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http://www.schoolmentalhealth.org/Resources/Educ/Tips%20for%20Teachers.pdf

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http://www.uft.org/teacher-teacher/teaching-children-who-are-hearing-impaired

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Disruptive Behavior Disorders

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Disruptive behavior disorders are among the easiest to identify of all coexisting conditions because they involve behaviors that are readily seen such as temper tantrums, physical aggression such as attacking other children, excessive argumentativeness, stealing, and other forms of defiance or resistance to authority.

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http://www.autismspeaks.org/science/science-news/largest-ever-autism-genome-study-finds-most-siblings-have-different-autism-risk

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Autism Spectrum Disorder

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"Is every man in America somewhere on it?" Nora Ephron wondered about the autism spectrum in an e-mail to a friend a few months before her death. "Is every producer on it? Is every 8-year-old boy who is obsessed with statistics on it? Sometimes, when we say someone is on the spectrum, do we just mean he's a prick? Or a pathological narcissist? I notice that at least three times a week I am told (or I tell someone) that some man or other is on the spectrum."

Ephron was hardly alone. In August, after a string of campaign-trail bloopers by Mitt Romney (e.g., at a New Hampshire parade, he described his lemonade as "lemon ... wet ... good"), noted diagnostician David Shuster, a television personality at Current TV, floated the idea that Romney might be on the spectrum. Shuster cited "an uncle who specializes in the field of Asperger's"-a mild variant of autism-who had "suggested that perhaps Mitt Romney has some sort of form of Asperger's because he's so socially inept in terms of being able to connect with people. What he thinks is funny is really sort of not so funny. I sort of wonder if there's some sort of tic or something that he has that's related to that."

Meanwhile, out on the Great Plains, one Dennis Stillings, writing in the Bismarck-based Dakota Beacon about Barack Obama, has adduced such telltale evidence as his "legendary clumsiness ... He has actually bowled a 37," "verbal glitches-possibly the reason for the ever-present teleprompters," and "infamous inability to relate" to arrive at a boldly contrarian thesis: "Obama may well not be narcissistic at all, but simply manifesting a typical feature of autism." Stillings then passes along the opinion of a friend of a friend "who actually works with autistic people" that the president of the United States "likely" has Asperger's, and speculates that this "may or may not be of significance" to the Obama administration's considerable funding of autism research.

The diagnosis is everywhere: Facebook's former head of engineering has stated that Mark Zuckerberg has "a touch of the Asperger's." Time suggested that the intensely awkward Bill Gates is autistic; a biographer of Warren Buffett wrote that the Oracle of Omaha, with his prodigious memory and "fascination with numbers," has "a vaguely autistic aura." On Celebrity Rehab, Dr. Drew Pinsky deemed Dennis Rodman (selectively hyperfocused, socially obtuse) a candidate for an Asperger's diagnosis, and the UCLA specialist brought in to make it official "seemed to concur," Pinsky told viewers. On the Asperger's community site Wrong Planet, threads like "Real life celebrities who have or probably have Asperger's" include Jim Carrey, Adolf Hitler, Daryl Hannah, Slash, Billy Joel, J. K. Rowling, and Adam Carolla, who makes the cut because "I've heard guests on his podcast remark on his lack of eye contact." "Kanye Probably Has Asperger's," BuzzFeed recently declared.

Still others are seeing it in themselves. David Byrne: "I was a peculiar young man-borderline Asperger's, I would guess." Craigslist founder Craig Newmark, noting his poor eye contact and limited social competency, blogged that Asperger's symptoms "feel uncomfortably familiar." Dan Harmon, the volatile creator of NBC's Community, told an interviewer last year that he had boned up on Asperger's symptoms when researching the character Abed: "The more I looked them up, the more familiar they seemed." Dan Aykroyd told NPR's Terry Gross that he was diagnosed with Asperger's as a child (a puzzling claim given that the diagnosis didn't exist prior to 1981, when Aykroyd turned 29); Aykroyd insisted he was being serious, and as evidence of his continuing symptoms he noted his "fascination with law enforcement and the police."

What is happening? What cultural through-line has emerged that would join such surreal-life bedfellows as a pop-piano-playing crooner, a flamboyant professional basketball player, a reclusive children's-book author, a twentysomething Internet gazillionaire, and a genocidal madman together in diagnostic brotherhood? How have we reached a point where partisans of left and right can regard the opposing candidates for the highest office in the land and see ... an arcane brain disorder? "It's an epidemic," Ephron wrote in her e-mail. "Or else a wildly over-diagnosed thing that there used to be other words for."

Every generation has its defining psychiatric malady, confidently diagnosed from afar by armchair non-psychiatrists. In the fifties, all those gray-suited organization men were married to "frigid" women. Until a few years ago, the country of self-obsessed boomers and reality-TV fame-seekers and vain politicians and bubble-riding Ponzi schemers made narcissistic personality disorder-diagnosis code 301.81 in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, fourth edition-the craziness of the moment. And who among us has not proudly copped to our own "OCD" or "ADD," deemed a mercurial sibling "seriously bipolar," written off an erratic ex as "obviously borderline," or nodded as a laid-off friend pronounced his former boss a "textbook sociopath"? Lately, a new kind of head case stalks the land-staring past us, blurting gaucheries, droning on about the technical minutiae of his boring hobby. And we are ready with our DSM codes: 299.00 (autistic disorder) and 299.80 (Asperger's disorder).

The pros have led the way. In the nineties, clinicians began reconceptualizing autism from a singular disorder to a cluster of related conditions on a spectrum of severity; as the criteria broadened to encompass less acutely impaired people-such as the more verbal group diagnosed with Asperger's-prevalence rose dramatically. Before 1980, one in 2,000 children was thought to be autistic. By 2007, the Centers for Disease Control were reporting that one in 152 American children had an autism-spectrum disorder. Two years later, the CDC updated the ratio to one in 110. This past March, the CDC revised the number upward again, to one in 88 (one in 54, if you just count boys, who are five times as likely to have one as girls). A South Korean study from last year put the number even higher, at one in 38. And in New Jersey, according to the latest numbers, an improbable one in 29 boys is on the spectrum.

Despite much debate about the causes of the so-called autism epidemic, the consensus among experts is that the increase is mostly due not to a rise in incidence but to greater awareness, recognition, and testing, and to the wider parameters of who qualifies for a place on the spectrum (New Jersey, for instance, has some of the most robust autism services in the country). Such elasticity is nowhere so relevant as at the fuzzy, ever-shifting threshold where clinical disorder shades into everyday eccentricity. The upper end of the spectrum is the liminal zone where Aspies, as people with Asperger's call themselves, reside.

But this is not a story about Asperger's, autism, or the spectrum-those very real afflictions that can bring untold hardship to the people who suffer from them and to their families. It is, instead, a story about "Asperger's," "autism," and "the spectrum"-our one-stop-shopping shorthand for the jerky husband, the socially inept plutocrat, the tactless boss, the child prodigy with no friends, the remorseless criminal. It's about the words we deploy to describe some murky hybrid of egghead and aloof.

Like the actual clinical disorder, the cultural epidemic in scare quotes may have less to do with changes in the world than with changes in those seeing it. To some degree, the spectrum is our way of making sense of an upended social topography, a buckled landscape where nerd titans hold the high ground once occupied by square-jawed captains of industry, a befuddling digital world overrun with trolls and avatars and social-media "rock stars" who are nothing like actual rock stars. It is, as the amateur presidential shrinks would have it, a handy phrase for the distant, cerebral men with the ambition and self-possession necessary to mount a serious run for the White House. When quants and engineers are ascendant, when algorithms trump the liberal arts, when Kim Kardashian and Justin Bieber tweet about the death of Steve Jobs, when the hyperspecialist has displaced the generalist and everyone is Matrix- ed into the Internet, it's an Other-deriding tool to soothe our cultural anxiety about the ongoing power shift from humanists to technologists. As the coders inherit the Earth, saying someone's on the spectrum is how English majors make themselves feel better.

But anxiety alone (generalized anxiety disorder: 300.02) doesn't fully explain it. There's something admiring, too, in the cultural uses of Asperger's, which makes it different from the psych put-downs du jour of previous eras. The popular but mostly false image of Rain Man-like asocial geniuses (whether on the sitcoms Big Bang Theory and Community, say, or in best-selling books like Jodi Picoult's novel House Rules and Michael Lewis's The Big Short) has helped create a mystique around high-functioning autism, and the idea that Asperger's offers selective advantages has midwifed a generation of self-outers: See, for example, Pulitzer Prize-winning music critic Tim Page's Parallel Play: Growing Up With Undiagnosed Asperger's, or contestant Heather Kuzmich's appearances on America's Next Top Model.

And so we find ourselves in a weird place. A psychiatric diagnosis first observed in four boys more than half a century ago has become common slang, a conceptual gadget for processing the modern world. Weirder still: At the same time it soothes the insecurities of those who would weaponize it as insult, it flatters the vanity of those who'd appropriate it as status credential.

In 1995, when Ben Nugent was 17 years old, his mother told him she thought he had Asperger's. This was particularly distressing to him, both because his mother was qualified to know-she was a psychologist specializing in the disorder-and because he was an aspiring novelist. As he puts it: "If what I had proposed to do with my life was to plumb the inner depths of other people, it could be a big problem." He never actually believed he had Asperger's, but at the time, it hadn't yet become a pop-culture phenomenon, and when his mother asked him to appear in an educational video she was making about the disorder, he agreed. By the time he watched the film for the first time, he was 22, lived in New York, worked as an arts reporter at Time, and had a new set of friends, and it was clear to him that he was neurologically typical. His girlfriend laughed as they watched the video together and he kept objecting to his inclusion. "When I saw this video and saw what the other people in it were like," Nugent says, "I was like, Oh my God. "

"I was totally awkward," Nugent says of his younger years, "but awkward in a totally normal way. I was an aspiring hipster in a bad vintage polo shirt and a Blur haircut talking about the understanding of literature I had in fifth grade. So, really annoying probably, but not on the autism spectrum."

Other than several years' resentment toward his mother, who was profusely apologetic, and free ammo for opponents ("A girlfriend who wanted to win an argument would say, 'Maybe your mom was right' "), Nugent seems to have survived the episode unscathed, and he's become something of a student of the modern conflation of social awkwardness with autism. In his nonfiction American Nerd: The Story of My People, he included a chart that matched up the diagnostic criteria for Asperger's with a list of classic nerd traits (social phobias, rule-bound speech, etc.). "If you look at certain nerd characters, like Jerry Lewis in The Nutty Professor," Nugent says, "he's basically acting like someone with Asperger's or mild autism. He's spastic, doesn't understand social cues, is a savant." More recently, Nugent wrote an op-ed in the Times lamenting the overdiagnosis of Asperger's.

Not that Nugent himself is always rigorous in applying the label to others. "When I get mad at someone I have a retail interaction with, like if I'm attempting to buy a shirt from someone who doesn't understand what I'm saying, later I'll say, 'That guy was kind of Asperger's-y. It means: not sensitive to my needs. I'm guilty of using the term in a sloppy vernacular way like everyone else."

The vagueness of the border between able and disabled has made Asperger's controversial from the time it was coined as a diagnosis, in 1981, by English psychiatrist Lorna Wing. Wing named it after Hans Asperger, a Viennese pediatrician who in a 1944 paper had described four boys as sharing "a lack of empathy, little ability to form friendships, one-sided conversations, intense absorption in a special interest, and clumsy movements." He called them "little professors." (Asperger himself seems to have been a bit spectrum-y as a child, endlessly reciting the verse of Austrian poet Franz Grillparzer, to his classmates' dismay.) By 1990, Asperger's syndrome was in common usage among clinicians as a term to describe a distinct verbal subset of autistics. But exactly how Asperger's made it into the DSM-IV, published in 1994, remains veiled in mystery.

The history of psychiatry is a long fade-in, a glacial zoom toward granularity. Autism emerged from a conceptual catchall called "childhood schizophrenia," and Asperger's, in turn, was carved out of autism. But the more fine-grained the distinctions, the more they threaten to overlap and blur into each other. The community of clinicians specializing in developmental neurology generally viewed DSM-IIIR, which had been published in 1987, as wildly overinclusive. It had only two categories of spectrum disorders-autism and the kitchen-sink PDD-NOS (pervasive developmental disorder-not otherwise specified)-and its imprecision was seen as having led to an alarming increase in the number of diagnoses.

The overarching agenda of DSM-IV, then, was to be more specific and to raise the bar for diagnosis. By the early nineties, the committee tasked with revising the taxonomy was focusing on whether Asperger's was fundamentally different from high-functioning autism. But their work was conscribed to hashing out the pros and cons of creating a separate diagnosis for Asperger's and didn't extend to making a decision or establishing what the diagnostic criteria would be. That work would fall to nonspecialist higher-ups at the APA. Even as the committee finished several years' work, its members had no idea whether Asperger's would make it into the big book. "It was like the election of the pope," says Peter Szatmari, a leading Canadian researcher who sat on the working group. "The message went upstairs, and we waited around for smoke to come out of the Vatican. And there it was."

