# data[].attributes.attachment_link.readable_text
Resources >> Browse Articles >> Special Education & Learning Disabilities

"Give fewer choices. If a child is asked to pick a color, say red, only give him two to three choices to pick from. The more choices, the more confused an autistic child will become."

Pat Hensley

I am currently teaching a practicum where my students (who are actually teachers getting their master's degree in special education) are teaching students with special needs. Some of these teachers are encountering students with autism for the first time and have felt some anxiety about this so they asked for some ideas and strategies to help them in the classroom. These are some of the suggestions that I have given them that I have used in the classroom successfully.

1. Use Task Analysis -very specific, tasks in sequential order.

2. Always keep your language simple and concrete. Get your point across in as few words as possible. Typically, it's far more effective to say "Pens down, close your journal and line up to go outside" than "It looks so nice outside. Let's do our science lesson now. As soon as you've finished your writing, close your books and line up at the door. We're going to study plants outdoors today".

3. Teach specific social rules/skills, such as turn-taking and social distance.

4. Give fewer choices. If a child is asked to pick a color, say red, only give him two to three choices to pick from. The more choices, the more confused an autistic child will become.

5. If you ask a question or give an instruction and are greeted with a blank stare, reword your sentence. Asking a student what you just said helps clarify that you've been understood.

6. Avoid using sarcasm. If a student accidentally knocks all your papers on the floor and you say "Great!" you will be taken literally and this action might be repeated on a regular basis.

7. Avoid using idioms. "Put your thinking caps on", "Open your ears" and "Zipper your lips" will leave a student completely mystified and wondering how to do that.

8. Give very clear choices and try not to leave choices open ended. You're bound to get a better result by asking "Do you want to read or draw?" than by asking "What do you want to do now?"

9. Repeat instructions and checking understanding. Using short sentences to ensure clarity of instructions.

10. Providing a very clear structure and a set daily routine including time for play).

11. Teaching what "finished" means and helping the student to identify when something has finished and something different has started. Take a photo of what you want the finished product to look like and show the student. If you want the room cleaned up, take a picture of how you want it to look some time when it is clean. The students can use this for a reference.

12. Providing warning of any impending change of routine, or switch of activity.

13. Addressing the pupil individually at all times (for example, the pupil may not realize that an instruction given to the whole class also includes him/her. Calling the pupil's name and saying "I need you to listen to this as this is something for you to do" can sometimes work; other times the pupil will need to be addressed individually).

14. Using various means of presentation - visual, physical guidance, peer modeling, etc.

15. Recognizing that some change in manner or behavior may reflect anxiety (which may be triggered by a [minor] change to routine).

16. Not taking apparently rude or aggressive behavior personally; and recognizing that the target for the pupil's anger may be unrelated to the source of that anger.

17. Avoid overstimulation. Minimizing/removal of distracters, or providing access to an individual work area or booth, when a task involving concentration is set. Colorful wall displays can be distracting for some pupils, others may find noise very difficult to cope with.

18. Seeking to link work to the pupil's particular interests.

19. Exploring word-processing, and computer-based learning for literacy.

20. Protecting the pupil from teasing at free times, and providing peers with some awareness of his/her particular needs.

21. Allowing the pupil to avoid certain activities (such as sports and games) which s/he may not understand or like; and supporting the pupil in open-ended and group tasks.

22. Allowing some access to obsessive behavior as a reward for positive efforts.

Need more tips?
Check out our resources for special education now.

# data[].attributes.attachment_link.keywords[]
22 tips teaching students autism spectrum disorders special education & learning disabilities benefits articles

# data[].attributes.attachment_link.title
22 Tips for Teaching Students with Autism Spectrum Disorders

# data[].attributes.attachment_link.description
I am currently teaching a practicum where my students (who are actually teachers getting their master's degree in special education) are teaching students with special needs. Some of these teachers are encountering students with autism for the first time and have felt some anxiety about this so they asked for some ideas and strategies to help them in the classroom.

# data[].attributes.attachment_link.description
Welcome to the Colorado Autism Education Network. The Network has been developed to support the needs of schools, districts, and AU's in providing high quality services and programming for students on the autism spectrum. The Colorado Autism Education Network team of state and regional coordinators will help your team determine and prioritize the needs for your setting.

# data[].attributes.attachment_link.keywords[]
ohio center for autism and low incidence

# data[].attributes.attachment_link.description
Ohio Center for Autism and Low Incidence

# data[].attributes.attachment_link.readable_text
This Colorado Roadmap for Families section of the Colorado Families for Hands & Voices web site has been built to augment the printable worksheet that has been developed and customized for each birthing hospital in Colorado.

The Roadmaps were created to serve as a safety net for families to ensure that babies could receive timely screening and follow up care for hearing loss. Families we spoke to were not aware of the "screen by one month, diagnose by three months, and enter intervention before six months of age" guidelines set by the Early Hearing Detection and Intervention (EHDI) system. The earlier a baby is diagnosed, the better off he or she is for optimal development.

The Roadmap is our attempt at getting the right information to the right people at just the right time

Each local community in Colorado has a team of people including parents of children with hearing loss and professionals, audiologists, nurses, and more who developed these Roadmaps. Each Roadmap contains customized information for every region in Colorado. This worksheet is available at your hospital as well as downloadable on our web site. Visit the Roadmap Section of our web site for info and to download specific roadmaps for your area. [ Visit the Roadmap Web site ]

# data[].attributes.attachment_link.description
This Colorado Roadmap for Families section of the Colorado Families for Hands & Voices web site has been built to augment the printable worksheet that has been developed and customized for each birthing hospital in Colorado. The Roadmaps were created to serve as a safety net for families to ensure that babies could receive timely [...]

# data[].attributes.attachment_link.title
Colorado Services for Children and Youth with Combined Vision and Hearing Loss Project (Deaf-Blind Grant) | CDE

# data[].attributes.attachment_link.description
The project provides free technical assistance to families, education teams and service providers of children birth through the year of their 21st birthday, if the children have a combined vision and hearing loss, or are highly suspect for both vision and hearing loss.

# data[].attributes.attachment_link.readable_text
"Aren't kids usually talking by now?"
People may not mean to be insensitive when they ask you questions like these. But it can still be upsetting to see other kids passing milestones before your child does.

Not meeting these types of milestones isn't always a sign that your child has a developmental delay. If it turns out he does have a delay, however, getting supports and services early may help him catch up more quickly. What follows may help you figure out whether it's time for early intervention.

Basics About Development and Delays

Kids don't develop skills on a strict timetable. For example, some babies start walking as young as 9 months, while others don't take their first steps until 15 months. Both of those babies are within the range of typical development. And minor differences in when kids perform a skill usually aren't cause for concern.

But a developmental delay is more than just being "slower to develop" or "a little behind." It means your child is continually behind in skills other kids his age have.

For example, a baby who isn't rolling over by 4 months may be just a little behind in that one skill. But if he also isn't able to hold his head up and push up when lying on his tummy, he's behind in more than one motor skill. That's a sign of a developmental delay. (If you're noticing this in your child, there are many ways to help.)

The Difference Between a Developmental Delay and a Developmental Disability

Doctors sometimes use the terms "developmental delay" and "developmental disability" to mean the same thing. They're actually not the same thing, but it is sometimes difficult to determine whether a young child has a delay or a disability, or why.

Developmental disabilities are issues that kids don't outgrow or catch up from, though they can make progress. They aren't the same as learning disabilities, but they can make learning more difficult. Some conditions that can cause developmental disabilities include Down syndrome, Angelman syndrome, autism, fetal alcohol spectrum disorders (FASD) and brain injuries.

Developmental delays may be caused by short-lived issues, such as a speech delay being caused by hearing loss from ear infections or a physical delay being caused by a long hospitalization. Delays may also be early signs of learning and attention issues. While it's not always clear what is causing the delay, early intervention can often help kids catch up. Some kids still have delays in skills when they reach school age. In that case, they may be eligible to receive special education services.

If a child isn't catching up as quickly as expected, a specialist may suggest doing an evaluation to get a better sense of what's going on. It could also help guide the types of services and supports that would meet his needs.

Five Areas of Skill Development and Possible Delay

A developmental delay can occur in just one area or in a few. A global developmental delay is when kids have delays in at least two areas.

Kids develop skills in five main areas of development:

1. Cognitive (or thinking) skills: This is the ability to think, learn and solve problems. In babies, this looks like curiosity. It's how your child explores the world around him with his eyes, ears and hands. In toddlers, it also includes things like learning to count, naming colors and learning new words.

2. Social and emotional skills: This is the ability to relate to other people. That includes being able to express and control emotions. In babies, it means smiling at others and making sounds to communicate. In toddlers and preschoolers, it means being able to ask for help, show and express feelings and get along with others.

3. Speech and language skills: This is the ability to use and understand language. For babies, this includes cooing and babbling. In older children, it includes understanding what's said and using words correctly and in ways that others can understand.

4. Fine and gross motor skills: This is the ability to use small muscles (fine motor), particularly in the hands, and large muscles (gross motor) in the body. Babies use fine motor skills to grasp objects. Toddlers and preschoolers use them to do things like hold utensils, work with objects and draw. Babies use gross motor skills to sit up, roll over and begin to walk. Older children use them to do things like jump, run and climb stairs.

