understanding special needs and the disabled in the martial arts
TRANSCRIPT
Understanding Special Needs
And the Disabled in the Martial Arts
One World Martial Arts Federation
• The 1WMAF aims to teach schools throughout the country the best way to offer our services for students with disabilities and special needs
• To do this, the 1WMAF offers certification programs for instructors, schools and individuals interested in offering superlative instruction.
• Certified schools and individuals are able to rank their students through the 1WMAF if they so desire.
Disabilities and Special Needs
What are they?
They are not the Same!
• Disability:
• : a condition (such as an illness or an injury) that damages or limits a person's physical or mental abilities
• : the condition of being unable to do things in the normal way : the condition of being disabled
• Special Needs
• : the individual requirements (as for education) of a person with a disadvantaged background or a mental, emotional, or physical disability or a high risk of developing one
They are not the Same!
• Disabilities are CONDITIONS!
• Special Needs are RESULTS of the conditions!
DisabilitiesClinical descriptions of common disabilities you
will be teaching.
Spina Bifida
a congenital defect of the spine in which part of the spinal cord and its meninges are exposed through a
gap in the backbone. It often causes paralysis of the lower limbs, and sometimes mental handicap.
Spina BifidaSpina bifida is actually an umbrella term encompassing a
number of neural tube defects (myelomeningoceles) that occur during the early weeks of gestation. During the first month of pregnancy, the spinal column fails to fully close, exposing the developing spinal cord to damage. Depending on the level of
the lesion, conditions such as full or partial paralysis, hydrocephalus and complications with bladder and bowel
function can develop.
Physical Management of Spina Bifida
• Physical therapy goals are most often directed at contractures of the hips and knees and include range-of-motion and strengthening exercises. Many patients will have muscle imbalance at the hip, interfering with proper gait. The most common effect on the knee is flexion contracture.
• Foot deformities are the most common orthopedic abnormality, occurring in 85 percent of children with myelomeningocele.1 Progressive kyphosis and scoliosis are common, and fractures occur in roughly 20 percent of cases, so orthotics and splints are often employed to accompany exercises to maximize mobility. Even children with partial and complete paralysis as a result of spina bifida can usually walk with the help of assistive equipment.
Recreational Therapy with Spina Bifida
• Children with SB often experience limited play and recreational opportunities because of limited movements and physical restrictions. This lack of activity decreases the urge for normal development in all areas and it can produce a negative effect on the patient’s dignity. For the infant and toddler with SB, recreational therapy increases chances for environmental exploration and interaction with other children. For the school-aged child, recreational therapy provides chances for participation in accommodated sports and exercise programs, which may result in a long-term interest in personal fitness and health.
Recreational Therapy with Spina Bifida
• Recreational and physical fitness targets include enculturation, weight control, and improved fitness (e.g., flexibility, strength, working capacity, CVS fitness and coordination). Recreational therapy is helpful for encouraging independence with adult living skills and often is used to help the patient with shopping for and purchasing personal things, use of public transportation, and development of suitable activities.
There is no cure for SB
• You will not “Fix” your student
• Your goal is to create a lifetime of physical and mental health for the student.
• Be supportive and realistic – do NOT over promise.
• Push your CP student to their limits, but not over them.
• The goal is “To be better today than we were yesterday.”
• Set three month goals that are hard, make a plan to reach them, and test them on their progress towards those goals.
• Depending on your belt structure, creating 3 month goals for belt promotion will take your student on a 4-5 year journey towards black belt.
Cerebral Palsy
a condition marked by impaired muscle coordination (spastic paralysis) and/or other
disabilities, typically caused by damage to the brain before or at birth.
Cerebral PalsySeveral cerebral palsy classification systems exist today to define the type and form of cerebral palsy an individual has. The classification is complicated
by the wide range of clinical presentations and degrees of activity limitation that exist. Knowing the severity, location and type of cerebral palsy
your child has will help to coordinate care and fund treatment.
What types of cerebral palsy are there?
• Below are the most commonly used classification systems understood and used by qualified practitioners.
• Classification based on severity level
• Classification based on topographical distribution
• Classification based on motor function
• Classification based on gross motor function classification system
Level of Severity
• Even when doctors agree on the level of severity, the classification provides little specific information, especially when compared to the GMFCS. Still, this method is common and offers a simple method of communicating the scope of impairment, which can be useful when accuracy is not necessary.
• Mild - Mild cerebral palsy means a child can move without assistance; his or her daily activities are not limited.
• Moderate – Moderate cerebral palsy means a child will need braces, medications, and adaptive technology to accomplish daily activities.
• Severe – Severe cerebral palsy means a child will require a wheelchair and will have significant challenges in accomplishing daily activities.
