U.S. Department of Education Office of Special Education Programs The University of Toledo These...

U.S. Department of Education Office of Special Education Programs The University of Toledo These materials made possible by grant # H325N110014 which is funded by the U.S. Department of Education, Office of Special Education Programs. The contents are solely the responsibility of the authors and do not represent the official views or policies of the funding agency, nor does publication in any way constitute an endorsement by the funding agency.

Addressing Inclusion Content and Practices in Intro to ECE Course in ECE Curriculum Webinar 5 - June 5, 2013 Guide: Bill McInerney, Ph.D. Co-Director - The Partner Project

Selected content for slides to accompany this webinar have been secured and edited from open source sites accessible via the www

Including Content Related to Inclusion in ECE in an Introduction to ECE Course

Sample Course Description: Introduction to ECE This comprehensive survey course of ECE identifies the core knowledge and competencies necessary for individuals working with all young children. This course is designed to.

Introduce students to the field of ECE Provide students an understanding of the complexity of the field and the issues around it Develop an awareness of the diversity of the field

Understand the diversity of the children and populations with whom early childhood professionals work Provide the opportunity to apply that knowledge with young children and their families within a variety of early childhood settings

Another Sample Course Description: Introduction to ECE Introduction to child development and philosophy of early childhood education, including developmentally appropriate practices in a variety of child care settings. Identification of effective multicultural and inclusive early childhood learning environments. Recognition of the importance of integrated curriculum as teaching strategy for young children. Introduction to role of the early childhood teacher as facilitator, and the development of effective family/center relationships. Observations in early childhood education settings.

Course descriptions suggest that basic information relating to inclusion should be addressed: Legal mandates for early intervention and early education Background information describing public agencies charged with identifying and serving young children with special needs

Course descriptions suggests that this basic information relating to inclusion should be addressed: Awareness of the scope of early intervention and early childhood special education service delivery options

Course descriptions suggest that basic information relating to inclusion, should be addressed: Range of ability and disability conditions of children who are eligible for enrollment in early education programs Implications for professional practices

Course description suggests that this basic information relating to inclusion, should be addressed: Range of programs in which young children with disabilities may be expected to be enrolled, including child care, public and private preschools, before and after school care programs, and Head Start

2010 NAEYC Standards Relevant to Introduction to ECE Course NAEYC Standards for Initial & Advanced Early Childhood Professional Preparation Programs

WHAT IS DIFFERENT IN THE 2010 NAEYC INITIAL AND ADVANCED STANDARDS ? Revisions to NAEYCs Initial Standards (2001), Advanced Standards (2002) and Associate Standards (2003) included a strengthened emphasis on academic content, diversity, inclusion, technology and early childhood focus

Standard 1 b Knowing and understanding the multiple influences on early development and learning

Standard 1 c Using developmental knowledge to create healthy, respectful, supportive, and challenging learning environments for young children

Standard 6 d Integrating knowledgeable, reflective, and critical perspectives on early education based upon mastery of relevant theory and research

Standard 6 e Engaging in informed advocacy for children and the profession, skillfully articulating and advocating for sound professional practices and public policies

The challenge to ECE faculty in expanding and enhancing the ECE teacher education curriculum is to: Recognize and accept the changing landscape of ECE, and to.. Organize key curriculum components (i.e. courses, course-related field requirements, and practica) to systematically and developmentally address information, skills, attitudes and values related to inclusion in ECE

There are several critical aspects to this task that involve collaborating with other ECE faculty in the ECE teacher education program in order to determine the scope and sequence of information and skills related to inclusion that will be introduced in the ECE curriculum

Before addressing the task of curriculum enhancement, it is important to consider a number of relevant facts. These realities must be recognized and respected in any redesign or enhancement of the ECE teacher education curriculum..

ECE Student Perceptions of Content Related to Inclusion in ECE Teacher Education Programs

Most ECE students have had limited experience with young children with special needs

ECE students who have relevant experiences (in child care, preschool programs, Head Start, etc.) probably had unguided experiences that did not include meaningful communication with early intervention/early childhood special education professionals or related services professionals (i.e. occupational therapists, physical therapists, speech and language pathologists, etc.)

