assess improvements.( Test kit can be obtained by writing to the following address:DML Teaching Resources, One DML Park, Allen, TX 75002).
RECOMMENDED ACTIVITIES
Yoga poses which help to stretch, tone and strengthen the whole body. Yoga benefits central nervoussystem and helps develop balance, body awareness, concentration and memory (www.specialyoga.com)
CONTRAINDICATED ACTIVITIES
Students and athletes with Down Syndrome should be restricted from participation in gymnastics, diving,the butterfly stroke in swimming, the high jump, heading in soccer, and any exercise which placespressure on the muscles of the neck.
EFFECTIVE TEACHING STRATEGIES
Preschool
Teach individual in a highly structuredenvironment.
Allow for touching and feeling to learn
Use lighter weight equipment.
Use smaller teaching space
Use visual and auditory aid
Elementary
Allow student to make choices with someactivities to help their decision-making skills
Keep the same routine for class structure
Keep directions specific and brief
Use visual and auditory aids
Demonstrate skills
Use lighter weight equipment.
Breakdown the task into simple, small steps
Use of peer partners
Use positive behavior managementstrategies
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EEPPIILLEEPPSSYYFACT SHEET
According to the Epilepsy Foundat ion of America, epi lepsy is a phys ical condi tion that occurswhen there is a sudden, brief change in how the brain works. When brain cells are not working
properly, a persons consciousness, movement, or actions may be altered for a short time. These
physical changes are called epileptic seizures. Epilepsy affects people in all nations and of allraces, and there are about two mi llion Americans that have epilepsy. Some people can experience
a seizure and have epilepsy. A single seizure does not mean that the person has epilepsy.
CHARACTERISTICS
Epilepsy is a group of symptoms caused from abnormal electrical activity in the brain which results inseizures of varying magnitude. These symptoms listed are not necessarily indicators of epilepsy, it wiseto consult a doctor if you or a person experiences one or more of them:
Blackouts or periods of confused memory
Episodes of staring or unexplained periods of unresponsiveness
Involuntary movement of arms and legs
fainting spells with incontinence or followed by excessive fatigue
Odd sounds, distorted perceptions, episodic feelings of fear that cannot be explained
Seizures can be generalized where all brain cells are involved. Partial are when those brain cells notworking properly are limited to one part of the brain. There are many different types of seizures. Not all ofthem involve convulsions. When naming seizures, it is important to use terms which describe what ishappening during the seizure and to avoid terms such as mild or major which do not describe theevent. A person can experience more than one type of seizure. The frequency, length and pattern ofseizures tends to be fairly constant for each person, although it may change in the longer term.
CAUSE
For some people seizures are triggered by certain stimuli, which may differ from one individual to another.Identifying these triggers can help to avoid situations where seizures might occur. Such triggers mayinclude: lack of sleep or fatigue, stress, alcohol, flickering lights (photosensitive), hyperventilation, growthspurts, high alkalinity of the blood, low blood sugar, constipation, excessive noise, improperly usedmedications, intense concentration, menstruation, hyperthermia, or hyperhydration.
ETIOLOGY AND PROGNOSIS
When naming seizures, it is important to use terms which describe what is happening during the seizureand to avoid terms such as mild or major which do not describe the event. A person can experiencemore than one type of seizure. The frequency, length and pattern of seizures tend to be fairly constant
for each person, although it may change in the longer term.
Partial / Focal: The seizures begin or involve one part of the brain. A persons experience duringtheir seizure will depend on which part of the brain that is being affected.
Simple Partial / Jacksonian Focal seizures : consciousness is not impaired. The seizure may beconfined to either rhythmical twitching of one limb or part of a limb, or to unusual tastes or sensationssuch as pins and needles in a specific area. Partial seizures sometimes develop into other sorts ofseizures and so they may be referred to as a warning or aura.
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danger, move all obstacles away from the person, keep people from crowding around, do not restrainthe person, do not place anything in their mouth, loosen any restricting clothing, observe the personthroughout seizure. Call for medical help if seizure lasts for more than 5 minutes, if one seizurefollows another, if it is the first one known, if the person has injured themselves, or has difficultybreathing.
After : Roll the person onto their side (recovery position), wipe excess saliva away, check airway if
breathing labored, allow the person to rest, minimize any embarrassment, stay with the person untilfully recovered, and do not give any food or beverage until fully recovered
*Convulsi ve seizures can be frightening to observe, but remember the person is not in pain andwill no t have any memory of it. Any of these funct ions can be temporarily disturbed during thecourse of a seizure; personality, mood, memory, sensations, movement, or consciousness.
ASSESSMENT SUGGESTIONS
School personnel should monitor the effectiveness of the medication as well as any side effects. If achilds physical or intellectual skills seem to change, it is important to tell the doctor. Written observationsof school staff will be helpful in the discussions with the childs doctor. When a student displays or hastheir first known seizure in class, the teacher must contact the school nurse, and write down all
information that pertains to the situation before, during, and after.
EFFECTIVE TEACHING STRATEGIES
Before actually setting up a strategy, check the districts medical history sheet and contact the studentsphysician, past teachers, and parents. Most parents and school staff find that a friendly conversation atthe beginning of the school year is the best way to handle the situation. Activities can improve bothmental and physical health and should be encouraged for people with epilepsy. Most individuals withepilepsy can safely exercise in a gymnasium, pursue sports and use equipment even though seizuresarent completely under control, but a buddy system may be needed. All activities should be monitoredand individually adjusted to each persons exercise tolerance and medical history. Through the use of thebuddy system and consistent use of safety equipment,(helmet, knee and elbow pads) the student canparticipate in most activities.
These are some suggested activities which require a physicians permission or should be modified:
water sports
activities that place the student a few feetabove ground
archery
activities that have repeated blows to thehead.
Children and youth with epilepsy must also deal with the psychological and social aspects of thecondition. These include misperceptions and fear of seizures, uncertain occurrence, loss of self controlduring the episode, and medications. To help children feel more confident about themselves and accepttheir epilepsy, there should be education programs for staff and students, including information on seizurerecognition and first aid.
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RESOURCES
There are many materials available for families and teachers so that they can understand how to workmost effectively as a team.
Epilepsy Foundation: http://www.efa.org/
SITES ON EPILEPSY Charge-The experience of Epilepsy: http://www.charge.org.uk
Aims to promote social understanding and acceptance of this disease by demystifying the processesin the human brain which lead to seizure. Includes a bulletin board.
Epiweb: http://www.epiweb.orgInformation for parents with children who suffer from epilepsy. Includes resources, news, links,education, treatment and a notice board.
To Aid Someone Having A Seizure:http://www.assumption.edu/HTML/Admin/HealthServices/SEI.HTMLWhat you should do if someone has a seizure.
