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Fill out CTC application and Print. Here is a sample form.

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Answers to the following questions are required. If you answer yes to any question, you must complete the corresponding Profession Fitness Explanation Form.

Before Granting your application, the Commission will review, at a minimum:

Federal Bureau of Investigation criminal history (rap sheet)

California Department of Justice criminal history (rap sheet)

International database of teacher misconduct maintained by the National Association of State Directors of Teacher Education and Certification (NASDTEC)

Previous reviews by the Commission

Complaints from others

Notifications from school districts

Teacher preparation test score violations

You must disclose misconduct, even if:

It happened a long time ago

It happened in another state, federal court, military or jurisdiction outside the United States

You did not go to court and your attorney went for you

You did not go to jail or the sentence was only a fine or probation

You received a certificate of rehabilitation

Your conviction was later dismissed (even if under Penal Code section 1203.4), expunged, set aside or the sentence was suspended

WARNING:

You will be required to sign your application under penalty of perjury; by doing so you are also stating that you understand:

That the information you provide is true and correct;

That you understand any and all instructions related to your application;

Failure to disclose any information requested is falsification of your application and the Commission may reject or deny your application or take disciplinary action against your credential;

The Commission may reject your application if it is incomplete and it will be delayed.

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Application For Credential Authorizing Public School Service

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Answers to the following questions are required. If you answer yes to any question, you must complete the corresponding Profession Fitness Explanation Form.

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Assignment: In what way can we help students with TBI or a physical disability improve their self-concept and emotional well-being?

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Assignment: In what way can we help students with TBI or a physical disability improve their self-concept and emotional well-being?

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In what way can we help students with TBI or a physical disability improve their self-concept and emotional well-being?
Provide your answer in 200 words or more.

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Assignment: Create a poster to share your resource

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Assignment: Create a poster to share your resource

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In a group, explore the assigned resource and be prepared to share how that resource will help support your work in planning and designing a system to support students with physical/orthopedic disabilities, other health impairments, and multiple disabilities. Your group will create a poster, slide, or verbal presentation to share your resource with the entire group.

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Padlet with Supports for Students with Physical Needs

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Padlet with Supports for Students with Physical Needs

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A physical disability is a limitation on a person's physical functioning, mobility, dexterity or stamina.
Limitations may be very severe and noticeable, or almost hidden. Some physical disabilities include wheelchair use, amputees, visual impairments, muscular dystrophy, multiple sclerosis, hearing impairment, and so on.

How can we support students with physical disabilities in the classroom?

Hearing Impairment (Deafness)

IDEA definition: "A hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing , with or without amplification."

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AT Tools for Physical Needs Meredith Chen

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A physical disability is a limitation on a person's physical functioning, mobility, dexterity or stamina. Limitations may be very severe and noticeable, or almost hidden. Some physical disabilities include wheelchair use, amputees, visual impairments, muscular dystrophy, multiple sclerosis, hearing impairment, and so on.

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Review an IEP of your choice under Autism, OI, and TBI.

Complete the chart by answering the questions thoughtfully and comprehensively. Create a lesson plan for the student that allows you to target one of the IEP goals.

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Create a new document and edit with others at the same time -- from your computer, phone or tablet. Get stuff done with or without an internet connection. Use Docs to edit Word files. Free from Google.

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Multiple Sclerosis Symptoms | Treatment and Causes | familydoctor.org

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Multiple Sclerosis symptoms are often mild and vary depending on the part(s) of the body where the myelin sheath is damaged. Tap here to learn more.

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Resilience Guide for Parents and Teachers

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Resilience Guide for Parents and Teachers

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Children's problems include adapting to a new classroom, bullying by classmates, or abuse at home, but resilience is the ability to thrive despite these challenges.

Cite this

American Psychological Association. (2012, January 24). Resilience guide for parents and teachers. https://www.apa.org/topics/resilience/guide-parents-teachers

We tend to idealize childhood as a carefree time, but youth alone offers no shield against the emotional hurts, challenges, and traumas many children face. Children can be asked to deal with problems ranging from adapting to a new classroom or online schooling to bullying by peers or even struggles at home. Add to that the uncertainties that are part of growing up in a complex world, and childhood can be anything but carefree. The ability to thrive despite these challenges arises from the skills of resilience.
The good news is that resilience skills can be learned.
Building resilience-the ability to adapt well to adversity, trauma, tragedy, threats, or even significant sources of stress-can help our children manage stress and feelings of anxiety and uncertainty. However, being resilient does not mean that children won't experience difficulty or distress. Emotional pain, sadness, and anxiety are common when we have suffered major trauma or personal loss, or even when we hear of someone else's loss or trauma.

10 tips for building resilience in children and teens

1. Make connections
Teach your child the importance of engaging and connecting with their peers, including the skill of empathy and listening to others. Find ways to help children foster connectivity by suggesting they connect to peers in-person or through phone, video chats, and texts. It's also important to build a strong family network. Connecting with others provides social support and strengthens resilience.

2. Help your child by having them help others
Children who may feel helpless can feel empowered by helping others. Engage your child in age-appropriate volunteer work or ask for assistance yourself with tasks that they can master. At school, brainstorm with children about ways they can help others in their class or in grades below.

3. Maintain a daily routine
Sticking to a routine can be comforting to children, especially younger children who crave structure in their lives. Work with your child to develop a routine, and highlight times that are for school work and play. Particularly during times of distress or transition, you might need to be flexible with some routines. At the same time, schedules and consistency are important to maintain.

4. Take a break
While some anxiety can motivate us to take positive action, we also need to validate all feelings. Teach your child how to focus on something that they can control or can act on. Help by challenging unrealistic thinking by asking them to examine the chances of the worst case scenario and what they might tell a friend who has those worries. Be aware of what your child is exposed to that can be troubling, whether it's through the news, online, or overheard conversations. Although schools are being held accountable for performance or required to provide certain instruction, build in unstructured time during the school day to allow children to be creative.

5. Teach your child self-care
Teach your child the importance of basic self-care. This may be making more time to eat properly, exercise, and get sufficient sleep. Make sure your child has time to have fun, and participate in activities they enjoy. Caring for oneself and even having fun will help children stay balanced and better deal with stressful times.

6. Move toward your goals
Teach your child to set reasonable goals and help them to move toward them one step at a time. Establishing goals will help children focus on a specific task and can help build the resilience to move forward in the face of challenges. At school, break down large assignments into small, achievable goals for younger children, and for older children, acknowledge accomplishments on the way to larger goals.

7. Nurture a positive self-view
Help your child remember ways they have successfully handled hardships in the past and help them understand that these past challenges help build the strength to handle future challenges. Help your child learn to trust themselves to solve problems and make appropriate decisions. At school, help children see how their individual accomplishments contribute to the wellbeing of the class as a whole.

8. Keep things in perspective and maintain a hopeful outlook
Even when your child is facing very painful events, help them look at the situation in a broader context and keep a long-term perspective. Although your child may be too young to consider a long-term look on their own, help them see that there is a future beyond the current situation and that the future can be good. An optimistic and positive outlook can enable children to see the good things in life and keep going even in the hardest times. In school, use history to show that life moves forward after bad events, and the worst things are specific and temporary.

9. Look for opportunities for self-discovery
Tough times are often when children learn the most about themselves. Help your child take a look at how whatever they're facing can teach them "what am I made of." At school, consider leading discussions of what each student has learned after facing a tough situation.

10. Accept change
Change often can be scary for children and teens. Help your child see that change is part of life and new goals can replace goals that have become unattainable. It is important to examine what is going well, and to have a plan of action for what is not going well. In school, point out how students have changed as they moved up in grade levels and discuss how that change has had an impact on the students.

Resilience and preschool children

Very young children will only recently have mastered the skills of walking and talking, and they may not be able to express their anxieties and fears. Although you may think they are too young to understand what is happening, even very young children can absorb frightening events from the news or from conversations they overhear.

Watch your children for signs of fear and sadness they may not be able to put into words. Have your children become extra clingy or needing more hugs than usual? Have your children started old habits after you thought they had outgrown the behavior? Are they suddenly more irritable? They may be feeling the pressure of what is going on in the world around them. Use play to help your children express their fears and encourage them to use art or pretend games to express what they may not be able to put into words.

Use family time like a security blanket for your children: wrap them up in family closeness and make sure your children have lots of family time. During times of stress and change, spend more time with your children playing games, reading to them, or just holding them close.

Resilience and elementary school children

Elementary school children may be starting to form new friend groups and participate in new activities as they come into their own. As they start to study subjects about the world outside of their homes, they look to teachers as well as to parents to make them feel safe and to help sort it all out.

Make sure your child has a place where they can feel safe, whether that is home or school (ideally, both would feel safe).

Talk to your children. When they have questions, answer them honestly and with reassurance that includes simple statements that let them know you are taking actions to keep them safe and are there to take care of them. Listen to their concerns and fears when they address them with you and let them know you are there for them.

When there is a situation outside of the home that is frightening, limit the amount of news your children watch or listen to. There is always the possibility that they misinterpret what they see or hear on the news. You don't need to hide what's happening in the world from your children, but neither do they have to be exposed to constant stories that fuel their fears. Check in on their understanding of what they have been exposed to.

Realize that extra stressors may heighten normal daily stresses. Your children might normally be able to handle a failed test or teasing, but be understanding that they may respond with anger or bad behavior to stress that normally wouldn't rattle them. Reassure them that you just want what is best for them and that you are there for them.

Resilience and middle school children

Even without larger traumas, middle school can be an especially difficult time for many children as they struggle to meet extra academic demands and avoid new social pitfalls. They look to teachers and friends as well as to parents to make them feel safe.

Reinforce empathy and help your child keep perspective. If your child falls into the shifting of social groups that form in middle school, help them understand that other children may be feeling just as lonely and confused, and help them to see beyond the current situation.

