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Traumatic Brain Injury is a condition caused by a head injury that results in lasting damage to the brain.
This injury disrupts normal brain functioning and may permanently impact how a person acts, moves, and/or thinks.

Traumatic brain injury is one of the categories of disability specified in IDEA. This means that a child with traumatic brain injury may be eligible for special education and related services if it adversely affects their education.
Traumatic brain injury can have wide-ranging physical and psychological effects. Some signs or symptoms may appear immediately after the traumatic event, while others may appear days or weeks later.

A traumatic brain injury often impacts functioning in the following areas:
Memory and cognition, social skills, emotional regulation, attention, behavior, speech and language, and physical health

Memory and cognition challenges:

Difficulty with logic, problem solving, and reasoning

Slower to respond, react and complete activities and tasks

Difficulty remembering facts, procedures, events, etc.

Frequently struggles with grade level work

Difficulty storing new information, working memory deficits

Difficulty retrieving old information

May be disoriented with time, places, and people

Difficulty sequencing events

Physical and verbal perseverations (repeating a word, phrase, or action, over and over again)

Poor judgment and reasoning skills

Strategies to address Memory and cognitive challenges:

Repeat instructions and directions as needed and provide one direction at a time.

Remember that the student may take a longer amount of time to process information.

Have consistent routines and rules to promote procedural memory.

Provide student with an outline so they can anticipate content and transition.

Use pictures or visual cues to alert the student of the need to do something different.

Practice systematic verbal rehearsal - student may have to "practice" a verbal cue and what is expected.

Teach memory strategies and memory tricks such as elaborative rehearsal, mnemonics, limericks, etc.

Use a scribe or note-taker and have notes photocopied at the end of class to give to student.

Check for understanding - recognition vs. recall.

Modify work amounts and shorten assignments to the minimum necessary (increase gradually if student is successful).

Be very specific and to the point - use simple, concrete language.

Provide specific feedback on responses - state that an answer is correct or needs more input.

Social and emotional characterists:

Inappropriate social behaviors

Emotional responses may be unpredictable in nature and severity

Difficulty regulating emotions

May struggle to accurately interpret verbal and non-verbal cues

Emotional responses may not "fit" the situation

Emotional instability (happy one moment, sad the next)

May exhibit signs of poor self-concept, depression, isolation, withdrawal, and paranoia

Strategies to address Social and emotional characterists:

Consider a modified schedule and / or a behavior plan.

Start a behavior modification program for academic and/or social skills and have student chart their progress.

Be aware that a previously effective behavior plan may not work due to memory deficits.

Talk with the student ahead of time and let them the discipline plan.

Have student be prepared for schedule changes, such as late start, substitute teacher, early dismissal, etc.

Let student carry pictures of family and friends.

Structure student's activities and schedule to reduce the number of unexpected changes and unstructured periods.

Explicitly teach coping and de-escalation strategies.

Engage the student in role-play scenarios to target specific social responses

Inattention and Impulsivity

Difficulty focusing attention

May have difficulty controlling impulses, thoughts, and feelings

Injury and memory loss may impact successful use of behavior modification strategies

Distracted by internal and external events and thoughts

Strategies to address Inattention and Impulsivity

Allow the student more time to complete tasks and reduce the workload if needed.Avoid activities requiring the student to concentrate for long periods of time.

Keep distractions to a minimum - use study carrels or room dividers as needed.

Provide direct support in organizational strategies.

Have student keep a planner or agenda, where all assignments are written down.

Use a communication book with parents.

Provide preferential seating.

Arrange seating to allow for more space between students.

Provide small group instruction.

Provide the student with a written schedule and keep the schedule as consistent as possible.

Provide an area for supplies and books (away from the student's work space).

Select a classroom buddy.

Limit task list to 5 things, and when each task is completed immediately erase that task or check it off

Speech and Language challenges

May have speech and language deficits (should be checked frequently)

Difficulty speaking words or phrases

Difficulty comprehending what others say

May struggle to follow multi-step instructions

Strategies to address Speech and Language challenges:

Use mnemonic devices such as rhymes or songs to remember names.

Read books and other materials that have pictures in them.

Allow student to have processing time when you ask questions.

Provide directions one at a time.

Give directions in verbal and written form.

Physical challenges indicators:

May struggle to process visual information (visual perceptual issues)

May experience visual deficits such as double vision and partial loss of vision

May have visual "blind spots"

Possible coma could produce some slowing and lethargy

Seizures are common following a head injury, and seizure medication may cause “cognitive dulling”

Difficulty staying awake

Inability to recognize post-injury deficits

Possible gross or fine motor deficits depending on what part of the brain was injured (may have some paralysis)

Short periods of disorientation or attention lapse

May tire frequently and easily

Strategies to address Physical challenges:

Realize that the student may get tired quickly, and let the student rest as needed.Be aware of and use the student's best sensory modality (e.g. auditory, visual).

Be aware of any medications the student takes and its side effects.

Provide preferential seating if the student has visual difficulties.

Be aware of any gross or fine motor difficulties

The symptoms/signs of TBI range from mild to severe:
Mild TBI:

Fatigue

Headaches

Visual disturbances

Memory loss

Poor attention/concentration

Sleep disturbances

Dizziness/loss of balance

Irritability/emotional disturbances

Feelings of depression

Seizures

Possible coma

Nausea

Loss of smell

Sensitivity to light and sounds

Mood changes

Getting lost or confused

Slowness in thinking

Moderate TBI:

Results in permanent brain damage

Produces lifelong deficits (to varying degrees)

Death may occur

Seizures

Coma (to varying degrees)

Confusion

Difficulty with "thinking skills" (memory, attention, judgment)

Blurred vision, loss of vision

Change in hearing acuity

Ringing in ears

Slurred speech

Difficulty understanding spoken language

Difficulty processing sensory input (touch, smell, hearing, etc.)

