Teachers must be exposed to information that will facilitate their management and teaching of students with disabilities. Specifically, teachers need to know:
There are three factors that are important for teachers to understand regarding needs of students with disabilities:
1. Severity of the impairment suggests the extent of involvement of a condition. For students with sensory
impairments, severity relates closely to the students ability to communicate and to their experiential background. Students with more severe sensory impairments are likely to use different methods of communication and assistive techniques for mobility.
2. Visibility of a disability brings unwanted attention. Unfortunately, this attention focuses on the perceived negative features of an individual. For many students, this attention causes them to feel devalued.
3. The age at which students acquire a disability has a profound effect on certain skills and abilities (e.g.,
language acquisition or concept development). Age also affects how students handle their condition and how educational personnel should address the condition.
HEARING IMPAIRMENTS
Approximately one-half of the students with hearing impairments continue to receive services in separate classes, separate schools, and residential facilities (USOE 1991). This group may need special equipment and materials as well as an interpreter to enable them to succeed in the regular classroom environment. It is estimated that 15 million Americans have some degree of hearing loss. Of these, it is estimated that 2.5 million are congenitally deaf or lost their hearing before age 5.
Individuals with hearing impairments may be classified as either deaf or hard of hearing. Deafness is defined as "a hearing impairment, which is so severe, that the child is impaired in processing linguistic information through hearing, with or without amplification, and that adversely affects educational performance" (Federal Register, 1977, p. 418). Hard of hearing is defined as a hearing impairment, whether permanent or fluctuating, that adversely affects a child's educational performance that is not included under the definition of "deaf" (pp. 418).
Hearing impairment is a generic term that encompasses the entire range of hearing loss.
Deafness usually refers to profound hearing loss such that the primary means of communication and speech/language development is visually based. Deaf students are those who are not able to hear a loudness of 90 decibels or more.
Hard of hearing students have decibel losses between 26 and 89. Hard of hearing refers to significant hearing loss such that the primary means of communication is auditory based. Intervention techniques capitalize on the use of a person’s residual hearing, with or without amplification.
Hearing is measured as a function of decibel loudness at a given frequency for threshold hearing. The louder the sound (measured in decibels) from zero (perfect hearing) the greater the hearing loss. Not being able to hear a loudness of 100 decibels is considered profoundly deaf.
Some typical characteristics of students with hearing impairments:
The student shows a lack of attention.
The student turns or cocks his or her head an unusual amount of the time.
The student has little difficulty following written directions but difficulty following oral directions.
The student exhibits behaviors such as shyness, acting out, stubbornness, or is withdrawn. The student may have
difficulty in making friends and may be less socially mature.
The student is reluctant to participate in oral activities.
The student looks to the class for clues for instructions.
The student's best achievement is in small groups.
The student exhibits a speech defect.
There is a difference between the student's expected and actual achievement.
Medical indications such as frequent earaches, sore throats, or fluid from the ears may indicate a hearing loss.
Implications for the teacher of students with hearing impairments
Accept the student as a person, that is, do not patronize, do not pamper.
Encourage students to request clarification and to ask questions. Repeat the comments of other students who speak.
Paraphrase or summarize discussions at the end of a class session.
Build on the student’s strengths.
Use visual aids or visually oriented materials as much as possible.
Speak clearly, use your natural tone, and be sure that your face can be easily seen. Use facial expressions and gestures. Maintain eye contact.
Make appropriate seating arrangements for students. Seat students so they can take advantage of their residual hearing. Seat students so they can see their interpreter. Let students use swivel chairs.
Learn American Sign Language.
Never shout.
VISUAL IMPAIREMENTS
Vision plays an important role in the development of concepts, the understanding of spatial relationships, and using printed material.
Visual impairment - This term includes both partial sight and blindness. These students may need special materials and equipment and preferential seating, and generally, their needs can usually be met with minimal additional effort in the regular class. Students who are blind are unable to read using print, regardless how much the print is enlarged. Students with low vision experience vision problems but are able to read print when it is enlarged by various degrees.
Vision is measured as a function of what a normal person sees at 200 feet, (legally blind is defined as 20/200).
Common types of visual impairments involve problems in refraction and are typically corrected through the use of corrective glasses or lenses. (OVERHEAD - Table 3.1)
1. Myopia (nearsightedness) - Cannot see distant objects clearly - concave glasses
2. Hyperopia (farsightedness) - Cannot see objects up-close, difficulty in refocusing from distant to near objects
- convex glasses
3. Astigmatism (blurred vision) - Eye strain and blurred vision - hard contact lenses to make the cornea spherical
4. Strabismus ("lazy eye") - double vision, dimness of vision, nausea and fatigue - specific medical treatment before the age of 5 or 6
Note: Childhood blindness has decreased in recent years due to a decline in the visual disorder retrolental fibroplasia, often caused by giving too much oxygen to premature babies. Currently, a leading cause of blindness in infants results form prenatal maternal rubella.
