Meeting the Needs of Children and FamiliesDajeong KimECEP 233 – 063Lisa McCaie-WattersApril 4th 2013
• Sonia is new child in my program • Sonia has Spina Biﬁda and she need to use a wheel chair • “She also has a shunt to lessen ﬂuid on the brain” • She is brilliant, and extrovert • Her parents are bilingual, so Sonia can speak English and French • Her family is new in Toronto, and they want to get some advice from me about services in this area • They are interested in sports and recreation programs (Meeting the Needs of Children with Special Needs Assignment-‐Case Studies)
• Identifying Sonia’s speciﬁc symptom with her parents• Changing the environment (Setting) for Sonia’s convenience (Wheel Chair)• Giving help Sonia to adapt to new environment, and get along with the children• Planning some activities for Sonia• Providing some agencies to help new comers• Providing some agencies that can help child with Spina Biﬁda• Providing some agencies that Sonia’s family can do sports and recreation
Normally embryo’s both side of spine bones close within the ﬁrst four weeks of pregnancy. However, if during this period, the spine does not close completely, it is cause of birth defect. (Spina Biﬁda Information)
Spina Biﬁda Segment(Video)
“Infants born with spina biﬁda may have an open lesion on their spine where signiﬁcant damage to the nerves and spinal cord occurs. Although the spinal opening is surgically repaired shortly after birth, the nerve damage is permanent. This results in varying degrees of paralysis of the lower limbs, depending largely on the location and severity of the lesion. Even with no visible lesion, there may be improperly formed or missing vertebrae, and accompanying nerve damage.” (Spina Biﬁda Information)
“Spina biﬁda is the most common of a group of birth defects known as newuraltube defects, which aﬀect the central nervous systm(brain and spinal cord).” (Spina Biﬁda) There are three most common types of Spina Biﬁda, which are Occulta, meningocele, and myelomeningocele. Each type has diﬀerent level of severity, and symptoms.
Occulta means “hidden” in Latin, and Spina Biﬁda Occulta is the mildest form and the most common form of spina biﬁda. “In spina biﬁda occlta, one or more vertebrae are malformed.” (Types of Spina Biﬁda) The skin on the surface may be normal. Otherwise, There are some hair growing or dimple on the skin. (Spina Biﬁda Information) “SBO is common; 10 to 20 percent of healthy people have it. Normally is safe and people often ﬁnd out they have it through an X-‐ray. Spina Biﬁda Occulta usually doesn’t ause nervous system problems.” (Spina Biﬁda Occulta)
Even though there is nothing wrong with the spine, people can have Spina Biﬁda Occulta. People could have neurological complication relate to SBO. There are some possible symptoms of neurological complication. (Spina Biﬁda Occulta) “ • Pain in the back or legs; • Weakness in the legs; • Numbness or other changes in feeling in the legs or backs; • Deformed legs, feet and back; and • Change in bladder or bowel function. People who could have a spinal cord problem should see a health care provider right away.” (Spina Biﬁda Occulta)
Meningocele spinal cords develop normally, but only problem is that meninges juts out from the opening. It is created by damaged or missing vertebrae and perhaps can be exposed. (Spina Biﬁda Information) “The membrane that surrounds the spinal cord may enlarge, creating a lump or “<cyst.” This is often invisible through the skin and causes no problems. If the spinal canal is cleft, or “biﬁd,” the cyst may expand and come to the surface. In such cases, since the cys does not enclose the spinal cord, the cord is not exposed. The cyst varies in size, but it can almost always be removed surgically if necessary, leaving no permanent disability. This is an uncommon type of spina biﬁda.” (Spina Biﬁda)
“In this rare form, the protective membranes around the spinal cord (meninges) push out through the opening in the vertebrae. Because the spical cord develops normally, these membranes can be removed by surgery with little or no damage to nerve pathways.” (Symptoms)