Personality changes

Loss of taste and/or smell

Paralysis

Lethargy

Loss of bowel/bladder control

Dizziness

Inappropriate emotional responses

Severe TBI:

Results in significant permanent brain damage

May result in total loss of speech ability

Produces lifelong deficits to a severe degree

May require lifetime care and assistance

Sustained loss of consciousness

Can result in death

References:

https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557

https://do2learn.com/disabilities/CharacteristicsAndStrategies/TraumaticBrainInjury_Strategies.html

https://www.google.com.hk/url?sa=i&url=https%3A%2F%2Fneurospabrain.com%2Fconcussion-and-traumatic-brain-injuries-tbi%2F&psig=AOvVaw0KbWD-bXF7s3BFO2HPgya8&ust=1647826146896000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCIjQmPfE0_YCFQAAAAAdAAAAABAD

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Assistive technology is the use of devices/services to enhance and improve the learning capabilities of a student with a disability.

Visual Impairment is considered a low-incidence disability which requires a medical diagnosis and evaluation from a multidisciplinary team.

Some ATTs that can be used in the classrooms are:
1. Braille-- this will allow students to feel aspects of the written language.
2. Digital Text-- this tool provides a large amount of resources that can be customized and manipulated to the students' learning style.
3. Screen magnifier-- this tool is usually embedded in all computers. It will enlarge text or a certain area on the screen and enhance the view of the content.

For more information, these websites provide great resources:
https://crb1.org/for-families/resources/tools/
https://www.afb.org/blindness-and-low-vision/using-technology/assistive-technology-products
https://project-ray.com/10-excellent-tools-to-assist-visually-impaired-students/
https://www.pathstoliteracy.org/resources/tools-support-you-having-student-visual-impairment-your-k-6-general-education-classroom
https://www.hdesd.org/services/vision-services/visual-impairment-resources-for-educators/
https://www.sess.ie/resources/assistive-technology-tools-and-applications-9

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"FamilyConnect is a service offered by the American Printing House for the Blind (APH) to give parents and other family members of children who are visually impaired–and professionals who work with them–a supportive place for sharing and finding resources on raising their children from birth to adulthood."

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What Are Accommodations and Modifications?

Children who are visually impaired can do virtually all the activities and tasks that sighted children can do, but they often need to learn to do them in a different way or using different tools or materials. For instance, your child may need reading materials in braille rather than in print or may need to examine a live rabbit with her hands to understand what it is, rather than learning from a picture in a book. Other examples might be arranging a classroom to let your child sit close to the science teacher who is demonstrating an experiment or allowing her extra time to complete a test that the whole class is taking.

Depending on your child's abilities and needs, she may need such adaptations to participate in the curriculum and various activities in school as well as to make use of instructional materials. Your child will most likely learn about such adaptations from his or her teacher of students with visual impairments or orientation and mobility (O&M) instructor.

Such adaptations in school are usually referred to by the terms "accommodations" and "modifications." Different school systems attach different meanings to these terms, but "accommodation" usually refers to a change in the way your child is taught or tested without changing the standard of learning or performance or the requirements that she needs to meet. Some examples include having extra time to complete assignments, using braille or large-print materials, having assignments or tests broken up into smaller parts, or completing assignments in a quiet setting away from other students. "Modification" commonly refers to a change to what your child is learning or tested on that changes the standards or requirements she needs to meet. Being taught material at a lower grade level or having to complete fewer items on a test are examples of modifications. Because these terms are not used in the same way in all school districts, it will be helpful for you to learn how your school district defines them.

Accommodations and Modifications at a Glance

Typically, students may require accommodations and modifications during the school day for various activities in the broad areas of

The following guide provides examples of accommodations and modifications that may be helpful for blind students in each of these areas. It is intended to provide you with a tool for working with your child's educational team to plan accommodations and modifications that will assist her. The ideas listed are only representative examples offered to stimulate your ideas and may not be appropriate for your particular child. It is also important to keep in mind that your child may need different solutions in different situations-no one device or technique will be the answer to everything.

Instructional Accommodations and Modifications for Students Who Are Visually Impaired

Children with visual impairments need to have access to both written and oral instruction and to demonstrations in all subject matter. Accommodations and modifications can help a student better understand the instruction provided by the regular education teacher in the classroom.

Instruction

Accommodations and Modifications for Instructional Materials

Instructional materials need to be put into an accessible format for visually impaired students. It is important that all materials be considered-not just textbooks, but worksheets and all supplemental reading materials. It is also important for your child to receive them at the same time as her sighted classmates who read print.

Materials

Accommodations and Modifications for Assignments

To make the best use of their education, students need to be responsible for all classroom and homework assignments. Additional time or alternatives to visual tasks may be important modifications for your child.

Assignments

Accommodations and Modifications for Classroom Testing

Different types of accommodations and modifications can help visually impaired students take their class tests along with their sighted classmates. For example, Ahmed, who is in third grade, has low vision and cerebral palsy and reads and writes more slowly than his classmates. To have the same opportunity as the rest of class to complete all the items on his class tests and to take the tests independently, he will need to be allotted more time than the other students.

Classroom Testing

Assistive Technology Accommodations and Modifications

Your child may need assistive technology tools to learn or to communicate with others. You can learn more about the range of assistive devices available for visually impaired children in the "Assistive Technology" section of FamilyConnect, but you may want to get started by browsing through the adaptations listed below.