Topographical and GMFCS
• Topographical classification describes body parts affected. The words are a combination of phrases combined for one single meaning. When used with Motor Function Classification System, it provides a description of where and to what extent a child is affected by cerebral palsy. This method is useful in ascertaining treatment protocol.
• Paresis means weakened
• Plegia/Plegic means paralyzed
• The prefixes and root words are combined to yield the topographical classifications commonly used in practice today.
• Monoplegia/monoparesis means only one limb is affected. It is believed this may be a form of hemiplegia/hemiparesis where one limb is significantly impaired.
• Diplegia/diparesis usually indicates the legs are affected more than the arms; primarily affects the lower body.
• Hemiplegia/hemiparesis indicates the arm and leg on one side of the body is affected.
• Paraplegia/paraparesis means the lower half of the body, including both legs, are affected.
• Triplegia/triparesis indicates three limbs are affected. This could be both arms and a leg, or both legs and an arm. Or, it could refer to one upper and one lower extremity and the face.
• Double hemiplegia/double hemiparesis indicates all four limbs are involved, but one side of the body is more affected than the other.
• Tetraplegia/tetraparesis indicates that all four limbs are involved, but three limbs are more affected than the fourth.
• Quadriplegia/quadriparesis means that all four limbs are involved.
• Pentaplegia/pentaparesis means all four limbs are involved, with neck and head paralysis often accompanied by eating and breathing complications.
Spastic Cerebral Palsy
• Spastic cerebral palsy is hypertonic and accounts for 70% to 80% of cerebral palsy cases. The injury to the brain occurs in the pyramidal tract and is referred to as upper motor neuron damage.
• The stress on the body created by spasticity can result in associated conditions such as hip dislocation, scoliosis, and limb deformities. One particular concern is contracture, the constant contracting of muscles that results in painful joint deformities.
• Spastic cerebral palsy is often named in combination with a topographical method that describes which limbs are affected, such as spastic diplegia, spastic hemiparesis, and spastic quadriplegia
Treating CPTreating cerebral palsy is almost as complex as the condition is, and there’s no cookie-cutter approach because each individual is
affected differently. Although the brain injury that causes cerebral palsy cannot be healed, the resulting physical
impairment can be managed with a wide range of treatments and therapies. Although there is no universal protocol developed for
all cases, a person’s form of cerebral palsy, extent of impairment, and severity level help to determine care.
Although each medical specialist may have specific care goals related to their specialty and the individual’s unique condition,
the overriding treatment goal for those with cerebral palsy is to:
• Optimize mobility
• Manage primary conditions
• Control pain
• Prevent and manage complications, associative conditions and co-mitigating factors
• Maximize independence
• Enhance social and peer interactions
• Foster self-care
• Optimize ability to communicate
• Maximize learning potential
• Provide quality-of-life
Conventional, Complementary and Alternative medicine
• Conventional treatment methods involve systems, practices and products that have been researched, tested and approved by the medical community as acceptable forms of treatment.
• Complementary medicine differs from conventional as it has not yet been fully tested or approved, but may be under consideration. Complementary medicine, when used under doctor supervision, can be used as a complement to an existing treatment plan.
• Alternative medicine is a treatment method that is used to replace conventional medicine.
• Martial arts is ALWAYS complimentary and NEVER Alternative!
• We do not replace, we support conventional therapy and treatment.
Working with CP in Martial Arts
• there is some risk associated with Physical Workouts. Physical therapy and Complimentary activities like MA are meant to be restorative in nature – a teacher more often than not will not over-work a patient. However, this can occur.
• If physical activity is taken too far in a given session, this can cause injury or unnecessary pain, which is not the goal of Martial Arts instruction.
• The key to minimizing risks and maximizing results is open communication between the child, his or her caregivers and physical therapists. Identify where your student’s physical and psychological limits are. Talk to your student regularly to discover difficult areas of training. Don’t be afraid to mention your concerns with the therapist and parent.
There is no cure for CP
• You will not “Fix” your student
• Your goal is to create a lifetime of physical and mental health for the student.
• Be supportive and realistic – do NOT over promise.
• Push your CP student to their limits, but not over them.
• The goal is “To be better today than we were yesterday.”
• Set three month goals that are hard, make a plan to reach them, and test them on their progress towards those goals.
• Depending on your belt structure, creating 3 month goals for belt promotion will take your student on a 4-5 year journey towards black belt.
Down Syndrome
a congenital disorder arising from a chromosome defect, causing intellectual impairment and physical abnormalities including short stature and a broad facial profile. It arises from a defect involving
chromosome 21, usually an extra copy (trisomy-21).
(picture of Garrett Holeve, via facebook page)
About Down Syndrome
• In every cell in the human body there is a nucleus, where genetic material is stored in genes. Genes carry the codes responsible for all of our inherited traits and are grouped along rod-like structures called chromosomes. Typically, the nucleus of each cell contains 23 pairs of chromosomes, half of which are inherited from each parent. Down syndrome occurs when an individual has a full or partial extra copy of chromosome 21.