Talk with your child about your own feelings during times of extraordinary stress. Your children may be old enough to appreciate hearing about your own thoughts and feelings, but also the ways in which you cope. Share how the ways you cope are helpful to you, but also find techniques that may benefit your child.

Resilience and high schoolers

Although your teens may tower over you, they still are young and can keenly feel the fear and uncertainty of both the normal stresses of being a teen, as well as events in the world around them. Emotions may be volatile and close to the surface during teen years, and finding the best way to connect to your teen can be difficult.

Talk with them whenever you can, even if it seems they don't want to talk. Sometimes the best time to talk may be when you are in the car together; sometimes it may be when you are doing chores together, allowing your teen to focus on something else while they talk. When they have questions, answer them honestly but with reassurance. Ask them their opinion about what is happening and listen to their answers.

Find a place that your teen can create as their safe place, whether it's their bedroom or somewhere they find comfort. In high school, emotions can intensify, and rejection, taunting, or bullying can also be present. A space of their own can serve as a constant and a place for them to have as their own. Your children may prefer to be with their friends rather than spend time with you, but be ready to provide lots of family time for them when they need it and set aside family time that includes their friends.

When stressful things are happening in the world at large, encourage your teen to take "news breaks," whether they are getting news from the television, magazines or newspapers, or online. Use what they're seeing and hearing as a catalyst for discussion. Teens may act like they feel immortal, but at bottom they still want to know that everything will be ok. Having honest discussions of your fears and expectations can help your high schooler learn to express their own fears. If your teen struggles with words, encourage them to use journaling or art to express emotions.

Many teens are already feeling extreme highs and lows because of hormonal levels in their bodies; added stress or trauma can make these shifts seem more extreme. Be understanding of feelings and emotions, but also be firm when teens respond to stress with angry or sullen behavior. Reassure your child that they will be ok and you are looking out for their best interest

The journey of resilience

Developing resilience is a personal journey, and you should use your knowledge of your own children to guide them on their journey. An approach to building resilience that works for you or your child might not work for someone else.

If your child seems stuck or overwhelmed and unable to use these tips, you may want to consider talking to someone who can help, such as a psychologist or other mental health professional. Turning to someone for guidance may help your child strengthen resilience and persevere during times of stress or trauma.

Acknowledgments

APA gratefully acknowledges the following experts: Mary K. Alvord, PhD, Robin Gurwitch, PhD, Jana Martin, PhD, and Ronald S. Palomares, PhD.

Information presented here should not be used as a substitute for professional health and mental health care or consultation. Individuals who believe they may need or benefit from care should consult a psychologist or other licensed health/mental health professional.

Recommended Reading

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Resilience guide for parents and teachers

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Children's problems include adapting to a new classroom, bullying by classmates or abuse at home, but resilience is the ability to thrive despite these challenges.

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Social & Emotional Learning (SEL)

Students need the tools to deal with adversity. Here's how teachers can help.

Michael Austin / theispot.com

For many children, the past year brought disruption on a grand scale, with the pandemic affecting virtually every aspect of their daily lives. And while "caregivers can't always alter children's circumstances or shield them from discomfort, they can offer a more enduring gift: tools to manage adversity," writes therapist and school counselor Phyllis L. Fagell for The Washington Post.

But it's clear that educators also play an essential role in helping children develop the determination and ability to persevere through difficult circumstances in school and life-this year, and anytime.

When educators help students "cultivate an approach to life that views obstacles as a critical part of success, we help them develop resilience," writes Marilyn Price-Mitchell, a developmental psychologist and author. "Resilience is not a genetic trait. It is derived from the ways that children learn to think and act when faced with obstacles large and small." When the adults in children's lives-caregivers, teachers, coaches-help young people develop resilience, it helps them "emerge from challenging experiences with a positive sense of themselves and their futures," says Price-Mitchell.

It's a skill that takes practice. "Resilience works like a muscle we can build through effort and repetition, and we want to keep our muscles strong and flexible so we can think of many ways to solve a problem," Mary Alvord, a psychologist and author, tells Fagell. "At the core, resilience is the belief that while you can't control everything in your life, there are many aspects you can control, including your attitude."

Here are five strategies, some recommended by Fagell and a few sourced from our Edutopia content, for helping students build the vital capacity for resilience.

Set Brave Goals

A big part of developing resilience involves being able to identify personal goals, and then being able to "tolerate the discomfort that's creating resistance toward that goal," psychologist Ryan C.T. DeLapp tells Fagell. This year, a brave goal might involve asking students to contemplate the camera-on/camera-off dilemma, exploring how it impacts their personal and academic growth. "Is not being on camera interfering with your academics, or likely to make it harder for you to be visual socially when the pandemic ends?" asks DeLapp. "That represents an opportunity for a brave goal."

Many educators use a SMART framework to help students set personal goals that are: specific; measurable; attainable; relevant; and timely. "It's not easy to write SMART goals," writes Maurice J. Elias, a professor in the psychology department at Rutgers University. "This skill takes time to develop, and it's especially important to have in place for students at the secondary level."

A vague goal, Elias writes, might look like this: "I will do better on my next report card." But a more productive goal-one that's a good mix of ambitious yet achievable-might look like this: "In the next marking period, I will take careful notes and review them at least two days before tests and quizzes so that I can ask the teacher questions about what I don't understand. I will do my math homework before I do things with friends, and when I hand it in, I will ask the teacher about anything I am not sure about. When I get anything wrong, I will make sure to ask the teacher, or one of my classmates how they got the right answer."

Once a child meets a goal, it's especially important to celebrate the achievement, notes DeLapp. "Make time to reflect on progress toward their brave goal, and express gratitude and excitement when they meet them," Fagell advises.

Model Learning from Mistakes

Learning from failure "is paramount to becoming a resilient young person," writes Price-Mitchell. Teachers can help by creating a classroom where "failure, setbacks, and disappointment are an expected and honored part of learning," where students are "praised for their hard work, perseverance, and grit, not just for grades and easy successes," and where they are held accountable for producing work about which they feel "ownership and internal reward."

Consider creating a classroom bulletin board where, in addition to showcasing students' achievements, "students can brag about their biggest mistakes and what they learned from them," wrote educational consultant and author, Richard Curwin. "Be sure to tell the class about your own mistakes, especially if they are funny, and what you learned from them," wrote Curwin, who died in 2018. Give students opportunities to correct mistakes and resubmit work and be sure to recognize when their work improves because "nothing shows learning from mistakes more than improvement," Curwin noted.

Or you can explicitly label some activities "rough-draft thinking" suggest math professor Amanda Jansen and her co-authors in a 2017 study, giving students "permission to ask questions, make mistakes, and then revise without the stifling prospect of failure."

Encourage Responsible Risks

High school special education teacher Daniel Vollrath likens resilience to a stress ball. "A stress ball is resilient because it springs back to its original shape after being squeezed," Vollrath writes. "Likewise, when students experience stress or frustration, we can think of that as pressure on them that they need to spring back from. The hope in presenting them with strategies to build resilience is that those strategies will ease the frustration and help them get back into optimal and productive focus for learning."

One way to foster resilience is to recognize and compliment students when they take responsible risks and challenge themselves-even and maybe especially when they don't achieve the desired results. For example, speaking up to answer a question during a Zoom class, even if the answer is incorrect, or "stumbling on words while reading out loud," writes Vollrath. "These are opportunities to build confidence, and risk-taking, and most importantly, to keep a resilient momentum going forward while in a safe space."

Label Difficult Emotions

Recognizing and naming emotions, from elementary school through high school, can help students "become self-aware and begin to manage their own emotional states effectively-psychologists call this labeling," writes Jorge Valenzuela, an education coach and adjunct professor at Old Dominion University. Once students learn to notice, name, and interpret their emotions, they are better prepared to make rational decisions and manage disorienting or disruptive emotions in their lives-critical elements of resilience.

A good place to start in the classroom is with quick daily emotional check-ins. Valenzuela lays the groundwork for these at the beginning of the year, using Plutchik's Wheel of Emotions to teach students the words they can use to describe the emotions they're feeling-with varying degrees of complexity based on grade level. "I find that [the emotion wheel] helps them categorize their emotions and their responses to those emotions," Valenzuela writes. "Additionally, students can recognize that other emotions are an amalgamation of the eight basic emotions or are derived from one or more of them. This is a very powerful realization for them-it serves to help them identify emotional triggers and begin planning to respond with good self-management strategies."

Write and Talk About Setbacks and Human Resilience

In middle and high school, writing assignments that focus on "sources of personal strength" can help kids explore different ways to build resilience, writes Price-Mitchell, who provides a few prompts to get started: "Write about a person who supported you during a particularly stressful or traumatic time. How did they help you overcome this challenge? What did you learn about yourself?" Another idea: "Write about a time in your life when you had to cope with a difficult situation. What helped and hindered you as you overcame this challenge? What learning did you take away that will help you in the future?"

But the topic of resilience isn't bound to one class-ELA, for example-it's relevant across the curriculum. "Opportunities abound to connect resilience with personal success, achievement, and positive social change," Price-Mitchell notes. "Expand discussions about political leaders, scientists, literary figures, innovators, and inventors beyond what they accomplished to the personal strengths they possess, and the hardships they endured and overcame to reach their goals. Help students learn to see themselves and their own strengths through these success stories."

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Students need the tools to deal with adversity. Here's how teachers can help.

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As youth grow and reach their developmental competencies, there are contextual variables that promote or hinder the process. These are frequently referred to as protective and risk factors.

The presence or absence and various combinations of protective and risk factors contribute to the mental health of youth. Identifying protective and risk factors in youth may guide the prevention and intervention strategies to pursue with them. Protective and risk factors may also influence the course mental health disorders might take if present.

