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    AASSPPEERRGGEERRSSSSYYNNDDRROOMMEEFACT SHEET

    Specific type of pervasive developmental disorder characterized by problems indevelopment of social skills and behavior.

    CHARACTERISTICS

    Cognitive:

    Normal intelligence

    Use words by age 2

    Speech patterns may be different, speakrapidly

    ADD

    Obsessive Compulsive Disorder

    High IQs Speech inaccuracies

    Psychomotor:

    Coordination difficulties

    Normal fine and gross motor development

    Clumsy

    Af fective:

    Difficulty interacting with peers

    Tend to be loners

    Display eccentric behaviors

    depression

    Frustration

    Low self esteem

    ETIOLOGY AND PROGNOSIS

    Individuals with Aspergers Syndrome are high functioning and have very adaptive behaviors. Thereis limited if any social interaction amongst peers. By age 2 individuals with Aspergers have aninability to use single words or to speak in full sentences or phrases by age 3.

    With early intervention individuals with Aspergers, although diagnosed as having autism at a youngage, respond well to specific teaching strategies.

    ASSESSMENT SUGGESTIONS

    TGMD2

    Brockport Physical Fitness

    Peabody

    EFFECTIVE TEACHING STRATEGIES

    Limit amount of stimulus in thegymnasium

    Activities that encourage interaction

    Positive reinforcement

    Avoid large amount of down time

    Provide direct instruction

    Tactile directions

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    RESOURCES

    Direct parental contact

    School Psychologist

    Teacher interaction

    Cross-disciplinary teaching

    REFERENCES

    American Academy of child and Adolescent psychiatry NO. 69 September, 1999

    Block, Martin E., 1995, A teachers guide to including students with disabilities in regular physicaleducation. pgs. 27, 144-145

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    AAUUTTIISSMMFACT SHEET

    Autism is a brain disorder that impairs a persons abil ity to communicate, form relationships,socially interact, and respond appropriately within a given environment.

    CHARACTERISTICS

    May avoid eye contact

    May seam deaf

    May lack awareness of the existencefeelings of others

    Can be physically aggressive or haveoutbursts when familiar environment ishanged

    Can remain fixated on single activity or

    object

    May engage in strange actions such ashand flapping, rocking, or flicking objects

    May lick toys/objects

    May not show sensitivity to pain (burns,bruises)

    May engage in self-mutilation, such as eyegouging

    Impaired social interaction

    Impaired verbal/non-verbal communication

    Seeks sensory input (ex. Weighted vest)

    Shows repetitive interests and activities,preoccupied with certain objects

    Absence of imaginative activity

    May withdraw from people

    Abnormal response to external stimuli suchas sound and lights

    May lack appropriate play

    May be tactile defensive

    May be sensitive to touch

    CAUSE

    Research continues to determine the causes of autism. These studies are looking at various parts of thebrain and how they function compared to a typical child. Scientists have come up with some hypothesis,which include the following:

    Brain cells may migrate to the wrong place in the brain that could affect communication skills.(Parietal area of brain controls communication.)

    Scientists have found impairments of the amygdala in autistic children. The area known as theamygdala helps regulate social and emotional behavior.

    Research has found that individuals with autism may have high levels of the neurotransmitterserontonin. Since neurotransmitters are responsible for the passage of nerve impulses to the brain,these chemical differences could distort sensations in individuals with autism.

    Research will continue as to the cause of autism that could someday lead to permanent treatment and

    prevention procedures.

    ETIOLOGY

    Autism is a brain disorder that impairs a persons ability to communicate, form relationships, sociallyinteract, and respond appropriately within a given environment. Autistic symptoms must be presentbefore the age of 3. The disability can affect the individuals level of functioning in a variety of ways.Some autistic individuals may have severe cases in which they have mental retardation and seriouslanguage delays. Others may be high functioning individuals that can speak and are very intelligent.

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    The symptoms of autisticindividuals can vary; however, most people with autism share problemsassociated with social, communication, motor, and sensory issues. Autism occurs in 5-15 per 10,000children. Boys are four times more likely to get autistic symptoms (National Dissemination Center forChildren with Disabilities, 2003).

    PROGNOSIS

    Autism is a very challenging disability to solve because of many unknown factors. Since there is no curefor autism, proper procedures such as therapy must be taken to help these individuals handle theirproblems. With proper therapy sessions, autistic individuals can improve their modes of communicationand socialization to live very productive independent lifestyles in society. Autistic children with IQ scoresof 70 and above normally can live and work more productive independent lifestyles within society (GaleEncyclopedia of Psychology, 2001).

    Autism symptoms vary from mild to severe. The prognosis for these individuals depends on the severityof their disability and the level of therapy they receive. Most autistic individuals will have some sort ofimpairment of their senses throughout life. These could include: smell, taste, vision, hearing, and sensoryissues. Autistic individuals are often labeled incorrectly as loners because of their inability to sociallyinteract. Approximately 33% of children with autism will eventually develop epilepsy. The highest risk iswith children that have severe cognitive impairments and motor deficits (Turkinson, 1999).

    Autistic individuals can live very active lifestyles. They are very capable of performing most physicalactivities. This will depend on the severity of the disability. Also, an active lifestyle is more likely to helpthese individuals with weight control, muscular endurance, muscular strength, cardiovascular endurance,self-esteem, and self-confidence.

    IMPLICATIONS FOR PHYSICAL EDUCATION

    In the community, may need 1:1 supervision for child

    Use a PECS book (Picture Exchange Communication System) to allow non-verbal student choices ofphysical activities.

    Provide an initial screening process to determine students physical strengths and weaknesses. Thiswill help in writing IEP objectives and goals.

    Establish routines and smooth transitions throughout the lesson

    Modify equipment so that the student can be successful, yet challenged.

    Provide balls that will provide sensory output during activities. (ie: Knobby balls)

    Videotapes can be useful for autistic children who can follow visual cues.

    ASSESSMENT SUGGESTIONS

    STANDARDIZED ASSESSMENTS

    BROCKPORT PHYSICAL FITNESSTEST:This is a criterion-referenced test that measures physical fitness

    levels for students between 10-17 years old. . It includes tests for body composition, muscularstrength, muscular endurance, speed, power, flexibility, coordination, and cardiovascular endurance.This test could be used for an individual with autism if there were a concern with their fitness levels.

    BRUININKS-OSERETSKYTEST OF MOTOR PROFICIENCY:This is a norm-referenced test that measures anindividuals speed, agility, fine motor, hand-eye coordination, and strength for disabled studentsbetween 4.5-14.5 years old.

    TGMD-2: This test provides criteria for different locomotor and object control skills for ages 3-10.

    ICAN:This criterion and content test is for disabled children who are ambulatory. The test measuresmotor and play skills and recreation skills.

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    MOTOR ACTIVITIESTRAINING PROGRAM:SPECIAL OLYMPICS SPORTS SKILL PROGRAM: This content-referenced test is for severe handicaps of any age. The test measures striking, kicking, aquatics, andmobility.

    OHIO STATE UNIVERSITY SCALE OF INTRA GROSS MOTOR ASSESSMENT: This content and criterionreferenced test measure basic locomotor skills, balance, object-control, gymnastics, health relatedfitness and sport skills for disabled individuals between 2.5-14 years old.

    PHYSICAL BEST: This criterion and norm based test could be used for severe cases of autisticindividuals. This test measures aerobic capacity, body composition, flexibility, upper and lower bodystrength and endurance for children between 5-17 years old.

    FITNESSGRAM: This criterion-referenced test (level of mastery) tests an individuals overallwellness. This includes: body composition, cardiovascular endurance, muscular strength andendurance, and flexibility.

    AUTHENTIC ASSESSMENTS

    RUBRICS: A rubric is a authentic assessment tool which can be used for assessing students withdisabilities. In the rubric, there are various sets to each progression which have a scoring criteria andlevel of achievement. These progressions can be used to assess any locomotor and object-control

    skills. This type of assessment will tell exactly where the individual lies in terms of skill/healthdevelopment.

    Types of rubrics:1. Holistic rubric: Addresses a skill without task analyzing. This rubric is usually used for older

    population who are at the mastery level for that particular skill.2. Analytic rubric: Breaks down a skill to meet the needs of someone working on mastering a

    skill. Usually addresses younger population.3. Individual rubric: This rubric is used to meet the individual need of a child. This can be used

    to address someone with a disability whose needs must be met in a small class setting. Thisis an excellent procedure to use to meet a childs IEP goals/objectives.

    OTHER ASSESSMENT IDEAS MOTOR DEVELOPMENT CHECKLIST: This is a progressive checklist for locomotor and object-control

    skills. Each skill is broken down from simplest to most difficult. As the student performs the assignedtask, teacher will observe physical movement and check off the components of the skill that wereaccomplished.

    RECOMMENDED ACTIVITIES

    Any activity that requires vigorous activity and will improve their overall fitness levels. (flexibility,cardiovascular endurance, strength, muscular endurance)

    Walking/Hiking

    Bike riding (Type of bike will depend on ability/balance levels)

    Swimming: An excellent low impact activity that can benefit student in a variety of health-related

    ways Activities that require the use of their senses. Autistic children like deep pressure that helps them

    relax. Weighted backpacks/vest can help provide this deep pressure.

    Find out the students physical activity interests.

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    CONTRAINDICATED ACTIVITIES

    Having class in a loud and/or bright environment; providing too much stimuli within the environment.(ie: Over stimulating with too much noise/equipment (Block et al, 2003).

