Via Buzzfeed Community at https://www.buzzfeed.com/gracespelman/jammin-on-my-planner?utm_term=.yy09VW6d3#.cvxn36rbP
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.
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
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
- Will identify a good smell
- Will identify a bad smell
- Will identify the smell (i.e. smells like apples)
- 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.
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
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 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:
- speech sound production, articulation, apraxia of speech, dysarthria, ataxia, dyskinesia,
- resonance- hypernasality, hyponasality, cul-de-sac resonance, mixed resonance
- voice- phonation quality, pitch, loudness, respiration
- fluency- stuttering, cluttering
- language (comprehension and expression)
–pragmatics (language use, social aspects of communication)
-literacy (reading, writing, spelling)
– prelinguistic communication (e.g., joint attention, intentionality, communicative signaling)
- cognition- attention, memory, sequencing, problem solving, executive functioning
- feeding and swallowing- 4 phases of swallowing
-oral, pharyngeal, laryngeal, esophageal
–orofacial myology (including tongue thrust)
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:
- Does the individual use speech functionally to communicate wants/needs in a variety of settings?
- 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.
- 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?
- 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.”
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
Source: ADD Attitude Magazine
Many adults and parents who live with ADHD use strategies that they’ve devised themselves, modified and refined. These tips don’t appear in articles about ADHD, but they work beautifully. What works for you may not work for someone else. Click here to read the rest of the article.
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.
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
- shoe box
- candy corn
- circus peanuts
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.
Discuss with the group or class the various sizes, the aroma, etc.
- 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.
- Have the group create a collage by cutting out items in a magazine that are orange. This will help with improving fine motor skills.
Art therapy can give disabled adults a sense of personal accomplishment, whether they have a mental, physical or emotional disability. Art projects can help to improve a person’s outlook on life, give voice to unexpressed emotions — especially for those with developmental disabilities — or provide a way to make some extra money selling artistic works. When Pablo Picasso said, “Art washes from the soul the dust of everyday life,” he wasn’t just referring to art’s beholders, but those who create it as well. Click here for the rest of the story
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.
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
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.
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.
Transition Services – Services provided to assist students with disabilities as they move from school to adult services and/or employment.
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.
Challenges may also include difficulties in handling buttons and closures. Here are 25 resources that focus on shoes, outerwear, and 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 Company– where 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.
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.
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.