A protective factor can be defined as "a characteristic at the biological, psychological, family, or community (including peers and culture) level that is associated with a lower likelihood of problem outcomes or that reduces the negative impact of a risk factor on problem outcomes."¹ Conversely, a risk factor can be defined as "a characteristic at the biological, psychological, family, community, or cultural level that precedes and is associated with a higher likelihood of problem outcomes."² The table below provides examples of protective and risk factors by five domains: youth, family, peer, community, and society.

Risk and Protective Factors for Mental, Emotional, and Behavioral Disorders in Adolescences

Risk Factors

Domains

Protective Factors

Female gender

Early puberty

Difficult temperament: inflexibility, low positive mood, withdrawal, poor concentration

Low self-esteem, perceived incompetence, negative explanatory and inferential style

Anxiety

Low-level depressive symptoms and dysthymia

Insecure attachment

Poor social skills: communication and problem-solving skills

Extreme need for approval and social support

Low self-esteem

Shyness

Emotional problems in childhood

Conduct disorder

Favorable attitudes toward drugs

Rebelliousness

Early substance use

Antisocial behavior

Head injury

Marijuana use

Childhood exposure to lead or mercury (neurotoxins)

Individual

Positive physical development

Academic achievement/intellectual development

High self-esteem

Emotional self-regulation

Good coping skills and problem-solving skills

Engagement and connections in two or more of the following contexts: school, with peers, in athletics, employment, religion, culture

Parental depression

Parent-child conflict

Poor parenting

Negative family environment (may include substance abuse in parents)

Child abuse/maltreatment

Single-parent family (for girls only)

Divorce

Marital conflict

Family conflict

Parent with anxiety

Parental/marital conflict

Family conflict (interactions between parents and children and among children)

Parental drug/alcohol use

Parental unemployment

Substance use among parents

Lack of adult supervision

Poor attachment with parents

Family dysfunction

Family member with schizophrenia

Poor parental supervision

Parental depression

Sexual abuse

Family

Family provides structure, limits, rules, monitoring, and predictability

Supportive relationships with family members

Clear expectations for behavior and values

Peer rejection

Stressful events

Poor academic achievement

Poverty

Community-level stressful or traumatic events

School-level stressful or traumatic events

Community violence

School violence

Poverty

Traumatic event

School failure

Low commitment to school

Not college bound

Aggression toward peers

Associating with drug-using peers

Societal/community norms favor alcohol and drug use

Urban setting

Poverty

Associating with deviant peers

Loss of close relationship or friends

School, Neighborhood, and Community

Presence of mentors and support for development of skills and interests

Opportunities for engagement within school and community

Positive norms

Clear expectations for behavior

Physical and psychological safety

Adapted from O'Connell, M. E., Boat, T., & Warner, K. E.. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, DC: The National Academies Press; and U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (2009). Risk and protective factors for mental, emotional, and behavioral disorders across the life cycle. Retrieved from http://dhss.alaska.gov/dbh/Documents/Prevention/programs/spfsig/pdfs/IOM_Matrix_8%205x11_FINAL.pdf

Resources

Mental Health: A Report of the Surgeon General
This Report of the Surgeon General on Mental Health is the product of a collaboration between two federal agencies, the Substance Abuse and Mental Health Services Administration and the National Institutes of Health. The report provides an overview of mental health as well as a section targeted at children's mental health. One of the key sections focuses on the risk and protective factors related to mental health in children.

References

¹ O'Connell, Boat, & Warner, 2009 p. xxvii
² O'Connell, Boat, & Warner, 2009 p. xxviii

Other Resources on this Topic

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As youth grow and reach their developmental competencies, there are contextual variables that promote or hinder the process. These are frequently referred to as protective and risk factors. The presence or absence and various combinations of protective and risk factors contribute to the mental health of youth.

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Centers for Disease Control and Prevention

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Muscular dystrophies are a group of muscle diseases caused by mutations in a person's genes. Over time, muscle weakness decreases mobility, making everyday tasks difficult. There are many kinds of muscular dystrophy, each affecting specific muscle groups, with signs and symptoms appearing at different ages, and varying in severity. Muscular dystrophy can run in families, or a person can be the first in their family to have a muscular dystrophy. There may be several different genetic types within each kind of muscular dystrophy, and people with the same kind of muscular dystrophy may experience different symptoms.

Muscular dystrophies are rare, with little data on how many people are affected. The Centers for Disease Control and Prevention (CDC) is working to estimate the number of people with each major kind of muscular dystrophy in the United States.
Learn more about CDC's research on muscular dystrophy "
Kinds of Muscular Dystrophy

The information on this page is a brief overview of the major kinds of muscular dystrophy.

Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) can have the same symptoms and are caused by mutations in the same gene. BMD symptoms can begin later in life and be less severe than DMD. However, because these two kinds are very similar, they are often studied and referred to together (DBMD).

How many people are affected?
About 14 in 100,000 males 5 - 24 years of age

Who is more likely to be affected: males or females?
Males

When does muscle weakness typically begin? DMD symptoms usually begin before 5 years of age. In BMD, symptoms usually appear later, even into adulthood.

Which parts of the body show weakness first?
Upper legs and upper arms

What other parts of the body can be affected?
Heart, lungs, throat, stomach, intestines, and spine

References for this page

1. Ciafaloni E, Fox DJ, Pandya S, et al. Delayed diagnosis in Duchenne muscular dystrophy: Data from the Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STARnet). J Pediatr. 2009 Sept;155(3):380-5

2. Bonne G, Leturcq F, Ben Yaou R. Emery-Dreifuss muscular dystrophy. 2004 Sep 29 [updated 2015 Nov 25]. In: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJH, Bird TD, Ledbetter N, Mefford HC, Smith RJH, Stephens K, editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2017.

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Muscular dystrophies are a group of diseases caused by defects in a person's genes.

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Centers for Disease Control and Prevention

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Cerebral palsy (CP) is the most common motor disability in childhood. Learn more facts.

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Centers for Disease Control and Prevention

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Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. Some people with ASD have a known difference, such as a genetic condition. Other causes are not yet known. Scientists believe there are multiple causes of ASD that act together to change the most common ways people develop. We still have much to learn about these causes and how they impact people with ASD.

People with ASD may behave, communicate, interact, and learn in ways that are different from most other people. There is often nothing about how they look that sets them apart from other people. The abilities of people with ASD can vary significantly. For example, some people with ASD may have advanced conversation skills whereas others may be nonverbal. Some people with ASD need a lot of help in their daily lives; others can work and live with little to no support.

ASD begins before the age of 3 years and can last throughout a person's life, although symptoms may improve over time. Some children show ASD symptoms within the first 12 months of life. In others, symptoms may not show up until 24 months of age or later. Some children with ASD gain new skills and meet developmental milestones until around 18 to 24 months of age, and then they stop gaining new skills or lose the skills they once had.

As children with ASD become adolescents and young adults, they may have difficulties developing and maintaining friendships, communicating with peers and adults, or understanding what behaviors are expected in school or on the job. They may come to the attention of healthcare providers because they also have conditions such as anxiety, depression, or attention-deficit/hyperactivity disorder, which occur more often in people with ASD than in people without ASD.

Signs and Symptoms

People with ASD often have problems with social communication and interaction, and restricted or repetitive behaviors or interests. People with ASD may also have different ways of learning, moving, or paying attention. These characteristics can make life very challenging. It is important to note that some people without ASD might also have some of these symptoms.
Learn more about signs and symptoms of ASD "
Diagnosis

Diagnosing ASD can be difficult since there is no medical test, like a blood test, to diagnose the disorder. Doctors look at the child's behavior and development to make a diagnosis. ASD can sometimes be detected at 18 months of age or younger. By age 2, a diagnosis by an experienced professional can be considered reliable. However, many children do not receive a final diagnosis until they are much older. Some people are not diagnosed until they are adolescents or adults. This delay means that people with ASD might not get the early help they need.
Learn more about screening and diagnosis of ASD "
Treatment

Current treatments for ASD seek to reduce symptoms that interfere with daily functioning and quality of life. ASD affects each person differently, meaning that people with ASD have unique strengths and challenges and different treatment needs. 2 Treatment plans usually involve multiple professionals and are catered to the individual.
Learn about treating the symptoms of ASD "
Risk Factors

There is not just one cause of ASD. There are many different factors that have been identified that may make a child more likely to have ASD, including environmental, biologic, and genetic factors.

Although we know little about specific causes, the available evidence suggests that the following may put children at greater risk for developing ASD:

Having a sibling with ASD

Having certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous sclerosis

Experiencing complications at birth

Being born to older parents

CDC is currently working on one of the largest U.S. studies to date on ASD. This study called the Study to Explore Early Development (SEED), was designed to look at the risk factors and behaviors related with ASD. CDC is now conducting a follow-up study of older children who were enrolled in SEED to determine the health, functioning, and needs of people with ASD and other developmental disabilities as they mature.

How Often ASD Occurs

CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network has been estimating the number of 8-year-old children with ASD in the United States since 2000.

ASD occurs in all racial, ethnic, and socioeconomic groups. It is more than 4 times more common among boys than among girls.
Learn more about how CDC estimates the number of children with ASD "
If You're Concerned

As a parent, you already have what it takes to help your young child learn and grow. CDC has developed materials to help you track your child's developmental milestones and share that progress, or any concerns, with your child's doctor at every check-up.
Learn more about CDC milestone checklists and other parent materials "
Contact your child's doctor if you think your child might have ASD or if you have any other concerns about the way your child plays, learns, speaks, or acts.

If you are still concerned, ask the doctor for a referral to a specialist who can do a more in-depth evaluation of your child. Specialists who can do a more in-depth evaluation and make a diagnosis include

Developmental pediatricians (doctors who have special training in child development and children with special needs)

Child neurologists (doctors who work on the brain, spine, and nerves)

Child psychologists or psychiatrists (doctors who know about the human mind)

At the same time, call your state's public early childhood system to request a free evaluation, sometimes called a Child Find evaluation, to find out if your child qualifies for intervention services. You do not need to wait for a doctor's referral or a medical diagnosis to make this call.