Some ECE students do not have a keen interest in working with young children with special needs. They are seeking to enter the profession to work with young children who are typically developing. Some of these students may be resistant, at least initially, to exposure to information and skills related to inclusion. They also may not welcome additional elements in course and field assignments that require students to address the characteristics, competencies and needs of young children with special needs

The focus of the ECE teacher education curriculum is effective and supportive interaction and engagement with young children who are typically developing however.. this is not at the exclusion of balanced content in the ECE curriculum

Approximately 10-20% of young children may be expected to be eligible for early intervention or preschool special education services. Encountering children with special needs in child care and early childhood education settings is likely and ECE program graduates should become awareness of this via focused experiences within the ECE curriculum

Despite the possibilities of ECE students lack of interest in inclusion, their intent to work only with young children who are developing typically, and/or their emerging or firm belief that inclusion doesnt work for all children, it is incumbent upon ECE faculty and program administrators to address the issue of curriculum enhancement.

ECE faculty involved in the enhancement process must understand that the expectations for content and skill acquisition in CC programs are tempered by an understanding that content and skills to be addressed are entry level. Outcome expectations are not the same as those for a student completing a 4 year program resulting in licensure by the Ohio Dept. of Education.

ECE Program Faculty Perceptions of Content Related to Inclusion in ECE Teacher Education Programs

ECE faculty may evidence a range of comfort/discomfort in being asked to include information and content related to young children with special needs within course content, course assignments and field assignments. This may be related to lack of academic preparation or professional experiences relating to young children with special needs.

Some ECE faculty may be uncomfortable with the task of enhancing the ECE curriculum re: inclusion as a result of their perception or experiences with inclusion of young children with special needs in child care, preschool, Head Start or related programs. In other words, some ECE faculty may have a belief system that does not support inclusion in ECE as a positive development

Position Statement Related to Addressing Inclusion Content and Practices in the ECE Teacher Education Curriculum

As the models and mandates for early education, child care, and early intervention change as the result of contemporary political, social and legal forces, public entities charged with preparation of professionals (i.e. community colleges and 4 year universities) must ensure that future graduates are prepared to meet the needs of all children, including children with special needs, children living in poverty, children whose primary language is not English, and children from a wide spectrum of family-living models.

As members of the ECE profession, we have no choice but to inform ECE teachers of the future that awaits them, even if we cannot fully understand that future or are uncomfortable with emerging and projected paradigms of early care and education. This is the challenge that must be met in the process of curriculum enhancement in ECE teacher education

Curriculum Enhancement in ECE While the process is comprehensive, it is not complex....... ECE faculty need to decide: Scope of content and skills related to inclusion. These decisions are driven by NAEYC and CEC-DEC guidelines for program standards in ECE teacher education

The Process of Curriculum Enhancement in ECE Appropriate sequence for introduction and refinement of content and skills within the ECE program course and field experience sequence. In other words, where, when and how will: Basic content and skills be introduced? Advanced content and skills be refined and practiced?

The Process of Curriculum Enhancement in ECE These guiding questions will shape decisions about which courses will include relevant content related to inclusion, including relevant instructional resources and assignments, as well as opportunities for skill practice in field and practicum placements.

The Process of Curriculum Enhancement in ECE ECE faculty will need to decide Which courses in ECE program sequence (e.g. 1000 level vs. 2000 level) will focus on basic information/content and. which course will focus on acquisition of skills and practice ? Should inclusion content be included in courses outside the control of ECE faculty (e.g. courses managed by other depts. such as PSY, etc.)?

The Process of Curriculum Enhancement in ECE ECE faculty will need to decide: Which courses will require complementary or separate instructional resources (i.e. articles, text, www links, etc.) that address content and skills related to successful inclusion in ECE settings Which courses will include introductory OR advanced assignments that address the needs of young children with developmental differences

The Process of Curriculum Enhancement in ECE ECE faculty will need to decide: Which course-related field hour experiences will address content and skills related to successful inclusion in ECE settings Which practicum or student teaching experience (s) will address advanced skills related to successful inclusion in ECE settings

The Process of Curriculum Enhancement in ECE ECE faculty will need to decide: What information or skills need repeated exposure and refinement and.. which do not Whether certain information or skills needs to be addressed in a developmental sequence that reflects the academic and professional maturation of ECE students (in 1000 level or 2000 level course and/or the student teaching experience)

LEGAL MANDATES FOR EARLY INTERVENTION AND EARLY EDUCATION BACKGROUND INFORMATION DESCRIBING PUBLIC AGENCIES CHARGED WITH IDENTIFYING AND SERVING YOUNG CHILDREN WITH SPECIAL NEEDS Examples of Inclusion Content that can be be Appropriately Embedded in the Intro to ECE Course in the ECE Curriculum

