Inclusion of Children with Special NeedsMeeting the Needs of children with Special Needs Assignment Case Study-Najia-Developmental Delay Rubina Akbar Student No: 300647837 Section 061 April 05, 2013 Professor: Lisa McCaie
Introduction of Najia & her familyAccording to the case study scenario, Najia is 11 months old. She is not babbling or pointing to objects in the room. Najia’s mother has three other children in the centre and often appears very stressed . Developmental Delay-Early Recognition
Najia’s development The development of Najia is atypical in the area of language and communication developmental domains. As far as the behaviour is concern, this child is not babbling at the age of 11 months and not pointing to the objects in the environment. Every child develops at their own pace, some children reached their milestone early in their life, but some children develop their developmental milestone later period in their life. Najia’s development seems delayed. According to ages and stages, at the age of 11 months, she should babble, point to objects, and respond to the environment. As compare to other children, her development is behind or she did not reach at her developmental milestone yet.
Language Developmental MilestoneBy the age of 5 months (cont.) baby should respond to loud noises turn toward sounds watch your face when you speak to him and try to "talk" backBy the age of 8 months babbles expressively as if talking respond to own name squeals, laughs, babbles, smiles in responseBy 12 months the baby should try to imitate sounds that you make the child should use at least a few real words, recognize and react to the sound of his name, incorporate consonants into his babbling use sound to communicate with you. baby should begin repeating syllables, like "baba," "dada" or "mama" by about nine months of age -- although probably he is not attaching meaning to the sounds yetAt 18 months the child should know the names of familiar objects and people An 18 month olds should use least 20 words, including different types of words, such as nouns (“baby”, “cookie”), verbs (“eat”, “go”), prepositions (“up”, “down”), adjectives (“hot”, “sleepy”), and social words (“hi”, “bye”).
Language Developmental Milestone By 24 months The child should be able to say at least 8 to 10 words and combine them in two-word phrases 24 month olds should use at least 100 words and combine 2 words together. These word combinations should be generated by the child, and not be combinations that are “memorized chunks” of language, such as “thank you”, “bye bye”, “all gone”, or “What’s that?”. Examples of true word combinations would be “doggie gone”, “eat cookie”, or “dirty hands”. For example:Some children start talking or walking very early as compare to the other children, on the otherhand, some children talk very late. Some children don’t talk until they are three years of age. Personal Experience with language concerns:My sister in law has three daughters. Her all three daughters did not start talking until they werethree of their age. Our family was very concerned about this. Now, all girls are about 8, 7, and 5years old, and they are very talkative and intelligent in their daily and school’s activities. There is noconcern at all.
Najia’s special needsNajia requires some special needs: Language development Communication skills Cognitive Development Social and emotional Hearing and Vision testing Fast reflexes Variation of Developmental Delay
Needs of Najia’s Family (cont.) The mother of Najia has three other children too. The mother has a lot of responsibilities of four children. She often seems much stressed in everyday life. It is a challenging job for a mother to take care of four children. Sometimes it becomes very hard to deal with four children especially when there is a child with special needs. The mother has to take care of all four children that is why sometimes the child who has special needs is not getting enough attention and care which is necessary or required for her development and growth. The mother’s schedule and her struggling period with four children can affect on Najia’s development. The family needs social and emotional support from peers, childcare, and from the community in this case to develop Najia’s developmental milestone. Child care center can meet the needs of parents by providing suggestion and resources. Also, caregivers can provide extra social and emotional support to Najia and her family.
Risk Factors for Language Development A list of risk factors has been identified, which suggest that a child is more likely to have continuing language difficulties]. These include: quiet as an infant; little babbling a history of ear infections limited number of consonant sounds (eg. p, b, m, t, d, n, y, k, g, etc.) does not link pretend ideas and actions together while playing does not imitate (copy) words uses mostly nouns (names of people, places, things), and few verbs (action words) difficulty playing with peers (social skills) a family history of communication delay, learning or academic difficulties a mild comprehension (understanding) delay for his or her age uses few gestures to communicate
Effects of children hearing on language development Active involvement between adult and a child can be improved by applying appropriate strategies based on needs and development of the child. The number of total words and different words that the parent uses with the child daily, the number of conversations, and the positive affirmations from the parent are all related to infants’ and toddlers’ language development. Some infants and toddlers hear an average 600 words an hour Others hear as many as words an hour 2100 words an hour Some children hear 100 words hour while others hear 500 words an hour“These differences in the amount of language that children hear make a difference in their language development”
Suggestions for Promoting Language Skills It’s never too early to seek help. We know that the earlier we start to help children, the better their outcomes. Consult a speech-language pathologist about your concerns. Have your child’s hearing evaluated – even if you think your child is hearing just fine, it is important to make sure he is hearing sounds at a variety of volumes and pitches. Even slight hearing impairments can cause difficulties with speech and language development. When to Seek Therapy
How parents can help in developing children’s communication skills Encouraging children to communicate There are many things parents can do at home on a daily basis to develop children’s communication skills. The key is to be consistent in expectations of children’s response.
