Choosing a school for your special child

Impressive right? well, as we say in Nigeria, "No be by dat wan abeg..." There are a lot of things to consider when picking a school for your child.

In Nigeria, children with special needs can be enrolled in a main stream class with additional supports, in a support class in the school, in a special school or center affiliates. Parents need to explore each option and decide on what they feel is most appropriate.

Guide and Checklist for Choosing a School.

As more and more people are agitating for inclusive education for special needs kids. It is imperative for parents to look for mainstream schools with good special education programs.

There are a lot of schools that seem to be offering these services but are they effective?

A parent lamented on the fact that her son has really regressed after a term in a mainstream school in Nigeria. A therapist complained about the way the teachers and cleaning staff ignored the child and expected her to see to the child’s needs. The child, a 3 year old with budding cognitive abilities who just started gaining speech was placed in the toddlers unit. It was with reluctance, after several meetings that she was then moved to a higher class.

Parents should consider the following tips and checklists in choosing a school for their kids.
Plan as early as possible in developing checklists of what you expect of a school for your child.
Visit websites of schools and ask parents with Special needs their opinion on schools.
Visit each school’s open day and talk to the principal of the school.

 School Culture and Inclusion
• Does the school culture fit with your child?
• Did the principal and staff seem genuinely supportive?
• Does the school philosophy specifically acknowledge different abilities and learning styles?
• Do you feel that the school staff will understand your child’s needs?
• Are there signs of inclusion?
• What programs are in place to effectively deal with bullying
• How many children with disabilities (or receiving additional funding) does the school currently
• Is the parent community supportive and involved?

 Class Size and Teaching strategies
 Are your child’s capabilities, strengths and challenges understood?

• Is there one staff member who has overall responsibility for the children with special needs        (e.g. Learning Support Teacher) and do they allow for parents to hire a shadow special education therapist to be with the child?

• Does the school have access to therapists (e.g. occupational therapist, speech therapist etc)?
• Do staff members undertake professional development in disability?
• What is the student to teacher ratio for all classes?


Is there a quiet place for one on one therapy follow-up session with his personal therapist or to calm the child down if he/she experiences sensory overload or melt downs?

Is there a general consensus by the parents and the child’s educational team to use the IEP
  [an individualized plan] for the child?

Do you think the IEP addresses the child’s challenges and will bring a positive outcome?
Are there Therapy materials in carrying out the IEP of the child?

What type of Assessment is being done?
Is it too structured or is it flexible enough to take into cognizance, the child’s challenges and progress attained?

Additional Services

Does the school have an introductory program to assist children transitioning into the school or an organized transition program for children moving from primary to secondary?
• How structured (prescriptive or open-ended) is the curriculum? Is there enough flexibility? How does the school support those students needing additional support in transport etc?
• What does the curriculum offer beyond the statutory subjects? Co-curricular activities?

• Does the school offer clubs, interest groups, etc?
• Do all students have access to specialist facilities (e.g. library, art rooms, science and technology laboratories, etc)?

 


What are the strategies in narrowing it down to the child so that learning takes place?

Social Skills and Inclusion.
Are the school grounds safe and secure?
What other signs of inclusion do you see?
Are there structured activities at lunch time and break time to encourage social skills and inclusion?

.........No comment.........

Image courtesy: logbaby.com, techloy.com, www.adeadegbiteschools.com, www.nairaland.com, meadowhallschool.org, www.coface-eu.org, helenogradydramaacademy-lagosislands.blogspot.com, www.stlouissisters.org, e4pr.blogspot.com, www.vanguardngr.com, woodlandschoolsng.com, www.thethresholdschools.com, www.loyolajesuit.org, www.ondostate.gov.ng

What's in a swing?

Aaaahhh......swinging.....an essential part of childhood.

