Teaching Students with Feeding Tubes: What You Need To Know

If you work in a special education class or a day habilitation setting, more than likely you are teaching a student or an individual with complex needs including the use of a feeding tube.

According to the Tube Feeding Awareness Foundation, there are over 300 conditions that require students and individuals to receive nutritional support through tube feeding.

What is a feeding tube?

A feeding tube is a device that is inserted in the stomach wall and goes directly into the stomach. It bypasses chewing and swallowing in a student or individual who no longer has the ability to safely eat or drink. This allows for students and individuals to receive adequate nutritional support.

A feeding tube is also used for students and adults who cannot take in enough food by mouth. Feeding tubes can be temporary or permanent .

Reasons to use a feeding tube
The student or individual may have a swallowing disorder or dysphasia. This means there is an increase risk for the student or individual to aspirate their foods or liquids into their lungs. Causes of swallowing problems include low-muscle tone, brain injury, genetic conditions, sensory issues, neurological conditions, cleft lip/palate and birth defects of the esophagus or stomach.
Types of Feeding Tubes

Gatro Feeding Tube

The gastrostomy tube (G tube) is placed through the skin into the stomach. The stomach and the skin usually heal in 5-7 days. This type of tube is generally used in people with developmental disabilities for long term feeding.

Nasogastric Feeding Tube

The nasogastric (NG tube)  is inserted through the nose, into the swallowing tube and into the stomach. The NG tube is typically used in the hospital to drain fluid from the stomach for short term tube feeding.

Neurological and Genetic Conditions Requiring Tube Feeding

Some students and individuals with neurological and genetic conditions often require tube feeding due to gastrointestinal issues including constipation, reflux, and abnormal food-related behaviors. It For example, it is estimate that 11% of children with cerebral palsy use a feeding tube due to difficulty with eating, swallowing, and drinking.

The following are different types of neurological or genetic conditions that may require the use of a feeding tube.

22q11.2 Deletion Syndrome

Angelman Syndrome

Aspiration

Cerebral Palsy

CDKL5 Disorder

Cornelia de Lange

Cri Du Chat Syndrome

Down Syndrome

Dravet Syndrome

Dysphasia

Edwards Syndrome

Fetal Alcohol Syndrome

Fragile X Syndrome

Hydrocephalus

Lennox-Gestaut Syndrome

Microcephaly

Ohtahara Syndrome

PPD- Not Otherwise Specified

Turner Syndrome

Trisomy 18

Spastic Diplegia

Traumatic Brain Injury

West Syndrome

Williams Syndrome

 

Signs and Symptoms of Issues related to a g-tube

Complications due to tube feeding may include:

  • constipation
  • dehydration
  • diarrhea
  • infections
  • nausea/vomiting

Aspiration

Aspiration can be caused by:

  • reflux of stomach contents up into the throat
  • weak cough, or gag reflux
  • the feeding tube is not in place
  • delayed stomach emptying
  • The head is not raised properly.

Students should be observed for aspiration during feeding. The following are signs and symptoms of aspiration:

  1. Choking or coughing while feeding
  2. Stopping breathing while feeding
  3. Faster breathing while feeding
  4. Increased blood pressure, heart rate and decreased oxygen saturation.

 

What is an ISP?

People with disabilities that are eligible for community habilitation, day habilitation, supportive employment and support services will receive an Individual Service Plan (ISP).
What is an ISP?

An Individual Support Plan (ISP) is an ongoing process of establishing goals for individuals and identifies supports and strategies that reflect the person’s strength and abilities and details all of the services and supports needed in order to keep the person in their community. The ISP should reflect an opportunity for the person to live in the least restrictive home setting and to have the opportunity to engage in activities and styles of living which encourage and maintain the integration of the individual in the community through individualized social and physical environments.

Who should be included in the development of the ISP?
  • The person receiving services.
  • family members, caregiver, or designated representative
The ISP Planning Process

The ISP should be developed with participation from the following people:

  • The individual
  • Members of the individual’s family
  • A guardian, if any
  • The individual’s Service Coordinator
When is an ISP meeting held?

The meeting is held when it is desired or needed. Some State require meetings every 6 months while others every 2 years, so check with your state regulations.

What is discussed at ISP meetings?

The meeting should focus on 5 areas:

  • Review and gathering information including any new changes or discoveries. Has the person’s health status changed?
  • The person’s goals and desires
  • Review or identify personal value outcomes.
  • Recent events that may affect the person’s health, safety and goals
  • Review and develop next-step strategies and resources
What must the ISP include?

The ISP should include:

  • Specific goals
  • The supports the individual needs to reach those goals without regard to the availability of those goals.
  • Who is responsible for providing those supports.
  • How often and how much support are needed.
  • The criteria foe evaluating the effectiveness of the supports.
  • Team members responsibilities for monitoring the ISP implementation.
  • The date of the next ISP review.

Updated 2/22/24.

Angleman Syndrome and Adulthood

Angelman syndrome is a genetic disorder that affects the nervous system. Characteristics include developmental delays, intellectual disabilities, epilepsy, short attention span, hyperactivity, hand flapping and speech impairments. It is a rare disorder that affects 1 in 12,000 to 20,000 a year. there are less than 200,000 cases a year and affects all ethnicities and sexes equally.

Typically, there is a severe developmental delay and learning disability as well as near absence of speech and ataxia including ataxia including jerky movements of the arms and legs. People with Angelman syndrome generally have a happy demeanor and an inappropriate laughter.

Life expectancy appears to be normal. As people with Angelman syndrome age, scoliosis tends to worsen and for many people born with epilepsy, there are cases where seizures stop, however, they tend to return as the person gets older.

 

Health Issues in Adults

Several research studies show a number of health complications for adults with Angelman syndrome. Less than half of people with Angelman syndrome also have a diagnosis of seizures. Seizures begin in early childhood and can continue through adulthood. Poor sleep in adults continue to be a challenge. This includes difficulty falling asleep, frequent waking up during the night and waking up too early. Other issues include, constipation, scoliosis, self-injurious behavior and obesity.

Due to cognitive and medical needs, a person with Angelman syndrome will always require support. Most people with Angelman syndrome attend a day habilitation setting. Support should include

  • staff trained on identifying seizures and providing assistance.
  • programs that support the person’s short attention span
  • evaluation for a communication device or a means to communicate.
  • support for self-injurious behavior.

Updated 2/15/24.

Autism and Sleep Disorders

Autism Spectrum Disorders is characterized as a neurodevelopmental disorder that are a group of conditions with onset in the developmental period that produces impairments in the area of social communication, reciprocal social action as well as repetitive and stereotyped behaviors and interest.

It is a spectrum meaning it varies from person to person with varying co-disorders including sleep.

Studies show that children with sleep disorders experience insomnia and sleep issues at a higher rate than children without autism.

Interviewed parents reported showed that 53% of children with ASD have difficulty sleeping including difficulty falling asleep(23),frequent awakening(19) and early morning wakening (11). Sleep disturbance included bedtime resistance, insomnia, breathing issues while sleeping, morning arising issues and daytime sleepiness. There is also evidence that children with autism spectrum disorder are reported to experience high levels of Parasomnias, defined as a group of sleep disorders involving unwanted events displayed by complexed behaviors during sleep. This includes:

  • Bed Wetting
  • Sleep Hallucination
  • Nightmares
  • Night Terrors
  • Sleep Walking

Sleep disturbance fin autism falls into one of the following categories:

  1. difficulty falling asleep
  2. night walking
  3. early walking
  4. night terrors

The Impact of Sleep

Lack of sleep for an autistic child and adult presents additional challenges. Studies show the lack of sleep can increase issues with repetitive behaviors, fatigued parents, increase anxiety and depression and increase cognitive issues. this decreases the quality of life for the person during daytime. In school, the child may have difficulty staying awake, regulating emotions and an increase in hyperactivity, aggression and poor appetite.  As children become adults, it is possible for the issue of sleeping to increase. there is evidence that autistic adults continue to have issues with insomnia and sleepwalking.

Causes

  • Psychiatric comorbidities including anxiety, behavior problems, and hyperactivity
  • Genetic Mutations including serotonin and melatonin which has been described as an important factor in the sleep-wake cycle. Studies have found abnormal melatonin in people with ASD.

Tips for Improving Sleep

  1. Create a regular bedtime routine including using a visual cue which will help the child or adult prepare for bed.
  2. Make sure the bedroom is comfortable including using  a dim light in the bedroom and blackout blinds. Also ensure the temperature in the room is comfortable
  3. Quiet activities. Plan for quiet play before bed which allows the person to relax. This can include reading, puzzles, or a craft activity.

Reference

Updated 4/7/21

 

 

What is Augmentative and Alternative Communication (AAC)?

According to the American Speech Language Hearing Association, there are over 2 million people with significant expressive language impairment who use AAC. AAC users including people with the following disorders; autism, cerebral palsy, dual sensory impairments, genetic syndromes, intellectual disability, multiple disabilities, hearing impairment, disease, stroke, and head injury.

According to the International Society for Augmentative and Alternative Communication Organization. AAC is a set of tools and strategies that an individual uses to solve everyday communicative challenges. Communication can take many forms such as: speech, a shared glance, text, gestures, facial expressions, touch, sign language, symbols, pictures, speech-generating devices, etc. Everyone uses multiple forms of communication, based upon the context and our communication partner. Effective communication occurs when the intent and meaning of one individual is understood by another person. The form is less important than the successful understanding of the message.

The types of AAC includes both low-tech and high tech. Low tech AAC includes symbol charts, PECS,  and communication boards, while high tech AAC include electronic devices such computers, tablets and devices.

The following information provides resources, articles and tips on using AAC:

3 sets of AAC goals for interactive books

5 quick and easy games that build AAC skills

50 simple switch or low tech activities

AAC and Echolalia

AAC for caregivers manual

AAC Quiz

Augmentative and alternative communication (AAC) systems for students with CVI and multiple disabilities 

How to make an AAC symbol library

Language opportunities to use AAC at home

Low-Tech AAC Ideas

Promoting inclusion and participation for people who use AAC

Reducing prompt dependence in AAC learners: 5 things to try

The periodic table of AAC

Using AAC more in the classroom

Using LIST in PODD communication books

What does it take to implement AAC

 

Invisible Disabilities You Should Know

What is an Invisible Disability?