“A section of the spinal cord and the nerves that stem from the cord are exposed and visible on the outside of the body. Or, if there is a cyst, it encloses part of the cord and the nerves. This condition, which was documented 4000 years ago, accounts for 94% of cases of true spina biﬁda.” (Spina Biﬁda)Myelomeningocele is the most omplex and intense form of spina biﬁda. Its protective covering and the meninges protrude from the spilt spine. (Spina Biﬁda Information)
“A new born may have a sac sticking out of the mid to lower back. The doctor cannot see through the sac when shining a light behind it. Symptoms include: • Loss of bladder or bowel control • Partial or complete lack of sensation • Partial or complete paralysis of the legs • Weakness of the hips, legs, or feet of a newborn Other symptoms may include: • Abnormal feet or legs, such as club foot • Build up of ﬂuid inside the scull (hydrocephalus) • Hair at the back part of the pelvis called the sacral area • Dimpling of the sacral area” (Myelomeningocele)
Researchers said that there are eﬀects of heredity, lack of folic acid, and environment could inﬂuence to Spina Biﬁda. However, it is not been identiﬁed yet exactly. (Spina Biﬁda Information) “Having a child with Spina biﬁda increases the chance that another child will also have Spina biﬁda by 8 times. In about 95% of cases of Spina biﬁda, however, there is no family history of neural tube defects.”(emedicinehealth)
Spina Biﬁda is able to diagnosed during pregnancy or after the baby is born. However, Spina biﬁda occulta could not be diagnosed even after the baby grows up, or might never be diagnosed. (Fact)
During pregnancy there are screening test ( prenatal tests) to check for spina biﬁda and other birth defects.“ • AFP – AFP stands for alpha-‐fetoprotein, a protein the unborn baby produces. This is a simple blood test that measures how much AFP has passed into the mother’s bloodstream from the baby. A high level of AFP might mean that the baby has spina biﬁda. An AFP test might be part of a test called the “triple screen” that looks for neural tube defects and other issues. • Ultrasound – An ultrasound is a type of picture of the baby. In some cases, the doctor can see if the baby has spina biﬁda or ﬁnd other reasons that there might be a high level of AFP. Frequently, spina biﬁda can be seen with this test. • Amniocentesis – For this test, the doctor takes a small sample of the amniotic ﬂuid surrounding the baby in the womb. Higher than average levels of AFP in the ﬂuid might mean that the baby has spina biﬁda.” (Fact)
“In some cases, spina biﬁda might not be diagnosed until after the baby is born. Sometimes there is a hairy patch of skin or dimple on the baby’s back that is ﬁrst seen after the baby is born. A doctor can use an image scan, such as an, X-‐ray, MRI, or CT, to get a clearer view of the baby’s spine and the bones in the back. Sometimes spina biﬁda is not diagnosed until after the baby is born because the mother did not receive prenatal care or an ultrasound did not show clear pictures of the aﬀected part of the spine.” (Fine)
There is not treatment exactly. However, medical care or surgical treatments will help to prevent occurring secondary conditions throughout an individual’s life. Through the surgery, the opening in the spine can be closed and this will reduce its eﬀects on the body. (Spina Biﬁda) “Since spina biﬁda causes injury to the spinal cord, treatment consists of managing the symptoms that the person has, such as diﬃculty standing, walking, or urinating. Some people will be able to walk with crutches or leg braces; others may need a wheelchair to get around. Children and adults with myelomeningocele will have the most medical complications and need the most medical care.” (Spina Biﬁda) “Just ﬁfty years ago, only 10% of babies born with spina biﬁda survived their ﬁrst year. Today, with research and advances in medical technology, 90% survive and thrive!” (Spina Biﬁda Information)