SITES IN RESOURCES Childhood Epilepsy: http://www.suite101.com/welcome.cfm/childhood_epilepsy
Informative site featuring information for parents of children with epilepsy. offers articles, helpfulwebsites, and discussions.
Epilepsy Facts & Latest News HealthNewsflash:http://www.healthnewsflash.com/conditions/seizures_and_epilepsy.htmThis resource has a medical fact book concerning information on diagnosis and treatment ofepilepsy with the latest medical news for patients and their families.
Epilepsy Resources on the Web: http://people.zeelandnet.nl/fhof/angelman/epilepsy.htmThe facts, links, parent support, personal stories.
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FFEETTAALLAALLCCOOHHOOLLSSYYNNDDRROOMMEE((FFAASS))FACT SHEET
A pattern of mental and physical defects which develop in some unborn babies when themother drinks too much alcohol during pregnancy.
CHARACTERISTICS
Distinct pattern of facial abnormalities, growth deficiency and evidence of central nervous systemdysfunction. Most individuals affected by alcohol exposure before birth do not have the characteristicfacial abnormalities and growth retardation identified with FAS, yet they have brain and otherimpairments that are just as significant.
Mental retardation, individuals with FAS, ARND and ARBD may have other neurological deficits suchas poor motor skills and hand-eye coordination.
May have a complex pattern of behavioral and learning problems, including difficulties with memory,attention and judgment. Have trouble generalizing behaviors and information Act impulsively Exhibit reduced attention span or is distractible Display fearlessness and are unresponsive to verbal cautions Demonstrate poor social judgment. Cannot handle money age-appropriately Difficulty structuring work time Show impaired rates of learning Experience poor memory Have trouble internalizing modeled behaviors
May have differences in sensory awareness (Hypo or Hyper).
Language Production higher than comprehension.
Show poor problem solving strategies.
CAUSE
FAS is a lifelong yet completely preventable set of physical, mental and neurobehavioral birth defectscaused by alcohol consumption during pregnancy.
FAS is the leading known cause of mental retardation and birth defects.
ETIOLOGY AND PROGNOSIS
Fetal Alcohol Syndrome (FAS) is a set of birth defects caused by maternal consumption of alcoholduring pregnancy. At birth, children with FAS can be recognized by growth deficiency and acharacteristic set of minor facial traits that tend to become more normal as the child matures. Lessevident at birthbut far more devastating to FAS children and their familiesare the lifelong effects
of alcohol-induced damage to the developing brain. FAS is considered the most common nonhereditary cause of mental retardation. In addition to deficits
in general intellectual functioning, individuals with FAS often demonstrate difficulties with learning,memory, attention, and problem solving as well as problems with mental health and socialinteractions. Thus these individuals and their families face persistent hardships in virtually everyaspect of life.
Birth defects related to alcohol use are permanent. Surgery can repair some of the physical problems,and schools and day care centers offer programs to improve mental and physical development.
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However, children born with FAS remain below average in physical and mental developmentthroughout their lives.
(http://www.nofas.org/main/what_is_FAS.htm)
IMPLICATIONS FOR PHYSICAL EDUCATION
Leisure, recreation, fitness, and sport activities. Teachers will need to modify instruction.
ASSESSMENT SUGGESTIONS
Brockport Physical Fitness Test
DEVPRO Motor Skills Assessment
Assessment for APE
Achievement Based Curriculum (ABC)
EFFECTIVE TEACHING STRATEGIES
Provide short and clear instructions.
Provide frequent feedback to the individual.
Repeat directions.
Have the individual demonstrate the task forclear understanding.
Keep the learning environment consistentwith little change.
Eliminate distractions (visual and auditory).
Demonstrate tasks for visual understanding.
Use peers as partners for the individual
Slow down the speed of the activityespecially if it is concerning anoncompetitive activity, i.e. (stretching,exercises, etc).
EFFECTIVE BEHAVIOR MANAGEMENT STRATEGIES
Set limits and follow them consistently.
Change rewards often to keep interest inreward getting high.
Review and repeat consequences ofbehaviors.
Ask them to tell you consequences.
Do not debate or argue over rules alreadyestablished. "Just do it."
Notice and comment when your child isdoing well or behaving appropriately.
Avoid threats.
Redirect behavior.
Intervene before behavior escalates.
Avoid situations where child will be over-stimulated.
Have child repeat back their understandingof directions.
Protect them from being exploited. They arenaive.
Have pre-established consequences formisbehavior
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RESOURCES
Teachers:
http://www.thearc.org/misc/fasresources.doc
Parents:
http://www.taconic.net/seminars/fas02.htmhttp://www.nofas.org/main/what_is_FAS.htm
Sport:
www.come-over.to/FAS/
REFERENCES
Troccoli, K.B. (1992). Fetal Alcohol Syndrome: the impact on childrens ability to learn. National EducationConsortium.
http://www.nofas.org/main/what_is_FAS.htm
http://www.nofas.org/main/what_is_FAS.htm
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Sensory-neural loss happens when the cochlea is damaged, destroyed, or the connection to thebrain is not working.
Mixed is a combination f conductive and sensory-neural loss.
The prognosis of an individuals hearing loss depend on the amount of nerve damage, which determinesthe severity. Some ways to help restore some hearing is by: hearing aids, cochlear implants, or removing
wax blockage.
IMPLICATIONS FOR PHYSICAL EDUCATION
Individuals with hearing impairments can do just about everything with the same motor ability as non-disabled individuals. However, a hearing impaired individual may experience static and dynamic balancechallenge, physical fitness, some delays in gross and fine motor skills, and some difficulty with appliedforce and coordination. Making small adaptations for individuals with hearing impairments will make themto be able to be just as successful as anyone else in their class:
Make the environment more conducive to them by: less excess noise, if you use music have it at areasonable level for all students, use an auditory device, have clear instructions better, and keep aroutine for the student.
Educate all the students in his/her class about his/her disability. Have disability awareness to increase acceptance, social skills, and tolerance of individuals that
maybe a little different for the entire school.
Simulating the students disability can help everyone feel more comfortable and aware of what it islike to be hearing impaired.