According to the Invisible Disabilities Association, the term invisible disability refers to symptoms such as debilitating pain, fatigue, dizziness, cognitive dysfunction, brain injuries, learning differences, mental health disorders, as well as hearing and visual impairments. They are not always obvious to the onlooker, but can sometimes or always limit daily activities range from mild challenges to severe limitations and vary from person to person

Attention Deficit Hyperactivity Disorder (ADHD)

 Attention Deficit Hyperactivity Disorder (ADHD) is a neurological disorder characterized by a pattern of inattention and/or hyperactivity-impulsivity that disrupts functioning in both children and adults typically, a person with ADHD, the difficulties lies in the part of the brain that allows people to perform higher level task known as the executive function. 90% of people with ADHD also have an executive function disorder. This is the part of the brain that engages in goal-direction and self-regulations.

Two Types of ADHD:

Types of ADHD

Type 1: Inattention Without Hyperactivity

  • Trouble paying attention
  • Trouble following direction
  • Trouble following through with task
  • Easily distracted
  • Seems disorganized or careless
  • Slow to process information

Type 2: Hyperactivity Without Inattention

  • Trouble paying attention
  • Restlessness
  • Impulsive speech and action
  • Excessive talking
  • Difficulty waiting turns
  • May have a quick temper
  • Overactive

 Autism Spectrum Disorder

 Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that impacts social, speech, behavioral and motor skills. It is a spectrum disorder meaning it varies from person to person. No two people have the same symptoms. It is estimated that 1% of the population is diagnosed with autism.

 Dyslexia

Dyslexia is also known as a language-based disability. It is defined as difficulties with accurate and word recognition and by poor spelling which can affect reading fluency, reading comprehension, recall, decoding, writing, spelling, and sometime speech. Signs of dyslexia in adults include:

  • Poor spelling
  • Avoids writing task
  • Gifted and creative
  • Difficulty in following oral and written instructions
  • Difficulty staying on task
  • High level of frustration
  • Difficulty in retaining information
  • Test-taking anxiety.
  • Highly curious
  • Insightful
  • Curiosity
  • Good communication of stories read to them

 Fetal Alcohol Spectrum Disorder

Fetal Alcohol Spectrum Disorders (FASD) according to the National Organization on Fetal Alcohol Syndrome describes the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These affects may include physical, mental, behavioral, and/or learning disabilities with lifelong implications.

Fetal Alcohol Spectrum Disorders is not a diagnosed rather, it is a term that is used to describe a wide-range of effects on a person whose mother drank alcohol during her pregnancy. Fetal Alcohol Spectrum Disorders, show in three areas: abnormal facial characteristics, slowed growth and the central nervous system.

Fetal Alcohol Spectrum Disorders affects each person differently. Signs and symptoms include the following:

  • Abnormal facial features including a smooth ridge between the nose and upper lip
  • Small head size
  • Shorter than average height
  • Poor coordination
  • Hyperactive behavior
  • Difficulty with attention
  • Poor memory
  • Difficulty in school
  • Learning disabilities
  • Speech and language delays
  • Intellectual disability or low IQ
  • Poor reasoning and judgement skills
  • Sleep and sucking problem
  • vision and hearing problems
  • Seizures
  • Processing information
  • Problems with the heart and kidneys
  • Poor concept of time
  • Trouble getting along with others
  • Staying on task

Sensory Processing Disorder

Sensory Processing Disorder (SPD, formally known as sensory integration dysfunction) is a condition in which the brain has difficulty in receiving information from the senses.

Signs and symptoms may include:

·       Oversensitive

·       Common sounds may be overwhelming

·       Uncoordinated

·       Hard to engage in conversation or play

What is Sepsis?

While Sepsis is a severe life-threatening medical condition, it can also affect people with disabilities. According to the Centers for Diseases and Control (CDC), Sepsis is the body’s extreme response to an infection. It is a life-threatening medical emergency. Sepsis happens when an infection you already have —in your skin, lungs, urinary tract, or somewhere else—triggers a chain reaction throughout your body. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death. Sepsis kills more than 250,000 people a year with 1.5 million diagnosed each year.

Signs and Symptoms
  • An initial infection
  • Fever
  • High heart rate
  • heavy breathing

Severe sepsis occurs during organ failure. signs include:

  • decrease urination
  • breathing problems
  • body chills
  • extreme weakness

Sepsis is caused by:

  • Pneumonia
  • Kidney infection
  • Bloodstream infections.

if you work with an individual displaying any of these signs and symptoms, seek medical attention.

Resources

Recovering from Sepsis– NHS

Sepsis Overview– Science Direct

What is Sepsis?– Sepsis Alliance

Adult Provider Training Resources

Abuse and Neglect

Sexual Abuse of People with Disabilities

Sexual Abuse Definition-The ARC

Preventing Abuse of Children with Cognitive, Intellectual and Developmental Disabilities

Abuse and Neglect: Individuals with Developmental Disabilities

Choking/ Aspiration

Teaching Material on Choking

Arizona Department of Economic Security

Eunice Kennedy Shriver-Dysphasia, Aspiration and Choking

Ohio Department of Developmental Disabilities

New York State Choking Prevention Resources

Washington State Department of Social and Health Services

State Agencies Choking Alerts

Georgia Department of Behavioral Health and Developmental Disabilities

Minnesota Mental Health and Developmental Disabilities 

New Jersey Health and Safety Alert Choking

CPR Training for Disabled Students

Fire Safety

Educational materials for people with disabilities

Fire safety and teaching people with intellectual disabilities

Fire Safety for Individuals with disabilities

Fire safety outreach materials for people with disabilities

Guide to teaching fire safety to students with disabilities

Incident Reporting

Incident/abuse, identification, reporting and processing 

Incident reporting for individuals with developmental disabilities

Incident response and reporting manual

Major unusual incidents and unusual incidents

Personal support worker incident report requirements

Overview of Developmental Disabilities

Introduction to developmental disabilities

Introduction to intellectual and developmental disabilities 

Introduction to developmental disabilities classroom participant guide

Orientation Manual for Direct Support Professionals

Van Safety

A guide for drivers of seniors and persons with disabilities

Oversight of Passenger Safety

Safe Transportation of People in Wheelchairs

Transportation Safety Awareness

Cerebral Palsy Training PowerPoint

This blog article is an introduction to cerebral palsy. In the past, very few educational programs offered courses on specific information pertaining to disabilities. I am hopeful this is beginning to change.  Ions when I started working in the field, I felt that there was simply not enough information so I started to do my own research by reading books, journal articles and talking to both professionals and parents.

Here, I have included a short PowerPoint presentation on a brief introduction of Cerebral Palsy. The objectives include, the definition, prevalence and causes, types and the causes. This format can be used in various ways including a teaching course since most of us are currently learning online, or as a self-study course. Below,  you will find a quiz along with the quiz answers.

[office src=”https://onedrive.live.com/embed?cid=90748358AD4AA436&resid=90748358AD4AA436%21859&authkey=ABuzc_FO-xzum58&em=2″ width=”402″ height=”327″]

If you would like  to print out a copy of the PowerPoint, Download here: Cerebral Palsy PowerPoint

Download quiz test here: cerebral palsy QUIZ

Download quiz test answers here: cerebral palsy QUIZ answer

Self- Injurious Behavior Resources

Working with individuals- both children and adults diagnosed with self-injurious behaviors can be challenging at the very least. Some examples of self-injurious behaviors include head banging, handbiting, and excessive scratching. There are many reasons why a student or individual may cause self-injurious behaviors including the inability to communicate needs, the environment, sensory issues and physiological issues. The following are articles on identifying cause of self-injury and ways to prevent it.

Autism, head banging and other self-harming behaviors– Autism Parenting

3 techniques to stop self-injurious behavior of children with autism– Steinberg Behavior Solutions

6 Strategies for Addressing Self-Injurious Behaviors– Wonderbaby

Effective evidence-based strategies to minimize self-injurious behaviors in young children with autism- CSUSB Scholarworks

Essential guide to self-injurious behavior and autism– Research Autism

Head banging, self-injury and aggression in autism– Treat Autism

Self-injurious behavior in people with developmental disabilities-crisis prevention.com

Self-injury in patients with intellectual disabilities- Nursing2020

Understanding and treating self-injurious behavior– Autism Research Institute

Understanding self-injury among autistic individuals- Good Therapy

 

Understanding and Treating Self-Injurious Behavior

Understanding and Treating Self-Injurious Behavior

What You Should Know About GERD and Developmental Disabilities

Feeding problems are common in people with an  intellectual/developmental disability. For example, it is reported that 37% of individuals with diplegia or hemiplegia and 86% of individuals with quadriplegia experience GERD. It is very common in people with cerebral palsy and can show up as anemia, failure to thrive and reoccurring infections.

It is usually missed by people who have been feeding and serving food to individuals with disability due to its subtle signs.

What is Gastroesophageal Reflux? (GERD)

GERD occurs when the muscle connecting  to the esophagus is weak and opens under pressure, allowing the stomach contents to flow back into the esophagus. It is the acid from the stomach to the esophagus. this will irritate the lining of the esophagus and causes heartburn. Without treatment, GERD can cause complications.

What causes GERD?

GERD is usually caused by inflammation from the exposure of the esophagus to the stomach acid. The following can cause GERD:

  • diet such as fatty foods, coffee, peppermint and chocolate
  • decreased muscle tone
  • overweight
  • backup in blockage of the intestinal tract.

There are many reasons for the high incidence of GERD in individuals with intellectual disability including immobility and positioning, abnormal postures, medication use and excessive drooling.

What is a developmental disability?

A developmental disability is described as an assortment of chronic conditions that are due to mental or physical impairments or both. For example, you may have a child or an adult with an intellectual disability or perhaps a person diagnosed with cerebral palsy and an intellectual disability. It is also considered a severe and chronic disability that can occur up to the age of 22, hence the word developmental. A developmental disability can occur before birth such as genetic disorders (i.e. cri du chat, fragile x syndrome,) or chromosomes ( i.e. Down syndrome, Edwards syndrome); during birth (lack of oxygen) or after birth up to the age of 22 (i.e. head injuries, child abuse or accidents).