The science writers hired to draft the DSM-IV text inexplicably dropped one of the criteria the committee had agreed distinguished Asperger's: gross motor clumsiness. And, arbitrarily, they decided that the criteria for Asperger's would be the same as for autism, with simply a different number of criteria needing to be met to qualify. "Asperger's got put in at the last minute," recalls working-group chairman Fred Volkmar, head of child psychiatry at the Yale-New Haven Children's Hospital, "with a lot of tweaking of it by powers on high ... There's so much of a rush to get the finished book done and copyedited and out. Things happen." Volkmar says that for the PDD-NOS diagnosis, a copy editor who happened not to like an "and" replaced it with "or," a seemingly tiny change that significantly expanded the diagnosis.

The publication of DSM-IV had unintended consequences. "We were glad that Asperger's was included," says psychologist Bryna Siegel, another working-group member, who directs clinical care at the autism clinic at the University of California, San Francisco, "but until the publication of DSM-IV, very few people had heard the term Asperger's. And when it came out, a lot of clinicians let their fingers do the walking in DSM. There were fully trained practicing clinicians who really didn't have any idea what Asperger's was. Everybody with Asperger's got diagnosed with Asperger's, but a lot of other people got diagnosed with Asperger's, too."

Siegel, who has been running her clinic since the eighties, says she's seeing "more false-positive assessments than ever before." Of the roughly ten new assessments she's asked to do every week-kids showing up with spectrum diagnoses from another therapist-six of them might not have an autism-spectrum disorder. This isn't to say that they may not have psychological issues, only that those are either other disorders or they don't rise to an impairing level. "A lot of kids are just delayed in development, slow to talk, or anxious, or hyperactive, and a lot of kids are just terribly parented."

Siegel sees overdiagnosis and misdiagnosis as driven largely by economic and social priorities rather than medical ones. Some adults who might be very high-functioning seek a formal diagnosis because it enables them to, in Siegel's words, "wallow" in their symptoms rather than "ameliorate" them, because they're "a lunch ticket." Poor parents want diagnoses serious enough to merit state-funded school services, and rich parents want the least stigmatizing diagnoses. ("When you say a kid is mentally retarded," Siegel says, "parents try to talk you out of it.") And some parents are simply flummoxed by their own kids' irrational mood swings, refusal of food, or inability to express emotion. When these parents come to Siegel, they get a surprise: She diagnoses their children as suffering from childhood. "We see a lot of diagnosis-of-childhood kids, whose parents have never set limits, plus kids who are temperamentally difficult to raise."

Also temperamentally difficult: husbands. Put-upon spouses have seized on the autism rainbow as a simple, esteem-boosting way to pathologize what used to be called "a typical guy." Simon Baron-Cohen, a leading expert on Asperger's at Cambridge (and, as it happens, the cousin of Sacha), has theorized that the autism spectrum represents the "extreme male brain," turned up to eleven. Hence the ubiquity of spectrum references in the coastal power centers where Nora Ephron spent most of her time. And the Internet abounds with unhappy married women diagnosing their callous workaholic husbands with Asperger's, whether or not a clinician has seconded their opinion. In a forum called Asperger Divorce Support Group, posters share war stories, some less harrowing than others: "My ex ... did not GET a sunset. He took pictures of fall color trees last year and said, 'I guess its cool looking, right?' "

"It's become more frequent in the last five years," confirms a Connecticut divorce lawyer who says she has represented parties in several cases where a wife accused the husband of being on the spectrum. "It's women complaining, 'He lines up my towels perfectly. He complains if his shoes aren't lined up right.' "

Men have caught on and, in a kind of inverted gaslighting, begun to describe themselves as having Asperger's as a way of controlling their spouses. "Having Asperger's-like syndrome does not give you Asperger's," says David Schnarch, a Colorado-based couples therapist. "Having a big belly does not make you pregnant. I've not seen a single case of what I would consider to be diagnosable Asperger's. But I have seen any number of cases of wives accusing husbands of it, any number of cases of husbands claiming to have it." It's the new ADHD, he says. "The wife doesn't want to accept that the husband knows what he's doing when he's doing something she doesn't like." Schnarch recalls a man who phoned him the day before a scheduled initial couples session and announced that he'd just been diagnosed with Asperger's. "As soon as this happened," Schnarch says, "I knew I had difficulty." He contacted the referring therapist, who said he'd suspected the man had Asperger's because he said things to his girlfriend that were so cruel he couldn't possibly understand their impact. As far as Schnarch was concerned, it was an all-too-familiar instance of sadism masquerading as disability. "If you're going to perp, the best place to perp from is the victim position."

Because Asperger's lives on the outskirts of normal, and because its symptoms can resemble willfully antisocial behavior, there's now a presumption of excuse-making whenever someone invokes it to get out of a pickle. Last October, South Park aired an episode in which the people at an Asperger's group-therapy center turn out to be faking their symptoms and not even to believe in the reality of the disorder. (Cartman, meanwhile, mishearing Asperger's as "Ass Burgers," tries to fake it by stuffing his underwear with hamburgers.) "You're not autistic," a doctor tells Hugh Laurie's abrasive character in an episode of House. "You don't even have Asperger's. You wish you did; it would exempt you from the rules, give you freedom, absolve you of responsibility, let you date 17-year-olds. But, most important, it would mean that you're not just a jerk."

The yen to see the world in SpectrumVision is not just a case of glib metaphor abuse. Some studies of twins suggest that autism traits are distributed throughout the population. And it's now understood that there's an autism phenotype, where the same genetics can manifest in mild forms in parents and as full-blown autism in their children.

No one has been so responsible for the spread of this idea as Baron-Cohen, who has conducted a number of studies showing concentrations of autism among techies. In 1997, he published one asserting that autistic children were twice as likely as non-autistic children to have fathers or grandfathers who were engineers; he found a higher rate of autistic traits among math students at Cambridge than among those in other disciplines; and he has argued that in Silicon Valley, geeks intermarry and are more likely to produce autistic offspring.

As it turns out, a striking number of criminal defendants diagnosed with Asperger's are computer hackers. Misha Glenny, author of a book about cybercrime, is convinced that hackers are often people on the spectrum who end up outside the law by default-their lack of social skills combined with a surplus of computer know-how. "The Internet is what has made them-it gave them a place to be criminals," he has said. Earlier this month, the British home secretary ruled against the extradition to the U.S. of Gary McKinnon, a hacker who in 2002 was arrested for breaking into dozens of American government computers in what a U.S. attorney called "the biggest hack of military computers ever." McKinnon, who has been diagnosed with Asperger's, has said that he was just trying to unearth proof that the government was covering up UFO secrets, including anti-gravity technology acquired from alien landings. He has become a cause célèbre, inspiring free gary T-shirts and a benefit song featuring Chrissie Hynde, Bob Geldof, and David Gilmour. McKinnon's diagnosis dates only to 2008, after a television viewer with Asperger's saw a news report about the case and contacted McKinnon's lawyer, who then had McKinnon evaluated by Baron-Cohen.

Baron-Cohen has come in for criticism by scholars and some autism advocates who view his methods as unrigorous. Other researchers have pointed out that so-called autism clusters tend to be in areas with more highly educated people-who tend to marry older (a factor that correlates with higher autism rates) and who have the money to have their kids tested. "I don't think Baron-Cohen understands the rudiments of genetics," says Jonathan Mitchell, a high-functioning autistic who writes the Autism's Gadfly blog. But Baron-Cohen's work gets all the media play. In 2001, Wired published an article, "The Geek Syndrome," popularizing the autistic-nerd meme. It was accompanied by Baron-Cohen's 50-question self-diagnostic questionnaire, and afterward, says Bryna Siegel, whose clinic is a short drive from Silicon Valley, "we had an incredible number of phone calls. I told my assistant, 'If someone has their secretary call, don't call back. If they have a secretary, they don't have Asperger's.' "

The self-diagnosis boom has been accompanied by self-diagnoses that can be bracing in their unpersuasiveness. Craigslist's Newmark has acknowledged that "psychologist friends" have dismissed his self-diagnosis as "hypochondria." Bram Cohen, the founder of BitTorrent, has revealed that his self-professed Asperger's, about which he has spoken publicly at great length, was suggested by his girlfriend and never confirmed by a professional. Nobel Prize-winning economist Vernon Smith, another self-diagnoser, has cited as a key symptom the "tremendous amount of strain" he finds in "a social situation that lasts a couple of hours."

Aspies, self-diagnosed and otherwise, speak of the relief that diagnosis brings. For someone who may have gone decades feeling socially alienated, and blaming himself for it, knowledge of the condition can offer a key to the puzzle of his personality and the interpersonal challenges he's experienced. It was "a biblical weight off," and an explanation "for all those social banana peels along the way," says Michael John Carley, who was diagnosed at 36, after his 4-year-old son was diagnosed with Asperger's.

Carley has an unusual background for someone with a disorder characterized by difficulty in social interaction; a graduate of Columbia, he previously worked as a diplomat in Bosnia and Iraq. He is now a leading Asperger's advocate, one of a vocal group who promote the idea of "neurodiversity" and consider non-autistic people to be "neurotypicals," or "NTs," with different but not superior cognitive styles.

The Aspie-pride movement-an extreme fringe of which goes so far as to argue for "autistic supremacy"-takes its intellectual framework partly from studies that have posited that autism is an evolutionary adaptation, enabling survival strategies including solitary foraging, and that a male in the ancestral environment might have benefited from being more systematic and less empathic than others. Penny Spikins, an archaeologist at the University of York, recently published a paper suggesting that autistics were responsible for nothing less than the Stone Age tool revolution. Others, such as Juan Enriquez, a "futurist" at Harvard Business School, have argued that autism isn't so much a vestige of the past as a glimpse of what's to come: "the next evolutionary step" in an increasingly data-choked world.

Less grandly, there may be something to the idea of an affinity between autistics and the Information Age, given that autistics, with their difficulty imagining minds apart from their own, tend to relate better to animals and machines than to people. Online, the off-putting physical manifestations of spectrum disorders are stripped away. Celebrity autistic Temple Grandin has said that "there is nothing out there closer to how I think" than the web, with its structure of associative links. The web is shaping our behavior in "what is broadly a more autistic direction," argues behavioral economist Tyler Cowen, such as the way it lets us "pursue our identities and alliances based around very specific and articulable interests." (Mobile phones, too: In the utilitarian, no-small-talk idiom of texting, he sees an autistic style of communication.)

The investor Peter Thiel has said of Internet companies that "the people who run them are sort of autistic. These mild cases of Asperger's seem to be quite rampant. There's no need for sales-the companies themselves are weirdly nonsocial in nature." This is a vision of Internet culture as spectral, of whole corporations that miss social cues. It explains how services like Facebook and Google continually offend people with their missteps-whether changing privacy settings without permission, or photographing homes for Google Earth, or, in the case of businesses like Napster and BitTorrent, being completely indifferent to intellectual property-and then seem genuinely, naïvely surprised.

Still, it has become fashionable in some circles to describe the spectrum as the very womb of modernity. "If you were to get rid of all the autism genetics, there would be no more Silicon Valley," Grandin told a ted audience. David Mamet, in his book Bambi vs. Godzilla, writes, "I think it is not impossible that Asperger's syndrome helped make the movies," citing such movie-director traits as "early precocity," high information-processing capacity, attachment to routine, unconventionality, and social deficits. A recent ripple of business journalism has emphasized the narrow competencies of those on the high-functioning end of the spectrum as a competitive advantage: "In Praise of Misfits" ( The Economist), "If You Really Want to Innovate, Put an Autistic Person on Your Team" ( Business Insider). Specialisterne, a Danish company, employs 60 people on the spectrum to do software testing and other repetitive tasks.

Cowen, one of the most prominent champions of autism-as-superpower, came to believe he has "an autistic cognitive style" after receiving an e-mail suggesting as much from a reader of his blog, and has credited his take on autism as being "much influenced" by his former colleague Vernon Smith. In The Age of the Infovore, Cowen makes the energetic if labored case that autism is "a hidden cultural force" and that "understanding human neurodiversity in terms of impairments is fundamentally misleading." He extols autistics' "cognitive strengths": "They are better at noticing details in patterns, they have better eyesight on average, they are less likely to be fooled by optical illusions ... and they are less likely to have false memories of particular kinds." In his zeal to present autism in a positive light, Cowen flirts with dottiness, writing things like, "Autistics are the culmination of Buddhist thought and indeed Buddhist practice," and coming very close to diagnosing the entire country of Finland as autistic.

The same rose-colored impulse has driven an Aspie wave of revisionist psychopathography, in which such diverse historical figures as Thomas Jefferson, Orson Welles, Charles Darwin, Albert Einstein, Isaac Newton, Andy Warhol, and Wolfgang Amadeus Mozart are supposed to have been residents of the spectrum. The time-traveling diagnoses often feel like cloud-reading-the case for Darwin as Aspie, as set forth in Genius Genes: How Asperger Talents Changed the World, relies on diagnostic bullet points: his childhood as "something of a loner," his "obsession" with nature, his routine of counting the laps of his nightly walks in later life. They also seem to have fueled more diagnoses in the present. "I got a letter from around the world from a man who was diagnosed when he was 80," says Genius Genes co-author Michael Fitzgerald, a professor of child psychiatry at Trinity College, Dublin. "A lot of people read my book, and that was the first time they found they had autism. Someone rang me from China to say he'd read about his distant relative in the Civil War and for the first time realized he had Asperger's."