    Activities that require a lot of contact.

    Spending too much time on a single activity and not providing enough choices (Block et al., 2003).

    EFFECTIVE TEACHING STRATEGIES

    Pre-school-Secondary

    Use teaching stations

    Change activities regularly

    Eliminate different distractions

    Keep directions short and age-appropriate.(Limit prompts)

    Use sensory stimulation to increaseattention span

    Use smooth transitions

    Instruct in an environment were noise,smells, lights will not interfere with learning.

    Teach in less stimulating environment.

    Provide students with ear plugs/cotton ballsin noisier environment.

    Keep motivational music at low level.

    Establish predictable routines within lessons

    Create high structured environment which isorganized and predictable

    Warm-up, Activity, Closure Stations

    Use visual aids during activities

    Use vigorous aerobic exercises to keepstudent on task

    Use a consistent behavior modificationprogram

    Provide lots of practice time/repetitions.

    Show enthusiasm when teaching.

    Preschool-Elementary

    Use sticker chart as a reward system Teach students basic locomotor and objectcontrol skills.

    Middle School - Secondary

    Provide reward system that allows studentsthe opportunity to participate in enjoyableactivity.

    Teach students lead-up activities for team,individual, and cooperative activities.

    Have child perform task and draw parts of a

    picture (face) every time task is completed

    Use a peer tutor to assist child in learning.

    Teach students lifelong activities that can beused for the rest of their lives. Allow choiceswhen setting up the curriculum so they canchoose an activity that is of interest to them.

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    Positive Behavior Management Strategies

    Set realistic goals and expectations

    Increase amount of activity time, whiledecreasing instructional and transitionperiods

    Check for basic understanding to make surestudents know expectations

    Provide a structured environment withappropriate routines

    Challenge the students to keep themmotivated

    Provide a reward system for good attitudesand behavior

    Provide non-verbal feedback andencouragement with high 5s and cheering

    Be consistent and fair with your rules andconsequences

    Use proximity control if a problem is arising

    Get to know the students and show interesttoward them outside of the physicaleducation environment.

    Create a positive and enthusiasticenvironment for everyone

    Provide vigorous activities to help studentsremain on task.

    RESOURCES

    Teachers and Parents:

    Web sites: P.E. Central Project Inspire PE Links4U California Physical Education Resources www.nichcy.org www.educationworld.com www.ncpad.org www.nimh.gov http://members.aol.com www.asd.k12.ak.us

    http://ncperd.usf.edu www.americanfitness.net (Physical Best) www.educationworld.com

    Journals: Palaestra Teaching Elementary Physical Education J OPERD Strategies Adapted Physical Activity Quarterly

    Books: Principles and Methods of Adapted Physical Education and Recreation Including Students with Disabilities in General Physical Education Inclusive Games

    Organizations : AAHPERD - www.aahperd.org

    Sport: Special Olympics - www.specialolypics.org Empire State Games for the Physically Challenged - www.empirestategames.org/physical Disabled Sport USA - www.dsusa.org

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    DDEEPPRREESSSSIIOONNAANNDDEEMMOOTTIIOONNAALLDDIISSTTUURRBBAANNCCEEFACT SHEET

    DepressionA feeling of low self -esteem that adversely affects the students behavior , educat ion, and social

    relationships

    Emotional DisturbanceAn inabi li ty to learn, bui ld relationships, and maintain happ iness over a period of time that

    negatively affects academic performance

    CHARACTERISTICS

    Depressed mood most of the day, nearlyevery day

    Markedly diminished interest or pleasurein almost all activities most of the day,nearly every day

    Significant weight loss/gain Feelings of helplessness and

    hopelessness.

    Feeling useless.

    Self-hatred, constant questioning ofthoughts and actions, an overwhelmingneed for reassurance.

    Being vulnerable and "over-sensitive".

    Feeling guilty.

    Self harm.

    Difficulty with getting off to sleep or feelingtired more then usual

    Agitation and restlessness.

    Finding it impossible to concentrate forany length of time, forgetfulness.

    A sense of unreality.

    Physical aches and pains, sometimes withthe fear that you are seriously ill.

    Suicidal tendencies

    Loss of appetite

    Decline in participation of everydayactivities

    A loss of energy and motivation, thatmakes even the simplest tasks ordecisions seem difficult.

    CAUSE

    Major life changes

    Traumatic event

    Death in the family

    End of a relationship

    Failure to meet expectations

    Family problems divorce, separation,abuse

    Loss of employment their employmentor parental employment

    Financial problems

    ETIOLOGY AND PROGNOSIS

    Biological Factors

    Genetic Factors

    Psycho-social Factors

    Imbalance in neurotransmitters

    Varies depending on cause and treatmentused.

    Must be evaluated according to recoveryfrom incident and reoccurrence

    74% recovery for children after 1 year

    92% recovery for children after 2 years

    70% of children have reoccurrence within5 years

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    IMPLICATIONS FOR PHYSICAL EDUCATION

    Student might have a developmental delay

    Lack of confidence could lead to inactivity

    Student might not be social and have poor teamwork habits

    The student could be overweight or have an eating problem resulting in low energy levels

    Not able to focus on activity due to short attention span

    Does not feel like doing activity, loss of interest

    ASSESSMENT SUGGESTIONS

    Use authentic assessment

    Dont have students perform skills test in front of other students

    Grade on effort and knowledge along with skill.

    Do assessment more then once in case the student is having a badday

    RECOMMENDED ACTIVITIES

    Do skills that will bring success

    Have enjoyable activities for that individual

    Let them be the leader or the person that is IT

    Exercise continuous activities such as running, walking, biking, swimming

    Stress Management techniques

    CONTRAINDICATED ACTIVITIES

    De-emphasize competition Do not pit the students against each other

    Test in separate areas or during game play (authentic), not in front of all of the students

    EFFECTIVE TEACHING STRATEGIES

    Structure the class for success Do not set a student up for failure

    Establish class rules that are stated positively Do not be negative

    Have a set routine - not different class outline each time

    Organize and plan class for active participation by all; little waiting time

    Show same attention to all students Dont play favorites

    Base grades on different aspects of the class Not just skill level

    Use teamwork skills to help with socializing and taking eyes off of individual students

    POSITIVE BEHAVIOR MANAGEMENT

    Reward appropriate behavior

    Enforce fair and humane consequences for inappropriate behavior

    Provide students with a safe space to be alone so that they can develop skills to control theirbehavior

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    RESOURCES

    Teacher: Familiarize themselves with the National SED (Serious Emotional Disturbances) The Relationship of Self-Esteem and Depression In Adolescence:

    http://www.help4teachers.com/depression.htm Lessons for Living: http://www.lessons4living.com Stress Management: http://stress.about.com/ Mastering Stress: http://www.psywww.com/mtsite/smpage.html Teacher Notes: http://ecdc.tamucc.edu/HELP/depression/teachernotes.html

    Parent: The Depression Resource Center: http://www.healingwell.com/depression/ Have a Hearts Depression Resource: http://www.have-a-heart.com/ National Mental Health Association: http://www.nmha.org/ What to do when a friend is depressed: http://www.hoptechno.com/book34.htm Depression Chat: http://www.depressionchat.com/ Parents Guide: http://ecdc.tamucc.edu/HELP/depression/parentguide.html

    Sport: Exercise Against Depression: http://www.physsportsmed.com/issues/1998/10Oct/artal.htm

    REFERENCES

    http://www.montana.edu/wwwebm/Depression.htm

    http://www.hp.ufl.edu/~jjohnson/1

    http://www.bipolarhome.org/understanding.html

    http://www7.twu.edu/~f_huettig/fact_sheets/Emotdis.htm

    http://ecdc.tamucc.edu/HELP/default.html

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    DOWN SYNDROMEFACT SHEET

    Down syndrome, also called Trisomy 21 is the most common cause of mental retardation andmalformation in a newborn.

    CHARACTERISTICS

    Psychomotor

    Possible difficulty in walking Severe motor delays will put individual at a disadvantage Balance deficits limit motor skills Poor muscle tone Hyperflexibility Heart conditions could affect activity and fitness levels through out lifetime.

    Cognitive

    Delayed mental or social skillsAf fective

    Stubbornness and refusal to talk when not fully understanding what is expected of them or whentrying to gain control over their lives Will talk to one-self in an uncomfortable or confusing situation

    CAUSE

    Down Syndrome, also called Trisomy 21, is caused by an error in cell division called non-disjunction. Anaccident in cell development results in 47 instead of the usual 46. The extra chromosome, number 21, ispresent in all or most of Down Syndrome individuals cells. This extra 21st chromosome has an impact onpsychomotor, cognitive and language development. Two other types of chromosomal abnormalities,mosaicism and translocation, are implicated but to a much lesser extent.

    ETIOLOGY AND PROGNOSIS

    Down Syndrome is the most common cause of mental retardation and malformation in a newborn. Itoccurs because of the presence of an extra chromosome, number 21, which has an effect on thepsychomotor, cognitive and language development. Some physical characteristics Down Syndromeindividuals display are being short in stature, having short fingers, toes, limbs and neck. They also displaydistinct facial features including small skull, slanting, almond shaped eyes, flat-bridged nose and smalloral cavity which can make tongue look large and protruding. Individuals with Down Syndrome have atendency to be overweight. Future conditions for individuals with Down Syndrome include; an inability toever reach normal growth development, possibility of poor hearing, heart conditions that will affect activityand fitness levels through life, and a faster aging process with a tendency to develop diseases of aginglike Alzheimers at an early age. Also, individuals with Down Syndrome are affected by certain eyedisorders including Strabismus (crossed eyes), which affects tracking skills and binocular vision throughout life.

