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January 5, 2009
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The Education of Children with Neuromuscular Disease:
A Guide for Teachers and Parents

Chapter 4: Academic Equity for Children with NMD

Children with NMD, like all other children, need a variety of services to support their education. As has been stated elsewhere in this guide, all children are unique and, therefore, require different things to accomplish the same goals. All children require the least restrictive environment in school in order to attain the maximum success in academics. Children with NMD are no different in this respect.

Because all children are different, the services that are needed and provided to a child by the educational system will depend upon the specific needs of the student. While one child may need a more structured environment to succeed, for example, another child may thrive with less structure and more leeway to explore. Further, both of these children's needs may change over time. Attaining the goal of instructing all children in the educational system requires providing for all children's needs.

The needs of children with disabilities vary from child to child, just as they do with all children. Some children may need physical modifications to the school to provide wheelchair access. Others may need adaptive equipment such as a computer, adaptive computer software such as voice recognition software, books in alternative formats or adapted pencil grips to provide a level playing field. Others may use a service dog as an accommodation. In addition, some students may require adaptive teaching strategies because recent research links learning disabilities with certain neuromuscular diseases. Some children may use a combination of a wide variety of accommodations. In this chapter, both the educational needs of children with NMD and the range of possible services and modifications to address these needs will be explored.

Academic and Environmental Assessment and Accommodation

  One of the major traps educators frequently fall into is focusing on correcting or fixing the disability rather than educating the child. For example, educators frequently spend more class time working on walking, talking or reading ink-based texts than teaching the skills required for the child's grade level (i.e. math, science, grammar or literature) in a format that is accessible. (Cheu and Tyjewski, 2001; Hehir, 2002; Crescendo, 2004). As Thomas Hehir, Director of the School Leadership Program at the Harvard Graduate School of Education, notes in “Beyond Inclusion,” “Considerable evidence points to unquestioned ableist assumptions that are handicapping the education of children with disabilities and resulting in educational inequities” (March 2003). Ableism is a term used by academics and activists to describe the societal prejudices that exist towards people with disabilities. Like racism, ableism frequently affects the way a child with a disability is (or isn't) taught within the educational setting. Just as, historically, the educational system had lowered expectations of children of color, children with disabilities are frequently provided fewer opportunities due to prejudicial views held by educators (Hehir, 2002). If educating the child is the goal, then encouraging the student with a disability to use the skills and modes of expression that are the most effective and efficient for the child will produce a more well- educated child. For example, promoting rather than discouraging, the use of adaptive technology (computers, spell check or books on tape) and alternative forms of learning and communication (oral examinations, multimedia reports, sign language or computer technology), while teaching the student the age appropriate material, will give the student the opportunity to perform up to his or her potential.

As stated in Chapter 2, each child's individual needs will be assessed and documented through the IEP team process or through a 504 Accommodation Plan. As with many disabilities, neuromuscular disabilities present a wide range of possible educational needs. Therefore, an individualized assessment will be useful in the development of an appropriate educational plan. Educational assessments can include testing in the areas of achievement, intelligence, communication, social-emotional development, self-help or adaptive behavior, and fine and gross motor skills. The identification of a child's unique strengths during this process will be an important element in the assessment of, as well as in the identification of educational needs. By identifying the strengths as well as the needs of a child, educators are better equipped to support the child's educational process.

As stated previously, children with NMD are usually educated in regular (mainstream) classrooms with accommodations and/or support services, such as occupational therapy and/or adapted physical education. Some accommodations that may be part of a child's IEP/504 Accommodation Plan may include: 1. Providing extra time to complete assignments, homework and/or exams, 2. Using a multimedia approach to learning, 3. Stating behavioral and/or learning expectations before starting a lesson, 4. Providing reading materials in alternative formats, 5. Providing adaptive computer hardware and/or software, and/or 6. Making the facility wheelchair accessible. As stated before, each child is unique and some may need all of these accommodation and others may only need a few. Many of these accommodations have been shown to benefit children both with and without disabilities, such as utilizing a multimedia approach to learning. Therefore, an accommodation, that is provided because one child in the classroom needs it, may actually contribute to the educational growth of the entire class.

Text Box: Types of Educational Placements  •	Regular (mainstream) Classroom with Modification  Regular classroom curriculum and placement on a full time basis with modifications and accommodations to address individual needs.  •	Resource Specialist Program (RSP)  Small group instruction for a portion of the child's school day with a special education teacher – an educator specializing in teaching children with disabilities.  •	Special Day Class (SDC)  Instruction, either full or part time, in a small self-contained classroom with children having different disabilities.  The class is taught by a special education teacher who is helped by an instructional assistant.  •	Orthopedic Disabilities Special Day Class (ODSDC)  Sometimes still referred to as OH, or Orthopedically Handicapped,  Special day classes of this nature are small self-contained classrooms comprised strictly of children with orthopedic disabilities (mobility impairments).  It is taught by a special education teacher who specialized in teaching children with orthopedic disabilities.  •	Home Instruction  Child receives instruction at home under the parents' supervision with coordinated by a home instructor from the school district who will oversee the program and meet with parents and child weekly.  •	Residential School  Residential schools are, traditionally, state schools for the blind or deaf and currently, primarily serve children with multiple disabilities that are considered severe.