5. Activities of daily living: This is the ability to handle everyday tasks. For children, that includes eating, dressing and bathing themselves.

There is no one cause of developmental delays, but some risk factors include:

Complications at birth: Being born too early (prematurely); low birth weight; not getting enough oxygen at birth.

Environmental issues: Lead poisoning; poor nutrition; exposure to alcohol or drugs before birth; difficult family situations; trauma.

Other medical conditions: Chronic ear infections; vision problems; illnesses, conditions, or injuries that have a significant and long-term effect on a child's day-to-day activities.

Sometimes parents worry that they might have contributed to their child's delays. That's usually not the case. For example, teaching a child more than one language does not lead to speech or language problems. And as one mother shares, even though it can be "heartbreaking" to hear the results of an evaluation, in the end, it's better to focus on next steps and ways to help.

The Link Between Developmental Delays and Learning and Attention Issues

In young kids, delays can be the first sign of learning and attention issues. For example, speech and language delays may point to a learning issue or a communication disorder.

It's not always easy to make the link between delays and learning and attention issues until kids start school. That's when teachers can see how kids do in areas like math, reading and spelling. They can also see how well kids focus in class.

The school can also do formal testing to find out more about your child's strengths and weaknesses. The tests show how kids' skills compare to those of their peers. They also show how kids think and solve problems. The results can help to determine whether a child has a learning or attention issue.

Are you concerned about your child's development? If so, speak with your child's doctor about a referral to an early intervention agency in your state for further evaluation and help for your child. And learn more about:

# data[].attributes.attachment_link.title
What You Need to Know About Developmental Delays

# data[].attributes.attachment_link.description
"Aren't kids usually talking by now?" People may not mean to be insensitive when they ask you questions like these. But it can still be upsetting to see other kids passing milestones before your child does. Not meeting these types of milestones isn't always a sign that your child has a developmental delay.

# data[].attributes.attachment_link.keywords[]
picture exchange communication system cards

# data[].attributes.attachment_link.title
Do2Learn: Educational Resources for Special Needs

# data[].attributes.attachment_link.description
picture communication cards, songs, games and learning activities for autism, aspergers, fetal alcohol syndrome and disabilities

# data[].attributes.attachment_link.readable_text
Colorado AG Bell is a non-profit, who in 2018, is celebrating it's 25th year of dedication to supporting Colorado's deaf and hard of hearing community. Through community outreach, education, and advocacy we strive to improve listening and spoken language outcomes for Coloradans who are deaf and hard of hearing, their families, and the professionals who work with them.

We believe when children are identified early, receive hearing technology and family-centered support, they can develop language on par with their peers. Learn more about the options and next steps following a hearing loss diagnosis.

Colorado Chapter History

The Colorado Chapter of AG Bell was founded in 1993 by a group of parents and professionals who were passionate about raising awareness for and promoting listening and spoken language options for the deaf and hard of hearing community in Colorado. Founding members of the Chapter were: LaFawn Biddle, Dusty Biddle, Ken Klaus, Jill Bader, Barbie Galoob, Judy Gorman, Mary Zuercher, and Mary Mosher-Stathes.

The Colorado Chapter of AG Bell is one of 35+ active chapters incorporated with AG Bell National , which was created over 125 years ago.

Colorado Board of Directors

Tara Bauman

Tara is an educational audiologist. She joined the Board of Directors in 2013 and started her term as President of the Colorado Chapter in January 2016. Through her work on the board, enjoys cultivating new relationships and sharing the positive impacts the Colorado Chapter and AG Bell National make in the lives of people who are deaf and hard of hearing.

Erika King

Erika is a speech-language pathologist and listening and spoken language specialist. For the past decade she has supported families who have children with hearing loss. Erika served on the cochlear implant team at the University of Minnesota Children's Hospital prior to moving to Colorado in 2015. She currently has a private practice and is a provider for the Listen Foundation and CHIP (Colorado Home Intervention Project). Erika is passionate about supporting families in their pursuit of listening and spoken language.

Vice President/Historian

Heather Macerinskas

Heather is a mother to a daughter who wears bilateral cochlear implants. Her daughter was diagnosed with a mild/moderate hearing loss at the age of 3 and her hearing loss progressed to severe/profound in 1 year. Heather loves being a part of the hearing loss community. She joined the Colorado AG Bell Board to help grow her support system for her daughter as well as help others on the same journey. She is also on the Peer Support Team for MED-EL.

Allison Armitage

Allison is a speech language pathologist who works with the pediatric population at Children's Hospital of Colorado. She is a member of Children's Hospital Colorado's deaf and hard of hearing team, as well as their cochlear implant team. Allison joined Colorado AG Bell because she is passionate about learning language through listening and helping families achieve their communication goals.

Jenn Reed

Jenn is a wife and mother of two boys. Both her husband and eldest son have hearing loss; she also has a brother with hearing loss. Jenn's son received his first cochlear implant on his left ear in early 2017 and wears a hearing aid on his right ear. She joined the Colorado AG Bell Board of Directors to help other families along their hearing loss journey.

Ally Bleidt

Ally, an adult with a hearing loss who uses hearing aids and works as a project manager, joined the Colorado AG Bell Board of Directors in 2010. She served as Chapter Treasurer for six years. She enjoys helping families who experience hearing loss have access to the support and resources they need.

Marti Bleidt

Marti has been a member of the Colorado AG Bell board for nearly 10 years and was Board President from 2013-2015. She is the mother of an adult daughter who uses hearing aids and a foster daughter who is in high school and uses bilateral cochlear implants. In her professional life, Marti is a teacher of deaf/hard of hearing for Denver Public Schools and a CHIP facilitator. She very much enjoys being active in helping families and children with hearing loss pursue their dreams and hopes.

Stacey E. Cohen McNulty is an audiologist at Denver Ear Associates. She is passionate about helping those with hearing loss by enhancing their communication abilities. Stacey has is honored to be on the Board of Colorado AG Bell to support spoken language outcomes for children and adults with hearing loss.

Todd Hallberg

Todd is a proud father of two young men. His youngest son, Derian, has a profound hearing loss and utilizes cochlear implants to hear. His oldest son, Tyler, has a unilateral hearing loss and benefits from the use of a hearing aid. Todd has a true passion helping those who are deaf and hard of hearing. He was a member of a grassroots effort to obtain hearing aid coverage for children in the state of Colorado. He has shared his family's story at the local and national levels, helping educate about hearing loss and the importance of listening and spoken language therapy.

Emma Kagel

Emma is a bilateral cochlear implant recipient. She received her first cochlear implant as part of the original FDA trial in the 1990's to have cochlear implants approved in the USA. She grew up as an active member in the Connecticut Chapter of AG Bell with her parents. Emma is a mother to a typically hearing son and bioethicist.

Gigi Placone

Gigi has been severely hard of hearing her entire life. She wore hearing aids until 2015 when she got a cochlear implant. She continues to use a hearing aid on her non-implanted ear. Gigi is an Enrolled Agent (federally licensed tax preparer). She is happy to be on the AG Bell Colorado Board.

Cathy Scruggs

As congenitally deaf adult who uses cochlear implants, Cathy is passionate about being part of our local community to raise awareness to help deaf children with listening and spoken language.

Hannah Bosisio

Hannah is a junior at the University of Denver where she is studying business marketing, hospitality management, and business analytics. She is a member of the Delta Zeta Rho Sorority, where she is Vice President of Philanthropy. Hannah was diagnosed with hearing loss as a child and is excited to help Colorado AG Bell grow and to support the Colorado deaf and hard of hearing community.

Ken Klaus - 1993-1994

Sharon Thompson - 1994-1995

Anne Beiter - 1995-1996

Mike Bruha - 1996-1997

Judy Gorman/Mary Mosher-Stathes - 1998-1999

Mary Bartholomew - 2000-2002

Carolyn Wolfrum - 2003-2004

Angela Wieker - 2005-2006

Regina Squibs - 2007-2009

Sheryl Muir - 2010-2011

Rob Frantum-Allen - 2012

Marti Bleidt - 2013-2015

# data[].attributes.attachment_link.description
Colorado AG Bell is a non-profit, who in 2018, is celebrating it's 25th year of dedication to supporting Colorado's deaf and hard of hearing community. Through community outreach, education, and advocacy we strive to improve listening and spoken language outcomes for Coloradans who are deaf and hard of hearing, their families, and the professionals who work with them.

# data[].attributes.attachment_link.description
This section provides best teaching strategies, based on Universal Design for Instruction, for instructors teaching in a mainstreamed classroom with a mix of hearing, deaf and hard-of-hearing students. The goal of these strategies is to improve teaching practice that will provide greater access to learning for deaf and hard-of-hearing students but will benefit all students in the classroom as well.

# data[].attributes.attachment_link.title
Early Intervention Colorado | Ei_families | Family

# data[].attributes.attachment_link.description
Colorado's Early Intervention (EI) program provides supports and services to children with developmental delays or disabilities and their families from birth until the child's third birthday. EI can help families learn ways to support and promote their child's development within their everyday routines and activities.

# data[].attributes.attachment_link.readable_text
Every family looks forward to seeing a child's first smile, first step, and first words. Regular screenings help raise awareness of a child's development, making it easier to celebrate milestones and identify possible development concerns as early as possible. With early and regular screening, you can make sure that your children get the support they need to succeed in school and thrive alongside their peers.