Where to call for a free evaluation from the state depends on your child's age:

If your child is not yet 3 years old, contact your local early intervention system.
You can find the right contact information for your state by calling the Early Childhood Technical Assistance Center (ECTA) at 919-962-2001.

If your child is 3 years old or older, contact your local public school system.

Even if your child is not yet old enough for kindergarten or enrolled in a public school, call your local elementary school or board of education and ask to speak with someone who can help you have your child evaluated.

If you're not sure who to contact, call the ECTA at 919-962-2001.

Research shows that early intervention services can greatly improve a child's development. In order to make sure your child reaches their full potential, it is very important to receive services as soon as possible.

References

1. Lord C, Risi S, DiLavore PS, Shulman C, Thurm A, Pickles A. Autism from 2 to 9 years of age. Arch Gen Psychiatry. 2006 Jun;63(6):694-701.

2. Hyman, S.L., Levy, S.E., Myers, S.M., & AAP Council on Children with Disabilities, Section on developmental and behavioral pediatrics. (2020). Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics, 145(1), e20193447.

3. Handleman, J.S., Harris, S., eds. Preschool Education Programs for Children with Autism (2nd ed). Austin, TX: Pro-Ed. 2000.

4. National Research Council. Educating Children with Autism. Washington, DC: National Academy Press, 2001.

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Basics About Autism Spectrum Disorder (ASD) | NCBDDD | CDC

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Autism Spectrum Disorders (ASDs) are a group of developmental disabilities that can cause significant social, communication and behavioral challenges. CDC is working to find out how many children have ASDs, discover the risk factors, and raise awareness of the signs.

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Assignment: Write a 200 word (or more) paragraph on how TBI affects family 

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Assignment: Write a 200 word (or more) paragraph on how TBI affects family 

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Answer in 200 words or more OR 5 to 6 complete sentences about how TBI affects family members. Knowing this information, what can we do as teachers to support the families? How should we respond to our parents? Think about what opportunities we have to interact with parents

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How does brain injury affect family members?

For most family members, life is not the same after TBI. We want you to know that you are not alone in what you are feeling. While everyone's situation is a bit different, there are some common problems that many family members experience such as less time for yourself, financial difficulties, role changes of family members, problems with communication, and lack of support from other family members and friends. These are just some of the problems that family members may face after injury. Sometimes these problems can seem too much and you may become overwhelmed, not seeing any way out. Family members have commonly reported feeling sad, anxious, angry, guilty, and frustrated.

Ways to reduce stress

Since the injury, you have likely been under a great deal of stress. A little stress is part of life, but stress that goes on for a long time can have a negative effect on the mind and body.

Stress is related to medical problems such as heart disease, cancer, and stroke.

Stress can make you do things less well because it affects your ability to concentrate, to be organized, and to think clearly.

Stress also has a negative effect on your relationships with other people because it makes you irritable, less patient, and more likely to lash out at others.

Stress can lead to depression and/or anxiety.

If you are under constant stress, you are not going to be as helpful to your injured family member or anyone else. If you do not take the time to rest and care for yourself, you will get fewer things done, which will lead to more stress. If you won't do this for yourself, do it for your injured family member. They will be better off if you are healthy and rested. Here are some suggestions for ways to reduce stress and stay healthy. These things have worked for many people, but not all of them may work for you. The important thing is that you begin thinking about ways to improve your life.

Learn to relax

Taking a few moments to relax can help you be more ready for the things you need to do. Learning to relax is not easy, especially in your current situation. There are relaxation techniques that can help you such as breathing deeply and focusing on your breathing, stating a word or phrase that has positive meaning (e.g. peace), or visual imagery. In order to train your body and mind to relax, you need to practice often. Don't give up if it doesn't work right away. If you keep practicing these techniques, you will feel more relaxed in the long run, and you will find that you're able to function better in all areas of your life.

Learn which coping strategies work for you

No matter what was going on in your life before, the injury has caused changes. You may never have experienced anything similar to the injury, and some of your usual coping strategies may not work in your current situation. The best thing that you can do for yourself is to be open to trying new ways of coping and find out what works for you.

Some coping strategies that others have found helpful:

Taking time for yourself

Keeping a regular schedule for yourself

Getting regular exercise such as taking a 20-30 minute walk each day

Participating in support groups

Maintaining a sense of humor

Being more assertive about getting the support you need

Changing roles and responsibilities within the family

Learn how to reward yourself

Everyone needs something to look forward to. You'll probably say, "I have no time; it's impossible." Just remember that you will be more ready to do the things you have to do if you take some time to do some things that you want to do. Even if you have very limited time, you can find some small way to reward yourself. Promise yourself a cup of your favorite coffee or an opportunity to watch a good TV show or read something you enjoy.

Problem-solving for caregivers

Sometimes you may feel overwhelmed by problems. There may be so many problems that you're not sure which one to tackle first. You can only solve one problem at a time, so pick one. Use the problem solving steps below to find a good solution. Try to choose a smaller problem to solve first. This will give you practice and make you more confident about solving bigger problems. If you deal with problems in this way, they may seem easier to handle.

Steps in Problem Solving

1. Identify the problem: What is the problem? Define it as clearly and specifically as possible. Remember that you can only solve one problem at a time.

2. Brainstorm solutions: What can be done? Think of as many things as you can. Don't worry about whether they sound silly or realistic. This is the time to think about all possibilities, even the ones that you don't think will happen. Be creative.

3. Evaluate the alternatives: Now you will start thinking about the consequences of the ideas you came up with in Step 2. For each idea, make a list of positives on one side of the page and a list of negatives on the other side.

4. Choose a solution: Pick the solution with the best consequences based on your list of positives and negatives. Keep in mind that more positives than negatives is not always the best rule. Sometimes you will have one negative that outweighs many positives.

5. Try the solution: Try out the idea you have chosen. Give it more than one chance to work. If it doesn't work right away, try to figure out why. Was there some consequence you didn't think of? Is there another problem in the way that could be easily solved?

6. If your first solution doesn't work, try another one: Don't give up. Everything doesn't always work out the first time. You can learn from your mistakes; they may help you to choose a better solution next time.

Ways family members can help the injured person

The treatment team can provide you with guidance in how to help the person while not giving them too much or too little assistance. Attending therapy when possible and working with the therapists and nurses are the best ways to learn to help the person before discharge from the hospital.

The following recommendations are intended to help families and caregivers care for their loved one once they have returned home. Not all of the following recommendation may apply to your situation.

Provide structure and normalcy to daily life

Establish and maintain a daily routine - this helps the person feel more secure in their environment.

Place objects the person needs within easy reach.

Have the person rest frequently. Don't let the person get fatigued.

Be natural with the person and help them to maintain their former status in the family.
Communication is important to the person's recovery. Although they may not be able to speak, they should continue to be involved in as normal a social world as possible.

Include the person in family activities and conversations.

Keep a calendar of activities visible on the wall. Cross off days as they pass.

Maintain a photo album with labeled pictures
of family members, friends, and familiar places.

Provide support in a respectful way

Try not to overwhelm the person with false optimism by saying statements like "You will be alright" or "You will be back to work in no time.

Point out every gain the person has made since the onset of the injury. Avoid comparing speech, language or physical abilities prior to the injury with how they are now. Look ahead and help the person to do the same.

Treat the person as an adult by not talking down to them.

Respect the person's likes and dislikes regarding food, dress, entertainment, music, etc.

Avoid making the person feel guilty for mistakes and accidents such as spilling something.

If the person has memory problems, explain an activity as simply as possible before you begin. Then as you do the activity, review with the person each step in more detail.

Avoid over-stimulation

Agitation can be heightened by too much activity and stimulation.

Restrict the number of visitors (1 or 2 at a time).

Not more than one person should speak at a time.

Use short sentences and simple words.

Present only one thought or command at a time and provide extra response time.

Use a calm, soft voice when speaking with the person.

Keep stimulation to one sense (hearing, visual or touch) at a time.

Avoid crowded places such as shopping malls and stadiums.

Safety Tips

The person who has confusion or impaired judgment may be unable to remember where dangers lie or to judge what is dangerous (stairs, stoves, medications). Fatigue and inability to make the body do what one wants can lead to injury. Therefore it is very important that a brain injured person live in an environment that has been made as safe as possible. The following are some safety guidelines to use in the home:

Keep clutter out of the hallway and off stairs or anywhere the person is likely to walk. Remove small rugs that could cause tripping or falls.

Remove breakables and dangerous objects (matches, knives, and guns).

Keep medications in a locked cabinet or drawer.

Get the doctor's consent before giving the person over-the-counter medication.

Limit access to potentially dangerous areas (bathrooms, basement) by locking doors if the person tends to wander. Have the person wear an identification bracelet in case he or she wanders outside.

Keep the person's bed low. If they fall out of the bed, you may want to place the mattress
on the floor or install side rails.

Make sure rooms are well lit, especially in the evening. Night-lights can help prevent falls.

Have someone stay with the person who is severely confused or agitated.

Keep exit doors locked. Consider some type of exit alarm, such as a bell attached to the door.

Consider a mat alarm under a bedside rug to alert others if the person gets up during the night.

Things that can be more dangerous after a TBI and should be resumed only after consulting a health care professional: contact sports, horseback riding, swimming, hunting or access to firearms, power tools or sharp objects, riding recreational vehicles, and cooking without supervision.

Individuals with brain injury should receive permission from a health care professional prior to using alcohol or other substances at any point after their injury. Also, NO DRIVING until approved by your doctor.