The goal in assessment and provision of accommodations is to provide the child with the least restrictive environment in which to obtain the academic skills the child needs to succeed in life. Therefore, children with NMDs and other disabilities should be encouraged to use the skills and techniques that work best for them. In this way, the child's abilities are being accentuated and she or he will be more inclined to succeed because they are being included within the classroom.

Valuing Diversity: Inclusive Learning

This section discusses types of programming that will promote inclusion within the classroom. How a school system functions profoundly impacts how children are educated. Many schools today are incorporating diversity components into their curricula. Other schools are creating what are known as inclusive school communities (Stainbeck and Stainbeck, 1992). Both types of programming have been shown to increase opportunities for all children to develop self-esteem, accept diverse groups of people, and thrive both academically and socially.

These goals are attained through a commitment to the valuation of diversity and difference that is an integral part of the child's education. Children learn about diversity and its value throughout the curriculum. For example, while teaching a component on health and the human body, a discussion of different body types could be included that helps children understand that diverse body shapes can all be “healthy.” Or, a discussion of a historical event might include several different perspectives of that one event (for example, the revolutionary war as seen by the revolutionaries, by the British, and by Native Americans). In this way, children are learning multiple skills at one time. They are learning in health class, for example, how to be healthy and that looking different is normal. This in turn provides the child with the building blocks of self-esteem related to body image and promotes the acceptance of different types of bodies as normal. Providing different perspectives on the same event in history not only teaches the child about the event, but also instills the idea that different people can see the same event in very different ways. This, again, promotes the acceptance of different opinions and cultures as a normal part of human existence.

By encouraging the valuation of differences, educators can offer an opportunity for children to learn more while covering the required curriculum. Although disability and other types of cultural awareness programming can be taught separately during a Disability Awareness Week or by studying African American literature and history during Black History Month, segregating it from the core curriculum sends a specific message to the students that diversity is not an integral and important part of society. As is discussed in the following chapter, these subtle messages tell children that it is acceptable to segregate peers who are different from the norm. By incorporating diversity programming into the curriculum, educators not only provide children with a well-rounded education, but also communicate the normalcy of diversity in everyday life.

Text Box: Disability Awareness Programs  Disability awareness programs often include several adults or young adults with disabilities who talk about their experiences as disabled people and can offer creative and fun ways for children to learn about disabilities.  An awareness plan may include:  o	Information about particular disabilities  o	Age appropriate literature that has characters with disabilities  o	Guest speakers with disabilities  o	Diversity programming that shows how people are alike and different as general concepts  o	Offers discussions of proper use of adaptive technology, service animals, etc.

This type of teaching values difference. However, many of these programs also recognize and respect the fact that people learn in different ways and that a one-size-fits-all approach to education does not provide the best education for all people. As a result, instruction is provided in a way that meets the needs of each student. This can be done in several ways. For example, an educator might use text, pictures, and hands-on material to help students learn multiplication tables. A multimedia approach to educating, like the one suggested above, repeats the information in several different formats. This not only reinforces the lesson, but also offers several different ways to learn the same information. Another example is reading along silently while someone else reads aloud. Because they have been given different approaches to receiving the same content more children learn the material. This method of teaching keeps the material fresh and interesting for all members of the classroom, while providing accommodations for those who need them. Although training and professional development may be needed to implement this type of classroom environment, the increased educational and psychosocial opportunities for all children make this a cost effective tool to increase excellence in education.

Accommodations that Promote Success in School

The child's unique learning profile will determine the types of modifications needed and these should be spelled out in the IEP or 504 Accommodation Plan. The following is a more detailed explanation of the kinds of alterations that may be required. As stated previously, every child is different and while some of the following accommodations may work for a particular student, other adaptations will not.

Physical Environment

The physical environment may need to be modified to allow the child access to the classroom, playground, or other areas in the school. Accessibility is critical when providing each child with an equal opportunity to learn and develop. Ramps may need to be installed in the school, as well as the widening of doorways to allow wheelchair access, and the modification of door handles to allow someone with limited use of their hands to open them independently. Adapted equipment may also need to be installed in bathrooms such as grab bars for transferring, wheelchair accessible sinks, and the lowering of paper towel and soap dispensers. Prior to the start of school, someone trained in making public spaces accessible can help identify the changes that need to be made at the school to allow access for the child and bring the school up to code. The school district will be responsible for seeing that the recommendations are followed so as to provide physical access and fulfill the legal mandate.

Classrooms should also be arranged to promote physical access and independence. An important first step in promoting independence for children who use wheelchairs includes changing desks and tabletops to appropriate heights. Other classroom modifications that may be needed include arranging desks in the classroom so that the child in a wheelchair can move about the classroom without difficulty; adaptive seats for children who need additional support in order to sit for long periods in a chair; and/or making science lab equipment (e.g. sinks or workstations) wheelchair accessible.