Even fictional characters come in for the treatment. In 2008, the Journal of Positive Behavior Interventions published a peer-reviewed article about "nonconforming, socially awkward" Bartleby the Scrivener, arguing that "retrospective analysis indicates that Bartleby may in fact have been a victim of the modern diagnosis of [autism spectrum disorder], more specifically, a high-functioning form of autism termed Asperger's syndrome." Cowen, for his part, avers in Infovore that Sherlock Holmes is "the most fully developed autistic character in the Western literary tradition."

For clinicians in the trenches, the more exuberant efforts to link autism with genius can be exasperating. "Do blind people hear music more exquisitely than people with sight?" asks Siegel. "We don't have any neurophysiological evidence that they do." Similarly, most people with Asperger's have average intelligence, with high IQs the exception. And many with ASD, and the families who care for them, suffer terribly. "There clearly are people with ASD who marry," says Catherine Lord, director of the Center for Autism and the Developing Brain at Weill Cornell Medical College, "but they are not many. More and more people with ASD have jobs, but the majority are underemployed, or have jobs that don't use their capabilities as much as possible. So these references to Einstein and Jefferson are not helpful."

At 6 p.m. on a recent Wednesday, in a carpeted rent-by-the-hour room in a sixteenth-floor conference center near Penn Station, some 25 people have gathered for the monthly meeting of a Manhattan Asperger's support group.

It's a largely male, mostly white group, ranging from a teenager to people in their sixties. They seem afflicted, or visibly off, to different degrees. Some appear to be straight-up NTs. Some, shorts hiked high, look like central-casting nerds. A handful have strange affects: A young Orthodox Jewish man in his late twenties smiles to himself, and another young man holds his hands near his chest, silent and fidgeting. Many, though, are smiling and socializing. "I like your forest shirt," one man says to a taciturn man named Gabe, who wears a green polo shirt patterned with trees.

Karl, a former engineer who runs the group for the Global Regional Asperger Syndrome Partnership (grasp), begins the meeting by having everyone in the room introduce himself: first name, diagnosis, employment and relationship status. As they speak, Karl chimes in occasionally, speaking in a distinctly enunciated, arrhythmic way. For a lot of the people here, Asperger's isn't their only problem. "Autism, borderline-personality disorder, depression, diabetes," one person says. Another person says: "1997, self-diagnosed; 1998, clinically diagnosed." A graphic designer named David got an online diagnosis after his six-and-a-half-year marriage crumbled: "My husband always said I had something." Nearly everyone is single, and a good number live with their parents.

A British woman, talking about a popular Asperger's memoir, John Elder Robison's Look Me in the Eye, starts crying, saying what a relief it had been to read, flooding her with memories of her own experiences; she'd always thought she was "daft." The room fills with a chorus of sympathetic voices ("It's okay to cry," another woman reassures her). These don't look like people seeking an excuse, or imagining a set of problems, or lacking in feeling, or just being eccentric. They seem to see the world through a particular lens, to have significant if narrow competencies, to be really struggling.

And their world is about to get shaken up. Next May, the fifth edition of the DSM is to be published, and the APA has proposed to eliminate the Asperger's diagnosis, folding it, as well as PDD-NOS, into the broader new all-purpose bucket of autism spectrum disorder. The thinking is that Asperger's isn't scientifically distinguishable from autism, and that a single diagnosis may help to combat the epidemic that is more diagnostic than real. But the debate has been fractious. Fred Volkmar, who'd headed the committee for DSM-IV, quit the DSM-5 committee, and has been vocal about the likelihood that the redrawn map of who's on the spectrum will cause a lot of people who currently have diagnoses to lose them. A report previewed in January suggested that as few as 45 percent of people who currently have Asperger's or PDD-NOS diagnoses will retain them, though a study in The American Journal of Psychiatry, published earlier this month, put the number closer to 90 percent.

For the people in this room, Asperger's is an identity as much as a diagnosis, and as much as this is a specialists' debate with real-world implications (insurance, school services), it's also an existential koan: If you lose your Asperger's diagnosis, do you not have Asperger's? Did you ever? grasp will continue to exist, but Karl tells the room that the AS may change to standing for Autism Spectrum, and Michael Carley, the head of grasp, has written a book titled The Last Memoir of Asperger's Syndrome. "I think I would say, if the term Asperger's helps you describe yourself and gives you community, use it," Catherine Lord, who is on the DSM-5 committee, tells me. "The fact that we're changing the medical diagnosis ... Most people who use Asperger's would not have met the DSM-IV criteria, so they're using the term already as a colloquial term. And that's fine. I don't think anyone wants to take that away, it just isn't a medical diagnosis. If someone needs someone to cut them slack, whether they have Asperger's or not, that's something they need to negotiate with their spouse."

Among the members of tonight's support group, people fall on both sides of the debate. "My belief," says an older man named Allen, "is it's impossible to distinguish Asperger's from high-functioning autism. It has more to do with where you get a diagnosis than the scientific criteria."

"What will it do for people who already have a diagnosis?" Gabe, in the green forest shirt, asks. "Where will we be? Anybody who agrees with me that Asperger's shouldn't be clumped under ASD, say 'No.' "

There are lots of "No"s. Someone mentions that the New York State Assembly is considering passing a law to exempt the state from the DSM-5.

"Yes!" Gabe says, doing a closed-fist power salute. "We can't just throw up our hands. What about Aspies and generations to come?"

"Woody Allen still makes movies about neurotics," Allen points out.

"Let's keep calling ourselves Aspies," Gabe says.

"Oh, hellz yes," says a guy in back.

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Is Everyone on the Autism Spectrum? -- New York Magazine - Nymag

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"Is every man in America somewhere on it?" Nora Ephron wondered about the autism spectrum in an e-mail to a friend a few months before her death. "Is every producer on it? Is every 8-year-old boy who is obsessed with statistics on it? Sometimes [...]

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A.D.H.D. and A.D.D.

http://www.help4adhd.org/education/rights

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Assistive Technology in Early Elementary:

http://www.edutopia.org/assistive-technology-young-children-special-education

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Visual Impairment

Creating tactile books for students for students who have visual impairments.

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My son became deafblind a year ago from Meningitis when he was 2 and 1/2 years old. Before he became sick, one of his favorite things was to be read to and look at books. I didn't want that to stop just because he lost his sight and hearing. I have created many books for Liam that match his interests and encourage his love for reading. Below are 4 examples of books that I have made for little Liam. I always try to use REAL LIFE OBJECTS, not abstract, as often as I can.

Shape book:

Textured shapes for pictures on each page with the braille word for the shape under each 'picture'. When my son 'reads' this book we trace the shape on the book and then create the shape with our finger in the air or on our hands.

Counting book:

I create a 'flip book' with objects to count under the flap. I put the braille number on top of the flap with the objects underneath it. I also added the sign language picture for each number on the flap as well so whoever is reading the book with Liam will know how to sign the number to him as well.

Face book:

On each page I added a new 'face part'. For example, on the first page I added just a face. I put the braille word for face on the page. When I would read it to Liam, I would have him feel the face, I would point to his face, and have him feel the braille word for face. The next page I would put a face on it and then add eyes. I would repeat the pattern of him feeling the eyes on the page, feeling his own eyes, and then feeling the braille word for eyes.

Liam likes book:

Up until now the books I have made for Liam have been one word books. I always try to use REAL LIFE OBJECTS not abstract. In this book I used 3-word sentences. All of the objects are words that Liam knows how to sign.

I wanted him to start correlating the sign language with the object in the book and then also to the word written in braille. I thought the best way to do that was to start with signs/words he already knew.

I'm hoping that this will be a bridge to being able to read short story books to Liam as he learns more sign language.

Tip: If you also have a deafblind child like Liam, it helps to add pictures of the words in sign language on the books so that people who are reading the book to your child will know the signs to use.

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Getting Books into the Hands of My 3-Year-Old, Deafblind Son - Paths to Literacy

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Paths to Literacy Getting Books into the Hands of My 3-Year-Old, Deafblind Son. For teachers, families, and others interested in literacy for children and youth with visual impairments

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http://psycnet.apa.org/books/11435/002.pdf

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Deaf:

http://www.deafwebsites.com/teaching-deaf-hard-hearing-students.html

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Autism Science Journal

http://www.autismsciencefoundation.org/science-journals

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Behavior Disorder http://www.nlm.nih.gov/medlineplus/childbehaviordisorders.html

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http://www.addcoach4u.com/teachingstudents/adhdaccomodations.html

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Emotional Disability

http://sped.dpi.wi.gov/sped_ed

http://ec.ncpublicschools.gov/instructional-resources/behavior-support/resources/screening-and-evaluation-for-serious-emotional-disability

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Emotional

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Autism Spectrum Disorder

Autism Speaks

http://www.autismspeaks.org

http://www.autismspeaks.org/site-wide/university-illinois-urbana-champaign

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Autism Speaks

http://www.autismspeaks.org

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Dyslexia

http://www.diannecraft.org/dyslexia-how-do-i-teach-this-child/

Asperger's Syndrome

http://www.webmd.com/brain/autism/tc/aspergers-syndrome-symptoms

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Spina Bifida

http://www.spinabifidaassociation.org/site/c.evKRI7OXIoJ8H/b.8028963/k.BE67/Home.htm

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Behavioral and Emotional Disabilities

http://ebx.sagepub.com/content/11/4/198.short

http://www.kidsmentalhealth.org/childrens-behavioral-and-emotional-disorders/

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Dyslexia (also known as "Specific Reading Disability)

http://www.mayoclinic.org/diseases-conditions/dyslexia/basics/definition/con-20021904

http://www.ldonline.org/article/14907

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Tips for teaching students with hearing impairments

-Use pictures and graphic organizers

-Repeat phrases

-Write instructions out on the board, do not speak while writing

-

http://www.uft.org/teacher-teacher/teaching-children-who-are-hearing-impaired

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Traumatic Brain Injury

Top three causes:

1. Car Accident

2. Firearms

3. Falls

More information on the major causes: http://www.traumaticbraininjury.com/understanding-tbi/%20what-are-the-causes-of-tbi/

Information on the effects of TBIs:
http://www.traumaticbraininjury.com/understanding-tbi/what-are-the-effects-of-tbi/

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ADHD http://www.helpguide.org/articles/add-adhd/attention-deficit-disorder-adhd-and-school.htm

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Practical tips for helping a child with ADHD thrive in school and enjoy learning.

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Emotional Disability: Eating disorders

http://www.nasponline.org/resources/principals/Eating%20Disorders%20WEB.pdf

http://www.nedc.com.au/files/Resources/Teachers%20Resource.pdf

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Emotional Disabilities

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Definition

In the special education realm, conditions which generate behavioral issues fall under the category emotional disturbance. Several disorders receive this classification, as the Individuals with Disabilities Education Act's (IDEA) definition suggests. This lengthy definition reads:

A condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:
(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.
(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
(C) Inappropriate types of behavior or feelings under normal circumstances.
(D) A general pervasive mood of unhappiness or depression.
(E) A tendency to develop physical symptoms or fears associated with personal or school problems.
The term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance.

Overwhelmed? A simpler way to understand emotional disturbances is to remember that, when it comes to special education, the term "emotional disturbance" is associated with mental health or severe behavior issues.

Common Traits

The National Dissemination Center for Children with Disabilities (often referred to as NICHCY) lists six types of emotional disturbances: anxiety disorders, bipolar disorder, conduct disorders, eating disorders, obsessive-compulsive disorder (OCD) and psychotic disorders; however, they note that this list isn't all-inclusive. To learn about the precise characteristics connected to a child's emotional disturbance, look into the specific subcategory that affects that child.

Educational Challenges

Given the behavioral issues related to the disability category at hand, educating students diagnosed with emotional disturbances can prove challenging. The challenge often stems from potential classroom disruptions; for instance, imagine the trouble created when a student begins crying uncontrollably or starts throwing a wild temper tantrum.

Tips for Teachers and Parents

Preventive measures are often the best solution to disruptions linked to emotional disturbances. The Arizona Department of Education's Parent Information Network mentions functional behavioral assessments (FBAs) as a preventative strategy. An FBA identifies what leads a student to act out so that an effective behavioral intervention plan (BIP) can be developed.

Avoiding disruptive behavior may entail behavior modification. Behavior modification can involve strategies such as positive reinforcement and incentives to help students learn behaviors that are less disruptive and more socially acceptable.

One final tip is likely to benefit both parents and teachers. Collaborate with other professionals who work with your child or student (psychotherapist, behavioral therapist, etc.) to determine specific ways to effectively educate the individual.

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What are Emotional Disturbances in Special Education?

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In the special education realm, conditions which generate behavioral issues fall under the category emotional disturbance. Several disorders receive this classification, as the Individuals with Disabilities Education Act's (IDEA) definition suggests.

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Including Students with Disabilities in General Education Classrooms

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December 2001/January 2002 | Volume 5 | Number 4
Schools and the Law

The Individuals with Disabilities Education Act (IDEA) requires that a continuum of placement options be available to meet the needs of students with disabilities. The law also requires that: "to the maximum extent appropriate, children with disabilities ... are educated with children who are not disabled, and that special classes, separate schooling, or other removal of children with disabilities from the regular environment occurs only when the nature or severity of the disability is such that education in regular classes with the use of supplementary aids and services cannot be attained satisfactorily." IDEA Sec. 612 (5) (B).