FEDERAL MANDATES AND STATE OF OHIO COMPLIANCE: EARLY INTERVENTION (PART C) AND PRESCHOOL SPECIAL EDUCATION SERVICES (PART B 619) Content Related to Policies and Program Options in Early Childhood Special Education

The Promise of IDEA (2004) All children with disabilities are entitled to: A Free, Appropriate, Public Education(FAPE) In the Least Restrictive Environment(LRE) Pursuant to Individualized Education Plan (IEP) or Individualized Family Service Plan (IFSP)

Part C of IDEA Infants and Toddlers with Disabilities For children under the age of 3, with some exceptions, urgent and substantial need to recognize the significant brain development that occurs during a childs first 3 years of life urgent and substantial need to maximize the potential for individuals with disabilities to live independently in society

Early Intervention Developmental services are : Provided under public supervision; Provided at no cost, except where Federal or State law provides for a system of payments by families, including a schedule of sliding fees; Designed to meet the developmental needs of an infant or toddler (ages birth to 3 years) with a disability, as identified by the individualized family service plan (IFSP) team in 1 or more developmental domains

Requirements for States Under Early Intervention Program (Part C IDEA, 2004) Early intervention services based on scientific research Timely, comprehensive, multidisciplinary evaluation of child and family Individualized Family Service Plan (IFSP) Comprehensive Child Find system Public awareness program focusing on early identification Central directory that includes information on early intervention services, resources, and experts Comprehensive system of personnel development

More requirements An EI lead agency in each state A policy re: contracting with service providers A procedure for securing timely reimbursements A system for compiling data on program outcomes A state Interagency Coordinating Council (ICC) Policies and procedures to ensure that: To the maximum extent possible, services are provided in natural environments or most appropriate setting, as determined by the parents and IFSP team

Child Find Child Find requires school districts to identify, locate, and evaluate ALL children with disabilities, including children who are homeless, home schooled, wards of the state, and children who attend private schools. If the child has a disability and is eligible for special education services, the school does not have to give the child a label before providing services.

Infant or Toddler with a Disability Any child under 3 years of age who needs early intervention services because the individual is experiencing developmental delays or has a diagnosed physical or mental condition that has a high probability of resulting in developmental delay.

Developmental Delay Extent of delay defined by each state however, generally, a delay in 1 or more of these areas/domains of development: Cognitive development Physical development Communication development Social/Emotional development Adaptive development, or A diagnosed mental or physical condition that has a high probability of resulting in developmental delay (risk factor).

At Risk Infant or Toddler Any child under 3 years of age who would be at risk of experiencing a substantial developmental delay if early intervention services were not provided

Indicators of Risk and Qualification for EI Services Generally accepted definitions of Risk status Birth weight under 1,500 grams (3.3 lbs) Neonatal intensive care unit treatment Born to chemically dependent mother And referred by doctor and parent Seriously abused and/or neglected As substantiated and referred by Children & Youth protection agency

Individualized Family Service Plan (IFSP) Legal requirements similar to IEPs (ages 3-22), but including a family-directed assessment of the familys resources, priorities, and concerns. New requirement that the IFSP must include measurable results or outcomes expected to be achieved including pre-literacy and language skills Usually used for infants and toddlers, but may be used w preschoolers/older children

The IFSP IFSP: Individualized Family Service Plan Services must be free of cost and be based on evaluation and assessment data/reports Created by a team of individuals: Parent of infant/toddler A Service Coordinator A Person directly involved in the evaluation Persons who will provide EI services to infant/toddler

The IFSP (cont.) What is included in the IFSP? Current levels in the 5 developmental areas (& results of family assessment, if consented to) List of Major outcomes child should achieve & how to measure child s progress Name of service coordinator

The IFSP (cont.) IFSP: Individualized Family Service Plan Services child/family will receive How often Where: In natural environment (including home, community settings); if not. IFSP must explain why not in natural setting Whether service is directly provided to the child or will be provided via consultation with another adult who will work with the child

Early Intervention Requires that intervention agencies use proven methods of teaching and learning based on replicable research. Provided in natural environments, including the home, and community settings to the maximum extent possible.

