Supporting a Special Needs Child with Sickle Cell Anemia in the Classroom

 

What is Sickle Cell Anemia?

According to the Centers for Disease Control and Prevention (CDC), SCD is a group of inherited red blood cell disorders. Healthy red blood cells are round, and they move through small blood vessels to carry oxygen to all parts of the body. In someone who has SCD, the red blood cells become hard and sticky and look like a C-shaped farm tool called a “sickle”. The sickle cells die early, which causes a constant shortage of red blood cells. Also, when they travel through small blood vessels, they get stuck and clog the blood flow. This can cause pain and other serious problems such infection, acute chest syndrome and stroke.

What is an Intellectual Disability?

DSM-V defines intellectual disability as a disorder with onset during the developmental period that includes both intellectual functioning including abstract thinking, judgment, academic learning, problem solving.  Adaptive functioning including limitations in activities of daily living, communication, social participation, and independent living across multiple environments such as home, school, work and community. Deficits are on the onset during the developmental period.

According the American Association on Intellectual Disabilities (AAIDD), Intellectual Functioning refers to general mental capacity such as, learning, reasoning and problem-solving.

Types

Although historically, the levels of severity was based on I.Q. scores, this has changed to adaptive functioning which determines the levels of support required.

Mild
  • Social Domain- There may be difficulties in regulating emotions and behaviors in an age-appropriate manner. There tends to be a limited understanding of calculated risk, and social judgment.
  • Practical Domain- May need assistance in independent living skills such as grocery shopping, transportation, banking and food preparation.
Moderate
  • Social Domain: Capacity for relationships is evident in ties to family and friends and may have successful friendships across life and sometimes relationships in adulthood.
  • Practical Domain: Can care for personal needs involving eating, dressing and hygiene and as an adult participate in all household task.
Severe
  • Social Doman: Spoken language is limited. Speech may be ingle words or phrases. The individual understands simple speech.
  • Practical Domain: Requires support for all activities of daily living, including meals, dressing and bathing. The person will require supervision at all times. Unable to make responsible decisions regarding self-care.
Profound
  • Social Domain: Has limited understanding of symbolic communication in speech and gestures. The person expresses his or her own desires and emotions through non-verbal communication.
  • Practical Domain: The child or adult is dependent on other people for basic needs including self-care and independent living including health and safety.

A sickle cell “crisis” occurs when the red blood cells decrease and the irregular sickle cells block the blood vessels leading to organ damage and pain. A person with an intellectual disability may not be able to communicate they are experiencing a crisis. signs and symptoms to look for include:

  • Pain
  • Tiredness
  • Fatigue
  • Leg Ulcers

Ways to support a student with sickle cell includes the following:

  1. Offer water throughout the day including frequent small amounts of water
  2. allow for accommodations during extreme weather conditions
  3. Watch for signs of a stroke
  4. Allow the student opportunities to make up homework if missed days from school are due to an illness or crisis.

Resources

Kids Health
Mayo Clinic
Medicine Net
NHLBI (National Heart, Lung, and Blood Institute)
WebMD
Organizations

Children’s Sickle Cell Foundation, Inc.

Foundation for Sickle Cell Research

Sickle Cell Disease Association of America

What is Tourette Syndrome?

According to the Tourette Association of America, tics are involuntary, repetitive movement and vocalizations. They are the defining feature of a group of childhood-onset, neurodevelopmental conditions known collectively as Tic disorders and individually as Tourette Syndrome.

Tics are common in childhood. The estimated prevalence of Tourette Syndrome disorder range from 3 to 8 per, 1,000 in school-aged children. Males are more commonly affected than females. Some people may have tic-free periods of weeks to months.