Assistive Technology

Low vision devices (near)

Magnification devices for viewing or completing near vision tasks.

Low vision devices (distance)

Telescopes for viewing or completing distance vision tasks.

Braillewriter

A mechanical tool resembling a typewriter that is used for writing or "embossing" braille.

Slate and stylus

A portable tool for writing braille made up of two flat pieces of metal or plastic that are used to hold paper and a pointed piece of metal used to punch or emboss braille dots.

Electronic braillewriter

An electronic device for writing braille, incorporating a braille keyboard, which frequently has additional features, such as a calculator.

Personal digital assistant (PDA)

An electronic device for organizing and managing data, often integrated with an electronic notetaker.

Notetaker (braille)

A portable device for reading and writing in class, with braille output, often integrated with the features of a PDA.

Notetaker (speech)

A portable device for reading and writing in class with speech output, often integrated with the features of a PDA.

Computer

A tool for literacy and learning activities and access to information, especially when equipped with specialized software and hardware.

Refreshable braille

A device that is connected to (or integrated into) a computer or notetaker and that represents braille text by means of pins that can be raised or lowered to form braille cells.

Speech access software

Computer software that enables a computer to "speak" the text on the screen through the use of synthetic speech that announces what is displayed on screen.

Braille translation software

Computer software that translates print into braille and braille into print.

Large monitor for computer

A monitor that, by virtue of its size, provides larger images for students with low vision.

Scanner

A device that copies print material and uses software to translate it into an electronic format so that it can be converted into a preferred reading medium.

Magnification software

Software that enlarges text displayed on a computer or other screen.

Braille embosser

A printer that embosses (prints) braille.

Print printer

A regular printer to provide print text for sighted teachers and classmates.

Tactile graphics maker

A tool that makes print images into tactile format that can be "read" through the fingers.

Word processor

A computer software program for writing and manipulating text.

Electronic mail (email)

Electronic mail sent through computers and other devices that is a communication medium for students to receive and return classroom assignments.

Talking calculator

A device that provides speech access to a calculator.

Large-print calculator

A calculator with large numbers on the keys to provide access for students with low vision.

Talking dictionary

An electronic device that provides a dictionary with speech access.

Audio recorders

A device for recording auditory information and listening to materials provided in audio format.

Digital players

A portable device to access digitally recorded audio books and materials.

Alternative computer access

A number of methods that allow a person with physical disabilities to use a computer, such as adapted keyboards and voice recognition technology.

Augmentative and alternative communication devices

Special communication devices for students who may have hearing disabilities or other limitations in communication. For example, some of these devices play prerecorded messages at the push of a button.

Adapted devices for daily living

A wide variety of devices adapted for use by people who are visually impaired, including measuring devices, kitchen utensils, games and toys, and writing aids.

Accommodations and Modification to the Educational Environment

Students who are visually impaired often cannot perceive information directly from their environment, but accommodations and modifications help them do so. Something as simple as the flexibility to sit closer to the chalkboard may meet your child's needs, or it could be necessary to alter the physical arrangement of the environment by providing additional furniture, shelving, or access to electrical outlets for the operation of specialized equipment.

The Environment

Accommodations and Modifications for Other Activities

Students with visual impairments need to be able to participate in all the educational activities their school offers, not just those that take place in the classroom. For example, Natasha, a blind high school student, is involved with her school's marching band. Special methods allow her to participate as independently as possible in the band routines and competitions.

Other Activities

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Accommodations and Modifications at a Glance: Educational Accommodations for Students Who Are Blind or Visually Impaired

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What Are Accommodations and Modifications? Children who are visually impaired can do virtually all the activities and tasks that sighted children can do, but they often need to learn to do them in a different way or using different tools or materials. For instance, your child may need reading materials in braille rather than in ...

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Lesions of the auditory nerve and the central centers at all levels in the auditory system transmission, sound sensing and its auditory conduction pathways cause hearing dysfunction and produce different degrees of hearing loss, collectively referred to as deafness. It is generally believed that whe…

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In this video, JD talks about different ways students can request for accommodations in the classroom.

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Although this is targeted towards students in traditional classrooms, it's important for teachers to recognize the different needs that could be modified in classrooms.

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Orthopaedic Impairment as defined by IDEA, under the 14 Disability Categories,  “A severe orthopaedic impairment that adversely affects a child’s educational performance. The term includes impairments caused by a congenital anomaly, impairments caused by disease (e.g., poliomyelitis, bone tuberculosis), and impairments from other causes (e.g.,cerebral palsy, amputations, and fractures or burns that cause contractures).”

According to (AT Tools for Physical Needs Meredith Chen, n.d.) There are tools that can help students. These tools are alternative grip tools, book stand and slant boards, e-readers and Ipad/tablets.

Grips and book stands are low tech devices that can help students with writing, cutting and following along in a book.

Here is a video explaining how different grips can help students with their writing - https://www.youtube.com/watch?v=KVf51TojK1U

Here is a video showing the different scissor grips available to help students fine motor skills -  https://www.youtube.com/watch?v=TUkHOweW25I

Resources:

How to Incorporate Assistive Technology in the classroom. (2021, March 2). LDRFA. Retrieved March 14, 2022, from https://www.ldrfa.org/incorporate-assistive-technology/

enTECH. (2019, January 12). Adaptive Scissors [Video]. YouTube. https://www.youtube.com/watch?v=TUkHOweW25I

AT Tools for Physical Needs Meredith Chen. (n.d.). Assistive Technology. Retrieved March 15, 2022, from https://assistedtechnology.weebly.com/at-tools-for-physical-needs-meredith-chen.html

Understood. (2017, September 7). The Different Types of Pencil Grips for Kids [Video]. YouTube. https://www.youtube.com/watch?v=KVf51TojK1U

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The Different Types of Pencil Grips for Kids

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- Link to a video that explains what AT is and different types of technologies that can be used to help students in the classroom.