ASSESSMENT SUGGESTIONS
Assess to see if the student has a hearing impairment by using standardized tests and from those testsdevelop the students IEP (Individual Education Plan). Some good standardized tests include:
ASSESSMENT FOR ADAPTED PHYSICAL EDUCATION (A-APE): assessment of motor developmentaccurately and makes the IEP process more efficient (http://a-ape.com/)
BROCKPORT PHYSICAL FITNESSTEST: for ages 10-17; addresses fitness concerns of individuals withdisabilities. The test describes 27 tests to assess an individual with disability. The manual makesrecommendations on which tests to use when assessing individuals with specific disabilities(http://www.humankinetics.com)
BRUININKS-OSERETSKYTEST OF MOTOR PROFICIENCY: for ages 4 - 14 ; subtests to measure suchareas as: speed, agility, balance, coordination, strength, and fine motor dexterity
TEST OF GROSS MOTOR DEVELOPMENT (TGMDII): for ages 3-10; tests 12 gross motor patterns suchas running, galloping, and jumping. The manipulative patterns include such items as bouncing,catching, and kicking (http://www.proedinc.com)
SPECIAL OLYMPICS SPORTS SKILLS PROGRAM: written and illustrated so that teachers and coaches atevery level of experience can improve their skills. There are several sports skill books, whichcontains an assessment instrument for the novice and experienced athlete, along withteaching/coaching ideas on basic skills and appropriate drills (http://www.specialolympics.org/)
Make your own informal types of assessments like: rubrics, checklists, authentic assessment, producttasks, portfolios, and through video taping.
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RECOMMENDED ACTIVITIES
Bowling: simplify/reduce the number of steps use two hands instead of one remain in stationary position use a bowling ramp
use a partner give continuous signed cues
Basketball: use various size balls (bright colors) allow traveling allow two-hand dribble use larger/lower goal slow the pace down
Golf: use a club with a larger head use shorter/lighter club use larger balls
use tee for all shots shorten distance to hole
Soccer: use walking instead of running use a deflated ball, nerf ball, bright
colored ball reduce playing area play six-a-side soccer use bigger goal
Softball: use a bright softball use larger or smaller bats use a batting tee
reduce the base distances provide a peer to assist
Tennis: use a soft bright ball use lighter racquets use larger head racquets hit ball off tee allow a drop serveuse a peer for
assistance
Volleyball: use larger, lighter, softer, bright colored
balls
allow players to catch ball instead ofvolleying allow student to self toss and set ball lower the net reduce the playing court stand closer to net on serve allow ball to bounce first hold ball and have student hit it
CONTRAINDICATED ACTIVITIES
Swimming, due to the damage already from their disability. Too much water pressure could damagetheir hearing even more.
EFFECTIVE TEACHING STRATEGIES
Need to have a safe environment that they can enjoy do the activity in. Keep it free of obstacles, andwith no loud noises.
Assistance may be needed for some activities to get the most out of the student. Learn basic sign language, and keep a positive attitude. Use other teachers as a valuable resource. Make sure hearing impaired students can see your lips when you talk. Use visual demonstrations when you teach. Learning basic sign language, so you can communicate better with the student and fellow classmates
can. Using an Alphanumeric Pager - is basically like any other pager that you call and text a message to,
except there are more options and a clearer display. When you teach standing in one place and giving visual attention-getters will help get him/her on
task. Have the student feel safe and comfortable in their environment and with others around them.
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POSITIVE BEHAVIOR MANAGEMENT
Determine the cause of your students behavior before the situation increases into a bigger problem. Be aware of everything that is going around in your class, and what kind of personalities each one of
your studentss have. Mange time effectively. Set a comfortable pace to learn at. Keep the students motivated before they get of track and into trouble.
RESOURCES
Teacher: http://www.as.wvu.edu/~scidis/hearing.html http://www.chelt.ac.uk/gdn/disabil/deaf/deaf.pdf
http://education.qld.gov.au/curriculum/learning/students/disabilities/practice/strategies/histrategies.html
http://www.pecentral.com
http://www.teachersfirst.com/sped/prof/deaf/strategies.html Parent: http://www.deafness.about.com http://www.kidshealth,org http://www.marky.com http://www.mayoclinic.com/
Sport: http://www.ciss.org/ http://www.nsad.org/ http://www.madd.org/ http://www.narha.org/ http://www.nwadd.org/
http://www.specialolympics.org/Special+Olympics+Public+Website/default.htm http://www.usdsaa.org/ http://www.usadsf.org/
REFERENCES
Winnick, P.J . (1995).Adapted Physical Education and Sport. Champaign, IL: Human Kinetics.
http://www.mayoclinic.com/ (hearing loss).
http://www.pecentral.com
http://www.deafness.about.com
http://www.twu.edu/~_huettig/
http://www.kidshealth,org
http://www.marky.com
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JJUUVVEENNIILLEEDDIIAABBEETTEESSFACT SHEET
Juvenile Diabetes, also called Type 1 diabetes, or insu lin-dependent diabetes, is a disorder of thebodys immune system the bodys system for protecting itself for viruses, bacteria or any foreign
substances.
CHARACTERISTICS
The warning signs of juvenile diabetes include extreme thirst, frequent urination, drowsiness or lethargy, sugarin the urine, sudden vision changes, increased appetite, sudden weight loss, fruity or sweet odor on the breath,heavy or labored breathing, stupor, or unconsciousness.
CAUSE
Scientists do not know exactly what causes J uvenile Diabetes. They believe it may stem from autoimmune,genetic, and/or environmental factors. The appearance of J uvenile Diabetes is suspected to follow exposure toan environmental trigger such as an unidentified virus. The exposure to a virus stimulates an immune attachagainst the beta celss of the pancreas (that produce insulin) in some genetically predisposed people.
ETIOLOGY AND PROGNOSIS
People with J uvenile Diabetes must take insulin in order to stay alive. This means undergoing multiple injectionsdaily, or having insulin delivered through and insulin pump, and testing blood sugar by pricking their fingers forblood six or more times daily. People with diabetes must also carefully balance food intake and exercise toregulate their blood sugar levels. Maintaining appropriate diet and exercise levels helps to avoid hypoglycemic(low blood sugar) and hyperglycemic (high blood sugar) reactions, which can be life threatening.
While insulin allows a person with J uvenile Diabetes to stay alive, it does not cure the disease. The potentialcomplications associated with J uvenile Diabetes include:
RetinopathyDiabetic retinopathy is the most common and serious eye-related complication of diabetes. It is a progressivedisease that destroys small blood vessels in the retina, eventually causing vision problems. In its mostadvanced form it can cause blindness. Nearly all people with J uvenile Diabetes show some symptoms of
diabetic retinopathy. After living with diabetes for 20 years, nearly 25% develop the advanced form.NephropathyDiabetic kidney disease is one of the most common and most devastating complications of diabetes. It is a slowdeterioration of the kidneys and kidney function. In severe cases, it can eventually result in kidney failure, alsoknown as end stage renal disease. About 30% of people living with J uvenile Diabetes develop nephropathy.
