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

February Day Habilitation Activity Ideas

February has arrived!! here in the northeast, it is seasonably warm , but still the month known for groundhog and valentine’s day. The following are February observances, celebrations, events, and holidays that can be used as ideas for your Day Habilitation Program.

Keep in mind the following when planning activities for individuals with special needs:

  • People with intellectual/developmental disabilities are more likely to learn when using a multi-sensory approach which includes engaging people on all levels where they are able to use some of their senses. For example a cooking activity should include, allowing individuals to see what they are doing, taste, smell, and touch, etc.
  • Make sure each activity is broken into small steps
  • Use continuous probing
  • Provide prompting strategies such as independence, verbal, gestural, hand over hand and physical prompting.
  • Allow extra time to complete the task
  • Give immediate feedback including praise.

11 Resources on Teaching Personal Safety Skills To Special Needs Children and Adults

Studies show that both children and adults with developmental disabilities are vulnerable to incidents of abuse and injuries. Personal safety includes learning about being safe and dangerous environments. The following articles focus on teaching tips in both the community and in the home.

5 tips on teaching safety skills to children with autism

A guide to personal safety

Community safety skills

How to help individuals with disabilities be safe in the community

Personal safety programs for children with intellectual disabilities

Safety First: Teaching safety skills to children with Autism Spectrum Disorder

Teaching people with intellectual disabilities about fire emergencies

Teaching safety awareness skills to children with autism

Teaching stranger safety skills to children and adults with disabilities

Safety Activities

Activities that teach safety

Safety worksheets from Teacher Vision

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.

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

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.

Williams Syndrome- Facts and Statistics

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May is Williams Syndrome Awareness Month. It is a rare genetic condition that affects over 1 in 10,000 people worldwide. If you teach in a special needs classroom or work in an adult day habilitation program, it is likely you have experienced working and teaching a student or individual diagnosed with Williams Syndrome. Below you will find some interesting facts and statistics on the disorder:

  • It is a genetic condition that is present a birth.
  • It is a developmental disorder
  • Tend to have a mild or moderate intellectual disability.
  • It is also known as Beuren Syndrome and Williams-Beuren Syndrome.
  • The symptoms were first described by John C.P. Williams in 1961.
  • A year later, German Physician, A.J. Beuren described three new incidents of patients with similar facial features.
  • It is caused by the spontaneous deletion of 26-28 genes on Chromosome #7
  • The deletion is caused by either the sperm or the egg.
  • The deletion is present at the time of conception
  • The most common symptoms of Williams Syndrome includes unusual facial features and heart defects.
  • The diagnosis is typically confirmed after identifying facial features and genetic testing.
  • An individual with Williams Syndrome has a 50% chance of passing the disorder on to their children.
  • Williams Syndrome affects 1 in 10,000 people worldwide.
  • An estimated 20,000 to 30,000 people in the United States are affected.
  • It occurs in both males and females equally
  • It is found in every culture
  • Individuals with Williams Syndrome tend to be overly friendly.
  • People with Williams Syndrome often have difficulty with visual-spatial tasks
  • Congenital heart defects (CHD) occur in approximately 75 percent of children
  • By the age of 30, the majority of individuals with Williams Syndrome have pre-diabetes or diabetes.

 

 

References

Genetics Home Reference

National Organizations for Rare Diseases

William Syndrome Association

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

What is an ISP?

Click here to download the article

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 is 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.

Adults with Special Needs and Housing Options

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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.