    IMPLICATIONS FOR PHYSICAL EDUCATION

    Some important things that may affect a students performance in P.E. include:

    visual problems

    mild to moderate hearing loss

    possible cardiovascular irregularities

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    In addition, some individuals with Down Syndrome have Atlantoaxial Instability(AAI), a condition wherethere is increased mobility between the first and second cervical vertebrae, allowing the vertebrae to slipout of alignment easily, causing damage to the spinal cord. Because there are no symptoms of AAI, it isimportant for individuals with Down Syndrome to have X-rays taken. Copies of these X-rays should begiven to the school before any participation in physical activities.(www7.twu.edu/~f_huettig/Fact_Sheets/down.htm)

    ASSESSMENT SUGGESTIONS

    BASIC MOTOR ABILITYTESTS REVISED (BMAT-R): This test is used in children ages 4-12 to evaluatemotor responses such as; eye-hand coordination, finger dexterity, hand speed, flexibility, leg power,agility, static balance, arm strength and eye-foot coordination (Test can be obtained by writing to thefollowing address: Motor Thearpy, 2nd Ed., C,V. Mosby Co., St. Louis, MO 63141).

    BROCKPORT PHYSICAL FITNESSTEST: For use in students ages 10-17. Test measures 3 components ofhealth related physical fitness; aerobic functioning, body composition and musculoskeletal function.(www.humankinetics.com)

    PEABODY DEVELOPMENTAL MOTOR SCALES: Tests motor abilities, early movement milestones andfundamental movement skills in children ages birth- 6 years 11 months. Test helps to determine if achild is delayed in skill development, determine if there is a need for intervention and plan theprogram and assess improvements.( Test kit can be obtained by writing to the following address:DML Teaching Resources, One DML Park, Allen, TX 75002).

    RECOMMENDED ACTIVITIES

    Yoga poses which help to stretch, tone and strengthen the whole body. Yoga benefits central nervoussystem and helps develop balance, body awareness, concentration and memory (www.specialyoga.com)

    CONTRAINDICATED ACTIVITIES

    Students and athletes with Down Syndrome should be restricted from participation in gymnastics, diving,the butterfly stroke in swimming, the high jump, heading in soccer, and any exercise which placespressure on the muscles of the neck.

    EFFECTIVE TEACHING STRATEGIES

    Preschool

    Teach individual in a highly structuredenvironment.

    Allow for touching and feeling to learn

    Use lighter weight equipment.

    Use smaller teaching space

    Use visual and auditory aid

    Elementary

    Allow student to make choices with someactivities to help their decision-making skills

    Keep the same routine for class structure

    Keep directions specific and brief

    Use visual and auditory aids

    Demonstrate skills

    Use lighter weight equipment.

    Breakdown the task into simple, small steps

    Use of peer partners

    Use positive behavior managementstrategies

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    EEPPIILLEEPPSSYYFACT SHEET

    According to the Epilepsy Foundat ion of America, epi lepsy is a phys ical condi tion that occurswhen there is a sudden, brief change in how the brain works. When brain cells are not working

    properly, a persons consciousness, movement, or actions may be altered for a short time. These

    physical changes are called epileptic seizures. Epilepsy affects people in all nations and of allraces, and there are about two mi llion Americans that have epilepsy. Some people can experience

    a seizure and have epilepsy. A single seizure does not mean that the person has epilepsy.

    CHARACTERISTICS

    Epilepsy is a group of symptoms caused from abnormal electrical activity in the brain which results inseizures of varying magnitude. These symptoms listed are not necessarily indicators of epilepsy, it wiseto consult a doctor if you or a person experiences one or more of them:

    Blackouts or periods of confused memory

    Episodes of staring or unexplained periods of unresponsiveness

    Involuntary movement of arms and legs

    fainting spells with incontinence or followed by excessive fatigue

    Odd sounds, distorted perceptions, episodic feelings of fear that cannot be explained

    Seizures can be generalized where all brain cells are involved. Partial are when those brain cells notworking properly are limited to one part of the brain. There are many different types of seizures. Not all ofthem involve convulsions. When naming seizures, it is important to use terms which describe what ishappening during the seizure and to avoid terms such as mild or major which do not describe theevent. A person can experience more than one type of seizure. The frequency, length and pattern ofseizures tends to be fairly constant for each person, although it may change in the longer term.

    CAUSE

    For some people seizures are triggered by certain stimuli, which may differ from one individual to another.Identifying these triggers can help to avoid situations where seizures might occur. Such triggers mayinclude: lack of sleep or fatigue, stress, alcohol, flickering lights (photosensitive), hyperventilation, growthspurts, high alkalinity of the blood, low blood sugar, constipation, excessive noise, improperly usedmedications, intense concentration, menstruation, hyperthermia, or hyperhydration.

    ETIOLOGY AND PROGNOSIS

    When naming seizures, it is important to use terms which describe what is happening during the seizureand to avoid terms such as mild or major which do not describe the event. A person can experiencemore than one type of seizure. The frequency, length and pattern of seizures tend to be fairly constant

    for each person, although it may change in the longer term.

    Partial / Focal: The seizures begin or involve one part of the brain. A persons experience duringtheir seizure will depend on which part of the brain that is being affected.

    Simple Partial / Jacksonian Focal seizures : consciousness is not impaired. The seizure may beconfined to either rhythmical twitching of one limb or part of a limb, or to unusual tastes or sensationssuch as pins and needles in a specific area. Partial seizures sometimes develop into other sorts ofseizures and so they may be referred to as a warning or aura.

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    danger, move all obstacles away from the person, keep people from crowding around, do not restrainthe person, do not place anything in their mouth, loosen any restricting clothing, observe the personthroughout seizure. Call for medical help if seizure lasts for more than 5 minutes, if one seizurefollows another, if it is the first one known, if the person has injured themselves, or has difficultybreathing.

    After : Roll the person onto their side (recovery position), wipe excess saliva away, check airway if

    breathing labored, allow the person to rest, minimize any embarrassment, stay with the person untilfully recovered, and do not give any food or beverage until fully recovered

    *Convulsi ve seizures can be frightening to observe, but remember the person is not in pain andwill no t have any memory of it. Any of these funct ions can be temporarily disturbed during thecourse of a seizure; personality, mood, memory, sensations, movement, or consciousness.

    ASSESSMENT SUGGESTIONS

    School personnel should monitor the effectiveness of the medication as well as any side effects. If achilds physical or intellectual skills seem to change, it is important to tell the doctor. Written observationsof school staff will be helpful in the discussions with the childs doctor. When a student displays or hastheir first known seizure in class, the teacher must contact the school nurse, and write down all

    information that pertains to the situation before, during, and after.

    EFFECTIVE TEACHING STRATEGIES

    Before actually setting up a strategy, check the districts medical history sheet and contact the studentsphysician, past teachers, and parents. Most parents and school staff find that a friendly conversation atthe beginning of the school year is the best way to handle the situation. Activities can improve bothmental and physical health and should be encouraged for people with epilepsy. Most individuals withepilepsy can safely exercise in a gymnasium, pursue sports and use equipment even though seizuresarent completely under control, but a buddy system may be needed. All activities should be monitoredand individually adjusted to each persons exercise tolerance and medical history. Through the use of thebuddy system and consistent use of safety equipment,(helmet, knee and elbow pads) the student canparticipate in most activities.

    These are some suggested activities which require a physicians permission or should be modified:

    water sports

    activities that place the student a few feetabove ground

    archery

    activities that have repeated blows to thehead.

    Children and youth with epilepsy must also deal with the psychological and social aspects of thecondition. These include misperceptions and fear of seizures, uncertain occurrence, loss of self controlduring the episode, and medications. To help children feel more confident about themselves and accepttheir epilepsy, there should be education programs for staff and students, including information on seizurerecognition and first aid.

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    RESOURCES

    There are many materials available for families and teachers so that they can understand how to workmost effectively as a team.

    Epilepsy Foundation: http://www.efa.org/

    SITES ON EPILEPSY Charge-The experience of Epilepsy: http://www.charge.org.uk

    Aims to promote social understanding and acceptance of this disease by demystifying the processesin the human brain which lead to seizure. Includes a bulletin board.

    Epiweb: http://www.epiweb.orgInformation for parents with children who suffer from epilepsy. Includes resources, news, links,education, treatment and a notice board.

    To Aid Someone Having A Seizure:http://www.assumption.edu/HTML/Admin/HealthServices/SEI.HTMLWhat you should do if someone has a seizure.

    SITES IN RESOURCES Childhood Epilepsy: http://www.suite101.com/welcome.cfm/childhood_epilepsy

    Informative site featuring information for parents of children with epilepsy. offers articles, helpfulwebsites, and discussions.

    Epilepsy Facts & Latest News HealthNewsflash:http://www.healthnewsflash.com/conditions/seizures_and_epilepsy.htmThis resource has a medical fact book concerning information on diagnosis and treatment ofepilepsy with the latest medical news for patients and their families.

    Epilepsy Resources on the Web: http://people.zeelandnet.nl/fhof/angelman/epilepsy.htmThe facts, links, parent support, personal stories.