• This additional genetic material alters the course of development and causes the characteristics associated with Down syndrome. A few of the common physical traits of Down syndrome are low muscle tone, small stature, an upward slant to the eyes, and a single deep crease across the center of the palm - although each person with Down syndrome is a unique individual and may possess these characteristics to different degrees, or not at all.
How Common is Down Syndrome?
• One in every 691 babies in the the United States is born with Down syndrome, making Down syndrome the most common genetic condition. Approximately 400,000 Americans have Down syndrome and about 6,000 babies with Down syndrome are born in the United States each year.
• Source: http://www.ndss.org/Down-Syndrome/What-Is-Down-Syndrome/#sthash.OKJfJMlh.dpuf
Types of Down Syndrome
• There are three types of Down syndrome:
• trisomy 21 (nondisjunction),
• translocation and
• mosaicism.
Trisomy 21 (nondisjunction)Down syndrome is usually caused by an error in cell division called "nondisjunction." Nondisjunction results in an embryo with three copies of chromosome 21 instead of the usual two. Prior to or at conception, a pair of 21st chromosomes in either
the sperm or the egg fails to separate. As the embryo develops, the extra chromosome is replicated in every cell of the body.
This type of Down syndrome, which accounts for 95% of cases, is called trisomy 21.
Mosaicism Mosaicism occurs when nondisjunction of chromosome 21 takes place in one - but not all - of the initial cell divisions after fertilization. When this occurs, there is a
mixture of two types of cells, some containing the usual 46 chromosomes and others containing 47. Those cells with 47 chromosomes contain an extra
chromosome 21.
Mosaicism accounts for about 1% of all cases of Down syndrome. Research has indicated that individuals with mosaic Down syndrome may have fewer
characteristics of Down syndrome than those with other types of Down syndrome. However, broad generalizations are not possible due to the wide range of abilities
people with Down syndrome possess.
Translocation
• Translocation accounts for about 4% of all cases of Down syndrome. In translocation, part of chromosome 21 breaks off during cell division and attaches to another chromosome, typically chromosome 14. While the total number of chromosomes in the cells remain 46, the presence of an extra part of chromosome 21 causes the characteristics of Down syndrome.
What Impact Does Down Syndrome Have on Society?
• Individuals with Down syndrome are becoming increasingly integrated into society and community organizations, such as school, health care systems, work forces, and social and recreational activities. Individuals with Down syndrome possess varying degrees of cognitive delays, from very mild to severe. Most people with Down syndrome have cognitive delays that are mild to moderate.
• Due to advances in medical technology, individuals with Down syndrome are living longer than ever before. In 1910, children with Down syndrome were expected to survive to age nine. With the discovery of antibiotics, the average survival age increased to 19 or 20. Now, with recent advancements in clinical treatment, most particularly corrective heart surgeries, as many as 80% of adults with Down syndrome reach age 60, and many live even longer. More and more Americans are interacting with individuals with Down syndrome, increasing the need for widespread public education and acceptance.
• - Source: http://www.ndss.org/Down-Syndrome/What-Is-Down-Syndrome/#sthash.OKJfJMlh.dpuf
Gross Motor Concerns of Down Syndrome
• Because of certain physical characteristics, which include hypotonia (low muscle tone), ligamentous laxity (looseness of the ligaments that causes increased flexibility in the joints) and decreased strength, children with Down syndrome don’t develop motor skills in the same way that the typically-developing child does. They find ways to compensate for the differences in their physical make-up, and some of the compensations can lead to long-term complications, such as pain in the feet or the development of an inefficient walking pattern.
• The goal of physical therapy for these children is not to accelerate the rate of their development, as is often presumed, but to facilitate the development of optimal movement patterns. This means that over the long term, you want to help the child develop good posture, proper foot alignment, an efficient walking pattern, and a good physical foundation for exercise throughout life.
Common Behavior Concerns
• Wandering/running off
• The most important thing is the safety of the child. This would include a plan regarding what each person's role would be in the event of the child leaving the classroom. Visual supports such as a STOP sign on the door and/or other students asking permission to go out the door can be a reminder to the child or adult with Down syndrome to ask permission before leaving the house.
• Stubborn/oppositional behavior
• A description of the child or adult's behavior during a typical day at home or school can sometimes help to identify an event that may have triggered non-compliant behavior. At times, oppositional behavior may be an individual's way of communicating frustration or a lack of understanding due to their communication/language problems. Children with Down syndrome are often very good at distracting parents or teachers when they are challenged with a difficult task.
Common Behavior Concerns
• Attention problems
• Individuals with Down syndrome can have ADHD but they should be evaluated for attention span and impulsivity based on developmental age and not strictly chronological age. Anxiety disorders, language processing problems and hearing loss can also present as problems with attention.