Medical and Health Issues

Children with NMD may also experience health difficulties as a result of muscular deterioration. Respiratory complications may occur because of poor upper body support, and chewing and swallowing problems may occur in some types of NMD. Some children may require suctioning during the school day to prevent respiratory infection or they may have specialized needs when eating.

When a child has medical or health needs which require specialized physical health care services, a credentialed school nurse or other qualified, designated school employee can providea complete evaluation of the child's needs. Collaboration and consultation with the child's physician will be a critical

Text Box: Types of Designated Instructional Services (DIS)    •	 Speech and Language Therapy  	  A credentialed practitioner provides speech therapy.  His or her job is to assist the child in improving his or her speech and language skills.  •	 Psychological Services  	  Counseling and consultation provided by a credentialed school psychologist to address the mental health needs of students.  •	 Occupational Therapy (OT)  	  A trained professional provides OT to assist the child's development of functional skills to adapt to their physical disability.  •	 Physical Therapy (PT)  	  A trained professional provides PT to assist the child's development of gross motor skills (i.e. large muscle movements) and ambulation.  •	 Adaptive Physical Education (Adaptive PE)  	  A physical education instructor who specializes in Adaptive PE teaches the child various sports and recreational activities such as goal ball, wheelchair basketball, and track and field.  •	 Health Services  	  Health services are medical and personal care needs that are provided by the school nurse, a trained technician, or a care attendant.  These types of services may include such things as  assistance when eating, catheterization, giving child prescribed medication, and other personal care or medical needs the child either cannot or should not provide for themselves.  •	 Instructional Assistant/Care Attendant  	  A part or full time aide who assists the child in participating in educational activities (i.e. note taker or reader) in the regular (mainstream) classroom, and/or a care attendant who assists with physical care needs (i.e. helping with transfers in and out of the wheelchair or assisting with personal care needs).

Collaboration and consultation with the child's physician will be a critical part of the assessment. Following this appraisal, a care plan will then be developed, which then becomes a part of either the 504 Accommodation Plan or IEP. The school nurse and/or other appropriate staff may need training to provide this type of support so that the child's education, health, and well being will not suffer.

Other environmental precautions may also be needed due to the increased susceptibility of children with NMD to health risks. Some children with NMD have immune systems that put the child at greater risk for disease and infection; therefore, necessary precautions include frequent hand washing by the child, teacher, and classmates, as well as the use of protective gloves when administering anything orally. Again, if this protocol is needed, it should be a part of the child's IEP or 504 Accommodation Plan.

In addition to a specific care plan for the child regarding medical interventions, children with NMD may also need curriculum modifications in their 504 Accommodation Plan or IEP to accommodate frequent or prolonged absences from school because of illness or surgery. Parents and teachers will need to communicate frequently when the child's health needs change and result in absences. This may be done in a variety of ways, some of which have been discussed in the previous chapter.

Learning Disabilities

Students with and without physical impairments have learning disabilities. However, certain cognitive disabilities have been linked with specific neuromuscular diseases, particularly Duchenne muscular dystrophy (DMD). Although these issues have not been fully explored by researchers, enough information exists to confirm that children with neuromuscular diseases frequently have learning disabilities, cognitive impairments, and some behavioral problems. As a result, if children show evidence of any educational problems, or have a physical disability that is associated with a cognitive impairment, parents should arrange for an evaluation by a developmental neuropsychologist. These learning disabilities usually can be improved through special instruction in a mainstream classroom. Further, having a particular neuromuscular disease that has been associated with a cognitive impairment does not necessarily mean that every individual with that disease will have a learning disability. The research only indicates that these students are at an increased risk for cognitive deficits, and thus should be evaluated if any learning problems develop.

There are a number of traits that identify a student with a cognitive impairment. For example, if a child appears to have problems with schoolwork, cannot focus or complete tasks, or has difficulty making friends, he or she may have a learning disability. Often, despite dedicated work in school, the student will seem to make no progress or will act frustrated with certain material. For instance, “Jake,” a boy with DMD, could not read his third grade texts, but could comprehend the material when his parents read the books to him. Also, he had auditory processing problems, which kept him from remembering more than a few directions at once. His parents learned to write longer lists of instructions, instead of directing him verbally. Individuals may have difficulties with many subjects depending on the disability, including English or math. If an evaluation shows that a student has a problem, the teacher can adopt specific strategies to help the child learn. First, the evaluation should show the specific issues a child has, and what the professional developmental psychologist believes to be the best aproach to improve the student's education. The IEP should include information about this recently observed cognitive impairment and parents and educators may want to hold a conference to decide what action to take. This program might also incorporate specific instructions for the educators of the child, such as using multi-modal strategies or lecture notes. If possible, children should remain in a mainstream classroom with their peers.