Movement is essential for typical development to occur in all children. Most of us have no problem combining all our senses.
For autistic children and other disorder however, it's a mighty challenging task. Processing stimuli from the senses of sight, smell, sound, touch, taste, balance and body is overwhelming. Those suffering from autism will often withdraw to avoid over stimulation, or try to sort out the input from their senses with self-developed soothing mechanisms and repetitive behaviors.
A significant amount of occupational therapy for special needs focuses on sensory integration through specially designed programs. Some of the greatest tools for sensory integration therapy for autism, cerebral palsy and other type disorders are various types of swings.

Swinging can have powerful impact the brain's ability to process and use sensory information. Whether the child is linear swinging on a strap swing, cuddled up in a net swing for proprioceptive input or spinning in a rotating movement, all of these movements can act as a powerful activator on the body's systems.
People with various autism spectrum disorders such as Autism, PDD, ADHD, Asperger's, proprioceptive dysfunction and tactile defensiveness will benefit from using swings as part of their therapy.
Children, who find the smooth, swaying motion soothing, will relax and unwind while using it. However, children who have a vestibular dysfunction will feel uneasy while in the hammock and might initially protest its use.

For them, hammock therapy is more about regaining equilibrium and learning to tolerate vestibular stimuli. The motion of swinging restores balance to the vestibular system provides proprioceptive input (deep pressure) and generally children feel more "in balance".



The soothing motion of swinging soothes, relaxes and increases concentration. Children who have trouble focusing on tasks such as reading or math, might find it easier to concentrate sitting in a hammock chair, their bodies engaged in a soothing motion.

Therapists, parents and teachers can use swings effectively to reinforce any therapy objectives for children and provide sensory diets for special needs children. In addition, swings can act as a strong motivator. Since all kids like to swing (special needs or not), swinging can be used as a reward for positive behavior.

 




When choosing a swing and swing apparatus it is critical to consider safety at all times.


• Adult supervision is always required at all times.
• Be aware of floor wall and head protection
• Make sure the swings are able to support the user(s).
• Children who are seizure prone may require additional precautions.
• Make sure the child has the ability to stop on their own at a moment's notice.
• The child must want to swing on their own. Never force a child to participate

Happy Swinging!


Image courtesy: makemesomethingspecial.co.uk, how-to-make-tips.com, www.novanatural.com,                                  www.dailymail.co.uk, Geoff Robinson, kidsdreamgym.com

The Sensory Brush

Sensory brush also called the Wilbarger or mushroom brush, is designed to provide deep pressure sensory input for the calming and integrating influence to the brain, putting the child in that calm alert stage for learning to take place. It is usually used for kids with sensory issues especially tactile defensiveness. Although it may be used alone, it is best with a sensory "diet" of input designed to help the child cope with their day. When done correctly, the brushing/joint compression should take 2-3 minutes and can be done in almost any location.

• Brushing: This gives deep pressure to all of the sensory areas of the arms, trunk and legs. It is calming, organizing and tends to normalize sensory reception. It feels good immediately to most people and starts to feel good to the rest after a few repetitions. To be most effective, the brushing should be done approximately every 1 ½ - 2 hrs from the time the child gets up in the morning until 1 ½ hrs before he normally goes to bed. (realistically, you ask the teachers to perform at least 3-4 times during the school day) The sensory input given like this, lasts 90-120 minutes. You may or may not notice any immediate change in the child since positive results may take two or more weeks of consistent performance to be evident. 

• How to do the calm brushing technique

• Use oval, soft surgical brush provided by therapist (OT).
• Hold the brush in one hand with the hard  side up. Cup hand over brush so that fingertips do not drag.
• Hold Child's forearm with palm of his hand up.
• Place brush firmly on palm. Using slow, FIRM, single stroke move brush from palm up forearm to just below the elbow. 
• Turn Child's arm so that palm faces down. Do not move brush. Maintain pressure.
• Brush downwards on the back of the forearm stopping on the back of the hand.
• In one, long stroke, brush up from the back of the hand to the shoulder. Stop.

• Place hand not holding the brush firmly on Child's shoulder. Lift brush and place at back of shoulder.
• With a single stroke, brush from back of shoulder to waist on one side of the back.
• Brush from waist up to the base of the skull.
• Brush down from the base of the skull to the waist on the other side of the back.
• Brush up from the waist to the other shoulder.

