Inclusion of Students with Neurobiological Disorders

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Inclusion of Students with Neurobiological Disorders

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

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