1. Physical Space / Removal of Barriers • Providing free space Sonia needs to use wheelchair, so she needs free space to use wheelchair freely. • Tables that have an openly for children in wheelchair By setting open tables, Sonia can easy to access the tables and do a variety activities at the table. • Easy access I need to set wheelchair accessible facilities for Sonia. She will be able to come to classroom or move in the classroom easily. Table height should be suitable level for the child. • Child’s eye-‐level When Sonia uses wheelchair, I have to change the environment that she can access with wheelchair. (ECEP 223)
2. Adaptive Devices for greater independence “Children with spina biﬁda may need to use assisted devices for walking.” (ECEP223, W3) Because their spinal cords are damaged, and it inﬂuences on their body. Mobility device can help a child to crawl, stand, or walk. “ • Crawling: Scooter boards can be propelled by the child’s arms as he lies across the board. • Standing: Many children with balance issues are unable to stand independently but can lay if they are supported in a standing position. Sometimes children who cannot hold their heads up while lying down are able to hold their heads up when they are in a sitting or standing position. • Walking: A child with weak leg muscles may require braces to help support the joints. Even with bracing, a child may require a walker for trunk balance. Young children usually require walkers with front wheels as they require less energy to use than walkers without wheels.” (ECEP223, Reading Package)
• Providing adaptive devices such as poisoning systems, ﬁdget kits, walkers, canes, and crutches. Poisoning systems can help to foster exercise therapy and general positioning. It will help Sonia to move and use her body. Also, she needs to balance when she practices walking, so walkers, canes, and crutches can be additional support to maintain balance or stability while Sonia is walking. One of Sonia’s weaknesses is attention, and ﬁdget kits will help her to focus and maintain attention during learning in the class. These kits contains sensory items that help Sonia to focus on her work. (ECEP 223, W8) The Importance of Physical Activity (Video)
Children with Spina Biﬁda have some weaknesses such as perceptual motor problems, comprehension, attention, hyperactivity/impulsivity, memory, organization, sequencing, and decision making/problem solving. (Learning Among Children with Spina Biﬁda) Based on the child’s weaknesses, I can change some teaching strategies. (ECEP 223 Reading Package)1. Work from where you are, not from where you want to be As an ECE, I should consider six developmental areas such as cognitive, social and emotional, gross motor, ﬁne motor, language and communication, and self-‐help skills. -‐ Cognitive skills: The child with spina biﬁda feels hard to decision making/problem solving. I will help Sonia to understand cause and eﬀect through brainstorming and give her opportunity to practice problem solving. -‐ Social and emotional skills: Sonia is new child in my program, so she might feel strange. I need to help her to get along with other children. I will ask her about her feeling , and teach her how to express her feeling.
(ECEP 223 Reading Package) -‐ Gross motor skills: Sonia has problem to walk, so I will provide some physical activities to use her body. Before nap time, I can help her to crawl over a pillow. -‐ Fine motor skills: Sonia needs to use her body with balance. I will provide her crayon to hold and write down something. Or she can practice to squeeze a sponge. -‐ Language and communication skills: Sonia can speak both English and French. I will ask her frequently about objects, and provide visual things that she could match pictures and languages. It will be provided in both English and French. -‐ Self-‐help skills: I will give opportunities to try something by herself. For example, she can put on her clothes, and she can eat by herself with tools. 2. Choose a single area to focus on By observing Sonia, I need to decide what she needs now. Then, I will focus on one area such as physical development, and help her to complete new skills. After she will be able to do it, I will ﬁnd out another area that she needs to improve.