Cardiovascular DiseaseCardiovascular disease, a range of blood vessel system diseases that include both stroke and heart attack, isthe major cause of death in people with diabetes. The two most common types of cardiovascular disease arecoronary heart disease, caused by fatty deposits in the arteries that feed the heart, and hypertension, or highblood pressure.
NeuropathyNeuropathy, or nerve damage, affects more than 60% of people with juvenile diabetes. The impact of nerve
damage can range from slight inconvenience to major disability and even death. Diabetic neuropathy leads toloss of feeling and sometimes pain and weakness in the feet, legs, hands, and arms. It is the most commoncause of amputations not caused by accident in the Unites States. In one type of neuropathy, known asautomatic neuropathy, high glucose levels injure the autonomic nervous system, which controls bodily functionssuch as breathing, circulation, urination, sexual function, temperature regulation, and digestion. Autonomicneuropathy may result in various types of digestive problems, diarrhea, erectile dysfunction, a rapid heartbeat,and low blood pressure.
IMPLICATIONS FOR PHYSICAL EDUCATION
Lack of insulin production by the pancreas makes J uvenile Diabetes particularly difficult to control. Studentswill need to maintain a carefully regulated diet, planned physical activity, blood glucose testing several times
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a day, and multiple daily insulin injections in order to maintain participation in physical education.Participation in physical activities and sport should be encouraged. However, be aware that hypoglycemiacan occur during and after physical activity. Be prepared to recognize the signs and symptoms of diabeticemergency and how to treat in an emergency situation.
Treat students with diabetes the same as other students, except to meet medical needs.
Make sure substitute P.E. instructor is aware of student needs without violating the students right to privacy
Create a Quick Reference Emergency Plan (QREP) in case the student goes into diabetic shock. TheQREP should be created by the student, his/her parent(s), the school nurse, and the physical education
teacher. The plan should include: Names and numbers of important contact personnel Causes, signs and symptoms of hypoglycemia Locations (gym, playing fields, off-campus facilities) for all units of instruction for quick response of
emergency medical personnel Actions needed, or instructions for response to hypoglycemia
o Include instructions for emergency glucagon kit if applicable
Carry personal supplies and keep readily available: Blood glucose monitoring equipment Emergency Glucagon Kit if prescribed
Sugar in the form of juice, candy, or glucose tabletsA Pract ical Program for Juveni le Obesi tyOften times, children with diabetes also struggle with obesity. The following guidelines pertain to exerciserecommendations for individuals who are obese:
Activity must involve large muscle groups to induce large energy expenditure. Examples include walking,cycling, swimming, dancing, cross-country skiing, skating, basketball, and soccer. By performing suchactivities for 30 to 45 minutes, 10- to 11-year-old obese children burned 200 to 250 kcal (40). Thisamount will vary according to the body weight of the child and the intensity of exercise.
It is the total energy expenditure, rather than the intensity of the activity, that matters. For example,walking 1 mile will have an almost identical effect to that of running 1 mile. At the start of a program,the intensity and duration of the activities should be low and gradually increase as the programprogresses.
Activity must be fun, and the child should enjoy it. A play-like, recreational atmosphere is particularly
important for children in the first decade of life. Compared with structured prescriptions, "lifestyle"activities yield more compliance during the intervention and a greater adherence once the structuredelement of the program has concluded (49).
Obese children and, particularly, adolescents feel less inhibited when they exercise in the company ofother obese patients, rather than exercising with nonobese people.
http://www.physsportsmed.com/issues/2000/11_00/bar_or.htm
ASSESSMENT SUGGESTIONS
Treat students with diabetes the same as other students, except to meet medical needs.
RECOMMENDED ACTIVITIES
Treat students with diabetes the same as other students, except to meet medical needs.
Water-based activities are often more suitable for obese patients than are land-based activities. Theadvantages of aquatic activities are threefold:
1) Because of their high fat content, obese individuals are more buoyant than their leaner peers2) Subcutaneous fat is an excellent thermal insulator, which gives obese people an advantage in cool
water3) During water-based activities, most of the body is submerged. This provides a psychological
advantage over land-based activities in which the body shape of the obese child is exposed.
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CONTRAINDICATED ACTIVITIES
Treat students with diabetes the same as other students, except to meet medical needs. Note that vigorousor unplanned exercise can trigger a diabetic emergency.
EFFECTIVE TEACHING STRATEGIES
Treat students with diabetes the same as other students, except to meet medical needs.
RESOURCES
Teachers:Websites:
http://www.ncpad.org/
http://www.ncpad.org/abstracts/default.htm Abstract ofCarnethon MR, Gidding SS, Nehgme R, Sidney S, Jacobs DR, Liu K.2003.
Cardiorespiratory fitness in young adulthood and the development of cardiovascular disease riskfactors. Journal of the American Medical Association. 290 (23): 3092-3100.
Abstract ofEpstein LH, Roemmich JN. Reducing sedentary behavior: Role in modifying physicalactivity. Exercise and Sport Sciences Review. 2001; 29 (3): 103-108.
Abstract ofVincent SD, Pangrazi RP, Raustorp A, Tomson LM and Cuddihy TF Activity Levels and
Body Mass Index of Children in the United States, Sweden and Australia . Medicine and Science inSports and Exercise. 2003; 35(8): 1367-1373.
http://www.palaestra.com/
Parents:Websites:
http://www.ncpad.org/discus_script/discus.cgi
http://www.disabilitycentral.com/activteen/magazine/entertainment_recreation/ent_rec.htm
http://www.nscd.org/TheNational Sports Center for the Disabled provides therapeutic recreation programs that are designed forindividuals with disabilities who require adaptive equipment and/or special instruction. Instructors have
taught individuals with a variety of disabilities, including amputation, congenital disabilities, visual andhearing impairments, developmental disabilities, and physical disabilities
http://www.jdf.org/
http://www.palaestra.com/
http://www.childrenwithdiabetes.com/d_0b_200.htm
http://www.childrenwithdiabetes.com/index_cwd.htm
http://www.diabetes.org/home.jsp
REFERENCES
http://www.physsportsmed.com/issues/2000/11_00/bar_or.htm
http://www.diabetes.org/home.jsp
http://www.jdf.org/
http://www.jdrf.org/index.cfm?fuseaction=home.viewPage&page_id=C7E16B03-5E34-4D9F-A5F8C6732367F03D
http://www.jdf.org/index.cfm?fuseaction=home.viewPage&page_id=0FC9970A-635A-43C2-8D37B6894CF78C72
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MMUULLTTIIPPLLEEDDIISSAABBIILLIITTIIEESSFACT SHEET
Concomitant impairments (such as mental retardation-blindness, mental retardation-orthopedicimpairments, etc.), the combination of which causes such severe educational needs that they
cannot be accommodated in a special program solely for one of the impairments. The term does
not i nclude deaf-blindness (IDEA, 1997).