• Obsessive/compulsive behaviors
• These can sometimes be very simple; for example, a child may always want the same chair. However, obsessive/compulsive behavior can also be more subtly repetitive, manifesting through habits like dangling beads or belts when not engaged directly in an activity. This type of behavior is seen more commonly in younger children with Down syndrome. While the number of compulsive behaviors in children with Down syndrome is no different than those in typical children at the same mental age, the frequency and intensity of the behavior is often greater. Increased levels of restlessness and worry may lead the child or adult to behave in a very rigid manner.
There is no cure for Down Syndrome
• You will not “Cure” your student
• Your goal is to create a lifetime of physical and mental health for the student.
• Be supportive and realistic about achievable short term goals.
• Push your DS student to their limits, but stress the importance of proper basics.
• The goal is “To be better today than we were yesterday.”
• Down Syndrome students are typically able to learn and complete martial arts activities, but “technique” and power are often lacking.
• Gross motor and fine motor issues typically result in slow growth and a school needs to recognize that “reasonable progress” should be measured individually, not by traditional standards.
Autism spectrum disorder (ASD) and Autism
Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction,
verbal and nonverbal communication and repetitive behaviors. With the May 2013 publication of the DSM-5 diagnostic manual, all autism
disorders were merged into one umbrella diagnosis of ASD. Previously, they were recognized as distinct subtypes, including autistic disorder,
childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome.
Autism spectrum disorder (ASD) and Autism
• ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. Some persons with ASD excel in visual skills, music, math and art.
• Autism appears to have its roots in very early brain development. However, the most obvious signs of autism and symptoms of autism tend to emerge between 2 and 3 years of age.
How Common is ASD?
Autism statistics from the U.S. Centers for Disease Control and Prevention (CDC) identify around 1 in 68
American children as on the autism spectrum–a ten-fold increase in prevalence in 40 years. Careful research shows that this increase is only partly explained by
improved diagnosis and awareness. Studies also show that autism is four to five times more common among boys than girls. An estimated 1 out of 42 boys and 1 in
189 girls are diagnosed with autism in the United States.
ASD affects over 3 million individuals in the U.S. and tens of millions worldwide. Moreover, government autism
statistics suggest that prevalence rates have increased 10 to 17 percent annually in recent years. There is no established explanation for this continuing increase,
although improved diagnosis and environmental influences are two reasons often considered.
What Does It Mean to Be “On the Spectrum”?
• Each individual with autism is unique. Many of those on the autism spectrum have exceptional abilities in visual skills, music and academic skills. About 40 percent have average to above average intellectual abilities. Indeed, many persons on the spectrum take deserved pride in their distinctive abilities and “atypical” ways of viewing the world. Others with autism have significant disability and are unable to live independently. About 25 percent of individuals with ASD are nonverbal but can learn to communicate using other means.
As illustrated by the graph on the right, the basic symptoms of autism are often accompanied other
medical conditions and challenges. These, too, can vary widely in severity.
Autism spectrum disorders (ASD) are characterized by social-interaction difficulties, communication challenges and a tendency to engage in repetitive behaviors. However, symptoms and their
severity vary widely across these three core areas. Taken together, they may result in relatively mild challenges for someone on the
high functioning end of the autism spectrum. For others, symptoms may be more severe, as when repetitive behaviors and
lack of spoken language interfere with everyday life.
Autism
a mental condition, present from early childhood, characterized by difficulty in communicating and forming relationships with other people and in
using language and abstract concepts.
Social Challenges
• Typically developing infants are social by nature. They gaze at faces, turn toward voices, grasp a finger and even smile by 2 to 3 months of age. By contrast, most children who develop autism have difficulty engaging in the give-and-take of everyday human interactions. By 8 to 10 months of age, many infants who go on to develop autism are showing some symptoms such as failure to respond to their names, reduced interest in people and delayed babbling. By toddlerhood, many children with autism have difficulty playing social games, don’t imitate the actions of others and prefer to play alone. They may fail to seek comfort or respond to parents' displays of anger or affection in typical ways.
• Research suggests that children with autism are attached to their parents. However the way they express this attachment can be unusual. To parents, it may seem as if their child is disconnected. Both children and adults with autism also tend to have difficulty interpreting what others are thinking and feeling. Subtle social cures such as a smile, wave or grimace may convey little meaning. To a person who misses these social cues, a statement like “Come here!” may mean the same thing, regardless of whether the speaker is smiling and extending her arms for a hug or frowning and planting her fists on her hips. Without the ability to interpret gestures and facial expressions, the social world can seem bewildering.
Social Challenges
• Many persons with autism have similar difficulty seeing things from another person's perspective. Most five year olds understand that other people have different thoughts, feelings and goals than they have. A person with autism may lack such understanding. This, in turn, can interfere with the ability to predict or understand another person’s actions.
