Inclusion of Students with Neurobiological Disorders

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  • 1. Inclusion of Students with Neurobiological Disorders Created by: Jim Messina, Ph.D. Connie Messina, Ph.D.
  • 2. Neurobiological Conditions ?
    • Attention Deficit Hyperactivity Disorder (ADHD) - with Inattention and/or Impulsivity
    • Specific Learning Disability with Auditory, Visual or Kinesthetic Processing Problems
    • Autistic Spectrum Disorder - PDD, MSD, Globally Delayed, Autistic
  • 3. Related Conditions:
    • Central Auditory Processing Disorder (CAPD)
    • Sensory Integration Disorder
    • Motor Planning Disorder
    • Self Regulatory Disorder
    • Dyslexia/Reading Disorder
    • Neurological Conditions: Epilepsy, Tourette Syndrome
  • 4. Impact of these conditions:
      • neurologically based behavioral issue keeping a child from developing normally
      • lack of full coordination of gross and fine motor skills
      • lack of complete age appropriate speech, language and communications ,
      • impaired self-esteem.
  • 5. Our Goal Today
    • To learn more about neurobiological conditions
    • To identify treatment approaches to these conditions
    • To identify ways to include children with neurobiological conditions within typical classrooms
  • 6. Attention Deficit Hyperactivity Disorder
    • Inattention - Traditionally known as ADD
    • Impulsivity - Traditionally known as Hyperactivity
  • 7. Inattention - Distractibility
    • doesn’t seem to listen
    • fails to finish assigned tasks
    • often loses things
    • can’t concentrate
    • easily distracted
    • daydreams
    • requires frequent redirection
    • can be very quiet and missed
  • 8. Impulsivity Behavioral Disinhibition
    • rushing into things
    • careless errors
    • risk taking
    • taking dares
    • accidents/injuries
    • impatience
    • interruptions
  • 9. Hyperactivity - Overarousal
    • restlessness
    • “ can’t sit still”
    • talks excessively
    • fidgeting
    • “ always on the go”
    • easy arousal
    • lots of body movement
  • 10. ADHD Characteristics
    • Inattention
    • Impulsivity
    • Overactivity
  • 11. Different Names for ADHD Through the years:
    • 1902 Defects in moral character
    • 1934 Organically driven
    • 1940 Minimal Brain Syndrome
    • 1957 Hyperkinetic Impulse Disorder
    • 1960 Minimal Brain Dysfunction (MBD)
    • 1968 Hyperkinetic Reaction of Childhood (DSM II)
    • 1980 Attention Deficit Disorder - ADD (DSM III) with-hyperactivity without-hyperactivity residual type
  • 12. Names for ADHD
    • 1987 Attention-Deficit Hyperactivity Disorder Undifferentiated Attention Deficit Disorder (DSM III-R)
    • 1994 Attention-Deficit/Hyperactivity Disorder (DSM IV) 314.01: ADHD, Combined Type 314.00: ADHD, Predominantly Inattentive type 314.01: ADHD, Predominantly Hyperactive -Impulsive Type
  • 13. TREATMENT OF ADHD
    • MEDICATING with STIMULANT MEDICATIONS:
    • RITALIN
    • CYLERT
    • DEXEDRINE
    • ADDERALL
    • Plus
  • 14. Plus these interventions:
    • PARENT TEAM
    • HOME MODIFICATIONS
    • PARENT-TEACHER TEAM
    • 504 PLAN MODIFICATIONS
    • CONSISTENCY OF PARENT - TEACHER - DOCTOR TEAM
    • UNCONDITIONAL LOVE FROM ALL ADULTS
  • 15. Learning Disability
    • Definition: A learning disability is a disorder that affects a person’s ability to either interpret what is seen and heard or to link information from different parts of the brain. These limitations can show up in many ways - as specific difficulties with spoken and written language, coordination, self-control, or attention. Such difficulties extend to school work and can impede learning to read or write or do math.
