Category Archives: Professional Development

What is Executive Function Disorder?

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What is Executive Functioning?

According to CHADD org, Executive function skills refers to brain functions that activate, organize, integrate and manage other functions which enables individuals to account for short- and long term consequences of their actions and to plan for those results.

According to Rebecca Branstetter, author of The Everything Parent’s Guide to Children with Executive Functioning Disorder, These skills are controlled by the area of the brain called the frontal lobe and include the following:

  • Task Initiation- stopping what you are doing and starting a new task
  • Response Inhibition- keeping yourself from acting impulsively in order to achieve a goal
  • Focus- directing your attention, keeping you focus, and managing distractions while you are working on a task
  • Time Management- understanding and feeling the passage of time, planning  good use of your time, and avoiding procrastination behavior.
  • Working Memory- holding information in your mind long enough to do something with it (remember it, process it, act on it)
  • Flexibility- being able to shift your ideas in changing conditions
  • Self-Regulations- be able to reflect on your actions and behaviors and make needed changes to reach a goal
  • Emotional Self-Control- managing your emotions and reflecting on your feelings in order to keep yourself from engaging in impulsive behaviors.
  • Task Completion- sustaining your levels of attention and energy to see a task to the end.
  • Organization- keeping track and taking care of your belongings (personal, school work) and maintaining order in your personal space.
What Causes Executive Functioning Disorder?
  • a diagnosis of attention deficit hyperactivity disorder (ADHD)
  • a diagnosis of obsessive-compulsive disorder (OCD)
  • a diagnosis of autism spectrum disorder
  • depression
  • anxiety
  • Tourette syndrome
  • Traumatic
Signs and Symptoms
  • Short-term memory such ask being asked to complete a task and forgetting almost immediately.
  • Impulsive
  • Difficulty processing new information
  • Difficulty solving problems
  • Difficulty in listening or paying attention
  • issues in starting, organizing, planning or completing task
  • Difficulty in multi-tasking

Issues with executive functioning often leads to a low self-esteem, moodiness, insecurities, avoiding difficult task. and low motivation

Managing Executive Functions Issues
  • Create visual aids
  • use apps for time management and productivity
  • Request written instructions
  • Create schedule and review at least twice a day
  • Create checklist

Updated 6/30/24

Teaching Students with Angelman Syndrome

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Angelman Syndrome is a genetic disorder that affects the nervous system, characteristics that include developmental delays, intellectual disability, and speech impairments. Angelman syndrome generally go unnoticed until the age of 1 year. Children typically have a happy demeanor and have a fascination with water

Characteristics include developmental delay, intellectual disability, epilepsy, microcephaly, short attention span, happy demeanor, hyperactivity, hand-flapping.

Angelman Syndrome  is  a rare disorder and affects 1 in 12,000 to 20,000 a year. Equally to less than 200,000 case a year. Affects all ethnicities and sexes equally.

Associated behaviors include, tongue thrusting, feeding problems during infancy, sensitivity to heat, frequent drooling, and attraction to water.

Developmental delays include fine motor skills such as using a palmar grasp, holding an object, picking up objects, dressing/undressing, brushing teeth and other self-care task.

The following are articles on teaching strategies:

Angelman Syndrome-Bridges for Kids

Angelman Syndrome Educational Material

Angelman Syndrome– Ontario Teachers Federation

Angelman Syndrome– National Association of Special Educators

Angelman Syndrome in the Classroom- Puzzle Place

Communication strategies for children with Angelman Syndrome– Cleveland Clinic

Education Resources- Angelman Resources

Some Angelman Tips– Teaching Learners with Multiple Special Needs

Working with a child who has Angelman Syndrome– St. Cloud State University

Writing instruction for students with Angelman Syndrome– PracticalAAC

Teaching Strategies for Individuals with Multiple Disabilities

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Evidence based practices for students with severe disabilities 

Instructional strategies for students with multiple disabilities

Multiple disabilities in your classroom: 10 tips for teachers

Severe and education of individuals with multiple disabilities

Strategies for inclusion of children with multiple disabilities including deaf-blindness

Students who are blind or visually impaired with multiple disabilities

Students with multiple disabilities

Supporting young children with multiple disabilities: What do we know and what do we still need to learn?