More in the Understanding TBI Series

Authorship

Understanding TBI was developed by Thomas Novack, PhD and Tamara Bushnik, PhD in collaboration with the Model System Knowledge Translation Center. Portions of this document were adapted from materials developed by the University of Alabama TBIMS, Baylor Institute for Rehabilitation, New York TBIMS, Mayo Clinic TBIMS, Moss TBIMS, and from Picking up the pieces after TBI: A guide for Family Members, by Angelle M. Sander, PhD, Baylor College of Medicine (2002).

Source: The content is based on research and/or professional consesnsus. This content has been reviewed and approved by experts from the Traumatic Brain Injury Model Systems (TBIMS), funded by the National Institute of Diability, Independent Living, and Rehabilitation Research, as well as experts from the Polytrauma Rehabilitation Centerse (PRC), funded by the U.S. Department of Veterans Affairs.

Disclaimer: This information is not meant to replace the advice from a medical professional. You should consult your health care provider regarding specific medical concerns or treatment.This publication was originally produced by the TBI Model Systems in collaboration with the University of Washington Model Systems Knowledge Translation Center with funding from the National Institute on Disability and Rehabilitation Research in the U.S. Department of Education (grant number H133A060070). It was updated by the TBI Model Systems in collaboration with the Model Systems Knowledge Translation Center at the American Institutes for Research with fuding from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR; grant number 90DP0082). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this factsheet do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

Copyright © 2018 Model Systems Knowledge Translation Center (MSKTC). You can freely reproduce and distribute this content. Include proper attribution. But you must get permission before using this content in fee-based products.

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Understanding TBI: Part 4 - The Impact of a Recent TBI on Family Members and What They Can Do To Help With Recovery

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How does brain injury affect family members? For most family members, life is not the same after TBI. We want you to know that you are not alone in what you are feeling.

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Living With Brain Injuries Taught Us Advocacy

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Living With Brain Injuries Taught Us Advocacy

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Living with Brain Injuries Taught Us Advocacy | Brandon Kidney Lauren Migliaccio | TEDxCSU

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The Invisible Rain Cloud: What's It Like To Live With A Traumatic Brain Injury?

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Assignment: Demonstrate knowledge of core challenges of students with TBI

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Assignment: Demonstrate knowledge of core challenges of students with TBI

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Visit the website https://msktc.org/TBI
Select three areas in which students with TBI are affected within the school setting. For each area, provide a description of the area and provide a reason why it is applicable to the school setting. You may want to view areas of behavioral issues, cognitive problems, returning to school after a brain injury, or change in memory or health problems

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MM 4.5 Demonstrate knowledge of core challenges of TBI

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The MSKTC works closely with researchers in the 16 Traumatic Brain Injury (TBI) Model Systems to develop resources for people living with traumatic brain injuries and their supporters. These evidence-based materials are available in a variety of formats such as printable PDF documents, videos, and slideshows.

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Living with Traumatic Brain Injury (TBI)

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The MSKTC works closely with researchers in the 16 Traumatic Brain Injury (TBI) Model Systems to develop resources for people living with traumatic brain injuries and their supporters. These evidence-based materials are available in a variety of formats such as printable PDF documents, videos, and slideshows.

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Changes that Might Occur as a Result of TBI

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Changes that Might Occur as a Result of TBI

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Changes That Might Occur as a Result of a TBI

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While each brain injury is unique, changes in cognitive ability, behavior, and physical abilities are common. Common changes include the following.

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Assignment: Complete the Accommodations/Modifications for a student with OI

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Assignment: Complete the Accommodations/Modifications for a student with OI

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After Reading "Supporting the Educational Needs of Students with Orthopedic Impairments" Article, complete the Accommodations/Modifications sheet for a student with orthopedic impairments. For a recap of Accommodations and Modifications in SIRAS, view the "IEP Development in SIRAS: A Reference Guide".

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Sarah E. LaRose, Andrew C. Thoron, and Blake C. Colclasure 2

Introduction

Agricultural education instructors teach a wide variety of students including those who may be disabled. Students requiring special services are not always cognitively impaired. Sometimes students may require modifications based on their physical abilities, particularly those classified with an orthopedic impairment. According to the Individuals with Disabilities Education Act, an orthopedic impairment is defined as

A severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments caused by a congenital anomaly, impairments caused by disease (e.g., poliomyelitis, bone tuberculosis), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures). (2004, Section 300.8.8)

Orthopedic impairments can be classified as belonging to one of three different categories: neuromotor impairments, degenerative diseases, or musculoskeletal disorders (Heller & Swinehart-Jones, 2003). Common examples of conditions according to each category include the following:

Neuromotor Impairments: spina bifida, cerebral palsy, spinal cord injuries

Degenerative Diseases: muscular dystrophy, spinal muscular atrophy

Musculoskeletal Disorders: club foot, missing/deformed limbs, scoliosis

The orthopedic impairment must interfere with the student's ability to perform in an educational environment in order to qualify for special services. This disability may interfere with a student's ability to walk, write, or perform other physical tasks in the classroom and laboratory setting. It might also affect the student's ability to communicate with others, hindering their ability to respond to questions orally. Furthermore, they might also have additional disabilities that can affect their educational performance, including mental retardation, learning disabilities, perceptual problems, distractibility, disorganization, visual-motor deficits, restlessness, and visual abnormalities (Heller & Swinehart-Jones, 2003). These various conditions all serve to affect the student's coordination and mobility as well as their ability to communicate, learn, and adjust (Vaughn, Bos, & Schumm, 2007). Orthopedic impairments may also affect the student's endurance in performing various tasks, and they might tire more easily. Due to the hands-on nature of agricultural education, instructors should plan ahead to meet the needs of learners in their classes with orthopedic impairments.

Application in the Learning Environment

Just as each student who is cognitively affected by a learning disability varies in the range and depth of their disability, students with orthopedic impairments vary widely as well. Some of the more common orthopedic impairments include cerebral palsy, muscular dystrophy, spinal cord injury, and spina bifida (Vaughn, Bos, & Schumm, 2007). The instructor needs to meet with the case manager of the student and with the parents/guardians of the student in order to best prepare for meeting the needs of the student. Students with orthopedic impairments will likely have a variety of needs influenced by the type of limitations they experience with their disability. Heller and Swinehart-Jones (2003) developed the following model which depicts the impact of orthopedic impairments on educational performance.

Figure 1.
Credit: Heller and Swinehart-Jones (2003, p. 7)

The model illustrates how the type of orthopedic impairment, as well as the psychosocial and environmental factors, all can affect the functional limitations of the educational performance of students with orthopedic impairments. Furthermore, the instructor should determine how the functional limitations of the student affect the amount of instructional delivery time. Motor limitations and neurocognitive impairments may increase the amount of time necessary to provide students with meaningful learning experiences, requiring the instructor to modify the time management of their classroom.

Consideration should be given to the psychosocial/environmental factors when tailoring instruction to students with orthopedic impairments. Instructors can use three basic principles when accommodating students with orthopedic impairments: (1) use others as resources, (2) be flexible in your planning, and (3) be ingenious and creative. Students with orthopedic impairments often have a large support team assigned to work with them to ensure that they are receiving appropriate educational services. For example, students might be given assistance from special education teachers, an occupational or physical therapist, or a speech and language pathologist. If the severity of the impairment is far less or temporary, the assistance may be from an adaptive physical education teacher (Vaughn, Bos, & Schumm, 2007). Involve the various members of this support team to gain clearer idea of what educational strategies will be appropriate for the student. The instructor should also be made aware of specific indicators of student health problems and have the ability to respond appropriately should an emergency situation arise (Heller & Swinehart-Jones, 2003). The manner in which the instructor should respond to these situations will vary among school districts, so it will be imperative that the instructor seek out this information. Ultimately, it is the responsibility of the instructor to provide a safe and healthy environment for all students.

Classroom Environment

Students with orthopedic impairments may have assistive technologies that allow them to communicate, read, record notes, or physically move around the room. Conversing with the members of the student's support team, who are familiar with these technologies, can help the instructor learn how these technologies can be incorporated into instruction. Instructors should work closely with special education teachers in order to provide appropriate modifications to tests, quizzes, and other assignments. For example, a student might be better able to respond to questions orally rather than writing a response or using assistive technology, or the number of questions on a test might be reduced if the student tires easily. Structured graphic organizers, which limit the amount of visual processing or physical writing, may also be useful modifications for students with orthopedic impairments. Since these students might also be affected by mental retardation and learning disabilities that might affect their ability to learn, students with orthopedic impairments may have modified expectations for knowledge and skills they are expected to acquire (Heller & Swinehart-Jones, 2003). For example, a student may be exempt from taking a class if it is determined that a particular subject might be too abstract for them to grasp. It would be wise for the agriculture instructor to meet with the special education teacher to determine unit content appropriate for the student's abilities.

In addition to determining appropriate instructional strategies and curricular expectations, it is vital that the instructor evaluate the physical classroom environment when planning to work with students with orthopedic impairments. Consideration should be given to seating (e.g., desk with attached chairs vs. tables), floor traction, lighting, board visibility, width of aisles, work surface accessibility, location of classroom supplies, and location of the student in the classroom. Creating a physical environment that allows a student to easily interact with their peers is the first step toward creating a welcoming, safe space for learning to occur.

Laboratory Environment

Student accessibility is likely to be the biggest concern for instructors planning to meet the needs of students with orthopedic impairments in the laboratory setting. Agricultural education laboratories vary widely and can include environments such as food science labs, chemistry labs, large animal handling facilities, small animal care and grooming labs, agricultural mechanics facilities, gardens, greenhouses, and more. Since these laboratory settings vary so widely, instructors will need to assess the physical layout of their own particular lab settings to determine what areas need to be addressed when instructing a student with orthopedic impairments. Agricultural-specific assistive technology is increasingly available from the National AgrAbility Project and may be available for school systems to implement into programs. The instructor should have conversations with the special education staff and possibly even the administration regarding the types of modifications that might be made to existing laboratory environments or equipment in order to make it accessible for students with orthopedic impairments. The instructor needs to explain the activities associated with working in the laboratory setting to the learner's case manager, paraprofessional, and parents before having the learner engage in such activities in order to decide which activities are appropriate and safe for the learner.

