Tag Archives: IEP

Teaching Students with Feeding Tubes: What You Need To Know

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If you work in a special education class or a day habilitation setting, more than likely you are teaching a student or an individual with complex needs including the use of a feeding tube.

According to the Tube Feeding Awareness Foundation, there are over 300 conditions that require students and individuals to receive nutritional support through tube feeding.

What is a feeding tube?

A feeding tube is a device that is inserted in the stomach wall and goes directly into the stomach. It bypasses chewing and swallowing in a student or individual who no longer has the ability to safely eat or drink. This allows for students and individuals to receive adequate nutritional support.

A feeding tube is also used for students and adults who cannot take in enough food by mouth. Feeding tubes can be temporary or permanent .

Reasons to use a feeding tube
The student or individual may have a swallowing disorder or dysphasia. This means there is an increase risk for the student or individual to aspirate their foods or liquids into their lungs. Causes of swallowing problems include low-muscle tone, brain injury, genetic conditions, sensory issues, neurological conditions, cleft lip/palate and birth defects of the esophagus or stomach.
Types of Feeding Tubes

Gatro Feeding Tube

The gastrostomy tube (G tube) is placed through the skin into the stomach. The stomach and the skin usually heal in 5-7 days. This type of tube is generally used in people with developmental disabilities for long term feeding.

Nasogastric Feeding Tube

The nasogastric (NG tube)  is inserted through the nose, into the swallowing tube and into the stomach. The NG tube is typically used in the hospital to drain fluid from the stomach for short term tube feeding.

Neurological and Genetic Conditions Requiring Tube Feeding

Some students and individuals with neurological and genetic conditions often require tube feeding due to gastrointestinal issues including constipation, reflux, and abnormal food-related behaviors. It For example, it is estimate that 11% of children with cerebral palsy use a feeding tube due to difficulty with eating, swallowing, and drinking.

The following are different types of neurological or genetic conditions that may require the use of a feeding tube.

22q11.2 Deletion Syndrome

Angelman Syndrome

Aspiration

Cerebral Palsy

CDKL5 Disorder

Cornelia de Lange

Cri Du Chat Syndrome

Down Syndrome

Dravet Syndrome

Dysphasia

Edwards Syndrome

Fetal Alcohol Syndrome

Fragile X Syndrome

Hydrocephalus

Lennox-Gestaut Syndrome

Microcephaly

Ohtahara Syndrome

PPD- Not Otherwise Specified

Turner Syndrome

Trisomy 18

Spastic Diplegia

Traumatic Brain Injury

West Syndrome

Williams Syndrome

 

Signs and Symptoms of Issues related to a g-tube

Complications due to tube feeding may include:

  • constipation
  • dehydration
  • diarrhea
  • infections
  • nausea/vomiting

Aspiration

Aspiration can be caused by:

  • reflux of stomach contents up into the throat
  • weak cough, or gag reflux
  • the feeding tube is not in place
  • delayed stomach emptying
  • The head is not raised properly.

Students should be observed for aspiration during feeding. The following are signs and symptoms of aspiration:

  1. Choking or coughing while feeding
  2. Stopping breathing while feeding
  3. Faster breathing while feeding
  4. Increased blood pressure, heart rate and decreased oxygen saturation.

 

Accommodations for Students with Dysgraphia

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Dysgraphia is describes as a learning disability that affects writing, spelling and fine motor skills. Dysgraphia is a neurodevelopmental disorder that can occur as a stand alone disorder or part of a co-occurring disorder with other disabilities such as ADHD, Autism, and Dyslexia. Typically it is diagnosed or discovered in the early years when children are beginning to learn how to write. Most adults often remain undiagnosed.

Early Signs of Dysgraphia

Signs and symptoms of dysgraphia generally begin to show up when children began to lean how to write. Early signs of Dysgraphia include:

  • Inconsistent spacing between letters
  • Poor spatial planning
  • Poor spelling
  • Unable to read own handwriting
  • Poor fine motor skills
  • Omitted words
  • Writes slow
  • Pain in hand from writing
  • Messy unorganized papers
  • Difficulty organizing thoughts on paper
  • Illegible printing and cursive letter formation
  • Slopping handwriting
  • Tight, cramped pencil grip
  • Tires quickly when writing
  • mixes upper and lower case or irregular sizes and shapes of letters.

The following articles provide resources on accommodations:

6 tips for creating a dysgraphia-friendly classroom

A guide to classroom and at-home accommodations for dysgraphia

Classroom accommodations for students with dysgraphia

Dysgraphia Accommodations

Dysgraphia accommodations and modifications

Dysgraphia accommodations in the classroom

Dysgraphia accommodations that improve learning

Dysgraphia symptoms, accommodations, and IEP goals

How to assist a student with dysgraphia in the classroom

Possible accommodations to consider for children with dysgraphia

Transition Planning Timeline

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Click here for a printed version

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