Years of research have contributed to our knowledge of how to successfully include students with disabilities in general education classes. Listed below are the activities and support systems commonly found where successful inclusion has occurred.
Attitudes and Beliefs

The regular teacher believes that the student can succeed.

School personnel are committed to accepting responsibility for the learning outcomes of students with disabilities.

School personnel and the students in the class have been prepared to receive a student with disabilities.

Parents are informed and support program goals.

Special education staff are committed to collaborative practice in general education classrooms.

Services and physical accommodations

Services needed by the student are available (e.g., health, physical, occupational, or speech therapy).

Accommodations to the physical plant and equipment are adequate to meet the student's needs (e.g., toys, building and playground facilities, learning materials, assistive devices).

School Support

The principal understands the needs of students with disabilities.

Adequate numbers of personnel, including aides and support personnel, are available.

Adequate staff development and technical assistance, based on the needs of the school personnel, are being provided (e.g., information on disabilities, instructional methods, awareness and acceptance activities for students, and team building skills).

Appropriate policies and procedures for monitoring individual student progress, including grading and testing, are in place.

Collaboration

Special educators are part of the instructional or planning team.

Teaming approaches are used for problem-solving and program implementation.

Regular teachers, special education teachers, and other specialists collaborate (e.g., co-teaching, team teaching, teacher assistance teams).

Instructional Methods

Teachers have the knowledge and skills needed to select and adapt curricula and instructional methods according to individual student needs.

A variety of instructional arrangements are available (e.g., team teaching, cross-grade grouping, peer tutoring, teacher assistance teams).

Teachers foster a cooperative learning environment and promote socialization.

Making It Work: A Sample Scenario

Classrooms that successfully include students with disabilities are designed to welcome diversity and to address the individual needs of all students, whether they have disabilities or not. The composite scenario below is based on reports from several teachers. It provides a brief description of how regular and special education teachers work together to address the individual needs of all of their students.

Jane Smith teaches third grade at Lincoln Elementary School. Three days a week, she co-teaches the class with Lynn Vogel, a special education teacher. Their 25 students include 4 who have special needs due to disabilities and 2 others who currently need special help in specific curriculum areas. Each of the students with a disability has an IEP that was developed by a team that included both teachers. The teachers, paraprofessionals, and the school principal believe that these students have a great deal to contribute to the class and that they will achieve their best in the environment of a general education classroom.

All of the school personnel have attended inservice training designed to develop collaborative skills for teaming and problem-solving. Mrs. Smith and the two paraprofessionals who work in the classroom also received special training on disabilities and on how to create an inclusive classroom environment. The school principal, Ben Parks, had worked in special education many years ago and has received training on the impact of new special education developments and instructional arrangements on school administration. Each year, Mr. Parks works with the building staff to identify areas in which new training is needed. For specific questions that may arise, technical assistance is available through a regional special education cooperative.

Mrs. Smith and Miss Vogel share responsibility for teaching and for supervising their two paraprofessionals. In addition to the time they spend together in the classroom, they spend 1 to 4 hours per week planning instruction, plus additional planning time with other teachers and support personnel who work with their students.

The teachers use their joint planning time to problem-solve and discuss the use of special instructional techniques for all students who need special assistance. Monitoring and adapting instruction for individual students is an ongoing activity. The teachers use curriculum-based measurement to systematically assess their students' learning progress. They adapt curricula so that lessons begin at the edge of the student's knowledge, adding new material at the student's pace, and presenting it in a style consistent with the student's learning style. For some students, preorganizers or chapter previews are used to bring out the most important points of the material to be learned; for other students, new vocabulary words may need to be highlighted or reduced reading levels may be required. Some students may use special activity worksheets, while others may learn best by using media or computer-assisted instruction.

In the classroom, the teachers group students differently for different activities. Sometimes, the teachers and para-professionals divide the class, each teaching a small group or tutoring individuals. They use cooperative learning projects to help the students learn to work together and develop social relationships. Peer tutors provide extra help to students who need it. Students without disabilities are more than willing to help their friends who have disabilities, and vice versa.

While the regular classroom may not be the best learning environment for every child with a disability, it is highly desirable for all who can benefit. It provides contact with age peers and prepares all students for the diversity of the world beyond the classroom.

References

Adamson, D.R., Matthews, P., & Schuller, J. (1990). "Five ways to bridge the resource room to regular classroom gap." TEACHING Exceptional Children, 22 (2), 74-77.

Cook, L. & Friend, M. (1992). "Interactions: Collaboration Skills for School Professionals." White Plains, NY: Longman Publishing.

Conn, M. (February, 1992). "How four communities tackle mainstreaming." The School Administrator, 2, 22-24.

The Council for Exceptional Children. (1993). "CEC policy on inclusive schools and community settings." Available from The Council for Exceptional Children, 1920 Association Drive, Reston, VA 22091. (703) 620-3660.

Friend, M., & Cook, L. (March, 1992). "The new mainstreaming: How it really works." Instructor, 101 (7), 30-36.

Giangreco, M.F., Chigee, J.C., & Iverson, V.S. (1993). "Choosing options and accommodations for children: A guide to planning inclusive education." Baltimore: Paul H. Brookes.

McLaughlin, M., & Warren, S.H. (1992). "Issues and options in restructuring schools and special education programs." Available from The Council for Exceptional Children, 1920 Association Drive, Reston, VA 22091-1589. (ERIC Number ED 350 774).

National Education Association. (May, 1992). "The integration of students with special needs into regular classrooms: Policies and practices that work." Washington, DC: National Education Association.

York, J., Doyle, M.B., & Kronberg, R. (December, 1992). "A curriculum development process for inclusive classrooms." Focus on Exceptional Children, 25(4).

Source: "Including Students with Disabilities in General Education Classrooms." ERIC Digest #E521
Note. An ERIC minibibliography, "Including Students with Disabilities," is also available.

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Including Students with Disabilities in General Education Classrooms

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December 2001/January 2002 | Volume 5 | Number 4 Schools and the Law The Individuals with Disabilities Education Act (IDEA) requires that a continuum of placement options be available to meet the needs of students with disabilities. The law also requires that: "to the maximum extent appropriate, children with disabilities ...

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Developmental Delay

http://www.scholastic.com/teachers/article/meeting-learning-challenges-working-children-who-have-developmental-delays

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Orthopedic Impairments

http://www.projectidealonline.org/v/orthopedic-impairments/

http://www.specialeducationguide.com/disability-profiles/orthopedic-impairments/

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Asperger's Syndrome

http://www.researchautism.org/educators/aspergersteps/index.asp

http://www.aspergersyndrome.org/Articles/Understanding-the-Student-With-Asperger-s-Syndrome.aspx

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Facilitating the Learning of Students with Asperger Syndrome and High-Functioning Autism, K-6

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Emotional Disturbances

http://www.education.com/reference/article/emotional-disturbance/

Strategies to Help Students with Emotional Disturbances

http://www.do2learn.com/disabilities/CharacteristicsAndStrategies/EmotionalDisturbance_Strategies.html

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http://www.adhdmoments.com/

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Tips for teaching students with Autism

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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.

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22 tips teaching students autism spectrum disorders special education & learning disabilities benefits articles

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22 Tips for Teaching Students with Autism Spectrum Disorders

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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.

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Blindness

http://www.nlm.nih.gov/medlineplus/ency/article/003040.htm

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Autism

https://www.naset.org/2561.0.html

http://education.jhu.edu/PD/newhorizons/Journals/specialedjournal/BakerC

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Down Syndrome

http://www.nads.org/pages_new/facts.html

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Bipolar Disorder

http://www.thebalancedmind.org/sites/default/files/edbrochure.pdf

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Visual Impairments

Teaching Students with Visual Impairments in the Classroom

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Teaching Students with Visual Impairments

# data[].attributes.attachment_link.entities[].name
Parent Resources History of VI Career Dev

# data[].attributes.attachment_link.entities[].name
Program Resources Professional Practice Vision Professionals In Service Trainings Vision Concerns Referrals Vision Exams Structure & Function Visual Impairments Deaf Blind Impact

# data[].attributes.attachment_link.entities[].name
AT Assessment Accommodations Goal Bank Service Delivery Transitions

# data[].attributes.attachment_link.entities[].name
Early Intervention Early Childhood Literacy Adaptations Math Adaptations Science Adaptations Social Studies Adaptations Electives Adapt

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Teaching Students with Visual Impairments

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The mission of Teaching Students with Visual Impairments is to: address and encompass all aspects related to educating students who are blind or visually impaired from diagnosis and referral to adaptations and unique instruction; provide all persons invol

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Blindness

http://www.afb.org/info/programs-and-services/professional-development/teachers/inclusive-education/1235

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http://www.addcoach4u.com/teachingstudents/adhdaccomodations.html

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ADHD

http://www.helpguide.org/articles/add-adhd/attention-deficit-disorder-adhd-and-school.htm

http://www.help4adhd.org/education/rights

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Information about Developmental Delay

http://www.do2learn.com/disabilities/CharacteristicsAndStrategies/DevelopmentalDelay_Characteristics.html

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Emotional Disturbances/Emotional Behavioral Disability:

Resource for effective programming:

http://sped.dpi.wi.gov/sites/default/files/imce/sped/doc/ebdeffprog.doc

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Disability Resources & Educational Services at UIUC (ADHD)

http://disability.illinois.edu/instructor-information/disability-specific-instructional-strategies/attention-deficithyperactivity

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Autism Spectrum Disorder

UIUC's TAP and YAK program: http://theautismprogram.illinois.edu/category/have-you-heard-about/area-resources/

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http://www.schoolbehavior.com/Files/tips_mood.pdf

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Speech or language impairments

http://www.parentcenterhub.org/repository/speechlanguage/

This is a wonderful website that walks you through the day of a speech-language pathologist, defines different speech-languge impairments, explains characteristics and causes of these impairments and much more.

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Autism Spectrum Disorder

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Autism Spectrum Disorder

http://teaching.monster.com/benefits/articles/8761-22-tips-for-teaching-students-with-autism-spectrum-disorders

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October 2010 | Volume 68 | Number 2
Interventions That Work Pages 46-51

R. Marc A. Crundwell and Kim Killu

Rita's story illustrates the essential features of clinical depression in children and adolescents: a persistent sad or irritable mood, loss of energy, decreased interest in daily activities or previously enjoyed activities, persistent feelings of worthlessness or guilt, withdrawal, and, possibly, recurrent thoughts of suicide. Children and adolescents with depression may also show appetite changes resulting in weight gain or loss, disturbed sleep patterns, increased defiance or oppositional behavior, and impaired concentration.

Recognizing Rita

Although depression is classified as an adult disorder-and depression in very young children is rare-middle to late adolescence is the most common age when symptoms first appear or a first major depressive episode happens (Burke, Burke, Regier, & Rae, 1990). Lewinsohn, Hops, Roberts, Seeley, and Andrews (1993) randomly sampled adolescents within a U.S. community and discovered that the average age of onset of major depression was 14. Sadly, the earlier the onset of depression in children and adolescents, the more protracted and severe the course of the disorder usually is (Kovacs, Feinberg, Crouse-Novak, Paulauskas, & Finkelstein, 1984).

As Figure 1 (p. 48) illustrates, research and clinical experience show that depression manifests itself differently in children than in adolescents in terms of what teachers see in the classroom (Kashani, Rosenberg, & Reid, 1989).

Figure 1. Characteristics of Depression in Children and Adolescents

When depression is recognized early and when professionals provide treatment, young people can experience improved mood and function better in school and life. Thus, the stakes are high. School personnel play a pivotal role in identifying depression-and intervening. Teachers, administrators, and other school staff must also be knowledgeable about depression because the disorder can seriously impair academic and interpersonal behavior at school (Hammen & Rudolph, 2003).

Depression is significantly correlated with poor academic grades, and students with higher ratings of depression are less likely to graduate from high school (Forehand, Brody, Long, & Fauber, 1988). Cognitive issues may include low tolerance for frustration and negative patterns of thinking. Depressed students often give up more quickly on tasks they perceive as daunting, refuse to attempt academic work they find too difficult, and quickly doubt their ability to independently complete academic tasks or solve problems. Memory, speech, physical and motor activity, and the ability to plan may also be affected. Many depressed children and adolescents are lethargic, speak laboriously, and have difficulty completely expressing thoughts and ideas.

Rita's case illustrates three other issues with regard to recognizing depression. First, the essential features of depression are as recognizable in youth as they are in adults, and the same diagnostic criteria are used for both age groups (Mitchell, McCauley, Burke, & Moss, 1988). Second, irritability is more common in depressed youth than in depressed adults. Third, teachers often overlook children with depression because symptoms like a sad mood or fatigue are more internal and subjective than the kinds of disruptive behavior shown by kids with more externalizing disorders, such as attention deficit disorder. Depressed young people often don't ask for help at school because of negative thinking patterns: No one cares about my feelings, nothing can be done to help me, and so on (Cash, 2003). Younger students often lack the necessary language skills and self-awareness to report-or recognize-their own depressed state.

Helping Students with Depression

Because depression can have broad negative effects on students' academic work and comfort in school, schools need to provide a variety of accommodations and instructional strategies to increase these students' success. Figure 2 (p. 50) shows strategies that can benefit children and adolescents battling depression.