Use the Developmental Screening Passport to track your child's screening history and results. Download a printable version to share this information with your child's doctor and other providers who might be screening your child.

By tracking your young child's developmental milestones, you can know a lot more about how your child is learning and growing. CDC's " Learn the Signs. Act Early" program offers free milestone checklists and other resources to help you track your child's development and take action if you ever have a concern.
Where is Bear? A Terrific Tale for 2-Year-Olds

# data[].attributes.attachment_link.description
Every family looks forward to seeing a child's first smile, first step, and first words. Regular screenings help raise awareness of a child's development, making it easier to celebrate milestones and identify possible development concerns as early as possible.

# data[].attributes.attachment_link.provider_name
Centers for Disease Control and Prevention

# data[].attributes.attachment_link.description
Download CDC's free Milestone Tracker app to complete a milestone checklist for your child. Available for iOS and Android in English and Spanish.

# data[].attributes.attachment_link.title
Intellectual Disabilities - Project IDEAL

# data[].attributes.attachment_link.description
Defining, characteristics, impact on learning, and teaching strategies for intellectual disabilities.

# data[].attributes.attachment_link.readable_text
As parents, the prospect of raising a child with an intellectual disability seems an overwhelming task. There will be many challenges ahead, and in order to provide him with the necessary love and guidance, you as parents, must learn to accept him as he is. With the right support, guidance and preparation, you can prevail. Learn the necessary skills needed to manage difficult behaviours, cope with his stress and live a long and fulfilling life together.

Understanding the Disease

By understanding the spectrum of the child's intellectual disablility, parents know what to expect and what needs to be done for the child's upbringing and future.

Parents of children with intellectual disability (ID) must cope with the daily stress of seeing their child struggle; even through the most mundane tasks. It is a condition that will last a lifetime and parents tend to feel some amount of grief, resentment, disappointment and frustration. These feelings can lead to guilt, hopelessness and even depression. Despite, underneath it all remains a deep love and desire of every parent to see that their child attains their maximum potential and, the hope that they will live as independent individuals.

What Is Intellectual Disability?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association defines ID as a developmental condition that begins in childhood and, is characterised by significant deficits in both intellectual functioning and adaptive behaviour, including conceptual, social and practical skills.

The DSM-5 diagnosis of ID is conducted by a trained clinician (e.g. psychiatrist, paediatrician or clinical psychologist) and looks at three main criteria:

1. Deficits in intellectual functioning confirmed by clinical assessment and individualised standardised intelligence testing (e.g. reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience).

2. Deficits in adaptive functioning (ability to navigate through the demands or challenges of everyday life effectively) that is not normal for a child's developmental age, in terms of being able to be independent and the ability to meet social responsibility.

3. The onset of these deficits during childhood.

ID is not a mental disorder. However, there is a risk of mental disorder co-occurring in a person diagnosed with ID. It is often commonly associated with communication disorders, learning disabilities, cerebral palsy, epilepsy and various genetically transmitted conditions (e.g. schizophrenia, depression and attention deficit hyperactivity disorder).

Causes & Symptoms of ID

Intellectual disability can be caused by any condition that impairs development of the brain before birth, during birt or in childhood years. The most common causes are:

Genetic conditions. These include conditions such as Down Syndrome and fragile X syndrome.

Pregnancy problems. Alcohol or drug use, malnutrition or preeclampsia.

Childbirth problems. Oxygen deprivation during childbirth, premature birth or low birth weight.

Illness or injury. Infections like meningitis, severe head injury, near-drowning, exposure to toxic substances such as lead and severe neglect or abuse.

In two-thirds of all children with ID, the cause is unknown.

Signs and symptoms of ID may start to appear during infancy, or not noticeable until a child reaches school age. Much of it depends on the disability's severity. Common symptoms may include:

Slow language development for age.

Delay in sitting up, crawling or walking.

Difficulty remembering.

Inability to connect actions with consequences.

Behavioural problems such as unprovoked explosive tantrums.

Difficulty with problem-solving or logical thinking.

Caring For Your Child

There is no quick fix for ID, it will be a life-long struggle. But like all parents, you have a lifetime to equip your children with the skills and knowledge they will need t live on their own and thrive. Just remember to:

Forget About What Others Say

Stigma may contribute to poor psychological health b increasing psychological distress and reducing quality of life. Do not let the stigma keep you or your child down. Ensure that your child is able to fully integrate with their communities. Support your child, listen to them, be affectionate and empower them.

Be Actively Involved

Family members should participate in decisions about services and not be afraid to speak up and advocate for the child or adult with ID. The more families become actively involved, the less helpless they feel. With parent involvement in their children's care, their children are less likely to require institutionalisation and more likely to enjoy a higher quality of life.

Ask For Help

Do not be afraid to seek help and support from family members. Some parents feel ashamed to ask for help as they fear rejection or people may not understand the situation. You would be surprised just how helpful people are once you ask. A positive family support network allows parents to have someone they can turn to and rely upon. A local parent/support group, society or NGO in the area can also be a source of support and strength in lobbying for services.

Start Treatment Early

Early intervention helps to maximise the child's potential as early experiences play a critical role in brain development. It is also strengthened by stable relationships with caring and responsive adults, safe and supportive environments and appropriate nutrition.

Take Some "Me" Time

Taking care of a child with ID can take a lot out of any parent. It is important not to neglect your own needs. Get sufficient rest; eat well; take time for yourself; and reach out to others for emotional support. Get family members or friends to fill in for you while you enjoy some time away.

Like any other child, children with ID develop and learn at different rates and ways. What is important is for you to continue to be patient and be affectionately supportive, as well as work hard to help your child hone his adaptive capabilities so that he may reach his full potential in life. With your help and that of those around you, your child can live a happy and fulfilling life.

Continue Reading...

Parenting A Child with Intellectual Disability: Education & Training

Parenting A Child with Intellectual Disability: Co-occurrence of Mental Illness in Intellectual Disability

# data[].attributes.attachment_link.title
Parenting A Child with Intellectual Disability - Positive Parenting

# data[].attributes.attachment_link.description
As parents, the prospect of raising a child with an intellectual disability seems an overwhelming task. There will be many challenges ahead, and in order to provide him with the necessary love and guidance, you as parents, must learn to accept him as he is. With the right support, guidance and preparation, you can prevail.

# data[].attributes.attachment_link.readable_text
The term "multiple disabilities" obviously means "more than one disability." Within the Individuals with Disabilities Education Act, however, it has a more technical meaning. "Multiple Disabilities" is a disability category under The Individuals with Disabilities Education Act (IDEA). As you might expect, children with multiple disabilities have two or more disabling conditions that affect learning or other important life functions.

Multiple Disabilities Versus Multiple Diagnoses

It's important to note that there is a difference between "multiple disabilities" and "multiple diagnoses." That's because a child may have multiple diagnoses as a result of having been seen by multiple practitioners-but not fall into the "multiple disabilities" category. For example, a child with high functioning autism spectrum disorder might have collected additional diagnoses such as social anxiety, sensory dysfunction, and social communication disorder before finally being diagnosed with autism. But the additional diagnoses describe symptoms which are encompassed in autism spectrum disorder.

It's also important to note that, to qualify for the "multiple disabilities" category, both of the student's disorders must be so significant that her educational needs could not be met in programs that are designed to address one of the disabilities alone. Thus, a child with learning disabilities and cerebral palsy might well qualify, as would a child with cognitive challenges and a sensory impairment such as a visual impairment or blindness. A child with ADHD and sensory challenges, however, would most likely NOT qualify, as his two disabilities could almost certainly be addressed in an ADHD classroom. However, the IDEA regulations include one exception. Deaf-blindness is excluded under the category multiple disability.

Teaching Students With Multiple Disabilities

Very often, students with multiple disabilities have very severe limitations in their ability to walk, talk, and otherwise engage with peers. They may also have severe cognitive challenges. As a result, they are typically taught by highly trained teachers using a range of specialized tools. They may also benefit from peer tutoring, and, when possible, should be included and accommodated in typical school activities and events.

Teaching Tools for Children With Multiple Disabilities

Some of the most useful and important tools used to teach and engage with multiple disabled students are technologies and other resources used for augmentative communication. For a child who cannot speak, or for whom physical movement is very difficult, there are quite a few available options. These include:

Simple picture cards

Keyboards with specialized interfaces to support users with fine motor difficulties

iPads and similar devices with apps designed for text-to-voice, picture selection, or other forms of communication

In addition to these, students with severe multiple handicaps may also benefit from a wide range of teaching tools such as:

Speech to text technology

Educational apps that support the pre-writing and writing process

Curricula that offer differentiated options for students with different learning styles or abilities

Parents of Children With Multiple Disabilities

A student with multiple disabilities may be able to learn and achieve at a high level, given the resources and opportunity to do so. If you are the parent of a child who falls into the multiple disability category, it is important to play an active role in planning, developing, and assessing a plan to support your child's educational and social needs.

It's important to make a special note for parents of children with learning disabilities as to their own health and well being. The majority of what you will talk about and learn through your child's special educational journey will be ways in which you can help your child. Yet parents have needs as well.