Part C Services in Ohio: Help Me Grow Agencies

http://www.ohiohelpmegrow.or/

Who Refers Children to EI/ECSE Programs? The greatest number of referrals are from: Parents Child care provider recommendations (via parents) Preschool teachers (via parents) Physicians Head Start/EHS (via parents) Child Advocacy agencies

How are children served? Home visits Parent training Parent-Toddler classes Consultation Specialized preschools Inclusive preschools Community preschools Service Coordination Related Services EI/ECSE Programs

Early Intervention Services Family training and counseling Home visits Special instruction Speech-language pathology and audiology services, occupational therapy, physical therapy, psychological, etc.

Early Intervention Services Service coordination services Medical services only for diagnostic or evaluation purposes

Early Intervention Services Early identification, screening, and assessment services Health services necessary to enable the infant or toddler to benefit from the other early intervention services

Early Intervention Services Social work services Vision services

Early Intervention Services Assistive technology devices and assistive technology services Transportation and related costs that are necessary to enable an infant or toddler and their family to receive another service.

Early Intervention Services Types of services (to child/family) also include: Service Coordination Facilitate assessments, development and review of IFSPs, and transition to pre-school services Coordinate/monitor delivery of EI services & more (even if services are not the responsibility of EI).

Early Interventionists and Related Services Professionals Special educators Speech/language pathologists Audiologists Occupational therapists Physical therapists Psychologists Social workers Nurses Registered dieticians Family therapists Vision specialists, including optometrists and ophthalmologists Orientation and mobility specialists Pediatricians and other physicians

Is EI Effective? EI improves developmental and educational gains for the child EI improves the functioning of the family Children in EI need fewer special education services later, and level of services (and costs) may be reduced Following EI, children are retained in early grades less often

Part B Section 619 of IDEA Part B Section 619 governs special education and related services for children with disabilities between the ages of 3 and 5 (preschool special education)

The Special Education Process Child must be referred to be evaluated for possible special education services Initial evaluation is usually conducted by a school psychologist Parent may wish to submit information from treating physician to supplement evaluation IEP Team -- parent & relevant school personnel make decisions about eligibility and childs individualized education program

What is an Individual Education Plan (IEP)? IEP (like an IFSP) is a guide for a childs special education Includes annual goals Specifies what kind of special education the student will receive and the frequency/intensity of services Specifies the setting in which the services will be delivered Specifies accommodations child will need to participate in LRE

Who is Responsible for Providing Special Education Services to 3-5 Year Olds in Ohio? The local school district in which the child lives is responsible for the screening, assessment and identification of preschool ages children (3-5) who have special needs. There are approximately 614 local school districts in the 88 counties in Ohio Some school districts choose to contract for preschool special education services with regional Education Service Centers (ESCs) or County Boards of Developmental Disability versus providing the service through the local school district

What Special Education Services are LEAs Responsible for Providing 3-5 Year Olds in Ohio? The local school districts are responsible for providing educational, developmental and related services to a 3-5 year old child with special needs as stipulated in the childs IEP. The IEP specifies the nature and intensity of specialized services to be provided. The IEP team determines the content of the IEP. Representatives of school districts or LEAs who provide special education services must be licensed or validated by the Ohio Department of Education. Preschool special education teachers usually hold the Early Childhood Interventions Specialist (ECIS) license or the Preschool Special Needs validation

How are Special Education Services Provided for 3-5 Year Olds in Ohio? Children with IEPs are served via 3 primary service delivery options: Preschool classroom under the direction of a licensed/validated preschool special needs teacher employed by the LEA. Related services also may be provided if included in the IEP. Preschool classrooms in Head Start, private for profit (i.e. Montessori) or not-for-profit preschool programs. Services are provided by an Itinerant teacher who visits children with IEPs in these programs and provides services to the child as well as consultation services to the lead teacher and other adults in the classroom. The Itinerant teacher is required to hold an appropriate license or validation. Related services also may be provided if included in the IEP. Itinerant services are specified in the IEP. Visits to the child in his home by an Itinerant teacher and/or related services professional (e.g. speech pathologist, occupational therapist, physical therapist, etc.) as specified in the IEP.

EARLY CHILDHOOD SETTINGS IN WHICH INCLUSION IS SUPPORTED

What is the Least Restrictive Environment or LRE ? The LRE is the setting in which children with disabilities can be educated with typical children to the maximum extent possible. LRE options in preschool services might include local preschool centers, inclusive preK classrooms operated by local school districts, County Bd of DD preK classrooms, Head Start, and other options

Head Start Open door policy ALL children who met the economic requirement, regardless of developmental status, were included in Head Start.