Figure 2. Strategies to Help Students with Depression

Give frequent feedback on academic, social, and behavioral performance.

Teach the student how to set goals and self-monitor.

Teach problem-solving skills.

Coach the student in ways to organize, plan, and execute tasks demanded daily or weekly in school.

Develop modifications and accommodations to respond to the student's fluctuations in mood, ability to concentrate, or side effects of medication. Assign one individual to serve as a primary contact and coordinate interventions.

Give the student opportunities to engage in social interactions.

Frequently monitor whether the student has suicidal thoughts.

Develop a home-school communication system to share information on the student's academic, social, and emotional behavior and any developments concerning medication or side effects.

The best approach is often individualized. Here we describe an approach school personnel might use to help Rita.

As Rita's teacher Mrs. Shannon became worried about her, she shared her concerns with Rita's parents. They were relieved that the school had contacted them and were encouraged by the school's willingness to collaborate with them to address Rita's downward spiral and make decisions about ways to help her. With their cooperation, Mrs. Shannon and the school's guidance counselor brought together a team to provide interventions for Rita. This team brought in the school psychologist, who first strongly recommended that Rita's family physician evaluate her to determine whether further referral to a child psychiatrist was appropriate.

The school's intervention team, the school psychologist, and Rita's parents together developed an individualized plan of accommodations and instructional strategies to help Rita cope. After determining some appropriate interventions, the team met with Rita to discuss these possibilities and get her feedback; they knew this would increase the chance she would buy in. All the players involved agreed to meet monthly to review Rita's response to the interventions, ensure that their actions were helping her, and make any modifications needed.

Establish a Touchstone Teacher

Rita and a teacher from the resource room in her school, Ms. Hunt, began meeting weekly to help Rita develop specific goals for how she could manage better academically, socially, and in terms of behavior. Ms. Hunt was chosen because, as a resource teacher, she had flexibility to meet with Rita and could coordinate services with all of Rita's teachers. They met each Monday morning to review any work that Rita completed over the weekend and to set goals, targeting four areas in which depression typically affects students most strongly: work completion, work submission, social interactions, and physical activity.

The team considered it important that Rita take an active role in setting and achieving goals. This would help her learn self-management skills, which would later serve her in managing her depressive symptoms, accomplishing difficult tasks, and achieving personal goals (Cooper, Heron, & Heward, 2007). On Fridays, Rita again met with Ms. Hunt to review the week's progress toward her goals and discuss any assignments for the weekend. She also informally checked in with Ms. Hunt before lunch and at the end of most days.

Ms. Hunt became a nonthreatening liaison between Rita and her other teachers. Rita's teachers met weekly with this resource teacher to communicate clear guidelines and expectations for Rita's coursework. Thus, Ms. Hunt could help Rita coordinate her work across subjects and follow through on a self-management checklist of in-class assignments. Getting kids to use such self-monitoring tools has been found to improve on-task behavior in the classroom (Wood, Murdock, Cronin, Dawson, & Kirby, 1998); homework completion (Trammel, Schloss, & Alper, 1994); and academic performance (Wolfe, Heron, & Goddard, 2000).

As a result of their fluctuating moods, depressed students often have difficulties organizing work and persisting. Proactive strategies like monitoring progress and providing frequent feedback on whether students are meeting teachers' expectations are essential.

Teach Study Strategies

Rita's classroom teachers monitored her mood and energy level closely, periodically giving her a short break when her energy appeared to flag or her frustration peaked. They developed a system for Rita to initiate a break on her own. She moved to a quiet area of the classroom or left class to sit in the school counselor's office for 10 minutes; after this break, Rita returned to the task at hand.

The school considered the impact of side effects from Rita's antidepressant medications. Rita was allowed to keep water or juice on her desk to combat "dry mouth." She was seated close to the door in each class and given permission to leave the room quietly as needed to use the restroom.

Instructors also broke Rita's schoolwork into discrete tasks and helped her develop and manage a time line for when to complete each task based on her mood and energy levels. This enabled Rita's teachers to shorten or modify work. Teaching students with depression to recognize their typical mood and energy fluctuations throughout the day and take a break before returning to the task at hand increases their self-management.

Students with depression often find studying for tests a struggle because their disorder hampers independent study and concentration. Rita was given access to recorded class lectures that she could review outside class to assist her with taking notes and organizing class material to focus on relevant information. Teachers coached Rita in learning and study strategies to increase her independence in the classroom, including making outlines, doing conceptual mapping, and using mnemonic devices (memory skills can be dulled by depression [Brigham & Brigham, 2001]). Depressed students benefit from teacher-developed study guides for tests that enable them to focus on the most important material.

Within the general education classroom, Rita's teachers integrated specific interventions into the classroom routine. Typically, after the class started doing individual work, the classroom teacher would review with Rita the assignment and expectations. Throughout class, the teacher would frequently check on Rita's progress and give feedback on her performance. At the end of class, she would review Rita's work and provide her with any necessary materials or help she needed to complete the task.

Promote Social Interaction

Students suffering from depression often experience social difficulties and problems maintaining friendships as a result of mood fluctuations and their tendency to perceive relationships and interactions negatively. To foster an accepting, social environment for Rita, her teachers included cooperative group activities in the classroom and carefully selected whom to place in Rita's groups to increase the likelihood she would enjoy some positive interactions. Group work also let her share cognitive responsibilities, alleviating the stress depressed learners often feel about engaging in and completing learning demands independently (Perkins, 1993). Rita's teachers monitored her peer interactions and contribution to the group to ensure that she was participating.

Because students with depression often stop attending group activities they previously found engaging and view interactions with others negatively, it's important to intervene and schedule activities for these youth. Rita's parents and school staff collaborated to enroll her in an after-school program that focused on teaching social skills, and they arranged for individual counseling with the school psychologist. They worked to ensure that Rita took part in physical activity for a short period every day.

Communicate with the Student's Family

Brentwood School developed a home-school communication and tracking system that facilitated better communication between the school and Rita's family. Such communication systems increase depressed learners' participation in school activities by drawing on their personal experiences, letting parents know about classroom events and deadlines, offering a venue for problem solving, and reporting on progress (Davern, 2004).

Ms. Hunt noted Rita's daily progress toward goals and provided feedback on her mood and interactions through a home-school communication notebook. This notebook also enabled the family to keep Brentwood up-to-date on events at home, Rita's treatment, and other helpful information.

Confront the Issue of Suicide

Because Rita had mentioned suicide, it was imperative that school personnel monitor her suicidal thoughts or intentions. For many students, it's important to develop a "no-suicide contract"-an agreement between student and school in which a student promises that if he or she experiences suicidal impulses, the student will inform a health care professional, family member, or teacher rather than engage in self-injurious behavior. In Rita's case, Rita, her parents, and Ms. Hunt signed a contract that indicated the key people Rita should go to if she experienced such thoughts and the procedures and process that would be followed. If Rita told school personnel she was having suicidal thoughts, they would immediately contact Rita's parents, and her parents would take her to an emergency room for a psychiatric evaluation.

Replicating This Approach

Rita's case study reflects an ideal approach in a school where high levels of collaboration exist. Although many schools have worked hard to become more collaborative in their approach to working with students like Rita, in many places teachers will not find this level of support and collaboration. Teachers who find themselves in a school with less support and collaboration may not be able to implement as complete an approach as that discussed here, but they could implement many of the strategies noted.

For example, any teacher could initiate Monday morning meetings with a student struggling with a mood disorder to discuss the coming week, develop goals, and talk over how the student might keep up social interactions. A classroom teacher could support a student like Rita by providing a list of daily in-class assignments, coaching the student in organizing and initiating these tasks, and setting up a schedule to monitor progress and provide frequent feedback. Any teacher who sees one of her students facing mood fluctuations like Rita's could make task-by-task accommodations or modifications to meet that learner halfway, supply the kind of study supports discussed, and flexibly provide intermittent breaks throughout the day.

Depression in children and adolescents has significant implications for students' academic, behavioral, social, and physical well-being. School personnel must educate themselves on the characteristics and effects of depression, so they can provide the most effective interventions. Educators are responsible for not only meeting the academic needs of depressed students, but also ensuring their safety and welfare.

References

Brigham, R., & Brigham, M. (2001). Current practice alerts: Mnemonic instruction. Reston, VA: Council for Exceptional Children.

Burke, K. C., Burke, J. D., Regier, D. A., & Rae, D. S. (1990). Age at onset of selected mental disorders in five community populations. Archives of General Psychiatry, 47, 511-518.

Cash, R. E. (2003). When it hurts to be a teenager. Principal Leadership, 4(2), 11-15.

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis (2nd ed.). Upper Saddle River, NJ: Pearson Education.

Davern, L. (2004). School-to-home notebooks: What parents have to say. Teaching Exceptional Children, 36(56), 22-27.

Forehand, R., Brody, G. H., Long, N., & Fauber, R. (1988). The interactive influence of adolescent and maternal depression on adolescent social and cognitive functioning. Cognitive Therapy and Research, 12, 341-350.

Hammen, C., & Rudolph, K. D. (2003). Childhood depression. In E. Mash & R. Barkley (Eds.), Childhood psychopathology (pp. 153-195). New York: Guilford Press.

Kashani, J., Rosenberg, T., & Reid, J. (1989). Developmental perspectives in child and adolescent depressive symptoms in a community sample. American Journal of Psychiatry, 146, 871-875.

Kovacs, M., Feinberg, T. L., Crouse-Novak, M. A., Paulauskas, S. L., & Finkelstein, R. (1984). Depressive disorders in childhood: I. A longitudinal prospective study of characteristics and recovery. Archives of General Psychiatry, 41, 229-237.

Lewinsohn, P. M., Hops, H., Roberts, R. E., Seeley, J. R., & Andrews, J. A. (1993). Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. Journal of Abnormal Psychology, 102, 133-144.

Mitchell, J., McCauley, E., Burke, P. M., & Moss, S. J. (1988). Phenomenology of depression in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 12-20.

Perkins, D. N. (1993). Person plus: A distributed view of thinking and learning. In G. Salmon (Ed.), Distributed cognition: Psychological and educational considerations (pp. 88-110). Cambridge, England: Cambridge University Press.

Trammel, D. L., Schloss, P. J., & Alper, S. (1994). Using self-recording, evaluation, and graphing to increase completion of homework assignments. Journal of Learning Disabilities, 27, 75-81.

Wolfe, L. H., Heron, T. E., & Goddard, Y. I. (2000). Effects of self-monitoring on the on-task behavior and written language performance of elementary students with learning disabilities. Journal of Behavioral Education, 10, 49-73.

Wood, S. J., Murdock, J. Y., Cronin, M. E., Dawson, N. M., & Kirby, P. C. (1998). Effects of self-monitoring on on-task behaviors of at-risk middle school students. Journal of Behavioral Education, 9, 263-279.

Author's note: All names are pseudonyms.

R. Marc A. Crundwell is a school psychologist with Greater Essex County District School Board, Windsor, Ontario, Canada; marc.crundwell@gecsb.on.ca. Kim Killu is associate professor of special education, School of Education, University of Michigan-Dearborn; kimkillu@umd.umich.edu.

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October 2010 | Volume 68 | Number 2 Interventions That Work Pages 46-51 R. Marc A. Crundwell and Kim Killu Rita's story illustrates the essential features of clinical depression in children and adolescents: a persistent sad or irritable mood, loss of energy, decreased interest in daily activities or previously enjoyed activities, persistent feelings of worthlessness or guilt, withdrawal, and, possibly, recurrent thoughts of suicide.

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Emotional Disability http://www.gallaudet.edu/clerc_center/information_and_resources/info_to_go/educate_children_%283_to_21%29/students_with_disabilities/emotionalbehavioral_disorders.html http://www.parentcenterhub.org/repository/emotionaldisturbance/

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Orthopedic Impairment

Project IDEAL

http://www.projectidealonline.org/v/orthopedic-impairments/

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World Federation of the Deaf

http://wfdeaf.org/our-work/focus-areas/deaf-education

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Behavioral Problems

http://www.wrightslaw.com/nltr/07/nl.0516.htm

http://youtu.be/yOPV8Z3JyQk

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Speech or Language Impairments

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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.

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A Playground specifically designed for students with Autism

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Hearing Impairment

http://cirrie.buffalo.edu/encyclopedia/en/article/272/

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Tips for teachers when working alongside students with physical disabilities
http://www.nea.org/home/55319.htm

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Speech Impairments

http://education.qld.gov.au/staff/learning/diversity/educational/sli.html

http://www.projectidealonline.org/v/speech-language-impairments/

http://sites.allegheny.edu/disabilityservices/students-with-speech-impairments/

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Autism Spectrum Disorder

http://www.autismspeaks.org

http://www.asha.org/public/speech/disorders/Autism/

http://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml

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Autism Symptoms Checklist:

http://www.autism-pdd.net/autism-symptoms-checklist/

Signs and Symptoms: Autism

http://www.cdc.gov/ncbddd/autism/signs.html

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Traumatic Brain Injury

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ABSTRACT: Students who have sustained a traumatic brain injury (TBI) return to the school setting with a range of cognitive, psychosocial, and physical deficits that can significantly affect their academic functioning. Successful educational reintegration for students with TBI requires careful assessment of each child's unique needs and abilities and the selection of classroom interventions designed to meet those needs. In this article, the author presents information about the range of services that are available in the school setting and discusses typical environmental and classroom accommodations that have proven effective. The author discusses a variety of specific research-based learning strategies, behavioral interventions, and instructional interventions available to educators who work with TBI students.