Life can be terribly stressful. While you have more demands on your time and patience than parents who do not have special needs children, you have less time to fill up your own emotional tank through time with friends and leisure time activity. Together that adds up to a lot of stress.

You've probably heard it a dozen times, but it is important to take care of yourself and put your own needs first at times.

Thanks for your feedback!

What are your concerns?

Other Inaccurate Hard to Understand

# data[].attributes.attachment_link.title
Supporting and Teaching Students With Multiple Disabilities

# data[].attributes.attachment_link.description
The term "multiple disabilities" obviously means "more than one disability." Within the Individuals with Disabilities Education Act, however, it has a more technical meaning. "Multiple Disabilities" is a disability category under The Individuals with Disabilities Education Act (IDEA). As you might expect, children with multiple disabilities have two or more disabling conditions that affect learning or other important life functions.

# data[].attributes.attachment_link.title
Multiple Disabilities - FamilyConnect: for parents of children with visual impairments

# data[].attributes.attachment_link.description
A child with multiple disabilities has more than one diagnosis-in this case, a visual impairment and at least one other condition. Multiple disabilities vary greatly in their range and severity. Depending on your childs abilities and needs, you may find helpful articles here on many topics, including information on:

# data[].attributes.attachment_link.readable_text
Definition

Orthopedic impairment is defined as a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments caused by congenital anomaly (e.g., clubfoot, absence of some member, etc.), impairments caused by disease (e.g., poliomyelitis, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).

Prevalence

The U.S. Department of Education reports 5,971,495 students receiving special education services in the 2003-2004 school year. Of that number, roughly 1.1%, or 68,188 students, received special education services based on a classification of orthopedic impairments.

Characteristics

The IDEA category of orthopedic impairments contains a wide variety of disorders. These can be divided into three main areas: neuromotor impairments, degenerative diseases, and musculoskeletal disorders. The specific characteristics of an individual who has an orthopedic impairment will depend on both the specific disease and its severity, as well as additional individual factors.

A neuromotor impairment is an abnormality of, or damage to, the brain, spinal cord, or nervous system that sends impulses to the muscles of the body. These impairments are acquired at or before birth, and often result in complex motor problems that can affect several body systems. These motor problems can include limited limb movement, loss of urinary control, and loss of proper alignment of the spine. The two most common types of neuromotor impairments are cerebral palsy and spina bifida.

Cerebral palsy refers to several nonprogressive disorders of voluntary movement or posture that are caused by malfunction of or damage to the developing brain that occurs before or during birth or within the first few years of life. Individuals with cerebral palsy have abnormal, involuntary, and/or uncoordinated motor movements. The four most common types of cerebral palsy include:

Spastic (very tight muscles occurring in one or more muscle groups that result in stiff, uncoordinated movements)

Athetoid (movements are contorted, abnormal, and purposeless)

Ataxic (poor balance and equilibrium in addition to uncoordinated voluntary movement)

Mixed (any combination of the types)

Cerebral palsy is also classified by which limbs (arms and legs) are affected. Major classifications include hemiplegia (left or right side), diplegia (legs affected more than arms); paraplegia (only legs), and quadriplegia (all four limbs).

Spina bifida is a developmental defect of the spinal column. Spina bifida is characterized by an abnormal opening in the spinal column and frequently involves some paralysis of various portions of the body. It may or may not affect intellectual functioning. Spina bifida is usually classified as either spina bifida occulta or spina bifida cystica. Spina bifida occulta is a mild condition while spina bifida cystica is more serious.

Degenerative diseases are composed of various diseases that affect motor development. The most common degenerative disease found in the school population is muscular dystrophy. Muscular dystrophy is a group of inherited diseases characterized by progressive muscle weakness from degeneration of muscle fibers.

Musculoskeletal disorders are composed of various conditions that can result in various levels of physical limitations. Two examples of musculoskeletal disorders include juvenile rheumatoid arthritis and limb deficiency.

Impact on Learning

The specific impact on learning of an individual is contingent upon the disease, its severity, and individual factors. Two individuals with identical diagnoses may be quite different in terms of their capabilities.

Many students with orthopedic impairments have no cognitive, learning, perceptual, language, or sensory issues. However, individuals with neuromotor impairments have a higher incidence of additional impairments, especially when there has been brain involvement. For most students with orthopedic impairments, the impact on learning is focused on accommodations necessary for students to have access to academic instruction.

Teaching Strategies

As with most students with disabilities, the classroom accommodations for students with orthopedic impairments will vary dependent on the individual needs of the student. Since many students with orthopedic impairments have no cognitive impairments, the general educator and special educator should collaborate to include the student in the general curriculum as much as possible.

In order for the student to access the general curriculum, the student may require these accommodations:

Special seating arrangements to develop useful posture and movements

Instruction focused on development of gross and fine motor skills

Securing suitable augmentative communication and other assistive devices

Awareness of medical condition and its affect on the student (such as getting tired quickly)

Because of the multi-faceted nature of orthopedic impairments, other specialists may be involved in developing and implementing an appropriate educational program for the student. These specialists can include:

Physical Therapists who work on gross motor skills (focusing on the legs, back, neck and torso)

Occupational Therapists who work on fine motor skills (focusing on the arms and hands as well as daily living activities such as dressing and bathing)

Speech-Language Pathologists who work with the student on problems with speech and language

Adapted Physical Education Teachers, who are specially trained PE teachers who work along with the OT and PT to develop an exercise program to help students with disabilities

Other Therapists (Massage Therapists, Music Therapists, etc.)

Assistive Technology

Due to the various levels of severity of orthopedic impairment, multiple types of assistive technology may be used. As with any student with a disability, the assistive technology would need to address a need of the student to be able to access the educational curriculum. For students with orthopedic impairments, these fall into three categories:

Devices to Access Information: These assistive technology devices focus on aiding the student to access the educational material. These devices include:

speech recognition software

screen reading software

augmentative and alternative communication devices (such as communication boards)

academic software packages for students with disabilities

Devices for Positioning and Mobility: These assistive technology devices focus on helping the student participate in educational activities. These devices include:

canes

walkers

crutches

wheelchairs

specialized exercise equipment

specialized chairs, desks, and tables for proper posture development

Organizations

United Cerebral Palsy Associations, Inc.

1660 L Street NW, Suite 700
Washington DC 20036

Web: www.ucp.org

United Cerebral Palsy of Texas

The national organization and its nationwide network of affiliates strive to ensure the inclusion of persons with disabilities in every facet of society-from the Web to the workplace, from the classroom to the community. As one of the largest health charities in America, the mission of United Cerebral Palsy is to advance the independence, productivity and full citizenship of people with disabilities through an affiliate network.

1016 La Posada, Suite 145
Austin, TX 78752

Email: info@ucptexas.org
Web: www.ucptexas.org

Center for Disability and Development

Dept. of Educational Psychology
4225 Texas A&M University
College Station, TX 77843-4225

Easter Seals--National Office

Easter Seals offers help, hope and answers to more than a million children and adults living with autism and other disabilities or special needs and their families each year. Services and support are provided through a network of more than 550 sites in the U.S. Each center provides exceptional services that are individualized, innovative, family-focused and tailored to meet specific needs of the particular community served.

230 West Monroe Street, Suite 1800
Chicago, IL 60606-4802

Web: www.easter-seals.org

March of Dimes Birth Defects Foundation

The March of Dimes mission is to improve the health of babies by preventing birth defects, premature birth, and infant mortality. They carry out this mission through research, community services, education and advocacy to save babies' lives. March of Dimes researchers, volunteers, educators, outreach workers and advocates work together to give all babies a fighting chance against the threats to their health: prematurity, birth defects, low birthweight.

1275 Mamaroneck Avenue
White Plains, NY 10605

Phone: 914-428-7100; 888-663-4637
Email: askus@marchofdimes.com
Web: www.marchofdimes.com

National Rehabilitation Information Center (NARIC)

The core mission of the Center is to collect and disseminate the results of research funded by the National Institute on Disability and Rehabilitation Research (NIDRR). NARIC staff members have been dedicated to providing direct, personal, and high-quality information services to anyone throughout the country.

4200 Forbes Boulevard, Suite 202
Lanham, MD 20706

Email: naricinfo@heitechservices.com
Web: www.naric.com

Spina Bifida Association of America

The Spina Bifida Association (SBA) serves adults and children who live with the challenges of Spina Bifida. Since 1973, SBA has been the only national voluntary health agency solely dedicated to enhancing the lives of those with Spina Bifida and those whose lives are touched by this challenging birth defect. Its tools are education, advocacy, research, and service.

4590 MacArthur Boulevard, N.W., Suite 250
Washington, DC 20007

National Institute of Neurological Disorders and Stroke (NINDS)

The mission of NINDS is to reduce the burden of neurological disease - a burden borne by every age group, by every segment of society, by people all over the world. NINDS conducts, fosters, coordinates, and guides research; operates research projects, program projects, and research center grants; and collects and disseminates research information related to neurological disorders.

National Institutes of Health
National Institue of Neurological Disorders and Stroke
P.O. Box 5801
Bethesda, MD 20824

Web: www.ninds.nih.gov

References

Gargiulo, R.M. (2006). Special education in contemporary society: An introduction to exceptionality. Belmont, CA: Thomson Wadsworth.

