Training Adaptations with MR Children


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Training Adaptations with MR Children

  1. 1. Training in Adaptive Skills and Functional Academics SATYANARAIN Lecturer in Special Education TTISE, YMCA Nizamuddin, New Delhi13 Email:
  2. 2. SELF HELP SKILLSMeal Time Activities :Thirst and hunger are basic physiological needs ofhuman being. Oral reflexes are present in infants duringthe time of birth. These reflexes help the child to suckand swallow. Gradually he learns to eat semi-solid andsolid food. As he grows, acceptable person in the society.So independence in eating is a self-care as well as asocial skill.In course of time , a person without disability is able toachieve this skill as a result of the opportunities given tohim in the family and the society.
  3. 3. Meal Time Activities cont...Where to start meal time activity ?Depending on the level of functioning of the child, use aappropriate checklist for assessment and find the currentlevel of functioning.(Developmental checklists-MDPS,BASIC-MR, FACP etc.)When to train ?Train the child to drink when he is thirsty.Train the child to eat when he is hungary.In case the child is not able to indicate hunger and thirst, follow a time schedule.
  4. 4. Meal Time Activities cont...4. As the child starts to indicate his / her hunger use that signal.5. If the child is able to use gestures for food, use this opportunity to train in eating and drinking.6. Gradually encourage him to indicate his hunger and thirst through gestures/words, when he is hungary and thirsty, use that time for training.7. Let the child join the family members during mealtime. Give him chances to observe the mealtime manners.8. Give him chances to eat with relatives, friends and in restaurants.9. The childs physiological need to eat and drink is the first important prerequisite for training.
  5. 5. Meal Time Activities cont...General Problems : Inability to suck and swallow.Inability to chew.Lack of finger coordination to pick up food.Lack of initiation and cooperation.Problems in digestionConstipationDoes not know how much to eat Eating non-edible items – mud, paper, chalk Spiling, spitting, vomiting.
  6. 6. Meal Time Activities cont...Possible solutions:1. Seek medical help for problems like constipation and indigestion.2. Give activities for finger coordination and arm movements to pick up food and put into mouth.3. If needed, seek the guidance of a physiotherapist for exercises for proper arm movements and finger coordination.4 . For proper sucking, and initition, after ruling our medical problems, observe the problems and use the appropriate techniques explaine.5. For developing proper mealtime habits, let the child have chances to eat with the family and to observe the manners.6. Obseve and list out the problems like eating non-edible items,piling, spitting, and overeating. Discourage him from doing such things by giving rewards for approprite behaviours.
  7. 7. Meal Time Activities cont...How to train ?1. Use the checklist. Praise the child for the items that he can do.2. Find the level to know where, when and what to train.3. Understand the problems and have practice to train one step at a time4. Use the appropriate rewards for the childs cooperation and attempts.5. Techniques in step by step trainning are exaplained in the following pages. Follow the methods during traing. If needed, modify the methods depending on the need of the child.
  8. 8. Meal Time Activities cont...Sucking and Swallowing1. A child should be able to suck and swallow quite smoothly a fewdays after.2. Sucking problems are often early sign of neurological problems. Insuch cases seek medical help.3. Proper jaw control is necessary for approprite sucking andswallowing.If a child lacks good jaw control assist him byusing your thumb, index, and middle finger to give support to thejaw.4. Positioning is important for proper sucking and swallowing. Keep the child in semi upright position in your arms.5. Selection of proper liqide is also important for teaching suckingand swallowing. Pleasant tasting and mildly sweetened juices,warm or cool but not hot or every cold can be given.6.Use nipple with regular size holes. Large holes in a nipple make a child who is retarded lazy to suck. It also causes choking if the child has difficulty in swallowing.7. A downward stroke on the childs cheek stimulate sucking8. The lip and jaw control process should be carried out before liquidfood is placed in the childs mouth. Hold the childs jaw closed andrub the chin. It stimulates swallowing
  9. 9. Meal Time Activities cont...Chewing and Swallowing1. A normal baby opens his/her mouth whilefeeding. Inability do so is a sighn of problems andindicates the need for medical treatment.2. Keep a small amount of baby food, a spoon and place iton the babys tounge, touching the bottom gums. Wait tosee whether the childs jaws close tightly. This is calledbite reflex.3.The bite reflex normally fades as the child begins to munch on foods. If the bite reflex is too strong use the following techniquues:A) Rub the gums with finger prior feeding.B) Use as a small spoon.C) Use food that encourage munching and chewing .
  10. 10. Chewing and Swallowing cont... 4. To train in chewing, place food in the babys mouth and observe. 5. If the child pushes it with the tongue, place the next spoonful in the side of the mouth.6. Help the child to start moving jaws up and down while using the tongue to mash food against the roof of his/her mouth.Pushing food out of the mouth with the tongue may be anearly reflex, and is not necessarily a rejection of food beingoffered.
  11. 11. Holding Milk Bottle1. Keep the baby up right on your lap2. Place the nipple of the bottle in his mouth, and continue to hold the bottle3. Once the baby is comfortably sucking the bottle, gently place his hand s on the bottle4. As the child holds the bottle, gradually relax your hold on the bottle.
  12. 12. Development of tongue movements1. Observe the child eating. Notice if the child moves the tongue, to touch food at the sides and the top of mouth.2. If you are notable to see tongue movements, try placing small amounts of sticky food (jam) on the roof of the childs mouth, near the front and between the cheek and gum.3. Observe the childs use of the tongue to retrive the food. If you note dificulty, during each feeding, place place his preferred food at the point of mouth, requiring action for retrieval.
  13. 13. Thank You.