For people with limited communication, the following are possible signs of gastroesophageal reflux:

If you suspect GERD, make arrangements for the person to be evaluated by a physician.

Dysgraphia and Workplace Accommodations

Some might be surprised to learn that there are several types of learning disabilities. Dysgraphia is describes as a learning disability that affects writing, spelling and fine motor skills. Dysgraphia is a neurodevelopmental disorder that can occur as a stand alone disorder or part of a co-occurring disorder with other disabilities such as ADHD, Autism, and Dyslexia. Typically it is diagnosed or discovered in the early years when children are beginning to learn how to write. Most adults often remain undiagnosed.

Early Signs of Dysgraphia

Signs and symptoms of dysgraphia generally begin to show up when children began to lean how to write. Early signs of Dysgraphia include:

  • Inconsistent spacing between letters
  • Poor spatial planning
  • Poor spelling
  • Unable to read own handwriting
  • Poor fine motor skills
  • Omitted words
  • Writes slow
  • Pain in hand from writing
  • Messy unorganized papers
  • Difficulty organizing thoughts on paper
  • Illegible printing and cursive letter formation
  • Slopping handwriting
  • Tight, cramped pencil grip
  • Tires quickly when writing
  • mixes upper and lower case or irregular sizes and shapes of letters.

Download a free dysgraphia checklist

Signs and Symptoms in the Workplace

A early signs that rarely disappears is having a “sloppy” handwriting. The person when writing leaves out letters at the end of a sentence, difficulty reading own handwriting after meetings, trouble with filling out routine forms, displays unorganized papers on the desk, difficulty thinking and writing at the same time and tends to mixes upper and lower case letters when writing. The person will also avoid writing when possible and show a preference to using a computer or texting neatness, line spacing, staying inside margins and capitalization rules.

Strategies to Use in the Workplace
  1. If you have a smart phone, you can use the device to record meetings, interviews or instructions that are given to you.
  2. Assitive technology such as tablets, computers and Apps are also useful in transcribing information
  3. Take the time to organize your desk before you leave work in the evening. Prioritize your workflow and create a plan for the next day.
  4. Pre-write. Before you take on the task of writing, create an outline on paper.

Aspiration Precautions

Children and adults with developmental disabilities often face challenges with eating, drinking and swallowing disorders than the general population. It is estimated that adults with intellectual disabilities require support from caregivers during mealtime. It is common among people who have a diagnosis of cerebral palsy, intellectual disability, physical  disability and muscular dystrophy.

Dysphasia is a medical term used to describe any person having difficulty swallowing foods and liquids taking  more energy and time to move food from the mouth to the stomach. Signs of dysphasia may include:

  • Drooling
  • Food or liquid remaining in the oral cavity after swallowing
  • Complaints of pain when swallowing
  • Coughing during or right after eating or drinking
  • Extra time needed to chew or swallow
  • Reflux of food

Dysphasia can lead to aspiration. Aspiration is defined when food, fluid, or other foreign material gets into the trachea or lungs instead of going down the esophagus and into the stomach. when this occurs, the person is able to cough to get the food or fluid out of their lungs, in some cases especially with children and adults with disabilities may not be able to cough. This is known as Silent Aspiration.

A complication of aspiration is Pneumonia which is defined as inhaling food, saliva, and liquids into the lungs

According to the Office of People with Developmental Disabilities Health and safety Alert, factors that place people at risk for aspiration include:

  • Being fed by others
  • Weak or absent coughing, and/or gag reflexes, commonly seen in people with cerebral palsy.
  • food stuffing and rapid eating/drinking
  • Poor chewing or swallowing pills
  • GERD- the return of partially digested food or stomach contents to the esophagus
  • Providing liquids or food consistencies the person is not able to tolerate such as eating whole foods.
  • Seizures that may occur during eating and/or drinking.

How to recognize signs and symptoms of Aspiration:

  • Choking or coughing while eating or just after eating
  • Drooling while eating or just after eating
  • Eyes start to water
  • Shortness of breath
  • Fever 30 minutes after eating
Intervene immediate if there are signs of aspiration:
  • Stop feeding immediately
  • Keep the person in an upright position
  • Call 911 if the person has difficulty or stops breathing and no pulse
  • Start rescue breathing

Minimize aspiration from occurring by serving the appropriate food texture and liquid consistency. If you are not sure of the right consistency, check with your health care provider. The following are pictures of food consistencies.

Courtesy of OPWDD

Courtesy of OPWDD

Whole. Food is served as it is normally prepared; no changes are needed in
preparation or consistency

Courtesy of OPWDD

1 ” Pieces cut to size. Food is served as prepared and cut into 1-inch pieces
(about the width of a fork).

Courtesy of OPWDD

1/4 Pieces Cut to Size. Food is cut with a knife or a pizza cutter or placed in a food
processor and cut into ¼ -inch pieces (about the width of a #2 pencil)

Courtesy of OPWDD

Ground. Food must be prepared using a food processor or comparable equipment
until MOIST, COHESIVE AND NO LARGER THAN A GRAIN OF RICE, or relish
like pieces, similar to pickle relish. Ground food must always be moist. Ground meat
is moistened with a liquid either before or after being prepared in the food processor
and is ALWAYS served with a moistener such as broth, low fat sauce, gravy or
appropriate condiment. Hard, dry ground particles are easy to inhale and must be
avoided.

 

Courtesy of OPWDD

Pureed. Food must be prepared using a food processor or comparable equipment.
All foods are moistened and processed until smooth, achieving an applesauce-like or
pudding consistency. A spoon should NOT stand up in the food, but the consistency
should not be runny. Each food item is to be pureed separately, unless foods are
prepared in a mixture such as a soup, stew, casserole, or salad.

Aspiration Precautions

  • Make sure the person eats slowly and takes small bites of food
  •  Ensure the person takes small sips of liquids
  • Focus on the person’s swallowing
  • Make sure the person remains upright for a minimum of thirty minutes after eating

Fine Motor-Flag Day Activities

June 14th is the designated day to celebrate the American flag. The purpose of Flag Day is to reflect on the foundations of the Nation’s freedom. The following activities can be used to improve fine motor skills for both children and adults with disabilities. From cutting to coloring , the activities also use a multi-sensory approach to learning.

Arts and Crafts

DLTK Flag Day– Flag day crafts including coloring pages and tracing.

Education World– Flag day lesson plan activities

Enchanted Learning– Allows you to click on any of the crafts to get to the instructions.

Flag Day Crafts– Includes creating a togetherness flag, star cookie cutter and a craft stick American Flag

No Time for Flash Cards- Create an American flag sticky window collage

Flag Day Inspired Recipes

Food Network– 6 Star spangled red, white, and blue recipes made for flag day.

Saralee Bread- Flag day food art recipe

Taste of Home- Top 12 flag-shaped recipes

Tasty Kitchen– Recipe for cakes and cupcakes in the shape of the American flag.

Flag Day Coloring

Color me good

Crayola

DLTK

Doodle Art Alley

Get Coloring Pages

Supercoloring

The color.com

Thoughtco

USA Printables

Woojr.

Free Printable Money WorkSheets

Summer will be here before you know it. If you want your student/ child or individual to continue practicing math skills, I have provided below 4 money sheets that you can printout and make several copies. The money sheets allows the child to work on both IEP and ISP goals including:

  1. Identifying coins
  2. Matching coins
  3. Visual discrimination
  4. Counting
  5. Transition skills
  6. Visual learners

 

Burger King.Worksheet. This is a fun activity especially for children, students and adults that enjoy going to Burger King. The individual will choose the picture and subject the cost of the item from $10.00.  This activity people with dysgraphia, increase money skills, attention skills, task initiation skills and works well as a pre-trip to Burger King. focusing on transition skills.

Matching Dimes Worksheet– The matching dime activity is great for goals on counting and identifying a time. it is useful for children adults that are visual learners and provides hands on materials. The students learning ability will increase with the use of actual dimes.

Circle Nickle Worksheet – This worksheet give the individual an opportunity to work on counting, identify various coins as well as explaining the value of the coin. The worksheet also provides additional support and increases visual discrimination skills.

Dime Counting – helps the child, student or adult with special needs practice counting skills and visual memory.

My plan for the rest of the year is to provide you with more resources that are more functional and allows you to download information.

 

Memorial Day Sensory Activities

Memorial Day is an American holiday observed to honor the men and women who died while serving in the U.S. Military. It originated following the Civil War and became an official holiday in 1971.

Memorial Day is also an opportunity to work on fun Memorial Day activities. Children and adults with special needs lean best when using a multi-sensory approach. This helps to stimulate learning and engage individuals on various levels of learning.

The activities and lessons that I have chosen focus on visual and tactile stimulation and includes both math and reading activities. The craft activities work to improve fine motor skills.

 

American flag on a pencil craft- Printable templates

Craft stick flag– U.S. flag made from craft sticks

Free Memorial Day packs- packets includes clip cards, word problems, fill in and missing numbers

Patriotic Pinwheel– Craft easy to make pinwheel

USA Wreath– Simple red, white and blue wreath made out of construction paper.

 

 

Cystic Fibrosis Awareness Month

According to the Cystic Fibrosis Foundation, cystic fibrosis is a progressive, genetic disease that causes persistent lung infections and limits the ability to breathe overtime. It is a life-threatening disorder that damages the lungs and digestive system. A thick mucus can block the lungs and the pancreas.

In the United States, about 30,000 people are affected by the disease. It is estimated that more than 70,000 people worldwide are living with cystic fibrosis. 1 in every 20 Americans is an unaffected carrier of an abnormal CE gene.

Wikipedia

Common symptoms of cystic fibrosis include:

  • Salty-tasting skin
  • Persistent coughing
  • Shortness of breath
  • Wheezing
  • Poor weight gain in spite of excessive appetite
  • Greasy, bulky stools
  • Repeated lung infections
  • Muscle and joint pain
  • Sinus infections.

Cystic Fibrosis does not affect any cognitive or learning abilities. However, the student may need modifications and supports due to the disease. Teachers with students with cystic fibrosis should be knowledgeable about the disease.

Day Habilitation May Activities

May Observances, Celebrations, Events and Holidays To Use As Ideas For Your Day Habilitation Program.