Turnbull, A., Turnbull, R. & Wehmeyer, M. L. (2007). Exceptional lives: Special education in today's schools. Upper Saddle River, NJ: Pearson Merrill Prentice Hall.

# data[].attributes.attachment_link.description
Orthopedic impairment is defined as a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments caused by congenital anomaly (e.g., clubfoot, absence of some member, etc.), impairments caused by disease (e.g., poliomyelitis, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).

# data[].attributes.attachment_link.readable_text
Links updated, July 2015

"Other Health Impairment" is one of the 14 categories of disability listed in our nation's special education law, the Individuals with Disabilities Education Act (IDEA). Under IDEA, a child who has an "other health impairment" is very likely to be eligible for special services to help the child address his or her educational, developmental, and functional needs resulting from the disability.

IDEA's Definition of OHI

Before we launch into more about how to access special services to help a child with OHI, let's look at how IDEA defines "other health impairment." That definition, in combination with a state's policies, is a very important factor in whether or not a child is found eligible for services.

IDEA states that:

Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that-

(i) Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and

(ii) Adversely affects a child's educational performance. [§300.8(c)(9)]What's immediately clear from this definition is that there are quite a few disabilities and disorders that fall under the umbrella of "other health impairment." And those disabilities are very different from one another. This makes it difficult for us to summarize "other health impairment" and connect you with more information and guidance on the subject.

And that's why, in a moment, we will break this discussion down into closer looks at each of the disabilities listed: ADD or AD/HD, diabetes, epilepsy, heart conditions, and so on.

We'd also like to point out that IDEA's definition uses the phrase "such as..." That's significant. It means that the disabilities listed are not the only ones that may be considered when a child's eligibility for special services under IDEA is decided. A child with another health impairment (one not listed in IDEA's definition) may be found eligible for special services and assistance. What's central to all the disabilities falling under "Other Health Impairment" is that the child must have:

limited strength, vitality, or alertness due to chronic health problems; and

an educational performance that is negatively affected as a result.

Special Help for Children

Two systems of help are available immediately to help eligible children with other health impairments. These divide out by age, as follows:

Early intervention services are for children under the age of 3. Known as Part C of IDEA, the early intervention program exists in every state and includes free evaluation of the baby or toddler to see what the problem is, identifying the needs of the child (and family) based on the child's disability or developmental delay, and designing and delivering an individualized family service plan (IFSP) to address the child's unique needs.

Special education and related services are for children from 3 to 21, sometimes older. These services include specially designed instruction and a wide range of supports to address the student's individual needs that result from his or her disability. Special education and related services are available to eligible children, free of charge, through the public school system. This includes a comprehensive and individual evaluation of the child to determine his or her eligibility, unique needs, and what types of services and supports are needed by the child to address those needs.

If your child has a health impairment, especially one listed in IDEA, you will want to find out all you can about these service systems. They can be incredibly helpful for your child. A lot of info is available here on CPIR's website, so we won't repeat ourselves. Use the active links here or above to find out all but the kitchen sink about both early intervention and special education and related services.

Specific Health Impairments

This section on "other health impairment" will connect you with information and resources on the specific disabilities IDEA mentions. We do so in separate files, because this fact sheet will get quite lengthy and cumbersome otherwise. Also be aware that you can identify more resources on each disability by using our SEARCH box that appears on every page on our site.

OK. What disabilities does IDEA mention in its definition of Other Health Impairment? Follow the links to more info on these disabilities. You'll also find these links again at the bottom of this fact sheet, if you'd like to keep reading about OHI in general, including life at school and other disabilities not mentioned in the OHI definition.

Other Health Impairments Not Mentioned in IDEA's Definition

As we mentioned at the beginning of this article, other health impairments can also fall under the umbrella of IDEA's disability category besides the ones specifically mentioned in the law. The U.S. Department of Education mentions specific other disorders or conditions that may, in combination with other factors, qualify a child for services under IDEA-for example:

fetal alcohol syndrome (FAS),

bipolar disorders,

dysphagia, and

other organic neurological disorders.

The reason these weren't specifically mentioned in IDEA's regulations? According to the Department:

...because these conditions are commonly understood to be health impairments...The list of acute or chronic health conditions in the definition of other health impairment is not exhaustive, but rather provides examples of problems that children have that could make them eligible for special education and related services under the category of other health impairment. (71 Fed. Reg. at 46550)

Note that the Department uses the phase "could make them eligible"-could, not does. Other aspects (adversely affected educational performance, a child's evaluation results, state policies) are considered in determining eligibility for services under IDEA, not solely the existence of the disability or condition.

If your child has a health impairment that isn't explicitly mentioned in IDEA or is mentioned in the Department's comments, you may be able to find more information about that impairment by using the Search box that appears on every page on our site.

Addressing Medical Issues

By their very nature, other health impairments involve medical care and medical concerns. The amount of time that must be devoted to doctor visits, medical appointments, hospitalization, and seeing to the child's well-being will depend greatly on the nature and severity of the child's health impairment. For many families, the actual medical care of their child can be a daily, weekly, monthly challenge.

How to deal with the medical side of things? This section of our OHI fact sheet is intended to connect you with resources and wisdom within the health care and parent communities both.
The Concept of a Medical Home
Recently, the term "medical home" has entered the lexicon of health care. A medical home is not a house, office, or hospital, but rather an approach to providing comprehensive primary care (Nolan, 2008). The Washington State Medical Home (2009) defines the term as follows:

A medical home is an approach to delivering primary health care through a "team partnership" that ensures health care services are provided in a high-quality, cost effective and comprehensive manner.

The principles of a medical home are well stated by the American Academy of Pediatrics (2007):

personal physician,

physician-directed medical practice,

whole person orientation,

coordinated care,

quality and safety,

enhanced access, and

appropriate payment.

To find out more about this approach to health care, and to connect with resources in your state, we'd strongly recommend visiting the website of the National Center for Medical Home Initiatives for Children with Special Needs. The National Center is a hub of national medical home activities for children and youth with special needs. You'll find their site full of information and tools for health care providers and families, including a national medical home training curriculum and links to medical home projects and activities in every state. Enter the site at: http://www.medicalhomeinfo.org/

Another resource you may find especially helpful in addressing the health care and medical issues associated with an OHI is Family Voices. Family Voices concerns itself proactively with the health care of children with special health care needs. Through a network of state chapters, Family-to-Family Health Information Centers, and political advocacy, Family Voices offers tools and informed guidance to professionals and families alike. FV's home page is to be found at: http://www.familyvoices.org/

Life at School

As IDEA's definition of OHI makes clear, a health impairment affects a student's educational performance. In fact, for a child to qualify for special education services in the public schools, the OHI must affect the child's educational performance.

When a child is found to be eligible for special education, he or she will also be eligible to receive related services in school-which can be very valuable and relevant to the child's needs. Related services are provided as required to enable children with disabilities to benefit form their special education. Two in particular come to mind for children who have an OHI:

medical services, which are provided for diagnostic and evaluative purposes only, and which are defined as "...services provided by a licensed physician to determine a child's medically related disability that results in the child's need for special education and related services." [34 CFR §300.34(c)(5)]

school health services and school nurse services, which are defined by IDEA as "...health services that are designed to enable a child with a disability to receive FAPE as described in the child's IEP. School nurse services are services provided by a qualified school nurse. School health services are services that may be provided by either a qualified school nurse or other qualified person." [34 CFR §300.34(c)(13)]

Many children with disabilities, especially those who are medically fragile, could not attend school without the supportive services of school nurses and other qualified people. Over the years, the extent of the health-related services provided in schools has grown, as might be expected when you consider medical advances in the last decade alone.

What was previously called "school health services" in IDEA was expanded in its 2004 reauthorization to distinguish between services that are provided by a qualified nurse and those that may be provided by other qualified individuals. States and local school districts often have guidelines that address school health services and school nurse services. These may include providing such health-related support as:

special feedings;

clean intermittent catheterization;

suctioning;

the management of a tracheostomy;

administering and/or dispensing medications;

planning for the safety of a child in school;

ensuring that care is given while at school and at school functions to prevent injury (e.g., changing a child's position frequently to prevent pressure sores);

chronic disease management; and

conducting and/or promoting education and skills training for all (including the child) who serve as caregivers in the school setting.

Determining what related services a child needs is the responsibility of the child's IEP team, the group that develops the child's individualized education program. Key information for decision makers will be available from the evaluation process, since a child must be assessed in all areas related to his or her suspected disability. The IEP team must look carefully at the evaluation results, which show the child's areas of strength and need, and decide upon which related services are appropriate for the child. The school must then provide these services as part of the child's education program.
When Health Affects School Attendance
It's not uncommon for a child with an OHI to have periodic absences from school, sometimes even lengthy ones, especially if hospitalization is necessary for whatever reason. During these times, the public school remains responsible for providing educational and related services to the eligible child with OHI. Because IDEA specifically states that special education can be provided in a range of settings, including the home or the hospital, states and school districts will have policies and approaches for addressing children's individualized needs and circumstances.

The school, therefore, is the best source of information about what local policies govern how services are made available to children with OHI who are home-bound or hospitalized.

When the child is at home, the school may arrange for a homebound instructor to bring assignments from school to home and help the student complete those assignments.