Implications for the teacher
1. Do not grab student in an attempt to assist; instead let the person place his or her hand through your arm or place it lightly on your shoulder.
2. When guiding a person physically and you come to an obstruction, such as a step or tree limb, simply step down or duck your body. Your body language indicates what is ahead.
3. When entering a new room, explain the layout of the room. Be sure that furniture, suitcases, books, and other objects are not positioned in the center of the floor space or the traffic pattern.
4. Assign a friend to a student with impaired vision or blindness until he or she becomes oriented to the physical design of the classroom.
5. In the school cafeteria, describe the food being served and where the food is being placed on the plate.
6. Let students with impaired vision or blindness speak for themselves. They are not speechless or helpless. Treat the student as you would anyone else. Do not be overly concerned with using words such as see or look. Persons with impaired vision or blindness know their strengths and limitations. When you are unsure of yourself in trying to help these students, ask them for advice.
Use more space for students who use Braille
Use extra long tables
Provide student with long desk and a bookcase - place in L-shape
Be flexible and feel free to change the student's seating arrangement
Provide space to store materials
Provide proper lighting and avoid glare
When unsure, ask.
Most students with blindness have mobility training and thus know how to move safely within the classroom.
Do not leave classroom doors half open; they should remain shut or open completely.
Have the student come to school before the rest of the class to explore the new environment.
If necessary, assist the student in exploring the classroom. Explain the major stationary items such as the door, windows, sink, closet, chalkboard, and the storage areas.
Clearly define the perimeters of the workspace so the student does not interfere with a classmate's space.
Orient the student to major areas of the school, such as the bathroom, cafeteria, gym, and exits and entranceways.
In the cafeteria, the noise makes it more difficult for students with visual impairments to function. Assist them moving through the line and finding the tray, tools, and so on. Have another student carry the tray until you are sure that the student can carry the tray and find the table.
During the orientation process, point out special sounds that help in orientation (the ticking of a clock or noise from cars).
Persons with physical disabilities make up a very heterogeneous group. Some of the disabilities included in this broad category are cerebral palsy, limb deficiencies, multiple sclerosis, muscular dystrophy, spina bifida, and spinal cord injuries.
Orthopedic impairments - Orthopedic impairments includes impairments caused by congenital anomaly (clubfoot, absence of some member); disease (poliomyelitis, bone tuberculosis); other causes (cerebral palsy, amputations, and fractures or burns that cause contractures).
Tire more quickly than others in the class
Have excessive absences due to medical appointments
Experience difficulty in performing gross motor tasks
Are unable to or have difficulty completing manipulative activities, such as holding a pencil, cutting, drawing, and stringing beads.
Have difficulty distinguishing differences in size, depth, and spatial relationships (common among children with cerebral palsy)
Are socially delayed due to a lack of interaction with other children.
Note: Individuals in this group vary. One needs to be cautious in categorizing individuals and generalizing.
1. Be aware of all associated disabilities of the student.
2. Allow adequate time for the student to travel from room to room and to get positioned in the classroom.
3. Be aware of the procedures by which to manage a seizure.
4. Preplan all emergency situations.
5. Work closely with all therapists involved in the education of the student.
6. Stabilize all structures such as stairs when sitting, wheelchairs, and so on.
7. Eliminate any barriers that the school may have.
8. Remember that the student may exhibit low vitality and have poor stamina.
HEALTH IMPAIREMENTS
The term health impairment, as defined in the Federal Register (1977), means having limited strength, vitality or alertness due to chronic or acute health problems such as heart condition, tuberculosis, rheumatic fever, nephrites, asthma, sickle cell anemia, hemophilia, epilepsy, lead poisoning, leukemia, or diabetes which adversely affect a child's educational performances. This group of students may have special needs that require specially designed equipment or facilities and close monitoring by school staff.
Seizures - There are three classifications of seizure disorders: 1. Generalized Tonic-Clonic (severe), 2. Absence (less dramatic and lasts for a few seconds, and 3. Complex Partial Seizure (inappropriate or purposeless behaviors that may last a few minutes and the student is unaware of the behavior). Listed below are suggestions to help teachers understand epilepsy and manage a seizure (Epilepsy Foundation of America, 1992).
Epilepsy is a very common condition and is no disgrace. Many persons with epilepsy can become seizure-free if they take medication as prescribed by their doctors. If a generalized tonic-clonic (grand mal) seizure should happen in class, it is vital that the teacher remains calm. Students will assume the same emotional reaction that the teacher does.
(a) Try to prevent the student from striking their head of body against any hard, sharp, or hot object.
(b) Do not try to revive the student, Let the seizure run its course.
(c) Do not try to restrain the student's movement or put anything in the student's mouth.
(d) Turn the student gently on their side and make sure their breathing is not obstructed.
(e) Carefully observe the details of the episode for a subsequent report to medical personnel.
(f) On the very rare occasions when an actual seizure continues for more than five minutes, an ambulance should be called.