Most children who have sustained a traumatic brain injury (TBI), even a severe brain injury, will eventually return to a school or classroom setting following discharge from acute hospitalization (Klonoff & Paris, 1974; Rosen & Gerring, 1986). Some will return after only a brief hospitalization and others after a lengthy hospitalization and rehabilitation program. Because the recovery process can take several months or even years, many of these children continue to have rehabilitation needs and cognitive impairments and will return to school while still in the recovery stages. It often becomes the responsibility of the educational system to facilitate ongoing recovery and to provide needed services to help these children progress in their academic and social functioning. My purpose in this article is to review intervention strategies from recent research that are available to educators as they assist children with TBI when they return to the school environment. An intervention is defined as the systematic application of research-validated procedures to change behaviors through manipulation of antecedents and consequences or by teaching new skills (Bowen, Jenson, & Clark, 2004). Successful readjustment to school may require adaptation of the learning environment, acquisition or reacquisition of skills, provision of compensatory aids and strategies, as well as support services from special education providers.

Setting the Stage

Regardless of the severity of the injury and length of rehabilitation services, advance communication and coordination between the hospital, therapists, family, and the school system is a critical first step in student's returning to school. The goal of this communication should be to gather medical and functional information to assist the school in developing an appropriate and individualized plan for the student's reentry into school, whether it is a few accommodations in a regular class setting or an intensive special education program. This communication should be ongoing and the reentry plan determined prior to the student's return to school. Specific classroom interventions and accommodations required to optimize a successful school reintegration should be developed after careful assessment of students' needs, including medical, physical, cognitive, and social-emotional problems. Thus, the educational program and classroom interventions designed to benefit students with TBI must be based on the unique needs of each individual. Because of the rapidly changing needs and recovery of children with TBI, initial evaluations conducted while in the hospital may not be accurate descriptions of the students at the time of their reentry into school. Therefore, ongoing observation and assessment of students after their return to school is usually required to develop appropriate interventions and to evaluate the effectiveness of interventions.

The range of neurologic sequelae following TBI is too diverse to prescribe specific intervention strategies that work for all students, and there are few empirical studies that validate specific interventions for students with TBI. However, validated approaches that are effective for students with other disabilities similar to those of students with brain injury offer practical intervention choices for teachers working with students with TBI. Ylvisaker and colleagues (2001) suggest that students with TBI be identified by functional need and that teachers may then select from proven instructional interventions for a particular need. Although serving students based on functional needs is important, it is also critical for educators to have an understanding of TBI as a disability and of the commonly associated features of an acquired brain injury.

Common Sequelae of TBI

Children who have sustained a TBI may exhibit a wide range of newly acquired deficits or alterations in cognition, physical mobility, self-care skills, and communication skills as well as changes in emotional and behavioral regulation, which may significantly affect school functioning (Fletcher & Levin, 1988). The nature and severity of the injury, acute medical complications, age of the child, preinjury characteristics, and the interaction of these factors with the family system and environment will affect the course of recovery and school outcome (Wilkening, 1997). Each child will present a unique pattern of sequelae ranging from mild to severe.

Although there is considerable variability in outcome following TBI, there are also general features of acquired brain injury common to many children who sustain a brain injury, particularly when structural brain damage is present. These are related to vulnerable areas of the brain often affected during a closed head injury, including damage to the frontal lobes, and the anterior and medial temporal lobes. Children with frontal lobe injury typically experience greater difficulty with executive function, which includes attentional processes, self-regulation, goal setting, initiating, and inhibiting behavior. Many behavior and social problems observed in children with TBI are related to poor executive functioning. They may also have problems with organization-planning, prioritizing, analyzing tasks, and completing a sequence of activities. Cognitive impairments can include memory problems, slowed information processing, and language disturbances. Memory impairment (recalling and retaining information) is one of the most common deficits associated with pediatric TBI (Ewing-Cobbs & Fletcher, 1990). Physical functioning can also be markedly impaired following severe TBI. Loss of function in all or some extremities, spasticity, decreased motor speed, and poor coordination in fine or gross motor movements may require physical and environmental accommodations and/or assistance with self-care skills (feeding and toileting) in the school setting.
Assessment
In addition to formalized assessment of cognitive skills that may be conducted, the special education team at the school (i.e., school psychologist, special educator, speech language pathologist), uses a Functional Behavioral Assessment (FBA) to examine, measure, and treat many deficits associated with TBI, particularly behavioral changes related to increased impulsiveness, inappropriate emotional outbursts, aggression, and inattention. An assessment of the environmental variables (immediate and distant) that contribute to the occurrence of a behavior that is negatively impacting school functioning will assist in developing effective strategies. The following are the four typical categories of behavioral function: (a) gaining attention from peers or adults, (b) escaping or avoiding a nonpreferred task or person, (c) gaining access to tangible reinforcement, and (d) gaining sensory stimulation or relief. An FBA includes a descriptive assessment based on observations of the student, structured interviews, and manipulation of variables to determine the function of problematic behaviors (Gardner, Bird, Maguire, Carreiro, & Abenaim, 2003). Studies involving use of FBA to develop effective intervention plans for individuals with TBI have been reported in the literature (e.g., Feeney & Ylvisaker, 1995).

An ABC (Antecendent-Behavior-Consequence) assessment is one simple means of conducting an FBA. In conducting an ABC Assessment, assessors record the events that occur immediately before and after the unwanted behavior (antecedents and consequences). They collect information such as time of day, with whom the behavior occurs, specific places, other events, and rate and type of reinforcers are collected to help select an appropriate replacement behavior and an effective intervention plan. Distant events and physiologic conditions (e.g., physical pain, cognitive limitations) that may be contributing to the behavior should also be considered (Bowen et al., 2004). Figure 1 provides a sample ABC form.

Structuring the Environment

Because a TBI involves a progressive recovery process, a student's physical and mental endurances may be limited during their initial return to school and steadily improve over time. Therefore, consideration of different schooling options may be necessary, including homebound instruction, gradual increase in school attendance, or change in class schedules to a less demanding course load. Academic programming and scheduling must be flexible and customized to fit children's changing needs. Class enrollment and expectations should be based on students' current, rather than previous, academic performances. Rather than push students quickly through classes and require them to make up missed assignments, students should be allowed additional time to relearn concepts and regain skills.

Structuring the school environment is a way to manage antecedents or consequences contributing to many problem behaviors, and to prevent the behavior from occurring. Many of the environmental strategies that will optimize success for students with TBI are effective with students with other learning problems. These strategies can be employed in general or special education settings. If attention, sensitivity to overstimulation, disinhibition, and emotional lability are identified as problems, the classroom environment should be quiet and simplified. Noise and activity levels should be controlled and unnecessary distracters and sensory stimulation (including noise, light, and movement) should be minimized (Farmer & Peterson, 1995). This may require seating the student near the teacher or by an appropriate peer, providing a study carrel, removing extra materials (e.g., pencils, books, papers), and dividing work or task lengths into smaller sections. Students may use an FM unit or earplugs to reduce external noise. Students may need a designated space in which to rest or take time out from stimulation and be allowed to have "down time."

Special attention should be given to the physical arrangement and structure of the classroom to facilitate mobility and accommodate physical needs. A student with poor mobility may need assistance to participate in typical classroom activities. The school may need to ensure the availability of accessible bathrooms and ramps. Frequently traveled areas should be sufficiently wide for smooth transition and be free of obstacles. Students may need to be specifically taught and allowed to rehearse the routines of the learning environment, including building orientation and room design. Students in secondary schools may have a particularly difficult time navigating hallways and moving from class to class. Providing extra time for transitions and leaving class a few minutes early, before other students are in the hallways, is often recommended. A peer buddy or an adult aide may be assigned to help with hallway transitions, to provide physical assistance (e.g., in the lunchroom or bathrooms), and to ensure safety.

Classroom structure should also include a predictable and consistent routine. Consideration should also be given to the length of school day that students can tolerate, their nutritional needs, and their fatigue levels and need for rest breaks; classes should be scheduled to capitalize on optimal attention periods. For students who are easily fatigued, a schedule consisting of alternating instruction, activity, and rest periods may be needed. Students with challenging behaviors are more likely to engage in appropriate, on-task behaviors when presented with a positive, well-understood daily routine. Providing a written schedule or posting a visual chart of the daily routine will help reduce confusion. Students may need simplified instructions, written or picture checklists of task steps, maps, or strategically placed signs to carry out tasks. It is important to involve the student in reviewing the schedule at the beginning of the day or period and verbally review the steps. Transition times and out-of-classroom activities should be preplanned and structured to reduce stimulation and emotional distress. Using auditory or visual cues to signal changes in the routine and giving the student advance warning is also helpful. Teachers of the same student should agree on environmental strategies and apply them consistently throughout the school day.
Typical Classroom Accommodations
Another way of altering the environment is to provide external devices and cues that the student can use to compensate for organization, memory, and motor deficits (Mateer, Kerns, & Eso, 1997). Assistive devices can include technical equipment and materials such as tape recorders, calculators, electronic spellers, computers or word processors, augmentative communication devices, timers, alarms, and beepers or equipment for mobility (e.g., wheelchair, walker, electric scooter). Other external cues used to remind students include labels, maps checklists, pictures or icons, photograph cues, post-it-notes, calendars, planners, and journals. A memory notebook is one such compensatory aid that has been used to assist in memory and organization following TBI. The memory notebook can be very flexible and may contain maps, checklists, feelings log, and other information (e.g., telephone numbers, names of contact people). Students should be trained to use the notebook (Tate, 1997).

Modifications to existing materials can assist students with TBI to learn and function in the classroom setting. Typical alterations that allow students to participate at their level include providing carbon paper notes, large print books, books on tape, and graphic organizers (visual displays to organize information). A similar approach involves altering the expectations for student participation. For example, allow more time on tests, reduce the amount of written work required, provide exams in multiple-choice format rather than recall format, and give pass-fail grades rather than letter grades (Mateer et al., 1997). It is important that students are not simply given aids or devices to use without adequate training to recognize when and where appropriate aids are useful, and how to use the strategy properly. Table 1 provides a sampling of external aids and interventions that can be used to assist students with attention, memory, organization, and processing speed deficits.
Available Resources and Services
School districts have a variety of options and resources to accommodate the particular learning needs of students returning to school following a TBI. Because of the extreme variability in outcome following brain injury, a wide range of services and accommodations may be needed and highly individualized planning is required. Many students with mild to moderate TBI can be integrated into existing school programs in regular education with some adaptations and modifications. Students with TBI who attend mainstream classes may also receive accommodations or related services under the Rehabilitation Act of 1973, Section 504. Section 504 covers all students who have a physical or mental impairment that substantially limits one or more major life activities, including learning. For students who do not require special education, but need some accommodations to participate in the regular school program, it is important to complete a 504 Plan and formalize suggested accommodations with parents and teachers. The 504 Plan documents the accommodations and designates persons involved. It must be reviewed annually and should be revised as students' needs change.

Students with significant impairments should be referred for special education evaluation to determine if specialized services are necessary to address any cognitive, communication, physical, or social limitations. Since 1990, students with TBI are eligible for services under the Individuals With Disabilities Education Act (IDEA) under the category of Traumatic Brain Injury (IDEA, 2005). To receive services, the brain injury must adversely affect students' educational performances and students must require specialized instruction. Special education programs are frequently selected as an intervention of choice for students with TBI because they can provide a lower adult-pupil ratio, individually designed curriculum and specialized instruction, and necessary therapies. In one follow-up study of children with head injuries, 30% required special education intervention at 1 year postinjury, and 78% of those with severe injuries were placed in special education (Greenspan & MacKenzie, 1994).

Within the special education program there are a variety of services available, ranging from least restrictive (i.e., one resource period per day) to more restrictive (i.e., self-contained program). In addition to resource services for academic or adaptive needs, students may receive services with a speech or language pathologist, occupational or physical therapist, psychologist, or other related services (i.e., adaptive physical education, vision specialist). As with a 504 Plan, an Individualized Educational Program (IEP) must be written, reviewed, and revised annually. However, because levels of functioning may change rapidly with TBI, it is recommended that IEP reviews occur more frequently. Although there may be one or several students with TBI attending a specialized program or class, a designated "TBI classroom" is not typically offered. Students with TBI may be placed in a noncategorical program, in which students are grouped by functional skills and ability levels, and provided appropriate curriculum content and teaching strategies based on these abilities (Cohen, 1991).

Specialized Teaching Strategies

Empirically supported teaching strategies that are effective with students with different types of learning difficulties also may prove useful for students with brain injury. Although teachers must find what works best with a particular student, these techniques are effective antecedent-based interventions that can prevent or significantly reduce challenging behaviors and teach students the active use of compensatory strategies.