How parents can help in developing children’s communication skills Encouraging children to communicate (cont.) Looking at child’s face when parents speak to the child Emphasizing or stressing important words by saying them a bit louder Speaking slowly and clearly Using gestures, objects, or pictures to match your words Repeating parts of questions or instructions Giving him time to respond to you Providing him with visual aids such as objects and pictures Looking at an object, activity, or person Pulling another person towards an object or activity he wants Gesturing to show what the child wants or does not wants Encourage your child to ask for “more” of something he enjoys by using sounds, words, gestures or pictures. Blow the bubbles and encourage your child to look at and touch the bubbles. When bubbles have disappeared, put the cap back on the container and ask you child if he would like more bubbles. Wait a few moments. If your child looks interested, encourage him/her to ask for more by gesturing, pointing to the container, saying “more” Pour a little bit of juice into a glass, play music and tickle, bounce or lift the child in the air one time and then stop.
How parents can help in developing children’s communication skills Encouraging children to communicate (cont.) Show the child two objects, crackers or cookies and let the child make choice. Wait a moment. Parent can point an object if child does not make choice. Playtime is an excellent time to build your child’s communication skills, use this time to have fun with the child. Model by making sound like “ba”, “wa”, “ma”,”da”,”cah ”
Who can help? Resource Teacher or Consultant Pediatrician Audiologist Infant Development Program Consultant Speech and Language Therapist Special Education Teacher Vision or hearing impairment Agency support person
Who can help? (cont.) Resource Teacher or Consultant Gather information in relation to children with special needs Assist families and child care staff in identifying strengths, needs and goals for the child with special needs Access and coordinate resources to support children, families and child care staff Develop appropriate strategies and service plans to support inclusion of the child with special needs Interact with related professionals in the community Pediatrician Specializes in child development and medical care for children Audiologist Provides hearing screening, assessments and intervention supports for children with or at risk for hearing loss
Who can help? (cont.) Infant Development Program Consultant Works with families of children under the age of three with, or at risk of , developmental delay Can provide home visits, assessments, program planning, and liaison with other families Speech and Language Therapist Works with children and their families to develop the child’s verbal and non- verbal communication skills, their understanding of language and their swallowing and feeding skills Special Education Teacher Specialty teacher who oversees and may also implement the education and development of children with special needs
Strategies for developmental Needs To plan appropriate strategies to meet the child’s needs within the child care setting, it is necessary to observe closely the child’s behaviour and development. For example, I will start by taking a look at her existing skills and abilities, or the things that she can do. This will give me a clearer picture of the child’s developmental strengths and needs. Secondly, before I implement a strategy, I would focus on specific area of development, such as cognitive, language, communication, social, and emotional development.
Strategies for Developmental Delay/ developmental Needs (cont.) Najia has special needs in language and communication development. Based on those needs, I would plan to implement some strategies for language development, for example: Spoken language Visual Language Repetition/Rhymes Signs/Gestures Use Self-Talk and Parallel Talk Offer Choices
Spoken language As an educator, to promote Najia’s language and communication skills, I would focus on using spoken language (words or sounds). For example, I would talk to Najia more often to promote her language skills and will use the technique looking at her face when I am speaking to her. I would emphasize or stress important key words by saying them a bit louder. Speaking slowly, loudly, and clearly can be very helpful in teaching language skills to Najia. Also, it will enhance other infants’ language skills too. Because in this room, I will have a larger group of infants, and they are also at the stage of learning new words, sounds, and vocabulary. Therefore, it will be a useful technique for all the other children too. When I will talk to Najia, other children will also listen and learn new words through our conversation.
Visual Language A visual language is a system of communication using visual elements. For example, I would use visual language for instance object, colour pictures, black and white photographs, colour line drawings, black and white line drawings and symbols to communicate with the child and will teach the child language skills. According to class notes, “Visuals can help the child to communicate with us. For example, the child can point to make a choice”
Repetition/Rhymes Another strategy I can apply is by asking for objects and repeating words, questions, instructions and rhymes. A little louder, clear, and low speed sound can be effective technique for children who have communication and language problem. For example, according to the reading package, it is mentioned that “A child will be more likely to use signs if the signs chosen are functional. For example, if singing “more” gets the child more of something he likes, the child will be motivated to learn. “My turn” and “help” are also useful as they help the child access something desired.” For Najia, we can apply same strategy such as we can practice babbling with her by saying “baba”, ma ma” etc.