In particular, recent studies associate DMD with specific cognitive impairments. Other neuromuscular diseases also may be correlated with learning disabilities, but the most comprehensive research focuses on DMD. Scientists have discovered that people with this impairment have an average IQ of around 80, but individual scores range from very low to very high. However, the IQ scores do not represent global learning issues, and for many individuals with DMD, does not appear to affect the brain at all. Children with DMD are born without the protein dystrophin in their tissues, including in their muscles and brains. Our brains normally process words as phonemes, or clusters of sounds. However, in children with DMD, a higher proportion of individuals process verbal information differently, or not as well. Consequently, approximately one-third of students with this disability display signs of cognitive impairment that influence IQ scores, specifically affecting their short-term memory, reading comprehension, ability to process verbal data, and occasionally their emotional state. The most significant and common issue for these individuals consists of problems with verbal short-term memory, which can cause difficulties in many aspects of education. For instance, a child with DMD may have difficulty remembering and following long verbal instructions, learning new vocabulary, and comprehending texts. Also, when the individual experiences phonological processing deficits, and thus cannot discriminate and process speech sounds as well, he or she often has a problem reading. These issues resemble dyslexia, a learning disability where a student struggles to differentiate speech sounds, and attention deficit disorder (ADHD), a behavioral problem that includes hyperactivity and distractibility. Younger children often experience greater difficulties related to these cognitive impairments because of the importance of early verbal development, but can improve with the aid of teachers. In addition, the absence of dystrophin affects emotional interactions in some children, described as emotional immaturity or a lack of connectedness with others. However, educators can also assist with this issue.

Other neuromuscular diseases have also been connected with learning disabilities. For example, research connects some children with hereditary motor sensory neuropathy and hereditary spinal cerebellar ataxia to a specific cognitive impairment. Although intelligence test scores were normal, detailed examinations showed that these individuals have problems with spatial construction. Students with facioscapulohumeral dystrophy and limb-girdle syndrome also appear to have some type of learning disability, but studies have not determined the specific nature of this impairment. However, not all individuals will exhibit any of these deficits, and others will be affected in different ways. Further, other neuromuscular diseases such as Becker's muscular dystrophy and spinal muscular atrophy do not seem to be linked with any specific learning disabilities. In addition, children may have learning disabilities or behavioral problems unrelated to neuromuscular diseases.

Parents and educators should adapt their approaches to teaching and giving instructions if a student in their class has a learning disability. For example, teachers could shorten and simplify verbal instructions, and write information on handouts or on a blackboard when lecturing. The instructor may also wish to repeat statements, particularly if they included a large amount of information. This will help children who have problems remembering verbal information understand and remember instructions and facts. All students will also benefit from multi-modal techniques of imparting data, such as combining audio, visual, and tactile forms of information. School texts recorded on cassette tapes or compact disks may assist individuals who have difficulty comprehending written material as well as verbal material. In addition, instructors might place children who cannot focus as well as others in the front of the classroom, where the instructor can pay greater attention to the student and he / she can concentrate more easily. Those with short-term memory problems or issues related to ADHD should keep a written daily assignment planner, and learn organizational techniques. Teachers should consider restructuring any lessons or educational strategies (e.g. testing, long lectures or lengthy reading assignments), that might prove more difficult for individuals with these learning disabilities. However, the educator should not make lessons less challenging for the student. Instead, the goal of these adaptations should be to allow the child to learn in the best environment possible for him or her. Most importantly, both teachers and parents must remember that, although many children with DMD possess these disabilities, they do so to varying degrees, and some may not be affected at all. As a result, every student should be treated as an individual, not as someone with a potential learning impairment.

Curriculum

Modification to classroom instruction and curriculum is perhaps one of the most critical forms of adaptation, and is performed to promote independence and the opportunity for success within the classroom. The classroom teacher can adapt or change activities so that students with disabilities can successfully participate in the curriculum. One way of modifying instruction is through the use of cooperative learning groups.

Cooperative learning structures can facilitate learning while, at the same time, promoting a supportive social network with classmates. In addition, specific modifications to materials and curriculum can increase achievement and completion of work. Children with NMD who may become fatigued faster than other students or who have difficulty sustaining attention for long periods may need shorter assignments or extended time to complete assignments so that breaks can be taken. The goal of the learning activity will be the same for all students; however, the outcome or product may be altered for those with disabilities by reducing the amount of written work, by providing more time to get the same amount of work done or by providing additional organizational support. For example, an outline of the topic to be written about might be given to the student in advance to help facilitate the completion of the assignment in a timely fashion.

Providing alternate methods for students to demonstrate an understanding of a concept can also facilitate learning. There are many ways to adapt instruction to meet the needs of individual students. For example, some alternate approaches that can be used to allow students to demonstrate their skills and knowledge include assigning team projects, oral reports, and/or computer-assisted learning assignments. The acquisition of the specific skill or knowledge should remain the goal, while the assignment may provide an alternative way of acquiring and assessing those abilities of the disabled student.

Expectations

Often, teachers and parents are unsure of when to challenge their child and how to do it. For a student with NMD, fatigue can play a role in academic output, and there may be times that the child will make more or less progress in the curriculum depending on the course of his / her muscular dystrophy. This fluctuation in performance can be confusing to both parents and educators. A child who is fatigued may be inaccurately perceived as not trying hard enough or being lazy. It will be important to evaluate which times of day the child is most alert and able to do academic tasks, as well as when the student needs a break. Keeping a record of when a child is normally more alert may help in determining when a student is more receptive to the education process.