The Direct Instruction (DI) model is based on the principles of applied behavior analysis (Engelmann & Carnine, 1982) that include pacing, frequent opportunity to respond, feedback, and reinforcement to maintain student engagement and ensure learning. These principles can be applied in designing an instructional program with students with a TBI (Glang, Singer, Cooley, & Tish, 1992). Some recommended steps in using a DI method include the following:

1. Select a meaningful goal or skill the student will need to learn and present it at the level of the student;

2. Provide a simple rationale to help the student understand the relevance of the skill;

3. Give clearly stated task directions (limit the number of steps) and ask the student to repeat or paraphrase the directions to ensure understanding;

4. Break tasks into small steps and demonstrate each step;

5. Provide opportunities for student response and practice at an appropriate pace;

6. Provide immediate feedback and error correction when necessary-feedback should be positive and systematic; and

7. Use verbal praise and encouragement frequently.

There are a variety of commercially produced DI materials available that include sequenced curricula and scripted wording; however, teachers may need to tailor these materials for students with TBI.

Another proactive teaching strategy that will facilitate compliance is use of effectively stated requests or precision commands (Rhode, Jenson, & Reavis, 1993). Precision commands consist of steps teachers can use to prevent escalation of behavior problems by giving clear instructions, allowing the student a chance to comply without interrupting, and reinforcing students who follow the request promptly. All teachers of students with TBI should consistently follow the same format for making requests. Some suggestions for giving effective requests include the following:

1. Use a direct statement telling the student to start (rather than stop) a behavior;

2. Look directly at the student as you give the request, move close, and use a soft, calm voice.; speak clearly, slowly and concisely-do not shout.

3. Limit requests to only two or three at a time and give requests that the student is capable of following;

4. Allow enough time for the student to follow through; and

5. Recognize their effort with verbal praise and encouragement.

Students with severe cognitive and memory problems may benefit from a teaching approach referred to as errorless learning (Wilson & Evans, 1996). Errorless learning is based on a model of behavioral rehabilitation that involves discrimination training with early prompting and support that is systematically faded to ensure successful responding. In errorless learning, individuals are not allowed to guess on recall tasks, but are immediately provided with the correct response, instructed to read the response, and write it down (Mateer et al., 1997). If errors do occur they are followed by nonjudgmental corrective feedback (Ylvisaker et al., 2001).

Successful positive support for students with TBI must include interventions designed to teach functionally equivalent skills or behaviors to replace problematic ones. The primary goal is to teach students new skills that will help them achieve their needs (e.g., skills to verbally express needs and emotions). Skills training in communication, coping and relaxation, pragmatic social, problem-solving, study, and task-specific skills will help students obtain access to desired outcomes, rendering problem behaviors irrelevant. Functional communication training, for example, is a validated approach that can be used to reduce maladaptive behaviors in individuals with brain injury (Ducharme, 1999). It involves identifying the communication function of a challenging behavior, teaching a communication skill that serves the same function, and providing ready access to the outcome or reinforcer that was previously obtained by the problem behavior.

Providing specific training in self-management or self-monitoring strategies is another approach to helping children. Self-management involves teaching students to evaluate and monitor their own behavior and performance. One simple approach involves routine recording of behavior. For example, the teacher gives the students a piece of paper with 20 boxes. At random intervals, the teacher instructs the students to ask him or herself at random intervals, "Am I listening (working, behaving, etc.)?" The student then records a plus or a minus sign in the box (Rhode et al., 1993). Other forms of self-management include the use of a checklist of open-ended questions to guide students through an assignment, the use of assignment rubrics to allow students to self-evaluate their progress, and the use of emotion logs to allow students to self-monitor their emotions (e.g., rating anger levels and responses on an Anger Log; Bowen et al., 2004).

Many children who sustain severe TBI exhibit difficulty with social adjustment related to newly acquired language deficits in pragmatic (social conversation) communication (Jordan & Ashton, 1996). Programs designed for improving social skills have been successfully implemented in the school setting that include teaching specific skills (e.g., initiation, topic maintenance, turn taking, active listening), using repeated practice and constructive feedback, and granting the opportunity to practice in the natural setting with peers, staff, and parents (Wiseman-Hakes, Stewart, Wasserman, & Schuller, 1998). Self-modeling and self-monitoring procedures can be combined with skills training, by videotaping students during the practice and having students rate their performance on scoring sheets.

The use of positive reinforcement is a valuable strategy used to create a rewarding environment and successfully reintegrate children with brain injury into school settings (Gardner et al., 2003). Reinforcement can be both contingent and noncontingent and can include a combination of primary and secondary reinforcers. For students with extremely difficult behaviors, a differential reinforcement of other behaviors or alternative behaviors contingency may need to be implemented to reinforce the student for compliance and engaging in positive or alternative behaviors. Praise is an extremely effective form of positive reinforcement and should be given more frequently than reprimands or directives (at least a 4:1 ratio). Praise should describe specific behaviors that are meaningful to the student and should be delivered immediately following a behavior. It is often necessary to prompt and reinforce each attempt at a skill or behavior that successfully approximates the desired behavior to shape the appropriate behavior over time. Other forms of positive reinforcement include social reinforcement (e.g., smile, thumbs up, high five), token economies, and awarding special privileges or small tangible or edible reinforcers. Opportunity to engage in a preferred activity or gain access to more preferred activities may be offered contingent on engaging in or meeting criteria on a less preferred task (Slifer et al., 1997).

Behavioral momentum is another strategy that has been used to increase positive behaviors and compliance in brain injury rehabilitation (Slifer et al., 1997). Behavior momentum involves making requests with which the students have a high probability of compliance before making a low-probability request-similar to the momentum of objects in motion. A sequence of high-probability requests is used to establish a high rate of reinforcement for compliance that will increase the momentum and carry over to tasks that might have a lower probability of compliance. Positive reinforcement is delivered immediately after the student performs each request. Feeney and Ylvisaker (2003) used behavior momentum as part of a multicomponent intervention for students with TBI. As part of the intervention, staff included relatively easy tasks with guaranteed high rates of reinforcement before introducing difficult work and preceded undesirable tasks with preferred activities.

Although many of the antecedent-focused interventions are effective in modifying challenging behaviors, consequences are also important components of an intervention plan; however, consequences for children with TBI should be natural and related to the behavior (Ylvisaker, Jacobs, & Feeney, 2003). Individuals with frontal lobe injury often demonstrate an inefficiency of learning from aversive consequences; therefore, punishments such as school suspension or expulsion are usually ineffective (Gardner et al., 2003). Rather than delivery of negative consequences (e.g., threats, nagging) for noncompliance or failure to complete tasks, natural consequences that will help the person complete the task are more appropriate (e.g., constructive feedback, guided compliance). Extinction is an effective intervention that consists of withholding reinforcers that were previously delivered following a target behavior (Yody et al., 2000). For example, if an inappropriate behavior is maintained by teacher attention, this teacher attention should no longer follow the inappropriate behavior. Extinction strategies can include planned ignoring of an inappropriate behavior until the student demonstrates behavioral control, and then reinforcing alternative, appropriate behaviors. Educators should try to anticipate students' difficulties and offer verbal or physical prompts or cues to redirect behavior. Time-outs may be required to remove students from environmental events contributing to the behavior. Time-out might consist of going to a quiet area and remaining calm for 10 min before rejoining the activity. Student who become angry or explosive in reaction to academic demands, for example, could be taught an impulse control procedure to calm down and take a 5-minute break. Skills training might include identifying a cue that prompts them to "stop" or "take 5." The student is given the cue and reminded to "stop" at natural times and is reinforced for rehearsal and eventual use of the skill to deescalate before an angry outburst occurs (Clark, Russman, & Orme, 1999).

Case Study: Josh

Josh, an 11-year old, sixth-grade student was severely injured in a motor vehicle accident when the car in which he was riding swerved out of control and collided with another car. Josh was found unconscious at the scene. He was intubated and transported to a local hospital where a head computer tomography scan revealed a severe TBI, with multiple areas of hemorrhage in the right frontal and temporal regions. Josh also sustained facial fractures, as well as a right humerus fracture. He remained in a coma for 2 days and, after regaining consciousness, spent an additional 3 weeks in the hospital's rehabilitation unit. After discharge, he continued to receive outpatient physical and occupational therapies 2-3 hrs per week.

Shortly after the accident, the school principal contacted Josh's parents and continued to communicate with them throughout the hospital stay. Prior to Josh's return to school, his teachers, principal, and the school psychologist scheduled a meeting with the parents. The principal asked the school psychologist to serve as Josh's case manager. Prior to his injury, Josh had been an average student in regular education, but struggled somewhat in math. He was social, had many friends, and was active in sports. At the meeting, Josh's parents discussed his current levels of functioning and areas of impairment and the school team developed a plan to accommodate his needs. Six weeks after his injury, Josh continued to have some cognitive problems in the area of memory, information-processing speed, and executive functioning. His verbal skills and reading skills remained relatively strong. Josh had slowed motor speed and had a mild right-sided weakness. He had decreased endurance and fatigued easily.

On the basis of this information, the school team recommended and developed accommodations for his return to school at the meeting. It was decided that Josh would initially return to school on a modified basis, starting with 2 hr per day, in the mornings, gradually increasing his attendance to all day as his physical endurance improved. The team scheduled more difficult subjects during the morning to minimize fatigue. Although Josh was eligible for special education services, the parents and school team decided Josh could be successful in his regular classroom with accommodations, and formalized these accommodations by developing a 504 Plan. These accommodations included the following:

1. Allowing Josh to take breaks in the counseling area as needed and to check in with the psychologist at the beginning of the day for organizing sessions and to review his schedule.

2. Seating Josh near the front of the classsroom in a quiet location near a designated peer buddy who could provide carbon copy notes and assist with prompts.

3. Reducing written work requirements giving additional time to complete assignments, allowing him to dictate responses, and provide him with an extra set of books for home use.

4. Providing multiple-choice exams and avoiding time limits in testing.

5. Posting a schedule of daily activities in a visible place and training and prompting Josh to record his assignments in a daily planner.

6. Determining environmental factors and situations that caused agitation and frustration (e.g., sensory overload, changes in routine) and avoiding them as much as possible. (The teacher and Josh developed a plan for him to "take 5" [take a 5 min. break when he became frustrated], by looking at magazines, or running an office errand).

7. Meeting with the middle school team: Prior to his transition to middle school in the 7th grade, the school team, parents, and Josh met with the middle school team to discuss concerns and review the plan.

Summary

Returning to school following a brain injury presents a number of new challenges for children with TBI, as well as for those who work with them. Although some children with brain injury experience persistent cognitive and behavioral changes, when provided appropriate resources and strategies, all students can reach maximum potential. Teachers and educators play a key role in helping students with TBI succeed in their adjustment and reintegration into the school environment. To develop programs that will facilitate a successful school reentry, educators must work together to develop a comprehensive plan based on each child's individual strengths and weaknesses. With careful planning, making needed adaptations to the learning environment, and using effective instructional aids and strategies to help children acquire new skills, most children can fortunately overcome many of these challenges and can experience success in their academic and social endeavors.

REFERENCES

Bowen, J., Jenson, W. R., & Clark, E. (2004).

School-based interventions for students with behavior problems. New York: Kluwer.

Clark, E., Russman, S., & Orme, S. (1999). Traumatic brain injury: Effects on school functioning and intervention strategies. School Psychology Review, 28, 242-250.

Cohen, S. B. (1991). Adapting educational programs for students with head injuries. Journal of Head Trauma Rehabilitation, 6, 56-63.

Ducharme, J. M. (1999). Subject review: A conceptual model for treatment of externalizing behaviour in acquired brain injury. Brain Injury, 13, 645-668.

Engelmann, S., & Carnine, D. W. (1982). Theory of instruction. New York: Irvington.

Ewing-Cobbs, L., & Fletcher, J. M. (1990). Neuropsychological assessment of traumatic brain injury in children. In E. D. Bigler (Ed.), Traumatic brain injury (pp. 107-128). Austin, TX: Pro-Ed.

Farmer, J. E., & Peterson, L. (1995). Pediatric traumatic brain injury: Promoting successful school reentry. School Psychology Review, 24, 230-243.

Feeney,T. J., & Ylvisaker,M. (1995). Choice and routine: Antecedent behavioral interventions for adolescents with severe traumatic brain injury. Journal of Head Trauma Rehabilitation, 10, 67-86.

Feeney, T. J., & Ylvisaker, M. (2003). Context-sensitive behavioral supports for young children with TBI: Short-term effects and long-term outcome. Journal of Head Trauma Rehabilitation, 18, 33-51.

Fletcher, J., & Levin, H. (1988). Neurobehavioral effects of brain injury in children. In D. Routh (Ed.), Handbook of pediatric psychology (pp. 258-295). New York: Guilford.

Gardner, R. M., Bird, F. L., Maguire, H., Carreiro, R., & Abenaim, N. (2003). Intensive positive behavior supports for adolescents with acquired brain injury: Long-term outcomes in community settings. Journal of Head Trauma Rehabilitation, 18, 52-74.

Glang, A., Singer, G., Cooley, E., & Tish, N. (1992). Tailoring direct instruction techniques for use with elementary students with brain injury. Journal of Head Ttrauma Rehabilitation, 7, 93-108.

Greenspan, A. I., & MacKenzie, E. J. (1994). Functional outcome after pediatric head injury. Pediatrics, 94, 425-432.

Jordan, F. M., & Ashton, R. (1996). Language performance of severely closed head injured children. Brain Injury, 10, 91-98.

Klonoff, H., & Paris, R. (1974). Immediate, short-term and residual effects of acute head injuries in children: Neuropsychological and neurological correlates. In R. M. Reitan & L. A. Davison (Eds.), Clinical neuropsychology (pp. 179-210). Washington, DC: Hemisphere.

