Choking Prevention for People with Developmental Disabilities

Children and adults with developmental disabilities have a higher risk of choking compared to the general population.

Risk Factors Include:

Some medical conditions that increase a person’s risk of choking are:

  • Cerebral Palsy
  • Seizure disorders
  • Neurological and muscular disorders
  • Down Syndrome
  • Brain Injury
  • Muscular Dystrophy
  • Inability to swallow certain food textures and liquids
  • Medication side effects which decrease voluntary muscles
  • Dysphasia (difficulty swallowing)

Other contributing factors include:

Eat or drink too fast

Have poor posture when eating

Swallow non-edible objects (PICA)

The following foods put people at greater risk:

  • Hotdogs served whole
  • Hard candy
  • Popcorn
  • Sandwiches
  • Broccoli
  • Raw carrots
  • Nuts

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

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Autism and Wandering Resources (update)

Studies show that nearly half of children with autism attempt to wander off or bolt from a safe supervised place (Autism Speaks). Children with Angleman Syndrome also tend to have an obsession with water and will tend to wander if water is nearby. The following resources includes wandering kits, articles and additional resources on the topic of wandering.

What is Wandering?

When a person, who requires some level of supervision to be safe, leaves a supervised, safe space and/or the care of a responsible person and is expected to potential dangers such as traffic, open water (drowning), falling from a high place , hypothermia, heatstroke, dehydration.

Types of Wandering

  • Goal-Directed Wandering- wandering with the purpose of getting to something ( a place of obsession, water, etc.).
  • Non goal-directed wandering- Wandering with no purpose, random from one place to another.
  • Confusion Wandering-Wandering due to disorientation or confusion.
  • Bolting/fleeing- The act of suddenly running or bolding, usually to quickly get away from something, or in negative reaction to an event, anxiety or stress.
 Facts and Statistics
  • Roughly half, or 49%, of children with an ASD attempt to elope from a safe environment, a rate nearly four times higher than their unaffected siblings.
  • In 2009, 2010, and 2011, accidental drowning accounted for 91% total U.S. deaths reported in children with an ASD ages 14 and younger subsequent to wandering/elopement.
  • More than one third of ASD children who wander/elope are never or rarely able to communicate their name, address, or phone number.
  • 32% of parents reported a “close call” with a possible drowning.
  • 40% of parents had suffered sleep disruption due to fear of elopement.
  • half of families with elopers report they never received advice or guidance about elopement from a professional.
Source: Interactive Autism Network research report: Elopement and wandering (2011)
Source: National Autism Association, Lethal Outcomes in ASD Wandering (2012)

Caregivers Information

Autism elopement and wandering kit for families (Parenting Chaos)

Big Red Safety Toolkit (National Autism Association)

28 page toolkit that provides information on preventing wandering. The toolkit includes the following information:

  • Caregiver checklist
  • Family wandering emergency plan
  • swimming lessons tool
  • Root-causes scenario and strategies tool
  • Caregivers log
  • How to get tracking technology in your town.

First Responder Resources

First Responder Checklist– A checklist for first responders developed by the National Autism Association

First Responder Notification Form

First Responder Tips

GPS Tracking Technology

The AngleSense Guardian Kit

  • Comes with a GPS device, embedded SIM card, customized wearables and a magnet key for parents $39.00 monthly service plan.

7 tracking devices to find a lost child with autism (Friendship Circle)

Articles

5 simple ways to prevent wandering in children with autism (Autism Parenting Magazine)

Autism and Wandering (SFGate)

Autism and Wandering: How ABA can help keep kids safe. (HuffPost Parents)

Teaching safety skills to children with autism (Our Crazy Adventures in Autismland)

The autism epidemic that can no longer be ignored (HuffPost Parents)

Wandering: A hazard for more than a third of kids with autism (U.S. News)

Wandering & Autism: Elopement within the classroom (Autism Classroom Blog)

Wandering & Autism: Students who flee, bolt, run and elope (Autism Classroom Blog)

Resources on Teaching Scissor Skills

One of the ways to improve fine motor skills is helping children and adults develop cutting skills also help with pre-writing skills and pencil control. Below are resources that will help in developing and teaching scissor skills.

Cutting Skill Development

2 years- snips with scissors

2.5 years- Cuts across a 6-inch piece of paper

3.5 years- Cuts along a 6-inch line

4.5 years- Cuts out a circle

6-7 years- Cuts a variety of shapes and pictures.

Resources on Teaching Scissor Skills

5 easy ways to introduce scissor skills

How to teach a child to use scissors

How to use scissors

Scissor cutting skills: Why they are important

Teaching kids how to use scissors

Teaching preschoolers to use scissors

The importance of teaching your child how to use scissors

Tips for teaching scissor cutting skills

Practice Scissor Skills- The following links below include practicing cutting straight lines, curved lines and circles, zig-zag lines and mixed lines.