There are several ways in which teachers and parents can evaluate a child's progress and develop appropriate methods for achieving expected outcomes. The use of an academic portfolio can provide concrete and specific examples of a child's development. In addition, frequent and more informal assessments of the child's improvement can provide the teachers with information about how the child is functioning in the classroom and curriculum. These types of informal assessments have also been found to be beneficial to children without disabilities, because they provide children with concrete examples of their continuous progress acquiring skills, which can boost their self-esteem. They can also be used as a kind of early warning system to show when a child may be developing problems in a particular area. In this way, educators will have the opportunity to help the child before he/she becomes discouraged.

Assistive Devices

Adaptive equipment and assistive technology can have a profound impact on a student's functioning in the classroom. Recent advances in technology, especially in the area of computer technology, have promoted independence for many individuals with disabilities. The well known physicist, Stephen Hawking, is one example of an individual with NMD who uses an augmentative computer communication system that allows him to communicate and be successful in his chosen profession. If needed, funding is available for children with disabilities, such as NMD, to attain this type of equipment. Therefore, every child with NMD who may benefit from technology should be assessed.

The goal of assistive technology is to promote access to the curriculum and school environment, as well as to increase independence. Areas to consider for assistive technology include: communication, mobility, self-help, and activities of daily living, fine and gross motor skills, as well as cognitive or learning requirements. When the IEP team determines a need, a referral to a qualified assessor can be made to gather important information about the child's assistive technology needs.

Assistive technology experts can help the teacher, parents, and child find ways to promote learning in the classroom. Assistive devices can include simple modifications, such as a calculator, an adaptive spoon or other eating utensil to promote independence in feeding, or an adaptive pencil grip which can reduce fatigue when writing. They can also be very high-tech such as computerized speech technology. Additional devices might include: an adaptive switch to help the student turn on and off electrical equipment; a voice activated or modified computer to assist in communication and in written work (e.g. Dragon Naturally Speaking or Scan Read ); software programs which promote organization and achievement and facilitate written effort (e.g. WYNN Wizard or Quick Fire ); and physical equipment, such as a hand rail, a manual or power wheelchair, an adaptive chair or desk, and even adaptive play equipment, such as a powered mobility toy. Again, each child will be different. While Dragon Naturally Speaking , for example, may work for one child, it may not work at all for another. This is why assessments should always be done in collaboration with the child.

When choosing assistive technology devices, it is important to include the student in the evaluation and decision making process. In addition, it may help to offer choices and opportunities to "test drive" or try out the device to evaluate how useful it may or may not be to the student. Although not all manufacturers of adaptive technology allow sampling of the product, many will provide a sample if asked. Trying out a variety of equipment and devices allows teachers and students to find the best "match" for the child's specific educational needs. Once a decision has been made, the piece of equipment can become a part of the child's educational tools just as pencils and books are scholastic tools. Keep in mind, the teachers, parents, and student will need to be trained in the proper operation of the technology. For example, teachers and staff will need instruction on the appropriate use and care of the child's wheelchair. Instruction on the proper use, care, and safety measures of a particular piece of technology may be given by the student, the parents, a school staff member or by an outside training person (such as an assistive technology expert or durable medical equipment provider).

Physical Education

Physical education, (PE), is often a daily educational activity in elementary school. Children with motor difficulties will frequently need modifications and assistance when participating in a PE program. Alternative activities can be provided to the student when involvement in the PE activity for that day is not appropriate. Some students may have a doctor's exemption from the PE requirements, if participation is not possible due to health reasons. However, many students with NMD will be able to join with accommodation, such as giving them a non-physically demanding role like scorekeeper. Other students may be able to participate in the activity, but with modified equipment or an alternative way of contributing. For example, when playing baseball the child with NMD may be able to hit the ball on a stand and maneuver her/his wheelchair to the bases. Adapted PE teachers can consult with the child's classroom teacher or PE teacher and can provide direct instruction to the child with a physical disability. As in most instances, an important step consists of including the student in the planning and decision making process concerning physical education activities. It is critical that the child has an opportunity to participate and be a part of the activity in any manner possible. Brainstorming ways to adapt the activity and include the child should be an ongoing part of the educational process.

Peer Support

Peers can provide social support and assist in specific ways in the classroom. Peer encouragement can offer a cultural/social means of help to students both with and without disabilities. For example, new students with and without disabilities often need help adjusting to a new classroom and school and can benefit from other students' assistance. This form of support offers students an opportunity to help others and provide social support to them. Students with and without disabilities should be encouraged to be a part of the peer support team. By being both a recipient and a giver of aid, students learn the value of cooperation and social responsibility.

Teachers can play an important role by encouraging appropriate peer support. For example, the teacher may split the class into teams that have to utilize their collective skills in order to complete a task or to win a learning game. When classrooms view peer support as a “norm” or a natural part of the classroom experience, helping others becomes a normal part of the day. For example, peers can assist in getting materials that are difficult for other students to reach or they can help another student learn a concept that individual is having a hard time grasping. Educators can also use this approach to create collaborative learning projects for the class that utilize cooperative efforts for completion. In this way, the instructor can encourage socialization, cooperative learning, networking, and social responsibility amongst the students.