You can download the PDF format here: May Day Habilitation Activities

Spring Fine Motor Activities

Spring has finally arrived! birds are signing, trees are budding and flowers are blooming. There is no better tome to strengthen fine motor skills for children and adults with developmental disabilities. Fine motor activities improve independent living skills including feeding, dressing and writing. The links below provide spring-themed activities providing opportunities to improve the child or adult’s pincer grasp by using scissors and pencils.

5 Spring inspired fine motor activities– Brain Balance

10 fine motor activities for spring- You Aut- Aknow

10 flower fine motor skills activities- Harry Brown House

40 fine motor skills activities– The Imagination Tree

Fine motor and color matching Flowers– The Kindergarten Connection

Fine motor and sensory play for spring using a sand-tray– Buggy and Buddy

Spring crafts for preschool fine motor skills– Lalymom

Spring fine motor and executive function skills freebie- Your Therapy Source

Spring fine motor activity tray– Little Bins Little Hands

Spring themed fine motor sensory activity– Hands On As We Grow

Spring-themed fine motor activities– Pink Oatmeal

Autism and Visual Impairments

Studies show that a small subgroup of individuals with visual impairments are also diagnosed with autism. The following articles are a great read in understanding visual impairments and autism.

A cross disability: Visual impairments and autism

Autism assessment in children with optic nerve hypoplasia and other vision impairments

Autism and sight or hearing loss

Autism and visual impairments

Could my visual impaired client be on the autism spectrum?

Is my blind child autistic?

Literacy ideas for students who are visually impaired with autism spectrum disorder

Visual impairments: Its effect on cognitive development and behavior

Visual impairment and autism

Visual impairment and autism spectrum disorder

15 Resources on Cerebral Palsy and Adulthood

Cerebral palsy is a condition caused by damage to the specific areas of the brain. Cerebral palsy refers to the brain and palsy to muscle weakness. Cerebral palsy is a syndrome of motor impairment with posture and movement disorder. It is a non-progressive disorder, however, as a person begins to age, muscle and skeletal problems begin to worsen resulting in more pain, discomfort and limited mobility. Due to muscle flexibility, strength and endurance issues, there is a greater risk of falls and injuries. The following articles includes information on understanding how aging and adulthood affect people with cerebral palsy.

5 common challenges for adults with cerebral palsy- Made For Movement Blog

Adults and cerebral palsy– Cerebral Palsy Organization

Adults with Cerebral Palsy- Cerebral Palsy Foundation

Aging with Cerebral Palsy and Chronic Pain– The Mighty

Care of adults with cerebral palsy-American Academy for Cerebral Palsy and Developmental Medicine

Cerebral Palsy and aging– Developmental Medicine and Child Neurology

Cerebral palsy and transitioning to adulthood-Cerebral Palsy Alliance

Cerebral Palsy effects through lifespan-Physiopedia

Cerebral Palsy in Adulthood– Everyday Health

Cerebral Palsy patients provide rare insight into aging– Cerebral Palsy News Today

Cerebral palsy symptoms in Adulthood- Healthfully

Living as an adult with cerebral palsy– Healthline

Living with cerebral palsy as an adult– WebMD

Progression and Correction of Deformities in Adult with Cerebral Palsy-ACNR

The good, the bad, and the ugly facts about adult cerebral palsy-Karen Pape

ISP Terms To Know

Click here to download a copy to print

You are probably familiar with IEP’s if your child or family member attend a public school here in the United States. For some people with a developmental disability, the next step may be attending a day habilitation program where adults with developmental disabilities receive Medicaid Waiver Services and has what is called an Individualized Service Plan (ISP).  If you are new the ISP process, the following terms that you will hear often before, during and after meetings.

Assessments. Serves to develop a body of information about an individual’s desires and goals his/her capabilities in areas in need of learning and skill development and the experiences or supports that will promote achievement of those goals.

Background/History. Provides an overview of the life experiences of the person and family.

Goals/Service. includes person-centered supports to enhance opportunities for individuals to make choices that increase their quality of life. An example would be a goal of increasing money or budgeting skills.

Interest and Activities. Describes personal preferences, gifts and interests, as well as conditions to avoid.

ISP Plan. A living document that provides details about what is important to an individual with developmental disabilities. It reflects a person-centered planning process.

Natural Supports. Personal associations and relationships developed in the community that enhance the quality and security of the life for people including family and friends.

Provider Program. The name of the voluntary agency delivering direct care to individuals with developmental disabilities. Providers may offer a variety of services and supports.

Habilitation Service. Services that help you keep, learn or improve skills and functioning for daily living skills

Individual Service Environment. Provides self-directed, individualized assistance and support to individuals living on their own, either alone or with roommates in their own home or apartment.

ISP Meeting

ISP Revision. Revisions and changes to the ISP can occur when an individual experiences a change in need throughout the year and must be reflected in the ISP. It is not necessary to wait annually to make the revisions. The date of the revisions should be reflected in the ISP.

HCBS Waiver Services.  A Home and Community-Based Service (HCBS) Waiver is a Medicaid program designed to meet the needs of children and adults who prefer to get long-term care services in their home or community, rather than in an institutional setting.

Medicaid. is a jointly funded, Federal-State health insurance program for low-income and people in need including children and adults with disabilities. It is a government insurance for people whose income and resources are insufficient to pay for healthcare. A Medicaid number is needed for an ISP and is used to bill services.

Person-Centered Planning (PCP). An ongoing problem-solving process used to help people with disabilities plan for their future. It allows individuals to be engaged in the decision making process about their options, preferences and values.

Protective Oversight. is a documented and approved plan used for the sole purpose of enhancing individual safety. It list the key activities that affect health and wellness of an individual.

Safeguards. a measure taken to protect the individual from harm by providing information on how it will be addressed. An example is fire evacuation. If a person is not able to evacuate independently from a fire emergency, protections are put in place to ensure his or her safety.

Service Provider. The name of the voluntary agency delivering direct care to individuals with developmental disabilities. The provider may offer a variety of services and supports.

Value Outcome. Statements that represent what is important to the person. It may include what the individual needs, wants to change or would like to maintain in his/her life. Outcomes are developed through the ISP process.

 

Identifying Street Signs Worksheet

This is an introduction to identifying street signs for children and young adults learning how to cross the street safely. The worksheet includes signs needed in teaching street crossing safety.

Learning Objectives:

  • Will match the traffic sign correctly
  • Will identify the traffic sign correctly
  • Will name the traffic sign correctly

Material Needed:

Traffic sign worksheet
laminated (optional)
laminator paper(optional)
Scissors

Instructions:

  1. Once you have printed the worksheet, cut the individual traffic signs and laminate.
  2. Explain each traffic sign and have the individual repeat.
  3. Once the signs are separated, mix them up and have the individual point to the correct ones.
  4. Have the individual state the traffic signs correctly and match

Traffic Signs Worksheet_ID Signs

 

Adults with Special Needs and Housing Options

Click here to download PDF article

For many years, most people with developmental disability had only the option of living at home with family or become institutionalized. Today, people are given many more housing options. Although there is still a challenge in finding the right fit, home opportunities are more available. The following are housing options for adults with special needs.

Living with parents or family

Adults with special needs may choose to live at home with their families as long as they can. In some cases, adults with developmental disabilities continue to live at home after their parent’s death by hiring a Personal care Attendant (PCA). A PCA is hired by a person with a disability to assist with his or her personal care routine. People are eligible for this service is they qualify for Medicaid if they have a severe, chronic disability and requires physical assistance for personal care.

Section 811

The Section 811 program allows persons with disabilities to live as independently as possible in the community by subsidizing rental housing opportunities which provide access to appropriate supportive services. Serves extremely low-income individuals with serious and long-term disabilities, including physical or developmental disabilities as well as mental illness.

  • Is designed to accommodate the special needs of such persons;
  • Makes available supportive services that address the individual health, mental health and other needs of such persons; and
  • Promotes and facilitates community integration for people with significant and long-term disabilities.”

Group Homes

Residential home which provides 24-hour support services in a group setting. Oversight, training and supervision are provided by staff employed by a provider agency. This type of facility is provided to those with significant health and/or safety needs.

Individual Supports

Are limited to 3 or fewer individuals and provide need-based support and services for those living in their own homes or apartments, but do not require 24-hour staff support and supervision.

Assisted living communities,

  • also referred to as supported care facilities, provide care to older adults who are unable to live independently, often needing assistance with ADLs. Most offer private and semi-private apartment-style living often containing a living area and kitchenette.

 

Guardianship

When an individual with a developmental disability becomes an adult, Guardianship is something you should consider. In many States, the law will see the individual as an adult able to make decisions on their own. If you have a child with a disability who many never have the ability to make legal decisions on their own, the following information are links on guardianship and what you need to know about them.

Does my child need a guardianship?– Special Needs Alliance

Guardianship– Cincinnati Children’s

Guardianship: A basic understanding for parents– Parenting Special Needs

Guardianship and adult children with developmental disabilities-ICHE

Legal guardianship and your adult child with disabilities– A day in our shoes

My child with a disability is an adult- Now what? – Parenting NH

Special needs children turning 18 years old– Today’s Caregiver

Understanding guardianship for adults with special needs– Protected Tomorrows

When your child turns 18: A guide to special needs guardianship– Friendship Circle

Guardianship- State Specific Requirements

Each State has it own requirements for Guardianship, click on your State below to find more information:

Alabama

Alaska

Arkansas

Arizona

California

Colorado

Connecticut

Delaware

District of Columbia

Florida

Georgia

Hawaii

Idaho

Illinois

Indiana

Iowa

Kansas

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Ohio

Oklahoma

Oregon

Pennsylvania 

Rhode Island

South Carolina

South Dakota

Tennessee 

Texas

Utah

Vermont

Virginia

Washington

West Virginia

Wisconsin

Wyoming

Bathing Training Curriculum For Direct Support Professionals

Click here to print PDF version of article
Studies show that most accidents occur in the home. There are a number of factors that increases this number in a residential setting. For example, Staff are responsible for providing care to more than one person and the may also be responsible for a number of other duties including, preparing dinner, giving out medication and working on performance goals. Given these factors, it is vital that attention and skill is given during bathing time. One minute away, could lead to a disastrous event.