Louise Bezuidenhout

What is ADD:

(Attention Deficit Disorder, n.d.) defined ADD as Attention Deficit Disorder. This term is used for those who have extreme problems of concentration but lack the hyperactive trait, impulsivity is a trait of ADD but the hyperactive trait is not present. ADD is present in girls more than boys.

The following technology can be used to help ADD and ADHD students:

Assistive technology for Reading skills:

Audio books: If the students are struggling to understand the words and sentences he or she has read, listening to the book might be able to benefit him/her.

Text to speech: This technology turns text into audio for students to listen to. Can be used to help the student with word recognition. Some students struggle with writing and being able to turn their speech into words can be beneficial and help them to complete the task, help keep their attention and help to comprehend words better.

Optical Character Recognition: This is software that converts a picture into spoken words. This image can be of a text, a worksheet, from a book or a sign.

Assistive Technology for Writing skills:

Printed Graphic Organizers: https://www.youtube.com/watch?v=-zxM9kBH2EE&t=18s , follow this link to learn more about graphic organizers.

Portable word processors: Help students take notes, type and some of these word processors have predictive text software built in. This is ideal for students who struggle with note taking.

Speech Recognition software: Students spoke words can be turned into text. This helps students get their thoughts down in a timely manner.

Assistive Technology For Math Skills:

Talking Calculator: Works the same as a conventional calculator, except that the calculator reads the math equation back to the student. This calculator can help students with their confidence.

Electronic Math Worksheet: This enables the students to do their math problems on a computer screen. This can help the student organize their thoughts and read the math equations, numbers and symbols back to the student.

Reminder devices: These devices give students a soft reminder to stay on task, great for those who struggle with concentration and get easily distracted. An example of one of these devices is a vibrating watch. The WatchMinder is a great tool to help students who have ADD/ADHD.

https://www.youtube.com/watch?v=E5D0mO11v1U a link to a short video explaining what a WatchMinder does.

Resources:
Attention Deficit Disorder. (n.d.). Lanc UK. Retrieved March 14, 2022, from https://www.lanc.org.uk/related-conditions/attention-deficit-disorder-adhd/#:%7E:text=Attention%20Deficit%20Disorder%20(ADD)%20is,as%20excessive%20impulsiveness%20or%20hyperactivity.

Starkman, E. (2021, April 7). Assistive Technology for Children With ADHD. WebMD. Retrieved March 14, 2022, from https://www.webmd.com/add-adhd/childhood-adhd/assistive-technology-adhd#:%7E:text=Assistive%20technology%20is%20any%20device,technology%20and%20how%20they%20help.

Tools for Life Georgia AT Program. (2020, August 20). Using Graphic Organizers to Support Students with Disabilities [Video]. YouTube. https://www.youtube.com/watch?v=-zxM9kBH2EE&t=18s

WatchMinder Explainer Video. (2013, September 16). WatchMinder Explainer Video [Video]. YouTube. https://www.youtube.com/watch?v=E5D0mO11v1U

OklahomaABLETech. (2013, December 10). Assistive Technology 101 [Video]. YouTube. https://www.youtube.com/watch?v=1nOD-XhpSAM&t=31s

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

Students are normally evaluated by medical professionals, sometimes in the classroom, to determine if their orthopedic impairment will have an impact on their academic progress.

How can we use assistive technology to support students with orthopedic impairment?

Depending on their orthopedic impairment, students may need different technologies to support them in their classes to help them communicate in different ways. Lessons can be developed to help address their orthopedic impairment, such as supporting and improving their fine motor skills. Some examples of devices and technologies that might be utilized may include wheelchairs, specialized desks, canes, crutches, communication software, or speech recognition software.

Additional Examples:

E-book: E-books (on an iPad, Kindle or websites such as Razkids) can allow students to find a variety of texts, turn the page by touching the screen, zoom in or out, and even read the text out loud for students.

Ipads: Apps on the iPad can support students with a variety of needs, such. as text to speech, speech to text, learning games, interactive materials, and many more.

What are other supportive tools?

Alternative grip tools: there are a variety of tools that can support students with challenges in coordination and grip. The tools can make it easier for children to complete activities such as cutting and writing.

Book Stands & Slant Boards: these tools allow students to write and read at adjustable angles, while keeping the paper in place and making it easier to turn the page. They can be portable and easy to use.

Always keep in mind…

Some classes, such as physical education, may pose difficulties for students with orthopedic impairments and some will need to be excused from gym class. Other students with mild orthopedic impairments may be able to participate.

Orthopedic disability may have an impact on a student's behavior in class for all subjects. For example, students with orthopedic impairment might get tired more quickly than their classmates without orthopedic disabilities.

Special seating arrangements may be necessary to support a student with an orthopedic impairment, such as posture and mobility, as moving around the classroom or moving around school hallways may be difficult for that student.

Schools may also need to arrange the schedules of students with orthopedic impairment in a way that prevents them from having to travel long distances from one class to another and providing elevator access can help these students move around the school building.

References:

14 Disability Categories under IDEA. http://sinche.uom.gr/sites/default/files/14_disability_categories_under_idea.pdf.

Logsdon, Ann. “Orthopedic Impairments and Special Needs Students Students' Education.” SPECIAL NEEDS, Verywell Family, 24 Oct. 2021, https://www.verywellfamily.com/what-is-orthopedic-impairment-2162506.