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    FFEETTAALLAALLCCOOHHOOLLSSYYNNDDRROOMMEE((FFAASS))FACT SHEET

    A pattern of mental and physical defects which develop in some unborn babies when themother drinks too much alcohol during pregnancy.

    CHARACTERISTICS

    Distinct pattern of facial abnormalities, growth deficiency and evidence of central nervous systemdysfunction. Most individuals affected by alcohol exposure before birth do not have the characteristicfacial abnormalities and growth retardation identified with FAS, yet they have brain and otherimpairments that are just as significant.

    Mental retardation, individuals with FAS, ARND and ARBD may have other neurological deficits suchas poor motor skills and hand-eye coordination.

    May have a complex pattern of behavioral and learning problems, including difficulties with memory,attention and judgment. Have trouble generalizing behaviors and information Act impulsively Exhibit reduced attention span or is distractible Display fearlessness and are unresponsive to verbal cautions Demonstrate poor social judgment. Cannot handle money age-appropriately Difficulty structuring work time Show impaired rates of learning Experience poor memory Have trouble internalizing modeled behaviors

    May have differences in sensory awareness (Hypo or Hyper).

    Language Production higher than comprehension.

    Show poor problem solving strategies.

    CAUSE

    FAS is a lifelong yet completely preventable set of physical, mental and neurobehavioral birth defectscaused by alcohol consumption during pregnancy.

    FAS is the leading known cause of mental retardation and birth defects.

    ETIOLOGY AND PROGNOSIS

    Fetal Alcohol Syndrome (FAS) is a set of birth defects caused by maternal consumption of alcoholduring pregnancy. At birth, children with FAS can be recognized by growth deficiency and acharacteristic set of minor facial traits that tend to become more normal as the child matures. Lessevident at birthbut far more devastating to FAS children and their familiesare the lifelong effects

    of alcohol-induced damage to the developing brain. FAS is considered the most common nonhereditary cause of mental retardation. In addition to deficits

    in general intellectual functioning, individuals with FAS often demonstrate difficulties with learning,memory, attention, and problem solving as well as problems with mental health and socialinteractions. Thus these individuals and their families face persistent hardships in virtually everyaspect of life.

    Birth defects related to alcohol use are permanent. Surgery can repair some of the physical problems,and schools and day care centers offer programs to improve mental and physical development.

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    However, children born with FAS remain below average in physical and mental developmentthroughout their lives.

    (http://www.nofas.org/main/what_is_FAS.htm)

    IMPLICATIONS FOR PHYSICAL EDUCATION

    Leisure, recreation, fitness, and sport activities. Teachers will need to modify instruction.

    ASSESSMENT SUGGESTIONS

    Brockport Physical Fitness Test

    DEVPRO Motor Skills Assessment

    Assessment for APE

    Achievement Based Curriculum (ABC)

    EFFECTIVE TEACHING STRATEGIES

    Provide short and clear instructions.

    Provide frequent feedback to the individual.

    Repeat directions.

    Have the individual demonstrate the task forclear understanding.

    Keep the learning environment consistentwith little change.

    Eliminate distractions (visual and auditory).

    Demonstrate tasks for visual understanding.

    Use peers as partners for the individual

    Slow down the speed of the activityespecially if it is concerning anoncompetitive activity, i.e. (stretching,exercises, etc).

    EFFECTIVE BEHAVIOR MANAGEMENT STRATEGIES

    Set limits and follow them consistently.

    Change rewards often to keep interest inreward getting high.

    Review and repeat consequences ofbehaviors.

    Ask them to tell you consequences.

    Do not debate or argue over rules alreadyestablished. "Just do it."

    Notice and comment when your child isdoing well or behaving appropriately.

    Avoid threats.

    Redirect behavior.

    Intervene before behavior escalates.

    Avoid situations where child will be over-stimulated.

    Have child repeat back their understandingof directions.

    Protect them from being exploited. They arenaive.

    Have pre-established consequences formisbehavior

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    RESOURCES

    Teachers:

    http://www.thearc.org/misc/fasresources.doc

    Parents:

    http://www.taconic.net/seminars/fas02.htmhttp://www.nofas.org/main/what_is_FAS.htm

    Sport:

    www.come-over.to/FAS/

    REFERENCES

    Troccoli, K.B. (1992). Fetal Alcohol Syndrome: the impact on childrens ability to learn. National EducationConsortium.

    http://www.nofas.org/main/what_is_FAS.htm

    http://www.nofas.org/main/what_is_FAS.htm

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    Sensory-neural loss happens when the cochlea is damaged, destroyed, or the connection to thebrain is not working.

    Mixed is a combination f conductive and sensory-neural loss.

    The prognosis of an individuals hearing loss depend on the amount of nerve damage, which determinesthe severity. Some ways to help restore some hearing is by: hearing aids, cochlear implants, or removing

    wax blockage.

    IMPLICATIONS FOR PHYSICAL EDUCATION

    Individuals with hearing impairments can do just about everything with the same motor ability as non-disabled individuals. However, a hearing impaired individual may experience static and dynamic balancechallenge, physical fitness, some delays in gross and fine motor skills, and some difficulty with appliedforce and coordination. Making small adaptations for individuals with hearing impairments will make themto be able to be just as successful as anyone else in their class:

    Make the environment more conducive to them by: less excess noise, if you use music have it at areasonable level for all students, use an auditory device, have clear instructions better, and keep aroutine for the student.

    Educate all the students in his/her class about his/her disability. Have disability awareness to increase acceptance, social skills, and tolerance of individuals that

    maybe a little different for the entire school.

    Simulating the students disability can help everyone feel more comfortable and aware of what it islike to be hearing impaired.

    ASSESSMENT SUGGESTIONS

    Assess to see if the student has a hearing impairment by using standardized tests and from those testsdevelop the students IEP (Individual Education Plan). Some good standardized tests include:

    ASSESSMENT FOR ADAPTED PHYSICAL EDUCATION (A-APE): assessment of motor developmentaccurately and makes the IEP process more efficient (http://a-ape.com/)

    BROCKPORT PHYSICAL FITNESSTEST: for ages 10-17; addresses fitness concerns of individuals withdisabilities. The test describes 27 tests to assess an individual with disability. The manual makesrecommendations on which tests to use when assessing individuals with specific disabilities(http://www.humankinetics.com)

    BRUININKS-OSERETSKYTEST OF MOTOR PROFICIENCY: for ages 4 - 14 ; subtests to measure suchareas as: speed, agility, balance, coordination, strength, and fine motor dexterity

    TEST OF GROSS MOTOR DEVELOPMENT (TGMDII): for ages 3-10; tests 12 gross motor patterns suchas running, galloping, and jumping. The manipulative patterns include such items as bouncing,catching, and kicking (http://www.proedinc.com)

    SPECIAL OLYMPICS SPORTS SKILLS PROGRAM: written and illustrated so that teachers and coaches atevery level of experience can improve their skills. There are several sports skill books, whichcontains an assessment instrument for the novice and experienced athlete, along withteaching/coaching ideas on basic skills and appropriate drills (http://www.specialolympics.org/)

    Make your own informal types of assessments like: rubrics, checklists, authentic assessment, producttasks, portfolios, and through video taping.

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    RECOMMENDED ACTIVITIES

    Bowling: simplify/reduce the number of steps use two hands instead of one remain in stationary position use a bowling ramp

    use a partner give continuous signed cues

    Basketball: use various size balls (bright colors) allow traveling allow two-hand dribble use larger/lower goal slow the pace down

    Golf: use a club with a larger head use shorter/lighter club use larger balls

    use tee for all shots shorten distance to hole

    Soccer: use walking instead of running use a deflated ball, nerf ball, bright

    colored ball reduce playing area play six-a-side soccer use bigger goal

    Softball: use a bright softball use larger or smaller bats use a batting tee

    reduce the base distances provide a peer to assist

    Tennis: use a soft bright ball use lighter racquets use larger head racquets hit ball off tee allow a drop serveuse a peer for

    assistance

    Volleyball: use larger, lighter, softer, bright colored

    balls

    allow players to catch ball instead ofvolleying allow student to self toss and set ball lower the net reduce the playing court stand closer to net on serve allow ball to bounce first hold ball and have student hit it

    CONTRAINDICATED ACTIVITIES

    Swimming, due to the damage already from their disability. Too much water pressure could damagetheir hearing even more.

    EFFECTIVE TEACHING STRATEGIES

    Need to have a safe environment that they can enjoy do the activity in. Keep it free of obstacles, andwith no loud noises.

    Assistance may be needed for some activities to get the most out of the student. Learn basic sign language, and keep a positive attitude. Use other teachers as a valuable resource. Make sure hearing impaired students can see your lips when you talk. Use visual demonstrations when you teach. Learning basic sign language, so you can communicate better with the student and fellow classmates

    can. Using an Alphanumeric Pager - is basically like any other pager that you call and text a message to,

    except there are more options and a clearer display. When you teach standing in one place and giving visual attention-getters will help get him/her on

    task. Have the student feel safe and comfortable in their environment and with others around them.

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    POSITIVE BEHAVIOR MANAGEMENT

    Determine the cause of your students behavior before the situation increases into a bigger problem. Be aware of everything that is going around in your class, and what kind of personalities each one of

    your studentss have. Mange time effectively. Set a comfortable pace to learn at. Keep the students motivated before they get of track and into trouble.