• Place hand not holding the brush firmly on Child's shoulder. Lift brush and place at front of shoulder.
• With a single stroke, brush from shoulder down to back of hand.
• Brush from back of hand to forearm just below inside of elbow, turning arm so that palm is up.
• Brush from elbow down to palm.

• While holding palm, lift brush, stoop down and place brush on back of calf just below inside of knee.
• Brush downwards on an angle to the outside of the ankle.
• Brush upwards on an angle to the front of the knee.
• Brush downwards, across the ankle to the top of the foot.
• Repeat with other leg.
• Follow with joint compressions.

• Joint compressions: This gives input to joints and muscles and will help Child have a better sense of where his body is in space. It is also deep pressure that tends to be calming and help the brain to organize itself to perform task. May be used alone or in combination with brushing technique.

Technique: NOTE  this feels good and should never hurt. Stop if it does and check technique.

• Grasp Child's right hand with your right hand as if you were going to shake hands.
• Use your left hand to hold Child's right forearm. Keep your fingers straight, do not pinch.
• With quick, firm movements, push Child's right hand towards his wrist. Repeat rapidly 7-10 times. Some call this "thunks".
• Now move your left hand to cup Child's right elbow and your right hand to hold his forearm. It is easier if elbow is bent.
• With quick, firm movements, push Child's forearm into his elbow. Repeat rapidly 7-10 times.
• Now keep your left hand cupping Child's left elbow and move your right hand to rest on the top of his right shoulder.
• With quick, firm movements, push Child's arm up towards his shoulders. If you're doing it correctly the shoulder will move upwards slightly.
• Repeat with Child's left arm. You may or may not need to change hands.
• Have Child sit down. Cup your hand around front of his left knee.
• With quick firm movements, push knee towards hip rapidly 7-10 times.
• Place hand over top of knee. Be sure foot is on the floor under the knee.
• With quick firm movements, push downwards towards floor 7-10 times.

IT IS IMPORTANT TO NOTE

The face, chest, and stomach area are never brushed because these are very sensitive areas. Brushing these areas may cause adverse reactions including vomiting.

  Do NOT brush over open sores or bony prominences

  Do NOT allow your fingers or edge of brush to drag or dig into the skin

  Do NOT hurry, but move at a steady pace (whatever pace you need to use to keep pressure even)

  It is OK to brush over clothing or shoes.

  DO keep brush flat, brushing with brush held sideways so that width is used

  DO be positive about brushing, make it fun, or at least not negative for child

  DO follow brushing with joint compressions (you may substitute hand hugs or deep rubs if child responds negatively to joint compression)

  Although many children will hold out their hands for the brushing t after having it done once or twice, some may take longer to feel the benefit.

  IF a child reacts negatively, stop. Try again in 15-60 minutes, checking your technique.

References: develomental-delay.com, nationalautismresources.com

Image courtesy: tamrynj.wordpress.com, pennyspeeps.blogspot.com, izaiahsscroll.blogspot.com, peoplesonline.blogspot.com, www.sensitreatment.com

It's Lego time

One of my special children, Udoh has ADHD. Last week during one of our therapy sessions, I found out that he had only simple large no-theme lego bricks.

He could use it to make cars, houses and other shapes and was really bored with this activity...and really too big for this size of lego. He needed another set of small sized lego with a theme to encourage more complex pretend play. 

Bricks are one of my favourite toys for fine motor drills, concept development, pretend play. As such, it was another opportunity to go lego hunting and window shopping. 

I entered the themed lego place and I was really impressed with the wide range of sizes and themed legos. After describing to the lego- crazy attendant what complex skills I needed Udoh to develop and what cognitive stage he was in; that is, I wanted him to learn to construct castles, houses, transit 2d to 3d concepts (spatial relation), to increase his concentration and attention and really improve hand function (complex) and also encourage pretend play and mid level between difficult and easy.