• It is common – but not universal – for those with autism to have difficulty regulating emotions. This can take the form of seemingly “immature” behavior such as crying or having outbursts in inappropriate situations. It can also lead to disruptive and physically aggressive behavior. The tendency to “lose control” may be particularly pronounced in unfamiliar, overwhelming or frustrating situations. Frustration can also result in self-injurious behaviors such as head banging, hair pulling or self-biting.
Communication Difficulties
• By age three, most children have passed predictable milestones on the path to learning language. One of the earliest is babbling. By the first birthday, most typically developing toddlers say a word or two, turn and look when they hear their names, etc. When offered something distasteful, they can make clear – by sound or expression – that the answer is “no.”
• By contrast, young children with autism tend to be delayed in babbling and speaking and learning to use gestures. Some infants who later develop autism coo and babble during the first few months of life before losing these communicative behaviors. Others experience significant language delays and don’t begin to speak until much later. With therapy, however, most people with autism do learn to use spoken language and all can learn to communicate.
• Many nonverbal or nearly nonverbal children and adults learn to use communication systems such as pictures, sign language, electronic word processors or even speech-generating devices.
• When language begins to develop, the person with autism may use speech in unusual ways. They may speak only single words or repeat the same phrase over and over. Some go through a stage where they repeat what they hear verbatim (echolalia).
• Some mildly affected children exhibit only slight delays in language or even develop precocious language and unusually large vocabularies – yet have difficulty sustaining a conversation. Some children and adults with autism tend to carry on monologues on a favorite subject, giving others little chance to comment. In other words, the ordinary “give and take” of conversation proves difficult. Some children with ASD with superior language skills tend to speak like little professors, failing to pick up on the “kid-speak” that’s common among their peers.
Body Language Issues
Another common difficulty is the inability to understand body language, tone of voice and expressions that aren’t meant to be taken literally. For example, even
an adult with autism might interpret a sarcastic “Oh, that's just great!” as meaning it really is great.
Conversely, someone affected by autism may not exhibit typical body language. Facial expressions, movements and gestures may not match what they are
saying. Their tone of voice may fail to reflect their feelings. Some use a high-pitched sing-song or a flat, robot-like voice. This can make it difficult for others know what they want and need. This failed communication, in turn, can lead to frustration and inappropriate behavior (such as screaming or grabbing) on the
part of the person with autism. Fortunately, there are proven methods for helping children and adults with autism learn better ways to express their
needs. As the person with autism learns to communicate what he or she wants, challenging behaviors often subside.
Repetitive Behaviors
• Unusual repetitive behaviors and/or a tendency to engage in a restricted range of activities are another core symptom of autism. Common repetitive behaviors include hand-flapping, rocking, jumping and twirling, arranging and rearranging objects, and repeating sounds, words, or phrases. Sometimes the repetitive behavior is self-stimulating, such as wiggling fingers in front of the eyes.
• The tendency to engage in a restricted range of activities can be seen in the way that many children with autism play with toys. Some spend hours lining up toys in a specific way instead of using them for pretend play. Similarly, some adults are preoccupied with having household or other objects in a fixed order or place. It can prove extremely upsetting if someone or something disrupts the order. Along these lines many children and adults with autism need and demand extreme consistency in their environment and daily routine. Slight changes can be extremely stressful and lead to outbursts
• Repetitive behaviors can take the form of intense preoccupations, or obsessions. These extreme interests can prove all the more unusual for their content (e.g. fans, vacuum cleaners or toilets) or depth of knowledge (e.g. knowing and repeating astonishingly detailed information about Thomas the Tank Engine or astronomy). Older children and adults with autism may develop tremendous interest in numbers, symbols, dates or science topics.
Associated Medical Conditions
• Genetic Disorders
• Fragile X syndrome
• Angelman syndrome
• tuberous sclerosis
• chromosome 15 duplication syndrome
• other single-gene and chromosomal disorders
• Gastrointestinal (GI) Disorders
• GI distress is common among persons with autism, and affects up to 85 percent of children with ASD. These conditions range in severity from a tendency for chronic constipation or diarrhea to inflammatory bowel disease. Pain caused by GI issues can prompt behavioral changes such as increased self soothing (rocking, head banging, etc) or outbursts of aggression or self-injury. Conversely, appropriate treatment can improve behavior and quality of life.
Associated Medical Conditions
• Seizure Disorders
• Seizure disorders, including epilepsy, occur in as many as 39 percent of those with autism. It is more common in people with autism who also have intellectual disability than those without. Someone with autism may experience more than one type of seizure. The easiest to recognize is the grand mal, or tonic-clonic, seizure. Others include “petit mal” seizures (when a person temporarily appears “absent”) and subclinical seizures, which may be apparent only with electroencephalogram (EEG) testing.