Head Start 1972 10% of enrollment reserved for children with developmental disabilities, even children with severely handicapped children. Since Head Start began in 1965, more than 23 million children have attended. Today, more than 12.5% of children who attend have an identified disability.

Head Start Act Requires...no less than 10 % of the total number of enrollment opportunities in Head Start programs in each state shall be available for children with disabilities and that services shall be provided to meet their special needs. Such policies and procedures shall require Head Start agencies to coordinate programmatic efforts with efforts to implement Part C and Section 619 of the Individuals with Disabilities Education Act

Head Start Disability Resources Head Start Center for Inclusion - University of Washington depts.washington.edu/hscenter/ Children with Disabilities in Early Head Start: Research to Practice... www.acf.hhs.gov Office of Planning, Research & Evaluation Office of Planning, Research & Evaluation

Technical Assistance Contacts National Early Childhood Technical Assistance Center (NECTAC) www.nectac.org www.nectac.org National Child Care Information Center (NCCIC) http://nccic.org/itcc http://nccic.org/itcc Regional Resource Centers for Special Education http://www.dssc.org/frc/rrfc.h tm http://www.dssc.org/frc/rrfc.h tm National Head Start Training and Technical Assistance Resource Center www.hsnrc.org www.hsnrc.org Head Start Regional Disabilities Services TA Providers

Integrated Activities and Instruction in Inclusive Settings

Definition of Inclusive Environments Early childhood inclusion embodies the values, policies, and practices that support the right of every infant and young child, and his or her family, regardless of ability, to participate in a broad range of activities and contexts as full members of families, communities, and society.

Curriculum Content is: EMBEDDED INTERVENTION Weaving Teaching and Intervention into Routine Activities

Embedded Interventions Embedded Interventions are specially designed practices that are used to promote childrens engagement, learning, and independence in everyday activities, routines, and transitions in the classroom, home, and community. Source: CONNECT Module 1: Embedded Interventions

A Routines-Based or Activity-Based Model for Intervention: Embedded Instruction - Focuses on a childs daily routines or activities like snack, playtime, circle time, dramatic play as a context for learning and OPPORTUNITY for EMBEDDING - Teachers give children opportunities to practice targeted IEP or IFSP goals or activities during these daily routines or activities instead of creating special instructional time.

Environmental Modifications

Adaptations Help All Children Adaptations allow teachers to do the same things that they would do with all children facilitate their participation in activities and routines. Adaptations can be used to: Make situations better for a particular child. Improve situations for the entire group.

Peer Supports

DIVERSITY OF YOUNG CHILDREN: DEVELOPMENTAL DISABILITIES IN EARLY CHILDHOOD

Incidence of Developmental Disability in Childhood An estimated 12-16% of children have a developmental and/or behavior disorder Approximately 30% are identified before school entrance Those detected after school entrance have missed out on early intervention services proven to have long term benefits Pediatricians, child care providers and preschool teachers are the primary professionals with whom families have contact during a child s first five years of life Early identification by primary care providers of developmental delays leads to early referral for evaluation and treatment

Under IDEA, can public schools choose not to provide education for some students with disabilities ? Federal legislation specifies that to receive federal funds, every school system must provide a free, appropriate education for every student regardless of any disabling condition or the extent/degree of impairment Exceptional Children

Under IDEA, the student with a disability must be placed in the least restrictive environment (LRE). Is the LRE always the regular or general education classroom? The law does require the student with a disability to be placed in the LRE however, the LRE is not always the regular classroom. What the LRE does mean is that the student shall be separated as little as possible from home, family, community, and the regular class setting while appropriate education is provided. In many, but not all instances, this will mean placement in the regular classroom. Exceptional Children

Is Disproportionate Representation of ethnic minorities in special education still a problem under IDEA (2004) ? Some ethnic minorities are still underrepresented or overrepresented in certain special education categories. For example, African American students, especially males, are overrepresented in programs for students with emotional or behavioral disorders and underrepresented in programs for gifted and talented students. Multicultural & Bilingual Aspects

Is disability ever related to ethnicity? Some disabilities are genetically linked and therefore more prevalent in some ethnic groups. For example, sickle cell disease (a severe, chronic, hereditary blood disease) occurs disproportionately in children with ancestry from Africa, Mediterranean and Caribbean regions, Saudi Arabia, and India.