Conclusion

Children may need a variety of support approaches during the educational process. Every child needs the least restrictive environment in order to succeed in an academic setting. Children with disabilities are no different. Some may need many accommodations to equalize the playing field, while others may need very few. By focusing upon the goal of educating every child, while assessing the individual needs of each child, all children are served better and have an equal opportunity at an equal education.

_______________________________________________________________________________________________________________________________

 

Appendix A

Example of an Individual Education Plan

  INDIVIDUAL EDUCATION PLAN

Student: Joey Cartwright IEP

Meeting Date: September 1, 1998

Address: 1234 Starbright Lane

Purpose of IEP: Initial placement

Phone: (555) 555-5555 Grade: 4 Age: 9

Birth Date: December 4, 1989

Teacher: Ann Rose

Parent/Guardian: Jill & John

School: Eisenhower Elementary Cartwright

Team Members Present:

Jill & John Cartwright Parents

Mrs. Rose Teacher

Mrs. Fuentes Principal

Mrs. Johnson Resource Specialist Teacher

Mr. Allen Adaptive P.E. Teacher

Mrs. Holden School Psychologist

Joey Cartwright Student

Educational Services/Instructional Individual Responsible for the Service Placement

Regular (mainstream) education classroom 90% Classroom teacher

Resource Specialist Services RSP teacher

Consultation to classroom 10%

Adaptive Physical Education A.P.E. teacher

Date services will begin : Duration of services:

September 1, 1998 One year.

  Instructional minutes: Time in the regular (mainstream) education program:

300 school day minutes 270 minutes in regular (mainstream) education

Justification for the educational placement: William has benefited from participation in the regular (mainstream) curriculum. Consultation from R.S.P. with regular (mainstream) classroom modification was determined to be the most appropriate and least restrictive program for William.

 

PARENT/GUARDIAN APPROVAL (INITIAL AND SIGN BELOW):

____ I have participated in the development of the IEP, received a Parent's Rights copy, and had my rights as a parent/guardian explained to me.

____ I consent to my child's participation in the Special Education program and/or related services.

____ I do not consent to my child's participation in the Special Education program.

____ I consent to all components of the Individualized Education Program with the exceptions noted (attached). I understand those components that I consent to may be implemented so as not to delay provision of services to my child.

____ I consent to my child's dismissal from Special Education.

____ I understand that my child does not qualify for Special Education at this time.

 

 

Signature: __________________________ Date: ________

 

 

Signature: __________________________ Date: ________

_________________________________________________________________________________________________________________

 

Current Level of Educational Functioning

Annual Goals

Instructional Objectives

Measured by:

Motor/Physical Education

Strengths:

1. Can throw a ball five feet
2. Independent with wheelchair
3. Plays wheelchair basketball

Needs:

1. Develop skills in team sports in adaptive P.E. and extracurricular activities

 

1. Participate in team sports during P.E.
and extracurricular activities weekly.

 

 

 

1. Hit a ball with an adapted bat and T during softball games in P.E. and extracurricular sports.

2. Independently negotiate
bases during a softball game.

 

 

 

1. Adaptive P.E. teacher will observe during P.E. team sports and evaluate use of adaptive bat and T and ability to negotiate bases during a softball game.

Reading

Strengths:

1. Can read 3rd grade text well.
2. Can answer main idea comprehension questions at 3rd grade level.

Needs:

1. Weak phonological skills.
2. Weak reading word vocabulary.
3. Weak 4th grade reading comprehension.

 

1. William will read beginning 4th grade materials with fluency.

2. William will comprehend beginning 4th grade reading materials.

 

1. Given a word followed by a series of four words, William will select the word that rhymes with the first word given.

2. Given a list of non-sense words, William will visually and auditorially blend the letters by reading the words they make.

3. When given a list of 50 sight words at the beginning 4th grade level, William will read the words correctly 9 out of 10 times.

 

1. Resource specialist will evaluate rhyming skills, phonological skills, and sight words using the Woodcock Johnson Revised and the Rhyming Phonological Awareness Assessment Measure.

 

Current Level of Educational Functioning

Annual Goals

Instructional Objectives

Measured by:

Written Language

Strengths:

1. Uses computer skills to write book reports.
2. Writes complete sentences using four words.

 

Needs:

1. Weak sentence construction and punctuation.
2. Weak skills in story writing.

 

 

1. William will write a short story with accurate sentence structure and punctuation.

 

 

1. Given a group of sentences, William will correctly punctuate with periods, question marks, comas, and capitalization.

2. Given five sentences, William will identify the nouns, verbal, and adjectives.

3. Given a subject, William will write a story containing a beginning, middle and end.

 

 

 

1. Resource specialist and classroom teacher will evaluate written language using a portfolio assessment. The Woodcock Johnson Revised will also be used to evaluate written language skills.