I finally settled on a car race/car repair themed Lego very smallest size. He was really excited, his expression of surprise was priceless. 

Okay he didn't look this excited...

At first I was scared it would be too difficult for him when he started tinkering with it but it's not as hard as I thought it would be. I am trying to teach him to use to use the miniature tool set (spanner, screw driver, hammer screws, nails crow bar) and he is so willing to be taught. Although the picture step by step manual is really really challenging for him.

The amazing thing is that Udoh actually sat quietly for 30 minutes!!!

Image courtesy: www.amazon.com, metro.co.uk, www.marchoftherobots.com, www.sodahead.com,                               lego.wikia.com, www.nkayesel.com, lego.brickinstructions.com,                        lego.brickinstructions.com

Watch that Splint

I promise this is an interesting topic...

After the Hip Ankle Foot Orthosis (HAFO) was made for Dewunmi who had severe Hemiplegia caused by Cerebral palsy, his mom was so excited but Dewunmi did not like this extra load and inconvenience. He was cranky all through the fittings. 

"Madam I need you to wear him at least 8 hours daily and we have to be consistent because the more he wears it, the better to prevent gradual joint stiffening."

She replied, "Don’t worry, trust me he will wear it even to sleep."

"Ahh!!! No o! Madam this is not a night splint and it could be very uncomfortable, 8 hours is very ok for his age."

After a month, we noticed sores on Dewunmi’s caudal region, I immediately knew that she had ignored my instructions. The HAFO had caused uneven pressure on the caudal bony prominence which had resulted in the development of the sore.

This is why I decided to write a short post on splinting.

Splints and orthosis are temporary devices in neurology used to correct or ensure proper anatomical positioning and sometimes movement and also prevent joint stiffening and subsequent deformity especially for spastic children. It also helps to reduce risk of injury, improve mobility performance and stabilize the joint.

How do Orthosis or splints work?

They work by applying forces to the body. By encompassing parts of the body and preventing movements, muscles and joints can be stretched. Many muscles cross two joints (for example, the calf muscles cross both the ankle and knee). 

To exert stretching effect, either both joints must be held by the device or activities that stretch the joint (passive and active exercises) not in the device should be encouraged. 

Splints and orthosis can also provide stability to help some children stand and walk. 

This is the bio-mechanical explanation of how the device works. 

Materials used include high temperature thermoplast, neoprene and even lycra garments etc.

The following considerations must be properly adhered especially at first fitting and through out the day:

1. Ensure that the splints are well contoured.

2. Always maintain Anti-deformity position (proper body alignment)

3. Snugly position and tighten straps to allow blood flow or veinous return (not too tight, not too      loose).

4. If the splints are too tight or inappropriately placed, circulation is compromised.

5. If a child cannot monitor the status of the affected area, Parents should be instructed to examine the body part for evidence of muscle strain, swelling, redness or sores between straps or muscles around the region.

6. Allow motion out of the splint at periodic interval (parents should learn some passive exercises to perform at these intervals).

7. Avoid or minimize bony prominence.

Foreign Pre-formed Splints

A lot of parents prefer the foreign splints because of the materials and its aesthetic beauty but they have the challenges of “one-size fits no one”  and as such, still have to be custom-fitted by a really experienced Occupational Therapist or Physiotherapist and Orthotist.

Lastly, Orthosis are never an answer in themselves but in many cases they are an extension of the therapist’s arm while away from hands-on active treatment.

The usual trend is this, when a splint, orthosis or an assistive device is made for a child, the parents are usually excited and are consistent within the next few months or weeks, after then, they start faltering, becoming inconsistent with some even totally stopping. 

I understand this because I also see this trend in myself (with abstinence from junk food) but for the device to do what it’s made to do, there has to be consistency and proper adherence to the rules.

Image courtesy:  arthritisbroadcastnetwork.org, www.nopcoclinics.com, www.oandp.org

                            haydentrigg.blogspot.com,  www.wannatowel.com, orthoinfo.aaos.org

                            www.dailymail.co.uk, www.ncmedical.com, www.splints.co.za