10-page scissor skills packet (Mama’s Learning Corner)- geared towards preschoolers and kindergartners.

12 free shapes and cutting page (www.mpmideas.com)- geared towards preschool aged children

Construction truck scissor cutting practice sheets (MO & MH)- Kids will practice cutting lines.

Cut, copy and glue for spring (Your Therapy Source)- Free 3-page packet in black and white. Includes a butterfly, ice cream cone and a snail.

Free cutting and coloring pack (Tot Schooling)- Cutting pack features straight, diagonal, curved and zig zag lines.

House scissor practice (Teaching Station)- Download free worksheets. Includes shapes of circles, squares, triangles, and rectangulars.

Printable preschool cutting busy box (Fun with Mama)- post includes ways to teach kids how to use scissors and develop cutting skills

Rocket scissor practice (Teaching Station)- Kids will practice cutting and pasting shapes to make a rocket.

Snake spiral worksheet (www.education.com)- Kids can both color and cut out the spiral design.

Trolls, hair-cutting (Tot Schooling Net)- Several different levels of difficulties.

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!

 

 

4 Tips On Task Initiation For Children and Adults

Task Initiation is often a challenge for children and adults with an executive functioning disorder. For a child, it may be lack of initiative in doing homework while for an adult, it may include forgetting or putting off paying bills. Children and adults with task initiation issues generally have a diagnosis of autism, ADHD, Intellectual disability or a learning disorder.

Signs of a task initiation impaired executive functioning skill would be someone having difficulty in getting started on a task and keeping the effort needed in order to complete the task. A child or an adult require external cues in order to complete the task. Also, it will require understanding what is expected and understanding the task. Here are a few strategies:

  1. Limit Distractions. In the classroom any type of added sensory input can defer the student from getting started in their school work.
  2. Create a List. Visual support will help to increase getting the work done for a school-age child, you may want to create a to-do list which the steps are broken down into smaller steps. When a person with an executive function is given a task, it may be overwhelming, making it more difficult to get started.
  3. Use Cues. A clock or a timer will help the child or adult stay on time and understanding the amount of time it will take to complete a task
  4. Break task down. Create where the work is done in chunks so that the work will not be as overwhelming for the student.

Duchenne Muscular Dystrophy

Image result for duchenne muscular dystrophy awareness month

February 13th is the first day of Duchenne Muscular Dystrophy Awareness Week. Here are some facts on Duchenne Muscular Dystrophy:

  • It is one of the nine types of muscular dystrophies
  • Duchenne muscular dystrophy was first described by French neurologist, Guillaune Benjamin Amand Duchenne in the 1860’s.
  • It is an inherited disorder
  • It is caused by an absence of dystrophin, a protein that bonds the muscle cell
  • It is characterized by progressive muscle degeneration
  • It occurs in about 1 out of every 3,600 male infants
  • Risks include a family history of Duchenne muscular dystrophy
  • Symptoms start appearing between the ages of 3-5.
  • By the age of 12, most males affected may lose their ability to walk
  • Breathing difficulties and heart disease usually start by the age of 20
  • Very rare are females affected by the disease.
  • Early symptoms include muscle weakness in the hips, pelvic area, thighs and shoulders.
  • By teen years, the heart and respiratory muscles are affected.
  • Duchenne muscular dystrophy carriers are females with one normal dystrophin gene on one x chromosome and an abnormal dystrophin gene on the other x chromosome
  • Most carriers do not show any signs or symptoms.
  • Affected children may have delayed motor skills including sitting, standing and walking.
  • Survival into the early 30’s is becoming more common due to advances in cardia and respiratory care.
  • Duchenne is associated with a heart disease that weakens the cardiac muscle
  • Between 400 and 600 boys in the United States are born with these conditions each year.
  • there are a few cases which results from new mutations in affected males
  • steroid drugs can slow the loss of muscular strength
  • There is no known cure for Duchenne muscular dystrophy

15 Great Fidget Sensory Gifts For The Holidays

With the holidays approaching, finding the right gift for someone with sensory issues can be challenging. Fidget toys are great gifts for both children and adults, especially for children diagnosed with autism and ADHD. Fidget toys provides sensory input in a less distracting way. They can help improve concentration and attention to task and also help children and adults focus and remain calm as well as decreases stress and anxiety.Below are links to a variety of fidgets including texture, tactile and visual.

fidgetgifts

 

 Texture Fidgets

Tangle Creations Jr.- amazon.com
Metallic Texture-amazon.com
Brain Noodle-Therapy Shoppe
Tangle Hairy-Office Playground
Bumpy Gel Sensory Ball- Children’s Therapy Store
Palm Size Massage Balls- Therapy Shoppe

Stretch Fidgets

Stretching String-Therapy Shoppe
Stretchy Happy Face-Office Playground
Spaghetti Stress Ball- Office Playground
Pull and Stretch Bounce Balls-Amazon