• Seizures associated with autism tend to start in either early childhood or adolescence. But they may occur at any time. If you are concerned that you or your child may be having seizures, it is important to raise the issue with your doctor for possible referral to a neurologist for further evaluation.
• Sensory Processing Problems
• Many persons with autism have unusual responses to sensory input. They have difficulty processing and integrating sensory information, or stimuli, such as sights, sounds smells, tastes and/or movement. They may experience seemingly ordinary stimuli as painful, unpleasant or confusing.
• Some of those with autism are hypersensitive to sounds or touch, a condition also known as sensory defensiveness. Others are under-responsive, or hyposensitive. An example of hypersensitivity would be the inability to tolerate wearing clothing, being touched or being in a room with normal lighting. Hyposensitivity can include failure to respond when one’s name is called. Many sensory processing problems can be addressed with occupational therapy and/or sensory integration therapy.
There is no cure for Autism
• You will not “Cure” your student.
• Your goal is to create a lifetime of physical and mental health for the student.
• Be supportive and realistic about achievable short term goals.
• Push your ASD student to their limits, but stress the importance of proper basics. Find new ways to teach the same skills!
• The goal is “To be better today than we were yesterday.”
• Autistic students are typically uninterested in martial arts for normal reasons. They may learn to enjoy the activity and a reliable schedule is a MUST!
• Gross motor and fine motor issues typically result in slow growth and a school needs to recognize that “reasonable progress” should be measured individually, not by traditional standards.
Asperger Syndrome
A developmental disorder related to autism and characterized by higher than average intellectual
ability coupled with impaired social skills and restrictive, repetitive patterns of interest and
activities
What Is Asperger Syndrome?
• Asperger syndrome is an autism spectrum disorder (ASD) considered to be on the “high functioning” end of the spectrum. Affected children and adults have difficulty with social interactions and exhibit a restricted range of interests and/or repetitive behaviors. Motor development may be delayed, leading to clumsiness or uncoordinated motor movements. Compared with those affected by other forms of ASD, however, those with Asperger syndrome do not have significant delays or difficulties in language or cognitive development. Some even demonstrate precocious vocabulary – often in a highly specialized field of interest.
The following behaviors are often associated with Asperger syndrome. However, they are seldom all present in any one individual and
vary widely in degree: • limited or inappropriate social
interactions
• "robotic" or repetitive speech
• challenges with nonverbal communication (gestures, facial expression, etc.) coupled with average to above average verbal skills
• tendency to discuss self rather than others
• inability to understand social/emotional issues or nonliteral phrases
• lack of eye contact or reciprocal conversation
• obsession with specific, often unusual, topics
• one-sided conversations
• awkward movements and/or mannerisms
How is Asperger Syndrome diagnosed?
• Asperger syndrome often remains undiagnosed until a child or adult begins to have serious difficulties in school, the workplace or their personal lives. Indeed, many adults with Asperger syndrome receive their diagnosis when seeking help for related issues such as anxiety or depression. Diagnosis tends to center primarily on difficulties with social interactions.
• Children with Asperger syndrome tend to show typical or even exceptional language development. However, many tend to use their language skills inappropriately or awkwardly in conversations or social situations such as interacting with their peers. Often, the symptoms of Asperger syndrome are confused with those of other behavioral issues and are initially diagnosed with ADHD until it becomes clear that their difficulties stem more from an inability to socialize than an inability to focus their attention.
Social Skills Deficits
• Someone with Asperger syndrome might initiate conversations with others by extensively relating facts related to a particular topic of interest. He or she may resist discussing anything else and have difficulty allowing others to speak. Often, they don’t notice that others are no longer listening or are uncomfortable with the topic. They may lack the ability to “see things” from the other person’s perspective.
• Another common symptom is an inability to understand the intent behind another person’s actions, words and behaviors. So children and adults affected by Asperger syndrome may miss humor and other implications. Similarly, they may not instinctually respond to such “universal” nonverbal cues such as a smile, frown or “come here” motion.
Social Skills DeficitsFor these reasons, social interactions can seem confusing and
overwhelming to individuals with Asperger syndrome. Difficulties in seeing things from another person's perspective can make it
extremely difficult to predict or understand the actions of others. They may not pick up on what is or isn’t appropriate in a particular
situation. For instance, someone with Asperger syndrome might speak too loudly when entering a church service or a room with a
sleeping baby – and not understand when “shushed.”
Physical Issues
• Some individuals with Asperger syndrome have a peculiar manner of speaking. This can involve speaking overly loud, in a monotone or with an unusual intonation. It is also common, but not universal, for people with Asperger syndrome to have difficulty controlling their emotions. They may cry or laugh easily or at inappropriate times.