Santaniello, Sabrina. “Assistive Technologies for Students with Physical Disabilities.” Assistive Technology, 23 Nov. 2020, https://assistedtechnology.weebly.com/at-tools-for-physical-needs-meredith-chen.html.

“Writing Tools for Special Needs Students: Assistive Devices for Success.” BrightHub Education, 2 Aug. 2008, https://www.brighthubeducation.com/special-ed-physical-disabilities/3775-ergonic-pens-and-pencils-for-students/.

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Here is a collated a list of characteristics, signs and symptoms, classroom strategies and resources regarding emotional disturbance.

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The Individuals with Disabilities Education Act (IDEA) defines Emotional Disturbance as: “Emotional disturbance means 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…

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Developmental Delay

According to the Cardinal Glennon Children’s Hospital: A developmental delay refers to a child who has not gained the developmental skills expected of him or her, compared to others of the same age. Delays may occur in the areas of motor function, speech and language, cognitive, play, and social skills. Global developmental delay means a young child has significant delays in two or more of these areas of development.

https://www.ssmhealth.com/cardinal-glennon/developmental-pediatrics/developmental-delay

Assistive technologies that can help students with Developmental Delay:

·      Audiobooks

·      Text-to-Speech Software

·      FM Systems

https://www.thetechedvocate.org/assistive-technology-to-help-students-with-developmental-delays-succeed-academically/

Accommodations:

·       Seat the student closer to the board, teacher, and/or another student who could help.

·       Adjust chair and/or desk height to ensure the student is in the proper position for desk work. (Feet flat on the floor, shoulders relaxed, and forearms supported on the desk.)

·       Allow the student to work in different positions, like standing.

·       Provide a slant board (or large three-ring binder) for a sloped writing surface.

·       Provide pencil grips .

·       Have spring-loaded or loop scissors available.

·       Provide special paper as needed, like raised-line paper or graph paper.

·       Provide different writing tools (thin markers, gel pens, etc.) to reduce pencil pressure.

·       Give the student an end locker or cubby and teach locker-opening skills .

·       Give breaks so the student can move around a few times a day.

·       Give extra time to get from class to class.

·       Build in extra time to get changed for gym and ready for recess.

https://www.understood.org/articles/en/at-a-glance-classroom-accommodations-for-dcd

Videos on Developmental Delay:

What is a Developmental Delay in Children Signs and Symptoms

https://study.com/academy/lesson/what-is-a-developmental-delay-in-children-definition-causes-symptoms.html

Assistive Technology for Developmental Delays Part 1

https://www.youtube.com/watch?v=0Zosc8dEBf8

Assistive Technology for Developmental Delays Part 2

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

To find out more information about Developmental Delay you can visit:

Illinois Department of Human Services

https://www.dhs.state.il.us/page.aspx?item=69744

Centers for Disease Control and Prevention

https://www.cdc.gov/ncbddd/developmentaldisabilities/facts.html

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Assistive Technology for Developmental Delays, Part 1

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A speech impairment affects people who have problems speaking in a regular tone of voice or tempo. It makes it hard for people to communicate properly or when they want to express something. This can happen in both children and adults. These disorders can cause frustrations and embarrassment to the person suffering from them.

What exactly is a speech impairment?

Speech Impairment are disorders of speech sounds, fluency, or voice that interfere with communication, adversely affect performance and/or functioning in the educational environment, and result in the need for exceptional student education.

People who have speech impairments have a hard time pronouncing different speech sounds. They might distort sounds of some words and leave other sounds out completely.

There are three general categories of speech impairment:

Fluency Disorder- an unusual repetition of sounds or rhythm. A child’s flow of speech is disrupted by sounds, syllables, and words that are repeated, prolonged, or avoided and where there may be silent blocks or inappropriate inhalation, exhalation, or phonation patterns.

Voice Disorder- means you have an atypical tone of voice. It could be an unusual pitch, quality, resonance, or volume.

Articulation Disorder- Distorting certain sounds. It can also fully omit sounds.

Where the child produces sounds incorrectly (ex. Lisp, difficulty articulating certain sounds such as “l” or “r”)

Accommodations:
High tech systems includes:

1.   Augmentative communication device
* Speech4Good app to be installed on smart phones
* Go talks 4+
* Speech tablet device
* Tablets

2.  Course modifications, such as one to one presentations and the use of a computer with a voice synthesizer

Augmentative and alternative communication includes low-tech system, such as:

* Sign language

* Picture boards

*Letter boards

*Communication notebooks

*Eye gaze

Instructional Strategies for Students:

·   Permit students the time they require to express themselves, without unsolicited aid in filling the gaps in their speech

·   Be patient and take the time to communicate effectively. Ask students to repeat or clarify if you do not understand their speech.

·   Permit students to be silent in class unless speech is a requires course competency appropriate for students

References:

Solodev. (n.d.). Speech impairment (SI). Florida Department of Education. Retrieved March 16, 2022, from https://www.fldoe.org/academics/exceptional-student-edu/ese-eligibility/speech-impairment-si.stml

Contributors, W. M. D. E. (n.d.). Speech impairment: Types and health effects. WebMD. Retrieved March 16, 2022, from https://www.webmd.com/brain/what-to-know-about-speech-impairment

Libguides: Speech disorders: Common assistive technologies. Common Assistive Technologies - Speech Disorders - LibGuides at University of Illinois at Urbana-Champaign. (n.d.). Retrieved March 16, 2022, from https://guides.library.illinois.edu/c.php?g=613892&p=4265891

ISpeech therapy. Tufts Now. (2012, February 13). Retrieved March 16, 2022, from https://now.tufts.edu/articles/ispeech-therapy

https://www.speechpathologygraduateprograms.org/2017/11/top-10-aac-augmentative-and-alternative-communication-devices/

https://safecaretechnologies.com/product/sc-tablet/

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Assistive Devices for Speech Impaired Students

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According to the Individuals with Disabilities Education Act (IDEA), visual impairment (blindness) is defined as

"an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness."

