severe impairment

Severe Impairment

Severe and Profound Disabilities means a primary disability that:

*Severely impairs cognitive abilities, adaptive skills, and life functioning.

*May have associated severe behavior problems.

*Has the high probability of additional physical or sensory disabilities.

*Requires significantly more educational resources than are provided for the children with mild and moderate disabilities in special education programs.

Most definitions are based on test scores of intellectual functioning, developmental progress compared to chronological age, or the extent of educational and other supports needed.

Profound
Exhibits profound developmental disabilities in cognitive, communication, social skills, motor-mobility, and self-help skills. They also require a service structure with continuos monitoring.

Multiple disabilities
IDEA definition - concomitant impairments(mental retardation-blindness, mental retardation-orthopedic impairment).

Deaf-blindness
IDEA definition - concomitant hearing and visual impairments.

Traumatic Brain Injury
An acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairments.

Shaken baby
In comparison with accidental traumatic brain injury in infants, shaken baby injuries have a much worse prognosis. Damage to the retina of the eye can cause blindness. The majority of infants who survive severe shaking will have some form of neurological or mental disability, such as cerebral palsy or mental retardation, which may not be fully apparent before 6 years of age. Children with shaken baby syndrome may require lifelong medical care.

In a preschool setting a main objective is to teach children to make choices. Severely disabled kids can be helped in many of the same ways as other children, keeping in mind that they will need more time and perhaps more prompting.

One way to allow the child to see what activities are available is to make a bulletin board with photos of typical activities (playing outdoors, building with blocks, looking at books, etc.). The bulletin board should be discussed and the child may indicate what he would like to do.

Another method of encouraging choice making is to make visual cue cards for the child to access to let others know of his needs (toileting, tissue need, drink, etc.) Immediate response is given.

At the lunch/snack table the child will be prompted to point, nod, verbalize (if possible) her wants. Immediate response is given.

To encourage group participation children enjoy making classroom books. For example, a title might be At The Circus What Do I See? Each child has his own page to contribute to. The page reads "I see a ______ looking at me. Child fills in the blank and draws his interpretation of his word. This activity instills ownership and pride. We read our classroom books over and over again.

The "Hello" game is fun to encourage children to acknowledge their friends. We sing "Hello everybody how are you?"..... Then individually the children may sing to another child until everyone has been recognized.

Visual cards are used to show basic skills such as getting a drink of water.
1. Picture of child getting a cup
2. Picture of child turning on water.
3. Picture of child filling cup.
4. Picture of child turning of water.
5. Picture of child drinking.
6. Picture of child throwing cup away.
The idea is to show every single step that you want them to perform.

Participation in physical games is a great way to stimulate socialization and a sense of being part of the group. Children in wheelchairs can hit a ball which is placed on a low T-stand. A bat with an enlarged handle is used to help with gripping.

A lowered basketball goal is easy and accommodating for those in wheelchairs.

Waterplay is relaxing and noncompetitive which allows child to feel secure and successful.

art time involves choice making-colors, medium, big brush/little brush etc.

open ended art allows children to be successful because there is no specific end product.

Art is displayed at child’s eye level so it can be viewed easily, and is given importance with it being displayed.

Crash The Cans game- child runs wheelchair into a stack of cans. Lots of noise and fun.

Parachute Activities. So versatile and enticing, these activities can fit in multiple categories (cause and effect, balls, and even in the music unit). Group cooperation, sensory stimulation, and just plain fun can all be achieved through participation in parachute games. The parachute can be fastened to the child (or even the wheelchair) if the child cannot grasp it independently.

Relays. Make these fun! Usually, the more zany, the less stressful and competitive they are. To maximize participation, emphasize fun. More severely involved students can zoom their wheelchairs (with or without help from the teacher) up and back between cone targets, simply having to knock something off the cone to prove they made their designated distance. They can also nudge something off their laptrays into an awaiting bucket or other container (i.e., net, target).

Hanging Balls. Suspend balls of all sizes, textures, colors, and softness from a basketball goal (or whatever). Students can now play many games. You, or they, can roll their chairs (selves) into them. They can use a whiffle ball bat to strike them (if they cannot hold the bat, the bat can be fastened to their hands, arm, or wheelchair). They can try tether ball with a friend. Activities are only limited by the imagination.

Blowing Games. Blowing games with soap bubbles, ping pong balls on a table top or in the water, and pin wheels are usually a hit with students with quadriplegia. Medically, it is important that activities like these be done to maintain and improve respiratory function as much as possible.

ADAPTING TOYS
Modifying toys can make them easier to use. There are several types of materials to
use for different needs:

Stabilizing
These materials support play by holding a toy within the child's reach or vision.
Often toys that stay "in one place" can be easier to use. Use them to hold a jackin-
the-box in place or connect a communication
device to a crib.
• Show loop
• Dycem
• Grip Liner; mug mats
• Velcro; Dual Lock (Commercial)
• Suction cups (Commercial)
• Carpet squares (Commercial)
• Magnet tape on toy with cookie sheet as
"table"

Extending/Building Up
These materials are used to build up certain access features. They help children
press too-small buttons or keys, hold puzzle pieces or make markers easier to hold.
• Plasticine
• Magic Model Clay (Crayola)
• Popsicle sticks
• Cylindrical foam padding
• Sponge rollers
• Knobs on puzzles

Highlighting Materials
These materials are used to highlight/enhance certain areas on toys, making them
easier to locate. Change the appearance or feel of the toy pieces. Try highlighting
certain areas or masking others. They help to simplify toy design and facilitate
independent play by children.
• Tape: painters, colored vinyl, colored masking tape
• Colored Velcro tape
• Wikki sticks
• Glued yarn, colored glue
• Black or contrasting color cloth for masking; cardboard templates,
etc.

Attaching
These materials are used to bring items closer to the child,
making reaching, grasping and playing less "work".
• Links (Right Start, Discovery Toys, Commercial)
• Snaps on fabric tape (Fabric store)
• "Stringers" or Magic Shoelaces
• Elastic Straps (Fabric store; other commercial)
• Attach-And-Play (Safety First; local)
• Colored Velcro straps (e.g. computer wire binders)

Confining
These materials preventing a toy from moving too far away from a child-- out of the
child's reach or vision. These items create boundaries to help
a child to control his immediate play environment.
• hula-hoops
• box tops
• planter bases

Other items can be used to create play areas which confine several toys. Their use
may particularly benefit children with visual or physical impairments.
• inflatable boats
• tents
• play environments – e.g. gardens, forts, castle, etc.
• cribs, bathtubs, laundry baskets

Technology

communication boards

screen reader

screen magnification

software

head pointing device

touch screens

talking word processing with writing support

arm support

tilt board

book holder

touch sensitive colored lights

voice recognition products

eye gazing or eye pointing systems

Annotations
http://www.palaestra.com/featurestory.html An incredible wealth of information. Fantastic ideas to benefit all students. Add this one to favorites!

http://letsplay.buffalo.edu/toys/adapting-toys.pdf good information on adapting materials

Cecchini, Marie (1997,September/October). Things To Do. Totline Magazine, 5 Nice activity for helping children communicate in the classroom.

Heward,William.((2009).Exceptional Children. New Jersey:Pearson Source for definitions on severe disabilities.

Kramer, Edith.((1979).Childhood and Art Therapy.New York:Schocken BooksOld book, but useful information regarding the benefits of using art with disabled individuals.