• Another common, but not universal, sign is an awkwardness or delay in motor skills. As children, in particular, they may have difficulties on the playground because they can’t catch a ball or understand how to swing on the monkey bars despite their peers’ repeated attempts to teach them.
Motor Issues
• A common expression of motor impairment is an inability to cross the centerline of the body or switch from one side of the body and back again.
• Also, an inability to consciously sync the upper and lower body during complex movements can often be observed.
• It is very important to note that the challenges presented by Asperger Syndrome are very often accompanied by unique gifts. Indeed, a remarkable ability for intense focus is a common trait.
Working with Asperger Syndrome
• Breaking complex movements down into their basic parts is a common strategy to teach Asperger students with motor issues.
• A traditional class structure is exceptionally helpful for students with Asperger Syndrome – provided you explain WHY you are doing what you do. Routine and structure create ability to thrive and succeed.
• Educational and social support programs for children with Asperger syndrome generally teach social and adaptive skills step by step using highly structured activities. The instructor may repeat important ideas or instructions to help reinforce more adaptive behaviors.
• Many of these programs also involve parent training so that lessons can be continued in the home – communication with the parents about class expectations and ways to continue them at home are usually tremendously appreciated
There is no cure for Asperger Syndrome
• You will not “Cure” your student.
• Your goal is to create a lifetime of physical and mental health for the student, and achieve Martial Arts Success.
• Be supportive and positive at all times.
• Push your ASD student to their limits, but stress the importance of proper basics. Find new ways to teach the same skills!
• The goal is “To be a Black Belt. Utilize key words and concepts (ie. focus, discipline honor, integrity, etc.)”
• Most Asperger students are able to learn martial arts and are typically EXTREMELY interested in Martial Arts due to things such as Anime, Yu-Gi-Oh, etc.
• Gross motor and fine motor issues can result in slow growth but by allowing for slow growth, you can hold most students to traditional standards.
PDD-NOS
A pervasive developmental disorder not otherwise specified (PDD-NOS) is one of the three autism
spectrum disorders (ASD) and also one of the five disorders classified as a pervasive developmental
disorder (PDD)
What is PDD-NOS?
• PDD-NOS stands for Pervasive Developmental Disorder-Not Otherwise Specified. Psychologists and psychiatrists sometimes use the term “pervasive developmental disorders” and “autism spectrum disorders” (ASD) interchangeably. As such, PDD-NOS became the diagnosis applied to children or adults who are on the autism spectrum but do not fully meet the criteria for another ASD such as autistic disorder (sometimes called “classic” autism) or Asperger Syndrome.
• Like all forms of autism, PDD-NOS can occur in conjunction with a wide spectrum of intellectual ability. Its defining features are significant challenges in social and language development.
PDD-NOS can be placed in one of three very different subgroups:
• A high-functioning group (around 25 percent) whose symptoms largely overlap with that of Asperger syndrome, but who differ in terms of having a lag in language development and mild cognitive impairment. (Asperger syndrome does not generally involve speech delay or cognitive impairment).
• A second group (around 25 percent) whose symptoms more closely resemble those of autistic disorder, but do not fully meet all its diagnostic signs and symptoms.
• A third group (around 50 percent) who meet all the diagnostic criteria for autistic disorder, but whose stereotypical and repetitive behaviors are noticeably mild.
How should PDD-NOS be treated?
• As with all autism spectrum disorders, early diagnosis and intervention offer the best chance for optimizing outcomes – including success in mainstream classrooms and the achievement of independence and a high quality of life in adulthood. However, it is never too late to begin behavioral therapy.
• As previously mentioned, no two individuals with PDD-NOS are alike. Indeed, they can have completely different strengths and challenges. As a result, treatments and interventions should be highly individualized based on a thorough assessment. The evaluation should consider such factors as behavioral history, current symptoms, communication patterns, social competence and neuropsychological functioning.
Working with PDD-NOS
• The relevant concern with PDD-NOS is to fully assess where the student fits in the Mild / Moderate / Severe categories.
• After assessment, you can tailor the program in the same way you would for Autism or Asperger Syndrome.
There is no cure for PDD-NOS
• You will not “Cure” your student.
• Your goal is to create a lifetime of physical and mental health for the student, and achieve Martial Arts Success.
• Be supportive and positive at all times.
• Push your ASD student to their limits, but stress the importance of proper basics. Find new ways to teach the same skills!
• The goal is “To be a Black Belt. Utilize key words and concepts (ie. focus, discipline honor, integrity, etc.)”
• Most Asperger students are able to learn martial arts and are typically EXTREMELY interested in Martial Arts due to things such as Anime, Yu-Gi-Oh, etc.
• Gross motor and fine motor issues can result in slow growth but by allowing for slow growth, you can hold most students to traditional standards.