(Dragoo, 2020, p.25).

Depending on the extent of impairment, the impact of learning will vary for each person. It can range from being born without vision to others gradually losing their sight or even having no vision at all. Some teaching strategies to be used in the classroom can include:
1. Enlarging fonts, providing notes
2. Verbalize what is being written or presented
3. Use tactile graphics (may include braille)
4. Provide materials that are accessible online (text-to-speech and speech-to-text friendly)
5. Arrange closer seating (get student's opinion, as well)

It's crucial for the homeroom teacher and the teacher overlooking students with visual impairment to stay in close contact to better meet the needs of the learning student.

References
ADCET. (2022). Inclusive Teaching: Blind and Vision Impaired. https://www.adcet.edu.au/inclusive-teaching/specific-disabilities/blind-vision-impaired

American Printing House for the Blind. (2021). Accommodations and Modifications at a Glance: Educational Accommodations for Students Who Are Blind or Visually Impaired. The American Printing House. https://familyconnect.org/education/know-your-rights/accommodations-and-modifications-at-a-glance/

Cicerchia, M. (n.d.). Visual impairment in the classroom. Touch-Type Read and Spell (TTRS). https://www.readandspell.com/visual-impairment-in-the-classroom

Dragoo, K. (2020, October). The Individuals with Disabilities Education Act: A Comparison of State Eligibility Criteria (No. R46566). Congressional Research Service. https://crsreports.congress.gov/

Tebo, L. (n.d.). A Resource Guide to Assistive Technology for Students with Visual Impairment. https://qiat.org/docs/resourcebank/TEBO_VI_Resource_Guide.pdf

Willings, C. (2020, April 12). Assistive Technology for Individuals who are Blind or Visually Impaired. Teaching Students with Visual Impairments. https://www.teachingvisuallyimpaired.com/vi-at.html

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What is Autism ?
According to Sec. 300.8 (C) (1) of IDEA
Autism is a developmental disability that significantly affects verbal and nonverbal communication, social interactions, and educational performance, adversely.
Autism is generally evident before age three and the term Autism doesn't apply if a child's educational performance is adversely affected primarily because of an emotional disturbance.

According to the CDC
Autism spectrum disorder, (ASD), is a developmental disability caused by differences in the brain.  Some people with ASD have a known genetic condition and other causes aren't yet identified.  There are multiple causes of ASD .  ASD begins before age three and can last throughout a person's life, however, symptoms may improve over time.  Some children with ASD meet developmental milestones and gain new skills until 18-24 months and stop gaining new skills and/ or lose the ones that they once had.  ASD includes, once separately diagnosed, autistic disorder, pervasive developmental disorder,  and Asperger Syndrome.

Characteristics often Associated with Autism according to IDEA & CDC

engagement in repetitive activities and stereotyped movements

resistance to environmental change or change in daily routines

unusual responses to sensory experiences

restricted behavior

fixation and obsessive interests

delayed language, movement, cognitive or learning skills

hyperactive, impulsive, and/or inattentive behavior

Epilepsy or seizure disorder

unusual sleeping and eating habits

GI issues

unusual mood or emotional reactions

anxiety, stress, or excessive worry

lack of fear or more fear than expected

Signs of Autism
By Six Months
F ew or no big smiles or other engaging expressions and limited or no eye contact.
By Nine Months
Little or no back-and-forth sharing of sounds, smiles, or other facial expressions
By Twelve Months
Little or no babbling, little or no back-and-forth gestures e.g. pointing, showing, reaching or waving,  little or no response to name
By Sixteen Months
Very few or no words
By Twenty-Four Months
Very few or no meaningful, two word phrases (not including imitating or repeating)
At Any Age
Loss of previously acquired speech, babbling or social skills, avoidance of eye contact, persistent preference for solitude, difficulty understanding other people's feelings, delayed language development, echolalia or persistent repetition of phrases or words, resistance to minor changes in routine or surroundings, restricted interests, repetitive behaviors, unusual or intense reactions to sounds, smells, tastes, textures, lights and/or colors.

***For more on developmental milestones follow the link:   https://www.cdc.gov/ncbddd/actearly/milestones/index.html

***For more information on early detection follow the link: https://www.autismspeaks.org/screen-your-child)

Strategies for Teaching Autistic Students

All racial and socioeconomic groups are impacted by autism and according to the CDC, 1 in 44 Children in the US has a diagnosis of autism: a number that has nearly tripled since 2000. Using specific strategies in the classroom can optimize the learning experience for students with special needs, especially students with autism.   For a complete list of Eligibility Criteria from the National Association of Special Education Teachers follow the link:  https://www.naset.org/fileadmin/user_upload/Autism_Series/Eligibility_Criteria_Children_with_ASD.pdf

Autism Severity Level

Level 1, Requiring Support: mild autism symptoms, struggle with social circumstances, some obstructive or recurring behaviors, can communicate verbally but might have difficulties maintaining conversations and friendships. They require minimal support to complete daily tasks and respond well to set routines.