  • 16. Learning Disabilities
    • Neurological in origin
    • impede person’s ability to store, process or produce information
    • affect ability to read
    • affect ability to speak
    • affect ability to compute math
    • impair socialization
  • 17. LD Symptoms: Language
    • Pronunciation problems
    • slow vocabulary growth
    • lack of interest in stories
    • poor spelling
    • delayed decoding
    • poor reading comprehension
    • trouble following directions
    • lack of verbal participation in class
  • 18. LD Symptoms: Memory
    • Trouble learning numbers, alphabet & days of the week
    • slow acquisition of new skills
    • poor memory for routines
    • slow recall of facts
    • organizational problems
  • 19. LD Symptoms: Attention
    • Trouble sitting still
    • extreme restlessness
    • impersistence at tasks
    • impulsivity
    • inconsistency
    • poor self-monitoring, insatiability
    • great knowledge of trivia
    • careless errors
  • 20. LD Symptoms: Fine Motor Skills
    • Trouble learning self-help skills
    • clumsiness
    • reluctance to draw, trace or color
    • poor pencil grasp
    • poor letter formation
    • fist-like or tight pencil grasp
  • 21. Autistic Spectrum Disorder
    • Symptom complex with different ideologies
    • Delays in understanding (RECEPTIVE) & use (EXPRESSIVE) of language
    • Unusual responses in sensory stimuli
    • Resistance to change & insistence on routines
    • Difficulties with typical social interactions
  • 22. Traditional Symptoms of Autism
    • SOCIAL AND EMOTIONAL UNRELATEDNESS
    • INTOLERANCE TO CHANGE-RIGIDITY
    • STEREOTYPED BEHAVIOR-ROUTINES, RITUALS, ATTACHMENT TO OBJECTS
    • ABSENCE OR DELAY OF LANGUAGE OR COMMUNICATION SKILLS
    • LACK OF EYE CONTACT
  • 23. Emerging Symptoms of Autism
    • IMPAIRED SMALL MOTOR SKILLS, INCLUDING DYSPHASIA AND APRAXIA
    • IMPAIRED MOTOR PLANNING
    • AUDITORY PROCESSING DISTURBANCE
    • FLUCTUATING SENSORY DYSREGULATION BOTH HYPO AND HYPER, INCLUDING: HEARING, TASTE, SMELL, TOUCH, SENSE OF BALANCE, SENSE OF POSITION IN SPACE, ETC .
  • 24. Emerging symptoms of Autism
    • GASTROINTESTINAL DYSFUNCTION-DIARRHEA, GAS, ETC.
    • EATING DISORDER - SEVERE DIETARY SELF-LIMITATION, CHEWING, SWALLOWING PROBLEMS
    • FOOD AND/OR ENVIRONMENTAL HYPERSENSITIVITY - ALLERGIES, BEHAVIORAL REACTION TO FOODS AND DIETARY AND ENVIRONMENTAL CHEMICALS
    • HYPERACTIVITY
    • HYPOTONIA-LOW MUSCLE TONE, SOFT EARS, DOUBLE JOINTED, UPPER BODY WEAKNESS
    • SLEEP DISORDERS
  • 25. GARLIC V.S. ONION
    • RULES OF THUMB:
    • GARLIC’S ODOR OUTDOES ONION’S ODOR SO TREAT GARLIC FIRST
    • RULE OUT A GARLIC ISSUE AND TREAT IT PRIOR TO ADDRESSING THE ONION ISSUES
    • LACK OF SUCCESS IN TREATING ONION MAY BE BECAUSE GARLIC WAS NOT IDENTIFIED
    • ONGOING SETBACKS MAY BE DUE TO THE POWER OF THE GARLIC’S STRENGTH AND INCAPABILITY OF DE-POWERING IT
  • 26. Onion Rule Outs:
    • Seizure Disorder or other neurological issue
    • Vision acuity problem
    • Hearing problem
    • Metabolic problem
    • Genetic problem
    • Each other ADHD, SLD, ASD
    • Child Psychiatric Problem
  • 27. 1. Classroom Modifications
    • Establish rules in classroom
    • Reinforce rules in classroom
    • Be consistent
    • Interact with student by: eye contact, call name, finger on desk, touching
    • Place student: in front, near positive peers, in low distracting areas
  • 28. 2. Classroom Modifications
    • Evaluate and structure environment
    • Reduce external visual and auditory stimuli
    • Repeat and have student paraphrase directions
    • Give short directions
    • Use predetermined signals
    • Multiple modalities
  • 29. 3. Classroom Modifications
    • Natural and logical consequences
    • Develop learning contracts with student
    • Use environmental clues: prompts, steps, written lists, schedules
    • Demonstrate acceptable ways to communicate displeasure, anger, frustration and pleasure
  • 30. 4. Classroom Modifications
    • Earphones and study carrels
    • Reduced Assignments
    • Longer time for testing
    • Read test to student
    • Assignment books and organizers
    • Keep Notebook for parent teacher communications after each class day
  • 31. 5. Classroom Modifications
    • Computer games and programs
    • Peer Buddy Tutors and Helpers
    • Classroom Shadow, 1 on 1 Assistant
    • Progress notes to parents
    • Quarterly conferences with parents
    • Parents selection of teacher for next school year
    • Medications monitoring
  • 32. What it takes for inclusion to work
    • Unconditional love of the child
    • Willingness to extend oneself
    • Openness to doing things differently
    • Working with the parents as a team
    • Admitting when you are lost
    • Flexibility
    • Willingness to change
  • 33. What it takes for inclusion to work
    • Getting outside help
    • Openness to other’s input
    • Enthusiasm
    • Optimism - “We Can” Attitude
    • Determination to make it work
    • Commitment to the process and to the child
  • 34. Inclusion Works If You Work at it
  • 35. Serving Kids from A to Z !