Final thoughts on ASD
• Routine is paramount for students on the Spectrum. It provides structure they can understand, and stability they crave. Routine builds students for LIFE.
• Positive reinforcement and praise always – NEVER punitive or negative reinforcement.
• When ever you get stuck with a negative behavior, remember to stop and explain the WHY behind your requests. Do not take for granted that they understand why you are telling them to do something.
• Build behavior modification plans based upon rewards. Keep consequences for negative actions consistent and clearly explained.
• Remember – the WORST thing your ASD student should be able to imagine is not being allowed to participate – that is the ultimate consequence of negative behaviors.
• You could fill your ENTIRE school with students on the spectrum if you wished. There are approximately 430 Nampa children under 18 years old on the spectrum, desperately looking for a social, physical outlet that can help them learn how to live and thrive in this world.
Emotional DisturbanceA condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely
affects a child's educational performance: An inability to learn that cannot be explained by intellectual, sensory or health factors; An
inability to build or maintain satisfactory interpersonal relationships with peers and teachers; Inappropriate types of behavior or feelings
under normal circumstances; A general pervasive mood of unhappiness repression; or A tendency to develop physical symptoms or fears
associated with personal or school problems.
Definition
• In the special education realm, conditions which generate behavioral issues fall under the category emotional disturbance. Several disorders receive this classification, as the previous pages definition suggests.
• The term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance.
• Overwhelmed? A simpler way to understand emotional disturbances is to remember that, when it comes to special education, the term “emotional disturbance” is associated with mental health or severe behavior issues.
Common Traits
• The National Dissemination Center for Children with Disabilities (often referred to as NICHCY) lists six types of emotional disturbances: anxiety disorders, bipolar disorder, conduct disorders, eating disorders, obsessive-compulsive disorder (OCD) and psychotic disorders; however, they note that this list isn’t all-inclusive.
Educational ChallengesGiven the behavioral issues related to the disability
category at hand, educating students diagnosed with emotional disturbances can prove challenging. The challenge often stems from potential classroom
disruptions; for instance, imagine the trouble created when a student begins crying
uncontrollably or starts throwing a wild temper tantrum.
Educational Challenges
• Avoiding disruptive behavior may entail behavior modification. Behavior modification can involve strategies such as positive reinforcement and incentives to help students learn behaviors that are less disruptive and more socially acceptable.
• Martial Arts classes should focus on mutual respect – earned not given - and clear, concise choices and simple, fair, and consistently enforced consequences for actions.
• Collaborate with other professionals who work with your student (psychotherapist, behavioral therapist, etc.) to determine specific ways to effectively educate the individual.
Biggest Hurdle to teaching students with Emotional disturbance?
• Parents…
• Parents fear of violence inherent in Martial Arts.
• Parents fear of abusive teachers
• Parents fear of uncontrollable children with fighting skills.
• Parent misunderstanding of what we REALLY DO in the Martial Arts.
• You must communicate with the parents!
You CAN Help Eliminate ED!
• You will not “Cure” your student. You can help them to gain COMPLETE control over their issues.
• Your goal is to create a lifetime of mental health for the student, and achieve Martial Arts Success.
• Be supportive and positive at all times. Build them up!
• Push your student to their limits, but stress the importance of never giving up. Stress the inevitability of success if they just keep trying!
• The goal is “To be a Black Belt. Utilize key words and concepts (ie. respect, confidence, success, dignity.)”
• Medicine is often essential to controlling ED. Regardless of your personal beliefs, never encourage your student to “try alternative ways”, or tell them Martial Arts will be all they need.
• NEVER, EVER BE ALONE WITH A SEVERE ED STUDENT! NEVER!
Attention Deficit Hyperactive Disorder
Any of a range of behavioral disorders occurring primarily in children, including such symptoms as poor concentration, hyperactivity, and impulsivity.
ADHD
• ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.
Symptoms of ADHD
• daydream a lot
• forget or lose things a lot
• squirm or fidget
• talk too much
• have trouble taking turns
• make careless mistakes or take unnecessary risks
• have a hard time resisting temptation
• have difficulty getting along with others
• talk all the time
Three types of ADHD
• Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.
• Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
• Combined Presentation: Symptoms of the above two types are equally present in the person.
Behavioral Therapy
Research shows that behavioral therapy is an important part of treatment for children with ADHD. ADHD affects not only a child’s ability to pay attention or sit still at school, it also affects relationships with family and how well they do in their classes. Behavioral therapy is a treatment option
that can help reduce these problems for children and should be started as soon as a diagnosis is made.
Tips for Martial Arts success:
• Use a folder for parent-school communications.
• Make activities clear
• Give positive reinforcement
• Be sensitive to self-esteem issues
• Involve the school and parent in a comprehensive, consistent plan.
• Avoid punishing for being ADHD – it’s not lack of focus or discipline.