    RESOURCES

    Teacher: http://www.as.wvu.edu/~scidis/hearing.html http://www.chelt.ac.uk/gdn/disabil/deaf/deaf.pdf

    http://education.qld.gov.au/curriculum/learning/students/disabilities/practice/strategies/histrategies.html

    http://www.pecentral.com

    http://www.teachersfirst.com/sped/prof/deaf/strategies.html Parent: http://www.deafness.about.com http://www.kidshealth,org http://www.marky.com http://www.mayoclinic.com/

    Sport: http://www.ciss.org/ http://www.nsad.org/ http://www.madd.org/ http://www.narha.org/ http://www.nwadd.org/

    http://www.specialolympics.org/Special+Olympics+Public+Website/default.htm http://www.usdsaa.org/ http://www.usadsf.org/

    REFERENCES

    Winnick, P.J . (1995).Adapted Physical Education and Sport. Champaign, IL: Human Kinetics.

    http://www.mayoclinic.com/ (hearing loss).

    http://www.pecentral.com

    http://www.deafness.about.com

    http://www.twu.edu/~_huettig/

    http://www.kidshealth,org

    http://www.marky.com

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    JJUUVVEENNIILLEEDDIIAABBEETTEESSFACT SHEET

    Juvenile Diabetes, also called Type 1 diabetes, or insu lin-dependent diabetes, is a disorder of thebodys immune system the bodys system for protecting itself for viruses, bacteria or any foreign

    substances.

    CHARACTERISTICS

    The warning signs of juvenile diabetes include extreme thirst, frequent urination, drowsiness or lethargy, sugarin the urine, sudden vision changes, increased appetite, sudden weight loss, fruity or sweet odor on the breath,heavy or labored breathing, stupor, or unconsciousness.

    CAUSE

    Scientists do not know exactly what causes J uvenile Diabetes. They believe it may stem from autoimmune,genetic, and/or environmental factors. The appearance of J uvenile Diabetes is suspected to follow exposure toan environmental trigger such as an unidentified virus. The exposure to a virus stimulates an immune attachagainst the beta celss of the pancreas (that produce insulin) in some genetically predisposed people.

    ETIOLOGY AND PROGNOSIS

    People with J uvenile Diabetes must take insulin in order to stay alive. This means undergoing multiple injectionsdaily, or having insulin delivered through and insulin pump, and testing blood sugar by pricking their fingers forblood six or more times daily. People with diabetes must also carefully balance food intake and exercise toregulate their blood sugar levels. Maintaining appropriate diet and exercise levels helps to avoid hypoglycemic(low blood sugar) and hyperglycemic (high blood sugar) reactions, which can be life threatening.

    While insulin allows a person with J uvenile Diabetes to stay alive, it does not cure the disease. The potentialcomplications associated with J uvenile Diabetes include:

    RetinopathyDiabetic retinopathy is the most common and serious eye-related complication of diabetes. It is a progressivedisease that destroys small blood vessels in the retina, eventually causing vision problems. In its mostadvanced form it can cause blindness. Nearly all people with J uvenile Diabetes show some symptoms of

    diabetic retinopathy. After living with diabetes for 20 years, nearly 25% develop the advanced form.NephropathyDiabetic kidney disease is one of the most common and most devastating complications of diabetes. It is a slowdeterioration of the kidneys and kidney function. In severe cases, it can eventually result in kidney failure, alsoknown as end stage renal disease. About 30% of people living with J uvenile Diabetes develop nephropathy.

    Cardiovascular DiseaseCardiovascular disease, a range of blood vessel system diseases that include both stroke and heart attack, isthe major cause of death in people with diabetes. The two most common types of cardiovascular disease arecoronary heart disease, caused by fatty deposits in the arteries that feed the heart, and hypertension, or highblood pressure.

    NeuropathyNeuropathy, or nerve damage, affects more than 60% of people with juvenile diabetes. The impact of nerve

    damage can range from slight inconvenience to major disability and even death. Diabetic neuropathy leads toloss of feeling and sometimes pain and weakness in the feet, legs, hands, and arms. It is the most commoncause of amputations not caused by accident in the Unites States. In one type of neuropathy, known asautomatic neuropathy, high glucose levels injure the autonomic nervous system, which controls bodily functionssuch as breathing, circulation, urination, sexual function, temperature regulation, and digestion. Autonomicneuropathy may result in various types of digestive problems, diarrhea, erectile dysfunction, a rapid heartbeat,and low blood pressure.

    IMPLICATIONS FOR PHYSICAL EDUCATION

    Lack of insulin production by the pancreas makes J uvenile Diabetes particularly difficult to control. Studentswill need to maintain a carefully regulated diet, planned physical activity, blood glucose testing several times

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    a day, and multiple daily insulin injections in order to maintain participation in physical education.Participation in physical activities and sport should be encouraged. However, be aware that hypoglycemiacan occur during and after physical activity. Be prepared to recognize the signs and symptoms of diabeticemergency and how to treat in an emergency situation.

    Treat students with diabetes the same as other students, except to meet medical needs.

    Make sure substitute P.E. instructor is aware of student needs without violating the students right to privacy

    Create a Quick Reference Emergency Plan (QREP) in case the student goes into diabetic shock. TheQREP should be created by the student, his/her parent(s), the school nurse, and the physical education

    teacher. The plan should include: Names and numbers of important contact personnel Causes, signs and symptoms of hypoglycemia Locations (gym, playing fields, off-campus facilities) for all units of instruction for quick response of

    emergency medical personnel Actions needed, or instructions for response to hypoglycemia

    o Include instructions for emergency glucagon kit if applicable

    Carry personal supplies and keep readily available: Blood glucose monitoring equipment Emergency Glucagon Kit if prescribed

    Sugar in the form of juice, candy, or glucose tabletsA Pract ical Program for Juveni le Obesi tyOften times, children with diabetes also struggle with obesity. The following guidelines pertain to exerciserecommendations for individuals who are obese:

    Activity must involve large muscle groups to induce large energy expenditure. Examples include walking,cycling, swimming, dancing, cross-country skiing, skating, basketball, and soccer. By performing suchactivities for 30 to 45 minutes, 10- to 11-year-old obese children burned 200 to 250 kcal (40). Thisamount will vary according to the body weight of the child and the intensity of exercise.

    It is the total energy expenditure, rather than the intensity of the activity, that matters. For example,walking 1 mile will have an almost identical effect to that of running 1 mile. At the start of a program,the intensity and duration of the activities should be low and gradually increase as the programprogresses.

    Activity must be fun, and the child should enjoy it. A play-like, recreational atmosphere is particularly

    important for children in the first decade of life. Compared with structured prescriptions, "lifestyle"activities yield more compliance during the intervention and a greater adherence once the structuredelement of the program has concluded (49).

    Obese children and, particularly, adolescents feel less inhibited when they exercise in the company ofother obese patients, rather than exercising with nonobese people.

    http://www.physsportsmed.com/issues/2000/11_00/bar_or.htm

    ASSESSMENT SUGGESTIONS

    Treat students with diabetes the same as other students, except to meet medical needs.

    RECOMMENDED ACTIVITIES

    Treat students with diabetes the same as other students, except to meet medical needs.

    Water-based activities are often more suitable for obese patients than are land-based activities. Theadvantages of aquatic activities are threefold:

    1) Because of their high fat content, obese individuals are more buoyant than their leaner peers2) Subcutaneous fat is an excellent thermal insulator, which gives obese people an advantage in cool

    water3) During water-based activities, most of the body is submerged. This provides a psychological

    advantage over land-based activities in which the body shape of the obese child is exposed.

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    CONTRAINDICATED ACTIVITIES

    Treat students with diabetes the same as other students, except to meet medical needs. Note that vigorousor unplanned exercise can trigger a diabetic emergency.

    EFFECTIVE TEACHING STRATEGIES

    Treat students with diabetes the same as other students, except to meet medical needs.

    RESOURCES

    Teachers:Websites:

    http://www.ncpad.org/

    http://www.ncpad.org/abstracts/default.htm Abstract ofCarnethon MR, Gidding SS, Nehgme R, Sidney S, Jacobs DR, Liu K.2003.

    Cardiorespiratory fitness in young adulthood and the development of cardiovascular disease riskfactors. Journal of the American Medical Association. 290 (23): 3092-3100.

    Abstract ofEpstein LH, Roemmich JN. Reducing sedentary behavior: Role in modifying physicalactivity. Exercise and Sport Sciences Review. 2001; 29 (3): 103-108.

    Abstract ofVincent SD, Pangrazi RP, Raustorp A, Tomson LM and Cuddihy TF Activity Levels and

    Body Mass Index of Children in the United States, Sweden and Australia . Medicine and Science inSports and Exercise. 2003; 35(8): 1367-1373.

    http://www.palaestra.com/

    Parents:Websites:

    http://www.ncpad.org/discus_script/discus.cgi

    http://www.disabilitycentral.com/activteen/magazine/entertainment_recreation/ent_rec.htm

    http://www.nscd.org/TheNational Sports Center for the Disabled provides therapeutic recreation programs that are designed forindividuals with disabilities who require adaptive equipment and/or special instruction. Instructors have

    taught individuals with a variety of disabilities, including amputation, congenital disabilities, visual andhearing impairments, developmental disabilities, and physical disabilities

    http://www.jdf.org/

    http://www.palaestra.com/

    http://www.childrenwithdiabetes.com/d_0b_200.htm

    http://www.childrenwithdiabetes.com/index_cwd.htm

    http://www.diabetes.org/home.jsp

    REFERENCES

    http://www.physsportsmed.com/issues/2000/11_00/bar_or.htm

    http://www.diabetes.org/home.jsp

    http://www.jdf.org/

    http://www.jdrf.org/index.cfm?fuseaction=home.viewPage&page_id=C7E16B03-5E34-4D9F-A5F8C6732367F03D

    http://www.jdf.org/index.cfm?fuseaction=home.viewPage&page_id=0FC9970A-635A-43C2-8D37B6894CF78C72

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    MMUULLTTIIPPLLEEDDIISSAABBIILLIITTIIEESSFACT SHEET

    Concomitant impairments (such as mental retardation-blindness, mental retardation-orthopedicimpairments, etc.), the combination of which causes such severe educational needs that they

    cannot be accommodated in a special program solely for one of the impairments. The term does

    not i nclude deaf-blindness (IDEA, 1997).