Non-Formal Environment

Agricultural education takes advantage of a variety of non-formal learning environments, including class field trips to area farms and businesses, FFA conferences and workshops, and Supervised Agricultural Experience projects (SAE). Students with orthopedic impairments will possibly have walkers, wheelchairs, or motorized equipment to help them move around independently; these will need to be accounted for when transporting students. Some agriculture education programs have activity vehicles such as pickup trucks, vans, or busses that are used to transport students. If an instructor is taking a class field trip, then it will be important to account for how students with orthopedic impairments will travel. The instructor may need to request a school bus with handicap accessibility to transport the student. The instructor should consult the special education department and the administration about the particular processed needed to ensure that students with orthopedic impairments can still participate in class or FFA field trips.

Students with orthopedic impairments may also have vocational goals written into their Individualized Education Plans (IEP) that expressly outline knowledge and skills that the students should develop in order to help prepare them for life after public education. The SAE requirements for students with orthopedic impairments can be modified to meet these goals and the student's ability. For example, a student might help sort mail and files at a veterinary office or stock produce at a grocery store. These students may also be assigned a workplace mentor by the special education department as part of addressing the vocational goals of the students' IEP. This mentor is frequently a paraprofessional the student may work with throughout the school day already, and who accompanies the student to their place of work. This person can give the instructor valuable feedback regarding the student's performance. Additionally, students with orthopedic impairments might conduct their own agriscience research project or entrepreneurship project at school or home in order to enrich their vocational skill development and augment their agricultural education.

Conclusion

Learners with orthopedic impairments are affected by their disability in unique ways and by a variety of conditions. In tandem with physical disabilities, these students might also be affected by other conditions such as developmental disorders, mental retardation, learning disabilities, or visual processing disabilities. Of primary difficulty for students with orthopedic impairments is the physical interaction with their environment. Agricultural education instructors should work closely with the special education department and other members of the support team for a student with orthopedic impairments to ensure that their instruction and instructional environments meet the needs of the learner. Resources for adaptive agricultural technology can be found from Extension or AgrAbility. Additionally, other resources for instructional strategies or supplies designed for individuals with disabilities are available from various websites listed below.

https://pubs.ext.vt.edu/442/442-084/442-084_pdf.pdf

http://www.agrability.org/

https://www.independentliving.com/default.asp

http://www.nsta.org/disabilities/motor.aspx

References

Heller, K.W., & Swinehart-Jones, D. (2003). Supporting the Educational Needs of Students with Orthopedic Impairments. Physical Disabilities: Education and Related Services, 22(1), 3-24.

Individuals with Disabilities Education Act of 2004 § 300, A § 300.8 c 8 (2004). Retrieved from https://sites.ed.gov/idea/regs/b/a/300.8/c/4

Vaughn, S., Bos, C.S., & Schumm, J.S. (2007). Teaching Students Who Are Exceptional, Diverse, and at Risk in the General Education Classroom (4 th ed.). Boston, MA: Pearson Education.

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AEC600/WC262: Teaching Students with Disabilities: Orthopedic Impairment

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University of Florida, Institute of Food and Agricultural Sciences Extension outreach is a partnership between state, federal, and county governments to provide scientific knowledge and expertise to the public. The University of Florida (UF), together with Florida A&M University (FAMU), administers the Florida Cooperative Extension Service.

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Disability Technology  | Jeff Paradee | TEDxLSSC

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TALK TO ME | Physical Disability Awareness

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The IDEA's Special Education Categories: Orthopedic Impairment

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Supporting the Educating Needs of Students with Orthopedic Impairments

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Supporting the Educating Needs of Students with Orthopedic Impairments

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Module 6.6 - Support and Services needed for TBI

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Module 6.6 - Support and Services needed for TBI

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Understand that when a student experiences a traumatic brain injury, it can lead to the loss or decline of their previous abilities in learning, socializing, and physical activities. This can have lasting effects on their self-image and emotional well-being, as well as impact their family. To help them cope with these challenges, it is important to provide suitable support and services.

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Building Blocks of Brain Development - Colorado Kids with Brain Injury

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The graphic to the right represents the Building Blocks of Brain Development. Our brains develop each and every "building block" or brain function in a progressive manner. They build upon each other to become more complex (i.e., higher order thinking). The building blocks included here represent typical areas of processing/learning and those that are commonly [...]

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Assignment: Design an Inclusive Classroom

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Assignment: Design an Inclusive Classroom

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Design your classroom or plan for a day for students with physical disabilities. Remember to include equal access to buildings or rooms, place important items within reach, identify ramps, seating arrangements, access to bathrooms and play areas. Use links and resources provided in the presentation, or find preferred resources.
Choose ONE of the methods below to design your classroom.
1. Draw and label it with pencils and paper
2. Fill out the Google Doc above.
3. Design and label it in Google Slides
4. Design and label it in Google Drawing

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Design your classroom for students with Physical Disabilities

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Must include paper CTC application, $100 processing fee and original LEA verification of completed work with administrator's signature.

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Answers to the following questions are required. If you answer yes to any question, you must complete the corresponding Profession Fitness Explanation Form.

Before Granting your application, the Commission will review, at a minimum:

Federal Bureau of Investigation criminal history (rap sheet)

California Department of Justice criminal history (rap sheet)

International database of teacher misconduct maintained by the National Association of State Directors of Teacher Education and Certification (NASDTEC)

Previous reviews by the Commission

Complaints from others

Notifications from school districts

Teacher preparation test score violations

You must disclose misconduct, even if:

It happened a long time ago

It happened in another state, federal court, military or jurisdiction outside the United States

You did not go to court and your attorney went for you

You did not go to jail or the sentence was only a fine or probation

You received a certificate of rehabilitation

Your conviction was later dismissed (even if under Penal Code section 1203.4), expunged, set aside or the sentence was suspended

WARNING:

You will be required to sign your application under penalty of perjury; by doing so you are also stating that you understand:

That the information you provide is true and correct;

That you understand any and all instructions related to your application;

Failure to disclose any information requested is falsification of your application and the Commission may reject or deny your application or take disciplinary action against your credential;

The Commission may reject your application if it is incomplete and it will be delayed.

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Application For Credential Authorizing Public School Service

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Answers to the following questions are required. If you answer yes to any question, you must complete the corresponding Profession Fitness Explanation Form.

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Disability and body image: fitting in when your body does not | Disability Horizons

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Listen Body image and confidence go hand-in-hand. If you're content with your body and accept it, then you will beam with confidence, leading others around you to do the same. But in reality, things are not that simple. Confidence issues can apply to everyone, disabled or not.

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Inclusive classroom spaces teach our students about the fundamental importance of inclusion and equality. They ensure our classrooms are accessible to all and enable every student to feel a sense of belonging.

We need to think about inclusion in every aspect of a classroom layout. As set out in the UN Declaration of Rights for People with Disabilities, all students with disabilities have the right to full participation in the daily life of a classroom.

Below are some important considerations for a teacher designing a space for students with physical disabilities.

1. Minimize Distances Traveled

Students with physical disabilities may find it difficult to travel between spaces in the classroom. To minimize travel distances for students with disabilities, ensure there is ample open space between workstations that allows ease of access to all areas of the classroom.

A horseshoe-shaped workstation, for example, might be insufficient for students with physical disabilities, as it requires taking long detours around the classroom.

2. Make the Whole Classroom Accessible

Mobility does not simply involve access between the student's desk and the door to the classroom.

Seating a student with a disability by the door or placing them at a separate desk may appear convenient and easy. However, it physically separates students from their peers and learning materials.

Similarly, giving a student with a disability a dedicated and separated space in the room also sends a damaging message to the student that they are an inconvenience.

Therefore, ensure students with disabilities are able to move around the whole classroom so that they can participate in all workstation and group-work activities. In particular, aim to ensure all pathways, desks, and computer workstations are accessible for students with physical disabilities.

Another common issue is clutter on the floor preventing students with walking aids or wheelchairs from moving around freely. Ensure all students are keeping their bags, pencil cases, and other belongings neatly stored at all times.

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3. Make All Materials Accessible

It is not always possible to place all materials at accessible heights and locations. However, I focus on placing the most commonly utilized classroom materials in the most accessible spaces. Whenever possible, I aim to make all regularly utilized materials accessible for students with physical disabilities.

While reach may be the primary concern when thinking about accessibility, it is not the only one. I have had several students with limited fine motor skills, for example. A solution here is to place all commonly used materials in drawers with large, easy-to-grasp handles.

4. Think About Lesson Transitions

Lesson transitions are often a pivotal moment in which a student's physical disability must be treated with sensitivity. Teachers may need to be proactive in giving subtle signals to a student with a physical disability to begin preparing for a lesson transition earlier than their peers.

Students with inhibited eyesight, for example, may require additional time to pack their belongings. Students who need walking aids may require additional time to set them up. By providing early warnings to these students, teachers can prevent instances where the student is singled out as 'running late.'

5. Make Accommodations for Guests With Physical Disabilities

Often, teachers only consider the needs of students in their class. A teacher may only actively think about accessibility when they learn they will have a child with a disability in their class for the year.

However, many important classroom guests may also have physical mobility requirements. Parents with disabilities have as much right as any other parent to access the classroom. Teachers in the school with physical disabilities may also need to access your classroom from time to time.

Being prepared for these possibilities before the guest arrives makes the guest feel more welcome within the space. It also prevents situations in which people with physical disabilities are made to feel like an inconvenience.