There are three types:
  1. Motor tics cause a movement including eye blinking, facial grimacing, jaw movements, and head bobbing
  2. Vocal/phonic tics produce a sound including throat clearing, grunting, hooting, and shouting
  3. Provisional tic disorders involve a person who experiences involuntary motor and/or verbal tics for one year.
Signs and Symptoms:

Tic Disorders:

  • eye blinking
  • coughing
  • throat clearing
  • sniffing
  • facial movement
  • shoulder shrugging

Vocal Tics:

  • barking or yelping
  • grunting
  • repeating what someone else says
  • shouting
  • sniffing
  • swearing
Co-Occurring Disorders Include:
  • Attention Deficit/Hyperactivity Disorder (ADHD)
  • Obsessive -Compulsive Disorder
  • Learning difficulties
  • Behavior problems
  • Anxiety
  • Mood problems
  • Sleeping issues
  • Social skills and deficits

 

Tourette Syndrome-It's not what you think it is » Movement ...

Risk Factors
  • Temperamental- it is worsened by anxiety, excitement and exhaustion.
  • Environmental- observing a gesture or sound in another person my result in an individual with a tic disorder making a similar sound.
  • Genetic- genetics and environmental factor influences tic symptoms.

Teaching Strategies for Students with Cerebral Palsy

Cerebral palsy is a motor disorder which results from damage to the brain occurring before, during and after birth. Cerebral palsy is the most common motor disability in childhood and it is estimated that 1 in 323 individuals have been identified with cerebral palsy.

Since cerebral palsy is the result of damage to the brain, it impacts each person differently ranging from severe to mild symptoms. It is estimated that many children with cerebral palsy also have at least one co-occurring condition. For instance, 41% had co-occurring epilepsy and 40% of children were diagnosed with an intellectual disability.

Teaching strategies should focus on assistive technology, fine and gross motor skills, and personal care. Accommodations and modifications should include providing extra time for task completion.

The following links provide information on teaching strategies.

Accommodating a student with cerebral palsy

Cerebral palsy in the classroom

How to make your classroom inclusive for students with cerebral palsy

How to teach children with cerebral palsy

Inclusive teaching strategies for students with cerebral palsy

Students with mild cerebral palsy in the classroom: Information and guidelines for teachers

What teachers should know about children with cerebral palsy

Teaching Strategies for Students with Orthopedic Impairments

The definition of orthopedic impairment under IDEA means a severe orthopedic impairment that adversely affects a child’s education performance. Causes include:

  • genetic
  • disease
  • injury
  • birth trauma
  • burns
  • fractures
  • cerebral palsy amputation

There are 3 classifications that an orthopedic impairment can fall under:

  1. Neuromotor impairment, this would include cerebral palsy, spinal cord injuries, spina bifida, and seizure disorders
  2. Degenerative Disease such as muscular dystrophy and Ehlers-Danlos Syndrome
  3. Musculoskeletal Disorders including scoliosis and deformed limbs.

Students with orthopedic impairments often qualify for therapy including physical and occupational therapy. assistive technology should be included for accommodating the students needs.

The following links provide resources on teaching assessment, modifications, and teaching information.

Orthopedic impairment: A guide for parents and teachers

Orthopedic impairment characteristics: Classroom modification and assistive technology

Orthopedic impairment and special needs students

Orthopedic impairment disability

Teaching strategies for mobility impaired students

Teaching strategies for orthopedic impairment

Teaching students with disabilities: Orthopedic impairment

Teaching students with orthopedic impairment

Understanding individuals with physical, health, and multiple disabilities

What is a Multiple Disability?

According to the Individuals with Disabilities Act (IDEA), multiple disabilities refers to simultaneous impairments such as intellectual-blindness, intellectual disability-orthopedic impairment. The combination of which causes such severe educational needs that cannot be accommodated in a special education program solely for one of the impairments, meaning a student has more than one or multiple impairments. According to the U.S. Department of Education, 2.0 percent of students currently are diagnosed with multiple disabilities.

The term multiple disability is a broad term and can include a number of disabilities. For example, a person diagnosed with cerebral palsy may also have a diagnosed of epilepsy, intellectual disability  and ADHD. The Center for Parent Information and Resources explains that from the term, your cannot tell how many disabilities a child has, which disabilities are involved or how severe each disabilities are involved or how severe each disability is. It is important to know the following in orde to support the child:

  • which individual disabilities are involved;
  • how severe (or moderate or mild) each disability is; and
  • how each disability can affect learning and daily living.