Current Level of Educational Functioning

Annual Goals

Instructional Objectives

Measured by:

Self-Help/Adaptive Behavior

 

Strengths:

1. Uses wheelchair for mobility independently.

2. Self-care skills are also independent.

 

Needs:

1. Transferring self from wheelchair to other chair when needed.

 

1. William will transfer from his wheelchair independently when needed

1. During toileting William will transfer partially to the toilet with assistance from the school aide. He will learn how to use the assistive devices in the bathroom to assist himself.

2. William will transfer independently to the toilet with minimal assistance from the school aide.

3. William will transfer to other types of furniture as needed with minimal assistance.

1. The occupational therapist will observe transfers and evaluate ability to use devices and assistance from others.

Social-Emotional

 

Strengths:

1. Friendly and liked by classmates.

Needs:

1. Learning how to be assertive.
2. Joining in play with other children.

1. William will develop social language skills that will increase his ability to be assertive.

1. William will ask his teacher or classmates to assist him when needed each day.

2. William will invite another student to participate in a game or to play daily.

3. When given a hypothetical situation of when he might need assistance, William will state two possible ways that he could be assertive.

1. Classroom teacher and school psychologist will observe William during school and interview him regarding ways to be assertive and ways to join in play at school.

 

___________________________________________________________________________________________________________________

 

Appendix B

Example of a 504 Accommodation Plan

504 ACCOMMODATION PLAN

 

Name: William Jones School: Martin Luther King Elementary

Birth Date: Oct. 23, 1990 Teacher: Mrs. Hanson Grade: 3rd

Age of child: 8 1/2 Disability: Becker's Muscular Dystrophy

A student study team/support team has identified both strengths and needs for William :

STRENGTHS NEEDS

Cooperative and friendly Extra time needed to complete tasks

Knowledgeable in science Math is three months behind

Smart creative thinker Reading is 8 months behind

Very adept with a computer Spends time alone during recess

Feeds the class pets Fatigues quickly during P.E.

Good sense of humor

Becomes distracted, especially when fatigued in the afternoon

William's needs have been determined by this team to significantly impact his/her learning and ability to participate in the school curriculum and activities, and therefore, this team recommends a 504 accommodation plan. The team suggests the following modifications in his/her regular (mainstream) class, lunchroom, and/or schoolyard to accommodate his/her needs.

• Provide a structured learning environment that includes:

Structure written assignments using graphic organizers and story charts. Use comprehension wheels to facilitate book report writing. Provide opportunities for frequent practice of newly learned materials. Provide frequent and specific feedback about William's progress.

• Provide the following architectural modifications for accessibility:

No structural modifications are needed at this time.

• Provide instruction in organization strategies:

Teach William study skills that will help him complete class work and homework. Provide him with a daily study schedule at home and at school with specific instructions on what work to complete for that day.

• Give the student additional time to complete assignments:

Provide William with adequate time to complete class work and homework.

• Provide the following materials/adaptive equipment to assist learning:

Provide William with access to the classroom computer for writing assignments when possible. Provide an adaptive pencil grip to help reduce fatigue when writing.

• Select modified textbooks and workbooks:

Provide William with reading materials that will challenge him and develop his reading skills.

• Tailor homework assignments:

Modify homework using a combination of team projects and homework daily progress reports. Provide William with a homework folder with the daily progress report.

• Use a one-to-one peer or cross-age tutor:

Use a cross-age tutor twice weekly during the third grade class reading time and utilize one-on-one peer reading within the classroom.

• Home-school communication:

Meet monthly to review progress and discuss further modifications. When William demonstrates adequate progress, the team meetings can take place as needed.

• Modify test delivery:

Provide William with more time to complete tests. He can take the tests in the reading room to reduce distractions.

• Use behavioral management techniques:

Provide frequent feedback to promote work completion.

• Modification of non-academic times such as lunchroom, recess, and P.E.:

Consult with adaptive P.E. teacher regarding appropriate modifications for regular (mainstream) classroom P.E. Provide William with alternative activities during P.E. when he is fatigued. Begin a science club during lunch recess for third and fourth graders twice weekly. Provide alternative games and activities during recess, such as computer games and board games.

• Adjust class schedules:

No adjustment is needed at this time.

• Other:

Provide staff with in-service on muscular dystrophy to increase awareness of this disability and provide teachers with an opportunity to learn about helpful classroom modifications.

PARTICIPANTS' SIGNATURES:

_______________________ ________________________

_______________________ ________________________


__________________________________________________________________________________________________________________________________


Appendix C

  IEP-Individual Transition Plan

 

Student's Name: Timothy Smith Date of Meeting: 01/02/02

Projected Transition Date/Graduation: 7/02/03

Team Members Present:

Mrs. Gibson – Itinerant OH Teacher Mr. And Mrs. Smith -- Parents

Mr. Ray – High School Counselor Timothy Smith -- Student

Ms. Fields – School Psychologist Mr. Hamm – Regional Center Rep.

Ms. McNeil – Dept. of Rehabilitation Mrs. Roberts – Program Specialist

Mr. Lott – Math Teacher

Long Range Plans (Desired Post-School Outcomes):

•  Instruction: Research skills on a voice activated computer and learn to use voice - activated software.