Teaching students with multiple disabilities

Teaching students with severe or multiple disabilities

What is a Visual Impairment?

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According to the Centers for Disease Control and Prevention (CDC), approximately 6.8% of children younger than 18 years in the United States have a diagnosed eye and vision condition and 3% of children younger than 18 years are blind and visually impaired. Visual disability is one of the most prevalent disabilities disabilities among children.

According to IDEA’s definition, visual impairment is defined s including blindness means an impairment in vision that even with correction, adversely affects a child’s educational performance. The World Health Organization (WHO), classifies visual impairment as occurring when an eye condition affects the visual system and one or more of its vision includes both partial sight and blindness

Classifications

The World Health Organization uses the following classification based on visual acuity in the better eye:

  • 20/30 to 20/60- mild vision impairment
  • 20/70 to 20/160- moderate visual impairment
  • 20/200 to 20/400- severe visual impairment
  • 20/500 to 20/1,000- profound visual impairment
  • More than 20/1,000- considered near-total visual impairment
  • No light perception- considered total visual impairment or total blindness
Types of Visual Impairment
  • Strabismus– a condition when the eyes do not align with each other (crossed eyes)
  • Congenital cataracts– a clouding of the eyes natural lens present a birth.
  • Retinopathy of prematurity– a blinding disorder that affects prenatal infants that are born before 31 week of gestation.
  • Coloboma- a condition where normal tissue in or around the eye is missing at birth.
  • Cortical visual impairment– a visual impairment that occurs due to brain injury.
Signs of Visual Impairments
  • Appears “clumsy” in new situation
  • Shows signs of fatigue or inattentiveness
  • Does not pay attention when information is on the chalkboard or reading material
  • Is unable to see distant things clearly
  • Squints
  • Eyes may appear crossed
  • Complains of dizziness.
Causes

The causes of childhood blindness or visual impairment is often caused by Vitamin A deficiency which is the leading cause of preventable blindness in children. Other causes include genetics, diabetes, injury and infections such as congenital rubella syndrome and chickenpox before birth.

Cortical Visual Impairment (CVI)

Cortical Visual Impairment in children is attributed to brain dysfunction rather than issues with the eyes. Causes included hypoxia, traumatic brain injury, neonatal hypoglycemia, infections and cardiac arrest.

 

 

References

World Health Organization (WHO)

www.cdc.org

Cerebral Palsy Training PowerPoint

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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.

[office src=”https://onedrive.live.com/embed?cid=90748358AD4AA436&resid=90748358AD4AA436%21859&authkey=ABuzc_FO-xzum58&em=2″ width=”402″ height=”327″]

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

Fragile X Syndrome Teaching Strategies Resources

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Fragile X Syndrome is a genetic disorder and is the most common form of inherited intellectual and developmental disability. It is estimated to affect 1 in 4,000 males and 1 in 8,000 females. Characteristics include learning disorders, sensory issues, speech and language and attention disorders.

Learning challenges include, difficulty in processing information, understanding concepts, poor abstract thinking and cognitive delays. The following sites provide information on teaching students with Fragile X Syndrome.

Best Practice in Educational, Strategies and Curricula (National Fragile X Foundation)

Education Planning for Fragile X Syndrome for Patients (UPMC Children’s Hospital of Pittsburg)

Fragile X in the Classroom (TeAchnology)

Fragile X Syndrome Teaching Strategies and Resources (Teacher’s Gateway to Special Education)

General Educational Guidelines for Students with Fragile X Syndrome (National Fragile X Foundation)

Student Teaching Tips: Helping your students with Fragile X (Magoosh)

Strategies for Learning and Teaching (National Council for Special Education)

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It’s hard to imagine a time when children with disabilities did not have access or the rights to an equal education as those students without disabilities. Prior to 1975, many children with disabilities were living in large institutions or went to private schools.