Final Thoughts

While sometimes our ideal classroom space is not possible due to financial and architectural limitations, there are always small steps that teachers can take to make their space more inclusive. Bigger picture issues-such as getting larger and more modern classrooms-may require further advocacy and lobbying.

Inclusive classroom design shows our students with disabilities that they are valued and normalizes inclusive attitudes for all our students to emulate. Small acts by the classroom teacher to make the classroom a more inclusive space such as rearranging desks, being sensitive to transition requirements and removing clutter can go a long way toward creating a sense of belonging and inclusion in every classroom.
Do you have any tips on setting up inclusive classroom spaces? Come and share in our WeAreTeachers HELPLINE group on Facebook. Plus, 50 tips and tricks for making your teaching more inclusive.

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How to Create Inclusive Classroom Spaces for Students With Physical Disabilities

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How can teachers create more inclusive classroom spaces for students with physical disabilities? Use these guiding principles to start.

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The way people experience or express emotions may change after a traumatic brain injury (TBI). While this can be distressing for family members and friends, many strategies can help manage these emotional concerns after TBI.

Anxiety

Anxiety is common in the general population and in people with moderate to severe TBI. Anxiety may look different from person to person, but most people with anxiety have intense fear and worry. Some people also have physical signs of anxiety. For example, they may have a racing heart, rapid breathing, sweating, shaking, or the sensation of butterflies in their stomach. They may feel anxious, stressed, or overwhelmed without knowing why. This stress can make recovery after a TBI even more difficult. People with TBI may have anxiety in situations that did not bother them in the past. They may feel anxious being in a crowd, when they are being rushed, or when adjusting to sudden changes in plans. They may feel overwhelmed in situations that require a lot of attention, fast thinking, or processing a lot of information at the same time.

Depression

People with depression may feel sad, irritable, or worthless. They may feel tired much of the time and may experience changes in sleep or appetite or difficulty concentrating. Sometimes, people may even have thoughts of death, hurting themselves, or taking their own life. People with these feelings often withdraw from others and lose interest in or feel less pleasure from activities they used to enjoy. Many signs of depression, such as fatigue and frustration, are also signs of TBI. However, someone with a TBI may experience these symptoms but not be depressed. Sadness, and grief are common after brain injury. Some people feel depressed right after TBI, but these feelings may also appear during the later stages of recovery. Symptoms of anxiety may appear before depression. If these feelings become overwhelming or interfere with recovery, the person with TBI may be experiencing depression.

What causes emotional changes after TBI?

Emotional changes can occur if the TBI affects areas of the brain that control emotions. Changes to these brain regions and to the chemicals that help the brain work can affect how the person with TBI experiences or expresses emotion.

People with TBI may have a hard time coping with their injury. They may need to adjust to a loss of independence, or to changes to their role in their family and in society. These changes can lead to frustration and dissatisfaction with their life.

People with TBI may also have changes in their thinking abilities, such as memory, attention, speed of thinking, and reasoning. These changes can cause them to feel overwhelmed if they can't remember things or keep up with what others are doing or saying. They may respond emotionally, with sadness, worry, or anger.

Use of alcohol or other drugs can lead to emotional changes, and emotional distress may also lead to alcohol and drug use.

People who had problems with depression or anxiety before the TBI may find that these problems are worse after the TBI. They may feel isolated, depressed, or misunderstood which can also affect emotions.

How to address emotional concerns after TBI

Remember that emotional distress is not a sign of weakness and it is no one's fault. A person can't get over their distress by wishing it away or "toughening up."

Medicine and counseling or psychotherapy can help with emotional distress after TBI. Sometimes, a combination of both works best.

If you choose to take medicine, you should work closely with the doctor or provider who prescribed the medication. Be sure to attend all follow-up visits about your medicine.

If you choose counseling or psychotherapy, let your therapist know about your TBI. Ask them to help you write important concepts down so that you can review them at home. Tell your therapist if you need to have something repeated in order to understand it better.

Stress and stressful situations can trigger emotional distress. People with TBI can take steps to reduce stress. For example, they can use relaxation techniques such as deep breathing or muscle relaxation, schedule breaks, and practice mindfulness activities.

A daily schedule of structured activities and exercise can help reduce distress. Activities may include exercise, puzzles, or games.

It is best to get treatment early to avoid needless suffering. Do not wait.

If you (or your family member) have thoughts of suicide, get help. You can call a local crisis line, 911, or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or go to your local emergency room.

Family members can help by changing the way they react to emotional distress after TBI:

Remember that anxiety, depression, irritability, and other changes in emotion after TBI may be due to brain injury. Try not to take it personally. Also remember that changes in emotion are no one's fault and try not to blame the person with TBI.

Stay calm and try not to react in an emotional way yourself or to argue with the person with TBI. If you are angry or hurt, take a break before you talk to them.

When they are acting out in anger, do not give in to their demands to try to calm them down. This can actually have the opposite effect of rewarding them for expressing their emotions in a non-helpful way. Resist the urge to give in to unreasonable demands. Instead, explain that you will talk to them when they are calm. Walk away and take a break until they are calmer.

Provide feedback in a gentle and supportive way after the person is calm.

Give the person with TBI opportunities to take a break to process their emotions. Encourage them to use deep breathing or listen to music to relax. Offer a quiet area, away from the stressor, to calm down and regain control. Then, redirect their attention to a different topic or activity.

Give the person with TBI time to have structured independence and more control over his or her life.

Tell them you recognize their emotions and want to understand their feelings and give the person with TBI a chance to talk about their feelings. People with TBI often have a hard time naming their emotions and might find it hard to recognize emotions in others. This means that they may not realize that they seem angry or that they are making others uncomfortable. You can help them identify their emotions and tell them how you feel.

Seek out support. The family may benefit from social and professional support. Counseling can help relieve the family's worry and help them to cope better each day.

Peer support and other resources

Remember, not all help comes from professionals! You and your family may benefit from the following:

Support groups: Some support groups are for the person with TBI, while others are for family members, and some are open to everyone affected by TBI. Information about support groups may be found through TBI organizations, rehabilitation facilities, and social media, among other places.

Peer mentoring: A peer is a person who is currently living with a TBI. A peer can offer support and advice to others who are new to TBI and dealing with similar problems.

Brain Injury Association (http://www.biausa.org): Reach out to your local chapter for resources, including training and resources for caregivers and family members.

Find someone to talk to. Reach out to a friend, family member, member of the clergy, or someone else who is a good listener.

Recommended reading

Senelick, R. C. (2013). Living with brain injury: A guide for patients and families (3rd ed.). Healthsouth Press.

Brain Injury Association of New York State. (2004). Making life work after head injury: A family guide for life at home. https://bianys.org/wp-content/uploads/2015/05/Making_Life_Work-after-TBI.pdf

Cassidy, J. W. (2009). Mindstorms: The complete guide for families living with traumatic brain injury. De Capo Lifelong Books.

Fann, J., & Hart, T. in collaboration with the Model Systems Knowledge Translation Center (2010) Depression after Traumatic Brain Injury . https://msktc.org/sites/default/files/lib/docs/Factsheets/TBI_Depression_and_TBI.pdf

Neumann, D., Miles, S. R., Sander, A., & Greenwald, B. in collaboration with the Model Systems Knowledge Translation Center (2021). Irritability, Anger, and Aggression After TBI. https://msktc.org/sites/default/files/MSKTC-IrrAftTBI-Factsheet-508.pdf

Authorship

Changes in Emotion After Traumatic Brain Injury was developed by Amanda Zwilling, Ph.D., Angelle Sander, PhD, and Robin Hanks, PhD, in collaboration with the Model Systems Knowledge Translation Center. It was an update to the factsheet entitled Emotional Problems after TBI developed by Tessa Hart, PhD and Keith Cicerone, PhD, in collaboration with the Model Systems Knowledge Translation Center.

Source: The content in this factsheet is based on research and/or professional consensus. This content has been reviewed and approved by experts from the Traumatic Brain Injury Model Systems (TBIMS), funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), as well as experts from the Polytrauma Rehabilitation Centers (PRC), funded by the U.S. Department of Veterans Affairs.

Disclaimer: This information is not meant to replace the advice of a medical professional. You should consult your health care provider regarding specific medical concerns or treatment. The contents of this factsheet were developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant numbers 90DP0082 and 90DPKT0009), and the Patient-Centered Outcomes Research Institute (PCORI grant number CER-1511-33005). NIDILRR is a Center within the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS). The contents of this factsheet do not necessarily represent the policy of NIDILRR, PCORI, ACL, or HHS, and you should not assume endorsement by the federal government.

Recommended citation: Zwilling, A., Sander, A., & Hanks, R. (2022). Changes in emotion after traumatic brain injury. Model Systems Knowledge Translation Center (MSKTC). https://msktc.org/tbi/factsheets/emotional-problems-after-traumatic-brain-injury

Copyright © 2022 Model Systems Knowledge Translation Center (MSKTC). May be reproduced and distributed freely with appropriate attribution. Prior permission must be obtained for inclusion in fee-based materials.

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Changes in Emotion After Traumatic Brain Injury

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The way people experience or express emotions may change after a traumatic brain injury (TBI). While this can be distressing for family members and friends, many strategies can help manage these emotional concerns after TBI. Anxiety is common in the general population and in people with moderate to severe TBI.

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Using External Aids for Memory and Organization

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Using External Aids for Memory and Organization

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Research shows that rather than "fixing" cognitive impairments following brain injury, survivors can learn to compensate for these challenges by using a variety of helpful tools. These tools are collectively described as external aids. This research brief provides an overview of various external aids, the needs assessment process used for aid selection, and tips for training these aids across environments.

What are external aids?

External aids fall into two categories: "low tech" and "high tech."