Special Education Eligibility Categories Speech/Language/Co mmunication Impairment Autism Spectrum Disorder (ASD) Emotionally Impaired Cognitive Impairment Developmentally Delayed (preK use) Physically Impaired Other Health Impaired (includes ADHD) Hearing impaired Multi-handicapped Visually Impaired ** Learning Disability is a school-age category (ages 6-22)

Communication Disorders

Do children with language disorders always have speech difficulties as well? It is possible for a child to have good quality speech; however, most children with language disorders have speech disorders, as well. Communications Disorders

Do individuals with communication disorders always have emotional or behavioral disorders or mental retardation? Some children with communication disorders experience typical cognitive, social, and emotional development. Communications Disorders

Are disorders of phonology (or articulation) ever very serious, or are these problems always easy to correct? Disorders of phonology can make speech unintelligible; it is sometimes very difficult to correct phonological or articulation problems, especially if the individual has cerebral palsy, mental retardation, or emotional or behavioral disorders. Communications Disorders

Is there much overlap between language disorders and learning disabilities? Problems with verbal skills-- listening, reading, writing, speaking-- are often central features of learning disabilities. The definitions of language disorders and several other disabilities overlap. Communications Disorders

Can children who learn few language skills before entering kindergarten easily pick up all the skills they need, if they have good peer models in typical classrooms? Early language learning is critical for later language development; a child whose language is delayed in kindergarten is unlikely to learn to use language effectively solely by observing peer models. More explicit intervention is typically required. Communications Disorders

Autism Spectrum Disorder (ASD)

Autism Spectrum Disorders Autism Spectrum Disorders (ASD) Neurodevelopmental disorders characterized by impairments in three domains: Socialization Communication Behavior Includes: Autistic disorder Asperger disorder Rhett s disorder Childhood Disintegrating disorder Pervasive developmental disorder, not otherwise specified (PDD-NOS)

ASD Autism Spectrum Disorders Occurs in ~1 in 80 to 1 in 150 children Increasing incidence since 1970sdue to increased awareness/changes in definition CD/MR /seizures commonly associated w ASD Causes not completely understood Overwhelming evidence does not support association of ASD with childhood immunizations

Autism Spectrum Disorder (ASD) For the preschool child, Autism signifies a developmental disability affecting the processing, integrating, and organizing of information that significantly impacts communication, social interaction, and developmental progress. Autism is a spectrum disorder. The symptoms and characteristics of autism present themselves in a wide variety of combinations, from mild to severe.

Diagnosis of ASD Delays or abnormal functioning in at least one of the following areas, with onset before 3 years old: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play. The disturbance is not better accounted for by Rett's Disorder or childhood disintegrative disorder.

Characteristics of Children with ASD Qualitative impairments in communication as manifested by at least one of the following: Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime) In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others

Characteristics of Children with ASD (cont.) Qualitative impairments in communication as manifested by at least one of the following: Stereotyped and repetitive use of language or idiosyncratic language Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

Characteristics of Children with ASD (cont.) Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following: Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus Apparently inflexible adherence to specific, nonfunctional routines or rituals

Characteristics of Children with ASD (cont.) Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following: Stereotyped and repetitive motor mannerisms (eg, hand or finger flapping or twisting, or complex whole-body movements) Persistent preoccupation with parts of objects

ASD Early Indicators of ASD and/or Communication and Interaction Disorders Often suspect the child may be deaf. Doesnt have typical startle response. Doesnt turn when you come into the room. Seems unaware of sounds in the room, etc. Extremely good babies seldom cry, are not demanding, seem very content to be alone or very fussy, colicky babies-cry a lot, sleep problems, not easily comforted. Engage in an excessive amount of rocking May hand gaze, look at lights through fingers or have other self-stimulatory behavior. Often very fussy eaters. Become upset with the change from pureed baby foods to junior baby foods. Prefer only salty foods or only sweet foods, etc.

ASD Lack of molding the baby just doesnt feel right when you pick him up. Often feels stiff, arches his back, etc. Does not have anticipatory response. Doesnt put up his arms to be picked up. Doesnt seem to want to be held. Seems to actively avoid looking at people. Lack of eye contact. Seems to tune out a lot. Isnt aware of what is happening around him Prolonged tantrums up to two hours in duration or more. Often it is difficult to figure out what set the child off. Wants things to stay the same. May have difficulty adapting to winter coat or boots. Wants to wear the same clothes. Doesnt want furniture or toys to be out of place.