President Gerald Ford signed into the Education For All Handicapped Children Act (Pubic Law-94-142) now knowns as the Individuals with Disabilities Education Act (IDEA). The purpose of IDEA is to protect the rights of infants, toddlers, children and youth with disabilities and to provide equal access to children for children with disabilities. The following list describes the 13 categories of IDEA eligibility including the definition below:

A child with a disability is defined as a child evaluated as having an intellectual disability, hearing impairment (including deafness), a speech or language impairment, visual impairment (including blindness), a serious emotional disturbance, an orthopedic impairment, autism, traumatic brain injury, an other health impairment, a specific learning disability, deaf-blindness, or multiple disabilities who need special education and related services.

  1. Autism means developmental disability significantly affecting verbal and nonverbal communication and social integration, generally evident before age 3, that adversely affect a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences.
  2. Deaf-blindness- defined as having both visual and hearing impairments. The combination of which causes such severe communication and other developmental and education needs that they cannot be accommodated in special education programs.
  3. Deafness- a hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, or with or without amplification, that adversely affects a child educational performance.
  4. Emotional disturbance- a condition exhibiting one or more of the following characteristics over a long period of time
  5. Hearing impairment- an impairment in hearing, whether permanent or fluctuating that adversely affects a child’s performance but that is not included under the definition of deafness.
  6. Intellectual disability- significantly lower general intellectual functioning, existing concurrently with deficits in adaptive behavior and manifested during the developmental period, that adversely affect a child’s educational performance.
  7. Multiple disabilities- A combination of impairments (such as intellectual disability-blindness or intellectual disability-orthopedic impairment). The combination causes severe educational needs that they cannot be accomplished in special education program solely for one of the impairments.
  8. Orthopedic impairment- a severe orthopedic impairment that adversely affects a child’s educational performance. The term includes impairments caused by a congenital anomaly, impairments caused by diseases (e.g. Poliomyelitis) and impairment causes (e.g. cerebral palsy, amputations, and fractures or burns that cause contractures)
  9. Other health impairments- having limited strength, vitality, or alertness including a heightened alertness to environmental stimuli that results in limited alertness with respect to the educational environment that is due to chronic or acute health problems such as asthma, ADHD, diabetes, epilepsy, heart condition, sickle cell anemia and Tourette syndrome which adversely affects a child’s education performance.
  10. Specific learning  disability- a disorder in  one or more of the basic psychological processes involved in understanding or in using language spoken or written that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell or to do mathematical calculations including conditions such as perceptual disabilities, brain injury, dyslexia and developmental aphasia.
  11. Speech or language impairment- a communication disorder such as stuttering impaired articulation, a language impairment, or a voice impairment that adversely affects a child’s educational performance.
  12. Traumatic brain injury- An acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment or both. Traumatic brain injury applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition, language, memory, attention, reasoning, abstract thinking, judgement, problem-solving, sensory, perceptual motor abilities and information processing and speech.
  13. Visual impairment including blindness- an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness.

Down Syndrome and Obesity

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Obesity is a major health concern and is more common in individuals with Down syndrome than the general population. Obesity is defined as excessive fact accumulation that increases health risk. It is an abnormal accumulation of body fact usually 20% of a person’s ideal body weight.

Medical complications of obesity includes sleep apnea, lung disease, pancreatitis, heart disease, cancer, arthritis, inflamed veins and gout. When the body mass increases, so does the risk of having a heart attack or heart failure.

In a study published by the American Association Intellectual and Developmental Disabilities found a difference between studies on children versus adults with Down syndrome. Children with Down syndrome have consistently been found to exhibit a reduced resting metabolic rate meaning children with Down syndrome are at a great risk for weight gain since they will burn fewer calories. at rest during activities.