When the child is hospitalized, services may be provided by the hospital, through arrangement with the school, although this will vary according to local policies. (In any event, the hospital is likely to have policies and procedures of its own, and it's important for the family to find out what those are.) The hospital may want to review the child's IEP and may, with the parent's permission, modify it during the child's hospitalization.

After the child is discharged, the hospital will share a summary of the child's progress with the school, in keeping with whatever local school policies are.

Planning for Transitions

After a child has been out of school for an extended period of time, it's important for parents and school staff to plan carefully for his or her return to that setting and the activities that go on there. However, it's important to understand that planning for a child's transition isn't just about when he or she returns to school. It needs to include "moves from Hospital to Home, Home to School, School to School, Hospital to School, School to Work or College, and from Pediatric to Adult Health Care" (Pola-Money, 2005).

That's a tall order, isn't it? Fortunately, there are numerous resources available that can help families, schools, and health care providers plan for each of these types of transition. Here are several to start, and they will likely lead you to more:

Transition issues.
Medical Home Portal.
http://www.medicalhomeportal.org/living-with-child/navigating-transitions-with-your-child

Transitioning from pediatric to adult health care.
The Adolescent Health Transition Project.
depts.washington.edu/healthtr/

Transitions for youth with health care needs.
Healthy & Ready to Work (HRTW) National Resource Center.
http://www.syntiro.org/hrtw/index.html

Conclusion

In closing, we hope that this information is helpful to you. We encourage you to learn more through the numerous resources we've listed and through the Search feature on our website, which will connect you with yet more resources on these disabilities.

References

American Academy of Pediatrics. (2007). What is a medical home? Retrieved May 5, 2009, from http://www.medicalhomeinfo.org/downloads/pdfs/JointStatement.pdf

Mattson, B. (2001). Related services (2nd ed.). NICHCY News Digest 16, 1-20.

Nolan, C. (2008). W hat is a medical home? Retrieved May 5, 2009, from the Medical Home Portal: http://www.medicalhomeportal.org/medical-home

Pola-Money, G. (2005). Transition issues. Retrieved August 21, 2012, from the Medical Home Portal: http://www.medicalhomeportal.org/clinical-practice/transition-issues

Washington State Medical Home. (2009). What is a medical home? Retrieved May 5, 2009, from http://www.medicalhome.org/

_________________

As promised, here's that list of of disabilities mentioned in IDEA's definition of OHI. Use the links to jump to more information about each of these disabilities.

# data[].attributes.attachment_link.description
Links updated, July 2015 "Other Health Impairment" is one of the 14 categories of disability listed in our nation's special education law, the Individuals with Disabilities Education Act (IDEA). Under IDEA, a child who has an "other health impairment" is very likely to be eligible for special services to help the child address his or her educational, developmental, and functional needs resulting from the disability.

# data[].attributes.attachment_link.readable_text
IDEA Definition of Other Health Impairments

According to IDEA, an Other Health Impairment is defined as:
Other health impairment means having limited strength, vitality or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that:

(i) is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, and sickle cell anemia; and
(ii) adversely affects a child's educational performance [34 C.F.R. 300.7(c)(9)].

Overview of Other Health Impairments

Many conditions and diseases can significantly affect a child's health and ability to function successfully in school. Most health impairments are chronic conditions; that is, they are always present, or they recur. By contrast, and acute condition develops quickly with intense symptoms that last for a relatively short period of time. To be served under the OHI category, the student's health condition must limit strength, vitality, or alertness to such a degree that the student's educational progress is adversely affected. More than 200 specific health impairments exist, and most are rare (Turnball et al., 2004). Within this category is Attention Deficit/Hyperactive Disorder. Only time will tell whether AD/HD finds its way to another special education category or whether it becomes a category of its own in the future. Presently, the inclusion of AD/HD has caused a significant increase in the size of the category (U.S. Department of Education, 2001).

Causes-Etiology of Other Health Impairments

The etiology of specific health impairments varies. Most result from infections, genetic factors, environmental influences, prenatal influences, perinatal influences, and postnatal influences. However, they can be grouped into some general areas (Smith, 2004):

Allergies e.g. Hepatitis

Heredity e.g. Hemophilia

Accidents e.g. seizure disorders

Multiple factors e.g. Epilepsy

Unknown

Prevalence of Other Health Impairments

According to the 26th Annual Report (U.S. Department of Education, 2004), 449,093 students between the ages of 6 to 21 years of age were identified as having other health impairments. This represents approximately 7.5 percent of all students having a classification in special education, or less than 1% of all school-age students.

Age of onset of Other Health Impairments

Due to the various types of health impairments that adversely affect children's performances in school, no specific age of onset can be generalized to the entire school-age population that receives special education services. Some health impairments are congenital (present at birth) and other conditions are acquired during the child's development as a result of accident, illness or unknown cause.

Gender Features of Other Health Impairments

Due to the number and specific types of health impairments covered in this section, no statement concerning gender patterns can be generalized.

Familial Patterns of Other Health Impairments

Due to the number and specific types of health impairments covered in this section, no statement concerning familial patterns can be generalized.

Cultural Features of Other Health Impairments

Although European Americans are proportionately underrepresented among students with disabilities, their highest representation is in the "Other Health Impairments" category.

Characteristics of Other Health Impairments

According to the Starbright Foundation (2002; cited in Turnball et al., 2004), there are numerous complex challenges facing children with health impairments. Common issues are: "loss of sense of control, lack of understanding about the condition, fear, worry, anxiety, stress, anger, and guilt, changes in family dynamics, isolation, isolation, medical noncompliance, boredom, depression, pain, decreased self-esteem, negative body image, and impact on identity and social interactions, including those at school" (p. 313).
Some general characteristics faced by individuals with other health impairments may include but not limited to:

Fatigue

Mobility issues

Issues involving attention

Coordination difficulties

Muscle weakness

Frequent absences or lateness's to school

Stamina

Inability to concentrate for long periods of time

Educational Implications of Other Health Impairments

When responsible educators encounter diseases and conditions they know little about, they seek out all the information they need to provide an appropriate education to students involved (Smith, 2004). One of the main considerations in the education of these students is the use of the team approach in developing and carrying out a child's educational program. The team generally includes the parents, teachers, medical professionals, and health-related professionals such as a physical therapist. Parents are critical members of the team and should be involved in all educational decisions. Sirvis (1988) noted that the team should design a program that meets the needs of the student in five basic goal areas: "(a) physical independence, including mastery of daily living skills; (b) self-awareness and social maturation; (c) communication; (d) academic growth; and (e) life skills training" (p. 400). Interdisciplinary services such as occupational and physical therapy and speech and language therapy are of prime importance for youngsters who have physical disabilities.

It is often necessary to modify and adapt the school environment to make it accessible, safe, and less restrictive since discriminating architecture doesn't have to discriminate (Leibrock & Terry, 1999, p.17). Accessibility guidelines are readily available, and when these guidelines are followed the environment becomes easier for the child to manage independently.

It is important that modifications be no more restrictive than absolutely necessary so that the student's school experiences can be as normal as possible. While it is necessary to stress the importance of avoiding overprotection of students with physical or health impairments, it is also important to permit students with disabilities to take risks just as their able-bodied cohorts do.
Recent advances in technology have helped to make life more nearly normal for students with physical disabilities. For example, students with cerebral palsy can use computer terminals to aid in communication. Through technology, even a person with the most severe handicaps can have greater control over communication and daily living skills.

Modifying the environment may mean providing special adaptive equipment such as specially designed desks, positioning devices, wedges, or standing tables. Adaptations also may include establishing procedures for dealing with medical emergencies when students have serious medical problems.

Finally, what role teachers should play in the medical management of children is an ongoing and contentious issue (Temple, 2000) since teachers are being called on to assume more responsibilities for the medical management of their students (Heller et al., 2000).

# data[].attributes.attachment_link.keywords[]
curriculum for children with disabilities

# data[].attributes.attachment_link.keywords[]
summer camps for children with disabilities

# data[].attributes.attachment_link.keywords[]
family educational rights and privacy act

# data[].attributes.attachment_link.title
Comprehensive Overview of Other Health Impairments

# data[].attributes.attachment_link.description
According to IDEA, an Other Health Impairment is defined as:Other health impairment means having limited strength, vitality or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that: (i) is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, and sickle cell anemia; and(ii) adversely affects a child's educational performance [34 C.F.R.

# data[].attributes.attachment_link.description
The Serious Emotional Disability (SED) Quality Indicators (QI) offer guidance to educators and administrators when developing, implementing, and evaluating quality programming and services for students with a SED.

# data[].attributes.attachment_link.readable_text
Definition

The Individuals with Disabilities Education Act (IDEA) defines a specific learning disability as "a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations." This disability category includes such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia and developmental aphasia (a type of language disorder).

However, as IDEA's definition notes, "Specific Learning Disability does not include learning problems that are primarily the result of visual, hearing, or motor disabilities; of intellectual disability; of emotional disturbance; or of environmental, cultural, or economic disadvantage." This clause helps to distinguish learning disabilities from the other disability categories specified by IDEA. Specific Learning Disabilities (SLD) is by far the largest category of disability within the Individuals for Disabilities Education Act. Nearly half of all disabled children are labeled in the category of SLD.