The following is a training curriculum that serves to train staff (Direct care Professionals) on bath safety. I have included the lesson plan also in a PDF format and a demonstrative checklist. Once completed, staff should be able to show their competency level in bathing an individual safely. This training also satisfies and supports Core Competency 5 (safety) and Core Competency 6(Having a home).

Title:  Bath Safety Training

Description Training:

This module is intended to provide direct support professionals with principles and strategies which will assist them in the preparation, supervision and assistance necessary to ensure the safety of people with developmental disabilities. The first section focuses on identifying and evaluating required staff supervision. Section 2 includes the responsibilities of staff during bathing time.

Learning Objective(s):

  • Demonstrates steps to ensure all necessary bathing items are in the bathroom before preparing for bathing time.
  • Evaluate the level of supervision needed
  • Define the characteristics of a burn
  • Distinguish temperature for bathing vs. showering
  • Identifying the process of bathing residents to ensure the process is safely carried out.
  • Explain the risk for people with disabilities

Maximum Group Size:

Training segment 10- competency portion should be conducted one person at a time.

Blooms Taxonomy:

  • Remember
  • Understand
  • Apply

Required Employees: Direct Support Professionals

Materials:

  • Handout
  • Handout
  • Competency test
  • Competency
Training:  1 Hour
Objective 1: The participants will be able to explain bathing risk for people with disabilities

Lecture:

The trainer will begin this session with a brief introduction on the magnitude of the problem regarding accidental deaths, bathing injuries including scalding. In your own words, please say the following:

Studies show that after the swimming pool, the bathtub is the second major site of drowning in the home including residential settings with seizures accounting for most of the common causes of bathtub drowning.

The National Safety Council reported that one person dies everyday from using bathtub in the United States. That more people have died from bathtub accidents than all forms of road vehicle accidents.

Injuries from the bathroom included slipping and falling when entering or exiting the bathtub or shower.

A study concluded by the State University of New York State found bathing difficulties included maintaining balance when bathing and making transfers.

Inform participants the following:

Near-drowning happens very quickly. Within three minutes of submersion, most people are unconscious, and within five minutes the brain begins to suffer from lack of oxygen. Abnormal heart rhythms (cardiac dysrhythmias) often occur in near-drowning cases, and the heart may stop pumping (cardiac arrest). The blood may increase in acidity (acidosis) and, under some circumstances, near drowning can cause a substantial increase or decrease in the volume of circulating blood. If not rapidly reversed, these events cause permanent damage to the brain

Ask – How much water does it take to drown?

Answer- inches of water in the bathtub. Any amount of water that covers the mouth and nose.

Who is at -risk?

Tell the participants the following people are considered high risk for accidents and drowning in the bathtub or shower:

  • Older people
  • Residence with a history of seizures
  • Residents diagnosed with dementia or Alzheimer
  • Residents who require assistance or supervision for mobility, transfer or ambulation.
  • Lack of understanding of one’s own physical and cognitive limitations.

Scalding

The trainer will introduce the segment on scald burns. Tell participants that individuals with physical, cognitive and emotional challenges are at high risk for burn injuries due to mobility impairments, muscle weakness and slower reflexes.  Further explain that, sensory impairments can result in decrease sensation in the hands and feet with the resident not realizing the water is too hot.

The instructor will discuss the following handout:

Time and Temperature relationship to Severe Burns

Water Temperature Time for a third degree burn to occur
155° F 1 second
148° F 2 seconds
140° F 5 seconds
133° F 15 seconds
127° F 1 minute
124° F 3 minute
120° F 5 minutes
100° F Safe temperature for bathing

 

Objective 2: Define the Characteristics of a Burn

In this section, the trainer will give the definition of a burn, Explain to participants that a burn is damage to the skin and underlying tissue caused by heat chemicals or electricity.

Further explain, Burns range is severity from minor injuries that require no medical treatment to serious, life-threatening and fatal injuries. Further explain that burns are categorized by degrees. Have participants turn to the handout on burns.

Superficial (first degree burns)

  • Causes : sunburn, minor scalds
  • Generally heal in 3-5 days with no scarring

Characteristics;

  • Minor damage to the skin
  • Color- pink to red
  • Painful
  • Skin is dry without blisters

Partial thickness (second degree) burns

  • Damages, but does not destroy top two layers of the skin
  • Generally heal in 10-21 days
  • Does not require skin graft*
  • Skin is moist, wet and weepy
  • Blisters are present • Color – bright pink to cherry red
  • Lots of edema (swelling)
  • Very painful

Full thickness (third degree) burns

  • Destroys all layers of the skin
  • May involve fat, muscle and bone
  • Will require skin graft for healing*
  • Skin may be very bright red or dry and leathery, charred, waxy white, tan or brown
  • Charred veins may be visible
  • Area is insensate – the person is unable to feel touch in areas of full thickness injury

*Except for very small (about the size of a quarter) full thickness burns will require a skin graft to heal.  The patient is taken to the operating room where all the dead tissue is surgically removed. Skin is taken or harvested off an unburned or healed part of that person’s body and grafted or transplanted to the clean burn area. In seven to 14 days, this grafted skin “takes” or adheres to the area and becomes the person’s permanent skin. The donor site (where the skin was harvested from) is treated like a partial thickness burn and heals within 1- to 14 days.

Objective 3: Identify the process of bathing residents to ensure the process is safely carried out

The trainer will discuss the importance of following the appropriate steps when giving a resident a shower:

When escorting a resident to the bathroom, the following items should be gathered and taken to the bathroom:

  • Washcloth/bath sponge
  • Towel
  • Body wash/soap
  • Body lotion
  • Toothbrush
  • Toothpaste
  • Mouthwash
  • Hair shampoo
  • Hair conditioner

The trainer will remind participants not to leave the participants in the bathroom alone under any circumstances for those requiring supervision.

Ask- What circumstance might a person leave the person alone.

The participant should respond- none.

Click on the link below to download the competency checklist:

COMPETENCY DEMONSTRATION CHECKLIST

Click on the link below to download the training in Word format

bathing module

 

 

10 Easy Steps of Audit and Survey Readiness

Annual audits and surveys can be very intimidating. A group of state surveyors showing up at the residence or day program to review services given to individuals with developmental disabilities.

What is the purpose of the audit?

In each state, Immediate Care Facilities (ICF), Immediate Residential Alternatives (IRAs), Waiver services or privately operated programs are funded through Medicaid Assistance Annually State agencies. Annual surveys serve the purpose of recertifying facilities and to make any further recommendations. Overall, the goal is to ensure the quality of for the individuals receiving services.

What are surveyors looking for?

In recent years, the focus is more on ensuring facilities that provide services and supports to individuals with intellectual and developmental disabilities are providing opportunities for individual choices including person-centered planning, community inclusion and choice-making. Typically, State auditors will review the Individualized service Plan (ISP) document to determine it the ISP is both current and accurate.

Audit Preparation

State Auditors generally spend some time talking to staff. They may ask you questions relating to the person’s plan. The questions are often generated after they have read the individual’s ISP plan. The questions that are asked are more than likely things that you do well everyday. here are 10 easy steps as you prepare for the auditing process:

  1. Knowledge of Individuals. know each person’s plan including person-centered planning plan, medical needs, preferences and habilitation plan.
  2. Cleanliness. Make sure the environment is neat and orderly.
  3. Privacy. Remember to give the person privacy when needed.
  4. Choice. Offer choices throughout activities whenever possible. The auditors may ask you how do you teach choice-making.
  5. Tone. Always speak in a positive and appropriate tone of voice.
  6. Small groups. Work in small groups whenever possible. Incorporate variety  of choice during activities.
  7. Community activities. Ensure individuals are able to make choices in activities in the community and community inclusion opportunities are available.
  8. Universal Precaution Guidelines. Know the precautions and follow them. Remember to change gloves when moving from one individual to the next.
  9. Active Programming. The auditors may ask questions related to what they have read in the individuals ISP or CFA (Comprehensive Functional Assessment).
  10. Safeguards. make sure you are able to describe the individual’s supervision needs.

Remember: Demonstrate your self-confidence, because you are good at what you do!

Election Lesson Plan and Activities for Day Hab

Since President Trump’s, election, there has been a vigorous interest in politics not only in the United States but also in other countries as well. The upcoming mid-term elections provides an opportunity for adults with developmental disabilities to participate through a lesson plan created not only on the upcoming election, but also ways to get individuals more involved on topics and platforms that impact their lives.

Sadly, I have heard very little from politicians on issues concerning people with disabilities and the impact it will have on people with disabilities and their families. This affords an opportunity to have real discussion with people on issues that are important to them through a series of multisensory activities.

  1. Who doesn’t like a game of bingo? Download the bingo template, make as many copies as you wish and set up an activity playing Bingo. Once you call out a name. use it as an opportunity to have discussion i.e. How would you describe a conservative? When is the election held? Below, click on the template


Bingo.download

2. The second activity includes a week-long lesson plan on election and representative in office using a multisensory approach.  The first day is set up for making an apple smoothie and a trip preparation activities allowing individuals to work on their social and money management skills. I left the lesson plan editable so that you can move activities around as you wish.


election.dayhab

Materials Needed for the lesson plan activities

Mock Voter Registration

mock voter registration

Apple Smoothie Recipe

Apple Smoothie Recipe

Caramel Apple Smoothie

Patriotic Printable Paper Chain

Free patriotic printable chain

Patriotic paper chain with needed supplies

Oh, this is also a great activity to use a home or school for students at the high school level.

 

15 Halloween Fine Motor Skill Activities

Candy is not the only great thing about Halloween. It is a chance to work on fine motor skills and eye-hand coordination while having fun at the same time. From ghosts to witches, there are a number of activities you child or student can do that will help increase fine motor skills. For some children and adults with disabilities, struggle with fine motor skills. These activities are a chance to improve the coordination between the brain and the muscles including dexterity and motor control. Click on the links below.