Squeeze Fidgets

Poppin Peeters- Jet.com
Bug-Out Bob-especial needs

Chewy Fidgets

Oval Chewy Necklaces-Therapy Shoppe
Scented Textured Chew Stixx- Therapy Shoppe
Chewable Gem Beads Necklace-Stimtastic

 

Epilepsy Facts

Epilepsy is a disorder of the central nervous system often caused by abnormal electrical discharges that develop into seizures. The following are additional facts on epilepsy and seizures:

30-epilepsy-facts

  • More people live with epilepsy than autism, spectrum disorders, Parkinson’s disease, multiple sclerosis and cerebral palsy combined.
  • You can’t swallow your tongue during a seizure. It is physically impossible.
  • You should never force something into the mouth of someone having a seizure.
  • Don’t restrain someone having a seizure.
  • Epilepsy is not contagious .
  • Anyone can develop epilepsy.
  • Epilepsy is not rare.
  • 1 in 26 Americans will develop epilepsy in their lifetime.4An estimated 3 million Americans and 65 million people worldwide live with epilepsy.
  • In 2/3 of patients diagnosed with epilepsy, the cause is unknown.
  • Up to 50,000 deaths occur annually in the U.S. from status epilepticus (prolonged seizures). (SUDEP) and other seizure-related causes such as drowning and other accidents.
  • SUDEP accounts for 34% of all sudden deaths in children.
  • Epilepsy costs the U.S. approximately 15.5 billion each year.
  • A seizure is a transient disruption of brain function due to abnormal and excessive electrical discharges in brain cells.
  • Epilepsy is a disease of the brain that predisposes a person to excessive electrical discharges in the brain cell.
  • It is diagnosed when 2 or more unprovoked seizures have occurred.
  • It must be at least 2 unprovoked seizures more than 24 hours apart.
  • About 14% have simple partial seizures.
  • 36% have complex partial seizures.
  • 5% have tonic-clonic seizures.
  • Seizures can be caused by head trauma, stokes, brain tumor and a brain infection.
  • Causes are unknown in 60 to 70% of cases.
  • The prevalence is 1% of the U.S. population.
  • Approximately 2.2 to 3 million in the U.S. have seizures.
  • It affects all ages, socioeconomic and racial groups.
  • Incidents are higher in children and older adults.
  • Seizures can range from momentarily blanks to loss of awareness
  • Almost 150,000 people in the U.S. develop epilepsy every year.
  • No gender is likely to develop than others.
  • 1/3 of individuals with autism spectrum disorders also have epilepsy.
  • The prevalence of epilepsy in people with an intellectual disability is higher than the general population.

Sensory Activity 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.

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.

 

 

Transition Planning Timeline

One of the goals of the Individuals with Disabilities Education Act is to include transition planning services for all special education students at age 16. Transition planning is mandated through IDEA 2004 which serves to help students begin the process of preparing for post-school activities including, postsecondary education, vocational education, integrated employment and adult services. A timeline will help you stay focused on achieving each step.

The law states transition planning should begin no later than 16 years old or before. It is recommended transition planning should begin by age 14 since services are different in the adult services world including long waiting list depending on where you live and what services are available.

14 Years Old
  • Transition planning should begin no later than when your child is 14.4- It is the law in most states.
  • Begin to research agencies who provide services for individuals with disabilities
  • IEP meeting should focus on the student’s needs, interest in preparation for adulthood
  • Research various aspects of transition services
  • Begin to explore recreation activities
15 Years Old
  • Develop a vision statement
  • Transition goals should be part of the IEP
  • Begin to discuss home services
  • Attend information fairs that offer information on future planning including residential, guardianship and employment
  • Start planning an independence plan at home where possible
16 Years Old
  • Transition goals at the IEP meetings should be updated.
  • Confirm how long students will attend high school- 4 years or until age 21
  • Start the process of getting referrals to your state agency
  • Begin researching adult services and programs. Some waitlist can last for years
  • Initiate application to adult service agencies
17 Years Old
  • Confirm a graduation date
  • Update transition goals in the IEP
  • Begin to invite adult service providers to IEP
  • Begin to investigate guardianship information and the process
18 Years Old
  • Adult eligibility should be completed
  • Apply for SSI (Supplemental Security Income) and Medicaid.
  • Visit adult providers programs
  • Attend job fairs if appropriate
  • Establish legal guardianship if necessary
  • Explore future planning
18-21 Years Old
  • Refine vision statement
  • Revise and update IEP goals
  • Invite transition coordinator your child’s IEP meeting
  • Explore and obtain necessary funding for adult programs
  • Ensure there is a plan for medical/health coverage
  • Confirm all support services are in place.

Below is a free transition printable planning checklist. Feel free to download the PDF.

transition-planning

transition-planning-checklist