Level 2, Requiring Substantial Support: central range of the spectrum and need more assistance than level 1, typically have problems maintaining appropriate social interactions and their unusual behaviors are more noticeable.  They may be verbal or nonverbal. Need extensive social support.

Level 3, Requiring Very Substantial Support:  severe end of the spectrum, having significant challenges with social and communication skills, restrictive and repetitive behaviors prohibit independent functionality. Many are nonverbal but some can use a few words.  Severe echolalia and rocking, unexpected events are very challenging for them and they require considerable support to get through the day.

How Autism Impacts Learning
Some students, depending on where they land on the spectrum, will struggle in social situations while those with more severe symptoms struggle with verbalizing thoughts.  The impact on learning is correlative to the severity of a student's symptoms.

develop skills at different rates and levels than neurotypical children (NTs)

delayed language development

do not always pay attention

may not instinctively engage in shared or joint attention making communication difficult

difficult time with perspective

hard to predict or understand behavior of others and themselves

essential classroom skills: focus, attention, transition management, organization, memory, time management, emotional control, frustration

difficulties seeing "big picture" in real life scenarios and in stories or books making the overall message in books and stories lost due to extreme focus on other details like pictures or nonessential details.

Enhancements

avoid sensory overload: reducing unnecessary environmental stimuli

pairing autistic students with positive peer role models

maintain structure and routine

encouraging a calm and positive environment in the classroom

Use visuals: quick and clear reminders about items in the classroom e.g. rules, where things go, resources, etc

be predictable: establish routines, set schedules, this will help autistic students by reducing anxiety

use concrete language: figurative language is difficult for people with ASD to understand.  ASDs typically interpret concrete terms and need clear and concrete instruction

teach social skills directly: hidden curriculum ideas to develop social skills can be too complex. Model and discuss appropriate behavior directly and easily.

treat students as individuals: each student on the spectrum is affected differently and some accommodations might not work with every student with ASD.

Types of Treatments

Behavioral (DTT & PRT): instructional

Developmental: Speech language Therapy, Occupational therapy, Social Integration Therapy, Physical Therapy

Educational: TEACCH Approach

Social-relational: Floor Time

Pharmacological: Medication

Psychological: CBT Cognitive Behavior Therapy

Complementary and alternative: special supplemental therapy, diets, etc.

***For More information on these types of treatments follow the link: https://www.cdc.gov/ncbddd/autism/treatment.html

Using Technology to Help ASD Students

Technology can help students with ASD on all ends of the spectrum, especially those who are nonverbal. Technology should be used and reevaluated frequently and adapted frequently as the student gets older and as certain capabilities are strengthened.

Augmentative and Alternative Communication (AAC) devices that can help students with minimal verbal communication or non verbal and allow them to better understand the foundational concepts of verbal communication while lowering the barriers that can prompt a child to become agitated and while having their needs recognized and understood.

Picture Exchange Communication Systems (PECS) low tech form of visual communication that can help facilitate clear communication between children and caregivers and rely on pictures to specify needs or to embody concepts. Can engage a child and allow them to explore their own grasp on communication. Rely on ABA principles.  These visuals can also supplement or replace typical verbal instruction.

Talk Light can be used to monitor noise levels in the environment

Noise Cancelling Earphones  can be used to help children cope with noisy environments.

Video Games might be a good way for ASDs to connect with peers and family members in ways that other activities cannot. Can encourage independent learning, exploration, and development of critical social skills due to stimulative capabilities.

For More information on Autism Spectrum Disorder (ASD)
https://www.youtube.com/watch?v=r29iOjnbbgA

References

Autism Spectrum Disorder (ASD) Signs and Symptoms. https://www.cdc.gov. (2021). Retrieved 15 March 2022, from https://www.cdc.gov/ncbddd/autism/signs.html.

Autism Spectrum Disorder Series: Eligibility Criteria for Children with ASD. Naset.org. Retrieved 15 March 2022, from https://www.naset.org/fileadmin/user_upload/Autism_Series/Eligibility_Criteria_Children_with_ASD.pdf.

Autism Spectrum Disorder: ASD. Youtube.com. (2019). Retrieved 15 March 2022, from https://www.youtube.com/watch?v=r29iOjnbbgA.

Expert-Recommended Strategies for Teaching Autistic Students. The Elemy Learning Studio. (2022). Retrieved 15 March 2022, from https://www.elemy.com/studio/autism-and-education/teaching-strategies/.

Sec. 300.8 (c) (1) of IDEA. IDEA: Individuals with Disabilities Education Act. (2017). Retrieved 14 March 2022, from https://sites.ed.gov/idea/regs/b/a/300.8/c/1.

What Tech Can Help Kids With ASD? | Therapeutic Pathways. Therapeutic Pathways. (2021). Retrieved 15 March 2022, from https://www.tpathways.org/faqs/how-can-i-use-technology-to-help-my-child-with-asd/#:~:text=Picture%20Exchange%20Communication%20Systems%20(PECS,such%20as%20brushing%20their%20teeth.

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Attention Deficit Hyperactivity Disorder (ADHD) is not listed as its own category, but is part of the category titled 'Other Health Impairment'.  Disabilities that belong to this category are classed as 'high-incidence disabilities' which often require a medical assessment and an evaluation by a multidisciplinary team (Dragoo, 2020).

What is Attention Deficit Hyperactivity Disorder (ADHD)?

Attention Deficit Hyperactivity Disorder (ADHD) is defined by the CDC as one of the most common neurodevelopmental disorders in children which can lead to difficulties paying attention, controlling impulsive behaviour, and/or being overly active.  There are three types of ADHD:

1) Predominantly Inattentive Presentation (easily distracted, forgetful, difficulties focusing/organizing etc.)