Mateer, C. A., Kerns, K. A., & Eso, K. L. (1997). Management of attention and memory disorders following traumatic brain injury. In E. D. Bigler, E. Clark, & J. E. Farmer (Eds.), Childhood traumatic brain injury (pp. 153-176). Austin, TX: Pro-Ed.

Individuals With Disabilities Education Act, 70 Fed. Reg. 19356-16358 (April 13, 2005) (to be codified at 20 C. F. R. pt. 406, 416).

Rehabilitation Act of 1973, 29 U. S. C. § 794 (1974).

Rhode, G., Jenson, W. R., & Reavis, H. K. (1993). The tough kid book. Longmont, CO: Sopris West.

Rosen, C. D., & Gerring, J. P. (1986). Head trauma: Educational reintegration. San Diego, CA: Col-lege-Hill Press.

Slifer, K. J., Tucker, C. L., Gerson, A. C., Seviers,

R. C., Kane, A. C., Amari, A., et al. (1997). Antecedent management and compliance training improve adolescents' participation in early brain injury rehabilitation. Brain Injury, 11, 877-889.

Tate, R. L. (1997). Beyond one-bun, two-shoe: Recent advances in the psychological rehabilitation of memory disorders after acquired brain injury. Brain Injury, 11, 907-918.

Wilkening, G. N. (1997). Long-term outcome after moderate to severe pediatric traumatic brain injury. In E. D. Bigler, E. Clark, & J. E. Farmer (Eds.), Childhood traumatic brain injury (pp. 79-99). Austin, TX: Pro-Ed.

Wilson, B. A., & Evans, J. J. (1996). Error-free learning in the rehabilitation of people with memory impairments. Journal of Head Trauma Rehabilitation, 11, 54-64.

Wiseman-Hakes, C., Stewart, M. L., Wasserman, R., & Schuller, R. (1998). Peer group training of pragmatic skills in adolescents with acquired brain injury. Journal of Head Trauma Rehabilitation, 13, 23-38.

Ylvisaker, M., Jacobs, H. E., & Feeney, T. (2003). Positive supports for people who experience behavioral and cognitive disability after brain injury: A review. Journal of Head Trauma Rehabilitation, 18, 7-32.

Ylvisaker, M., Todis, B., Glang, A., Urbanczyk, B., Franklin, C., DePompei, R., & et al. (2001). Educating students with TBI: Themes and recommendations. Journal of Head Trauma Rehabilitation, 16, 76-93.

Yody, B. B., Schaub, C., Conway, J., Peters, S., Strauss, D., & Helsinger, S. (2000). Applied behavior management and acquired brain injury: Approaches and assessment. Journal of Head Trauma Rehabilitation, 15, 1041-1060.

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Classroom Interventions for Students with Traumatic Brain Injuries | BrainLine

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There is a lot to know about helping children with TBI successfully return to the classroom.

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Hearing Impairments

http://kidshealth.org/teen/diseases_conditions/sight/hearing_impairment.html

http://www.hearingloss.org/content/basic-facts-about-hearing-loss

http://www.who.int/mediacentre/factsheets/fs300/en/

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Behavioral Intervention Plans

http://www.specialeducationguide.com/pre-k-12/behavior-and-classroom-management/functional-behavior-assessment-and-behavior-intervention-plans/

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Traumatic Brain Injury

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Autism Spectrum Disorder

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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.

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22 tips teaching students autism spectrum disorders special education & learning disabilities benefits articles

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22 Tips for Teaching Students with Autism Spectrum Disorders

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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.

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Learning Strategies for Deaf-blind Students

http://www.projectsalute.net/Learned/Learnedhtml/TactileLearningStrategies.html

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http://nymag.com/news/features/autism-spectrum-2012-11/index1.html

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Emotional Disturbances

http://www.parentcenterhub.org/repository/emotionaldisturbance/

http://www.education.com/reference/article/emotional-disturbance/

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World Federation of the Deaf

http://wfdeaf.org/our-work/focus-areas/deaf-education

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Speech or Language Impairment

http://www.asha.org/public/speech/disorders/ChildSandL.htm

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Orthopedic impairment resources for teachers.

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According to the U.S. Department of Education “School districts are required to provide a free appropriate education to students with disabilities based on their individualized educational needs. The…

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http://cdn2-b.examiner.com/sites/default/files/styles/image_content_width/hash/c5/b7/autism.png?itok=Fn4gNbS4

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Developmental Delay

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Centers for Disease Control and Prevention

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Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person's lifetime.1

Developmental Milestones

Developmental monitoring is an active, ongoing process of watching a child grow and encouraging conversations between parents and providers about a child's skills and abilities. Developmental monitoring involves observing how your child grows and whether your child meets the typical developmental milestones, or skills that most children reach by a certain age, in playing, learning, speaking, behaving, and moving.

Parents, grandparents, early childhood education providers, and other caregivers can participate in developmental monitoring. CDC's Learn the Signs. Act Early. program has developed free materials, including CDC's Milestone Tracker app, to help parents and providers work together to monitor your child's development and know when there might be a concern and if more screening is needed. You can use a brief checklist of milestones to see how your child is developing. If you notice that your child is not meeting milestones, talk with your doctor or nurse about your concerns and ask about developmental screening. Learn more about CDC Milestone Tracker app, milestone checklists, and other parent materials.

When you take your child to a well visit, your doctor or nurse will also do developmental monitoring. The doctor or nurse might ask you questions about your child's development or will talk and play with your child to see if they are developing and meeting milestones.

Your doctor or nurse may also ask about your child's family history. Be sure to let your doctor or nurse know about any conditions that your child's family members have, including ASD, learning disorders, intellectual disability, or attention deficit/hyperactivity disorder (ADHD).

If your child is not meeting the milestones for his or her age, talk to your child's doctor and share your concerns.

Skills such as taking a first step, smiling for the first time, and waving "bye bye" are called developmental milestones.

Developmental Monitoring and Screening

Developmental screening takes a closer look at how your child is developing.

Developmental screening is more formal than developmental monitoring. It is a regular part of some well-child visits even if there is not a known concern.

The American Academy of Pediatrics (AAP) recommends developmental and behavioral screening for all children during regular well-child visits at these ages:

9 months

18 months

30 months

In addition, AAP recommends that all children be screened specifically for ASD during regular well-child visits at these ages:

Screening questionnaires and checklists are based on research that compares your child to other children of the same age. Questions may ask about language, movement, and thinking skills, as a well as behaviors and emotions. Developmental screening can be done by a doctor or nurse, or other professionals in healthcare, community, or school settings. Your doctor may ask you to complete a questionnaire as part of the screening process. Screening at times other than the recommended ages should be done if you or your doctor have a concern. Additional screening should also be done if a child is at high risk for ASD (for example, having a sibling or other family member with ASD) or if behaviors sometimes associated with ASD are present. If your child's healthcare provider does not periodically check your child with a developmental screening test, you can ask that it be done.

Developmental monitoring observes how your child grows and changes over time and whether your child meets the typical developmental milestones.

References

Developmental Disabilities: Delivery of Medical Care for Children and Adults. I. Leslie Rubin and Allen C. Crocker. Philadelphia, Pa, Lea & Febiger, 1989.

Page last reviewed:

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national center on developmental disabilities and developmental disabilities

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Facts About Developmental Disabilities | CDC

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Articles on how CDC works to identify causes of Developmental Disabilities and opportunities to prevent them. By applying a public health approach incorporating three essential elements-surveillance or disease tracking, research to identify causes, and prevention research and programs-we can rapidly translate scientific findings into appropriate public health interventions.

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Emotional Disabilities

http://eric.ed.gov/?id=EJ555501

http://sed.sagepub.com/content/37/3/148.short

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Orthopedic Impairment

http://www.projectidealonline.org/v/orthopedic-impairments/

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Developmental Delay

http://www.med.umich.edu/yourchild/topics/devdel.htm

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Traumatic Brain Injury

http://www.jdsupra.com/legalnews/special-school-related-needs-of-children-09513/

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Traumatic brain injury, often referred to as TBI, is most often an acute event similar to other...

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Deaf-blindness

https://nationaldb.org/library/list/3

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Hearing Impairments http://www.ferris.edu/htmls/colleges/university/disability/faculty-staff/classroom-issues/hearing/hearing-strategy.htm

https://www.youtube.com/watch?v=ln8NHzVfJkQ

http://disability.illinois.edu/instructor-information/disability-specific-instructional-strategies/hearing-impairments

http://www.isrc.us/

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http://www.specialeducationguide.com/disability-profiles/emotional-disturbance/

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hearing impairments

http://www.gallaudet.edu/clerc_center/information_and_resources/info_to_go/educate_children_(3_to_21)/504_plan.html

Teaching strategies

http://www.ferris.edu/htmls/colleges/university/disability/faculty-staff/classroom-issues/hearing/hearing-strategy.htm

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Autism Spectrum Disorder:

http://teaching.monster.com/benefits/articles/8761-22-tips-for-teaching-students-with-autism-spectrum-disorders

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National Center for Learning Disabilities

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What Does "Autism Spectrum" Actually Mean?

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The conditions autism and aspergers have been in the news a lot over the last few years. Including some people using the term "spectrum-y" to describe a person showing characteristics of autism spectrum disorder. But what does the spectrum actually consist of? Learn More: What Is Autism? What is Autism Spectrum Disorder?

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Emotional Disability

http://www.parentcenterhub.org/repository/emotionaldisturbance/

(parent help information)

http://www.nolo.com/legal-encyclopedia/psychiatric-service-dogs-emotional-support-animals-access-public-places-other-settings.ht

(emotional support animals)

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Emotional Disability

http://schoolpsychologistfiles.com/emdisability/

http://www.gallaudet.edu/clerc_center/information_and_resources/info_to_go/educate_children_%283_to_21%29/students_with_disabilities/emotionalbehavioral_disorders.html

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speech or language impairment:

"Under the Individuals with Disabilities Education Act (IDEA) 2004, the federal government has defined a speech or language impairment as "a communication disorder such as stuttering, impaired articulation, a language impairment, or a voice impairment, which adversely affects a child's learning."

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Emotional Disabilities

Powerpoint on an overview of Emotional Disabilities:

http://www.nasponline.org/conventions/2013/handouts/ms/AssessEmDNASPPresentationFinal.pdf

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Orthopedic impairments http://www.projectidealonline.org/v/orthopedic-impairments/

http://www.specialeducationguide.com/disability-profiles/orthopedic-impairments/

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Hearing Impairments

https://www.youtube.com/watch?v=nCKAJ_H0rPw

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When teaching students with disabilities, it is important to realize their educational goals are about more than academics. Although those things are important, students with developmental delays may show signs of inattentiveness, aggression and an inability to socialize with others. Because of their special needs, some specific instructional strategies must be utilized to effectively reach all the students in your classroom.

Seating Arrangements

Children with developmental disorders can have a variety of issues that can effect learning for themselves and those around them. Keep in mind that a student that displays behaviors that are distracting would work better at an individual desk. If there is not a way to seat the students in the classroom in his own space, pairing him with a capable buddy that can assist with keeping the student on track without it being detrimental to his own education would be beneficial. Also, minimizing distractions and the possibility for over stimulation will assist the student with focusing. For example, do not seat the student next to a window facing the playground.

Routines

Students with developmental disabilities struggle with becoming more independent. One way to encourage that behavior is to be consistent with classroom routines. By doing the same thing each day the student knows what to expect and can begin following the same actions without additional guidance. For example, if the requirement each day is to come into the classroom, hang up her jacket, empty her back pack and put her lunch away, she will likely begin doing that independently due to the predictability and consistency.

Predictability

Routines and procedures that provide predictability are important to a student with developmental delays. Predictable procedures will not only help teach skills and promote independence, but also decrease unwanted behaviors caused by not understanding expectations. One way to do this is by providing a schedule of activities that can be understood by the student. This will vary depending on the age and cognitive level of the student. For example, one student might be successful using a daily planner with a schedule written in while another might only be able to understand an object or photo representing the activity.

Another tool to assist with predictability is a visual timer. This lets the student know when an activity will be over and they can move on to the next task. This ability to know when something must be finished can increase attentiveness. Also, by understanding that the current task will be over within a definitive amount of time, unwanted behaviors used by the student to avoid the activity may be avoided.

Things to Remember

When developing your own strategies for your classroom, it is necessary to remember the importance of promoting appropriate social interaction. Do not single out the student by doing things that will make them more of an outsider in the classroom. Using age appropriate materials is one way to avoid that. Use activities that are similar to same aged peers will provide an opportunity for interaction. These steps will allow the student to feel comfortable interacting with others and encourage peers to interact with him. Doing this will make the educational process more enjoyable and beneficial to the student.

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Teaching Strategies for Students With Developmental Delays: Tips for Teachers

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There are many types of students within a classroom and teachers may find themselves teaching a student with a developmental delay in their mainstream classroom. Learn some effective instructional strategies to encourage a student with a developmental delay to interact with others socially, and to reach their goals academically.

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Emotional Disabilities

http://schoolpsychologistfiles.com/emdisability/

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Visual Impairments
http://www.afb.org/info/programs-and-services/professional-development/teachers/inclusive-education/1235

http://esvi.org/