Support should include the following areas:

  • caring for oneself;
  • performing manual tasks;
  • seeing, hearing, eating, and sleeping;
  • walking, standing, lifting, and bending;
  • speaking and communicating;
  • breathing;
  • learning;
  • reading;
  • concentrating and thinking; and
  • working.
Resources

Parent Center Hub

What is Childhood Disintegrative Disorder?

Did you know that Childhood Disintegrative Disorder is  considered part of Autism Spectrum?

Childhood Disintegrative Disorder (CDD) is a condition where a child develops normally and achieves appropriate milestones up to the age of 4 and then begins to regress in both developmental and behavioral milestones and lose the skills they already learned. with a loss o skills plateauing around the age of 10.

Childhood Disintegrative Disorder is rare. It affects 1.7 in 100,000 and affects males at a higher rate than females. It is also known as Heller’s Syndrome and Disintegrative psychosis. The causes are unknown but may be linked to issues with the brain and nervous systems with some researchers suggesting it is some form of childhood dementia.

First discovered by Dr. Theodor Heller in 1908, Dr. Heller began publishing articles on his observation of children’s medical history in which he reported that in certain cases, children who were developing normally began to reverse at a certain age.

Signs and Symptoms

Children begin to show significant losses of earlier acquired skills in at least two of the following areas:

  • Lack of play
  • Loss of language or communication skills
  • Loss of social skills
  • Loss of bladder control
  • Lack of motor skills

The following characteristics also appear:

  • Social interaction
  • Communication
  • Repetitive interests or behaviors

Due to the small number of reported cases, it is included in the broad grouping of autism spectrum disorder in DSM-V under pervasive developmental disorder (PDD).  Although grouped with the autism spectrum disorder diagnosis, there are distinct differences. For example, children with CDD were more likely to be diagnosed with severe intellectual disability, epilepsy and long term impairment of behavior and cognitive functioning.

Resources

NCBI

Summit Medical Group

Teaching Strategies for Dysgraphia

Dysgraphia is  learning disability that affects handwritng, spelling and the ability to put thoughts on paper. It affects fine motors skills leading to illegible handwriting, inconsistent spacing between letters and poor spelling ability. It is possible for dysgraphia to be part of the diagnosis of ADHD, autism, and dyslexia. Signs often include an awkward pencil grip, becoming quickly tired from writing and lack of punctuation and capitalization. The following links provide teaching strategies which will help to improve writing skills.

5 helpful strategies for dysgraphia

9 strategies for dysgraphia

Creating a dysgraphia- friendly classroom

Dyslexia and dysgraphia: Teaching strategies to help your students

How can teachers and schools help kids with dysgraphia?

Intervention for dysgraphia

Strategies for Dealing with Dysgraphia

Strategies for students with dysgraphia

What is dysgraphia? Support and strategies for your classroom

What teachers need to know about dysgraphia

Teaching Visually Impaired Students

According to IDEA’s definition, visually impairment is defined as including blindness means an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness. There are 3 types of blindness including The types of vision impairments are low visual acuity, blindness, and legal blindness (which varies for each country): Low visual acuity, also known as moderate visual impairment, is a visual acuity between 20/70 and 20/400 with your best corrected vision, or a visual field of no more than 20 degrees.

The following articles and links provide resources on teaching students with visual impairments.

Teaching Strategies

The following are articles that provide tips and resources on teaching students with visual impairments.

10 tips for teaching blind or visually impaired students

Classroom strategies for regular education teachers who have students with visual impairments

General tips for teaching visually impaired students

How to teach a blind or visually impaired student

Inclusion teaching: Vision impairment and blindness

Teaching languages to blind and visually impaired students

Teaching strategies for vision impaired students

Teaching the blind and visually impaired

Strategies for helping children with visual impairments to develop listening skills

Visual impairment in the classroom

Teaching Activities

The following links provide activities that can used to teach students with visual impairments.

Adapting materials for visually impaired students

Create a restaurant book with tactile symbols

Durable braille flashcards

Tips and tools for teaching beginning braille skills