Common Traits

According to the National Dissemination Center for Children with Disabilities (known as NICHCY), specific learning disabilities commonly affect skills in the areas of:

Reading (called dyslexia)

Writing (called dysgraphia)

Listening

Speaking

Reasoning

Math (called dyscalculia)

Signs that a child might have a learning disability tend to appear in elementary school. For example, difficulty learning the alphabet, problems with following directions, trouble transforming thoughts into written words and misreading math problems are all possible indicators of a specific learning disability.

Educational Challenges

It's clear from reading the above traits that students with learning disabilities can face a number of educational challenges. Oklahoma's State Department of Education alludes to several of these challenges in their online fact sheet on specific learning disabilities; they include:

Difficulty reading out loud

Poor reading comprehension

Struggling to write papers and essays

Trouble understanding lectures

Difficulty holding a pencil

Tips for Teachers and Parents

Don't let the term "learning disabilities" mislead you, teachers and parents. Rooted within this term is a common assumption that children with learning disabilities can't learn. NICHCY proposes otherwise, stating, "Children with learning disabilities are not 'dumb' or 'lazy.' In fact, they usually have average or above average intelligence. Their brains just process information differently."

Indeed, the more politically-correct phrase "learning differences" offers a more accurate snapshot that captures the essence of learning disabilities. Supplied with the appropriate special education services, students with learning disabilities can flourish academically. Take a student with dysgraphia for example. He or she may have A-worthy ideas for a paper inside his or her head, but without accommodations those ideas will probably not earn the grade they deserve. One potential accommodation for such a scenario entails using speech-to-text technology to write papers.

Overall, the best educational accommodations for students with specific learning disabilities stem from assessing a child's particular case and identifying his or her strengths and weaknesses. This evaluation is worked into the individualized education program (IEP) process.

Parents, are you concerned that your youngster might possess a learning disability? NICHCY notes you can ask your school to evaluate your son or daughter to diagnosis any learning disabilities. If your child has a specific learning disability, the IEP process will begin to unfold.

# data[].attributes.attachment_link.title
A Guide to Specific Learning Disabilities | Special Education Guide

# data[].attributes.attachment_link.description
The Individuals with Disabilities Education Act (IDEA) defines a specific learning disability as "a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations."

# data[].attributes.attachment_link.description
IDEA's definition of specific learning disability remains unchanged since 1975.

# data[].attributes.attachment_link.readable_text
Technology has a place in all facets of our lives, and in terms of speech therapy, we thought we'd cover some ofour favorite types of technology in the form of apps. Apps for a mobile device or tablet are excellent tools to help develop a child's speech, language and cognitive skills. Technology continues to take on an increasingly important part of our daily lives. While there are seemingly endless applications available, we've narrowed down a few of our favorites that can be used to improve and/or maintain vocabulary, articulation, speech and language skills. These are some of our favorite apps designed to help kids with speech impediments.

Our 6 Favorite Apps for Kids with Speech Impediments

Articulation Games - This is a comprehensive, flexible and fun speech-therapy app created by a certified Speech and Language Pathologist for children to practice the pronunciation of over forty English phonemes. The games are organized according to placement of articulation. It includes thousands of real-life flashcards, professional audio recordings and matching games designed to help articulation on every level.

Fun with R - This app offers a detailed program for children to practice articulation of one of the most difficult to produce sound "r". It includes over 2000 audio recorded words where the sound of "r" is placed at the beginning, middle or end of a word or phrase. "R" blends are also included. Users are encouraged to select specific words for each phoneme, as well as customize their own using photos and audio recordings.

Story Builder - Story Builder is designed to help children improve paragraph formation and the integration of ideas in order to produce an effective story. Included with this app is extensive use of audio clips, which promote improved auditory processing for special needs children such as autism spectrum disorders or sensory processing disorders. Story Builder targets all aspects of creating an effective story from picture description, word order, sentence formation, vocabulary, making predictions, cause/effect, pronouns, verb tense, and sequencing.

Articulation Station Pro, by Little Bee Speech, created by a Speech Language Pathologist is designed to help children learn to speak and pronounce their sounds more clearly. High quality images and engaging activities offer kids the choice of word, sentence or story levels. The activities are so fun that kids love practicing sounds and do not realize they are working on articulation!

Splingo's Language Universe is an interactive game app designed by Speech and Language Pathologists to help children learn listening and language skills. A cute alien helps children focus on a variety of different aspects of language, including naming words (nouns), action words (verbs), location words (prepositions) and description words (adjectives). Language Universe comes with thousands of different word and sentence possibilities in US or UK voice options and offers a range of language development possibilities from single word recognition, to more complex such as combining several aspects of language at once.

ArtikPix, by Expressive Solutions LLC/Eric Sailers, is an entertaining articulation app with flashcard and matching activities for children with speech sound delays. Utilizing fun and modern graphics, ArtikPix has 24 decks with 40 cards each (113 cards in r deck, 1,033 total cards) for the following sounds: th, w, y, h, f, v, ch, sh, k, g, s, z, l, r, s-blends, r-blends, l-blends, p, b, m, n, t, d, j. The decks can be combined, selected for sound group (e.g., beginning th, er), then practiced in flashcard and matching activities.

What are some of your favorite apps? We'd love to hear from you!

Apps At Home Ideas Language Development

Tagged: Apps, apps for speech impediment, apps for speech therapy, articulation therapy, communication skills, games, iPad, language development, parents' corner, speech and language development, speech impediment, speech impediment in children, speech therapy apps, speech therapy tools, technology, using apps for speech therapy

# data[].attributes.attachment_link.title
Our 6 Favorite Apps for Kids with Speech Impediments

# data[].attributes.attachment_link.description
Technology has a place in all facets of our lives, and in terms of speech therapy, we thought we'd cover some ofour favorite types of technology in the form of apps. Apps for a mobile device or tablet are excellent tools to help develop a child's speech, language and cognitive skills.

# data[].attributes.attachment_link.readable_text
Most children develop speech and language skills within a specific age range. A child who takes longer to learn a skill may have a problem.

Learn more about what to expect from your child from birth to 5 years old.

Speech-language pathologists, or SLPs, can help your child.

To find an SLP near you, visit ProFind.

Find out more about child speech and language...

Speech Disorders

Language Disorders

Early Detection

Medical and Developmental Conditions

Communication Options

Additional Resources

# data[].attributes.attachment_link.description
Most children develop speech and language skills within a specific age range. A child who takes longer to learn a skill may have a problem. Learn more about what to expect from your child from birth to 5 years old. Speech-language pathologists, or SLPs, can help your child.

# data[].attributes.attachment_link.title
Home Page - Colorado Kids with Brain Injury

# data[].attributes.attachment_link.description
Colorado Kids with Brain Injury serves as a tool for educators, school administrators, school psychologists, related services professionals, community partners, and families to help support our kids in Colorado with brain injuries. The website was funded through a community grant from MINDSOURCE Brain Injury Network within the Colorado Department of Human Services and is maintained by the Brain Injury Consultants at the Colorado Department of Education.

# data[].attributes.attachment_link.title
MINDSOURCE Brain Injury Network (Colorado Brain Injury Program)

# data[].attributes.attachment_link.description
Housed within the Colorado Department of Human Services (CDHS), MINDSOURCE strives to enhance the quality of life for everyone in Colorado living with, or affected by brain injury, and their communities.

# data[].attributes.attachment_link.description
CABS, the state chapter of the NFB's National Association of Blind Students, provides support, information, and encouragement to blind college students and to high school students who are looking forward to college.

# data[].attributes.attachment_link.title
Classroom Tools for Visually Impaired Students

# data[].attributes.attachment_link.title
About Us - Anchor Center For Blind Children

# data[].attributes.attachment_link.description
About us Anchor Center for Blind Children. Teaching visually impaired infants, young children and their families. Seeing life differently.

# data[].attributes.attachment_link.title
Lesson Planning for ELLs | Colorín Colorado

# data[].attributes.attachment_link.description
When planning a lesson for a class that includes English language learners (ELLs), it may be difficult to know how to help students at different language levels participate fully in the activities. However, there are a number of steps you can take to help strengthen students' language development and engage them, no matter their level of language proficiency.

# data[].attributes.attachment_link.readable_text
Listen to this post as a podcast:
A note on terminology: The acronym ESL is used less often now in schools than it used to be, because we recognize that many students who are learning English already speak several other languages, so English would not be a "second" language. I use it several times in the post because schools sometimes refer to the teachers as ESL teachers, and the term is still widely used as a search term for this topic. My intent in using the acronym is to make this post easier to find online.

You have a new student, and he speaks no English. His family has just moved to your town from Japan, and though he receives English as a Second Language (ESL) support, he will also be sitting in your room every day to give him more exposure to his new language. How can you be a good teacher to someone who barely understands you?

According to the National Center for Education Statistics, an average of 9 percent of students in U.S. public schools are English Language Learners (ELLs); that number is closer to 14 percent in cities. Although many of these students start off in high-intensity, whole-day English programs, most are integrated into mainstream classrooms within a year, well before their English language skills would be considered proficient.

How prepared are you to teach these students? If you're like most classroom teachers, you have little to no training in the most effective methods for working with English language learners (Walker, Shafer, & Iiams, 2004). So that means we have a problem here: Lots of ELL kids in regular classrooms, and no teacher training to ensure the success of that placement.