CHARACTERISTICS
Individuals may have one or more of the following:
Movement difficulties
Sensory losses
Behavior problems
Limited speech or communication
Difficulty in basic physical mobility
Tendency to forget skills through disuse
Trouble generalizing skills from onesituation to another
A need for support in major life activities(domestic, leisure, communityintegration, and vocational)
Presence of primitive reflexes
Possibly nonambulatory
CAUSE
There is no identifiable cause in 40% of cases of multiple disabilities. Most individuals withmultiple disabilities with known causes are due to prenatal biomedical factors. Other possiblecauses may be linked to genetic metabolic disorders, dysfunction in production of enzymesleading to a buildup in toxic substances in the brain, or brain malformations.
PROGNOSIS
The prognosis of multiple disabilities is dependent on specific disabilities associated with each
individual.
IMPLICATIONS FOR PHYSICAL EDUCATION
An individual with multiple disabilities may be challenged with:
Motor delays
Abnormal muscle tone
Muscle atrophy, contractures
Problem balancing
Behavioral problems
ASSESSMENT SUGGESTIONS
Traditional or standardized assessments are often not practical. Authentic assessments have tobe developed to suit the needs of the student Keep in mind these assessments should befunctional to skills the student will need in life. For many individuals, posture and range of motionare more appropriate criteria to assess compared to strength and skills.
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CONTRAINDICATED ACTIVITIES
Activities that involving fast moving objects student may have difficulty tracking and movingout of the way
Holding a child with head and neck out of mid-line
W sitting position Dynamic stretching
EFFECTIVE TEACHING STRATEGIES
Maintain a small teacher to student ratio
Learn from caregivers what the child likes and dislikes
Use positive reinforcement
Establish rapport
Talk to child as if they were any other child
Mirror their movements to see if they notice assessing
Obtain behavior management information use consistently
Use all forms of communication sign, language, visual and tactile
Slow instructions avoid excess words
Learn what primitive reflexes are still present
Focus instruction on lifetime physical activity
Teach in the pool monitor temperature of pool (most cases the warmer the water the better) learn of any allergies of chlorine
Find out as much information about the child as possible allergies and feeding procedures
Use sensory integration instruction when appropriate
Preschool age children should be included
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RESOURCES
Teachers:
Websites: www.slc.sevier.org/sevmltol.htm www.nichey.org.disabinf.asp
Books:
Adapted Physical Activity, Recreation and Sport Sherrill
Parent:
Websites: www.parentsoup.com/offline/special/articles/ www.childrensdisabilities.info/ parenting/bklivingskin.html www.teach-at-home.com/FastFacts/ disabilities/FactSheet.asp?A=10
Sport:
Websites: http://www.lowvision.org/sports_and_recreation.htm http://recreation-and-leisure-for-students-with-severe-disabilities.thecycles.com/ www.skillsndrills.com
REFERENCES
Sherril, C. (1998). Adapted physical activity, recreation and sport: crossdisciplinary and lifespan(5th ed.). Boston: McGraw Hill.
Curtis, S.R. (1982). The joy of movement in early childhood. New York: Teachers College.
National Dissemination Center for Children With Disabilities 2003. Severe/Multiple disabilities.Retrieved March 2, 2004, from http://www.nichcy.org/pubs/factshe/fs10.pdf.
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MMUUSSCCUULLAARRDDYYSSTTRROOPPHHYYFACT SHEET
Genetic muscle diso rders that may also involve atrophy of the heart and respiratory muscles.
CHARACTERISTICS
Muscular Dystrophy involves a group of genetic muscle disorders that may also involve atrophy of theheart and respiratory muscles. Muscular Dystrophy may also be referred to as:
MD, Inherited myopathy or Pseudohypertrophic muscular dystrophy.
Depending upon the type, symptoms may range from muscle weakness with low disability, to functionalloss of ambulation and with certain types, death. The different types below differ from each other by:
inheritance-from a dominant or recessive gene, the age symptoms appear
The development or onset of specific symptoms. Most often the genetic abnormality comes from one orboth parents and causes missing or malformed muscle membranes, leading to muscle weakness anddeterioration.
CAUSE
Duchenne muscular dystrophy: caused by a defective gene (x-recessive) meaning it almost neveraffects females, since females have two x chromosomes.
Becker muscular dystrophy: Myotonic dystrophy: Myotonia congenital: due to excess chloride in a muscle cell Limb-girdle muscular dystrophy: Fascioscapulohumeral muscular dystrophy:
ETIOLOGY AND PROGNOSIS
Duchenne muscular dystrophy: Occurs in approximately 2 out of 10, 000 individuals and can be detected through genetics during
pregnancy, with about 95% accuracy Symptoms usually appear in males, ages 1 to 6 years with initial muscle weakness in the legs
and lower body. Children may require braces for walking by age 10 and experience wheelchair confinement by
age 12. Muscle weakness and skeletal deformities can cause breathing disorders. Some intellectual
impairment, although not progressive, may occur Students may have difficulty with basic locomotor skills such as running, jumping or hopping and
may frequently fall. Progressive muscle weakness, difficulty walking, fatigue, scoliosis and calfmuscle enlargement is obvious. Death, due to respiratory conditions, may occur by early twenties.
Becker muscular dystrophy:. Occurs in 3-6 out of 100,000 male births with females rarely demonstrating symptoms Onset of symptoms typically occur during adolescence, but may occur anywhere from age 5 to age 25. Pelvic muscle deterioration may lead to inability to walk and loss of strength in back and shoulders. Unlike Duchenne, individuals may have a normal life span. similar to Duchenne muscular dystrophy however with much slower progression
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IMPLICATIONS FOR PHYSICAL EDUCATION
General consideration factors include:
Communication and collaboration with physical therapists, special education teachers, parents andothers involved with the child, to gain insight concerning disability, behavior, safety, medications andother information.
Safety considerations for all students: wheelchairs or braces must not provide an unsafeenvironment.
Allowing the involvement of older students, enabling them to participate in their own specificindividual modification planning.
Adapting different teaching styles to meet learner needs and designing an individualized learning environmenwith multiple success levels, thus benefiting all students.
Using different ball/bat choices, target selections, playing area modifications and ramps forwheelchairs.
An ecological approach:(Block, 2000) based upon student and parent interests, specific targeted skilldevelopment, available supports and lifetime community recreational activities could be valuable to a studentwith Becker muscular dystrophy.
ASSESSMENT SUGGESTIONS
Assessment should be individual, appropriate and consider disability limitations. For example, a studentin a wheelchair should not be assessed using the same throwing criteria as another. The student in thewheelchair is unlikely to step with opposition, demonstrate side orientation or show upper body rotation.