Children with Down syndrome also tend to have a condition known as hypothyroidism. Approximately 10 percent of children with Down syndrome have hypothyroidism. As children with Down syndrome get older, eating behaviors change leading to obesity (Approximately 30%). These changes may be due to low muscle tone or inactivity due to thyroid problems or heart conditions.

Exercise and recreation are crucial to the well-being of individuals with Down syndrome. The following are strategies for helping to maintain weight control and to live longer and healthier lives:

  1. Develop a regular exercise program. According to Drs. Chicoine and McGuire, authors of The Guide to Good Health for Teens and Adults with Down syndrome, Exercise should be free of risk. Push ups and weightlifting are not appropriate due to many people with Down syndrome who have issues with the upper 2 vertebrates.
  2. Swimming is an effective exercise. Many pool have walking exercises in the pool as well.
  3. Exercise should be fun, socially and realistic.
  4. For older adults with Down syndrome, look for teachable moments to teach portion control, drinking enough fluids, and eating a well-balanced meal.

Reference

Chicoine, B. and McGuire, B. (2010). The Guide to Good Health for Teen and Adults with Down Syndrome. Bethesda, MD

Most States Failing To Meet Requirements Under IDEA

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Source: Disability Scoop

Fewer than half of states are meeting their obligations to properly serve students with disabilities, the U.S. Department of Education says.

In an annual review of performance under the Individuals with Disabilities Education Act, federal officials found that just 21 states deserved the designation of “meets requirements” for the 2017-2018 school year.

The remaining states were classified as “needs assistance.” Click here to read the rest of the story.

Bathing Training Curriculum For Direct Support Professionals

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Click here to print PDF version of article
Studies show that most accidents occur in the home. There are a number of factors that increases this number in a residential setting. For example, Staff are responsible for providing care to more than one person and the may also be responsible for a number of other duties including, preparing dinner, giving out medication and working on performance goals. Given these factors, it is vital that attention and skill is given during bathing time. One minute away, could lead to a disastrous event.

The following is a training curriculum that serves to train staff (Direct care Professionals) on bath safety. I have included the lesson plan also in a PDF format and a demonstrative checklist. Once completed, staff should be able to show their competency level in bathing an individual safely. This training also satisfies and supports Core Competency 5 (safety) and Core Competency 6(Having a home).

Title:  Bath Safety Training

Description Training:

This module is intended to provide direct support professionals with principles and strategies which will assist them in the preparation, supervision and assistance necessary to ensure the safety of people with developmental disabilities. The first section focuses on identifying and evaluating required staff supervision. Section 2 includes the responsibilities of staff during bathing time.

Learning Objective(s):

  • Demonstrates steps to ensure all necessary bathing items are in the bathroom before preparing for bathing time.
  • Evaluate the level of supervision needed
  • Define the characteristics of a burn
  • Distinguish temperature for bathing vs. showering
  • Identifying the process of bathing residents to ensure the process is safely carried out.
  • Explain the risk for people with disabilities

Maximum Group Size:

Training segment 10- competency portion should be conducted one person at a time.

Blooms Taxonomy:

  • Remember
  • Understand
  • Apply

Required Employees: Direct Support Professionals

Materials:

  • Handout
  • Handout
  • Competency test
  • Competency
Training:  1 Hour
Objective 1: The participants will be able to explain bathing risk for people with disabilities

Lecture:

The trainer will begin this session with a brief introduction on the magnitude of the problem regarding accidental deaths, bathing injuries including scalding. In your own words, please say the following:

Studies show that after the swimming pool, the bathtub is the second major site of drowning in the home including residential settings with seizures accounting for most of the common causes of bathtub drowning.

The National Safety Council reported that one person dies everyday from using bathtub in the United States. That more people have died from bathtub accidents than all forms of road vehicle accidents.

Injuries from the bathroom included slipping and falling when entering or exiting the bathtub or shower.

A study concluded by the State University of New York State found bathing difficulties included maintaining balance when bathing and making transfers.