Below, three ESL teachers tell us what they know about the things regular classroom teachers can do to improve instruction for ELL students. These 12 strategies are simple, they are not very time consuming, and best of all, they will help everyone in your class learn better:

1. Make it Visual

"Avoid giving instructions in the air," says Melissa Eddington, an Ohio-based ESL teacher. "ELL kids have a harder time processing spoken language." So instructions - even basic directions for classroom procedures - should be written on the board whenever possible. Challenging concepts should be diagrammed or supported with pictures. And modeling the steps of a process or showing students what a finished product should look like can go a long way toward helping students understand. "Sometimes showing our students what to do is all they need in order to do it," Eddington says. Not only will this kind of nonlinguistic representation improve comprehension for ELL students, it will help all of your students grasp concepts better.

2. Build in more group work.

"Kids aren't just empty glasses that we pour stuff into and then at the end of the day they dump it back onto a test," says Kim, an ESL teacher who was the subject of my very first podcast interview. "If you really want the kids to learn, they've got to be engaged." That means less teacher-led, whole-class instruction, and more small groups, where students can practice language with their peers in a more personal, lower-risk setting. And if ELL students attend your class with a resource teacher, make use of that person: In most cases the resource teacher doesn't have to work exclusively with the ESL students; they can work with smaller groups that happen to contain these students, helping to improve the teacher-student ratio and give kids more time to practice.

3. Communicate with the ESL teacher.

Mary Yurkosky, a former ESL teacher in Massachusetts, credits much of her students' success to the strong relationship she had with the regular classroom teachers. "The classroom teachers were always talking to me about what they were doing in their classes," she says. "They made it so easy for me to support them: If a teacher was going to be doing a unit on plants, I could make sure we used some of that same vocabulary in the ESL class."

Ideally, this could be systematized, where ESL teachers could regularly get copies of lesson plans or collaborate with regular classroom teachers to build solid back-and-forth support, but "it doesn't have to be that much work," Yurkosky insists. "Just talk to each other. Talk about what's going on in your classrooms, invite each other to special presentations, share what your students are learning, and the words will naturally find their way into the ESL class."

4. Honor the "silent period."

Many new language learners go through a silent period, during which they will speak very little, if at all. "Don't force them to talk if they don't want to," says Eddington, "A lot of students who come from cultures outside of America want to be perfect when they speak, so they will not share until they feel they are at a point where they're perfect." Just knowing that this is a normal stage in second language acquisition should help relieve any pressure you feel to move them toward talking too quickly.

5. Allow some scaffolding with the native language.

Although it has been a hotly debated topic in the language-learning community, allowing students some use of their first language (L1) in second-language (L2) classrooms is gaining acceptance. When a student is still very new to a language, it's okay to pair him with other students who speak his native language. "Some students are afraid to open their mouths at all for fear of sounding stupid or just not knowing the words to use," Yurkosky says. "Letting them explain things or ask questions in their first language gets them to relax and feel like a part of the class."

And this doesn't only apply to spoken language. If you give students a written assignment, but the ELL student doesn't yet have the proficiency to handle writing his response in English, "Don't make them just sit there and do nothing," Eddington says. "Allow them to write in their first language if they're able. This allows them to still participate in journal writing or a math extended response, even if you can't read what they write." There has even been some evidence that allowing second-language learners to pre-write and brainstorm in L1 results in higher-quality writing in L2 in later stages of the writing process (Yigzaw, 2012).

6. Look out for culturally unique vocabulary.

"For most of these kids, their background knowledge is lacking, especially with things that are unique to American or westernized culture," says Eddington. It's important to directly teach certain vocabulary words: "Show them videos of what it looks like to toss pizza dough, show pictures of a juke box or a clothing rack - things that are not common in their own language."

One way to differentiate for ELL students is to consider the whole list of terms you're going to teach for a unit, and if you think an ELL student may be overwhelmed by such a long list, omit those that are not essential to understanding the larger topic at hand.

7. Use sentence frames to give students practice with academic language.

All students, not just English language learners, need practice with academic conversations. Sentence frames - partially completed sentences like "I disagree with what _________ said because..." - show students how to structure language in a formal way. Keep these posted in a highly visible spot in your classroom and require students to refer to them during discussions and while they write.

For this kind of language to really sink in, though, Kim says it has to become a regular part of class. "They won't do it if it's not the norm in the class, because they'll be embarrassed to use it among their peers," she says. "But if they can put it off on the teacher and say, Oh, well, you know, Miss Kim makes me talk like this, then they don't look as hoity-toity as they would otherwise."

8. Pre-teach whenever possible.

If you're going to be reading a certain article next week, give ESL students a copy of it now. If you plan to show a YouTube video tomorrow, send a link to your ESL students today. Any chance you can give these students to preview material will increase the odds that they'll understand it on the day you present it to everyone else. "That kind of thing is wonderful," Yurkosky says. "The kids feel so empowered if they've had a chance to look at the material ahead of time."

9. Learn about the cultural background of your students...

Our second-language populations grow more diverse every year. Taking the time to learn the basics of where a child comes from - exactly, not 'somewhere in the Middle East/South America/Asia/Africa' - tells the student that you respect her enough to bother. Kim remembers one time when she had to set the record straight about the diverse South American population at her school: "I was listening to the teachers talking about the 'Mexican' kids in our building," she says, "and I was like, 'We don't have any Mexicans.'" Not taking the time to at least correctly identify a child's country of origin, much like not bothering to pronounce their name correctly, is a kind of microaggression, a small, subtle insult that communicates hostility toward people of color. Make a commitment to be someone who bothers to get it right.

Once you have the country straight, take things up a notch by learning about students' religious and cultural practices. If he is a practicing Muslim, he should be told if one of the pizzas you ordered for the class party has sausage on it. If she comes from a culture where eye contact with adults is viewed as disrespectful, you'll know not to force her to look you in the eye when she's talking.

10. ...but don't make a child speak for his entire culture.

In her podcast interview, Kim shared a story about watching a teacher ask a new Iraqi student how he felt about the war in his country, right in the middle of class. "That's not cultural inclusiveness," she explains. "I've seen teachers do this and then pat themselves on the back. The students' English is limited so they can't express themselves very well, and they don't want to 'represent'; they just want to be there." If you anticipate a theme coming up in your class that's going to be relevant to one of your students, have a conversation with them in advance, or check with your ESL teacher to see if they think it's appropriate for in-class discussion.

11. Show them how to take themselves less seriously...

By modeling the risk-taking that's required to learn a new language, you help students develop the courage to take their own risks, and to have a sense of humor about it. "I tried to say the word 'paint' ( pinta) in Portuguese and instead I said the word for 'penis' ( pinto). They all roared with laughter while I stood there with a What?? look on my face," Yurkosky says. "When they explained what I'd said, I laughed so hard! I told them that laughing was fine because sometimes mistakes are really funny, but ridicule is never okay."

12. ...but always take them seriously.

One of Kim's pet peeves about how teachers interact with English language learners is the way they often see students' efforts as 'cute,' missing the whole point of what the student is trying to say. "A student will be desperate to communicate, and the teacher will get distracted by the delivery and miss the message," she says. "That's painful for me to watch." It bothers her when teachers mistake a lack of language for a lack of intelligence or maturity. When a child can't express themselves as well as they would in their native language, it's far too easy to assume the concepts just aren't in their heads.

"It breaks my heart when I hear teachers say (ELL kids) don't know anything," says Eddington. "These are brilliant kids and they know a lot. They just can't tell us in English yet." Make a conscious effort to see past the accent and the mispronunciations and treat every interaction - every student - with the respect they deserve.

"They're doing twice the job of everybody else in the class," Kim adds, "even though the result looks like half as much." ♦

Further Reading

The ESL/ELL Teacher's Survival Guide is one of the highest-rated books on teaching English-language learners available. In addition to offering an overview of the research on second-language learners and best practices in teaching ESL, it also includes a whole section on teaching ESL in the content areas and another specifically geared toward teaching ELL students in mainstream classrooms.
References:
Walker, A., Shafer, J., & Iiams, M. (2004). "Not in my classroom": Teacher attitudes towards English language learners in the mainstream classroom. NABE Journal of Research and Practice, 2(1), 130-160.

Yigzaw, A. (2012). Impact of L1 use in L2 English writing classes. Ethiopian Journal of Education and Sciences, 8(1), 11-27.

If you thought this was helpful, stick around.
Join my mailing list and never miss another post. You'll get weekly tips, tools, and inspiration - in quick, bite-sized packages - all geared toward making your teaching more effective and joyful. To thank you, I'll send you a free copy of my new e-booklet, 20 Ways to Cut Your Grading Time in Half. I look forward to getting to know you better!

Click here to get a PDF of this article.

# data[].attributes.attachment_link.title
12 Ways to Support English Learners in the Mainstream Classroom

# data[].attributes.attachment_link.description
Advice from three ESL teachers on the things regular classroom teachers can do to help English language learners thrive in mainstream classrooms.

# data[].attributes.attachment_link.title
Welcome to CALLA! - Cognitive Academic Language Learning Approach

# data[].attributes.attachment_link.description
Anna Uhl Chamot spoke to Keyana Young at the Voice of America Learning English booth during the international Teachers of English to Speakers of Other Languages (TESOL) conference in April 2016. She describes the beginnings of the CALLA approach.