ASD Doesnt play typically with toys is more likely to spin wheels on truck rather than move truck across the floor. Will line things up rather than play. Does not begin to talk or use words in a communicative way at the appropriate age. Fails to develop language or uses echolalic speech (echoing) without really understanding the meaning of the words. Often seems to be a perfectionistic. Wants everything to be just right. If he tries to make something work and it doesnt, he gets upset and will quit or get angry and wont try the activity again.

ASD Often has splinter skill in areas like music or can do puzzles extremely well or has excellent gross motor skills or is very interested in numbers and letters. Seems to have an excellent memory. Knows exactly where cookie jar is in a home he hasnt visited for several months, etc. Likes to watch things go around such as record players, tops, etc. May bang his head or engage in other self-injurious behaviors May have very high tolerance for pain. He may get hurt but not come to an adult for comfort. Changes in routine are very upsetting.

ASD Does not spontaneously imitate the play of other children. May have difficulty generalizing information from one setting to another May not experience separation anxiety at the typical age of 8 12 months. May experience extreme auditory sensitivity. May use an adults hand like a tool for accomplishing a task.

Attention Deficit- Hyperactivity Disorder (ADHD)

ADHD/ADD Early Indicators: The following list should serve as a guideline to determine if further medical examination is warranted. Not all children with ADD will exhibit these behaviors and not all children with these behaviors will have ADD/ADHD. A good developmental screening is important when considering any further evaluation. If a child has had inconsistency in parenting, has experienced traumatic events, or has delays in language development they may exhibit many of the symptoms listed in the following slides.

ADHD/ADD Infancy/Late Infancy Problems sleeping through the night Short, sporadic naps during the day Excessive crying/colic Ear infections/allergies/asthma Not interested in being held Content when put down Difficulty bonding Cries when held Rapid or delayed milestones Irritable in high stimulus settings Irritable when routines change

ADHD/ADD Toddler Does not respond to normal behavioral controls Difficulty in sharing/taking turns Inability to sit still or sustain attention High incident of falling or accidents Clumsiness Can be destructive with toys Trouble with playing with other children, higher incident of biting, kicking, or pushing playmates Does not like to be read to Fidgets when restrained or help for more than a few minutes Can act as if driven by a motor

ADHD/ADD Preschool Always in motion Inability to sit sill or sustain Clumsiness Coordination problems or delays Difficulty following directions Seem as if they are not paying attention Impulsive: grabs toys, acts before thinking Difficulty sharing and taking turns Trouble waiting turn or standing in line Inappropriate touching, poking of other children or intruding on others personal space

ADHD/ADD Preschool Interrupts often Can be aggressive: hitting, kicking or biting playmates Forgetful http://add.about.com/cs/adhdinpreschool/a/earlyindicators.htm

Summary ADHD/ADD ADD/ADHD is a medical diagnosis, not an education diagnosis (similar to ASD as a medical diagnosis) Many children with ADD/ADHD do not require special education and may not meet requirements for eligibility for special education services

Cognitive Impairment/ Developmental Delay

Developmental Disability/Delay (DD) Developmental Disability/Delay (DD) is present when functional aspects of a child s development in one or more domains (gross/fine motor, speech/language, cognition, social/personal, and activities of daily living) are significantly delayed compared to the expected level for age (25% from the expected rate or a discrepancy of 1.5 to 2 standard deviations from the norm)

Global or General Developmental Delay (GDD) Global or General Developmental Delay (GDD) is a subset of DD defined as significant delay in 2 or more developmental domains (reserved for children less than 5 years old)

Cognitive Delay or Intellectual Impairment Mental Retardation (MR)-a state of functioning beginning in childhood characterized by limitations in intelligence and adaptive skills. Prevalence of CD/MR in general population is 1-3% DSM-IV Criteria for MR (current DSM V just released.2013): Significant sub-average intellectual functioning Adaptive functioning deficit or impairment Onset before 18 years of age Cognitive impairment requires IQ testing (accurate ages 5 yrs.) Mild50 to 70 IQ ( 70 is 2 SD from normal100) Moderate40 to 50 Severe20 to 40 Profound

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