•  Community Experience: Transition to adult services—Independent Living Services to access community resources.

•  Employment: Interest in Math for College Major

•  Daily Living Skills/Functional Vocational Evaluation Activities: Teach self-advocacy for working with personal aides.

Activities to Support the Above Outcomes:

Activities

Responsible Persons

Time-line

Completion Date

1.Instructional:

Timothy will maintain college eligibility in school and will be aware of needed University requirements. Timothy will use voice activated word processor to research colleges on the internet.

Student, Family

School, Counselor

1/02 – 1/03

 

2. Community Experience:

Timothy and his family will coordinate with the Regional Center and the Dept. of Rehabilitation to secure independent living services, including personal assistants.

Student, Family, Regional Center , Dept. of Rehab.

By 18 th birthday

 

•  Development of Employment and Other Post-School Living Objectives:

Timothy will continue to pursue interests in math, and will attend the annual regional math conference. Timothy will apply to 4 year Universities.

Student, Family

Math Teacher, School, Counselor

1/02 – 5/02

 

•  Daily Living Skills/Functional Vocational:

Timothy will work with educational aides and personal aides, communicating with them effectively.

Student, Aides, Teacher, Regional Center

1/02- 1/03

 

Student Participation:

Document how student's input, interests, and preferences were obtained:

Student participated in the transition planning and shared interests and goals.

Individual rights have been provided at least one year before becoming a member of the majority age (18): yes

_________________________________________________________________________________________________________________

Appendix D

Example of a Blank 504 Accommodation Plan Form

504 ACCOMMODATION PLAN

 

Name: _______________________ School : ______________________

Birth Date: _________ Teacher: __________________ Grade: _______

A student study team/support team has identified both strengths and needs for _______________________ :

STRENGTHS NEEDS

 

 

 

 

 

_[Child's Name]____ needs have been determined by this team to significantly impact his/her learning and ability to participate in the school curriculum and activities, and therefore, this team recommends a 504 accommodation plan. The team suggests the following modifications in his/her regular (mainstream) class, lunchroom, and/or schoolyard to accommodate his/her needs.

• Provide a structured learning environment that includes:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Provide the following architectural modifications for accessibility:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Provide instruction in organization strategies:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Give the student additional time to complete assignments:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ • Provide the following materials/adaptive equipment to assist learning:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Select modified textbooks and workbooks:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Tailor homework assignments:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Use a one-to-one peer or cross-age tutor:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Home-school communication:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Modify test delivery by:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Use behavioral management techniques:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Modification of non-academic times such as lunchroom, recess, and P.E.:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ • Adjust class schedules:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Other:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

PARTICIPANTS SIGNATURES:

_____________________________________________________________________________________________________________________

Appendix E

  MAINSTREAMING CHECKLIST

•  Physical arrangement of classroom (i.e., desk and equipment placement) allows for access to materials.

•  Physical arrangement of classroom allows for access to peers.

•  Emergency plan has clear procedures for addressing the evacuation of a person with a disability (i.e. an extraction point for people who use wheelchairs that are on a floor other than ground level). The child should be made aware of these procedures so they may act appropriately during a drill.

•  Training for school staff regarding the disability, inclusion, guide/service dogs, wheelchair safety, and other health and educational issues is provided as needed.

•  Fatigue – how to identify it, how the child and teacher can recognize and communicate this need, and how to address it in the school day.

•  Share IEP information and discuss accommodations necessary for the child. Consider 504 Accommodation Plan when appropriate.

•  Consider a peer support system in the classroom (i.e. a buddy system or cross-age tutor) when appropriate.

•  Recess and lunchtime have alternative activities that the child and peers can engage in (i.e. computer games, adaptive equipment, etc.) that will promote peer interactions and the development of friendships through common interests and abilities.

•  Adaptive equipment and assistive technology needs are evaluated and requested through Low Incidence Funds via the IEP when needed to address educational goals.

•  Informal or formal conferences are scheduled on a regular basis to ensure ongoing communication and collaboration.

•  Teacher-child talks take place frequently, either informally or formally to promote communication and to give specific feedback on what is working well and what needs improvement.

•  Increase social access to peers by planning group activities, team projects and other social and educational interactions that will encourage students to form support networks.

•  Accessible transportation is provided to and from school and planned for when organizing class field trips.

•  Special Education Personnel are available to teachers and parents to share expertise and information regarding classroom modifications and adaptations.

•  Adapted physical education services are considered when necessary.

•  Curriculum modifications to consider: 1) Modifying assignments and tests so that they accomplish the same goal and accommodate for fatigue or other condition related to the disability (i.e. shortening written assignments, providing oral exams and reports, providing extra time to complete the task, etc.); 2) Utilize assistive technology such as computer writing programs, text-to-speech software, speech-to-text software, etc.); 3) Institute and encourage team or cooperative learning networks; 4) Provide and encourage frequent and specific feedback on academic work.

__________________________________________________________________________________________________________________________


Appendix F

  YEARLY TRANSITION CONFERENCE

 

UC Davis: Educational Mainstreaming and Children with a Neuromuscular Disease

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