(g) Do not be frightened if, during a seizure, the student's breathing becomes shallow and the skin takes on a bluish tinge.
(h) Remember a seizure cannot hurt the onlookers.
(i) When the student regains consciousness, he or she may be incoherent or very sleepy. Rest should be encouraged.
(j) Notify the proper persons of the incidence.
(k) If a person has two successive seizures within a short period of time without regaining consciousness, call for emergency medical assistance.
(l) If a seizure happens in a student who does not have epilepsy, or has some other medical condition emergency medical assistance should be called.
Turn a seizure in a class into a learning experience, where accurate information, wholesome attitudes, and understanding (not pity), are end results.
A non-convulsive seizure affecting behavior, movement, and awareness is called a complex partial seizure. It produces a temporary state similar to sleepwalking, or suspended animation. During an episode, the student's awareness is clouded. A student should, if necessary, be guided away from hazards, reassured, and monitored carefully until full awareness returns. Remember that with proper treatment, most students with epilepsy are able to live and function like any other student.
Nearly one million children sustain head injuries annually, resulting in 100,000 hospitalizations per year in children under the age of 15. Of these children, approximately 18,000 will receive traumatic brain injuries (TBI). These injuries (TBI) are typically referred to as open head injuries. In 1990, traumatic brain injury was added as a separate special education category under IDEA.
Traumatic Brain Injury - an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment.
Teachers must be aware of lengthy recovery periods for those with TBI and realize that some students never regain the same level of achievement and ease of learning as they attained prior to their injuries. Intellectual demands should be relaxed during the early phases of recovery and the teacher should strive to individualize each student's educational program accordingly, that is as the student's needs change.
Autism is a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age 3. This category was also added in the IDEA of 1990.
Autism is a neurological or brain disorder in which behavior, communication, and social interactions are the primary disabilities. Incidence figures range form 5 to 15 out of 10,000 live births.
The definitions of autism are controversial. Autism is three times more common in boys than in girls. The exact cause of autism is not known.
1. Difficulty relating to people, objects, and events
2. Repetitive movements such as rocking, spinning, finger snapping, or hand flapping
3. Insistence on sameness in the environment and in following routines and marked distress over changes in trivial aspects of either
4. Avoidance of eye contact
5. Impaired communication skills, verbal and nonverbal
6. Unconventional use of toys and objects
7. Impairment of social interaction and abnormal social play
8. Restricted range of interests and preoccupation with one narrow interest
9. Cognitive problems in attention, organization, and sequencing
1. Structure the learning environment so that it is predictable and consistent. This includes physical structure as well as routines, schedules, and teacher behavior.
2. Design instructional programs to provide ways to help students learn to communicate. Remember there are many ways to communicate.
3. Since students with autism have difficulty managing their own behavior without structure, develop individual and group behavior plans that stress positive behavior management and set forth clear instructions, rules, and consequences.
4. Work closely with the family to ensure consistency between school and home and other settings in approaches, methods of interaction, and response to students.
Attention deficit (the inability to attend to a task) and hyperactivity (high rates of purposeless movement) are frequently cited as characteristics of children with learning disabilities. The term to describe this combination of behavioral traits is attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). Its symptoms include hyperactivity, distractibility or inattention, and impulsiveness. To diagnose ADD or ADHD, a physician must determine that child consistently displays six or more symptoms of either inattention or hyperactivity-impulsively for a period of at least 6 months. The diagnosis
criteria for ADD are so diverse and subjective that a child who is not diagnosed by one physician may very well be by the next doctor his parents take him to.
There is no universally accepted definition of Attention Deficit Disorder. Typically observed behavioral characteristics include distractibility, impulsiveness, inattention, hyperactivity, and mood fluctuations to a marked degree. Common features of ADD are:
The student may exhibit developmentally inappropriate degrees of inattention, impulsiveness, and hyperactivity.
Onset of problems is noticed as early as age 4.
Boys will be three times as likely as girls to be diagnosed.
Some will be hyperactive, some will not.
Hyperactivity appears to diminish by adolescence; yet the attention and impulse problems tend to persist.
It is not uncommon to find a family member of a child with ADD who also exhibits the same characteristics when younger.
Implications for teachers
1. Place the student away from visually or auditorially distracting situations.
2. Provide structure for instruction as well as for transitioning from on activity to the next.
3. When providing the class information or directions for tasks, use a multi-modality approach.
4. Seatwork or individual tasks should be carefully monitored. Use checklists and peer tutors. Make sure the assignments result in success and not failure.
5. When giving homework assignments, be sure that the student can complete the amount given.
6. Alternate class activities so that a long period of sitting will not be required.
7. Note taking may prove difficult. Provide carbon copies, allow students to tape record. Provide a note-taking partner.
8. Allow students to tape record answers to tests instead of writing them. Be sure that tests are short. Limit the number of distracters on multiple-choice items.
9. These students are overly sensitive to criticism. Therefore, frequent praise is necessary.