The goal of assessment, regardless of tool, should be to determine a baseline, provide intervention(instruction) and improve skill level. The need for ongoing, individualized assessment of targeted skills iscritical. Individualized assessment, similar to individualized instruction, benefits all participants.
RECOMMENDED ACTIVITIES
Aquatics, with the natural buoyancy, may foster movement and range of motion objectives.
EFFECTIVE TEACHING STRATEGIES
Specific Aquatic Teaching Strategies:
Students with Duchenne are generally good floaters.
As the disease progresses, swimmers may lose the strength necessary to hold their head out of thewater while in a prone position.
Activities in the supine position may promote relaxing and optimize respiratory function.
Recoveries to supine, elementary backstroke and sculling may be useful skills.
Swimmers with MD are often heavy and difficult to lift into and out of the pool. Avoid lifting that putspressure on the shoulders, where muscle tone may be lacking.
An important objective is to slow the MD atrophy by maintaining muscle tone throughout activity ...while avoiding undue fatigue.
Know your student and do not hesitate to seek his/her input. Help him/her keep a positive outlook.Students may have lowered motivation, lack of interest, or a low frustration tolerance when unable to doskills once had ability to do (as disease progresses).
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http://www.as.wvu.edu/~scidis/motor.htmlRetrieved April 14, 2004
http://www.brookespublishing.com/cgi-bin/dictionary.plRetrieved March 28, 2004
http://www.mdausa.org/Retrieved April 13, 2004
http://www.noah-health.org/english/illness/neuro/musdys.htmlRetrieved March 28, 2004
http://www.uvm.edu/~rgobin/imanual/28SPEC~1.HTM)Retrieved April 14, 2004
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SSEEIIZZUURREEDDIISSOORRDDEERRFACT SHEET
There are two kinds o f seizure disorders, anisolated, non-recurrent attack, such as may occurduring a febrile illness or after head trauma, and epilepsy--a recurrent, paroxysmal disorder of
cerebral function characterized by sudden, brief attacks of altered consciousness, motor activity,
sensory phenomena, or inappropriate behavior caused by excessive discharge of cerebralneurons. This fact sheet will focus more on the isolated, non-recurrent attacks and those seizures
that are drug-induced.
CHARACTERISTICS
Aura - warning signs of a seizure
Postictal state - symptoms that follow a seizure deep sleep headache confusion muscle soreness
Simple partial seizure - motor, sensory, or psychomotor phenomena without a loss ofconsciousness
Jacksonian seizure - a seizure that starts in one part of the body and spreads. Ex - starts in handand moves up arm
Complex partial seizure - a seizure in which the individual will lose contact with surroundings for 1-2minutes. The individual might: Stare Perform automatic purposeless movement Utter unintelligible sounds Resist aid Mental confusion continues for 1-2 minutes after the seizure
Generalized seizure - this type of seizure causes a loss of consciousness and motor function. It isgenetic or metabolic in cause
Infantile spasms - a seizure characterized by sudden flexion of arms, forward flexion of trunk, andflexion of legs. They last only a few seconds and repeat many times a day. They only occur inchildren within the first three years.
Absence seizure - (petit mal) - brief primarily generalized attacks manifested by a 20-30 second lossof consciousness, eyelid fluttering, may or may not have the presence of axial muscle tone loss. Theindividual will not fall over or convulse and will resume activity as soon as seizure is over. They willhave no knowledge of the seizure once it is over. These types of seizures often happen when anindividual is sitting quietly, they rarely occur during activity.
Generalized ton ic-clonic seizure - begins with outcry, continues loss of control and a fall, tonic-
clonic contractions of muscles, possible loss of bowels. Lasts 1-2 minutes, usually begins withsimples or complex partial seizure.
Aton ic Seizure - brief, primarily generalized seizure in children complete loss of muscle tone and consciousness fall or pitch to the ground chance of serious head trauma
Myoclonic seizure - brief, lightening like jerks of the limbs or trunk, may be repetitive leading totonic-clonic seizure. No loss of consciousness
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Febrile seizure - associated with fever without evidence of intracranial infection. They occur inchildren ages 5 and younger.
CAUSE
The following may be triggers for a seizure:
Convulsant drug
Growth spurts
Hypoxia
High alkalinity of blood
Hypoglycemia
Low blood sugar
Lack of sleep
Constipation
Stress
Excessive noise
Alcohol
Improperly used medication
Flickering lights
Intense concentration
Hyperventilation
Menstruation
Hypothermia
Hyper hydration
ETIOLOGY AND PROGNOSIS
Our brain is an enormously huge and complex network of electrical circuits. Seizures are the result ofabnormal activity in one area of this circuit which causes abnormal currents to spread to the rest of thebrain. The result is a seizure with physical and/or behavioral manifestations.
Seizures are associated with many medical conditions:
Most convulsions in infants and toddlers are caused by fever; rarely cause lasting damage
Gastrointestinal disease
Poisoning
Head injury
Brain disease such as a tumor
Breath-holding during a tantrum (rare)
In order for a medical provider to diagnose cause of the seizure the following needs to be recorded:
Eyewitness account of a typical seizure
Frequency of seizures and the longest and shortest intervals between them
History of prior head trauma, infection, or toxic episodes must be evaluated
Family history of seizures or neurological disorders
IMPLICATIONS FOR PHYSICAL EDUCATION
A PE teacher can best help a student with seizure disorder by trying to prevent a seizure from occurringby choosing appropriate activities for the class to participate in. They should also be prepared byknowing what to do if a student does have a seizure in class.
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A PE teacher should:
Encourage a normal life for a student with seizure disorder
Recommend exercise
Encourage student to be social
If a seizure occurs the PE teacher should:
Remain calm
Remove sharp objects from the area
Loosen clothing around neck to help personbreathe
Place a pillow or soft object (mat) under thehead
Roll the patient onto his/her side to keep airpassage clear
Do not attempt to force open the person'smouth or insert any objects inside theperson's mouth
Do not try to hold the person down or restrictmovement
Do not attempt CPR, unless the persondoes not start breathing again after theseizure is over
Remain with the person until the seizure hasended
Reassure the person as consciousnessreturn
ASSESSMENT SUGGESTIONS
What to assess in PE if a child has seizure disorder:
Motor skills; if the skills seem to change a doctor should be notified
CONTRAINDICATED ACTIVITIES
Students with seizure disorder should refrain from:
Doing activities that require them to be off the ground:
balance beam jumping from elevated mats cargo net adventure activities that require elevation rope climbing ex-rock climbing
They should also be monitored closely when participating in any water activity: swimming water aerobics water polo diving synchronized swimming scuba diving or snorkeling
EFFECTIVE TEACHING STRATEGIES
Teachers who have students with seizure disorder in their class should be aware of the disorder andknow the implications and etiology for that specific child. They should know the situations or externalfactors that affect the student and teach and to avoid those situations. Teachers could use a buddysystem with students with seizure disorder. This would assure that the student always had someone withthem to alert a teacher if a seizure were to occur. The other student should be educated about seizuresso they do not become frightened if a student has a seizure in class.