    CHARACTERISTICS

    Individuals may have one or more of the following:

    Movement difficulties

    Sensory losses

    Behavior problems

    Limited speech or communication

    Difficulty in basic physical mobility

    Tendency to forget skills through disuse

    Trouble generalizing skills from onesituation to another

    A need for support in major life activities(domestic, leisure, communityintegration, and vocational)

    Presence of primitive reflexes

    Possibly nonambulatory

    CAUSE

    There is no identifiable cause in 40% of cases of multiple disabilities. Most individuals withmultiple disabilities with known causes are due to prenatal biomedical factors. Other possiblecauses may be linked to genetic metabolic disorders, dysfunction in production of enzymesleading to a buildup in toxic substances in the brain, or brain malformations.

    PROGNOSIS

    The prognosis of multiple disabilities is dependent on specific disabilities associated with each

    individual.

    IMPLICATIONS FOR PHYSICAL EDUCATION

    An individual with multiple disabilities may be challenged with:

    Motor delays

    Abnormal muscle tone

    Muscle atrophy, contractures

    Problem balancing

    Behavioral problems

    ASSESSMENT SUGGESTIONS

    Traditional or standardized assessments are often not practical. Authentic assessments have tobe developed to suit the needs of the student Keep in mind these assessments should befunctional to skills the student will need in life. For many individuals, posture and range of motionare more appropriate criteria to assess compared to strength and skills.

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    CONTRAINDICATED ACTIVITIES

    Activities that involving fast moving objects student may have difficulty tracking and movingout of the way

    Holding a child with head and neck out of mid-line

    W sitting position Dynamic stretching

    EFFECTIVE TEACHING STRATEGIES

    Maintain a small teacher to student ratio

    Learn from caregivers what the child likes and dislikes

    Use positive reinforcement

    Establish rapport

    Talk to child as if they were any other child

    Mirror their movements to see if they notice assessing

    Obtain behavior management information use consistently

    Use all forms of communication sign, language, visual and tactile

    Slow instructions avoid excess words

    Learn what primitive reflexes are still present

    Focus instruction on lifetime physical activity

    Teach in the pool monitor temperature of pool (most cases the warmer the water the better) learn of any allergies of chlorine

    Find out as much information about the child as possible allergies and feeding procedures

    Use sensory integration instruction when appropriate

    Preschool age children should be included

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    RESOURCES

    Teachers:

    Websites: www.slc.sevier.org/sevmltol.htm www.nichey.org.disabinf.asp

    Books:

    Adapted Physical Activity, Recreation and Sport Sherrill

    Parent:

    Websites: www.parentsoup.com/offline/special/articles/ www.childrensdisabilities.info/ parenting/bklivingskin.html www.teach-at-home.com/FastFacts/ disabilities/FactSheet.asp?A=10

    Sport:

    Websites: http://www.lowvision.org/sports_and_recreation.htm http://recreation-and-leisure-for-students-with-severe-disabilities.thecycles.com/ www.skillsndrills.com

    REFERENCES

    Sherril, C. (1998). Adapted physical activity, recreation and sport: crossdisciplinary and lifespan(5th ed.). Boston: McGraw Hill.

    Curtis, S.R. (1982). The joy of movement in early childhood. New York: Teachers College.

    National Dissemination Center for Children With Disabilities 2003. Severe/Multiple disabilities.Retrieved March 2, 2004, from http://www.nichcy.org/pubs/factshe/fs10.pdf.

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    MMUUSSCCUULLAARRDDYYSSTTRROOPPHHYYFACT SHEET

    Genetic muscle diso rders that may also involve atrophy of the heart and respiratory muscles.

    CHARACTERISTICS

    Muscular Dystrophy involves a group of genetic muscle disorders that may also involve atrophy of theheart and respiratory muscles. Muscular Dystrophy may also be referred to as:

    MD, Inherited myopathy or Pseudohypertrophic muscular dystrophy.

    Depending upon the type, symptoms may range from muscle weakness with low disability, to functionalloss of ambulation and with certain types, death. The different types below differ from each other by:

    inheritance-from a dominant or recessive gene, the age symptoms appear

    The development or onset of specific symptoms. Most often the genetic abnormality comes from one orboth parents and causes missing or malformed muscle membranes, leading to muscle weakness anddeterioration.

    CAUSE

    Duchenne muscular dystrophy: caused by a defective gene (x-recessive) meaning it almost neveraffects females, since females have two x chromosomes.

    Becker muscular dystrophy: Myotonic dystrophy: Myotonia congenital: due to excess chloride in a muscle cell Limb-girdle muscular dystrophy: Fascioscapulohumeral muscular dystrophy:

    ETIOLOGY AND PROGNOSIS

    Duchenne muscular dystrophy: Occurs in approximately 2 out of 10, 000 individuals and can be detected through genetics during

    pregnancy, with about 95% accuracy Symptoms usually appear in males, ages 1 to 6 years with initial muscle weakness in the legs

    and lower body. Children may require braces for walking by age 10 and experience wheelchair confinement by

    age 12. Muscle weakness and skeletal deformities can cause breathing disorders. Some intellectual

    impairment, although not progressive, may occur Students may have difficulty with basic locomotor skills such as running, jumping or hopping and

    may frequently fall. Progressive muscle weakness, difficulty walking, fatigue, scoliosis and calfmuscle enlargement is obvious. Death, due to respiratory conditions, may occur by early twenties.

    Becker muscular dystrophy:. Occurs in 3-6 out of 100,000 male births with females rarely demonstrating symptoms Onset of symptoms typically occur during adolescence, but may occur anywhere from age 5 to age 25. Pelvic muscle deterioration may lead to inability to walk and loss of strength in back and shoulders. Unlike Duchenne, individuals may have a normal life span. similar to Duchenne muscular dystrophy however with much slower progression

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    IMPLICATIONS FOR PHYSICAL EDUCATION

    General consideration factors include:

    Communication and collaboration with physical therapists, special education teachers, parents andothers involved with the child, to gain insight concerning disability, behavior, safety, medications andother information.

    Safety considerations for all students: wheelchairs or braces must not provide an unsafeenvironment.

    Allowing the involvement of older students, enabling them to participate in their own specificindividual modification planning.

    Adapting different teaching styles to meet learner needs and designing an individualized learning environmenwith multiple success levels, thus benefiting all students.

    Using different ball/bat choices, target selections, playing area modifications and ramps forwheelchairs.

    An ecological approach:(Block, 2000) based upon student and parent interests, specific targeted skilldevelopment, available supports and lifetime community recreational activities could be valuable to a studentwith Becker muscular dystrophy.

    ASSESSMENT SUGGESTIONS

    Assessment should be individual, appropriate and consider disability limitations. For example, a studentin a wheelchair should not be assessed using the same throwing criteria as another. The student in thewheelchair is unlikely to step with opposition, demonstrate side orientation or show upper body rotation.

    The goal of assessment, regardless of tool, should be to determine a baseline, provide intervention(instruction) and improve skill level. The need for ongoing, individualized assessment of targeted skills iscritical. Individualized assessment, similar to individualized instruction, benefits all participants.

    RECOMMENDED ACTIVITIES

    Aquatics, with the natural buoyancy, may foster movement and range of motion objectives.

    EFFECTIVE TEACHING STRATEGIES

    Specific Aquatic Teaching Strategies:

    Students with Duchenne are generally good floaters.

    As the disease progresses, swimmers may lose the strength necessary to hold their head out of thewater while in a prone position.

    Activities in the supine position may promote relaxing and optimize respiratory function.

    Recoveries to supine, elementary backstroke and sculling may be useful skills.

    Swimmers with MD are often heavy and difficult to lift into and out of the pool. Avoid lifting that putspressure on the shoulders, where muscle tone may be lacking.

    An important objective is to slow the MD atrophy by maintaining muscle tone throughout activity ...while avoiding undue fatigue.

    Know your student and do not hesitate to seek his/her input. Help him/her keep a positive outlook.Students may have lowered motivation, lack of interest, or a low frustration tolerance when unable to doskills once had ability to do (as disease progresses).