Easy Halloween fine motor activity

Eyeball sensory bag

Feed the spider

Frankenstein monster pumpkin

Halloween fine motor: Giant lacing spiderweb

Halloween fine motor activities for preschool

Halloween fine motor activities that promote cutting practice

Halloween mask to print and color

Halloween Necklaces

Halloween Play Dough

Halloween themed cutting tray

Scissor skill pumpkins

Spider web yarn

Witchy fingers

Yarn wrapped spider craft for halloween

15 Visual Schedule Resources

Imagine during the course of the day you have no idea what is expected of you. Moving from one activity to the next depending on others to inform you of your daily plans. there are many benefits to using visual schedules especially for autistic children and adults. Studies show that many people diagnosed with autism experience high levels of anxiety often caused by unstructured activities.

Visual schedules are a way to communicate an activity through the use of images, symbols, photos, words, numbers and drawings that will help a child or adult follow rules and guidelines and understand what is expected during the course of the day.

Th following are resources containing information on creating visual schedules and free printables:

8 types of visual student schedules

Building a daily schedule

Daily visual schedule for kids free printable

Examples of classroom and individual schedule and activity cards

Free picture schedule

Free visual schedule printables to help kids with daily routines

Free visual school schedules

How to templates- visual schedules

How to use visuals purposefully and effectively

Time to eat visual schedules

Using visual schedules: A guide for parents

Visual schedule for toddlers

Visual schedule resources

Visual supports and autism spectrum disorders

What is visual scheduling?

Teaching Telling Time To Special Needs Children and Adults

Teaching children and adults with disabilities to tell time is one of the many steps towards independence. While neurotypical children tend to start learning how to tell around the first grade, for children with disabilities, it may take a little longer.

When teaching a child with a disability to learn how to read, teaching time telling skills requires more practice a most. each step should be broken Use multi-sensory activities as much as you can including practices that involve tactile, visual, touch, etc. Be aware if the child has a sensory processing disorder. Look for clues of a pending meltdown as the child may begin to feel overwhelmed. Allow the opportunity to calm down before returning to the activity.

The following resources below includes worksheets, templates and interactive games.

Busy Teacher. Provides beginner steps to teaching time

Education World. Lesson plans including a bingo card and additional resources on telling time

Scholastic. A lesson plan on teaching time using an analog clock model including information on pre-instructional planning and a clock template

Scholastic. Provides 10 ways to practice time skills

Teaching Time. Site includes worksheets, interactive games and templates.

The Mad House. Blog on how to make a paper plate clock- Great multisensory activity for learners

Third Space Learning. A blog article that provides a step by step technique on teaching time including ways to reduce cognitive overload.

We Are Teachers. 5 hands on ways to teach telling time. The webpage also includes a free blank watch for children to color.

Worksheet Generator

Home School Math.Net

Telling Time Quiz

Clock Wise

Games For Telling Time

Clock Games

Just In Time

Teaching Clock

What Time Is It?

Worksheets Printables

Common Core Worksheets

Education.com

Math.aids.com

Telling Time To The Hour

What is Prader Willi Syndrome?

May is Prader Willi Syndrome Awareness Month

Click here to download PDF version

What Exactly is Prader Willi Syndrome?

Prader Will Syndrome is a genetic disorder resulting from an abnormality of chromosome 15 such as a loss of active genes. In most cases (70%) the paternal copy is missing and in some cases (25%), will exhibit two maternal copies of Chromosome 15. The genetic disorder was initially described by John Langdon Down and was named after Drs. Andrea Prader, Heimrich Willi and Alexis Labhart in 1956 and is found in 1 in 20,000 births affecting both sexes. It is also the most common recognized genetic form of obesity.

During childhood, individuals diagnosed with Prader-Willi Syndrome tend to eat constantly leading to obesity and for some, type 2 diabetes will develop. This complex disorder affects appetite,growth, metabolism, cognitive functioning and behavior.

Signs and Symptoms

People with Prader-Willi Syndrome (PWS) tend to never feel full (hyperphagia) which leads to constant eating. Signs in infants include, problems with strength, coordination and balance. Often there are feeding problems at birth, delayed speech and gross motor development. Children may be born with almond-shaped eyes and undeveloped sexual organs. Cognitive disabilities and developmental delays may also be present.

As children began to grow, constant craving for food often leads to behavior challenges including hoarding food, eating frozen food and food left in the garbage causing controlling or manipulative behavior.

Medical Issues

Medical concerns may include the following:

  • Sleep Apnea
  • Respiratory/Breathing
  • High pain tolerance
  • Severe stomach illness
  • Difficulty with vomiting reflex
  • Excessive appetite
  • Binge eating
  • Eye problems
  • Choking
  • Hypothermia
  • Leg Swelling
  • Consuming unsafe items
  • Negative reactions to medications
Teaching Strategies

Most people diagnosed with Prader Willi Syndrome fall between the moderate and mild levels of an intellectual disability meaning there may be challenges in the area of reasoning, problem-solving, planning, judgment, abstract thinking and learning.  A child or student functioning at the moderate level may lag behind their peers in the area of language and pre-academic skills. Adults may function at an elementary school level and will require support in both work and daily living skills. For children and students functioning at the mild level, there may be difficulties in the area of reading, writing, math and money management. as children grow into adults, there may be a need for support in abstract thinking, executive functioning (planning, prioritizing and flexibility) as well as short-term memory and money management.  Teaching strategies should focus on the following:

  • Aggression management
  • Anger management skills
  • Anxiety management
  • Emotional regulation
  • Personal safety
  • Social skills

Keep in mind that many children and adults diagnosed with Prader-Willi Syndrome may have additional challenges in learning due to medication. Some people take medication such as a growth hormone therapy which can cause fatigue.  The following teaching strategies may also be useful when teaching a student diagnosed with Prader Willi Syndrome:

  • Use a multi-sensory approach. This involves a teaching style that includes auditory, visual, tactile, spatial, and kinesthetic (hands on activities)
  • Break learning into small steps. Check for understanding by asking the student to repeat back to you.
  • Teach a skill at least 2-3 times a day. This will help the student retain information.
  • Managing perseveration. Set up a rule where the student can a question no more than 3 times. After the third answer. Ask the student to repeat the response back to you.
Adult Day Program/Residential Setting

Most people with Prader Willi Syndrome due to their cognitive level, will be provided services in either a day habilitation program or live in a community providing residential services. Once a person becomes an adult, it becomes a little bit more tricky on maintaining issues especially behavioral. For instance, while living at home, a parent has the right to lock the refrigerator which is often suggested by experts. However, this becomes a violations of a person’s rights once they reach adulthood. Typically, committees meet to help make the right decisions along with family members and the adult diagnosed with Prader Willi Syndrome. Here are some suggestions.

  • Allow the person to have control of what is important to them. Have discussions on nutrition and staying healthy. Check to see if this may be an appropriate topic the person may want to improve by adding to their person-centered plan. Hold discussion groups in both day programs as well as in residential to discuss various topics on health and nutrition including holding classes on mindfulness and meditation.
  • Trips to shopping malls can be very tricky. Try to avoid mall’s eatery and plan if it is a group trip to have people bring their own lunches.
  • When teaching, allow time before giving additional prompts
  • Give praise as much as you can when it is appropriate.
  • Use visuals as much as you can including graphics and pictures.
Staff Training

Staff training on Prader-Willi Syndrome should include the following topics:

  • Overview of Prader-Willi Syndrome including, causes, symptoms, characteristics, nutrition, and self-regulation.
  • Impact on the family including the stresses families experience.
  • Teaching techniques including problem-solving, forward shaping and role-modeling.
  • Individual rights
  • Managing behavior and crisis intervention
  • Community inclusion trips and activities
Resources

Foundation for Prader-Willi Research

Prader-Willi Syndrome Association (USA)

Prader-Willi Syndrome (Mayo Clinic)

Reference

Prader-Willi Syndrome Association

 

Shopping Center Teaching Activities For Children and Adults With Special Needs

Shopping Centers (or malls as we call them in North America) provide a great way for customers to walk from one store to another without the hassles of having to leave one store in order to go into another. Through the years, Shopping centers  have added on movie theatres, arcades, and food eateries. This has led to a variety of ways of teaching children and adults with disabilities a number of skills.

 

Money Management.

Increasing money skills can be used in almost all areas of a shopping mall. Opportunities include stores such as banking, clothing , restaurants, etc. examples of items to teach include:

  • Will identify coins
  • Will identify money
  • Will count change
  • Will create a budget
  • will fill out deposit slip
  • Will fill out a withdrawal slip
  • Will use an ATM
Sensory

A shopping center provides a low-cost and effective way of arousing more of  more of the five senses (hearing, sight, smell, taste and touch). Yankee Candle offers candles with a variety of fragrances including apple pumpkin, apple spice, beachwood, black cherry, etc.  Bath and Body Works also provides samples for both olfactory (smell) and touch. Samples of fragrances include lotions, cream, massage oils and fragrance mist. Window shopping is an additional opportunity to enhance visual cues with teaching a number of basic skills.  Other places include day spas, massage chairs and nail salons. Examples of sensory teaching activities include:

Window Shopping (Visual)
  • Will describe the color of the outfits
  • Will identify which items cost the most
  • Will describe how many of the outfits are the same, different
  • Will describe the various shapes (circle, square, triangle, rectangular)
  • Will count the number of items in the window
Olfactory (Smell)
  • Will identify a good smell
  • Will identify a bad smell
  • Will identify the smell (i.e. smells like apples)
Tactile (Touch)
  • Will identify the object
  • Will tolerate hand massage
  • Will touch the object
  • Will describe the shape of the object

***  Be mindful some children and adults may have sensory processing issues and can be oversensitive to sights, textures, flavors and smells.

Social Skills

Teaching social skills involves communication, decision-making, self-management and relationship building. Locations in a shopping center to develop these skills includes, eatery and restaurants, banks, department stores and movie theatres. Samples of teaching social skills includes:

  • Will greet the store associate
  • Will say thank you
  • When promoted, will ask for help
  • Will wait patiently
  • Will make eye contact
  • Will use appropriately voice tone
Teaching Prompts

A few guidelines in teaching new skills:

  • Teach a new skill at least 2-3 times. The shopping center allows multiple opportunities to work on a number of skills including money management, and social skills.
  • Allow the person to think for themselves use prompt levels to help navigate levels of independence: Independent, verbal, gestural and physical.
  • Allow for real choice-making. Choice is more realistic when it involves at least 3 items or more. Choosing a new outfit or an item from a menu are perfect examples.
  • Always remember to praise!