3. Break the skill into smaller steps -‐ Every skill has steps, but I should break the skill into smaller steps until she can understand and complete by herself. I will combine this strategy with ‘chaining’, so when I teach new skill, I repeat the steps until she can do it on her own. 4. Decide how to teach -‐ All learners are diﬀerent, and I should provide diﬀerent teaching strategies. Before teaching the child, I should think what I want to teach to her and what she needs to know. Sonia is bight and outgoing person, so I will help her to learn in interesting way such as combining vision and movement. She can see the visual objects, and express what she saw by making objects with clay. (ECEP 223 Reading Package)
4. Decide how to teach -‐ All learners are diﬀerent, and I should provide diﬀerent teaching strategies. Before teaching the child, I should think what I want to teach to her and what she needs to know. Sonia is bight and outgoing person, so I will help her to learn in interesting way such as combining vision and movement. She can see the visual objects, and express what she saw by making objects with clay. 5. Build your child’s conﬁdence -‐ She is new child in my program, and she needs to know other children. Maybe it is hard to play with other children at ﬁrst time. I will encourage her to interact with one other child ﬁrst, and help her to join in large group gradually. Then, I will prepare some activities that Sonia and other children can play together. (ECEP 223, Reading Package)
6. Motivate and reinforce -‐ I will observe Sonia and try to ﬁnd her interests. And I should consider how to give appropriate reinforcement. When I give her more natural forms of reinforcement, Sonia could better success learning new skills. I should consider her comprehension skill, so it will be helpful to teach her based on her personal experiences or special interests. 7. Set short deadlines -‐ When I give a new skill to Sonia, I need to set the time. I will check the time how long does it take that Sonia gets new skills, and I will work with other teachers together. Setting time is important because I will be able to observe her development process based on how long she needs to get the new skills. 8. Keep track -‐ Whenever I give to Sonia new skill, I need to write down her status. Then, I can see that she can follow the instruction well or not. If Sonia is struggling, it means that she feels diﬃcult to learn it at this time. Then, I can ﬁnd other skills for her. (ECEP 223, Reading Package)
(ECEP 223, Reading Package)9. Generalize the skill -‐ When I teach new skills to Sonia, I should encourage her to use that skills in many diﬀerent places, with many people, and many situations. “To encourage the use of new skills in as many ways and places as possible, a few tips include: • Use similar but diﬀerent items to teach the same skills • Have other caregivers teach the same skill BUT be certain that they know what steps are being taught and how you are teaching them • Teach the skill in several diﬀerent locations • Teach the skill during diﬀerent times of the day, if possible.” (ECEP233, Reading Package) Generalize the skill is important because one of their major diﬃculties is transferring skills to a new environment. (Teaching Strategies to improve Classroom Performance)
10. Include others -‐ Working with others is important. Every teacher has diﬀerent thought, and I cannot tell that which one is the best. I will ask to other teachers to join to teach Sonia a new skill. Then, they could help her in their best way. Also, I can get some advices from her if I am not sure of my strategies and next steps. (ECEP 223, Reading Package)
Sprit Breakthrough & Hope “The mission of the Spina Biﬁda and Hydrocephalus Association is to build awareness and drive research, support and advocacy to help ﬁnd a cure while continuing to improve the quality of life of all individuals with spina biﬁda and/or hydrocephalus. The association is also committed to educating the public about the important role folic acid plays in the prevention of neural tube defects, which includes spina biﬁda. SB&H receives no government funding. Its operating budget comes directly from fundraising and donations.” (Spina Biﬁda and Hydrocephalus Association SB&H)
Sprit Breakthrough & Hope http://www.sbhao.on.ca/ P.O. Box 103, Suite 1006 555 Richmond Street West Toronto, Ontario M5V 3B1 Toronto & GTA: 416-‐214-‐1056 Toll Free: 800-‐387-‐1575 (Ontario Only) Fax: 416-‐214-‐1446 Email: email@example.com
Holland Bloorview Holland Bloorview Kids Rehabilitation Hospital (formerly Bloorview Kids Rehab) is Canada’s the biggest children’s rehabilitation hospital. They provides treatments, technologies, therapies and real-‐world programs to children with special needs. They help children’s development, support children participation, and complex continuing care. Also, they provide some special programs for children with special need. (Holland Bloorview Kids Rehabilitation Hospital – An Overview)
Holland Bloorview http://www.hollandbloorview.ca/index.php Holland Bloorview Kids Rehabilitation Hospital 150 Kilgour Road Toronto, Ontario, Canada M4G 1R Tel: 416-‐425-‐6220 Toll Free: 1-‐800-‐363-‐2440 Child Development Program Tel: 416-‐425-‐6220 ext. 7050
Our Kids http://www.ourkids.net/disability-‐camps.php This website helps to ﬁnd camps for kids with special needs. “Disability Camps provide summer recreation for children with various types of disabilities. Camps are conducted for a variety of disabilities that may include cerebral palsy, muscular dystrophy, spina biﬁda, brain injury, autism, multiple sclerosis, epilepsy, quadriplegia, paraplegia, arthritis, hearing and/or visual impairments, Downs syndrome, schizophrenia, heart problems, strokes, attention deﬁcit disorders, fetal alcohol syndrome, diabetes and Alzheimer’s disorder. Some camps are especially for children with learning disabilities like dyslexia. There are also many disability camps covering only a speciﬁc type of disability.” (Disability Camps) This website is designed to ﬁnd the camp easily. Parents can ﬁnd camp by region, and purpose. Also, they can compare them easily. Each camp includes contact information, and parents can contact with them after deciding.