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RESOURCES
Websites:
http://www.familyvillage.wisc.edu/lib_epil.htm This is a comprehensive website giving a huge amount of information. It gives parents
associations to contact to find out more about seizure disorder and what they can do for their
children. It gives parents a place to go online to talk with others and get support. There are linksto other websites that teach about seizure disorder and finally there are links to otherorganizations and websites that deal with seizure disorder.
http://xpedio02.childrenshc.org/stellent/groups/public/@xcp/@web/@bibliography/@parents/documents/policyreferenceprocedure/web020893.asp &http://www.amazon.com/exec/obidos/tg/detail/-/0596500033/103-4185789-3707031?v=glance These two websites talk about books parents can purchase to learn more about seizure disorder
and what they can do for their children.
http://health.indiamart.com/kidshealth/illness/seizures.html This is a very easy to read, informational website about seizures and seizure disorder.
REFERENCES
http://www.merck.com/mrkshared/mmanual/section14/chapter172/172a.jsp
http://groups.msn.com/ParentsofVaccineDamagedChildren/yourwebpage2.msnw
http://health.indiamart.com/kidshealth/illness/seizures.html
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SSEERRIIOOUUSSEEMMOOTTIIOONNAALLDDIISSTTUURRBBAANNCCEEFACT SHEET
CHARACTERISTICS
Exhibits one or more of the characteristics over a long period of time:
inability to learn which cannot be explained by intellectual, sensory, or health factors
inability to build or maintain satisfactory interpersonal relationships with peers and teachers
inappropriate types of behavior or feelings under normal circumstances
general pervasive mood of unhappiness or depression
tendency to develop physical symptoms or fears associated with personal or school problems
(Federal Register, Sept. 1992, p. 44802)
Students may also show signs of these over a long period of time, when a person or student isemotionally disturbed:
Defiant
Impertinent
Uncooperative
Irritable
Attention seeking
Negative
Hypersensitive
Hyperactivity (short attention span,impulsiveness)
Aggression/self-injurious behavior (actingout, fighting)
Withdrawal (failure to initiate interaction withothers)
Retreat from exchanges of social interaction
Excessive fear or anxiety
Immaturity (inappropriate crying, tempertantrums, poor coping skills)
Learning difficulties (academicallyperforming below grade level)
Academy of Education, kidsource.com, 2004Sherrill, 1998, p.552
CAUSE
The cause of serious emotional disturbance has not been determined exactly some factors that maycontribute to it are:
heredity, brain disorder, diet, stress, and family functioning
abuse when younger, late or no pre-natal care
nichy.org, Fact Sheet, 2004
ETIOLOGY AND PROGNOSIS
Students described as Seriously Emotionally Disturbed (SED) make up 10.5% of all students withdisabilities. In 1991-92 there were 400,670 ages 6-21 qualified as Seriously Emotionally Disturbed(Wagner, Mary, 1995). However, 16% did not show these characteristics until secondary levels ofeducation. Males make up the greatest number of students with SED at 76.4% (Wagner, 1995). Familieswith earnings of less than $12,000 a year make up the greatest percent at 38.2% (Wagner 1995).
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Percentages show that students with SED in grades 9-12 receive more attention than other students withdisabilities (Wagner, Table 7, 1995). Approximately 60% of these students are receive planning for whenthey continue with life out of High School. (Wagner, Table 7, 1995)
www.futureofchildren.org/usr_doc/vol5no2ART7.pdf, Mary Wagner
ASSESSMENT SUGGESTIONS
One model for use in assessing includes Don Hellisons Social Development or Social ResponsibilityModel (1978, 1984). The social development levels assessed include:
Level 0:Irresponsibility disruptive behaviors, abuse, and refusal to participate and cooperate
Level 1: Self Control accepting responsibility for ones action, no longer disruptive, not prepared or fullyparticipating
Level 2: Involvement effort to follow instructions and cooperate with others, behavior inconsistent,needs frequent prompts and rewards
Level 3: Self-Responsibility works independently, sets personal goals, stay on task with minimal or noassistance
Level 4: Control self-initiative in helping others, emphasize and sustain caring relationshipsLevel 5: Going Beyond social maturity to accept leadership responsibilities
Sherrill, 1998, p. 558
Other Assessments:
Westchester IQ Series
Walker and McConnell Scale of Social Competence and School Adjustment
Woodcock-J ohnson Psycho-Educational Battery
RECOMMENDED ACTIVITIES
Exercise can help decrease anger, depression and disruptive behaviors. Exercise should be:
perceived as pleasant
aerobic or as close as the individual can handle
noncompetitive
non threatening
moderate intensity
used two or three times or as individual sees fit
Ideally, structure the environment that provides the student with the greatest opportunity for success.
CONTRAINDICATED ACTIVITIES
Students with SED can participate in activities that all other students in general PE may participate in. Astudent with SED will be least constructive in an activity that does not personally interest him/her.
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EFFECTIVE TEACHING STRATEGIES
Guidelines for class with students with SED:
Display appropriate authority
Explain class goals on 1st day and routine to be followed
Discuss goals often with each student, develop a contract what student must do to achieve goal,relate goals to the group goals
Keep simple class rules, set as few as possible to obtain order
Clearly explain consequences of not following the rules, or regulations and the rewards for followingthem as well
Allow students to be involved in the consequence process, post in the room or allow them to take partin making them.
Demonstrate consistency in enforcing rules and providing feedback.
Appl ied Behavior Princ iples (ABA)
Target behaviors that need to change and define components of these behaviors
Observe, chart and analyze behaviors to change
Select and apply specific strategies to achieve behavior changes (i.e. start and stop signals, routinesfor transitions, techniques for forming groups, strategies for coping with disruptive behaviors)
Periodically evaluate progress toward changing an individuals behaviors and revise their behaviorchange plan
Banduras (1977) Self Efficacy Theory :
Allow individuals to feel safe by task analyzing and structuring activities to assure personal mastery
Promote vicarious feelings of mastery by watching and listening to models who look successful andappear to be having fun
Use personal persuasion by significant others
Provide counseling or psychotherapy that teaches cognitive control of anxiety and fear
Sherrill, 1998, p. 559-560
RESOURCES
People who should be used in this process are the students immediate family, including distant family ifthey are around the student a lot. Also special education teachers should be contacted to find out the bestmanagement techniques. Heads of each department as well, Special Education and Adapted PhysicalEducation will aid in the management process.