 

 

Speech-language Pathology and Adult Services

speech-word-cloud
Guest Blogger, Anne Marie Pineiro, M.A. CCC-SLP, 

Speech-language Pathologists serve individuals, families, and groups from diverse

linguistic and cultural backgrounds. Services are provided based on applying the

best available research evidence, using expert clinical judgments, and considering

clients’ individual preferences and values. Speech-language pathologists address

typical and atypical communication and swallowing in the following areas:

pragmatics (language use, social aspects of communication)

-literacy (reading, writing, spelling)

– prelinguistic communication (e.g., joint attention, intentionality, communicative signaling)

paralinguistic communication

  • cognition- attention,  memory,  sequencing,  problem solving,  executive functioning
  • feeding and swallowing- 4 phases of swallowing

-oral, pharyngeal, laryngeal, esophageal

orofacial myology (including tongue thrust)

-oral-motor functions

Source:   http://www.asha.org/uploadedFiles/SP2007-00283.pdf

In providing services to those Adults diagnosed with a variety of Developmental Disabilities, the SLP’s role may become much more defined, focusing on what is most functional to an individual in the areas of speech, receptive and expressive language (verbal or non-verbal communication) and feeding/ swallowing.  Very often we are attempting to assess and/or maintain an individual’s current level of functioning in the above areas and to train all those involved in the care of that individual in the strategies and implementation of them to achieve that goal.  In our Agency, for example, we break the assessment down into the following areas in order to develop functional and measurable outcomes:

Speech

  1. Does the individual use speech functionally to communicate wants/needs in a variety of settings?
  2. If so, is their speech understood by all, some, few communicative partners?  Are there any strategies a person might use to increase his/her intelligibility- modifying volume, rate, resonance, increasing fluency, etc.?  Does the person use Augmentative Communication to supplement speech when he/she cannot be understood e.g. low/high tech communication device, writing, American Sign Language, Picture Language Board, etc.

Language

  1. Receptive language (Language comprehension) including attention to objects, using objects functionally, identification of objects and/or pictures, comprehending one, two or three-step oral directives, vocabulary, comprehension of attributes and spatial relationships, or auditory comprehension on the word, sentence and paragraph levels.  Is comprehension on the literal or inferential levels?
  2. Expressive language- (Language expression)- for those who are verbal, the MLU (mean length of utterance) is assessed.  For non-verbal individuals, language expression can be in the form of pointing to one or two picture symbols consecutively on a picture language communication board or AAC device, writing or typing single words, phrases, sentences or paragraphs on paper, computer or AAC device.

-AAC device assessments for nonverbal individuals take into account the individual’s cognitive skills, physical abilities in order to access the device (direct selection with hand or finger, eye gaze, head pointer, switch/scanning, etc.), receptive and expressive language skills, communicative intent and pragmatic language abilities, and literacy.  All those involved in the individual’s care play an extremely important role in whether or not someone may receive an AAC device since they will be the ones to set up/take down the device and provide basic maintenance for the device, including programming, charging, etc.

Feeding and Swallowing:

Many people wonder why an SLP would be the one to review an individual’s mealtime plan or protocol.  ASHA guidelines state it best: “The speech-language pathologist is a primary professional involved in assessment and management of individuals with swallowing and feeding disorders. These areas include:

  • Performing clinical swallowing and feeding evaluation;
  • Performing instrumental assessment of swallowing function with medical professionals as appropriate;
  • Identifying normal and abnormal swallowing anatomy and physiology;
  • Identifying signs of possible or potential disorders in upper aerodigestive tract swallowing and making referrals to appropriate medical personnel;
  • Making decisions about management of swallowing and feeding disorders;
  • Developing treatment plans;
  • Providing treatment for swallowing and feeding disorders, documenting progress, and determining appropriate dismissal criteria;
  • Providing teaching and counseling to individuals and their families;
  • Educating other professionals on the needs of individuals with swallowing and feeding disorders and the speech-language pathologists’ role in the diagnosis and management of swallowing and feeding disorders;
  • Serving as an integral part of a team as appropriate;
  • Advocating for services for individuals with swallowing and feeding disorders;
  • Advancing the knowledge base through research activities.

In addition, Speech-language pathologists have extensive knowledge of anatomy, physiology, and functional aspects of the upper aerodigestive tract for swallowing and speech across the age spectrum including infants, children, and adults (including geriatrics). The upper aerodigestive tract includes oral, pharyngeal, and cervical esophageal anatomic regions. Speech-language pathologists also have extensive knowledge of the underlying medical and behavioral etiologies of swallowing and feeding disorders. In addition, they have expertise in all aspects of communication disorders that include cognition, language, and behavioral interactions, many of which may affect the diagnosis and management of swallowing and feeding disorders.”

Source: http://www.asha.org/policy/TR2001-00150/#sec1.3

The dysphagia and feeding disorders that are seen in adults with developmental disability include poorly developed and absent feeding and oral preparation skills and competencies, physiological and anatomical impairments that degrade oral-pharyngeal and esophageal bolus motility, and disruptive or maladaptive mealtime behaviors. Nutrition, hydration, saliva management, ingestion of medications, and management of the oral hygiene bolus may be involved. Upper airway obstruction (choking), aspiration, malnutrition, and dehydration may result from the disorder (Rogers et al., 1994, Sheppard et al., 1988).  Source: http://www.asha.org/policy/TR2001-00150/#sec1.3

Therefore, in our Agency that serves Adults with Developmental Disabilities, the SLP works as one member of the Team, including the Occupational Therapist, Physical Therapist, Nurse, Residential Team and Family Members to create a mealtime protocol or plan which simply states the best way to maximize nutrition while at the same time attempting to decrease incidents of choking (partial or complete blockage of the airway) or aspiration (food or liquid making its way into the lungs which can lead to aspiration pneumonia).  These plans are developed so that all involved in the individual’s care may be informed of the best feeding practices for that individual which include: adaptive mealtime equipment (any cup spoon, plate, straw, etc. used for an individual to improve ability to eat independently and to improve oral-motor control), positioning in chair or wheelchair, degrees of assistance needed for self-feeding, food and liquid consistencies, food allergies and intolerances, the presence of any mealtime behaviors, including rapid pace of eating which may increase risk of choking or aspiration, and any specific instructions the caregiver would find useful in feeding the individual or maximizing the individual’s ability to feed themselves.

I hope you find this information helpful in identifying the SLP’s role in providing services to adults with Developmental Disabilities.

This information is in no way intended to serve as a complete guide in this area, but is meant to simply assist in identifying ways the SLP works as part of the Interdisciplinary Team in serving adults with developmental disabilities in a day habilitation setting

Lesson Plan: Sensory Activities for Children and Adults

Image result for orange

Orange is a color that is associated with the fall months of October and November. It can also be used as a training activity for people with developmental disabilities.

Click here to download a printed version

Facts about the color orange:

  • Orange is the color between red and yellow
  • It is associated with amusement, extroverts, warmth, fire ,energy, danger taste, aroma and autumn
  • It is the national color of Netherlands
  • It is the symbolic color of Buddhism and Hinduism.

Activity: What’s in the Box

Learning Objective: to identify various items using a multi-sensory approach

Activity Area:

  • Visual
  • Tactile
  • Olfactory
  • Kinesthetic

Materials needed:

  • shoe box
  • candy corn
  • carrot
  • orange
  • circus peanuts
  • crayon
  • cheeze-it
  • balloon
  • pumpkin
  • leaf

Instructions: Place all items into an empty container such as a shoe box. Once completed, have participants sit in a circle and pass around the box. Give each person an opportunity to touch the object and to guess the name of the object. For people with a severe cognitive level or multi-disabilities, provide hand over hand guidance.

Prompting:

Discuss with the group or class the various sizes, the aroma, etc.

Alternative Activity:

  1. You can also do a compare and contrast activity by adding items into the box of different colors and having the group choose the orange items.
  2. Have the group create a collage by cutting out items in a magazine that are orange. This will help with improving fine motor skills.

 

 

Understanding Medicaid Waiver Services

Medicaid.gov - Keeping America Healthy

Home and Community-Based services Waiver allows people with long-term such as disabilities to receive services in a home or community setting. The goal of the waiver program is to enable States to tailor services to meet the needs of a particular group. Standard services can include case management, home health aide, adult day habilitation and respite care. The Federal and State Governments jointly fund and administers the program. At the Federal level, the Centers for Medicare and Medicaid Services (CMS) administers the program. Each State administer its Medicaid program in accordance with CMS approved State plan. Each State is allowed a great amount of flexibility in designing and operation it its Medicaid program as long as it complies with the Federal requirements.

 

Activity Ideas for Developmental Disabled Adults

Board games.
Source: E-How

When it comes to activities, disabled adults have distinctive needs. Unlike average adults, disabled people may require the help of respite workers to do certain activities. However, the needs of disabled adults are not always comparable to those of disabled children because many disabled adults are sexually mature and socially competent. Many activities meet the needs of developmentally disabled adults. Click here to read the rest of the story

Developmental Disability Acronyms You Should Know

Similar to special education, adult programs are full of acronyms that are used during meetings and in general conversation. Whether you are new to the field or a parent or caregiver with a child entering adult services, you will find this page useful as you navigate your way through adult services and programs.

Click here for a printed version

acronyms

 

Active Treatment (AT). A continuous, aggressive, and consistent implementation of a program of specialized training, treatment and related services that helps people function as independent as possible.

American Disabilities Act (ADA)- A civil rights law that prohibits discrimination against individuals with disabilities in all areas of public life.

Assessment– A way of diagnosing and planning treatment for individuals with disabilities as part of their individual plan of service.

Autism Spectrum Disorder (ASD)- A group of development disorders that can cause significant social, communication and behavioral challenges.

Cerebral Palsy– A disorder that affects muscle tone, movement and motor skills.

Commission on the Accreditation of Rehabilitation Facilities (CARF)- An independent, non-profit accreditor of health and human service organizations.

Council on Developmental Disabilities-State Councils on Developmental Disabilities (Councils) are federally funded, self-governing organizations charged with identifying the most pressing needs of people with developmental disabilities in their state or territory. Councils are committed to advancing public policy and systems change that help these individuals gain more control over their lives.

