Teaching Students with Feeding Tubes: What You Need To Know

Posted on July 11, 2024 by specialneedsresourcetrainingblog

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

CDKL5 Disorder

Dysphasia

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:

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

What is an ISP?

Posted on February 26, 2024 by specialneedsresourcetrainingblog

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

Posted on February 15, 2024 by specialneedsresourcetrainingblog

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

Posted on April 7, 2021 by specialneedsresourcetrainingblog

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:

difficulty falling asleep
night walking
early walking
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

Create a regular bedtime routine including using a visual cue which will help the child or adult prepare for bed.
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
Quiet activities. Plan for quiet play before bed which allows the person to relax. This can include reading, puzzles, or a craft activity.

Reference

Denani, P., & Hegde, A.(2015). Autism and Sleep Disorders. Journal of Pediatric Neurosciences 10(4)
The link between autism and sleep issues (VeryWell)
Wide Awake: Why children with autism struggle with sleep (Spectrum)

Updated 4/7/21

What is Augmentative and Alternative Communication (AAC)?

Posted on October 1, 2020 by specialneedsresourcetrainingblog

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

Posted on September 15, 2020 by specialneedsresourcetrainingblog

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?

Posted on September 2, 2020 by specialneedsresourcetrainingblog

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

Posted on August 11, 2020 by specialneedsresourcetrainingblog

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

Cerebral Palsy Training PowerPoint

Posted on April 14, 2020 by specialneedsresourcetrainingblog

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.

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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

Posted on March 4, 2020 by specialneedsresourcetrainingblog

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.