Toronto Community Foundation Helps individual or family whowant to live, work, and get education in Toronto. This community is one of largest Canadas community foundations. "The Toronto Community Foundation connects philanthropy with community needs and opportunities in order to make Toronto the best place to live, work, learn, and grow." (About Toronto Community Foundation)They provides a professionaladvisor for helping people.
Toronto Community Foundation http://www.tcf.ca/Toronto Community FoundationXerox Centre33 Bloor Street East, Suite 1603Toronto ON M4W 3H1Tel: 416-921-2035Fax: 416-921-1026General Inquiries: firstname.lastname@example.org
• "Spina Bifida." emedicinehealth. N.p., n.d. Web. 20 Mar. 2013. <www.emedicinehealth.com/spina_bifida_causes>• "Spina Bifida Information | Spina Bifida and Hydrocephalus." Spina Bifida & Hydrocephalus Association of Ontario (SB&H) | Spina Bifida and Hydrocephalus. N.p., n.d. Web. 20 Mar. 2013. <http://www.sbhao.on.ca/spina-bifida>.• "Types of Spina Bifida." Nervous System Home Page. N.p., n.d. Web. 20 Mar. 2013. <http://nervous-system.emedtv.com/spina-bifida/types-of-spina-bifida.html>.• "Spina Bifida Occulta." Spina Bifida Association. N.p., n.d. Web. 20 Mar. 2013. <www.spinabifidaassociation.org/site/c.evKRI7OXIoJ8H/b.8277205/>• "Spina bifida: Symptoms - MayoClinic.com." Mayo Clinic. N.p., n.d. Web. 20 Mar. 2013. <http://www.mayoclinic.com/health/spina-bifida/DS00417/DSECTION=symptoms>.• "Myelomeningocele: MedlinePlus Medical Encyclopedia." National Library of Medicine - National Institutes of Health. N.p., n.d. Web. 20 Mar. 2013. <http://www.nlm.nih.gov/medlineplus/ency/article/001558.htm>• "CDC - Spina Bifida, Facts - NCBDDD."Centers for Disease Control and Prevention. N.p., n.d. Web. 20 Mar. 2013. <http://www.cdc.gov/ncbddd/ spinabifida/facts.html>• "Spina Bifida." About.com. N.p., n.d. Web. 20 Mar. 2013. <spinabifida/facts.html>.• "Spina Bifida and Hydrocephalus Association SB&H :: Toronto Charity Events." Toronto Charity Events 2013 | Fundraising & Volunteer in Toronto, ON. N.p., n.d. Web. 25 Mar. 2013. <http://www.toronto-charities.ca/page.aspx?dt=259>.• "Disability Camps." Our Kids. N.p., n.d. Web. 25 Mar. 2013. <www.ourkids.net/disability-camps.php>.• "Holland Bloorview Kids Rehabilitation Hospital." Holland Bloorview Kids Rehabilitation Hospital. N.p., n.d. Web. 25 Mar. 2013. <http://www.hollandbloorview.ca/index.php>.• "Spina Bifida & Hydrocephalus Association of Ontario (SB&H) | Spina Bifida and Hydrocephalus." Spina Bifida & Hydrocephalus Association of Ontario (SB&H) | Spina Bifida and Hydrocephalus. N.p., n.d. Web. 25 Mar. 2013. <http://www.sbhao.on.ca/>.• "Spina Bifida & Hydrocephalus Association of Ontario (SB&H) | Spina Bifida and Hydrocephalus." Spina Bifida & Hydrocephalus Association of Ontario (SB&H) | Spina Bifida and Hydrocephalus. N.p., n.d. Web. 25 Mar. 2013. <http://www.sbhao.on.ca/>.