Day Program– A day program to assist individuals in acquiring, retaining, and improving skills necessary to successfully reside in a community setting. Services may include assistance with acquisition, retention, or improvement in self-help, socialization, and adaptive skills; provision of social, recreational, and therapeutic activities to maintain physical, recreational, personal care, and community integration skills; and development of non-job task-oriented prevocational skills such as compliance, attendance, task completion, problem solving, and safety; and supervision for health and safety.

Developmental Disability– A group of conditions due to an impairment in physical, learning, language or behavior areas.

Developmental Center– residential facility serving individuals with developmental disabilities owned and operated by the State.

Habilitation– Service that help you keep, learn, or improve skills and functioning for daily living.

Human and Community Based Services (HCBS Waive)- Provides opportunities beneficiaries  for Medicaid beneficiaries to receive services  in their own home or community.

Health Insurance Portability and Accountability Act (HIPPA) – Protects individuals records and other personal information.

Intermediate Care Facilities (ICF/ID)- Medicaid benefit that enables states to provide comprehensive and individualized healthcare and rehabilitation services to individuals to promote their independence.

Independent Living Center (ILC)- Community-based resource, advocacy and training center dedicated to improving the quality of life for people with disabilities.

Individualized Service Plan (ISP)- Written details of the supports, activities and resources required for the individual to achieve personal goals.

Individual supported employment-  Competitive employment in the community in integrated business settings for comparable wages.  Paid support staff provides training on the job site as well as follow along services and supports to the individual and business as needed.
Job Coach– An individual employed to help people with disabilities learn, accommodate and perform their work duties including interpersonal skills.

Individualized Supported Living Arrangement (ISLA) – This residential service is provided to people with developmental disabilities and/or intellectual disabilities in their own homes or apartments.  The level of support provided is individualized to the person’s need for training and assistance with personal care, laundry, money management, etc.  Individuals who receive ISLA typically need a higher level of support than people in a Supported Living Arrangement (SLA).

Intellectual Disability–  a disability characterized by significant limitations both in intellectual functioning (reasoning, learning, problem solving) and in adaptive behavior, which covers a range of everyday social and practical skills. This disability originates before the age of 18.

Least Restrictive Environment (LRE)- Individuals with disabilities should live in the community of their choice and receive the necessary services that will help them maintain their independence.

Level of Care- ICF eligibility determination

Person Centered Planning (PCP)- A set of approaches designed to assist someone to plan their life and supports. Used as an ongoing problem-solving process uses to help people with disabilities plan for their future.

Plan of Care– A document developed after the assessment that identifies the nursing diagnoses to be addressed in the hospital or clinic. The plan of care includes the objectives, nursing interventions and time frame for accomplishments and evaluation.

Provider-Typically private non-profit community organizations that provide vocational (and other types) of services to adults with disabilities.  These services are usually paid by state agencies.

Qualified Intellectual Disability Professional (QIDP) -Ensures individuals with Developmental and Intellectual disabilities receive continuous active treatment in accordance with Individual Support Plans (ISPs). Provide counseling, case management, and structured behavior programming to people with disabilities receiving Residential Services.  Responsible for the implementation of rules and regulations as required by licensing entities. Qualified Developmental Disability Professional (QDDP): Individual qualified to work as an expert with persons with developmental disabilities. The QDDP has a four-year college degree in an area related to developmental disabilities and a minimum of one-year experience working in that field.

Quality Assurance/Improvement (QA/QI)- Facilitate quality improvement activities to ensure compliance with accreditation standards regulations, funding source requirements, agency standards and assurance that all required manuals and procedures are maintained and implemented

Residential Care – Services provided in a facility in which at least five unrelated adults reside, and in which personal care, therapeutic, social, and recreational programming are provided in conjunction with shelter.  This service includes 24-hour on-site response staff to meet scheduled and unpredictable needs and to provide supervision, safety, and security.

Respite Care – Temporary relief to a primary caregiver for a specified period of time.  The  caregiver is relieved of the stress and demands associated with continuous daily care.
Self-Advocacy: an individual with disabilities speaking up and making their own decisions.

Self-Determination- Individuals have control over those aspects of life that are important to them, such as the services they receive, their career choices and goals, where they live, and which community activities they are involved in.

Service Coordination- Assists individuals with developmental disabilities and their families in gaining access to services and supports appropriate to their needs.

Supported Employment- Community based employment for individuals with disabilities in integrated work settings with ongoing training and support typically provided by paid job coaches.
Supported

Transition Services – Services provided to assist students with disabilities as they move from school to adult services and/or employment.

26 Great Resources on Special Needs Clothing

Children and adults with disabilities with sensory issues, autism, ADHD, down syndrome and cerebral palsy often find challenges in finding clothing that meets the need of feeling good and appropriate.

25clothing.resources

Challenges may also include difficulties in handling buttons and closures. Here are 25 resources that focus on shoes, outerwear, and adaptive clothing.

Adaptive Clothing

Adaptations By Adrian- Adaptive clothing including side zippers, wide band elastic waist for custom-made capes, wheelchair, pants, shorts adult protectors and cape protecting scarf.

CAPR-Style– Located in the U.K, adaptive clothing for adults and children including feeding tube covers.

Designed By Dignity– Adaptive clothing fashion clothes for men and women.

Down Design Dream– Adapting Clothing for children and adults with special needs

Easy Access Clothing– Adaptive clothing for adults and children.

Professional Fit Clothing– Adaptive clothing for adults and children including adults bibs, clothing protectors and nightware.

Rackety’s- Based in the U.K, products include adaptive clothing for children and adults such as vests, outdoor clothing, and nightwear.

Something Sew Special– Handmade adaptive clothing for children with special needs including bibs, ponchos, bodysuits and bandanas.

Special Kids Companywhere every child should be seen and not hidden!  International provider of bodysuits for older children with special needs including PEG/tube fed children aged 2-14 years old.  Available on all Amazon platforms (.com/.ca/.co.uk/.fr/.de/.es/.it)

Specially For You Inc.– Custom clothing for children with physical disabilities. Products include night wear, dresses, tops, one piece outfits and hooded poncho’s.

Tender Ivy– Onesie garment designed for protecting vulnerable areas.

Wonsie– Based in Australia, products include special needs onesie bodysuits for older children and adults.

Sensory Clothing

Children and adults with sensory processing issues may find it difficult wearing certain types of clothing. The following stores sell items that are for sensitive skin, medically fragile and pressure points.

Cool Vest– products includes children’s cooling vest.

Independent You– Adaptive outerwear, sportswear and sleepwear.

Kozie Clothes– Adaptive medical and sensory clothing for medically fragile and special needs babies and children.

No Netz– Anti-chafe swimwear for boys and men.

SmartKnit Kids– Seamless products for children with sensory issues. Products include, socks, undies, tees and bralettes.

World’s Softest– Socks for sensitive skin

Shoes for AFO’s

The following are stores that sell shoes that fit over orthotics.

Ablegaitor- Orthopedic shoes for children. Can be used without AFO’s.

Hatchbacks– Children’s orthopedic shoes for use with orthotics.

Healthy Feet Store– An online orthopedic shoe and footcare store including AFO’s accommodations.

Keeping Pace– Children’s orthopedic footwear designed for AFO’s.

Shoby Shoes– Custom-made orthopedic shoes and support boots for special needs children

Soft Star Shoes– Will customize shoes to work wit AFO’s and DAFO’s.

Coats for Wheelchairs

Coats for individuals who use wheelchairs  made need special clothing. The following online stores, specialize in adaptive outerwear for children and adults.

Koolway Sports– Based in Ontario, Canada, Koolway Sports items include blankets, hoods, and capes.

Silvert’s– Adaptive clothing for men and women including footwear and wheelchair clothing.

Weighted Vest

Weighed vest can be used for children and adults with autism, ADHD, Cerebral Palsy, Muscular Dystrophy and a sensory processing disorder.

e-Special Needs– provides a selection of weighted vests and clothing

Fun and Function– Includes items such as explorers vest, fleece hoodies and compression vests.

Transition Planning

IDEA Regulations and Transition Services

The term “transition services” means a coordinated set of activities for a child with a disability that:

  • Is designed to be within a results-oriented process, that is focused on improving the academic and functional achievement of the child with the disability to facilitate the child’s movement from school to post-school activities, including postsecondary education, vocational education, integrated employment (including supported employment), continuing and adult education, adult services, independent living, or community participation
  • Is based on the individual child’s needs, taking into account the child’s strengths, preferences, and interest.
  • Includes instruction , related services, community experiences, the development of employment and other post-school adult living objectives, and if appropriate, acquisition of daily living skills and functional vocational evaluations.
What is the Transition Process?

The transition process is designed to help students with disabilities move smoothly from school to adult life.

Resources on Transition Planning

Center for Parent Information and Resources– Webpage includes information on IDEA’s requirement on transition and how to include the student in the transition process.

Disability’s.gov’s Guide to Student Transition Planning– Topical links on secondary education and transition, transitioning to adult health care and options for life after high school.

National Association of Special Education Teachers– Great webpage on a variety of topics relating to transition planning including, overview of transition services, types of services covered, recordkeeping, employment planning, travel training, assistive technology and residential placement options.

National Parent Center on Transition and Employment– Website includes information on middle and high school transitioning planning including, IDEA, IEP, college planning and several worksheets on preparing for employment and transition planning.

Understood– article on understanding the transition process.

WrightsLaw– This page contains loads of information on transitioning planning including articles on IEP and transition planning, legal requirement for transition components of the IEP and IDEA 2004.

Happy Holidays!

 

HAPPY HOLIDAYS2015

Special Needs Resource Blog will take a break during the holidays and will return Monday, January 4, 2016 with new information, tools and resources to post including more downloadable free tools and templates Monday thru Thursday. I am excited and look forward to sharing more resources with you in the new year.
Thanks to all of you for following my blog this year. Wishing you and your families joy and peace all through the holidays and throughout the new year. May the spirit of the holidays be with you throughout the new year.  🙂   🙂

 

HAPPY THANKSGIVING!

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Happy Holidays

The Special Needs Blog wishes you and yours a happy holiday!

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