Signs/Gestures Examples Children who learn through movement are good candidates for using signs them selves. Some basic signs can be introduced into the classroom as a general support . This strategy is equally useful for the other group of children
Signs/Gestures Examples In addition, using signs and/or gestures is an important component of a total communication approach. For example, I would model signs or gestures while using spoken language with Najia because it can help to enhance her receptive language (understanding). Furthermore, I would provide visual cues and cards to support speech and I will assist adults by slowing down their accompanying speech and emphasizing the key words. Some examples of using gestures are “directions, greetings, and concepts”.
Use Self-Talk and Parallel Talk Self-talk is talk that adults use to describe what they are doing while with the infant or toddler. For example, if I am diapering a baby might say, “I’m Example getting your diaper. Now I’m lifting your feet. I’m putting the diaper on. All done.” Parallel talk occurs when an adult talks about what a child is doing. For example, while the child is playing or eating I might say, “Mmm, you’re eating your toast” while pointing to the toast. These strategies tie language to Self-Talk and Parallel Talk an act or object manipulation, making words come alive and have meaning for the child. This strategy will also be helpful for other group of children, because with the help of self talk and parallel take, children will learn the sequence, steps, or order. They will also learn
Picture Exchange Communication System (PECS) It was designed for children who are Example: not yet initiating communication to express their needs or interests. It contains the six phases, but for Najia’s case I can only use phase one because it is designed for children who are not verbal. For example, two adults are required during the first teaching session. One sits directly across from the child to receive the picture. The other is behind the child to prompt the exchange. Place the desired items and the picture of it in front of the child. Do not ask the child what he wants. Provide the child with the desired object immediately and say, “Oh you want this”. Children like to play with other people. Other children PECS
Offer Choices (cont.)Choice Boards Example: For Najia, I would use individual choice board, and for other children I would use class wide choice board.For example, This age group attract by colours, so I will provide choice board of different colours. She might attracts by any colour or make some choice. In addition, Najia is learning to making a choice. I can provide choices by showing Najia two real objects, and wait for her reply or pointing something to develop communication skills. If she indicate her choice by vocalizing, verbalizing, or gesturing, I will immediately provide her indicated choice to reinforce having made a choice.
Offer Choices (cont.)For older infants, I would provideclass wide choice board.For example, I would provide a boardof activity pockets for where childrencan make choice for toys, pictures, orfood etc. I will show the choice boardthen older infant can choose may befavourite toys to play or can choosemilk bottle if he/she is hungry etc.
Offer Choices (cont.) Song Boards Example: For Najia and other children I would find props or pictures that correspond to a few favourite songs. I will make a board with name of the songs represented on the board then I will ask “Do you want Twinkle Twinkle Little Star or Eensy Weensy Spider. I will allow Najia to make a choice through eye gaze, pointing or gesturing. Other children can indicate song by pointing or saying. When song is finished I will put away the prop or picture.
Some Other Examples of StrategiesExamples would include the following strategies: Use responsive talk. Use shorter sentences and decreased vocabulary. Exaggerate the pitch and intonation of your voice. Direct your communication at the infant or toddler. Use longer pauses between words and utterances. Frequently repeat words. Don’t be afraid to be redundant—for example, say, “A bird—a blue bird,” repeating the word bird. Elongate the vowels in words (“Oooh, whaaaat is that?”). Use diminutive words (blanky, piggy, doggy). Use frequent paraphrasing or recasting of previous utterances (toddler says “We go” and parent recasts by saying “Yes, we’re going”). Talk about what is immediately present. Use frequent phrases and parts of sentences in isolation (“in the car”). Use questions and attempts to elicit speech. Label words—nouns and actions—in context.
Changes in the physical environment For physical environment, I would develop curriculum based on the needs of children and focusing as a larger group in the room that meet the needs of all visual, auditory, and kinaesthetic learner. For example, using visual pictures would be better choice for developmental delay, speech delay, cognitive delay and autism etc. To meet the auditory learner’s needs, I would increase the use of audio and video material in the centre. I would also provide real material for hands on experiences and sensory experiences for kinaesthetic learners and other special needs learners..
Changes in the teaching strategies For meeting the needs of special needs child, I would provide extra time to respond. I would not be in a rush, I would wait and observe the child’s behaviour and response. In addition, I would arrange practice sessions for speaking practice. During these sessions, I would start sentence and encourage the child to complete the sentence.