Low tech aids include pencil/paper systems and simple organization tools. Examples include:

Checklist: used to record lists for items (e.g., shopping list) and/or steps for specific routines (e.g., laundry routine, homework routine)

Wall or pocket calendar: used to record/check appointments and events (e.g., doctor's appointments, birthdays)

Notebooks/daily planner: used to record/check information across several categories (e.g., calendars, contact information, expenses)

Timer: used to monitor time during specific activities (e.g., homework, cooking task)

Medication boxes: used to organize medications by day and time

High tech aids include electronic devices that have a range of programming options and uses. Examples include:

Digital voice recorder: a device used to record information "in the moment" for later recall. Example: Olympus Voice recorder™

Programmable watch: a wristwatch used for alarms/reminders to help recall important activities/events. Example: Timex DataLink™

PDA (personal digital assistant): a "pocket computer" with several features including: alarms, calendar, contact information, internet, e-mail, and music. Example: IPod Touch™

Cell phone: a mobile phone that includes contact information; several models include alarm/calendar programs, and camera. Example: Samsung™, Jitterbug™

Smartphone: a device that combines a full-featured mobile phone with handheld computer functions as well as GPS (global positioning system). Example: IPhone™, Blackberry™

What is the Needs Assessment?

Before selecting an external aid, it is important to answer these questions to ensure that it is well matched to the needs of the user.

Who? Who will use the aid? What are his/her unique strengths and challenges? Specific considerations include: severity of injury; cognitive abilities (e.g., awareness, attention, executive functions, problem solving, memory, language); hearing; vision; motor; financial resources to pay for external aid and service contracts; and past/current use of external aids.

Why? Why is the aid needed? What goals and activities will the aid help the user achieve? Does the user need an aid to complete one simple task or to accomplish multiple tasks?

Where & When? Where, when and with whom will the individual use the aid?

Sample Needs Assessment

LIZ
(15 years old; 5 years post-injury)

Who? (user background):
impaired awareness, executive functions, and vision; limited financial resources; no prior use of external aids

Why? (Goals/activities):
needs to turn in homework consistently

Where and When? (Target Environments):
School (teachers); home (parents)

Recommended External Aid:
use large-print homework checklist in the front cover of notebook ("Step 1: record assignments; Step 2: place sheets in course folder ...")

* * *

JOE
(45 years old; 1 year post-injury)

Who? (user background):
impaired memory; cell phone use pre- and post-injury for phone calls only

Why? (Goals/activities):
needs to get to appointments on time

Where and When? (Target Environments):
work and community (e.g., medical appts)

Recommended External Aid:
use cell phone alarm as reminder system; program alarms to go off at least 30 minutes before scheduled activity

What is the best way to train external aids?

Once the external aid(s) has been selected, the user is provided with the opportunity to explore the aid followed by systematic training in how to check and enter information. Note: Initially users with more severe impairments should only be taught how to check information; someone else should enter the information for them. It is also possible that the user will not learn to program the device but that s/he can respond to the device and use it successfully.

Before training, the instructor (e.g., teacher, parent, job coach) determines the steps needed to learn how to use the aid across environments. During training, the instructor first models the steps, providing the user multiple opportunities to correctly practice each step until mastery is achieved. After training, the user and instructor determine whether the external aid is helping achieve the target goal. Future briefs will specifically address the topic of best practice instruction applied to a wide range of instructional targets.
Where can I fi nd out more information?

Ehlhardt, L., Sohlberg, M.M. et al. (2008). Evidence-based Practice Guidelines for Instructing Individuals with Acquired Memory Impairments: What Have We Learned in the Past 20 Years? Neuropsychological Rehabilitation, 18 (3), 300-342. http://www.ancds.org/pdf/articles/Erlhardt_EBP_instruction.pdf

Gillette, Y., DePompei, R., & Goetz, E. http://www.brainline.org/downloads/PDFs/PDAInterventionPlan.pdf

Matching Person and Technology. http://matchingpersonandtechnology.com/

Sohlberg, M.M. & Turkstra, L. (in press). Cognitive Rehabilitation: Teaching New Skills, Strategies and Facts to People with Acquired Brain Injury. New York: Guilford Press.

Sohlberg, M.M., Kennedy, M.R.T. et al. (2007). Evidence based practice for the use of external aids as a memory rehabilitation technique. Journal of Medical Speech Pathology, 15(1) http://www.ancds.org/pdf/articles/ sohlberg_et_al_jmslp2007-2.pdf

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Using External Aids to Compensate for Memory and Organizational Problems Post-TBI | BrainLine

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Research shows that rather than "fixing" cognitive impairments following brain injury, survivors can learn to compensate for these challenges by using a variety of helpful tools. These tools are collectively described as external aids. This research brief provides an overview of various external aids, the needs assessment process used for aid selection, and tips for training these aids across environments.

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Every day people around us are struck with a sudden or gradual loss of ability. Sometimes they are young, often they are older. The losses arise from various issues, such as cardiac conditions, Alzheimer's, cancer, diabetes, Parkinson's, brain injuries, stroke, injuries leading to chronic pain, aging and the list goes on. You undoubtedly know, love or possibly care for somebody with at least one of these medical conditions. They are all very different conditions and have a different course in each individual, but they all have one thing in common: they change people's lives in ways they are often very unprepared for. The changes often center on losing the ability to do certain things (e.g. drive, fully care for themselves, remember things well, work, bike).

I have had patients present in my office with all of the above medical conditions and often with concurrent mental health diagnoses of depression and/or anxiety. I let them know that there are many ways to adapt and learn to cope with illness and loss of ability. It is not always easy and sometimes requires more patience and creativity than patients realize they will need at the outset, but it is always possible.

Psychologist Richard Wanlass, Ph.D. states that an important first step in adapting to loss of ability is to deal with related grief feelings, which can vary among and within this population. However, he also cautions that while grieving is an important step in the process, so are the steps that keep one moving forward. I find it very important early on for patients to try to talk about and focus on the many things they CAN still do instead of the things they can't do anymore. This can require a good bit of practice and cognitive restructuring with the patient. In his work with traumatic brain injured patients, Dr. Donald Ruff takes this practice a step further and focuses on what the person still believes in or what their "core values" are. Many times these core values can help those who have lost the ability to do certain things to shape a new sense of identity and sense of purpose.

Mood improvement with these patients usually involves suggesting ways to change their behaviors and/or change their thoughts. There are many different ways to try to do both of these and some research shows their effects can be additive.
Here are a few ways to improve mood via behavior change:

1. Increase pleasant events/activities in ones schedule - this can require some of that creative thinking I mentioned earlier in that you may need to think about ways to modify activities you used to enjoy to accommodate some loss of ability or try out brand new activities that you are currently able to engage in (brainstorm with friends or relatives, if needed).

2. Physical Exercise - consult healthcare providers about this and think outside the box, and outside the gym; i.e. walk in your house or on your property, do housework, gardening, chair yoga or other sitting exercises.

3. Do things for others - can be as small as a friendly smile or greeting and can include caring for pets or plants.

4. Laugh and smile - at something, or even nothing, because it has been shown to improve mood, boost the immune system and lower levels of stress hormones.

5. Change "the channel" - change your surroundings (e.g. step outside, put more lights on, open the blinds, visit a friend) to try to break negative thinking and mood.

Here are a few ways to improve mood by changing thoughts:

1. Change Self-Critical Thoughts - can be done by practicing transforming them into more positive and accepting thoughts.

2. Focus on what there still is to be grateful for despite losses - this has been shown to relate to better sleep, stronger immune systems and fewer visits to the doctor.

3. Focus on the positive - the purposeful practice of experiencing and remembering events with the positive in the forefront helps break negative thinking cycles and low mood.

There are also many ways to help reduce stress and anxiety, which tend to be very prevalent in people experiencing a disability. This includes practicing: muscle relaxation, breathing relaxation, mindfulness, meditation, imagery and positive coping statements. Also very useful is the exploration of how to best manage expectations for oneself and others in the face of lost abilities. This often takes some time and openness to vulnerability, but tends to help reduce anger and frustration.
www.apdaparkinson.org www.caregiver.org www.maketheconnection.net/TBI
Depending on if there are memory losses and ongoing chronic pain symptoms, there are numerous additional techniques that can be taught to help with these as well. It's often helpful to include spouses and loved ones in these sessions to help with follow through outside of sessions. Additionally, I often recommend support groups for the patients and families/caregivers. Many websites specific to disorders exist that provide a great deal of educational and support resources, including:

Make use of as many techniques and resources as possible; I think you'll be glad you did.

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Coping with Loss of Ability, By Dr. Hayley Hirschmann

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Every day people around us are struck with a sudden or gradual loss of ability. Sometimes they are young, often they are older. The losses arise from various issues, such as cardiac conditions, Alzheimer's, cancer, diabetes, Parkinson's, brain injuries, stroke, injuries leading to chronic pain, aging and the list goes on.

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Disabling Segregation: Dan Habib Ted Talk Video

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Disabling Segregation: Dan Habib Ted Talk Video

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Disabling segregation: Dan Habib at TEDxAmoskeagMillyard

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Center for Innovative Teaching and Learning

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This page describes how to create classroom environments that help all students succeed.

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STEP 3: Mail Original LEA verification form with check and printed CTC application.

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STEP 3: Mail Original LEA verification form with check and printed CTC application.

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*Scan application and LEA verification before sending to CTC.

Mail application and payment (check or money order payable to CTC) to:
Commission on Teacher Credentialing Certification Division
1900 Capitol Avenue
Sacramento, California 95811-4213

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Disability Horizons magazine is an online disability lifestyle publication that aims to give disabled people a voice. Founded by two disabled guys in 2011, Disability Horizons publishes articles on a wide variety of topics, all to support the aim of a world where disabled people live exactly as they choose to.