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    http://www.as.wvu.edu/~scidis/motor.htmlRetrieved April 14, 2004

    http://www.brookespublishing.com/cgi-bin/dictionary.plRetrieved March 28, 2004

    http://www.mdausa.org/Retrieved April 13, 2004

    http://www.noah-health.org/english/illness/neuro/musdys.htmlRetrieved March 28, 2004

    http://www.uvm.edu/~rgobin/imanual/28SPEC~1.HTM)Retrieved April 14, 2004

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    SSEEIIZZUURREEDDIISSOORRDDEERRFACT SHEET

    There are two kinds o f seizure disorders, anisolated, non-recurrent attack, such as may occurduring a febrile illness or after head trauma, and epilepsy--a recurrent, paroxysmal disorder of

    cerebral function characterized by sudden, brief attacks of altered consciousness, motor activity,

    sensory phenomena, or inappropriate behavior caused by excessive discharge of cerebralneurons. This fact sheet will focus more on the isolated, non-recurrent attacks and those seizures

    that are drug-induced.

    CHARACTERISTICS

    Aura - warning signs of a seizure

    Postictal state - symptoms that follow a seizure deep sleep headache confusion muscle soreness

    Simple partial seizure - motor, sensory, or psychomotor phenomena without a loss ofconsciousness

    Jacksonian seizure - a seizure that starts in one part of the body and spreads. Ex - starts in handand moves up arm

    Complex partial seizure - a seizure in which the individual will lose contact with surroundings for 1-2minutes. The individual might: Stare Perform automatic purposeless movement Utter unintelligible sounds Resist aid Mental confusion continues for 1-2 minutes after the seizure

    Generalized seizure - this type of seizure causes a loss of consciousness and motor function. It isgenetic or metabolic in cause

    Infantile spasms - a seizure characterized by sudden flexion of arms, forward flexion of trunk, andflexion of legs. They last only a few seconds and repeat many times a day. They only occur inchildren within the first three years.

    Absence seizure - (petit mal) - brief primarily generalized attacks manifested by a 20-30 second lossof consciousness, eyelid fluttering, may or may not have the presence of axial muscle tone loss. Theindividual will not fall over or convulse and will resume activity as soon as seizure is over. They willhave no knowledge of the seizure once it is over. These types of seizures often happen when anindividual is sitting quietly, they rarely occur during activity.

    Generalized ton ic-clonic seizure - begins with outcry, continues loss of control and a fall, tonic-

    clonic contractions of muscles, possible loss of bowels. Lasts 1-2 minutes, usually begins withsimples or complex partial seizure.

    Aton ic Seizure - brief, primarily generalized seizure in children complete loss of muscle tone and consciousness fall or pitch to the ground chance of serious head trauma

    Myoclonic seizure - brief, lightening like jerks of the limbs or trunk, may be repetitive leading totonic-clonic seizure. No loss of consciousness

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    Febrile seizure - associated with fever without evidence of intracranial infection. They occur inchildren ages 5 and younger.

    CAUSE

    The following may be triggers for a seizure:

    Convulsant drug

    Growth spurts

    Hypoxia

    High alkalinity of blood

    Hypoglycemia

    Low blood sugar

    Lack of sleep

    Constipation

    Stress

    Excessive noise

    Alcohol

    Improperly used medication

    Flickering lights

    Intense concentration

    Hyperventilation

    Menstruation

    Hypothermia

    Hyper hydration

    ETIOLOGY AND PROGNOSIS

    Our brain is an enormously huge and complex network of electrical circuits. Seizures are the result ofabnormal activity in one area of this circuit which causes abnormal currents to spread to the rest of thebrain. The result is a seizure with physical and/or behavioral manifestations.

    Seizures are associated with many medical conditions:

    Most convulsions in infants and toddlers are caused by fever; rarely cause lasting damage

    Gastrointestinal disease

    Poisoning

    Head injury

    Brain disease such as a tumor

    Breath-holding during a tantrum (rare)

    In order for a medical provider to diagnose cause of the seizure the following needs to be recorded:

    Eyewitness account of a typical seizure

    Frequency of seizures and the longest and shortest intervals between them

    History of prior head trauma, infection, or toxic episodes must be evaluated

    Family history of seizures or neurological disorders

    IMPLICATIONS FOR PHYSICAL EDUCATION

    A PE teacher can best help a student with seizure disorder by trying to prevent a seizure from occurringby choosing appropriate activities for the class to participate in. They should also be prepared byknowing what to do if a student does have a seizure in class.

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    A PE teacher should:

    Encourage a normal life for a student with seizure disorder

    Recommend exercise

    Encourage student to be social

    If a seizure occurs the PE teacher should:

    Remain calm

    Remove sharp objects from the area

    Loosen clothing around neck to help personbreathe

    Place a pillow or soft object (mat) under thehead

    Roll the patient onto his/her side to keep airpassage clear

    Do not attempt to force open the person'smouth or insert any objects inside theperson's mouth

    Do not try to hold the person down or restrictmovement

    Do not attempt CPR, unless the persondoes not start breathing again after theseizure is over

    Remain with the person until the seizure hasended

    Reassure the person as consciousnessreturn

    ASSESSMENT SUGGESTIONS

    What to assess in PE if a child has seizure disorder:

    Motor skills; if the skills seem to change a doctor should be notified

    CONTRAINDICATED ACTIVITIES

    Students with seizure disorder should refrain from:

    Doing activities that require them to be off the ground:

    balance beam jumping from elevated mats cargo net adventure activities that require elevation rope climbing ex-rock climbing

    They should also be monitored closely when participating in any water activity: swimming water aerobics water polo diving synchronized swimming scuba diving or snorkeling

    EFFECTIVE TEACHING STRATEGIES

    Teachers who have students with seizure disorder in their class should be aware of the disorder andknow the implications and etiology for that specific child. They should know the situations or externalfactors that affect the student and teach and to avoid those situations. Teachers could use a buddysystem with students with seizure disorder. This would assure that the student always had someone withthem to alert a teacher if a seizure were to occur. The other student should be educated about seizuresso they do not become frightened if a student has a seizure in class.

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    RESOURCES

    Websites:

    http://www.familyvillage.wisc.edu/lib_epil.htm This is a comprehensive website giving a huge amount of information. It gives parents

    associations to contact to find out more about seizure disorder and what they can do for their

    children. It gives parents a place to go online to talk with others and get support. There are linksto other websites that teach about seizure disorder and finally there are links to otherorganizations and websites that deal with seizure disorder.

    http://xpedio02.childrenshc.org/stellent/groups/public/@xcp/@web/@bibliography/@parents/documents/policyreferenceprocedure/web020893.asp &http://www.amazon.com/exec/obidos/tg/detail/-/0596500033/103-4185789-3707031?v=glance These two websites talk about books parents can purchase to learn more about seizure disorder

    and what they can do for their children.

    http://health.indiamart.com/kidshealth/illness/seizures.html This is a very easy to read, informational website about seizures and seizure disorder.

    REFERENCES

    http://www.merck.com/mrkshared/mmanual/section14/chapter172/172a.jsp

    http://groups.msn.com/ParentsofVaccineDamagedChildren/yourwebpage2.msnw

    http://health.indiamart.com/kidshealth/illness/seizures.html

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    SSEERRIIOOUUSSEEMMOOTTIIOONNAALLDDIISSTTUURRBBAANNCCEEFACT SHEET

    CHARACTERISTICS

    Exhibits one or more of the characteristics over a long period of time:

    inability to learn which cannot be explained by intellectual, sensory, or health factors

    inability to build or maintain satisfactory interpersonal relationships with peers and teachers

    inappropriate types of behavior or feelings under normal circumstances

    general pervasive mood of unhappiness or depression

    tendency to develop physical symptoms or fears associated with personal or school problems

    (Federal Register, Sept. 1992, p. 44802)

    Students may also show signs of these over a long period of time, when a person or student isemotionally disturbed:

    Defiant

    Impertinent

    Uncooperative

    Irritable

    Attention seeking

    Negative

    Hypersensitive

    Hyperactivity (short attention span,impulsiveness)

    Aggression/self-injurious behavior (actingout, fighting)

    Withdrawal (failure to initiate interaction withothers)

    Retreat from exchanges of social interaction

    Excessive fear or anxiety

    Immaturity (inappropriate crying, tempertantrums, poor coping skills)

    Learning difficulties (academicallyperforming below grade level)

    Academy of Education, kidsource.com, 2004Sherrill, 1998, p.552

    CAUSE

    The cause of serious emotional disturbance has not been determined exactly some factors that maycontribute to it are:

    heredity, brain disorder, diet, stress, and family functioning

    abuse when younger, late or no pre-natal care

    nichy.org, Fact Sheet, 2004

    ETIOLOGY AND PROGNOSIS

    Students described as Seriously Emotionally Disturbed (SED) make up 10.5% of all students withdisabilities. In 1991-92 there were 400,670 ages 6-21 qualified as Seriously Emotionally Disturbed(Wagner, Mary, 1995). However, 16% did not show these characteristics until secondary levels ofeducation. Males make up the greatest number of students with SED at 76.4% (Wagner, 1995). Familieswith earnings of less than $12,000 a year make up the greatest percent at 38.2% (Wagner 1995).