Resource No.1 Overview of Collage Therapies“Collage Paediatric Therapy is ateam ofspeech-language, pathologists,psychologists,occupational therapists,physical therapists andbehaviour specialists who worktogether in a practice and focusedexclusively on children.Collage offers the convenience ofback-to-back therapy appointmentswith different clinicians in the samecentre. In order to achieve the bestpossible results, Collage centres alsoprovide parents and teachers withthe resources to help the child Find out more about Collage byintegrate their newly learned skills in visitingthe home and in school. Theyprovide full support to families, givingthem the time they need to discuss Collage Therapies Websitetheir child’s specific situation andanswering any questions they mayhave”.
Collage’s Services They like to serve as many people as it possible. There is no limit of population whom they serve. Assessments/Evaluation Treatments Tips for an Effective Treatment Program Offsite Services-In Home services, In school services Services for adults
Availability In home services are available for children to learn and engage in their own environment. In school services, the therapists are available to do therapies in school either for an individual child at the request of parents or for a group of children if contracted by the school.
Therapists The following therapists provide services at collage’s Mississauga centre: Speech-Language Therapy Jessica Mason, Aviva Bauer, Shani Lantos, Katherine Kovler, Andrea Tsang Occupational Therapy Barri Trager Psychology Lena Solomon
Cost Families meeting household income requirements may qualify for funding from certain charitable foundations. Alternatively, payment plans are available from their financing partners where balances can be paid out over 6 months, 1, 2, 3, 4 or 5 years.
LocationThe centre is located at: 1100 Central Parkway West, Unit 4, Suite 100 Mississauga , ON L5C 4E5 Tel (905 ) 402-3122 Fax (905) 402-3124
Resouce No.2 Overview of CASLPA, Speechandhearing.ca About CASLPA “With more than 6,000 members, the Canadian Association of Speech- Language Pathologists and Audiologists (CASLPA) is the only national body that supports and represents the professional needs of speech-language pathologists, audiologists and supportive personnel inclusively within one organization. Through this support, CASLPA champions the needs of people with communications disorders.” CASLPA is confident that their program’s guidelines will shed light on APD and help ensure that this disorder is managed in a consistent Find out more by visiting way across Canada. CASLPAs website.
Speech and hearing’s Services Speech-language pathologists are involved in a number of different activities to promote effective communication and swallowing for the individuals they serve. These activities may include: Assessment of communication and swallowing disorders Intervention for communication and swallowing disorders Education and supervision Consultation Research Youtube video-APD
Availability Speech-language pathologists may work directly with clients, and/or with their caregivers or other persons who regularly interact with them (e.g. friends, relatives, professionals, colleagues, supportive personnel etc.), for the purpose of creating environments that promote optimal communication and swallowing. Branches for Speech-Language Pathologists and Audiologists are available in all provinces and big cities of Canada. Visit for more information about Availability
TherapistsTherapists Cost: Cost is not mentioned on the website. For further information about APD, cost, or to schedule an appointment, contact an audiologist.
Location The centre is located at: Ontario Association of Speech-Language Pathologists and Audiologists (OSLA)President: Shanda Hunter-Trottier Executive Director: Mary Cook 410 Jarvis Street Toronto, ON M4Y 2G6 Tel: (416) 920-3676 or 1-800-718-6752 Fax: (416) 920-6214 Email: email@example.com www.osla.on.caCollege of Audiologists and Speech-Lanaguage Pathologists of Ontario (CASLPO) 3080 Yonge Street, Suite 5060 Toronto ON M4N 3N1 Tel: (416) 975-5347 or 1-800-993-9459 Fax: (416) 975-8394 Email: firstname.lastname@example.org
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Bibliography http://www.connectability.com/ http://www.speechandhearing.ca/en/find-a-professional/find-a-professional-search-form/ ww.hanen.org http://www.chs.ca/ http://www.collagetherapies.ca/en/our-approach http://www.parentbooks.ca/ http://autism.about.com/od/SymptomsofAutism/f/Early-Symptoms-Of-Autism-Include-No- Babbling-Or-Pointing.htm http://www.webmd.com/brain/autism/autism-symptoms http://www.keepkidshealthy.com/growthcharts/ http://family-alliance.com/ http://www.abilityonline.org/ http://cltoronto.ca/ http://www.pwd-online.gc.ca/p.6dh.4m.2@.jsp?lang=eng http://www.youtube.com/watch?v=0gkGYP4fgMs http://www.youtube.com/watch?v=OFojO-ot5Ok http://www.youtube.com/watch?v=NbZhcyXfaNo Ages/stages Birth to 12 years (Connectability-Visual Communication Workshop, class notes, week 8). Assingment Package, (Unit four: Facilitating communication and social skills, pg 2of2) Class notes (using signs & gestures in the classroom, class notes, week 8). Using signs & gestures in the classroom, class notes, week 8 Twenty Questions, class notes, week 8 Inclusion of children with special needs, assignment package, class notes