REFERENCES
Sherrill, Claudine; Adapted Physical Activity, Recreation and Sport; 1998, McGraw Hill, ch. 22
pecentral.com
kidsource.com
nichy.org
www.futureofchildren.org/usr_doc/vol5o2ART7.pdf, Mary Wagner
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SSPPIINNAABBIIFFIIDDAAFACT SHEET
A cleft spine, which is an incomplete closure in the spinal column. According to Individualswith Disabilities Education Act (IDEA) 1991; all children and youth with disabilities are
entitled to receive instruction in Physical Education.
CHARACTERISTICS
Spina Bifida Occulta This is the mildest form. There is an opening in one or more of the vertebrae (bones) of the spinal
column without apparent damage to the spinal cord. Approximately 40% of Americans may have it,but because they experience little to no symptoms, very few of them ever know that they have it(http://www.nichcy.org/pubs/factshe/fs12txt.htm).
Meningocele A moderately severe form of spina bifida in which the meninges protrude, causing a bulge under the
skin. The spinal cord remains intact. This form can be repaired with little or no damage to the nerve
pathways.Myelomeningocele Most Severe Form and also the most common complex congenital (present at birth) abnormality. A
portion of the spinal cord itself protrudes through the back. In some cases, sacs are covered withskin; in others, tissue and nerves are exposed.
Spina Bifida Manifesta
The combination of Meningocele and Myelomeningocele. This occurs in approximately one out ofevery thousand births.
(http://www.kimber.cjscreations.com/ksbpics.htm)
Common Characteristics:
Muscle Weakness (in the feet, ankles and/orlegs)
Paralysis below the area of the spine wherethe incomplete closure (or cleft) occurs.
Loss of sensation below the cleft Loss of bowel and bladder control Hydrocephalus (fluid build up that causes
accumulation of fluid in the brain. This canbe controlled by shunting. Shuntingrelieves the fluid build up in the brainlessening the chances of brain damage,seizures, or blindness.)
Growth Deficiency Difficulty with learning
Difficulty with paying attention Difficulty with expressing or understanding
language Difficulty grasping reading and math
Difficulty in locomotor and mobilitymovements Difficulty with fitness levels (Obesity is
common) Motor Difficulties in the arms and hands with
perhaps some slowness in performingcertain tasks.
Possible Seizures Latex Allergies
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CAUSE
Present at Birth (congenital) Inefficient amounts of Folic Acid in the mothers diet while pregnant.
ETIOLOGY This birth defect results from the failure of the vertebrae to close completely around the part of the
spinal cord that it is supposed to protect. This occurs during the first three months of pregnancy. Spina bifida is a congenital malformation however the causes are still unknown. Taking folic acid before conception and during the first few weeks of pregnancy may help reduce the
risk of spina bifida.
PROGNOSIS Spina bifida doesnt deteriorate Hydrocephalus can be controlled by a surgical procedure called shunting The child should learn to manage their bowel and bladder functions. Those with a history of hydrocephalus experience learning problems Early intervention can help considerably
IMPLICATIONS FOR PHYSICAL EDUCATION
Be aware of weather conditions extreme conditions (Cold or Heat) can have an adverse affect onthe individual and their learning. Maintain Steady and ambient conditions(http://www.nichcy.org/pubs/factshe/fs12txt.htm).
Be aware of Latex Materials. It is common for a child with Spina Bifida to be allergic to latex. Be aware of latex equipment like: Balloons, Rubber Bands, Elastic in clothing, Beach toys, Koosh
Balls, Diapers, Art supplies, gloves, elastic bandages, adhesive tape, Band-Aids.
RECOMMENDED ACTIVITIES
Mobility Skills (Using crutches, braces, or wheelchairs)
Emotional and Social DevelopmentEncourage children within the limits of safety and health, to be independent and to participate inactivities with their non-disabled peers.
Bladder Management Program
Modify equipment and curriculum for inclusion purposes
Early Intervention can help considerablyWork on Physical Fitness
Develop good cardiorespiratory fitness early in life.
Cooperative ActivitiesIncrease self-esteem, self-consciousness and self-imageIncrease Peer Awareness
ASSESSMENT SUGGESTIONS
DENVER DEVELOPMENTAL SCREENING TEST II http://www.denverii.com/ http://www.fpnotebook.com/PED59.htm
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http://www.uvm.edu/~cdci/pedilinks/pediatric/tools/ddstII.htm
HAWAII EARLY LEARNING PROFILE (HELP) http://www.vort.com/profb3.htm
PEDIATRIC EVALUATION OF DISABILITY INVENTORY (PEDI) http://www.med.unc.edu/wrkunits/syllabus/distedu/childas/publish/refsupp/pedi.pdf
http://www.nemc.org/rehab/pedi_inf.htm OBSERVE
Social interactive signals between the child and caregiver (learn about the childs communicationstyles, behavior management procedures, and the childs responses to the environment)
Observe the child in a pre-established free play environment. Observe the physical, motor, andinteractive abilities. Look for visual pursuits, muscle, tone, gross motor patterns, functional mobility, and fine
motor/hand function. With formal assessments look for: reflexes, development of equilibrium and balance
reactions, and development of gross motor and fine motor patterns.
EFFECTIVE TEACHING STRATEGIES
Modify equipment, and the environment. larger racket, Velcro band to help
student hold racket, larger ball, largertarget, smaller field, less distractions,softer balls, slower down the activity,modify the rules (ex: two bounces intennis).
Use developmentally appropriate equipment
Set up Exercise Routines
Use large bright and to the point visual aids
Having repetition in activities and verbalinstructions/demonstrations
Setting up routines
Modeling organization
Teaching organization (have the studentsthink to themselves how they can stayorganized and what they can do to be moreorganized)
Teaching the concept of time andperforming activities in steps, providingexercises that work on sequence
Developing games for the students wherethey work on solving problems
To increase the lack of attention give short
assignments or chores that can be donesuccessfully. This will increase the childsconcentration.
POSITIVE BEHAVIOR MANAGEMENT STRATEGIES
Keeps activities developmentally appropriate Use routines Use peer tutoring
Limit transition time Use reward systems (token economy,
stickers)
RESOURCES
Teachers:
Websites Http://www.sbaa.org www.sbaa.org/html/sbaa_facts.html www.waisman.wisc.edu/~rowley/sb-kids/index.htmlx www.nichcy.org/pubs/factshe/fs12txt.htm
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Parents:
Websites www.wais