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    Percentages show that students with SED in grades 9-12 receive more attention than other students withdisabilities (Wagner, Table 7, 1995). Approximately 60% of these students are receive planning for whenthey continue with life out of High School. (Wagner, Table 7, 1995)

    www.futureofchildren.org/usr_doc/vol5no2ART7.pdf, Mary Wagner

    ASSESSMENT SUGGESTIONS

    One model for use in assessing includes Don Hellisons Social Development or Social ResponsibilityModel (1978, 1984). The social development levels assessed include:

    Level 0:Irresponsibility disruptive behaviors, abuse, and refusal to participate and cooperate

    Level 1: Self Control accepting responsibility for ones action, no longer disruptive, not prepared or fullyparticipating

    Level 2: Involvement effort to follow instructions and cooperate with others, behavior inconsistent,needs frequent prompts and rewards

    Level 3: Self-Responsibility works independently, sets personal goals, stay on task with minimal or noassistance

    Level 4: Control self-initiative in helping others, emphasize and sustain caring relationshipsLevel 5: Going Beyond social maturity to accept leadership responsibilities

    Sherrill, 1998, p. 558

    Other Assessments:

    Westchester IQ Series

    Walker and McConnell Scale of Social Competence and School Adjustment

    Woodcock-J ohnson Psycho-Educational Battery

    RECOMMENDED ACTIVITIES

    Exercise can help decrease anger, depression and disruptive behaviors. Exercise should be:

    perceived as pleasant

    aerobic or as close as the individual can handle

    noncompetitive

    non threatening

    moderate intensity

    used two or three times or as individual sees fit

    Ideally, structure the environment that provides the student with the greatest opportunity for success.

    CONTRAINDICATED ACTIVITIES

    Students with SED can participate in activities that all other students in general PE may participate in. Astudent with SED will be least constructive in an activity that does not personally interest him/her.

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    EFFECTIVE TEACHING STRATEGIES

    Guidelines for class with students with SED:

    Display appropriate authority

    Explain class goals on 1st day and routine to be followed

    Discuss goals often with each student, develop a contract what student must do to achieve goal,relate goals to the group goals

    Keep simple class rules, set as few as possible to obtain order

    Clearly explain consequences of not following the rules, or regulations and the rewards for followingthem as well

    Allow students to be involved in the consequence process, post in the room or allow them to take partin making them.

    Demonstrate consistency in enforcing rules and providing feedback.

    Appl ied Behavior Princ iples (ABA)

    Target behaviors that need to change and define components of these behaviors

    Observe, chart and analyze behaviors to change

    Select and apply specific strategies to achieve behavior changes (i.e. start and stop signals, routinesfor transitions, techniques for forming groups, strategies for coping with disruptive behaviors)

    Periodically evaluate progress toward changing an individuals behaviors and revise their behaviorchange plan

    Banduras (1977) Self Efficacy Theory :

    Allow individuals to feel safe by task analyzing and structuring activities to assure personal mastery

    Promote vicarious feelings of mastery by watching and listening to models who look successful andappear to be having fun

    Use personal persuasion by significant others

    Provide counseling or psychotherapy that teaches cognitive control of anxiety and fear

    Sherrill, 1998, p. 559-560

    RESOURCES

    People who should be used in this process are the students immediate family, including distant family ifthey are around the student a lot. Also special education teachers should be contacted to find out the bestmanagement techniques. Heads of each department as well, Special Education and Adapted PhysicalEducation will aid in the management process.

    REFERENCES

    Sherrill, Claudine; Adapted Physical Activity, Recreation and Sport; 1998, McGraw Hill, ch. 22

    pecentral.com

    kidsource.com

    nichy.org

    www.futureofchildren.org/usr_doc/vol5o2ART7.pdf, Mary Wagner

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    SSPPIINNAABBIIFFIIDDAAFACT SHEET

    A cleft spine, which is an incomplete closure in the spinal column. According to Individualswith Disabilities Education Act (IDEA) 1991; all children and youth with disabilities are

    entitled to receive instruction in Physical Education.

    CHARACTERISTICS

    Spina Bifida Occulta This is the mildest form. There is an opening in one or more of the vertebrae (bones) of the spinal

    column without apparent damage to the spinal cord. Approximately 40% of Americans may have it,but because they experience little to no symptoms, very few of them ever know that they have it(http://www.nichcy.org/pubs/factshe/fs12txt.htm).

    Meningocele A moderately severe form of spina bifida in which the meninges protrude, causing a bulge under the

    skin. The spinal cord remains intact. This form can be repaired with little or no damage to the nerve

    pathways.Myelomeningocele Most Severe Form and also the most common complex congenital (present at birth) abnormality. A

    portion of the spinal cord itself protrudes through the back. In some cases, sacs are covered withskin; in others, tissue and nerves are exposed.

    Spina Bifida Manifesta

    The combination of Meningocele and Myelomeningocele. This occurs in approximately one out ofevery thousand births.

    (http://www.kimber.cjscreations.com/ksbpics.htm)

    Common Characteristics:

    Muscle Weakness (in the feet, ankles and/orlegs)

    Paralysis below the area of the spine wherethe incomplete closure (or cleft) occurs.

    Loss of sensation below the cleft Loss of bowel and bladder control Hydrocephalus (fluid build up that causes

    accumulation of fluid in the brain. This canbe controlled by shunting. Shuntingrelieves the fluid build up in the brainlessening the chances of brain damage,seizures, or blindness.)

    Growth Deficiency Difficulty with learning

    Difficulty with paying attention Difficulty with expressing or understanding

    language Difficulty grasping reading and math

    Difficulty in locomotor and mobilitymovements Difficulty with fitness levels (Obesity is

    common) Motor Difficulties in the arms and hands with

    perhaps some slowness in performingcertain tasks.

    Possible Seizures Latex Allergies

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    CAUSE

    Present at Birth (congenital) Inefficient amounts of Folic Acid in the mothers diet while pregnant.

    ETIOLOGY This birth defect results from the failure of the vertebrae to close completely around the part of the

    spinal cord that it is supposed to protect. This occurs during the first three months of pregnancy. Spina bifida is a congenital malformation however the causes are still unknown. Taking folic acid before conception and during the first few weeks of pregnancy may help reduce the

    risk of spina bifida.

    PROGNOSIS Spina bifida doesnt deteriorate Hydrocephalus can be controlled by a surgical procedure called shunting The child should learn to manage their bowel and bladder functions. Those with a history of hydrocephalus experience learning problems Early intervention can help considerably

    IMPLICATIONS FOR PHYSICAL EDUCATION

    Be aware of weather conditions extreme conditions (Cold or Heat) can have an adverse affect onthe individual and their learning. Maintain Steady and ambient conditions(http://www.nichcy.org/pubs/factshe/fs12txt.htm).

    Be aware of Latex Materials. It is common for a child with Spina Bifida to be allergic to latex. Be aware of latex equipment like: Balloons, Rubber Bands, Elastic in clothing, Beach toys, Koosh

    Balls, Diapers, Art supplies, gloves, elastic bandages, adhesive tape, Band-Aids.

    RECOMMENDED ACTIVITIES

    Mobility Skills (Using crutches, braces, or wheelchairs)

    Emotional and Social DevelopmentEncourage children within the limits of safety and health, to be independent and to participate inactivities with their non-disabled peers.

    Bladder Management Program

    Modify equipment and curriculum for inclusion purposes

    Early Intervention can help considerablyWork on Physical Fitness

    Develop good cardiorespiratory fitness early in life.

    Cooperative ActivitiesIncrease self-esteem, self-consciousness and self-imageIncrease Peer Awareness

    ASSESSMENT SUGGESTIONS

    DENVER DEVELOPMENTAL SCREENING TEST II http://www.denverii.com/ http://www.fpnotebook.com/PED59.htm

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    http://www.uvm.edu/~cdci/pedilinks/pediatric/tools/ddstII.htm

    HAWAII EARLY LEARNING PROFILE (HELP) http://www.vort.com/profb3.htm

    PEDIATRIC EVALUATION OF DISABILITY INVENTORY (PEDI) http://www.med.unc.edu/wrkunits/syllabus/distedu/childas/publish/refsupp/pedi.pdf

    http://www.nemc.org/rehab/pedi_inf.htm OBSERVE

    Social interactive signals between the child and caregiver (learn about the childs communicationstyles, behavior management procedures, and the childs responses to the environment)

    Observe the child in a pre-established free play environment. Observe the physical, motor, andinteractive abilities. Look for visual pursuits, muscle, tone, gross motor patterns, functional mobility, and fine

    motor/hand function. With formal assessments look for: reflexes, development of equilibrium and balance

    reactions, and development of gross motor and fine motor patterns.

    EFFECTIVE TEACHING STRATEGIES

    Modify equipment, and the environment. larger racket, Velcro band to help

    student hold racket, larger ball, largertarget, smaller field, less distractions,softer balls, slower down the activity,modify the rules (ex: two bounces intennis).

    Use developmentally appropriate equipment

    Set up Exercise Routines

    Use large bright and to the point visual aids

    Having repetition in activities and verbalinstructions/demonstrations

    Setting up routines

    Modeling organization

    Teaching organization (have the studentsthink to themselves how they can stayorganized and what they can do to be moreorganized)

    Teaching the concept of time andperforming activities in steps, providingexercises that work on sequence

    Developing games for the students wherethey work on solving problems

    To increase the lack of attention give short

    assignments or chores that can be donesuccessfully. This will increase the childsconcentration.

    POSITIVE BEHAVIOR MANAGEMENT STRATEGIES

    Keeps activities developmentally appropriate Use routines Use peer tutoring

    Limit transition time Use reward systems (token economy,

    stickers)

    RESOURCES

    Teachers:

    Websites Http://www.sbaa.org www.sbaa.org/html/sbaa_facts.html www.waisman.wisc.edu/~rowley/sb-kids/index.htmlx www.nichcy.org/pubs/factshe/fs12txt.htm

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    Parents:

    Websites www.wais