Inform participants the following:

Near-drowning happens very quickly. Within three minutes of submersion, most people are unconscious, and within five minutes the brain begins to suffer from lack of oxygen. Abnormal heart rhythms (cardiac dysrhythmias) often occur in near-drowning cases, and the heart may stop pumping (cardiac arrest). The blood may increase in acidity (acidosis) and, under some circumstances, near drowning can cause a substantial increase or decrease in the volume of circulating blood. If not rapidly reversed, these events cause permanent damage to the brain

Ask – How much water does it take to drown?

Answer- inches of water in the bathtub. Any amount of water that covers the mouth and nose.

Who is at -risk?

Tell the participants the following people are considered high risk for accidents and drowning in the bathtub or shower:

  • Older people
  • Residence with a history of seizures
  • Residents diagnosed with dementia or Alzheimer
  • Residents who require assistance or supervision for mobility, transfer or ambulation.
  • Lack of understanding of one’s own physical and cognitive limitations.

Scalding

The trainer will introduce the segment on scald burns. Tell participants that individuals with physical, cognitive and emotional challenges are at high risk for burn injuries due to mobility impairments, muscle weakness and slower reflexes.  Further explain that, sensory impairments can result in decrease sensation in the hands and feet with the resident not realizing the water is too hot.

The instructor will discuss the following handout:

Time and Temperature relationship to Severe Burns

Water Temperature Time for a third degree burn to occur
155° F 1 second
148° F 2 seconds
140° F 5 seconds
133° F 15 seconds
127° F 1 minute
124° F 3 minute
120° F 5 minutes
100° F Safe temperature for bathing

 

Objective 2: Define the Characteristics of a Burn

In this section, the trainer will give the definition of a burn, Explain to participants that a burn is damage to the skin and underlying tissue caused by heat chemicals or electricity.

Further explain, Burns range is severity from minor injuries that require no medical treatment to serious, life-threatening and fatal injuries. Further explain that burns are categorized by degrees. Have participants turn to the handout on burns.

Superficial (first degree burns)

  • Causes : sunburn, minor scalds
  • Generally heal in 3-5 days with no scarring

Characteristics;

  • Minor damage to the skin
  • Color- pink to red
  • Painful
  • Skin is dry without blisters

Partial thickness (second degree) burns

  • Damages, but does not destroy top two layers of the skin
  • Generally heal in 10-21 days
  • Does not require skin graft*
  • Skin is moist, wet and weepy
  • Blisters are present • Color – bright pink to cherry red
  • Lots of edema (swelling)
  • Very painful

Full thickness (third degree) burns

  • Destroys all layers of the skin
  • May involve fat, muscle and bone
  • Will require skin graft for healing*
  • Skin may be very bright red or dry and leathery, charred, waxy white, tan or brown
  • Charred veins may be visible
  • Area is insensate – the person is unable to feel touch in areas of full thickness injury

*Except for very small (about the size of a quarter) full thickness burns will require a skin graft to heal.  The patient is taken to the operating room where all the dead tissue is surgically removed. Skin is taken or harvested off an unburned or healed part of that person’s body and grafted or transplanted to the clean burn area. In seven to 14 days, this grafted skin “takes” or adheres to the area and becomes the person’s permanent skin. The donor site (where the skin was harvested from) is treated like a partial thickness burn and heals within 1- to 14 days.

Objective 3: Identify the process of bathing residents to ensure the process is safely carried out

The trainer will discuss the importance of following the appropriate steps when giving a resident a shower:

When escorting a resident to the bathroom, the following items should be gathered and taken to the bathroom:

  • Washcloth/bath sponge
  • Towel
  • Body wash/soap
  • Body lotion
  • Toothbrush
  • Toothpaste
  • Mouthwash
  • Hair shampoo
  • Hair conditioner

The trainer will remind participants not to leave the participants in the bathroom alone under any circumstances for those requiring supervision.

Ask- What circumstance might a person leave the person alone.

The participant should respond- none.

Click on the link below to download the competency checklist:

COMPETENCY DEMONSTRATION CHECKLIST

Click on the link below to download the training in Word format

bathing module