2) Predominantly Hyperactive-Impulsive Presentation (restless, impulsivity, difficulties in waiting turns, interrupting others etc.)

3) Combined Presentation (combination of symptoms that are equally present)

How can ADHD affect a child's educational achievement?

Research suggests that ADHD has been associated with an increased risk of lower scores in achievement tests for both reading and arithmetic, a lower grade point average (GPA), grade repetition and placement in special education classes (Jangmo et al., 2019).

Students with ADHD may feel frustration as they perhaps understand the content being taught however they struggle to demonstrate their understanding in the form of tests, writing tasks and assignments.  They may miss important  instructions due to moments when they are unable to focus and, as a result, they may fall behind in class their class work.

What forms of assistive technologies or other accommodations can be used to assist students with ADHD who are struggling?

Assistive technologies help students by either helping them learn how to complete a task or by bypassing an area of difficulty for the student.  They can be both high-tech and low-tech.  For students with ADHD, the following assistive technologies may be beneficial:

Graphic Organizers: Students with ADHD may find it difficult to organize their thoughts when beginning a writing task.  Graphic organizers, whether simply print-outs or web-based programs, help students to visually organize their thoughts and and outline information as they begin a writing project.  Web-based programs offer the added benefit of allowing the student to add information in an unstructured manner and the program can then help to organize the information into appropriate categories (Young & MacCormack, 2018).  An example is https://www.mindomo.com/ which includes templates and asks students questions to help them in the initial stages of writing.

Scanning pens: For students with ADHD who struggle with reading, they are able to scan a word to hear the definition or to hear whole sentences read aloud.  This can help improve reading comprehension and speed of reading.

Audio books and reading software: These tools also may be beneficial to students with ADHD that struggle with reading as they allow students to listen to the text and they can also search for specific pages or chapters and bookmark them.

Personal FM Listening Systems: This allows the teacher's voice to be transmitted directly to the student's ear through an earphone worn by the student.  Although not designed specifically for students with ADHD, this has been found to improve speech recognition performance and lead to an increase in on-task behaviours for students with ADHD.

Portable word processors: These are lightweight devices which can be used for note-taking and writing assignments.  They can be helpful for students with ADHD who have difficulties taking notes or with handwriting in general.

Talking Calculators: These have a built-in speech synthesizer which reads each number aloud as the student presses the keys.  This will provide instant feedback to the student that they have pressed the correct calculator keys and it can also help students to process the digits they see in a math problem more easily.

Electronic Math Worksheet Software: This allows students to work through math problems on a computer screen with the numbers being read aloud by a speech synthesizer.  It is useful for students who find it difficult to align math problems on paper  An example application is 'MathPad' which translates what students have written on the tablet screen into a more readable and solvable math problem.

Motivation Aid tools: There are some assistive technology tools which can be used to help students with ADHD remain focused, on-task, and motivated to learn.  An example of which is a MotivAIDER device which can be set to vibrate and display a motivational message at set intervals throughout the day reminding the student to remain focused.  Such devices can help keep students on-task and can lead to greater productivity in students with ADHD.

Time aids: These can be used to help improve time management in students with ADHD.  It can be difficult for students with ADHD to comprehend and manage time effectively, therefore these tools help to make the passage of time more understandable and concrete by providing a visual timer that can actually show them the passage of time. Timetimer.com have a number of different visual timers available where the coloured disk disappears as the set amount of time elapses.

Fidget toys: A low-tech option is one of a variety of 'fidget toys' which can help to keep the hands of students with ADHD busy in a way that is not distracting for others and is both soothing for the student and can also assist in keeping them on-task.  A number of such toys are listed here: https://www.additudemag.com/slideshows/fidget-toys-for-classroom-focus-top-picks-for-adhd/

There are also a number of strategies that can be implemented to assist a student with ADHD in the classroom:

Seating the student near the front of the class and away from areas where there are many potential distractions.

Planning for periods of movement around the classroom and avoiding having students sat in one place for extended periods of time.

Breaking tasks down into manageable steps and providing students with a visual of the day's schedule.  As a lesson or task is completed, the teacher can cross it off the list.

Using a timer in class and telling students how long they have to work on a particular task.

Establishing a classroom routine with clear rules which could be displayed in picture form around the classroom as visual cues.

Alternating activities and allowing for smooth transitions between activities by informing (and showing) students how much time remains for each activity.

Highlighting important information for the students and providing plenty of positive feedback to recognize their achievements.

The following website provides an extensive list of strategies that can be implemented to assist students with ADHD: https://do2learn.com/disabilities/CharacteristicsAndStrategies/AttentionDeficitDisorder_Strategies.html

References:

Attention Deficit Disorder (ADD). (n.d.). Do2Learn. Retrieved March 13, 2022, from https://do2learn.com/disabilities/CharacteristicsAndStrategies/AttentionDeficitDisorder_Strategies.html

Dean, R. (2015, January 2). A Gadget for Every Need: Assistive Technology for Students. Edutopia. Retrieved March 15, 2022, from https://www.edutopia.org/discussion/gadget-every-need-assistive-technology-students

Dragoo, K. E. (2020, October). The Individuals with Disabilities Education Act: A Comparison of State Eligibility Criteria (No. R46566). Congressional Research Service.

Flewelling, J. (2016, April 5). How Does ADHD in Children Impact Academic Performance? Beyond Book Smart. Retrieved March 15, 2022, from https://www.beyondbooksmart.com/executive-functioning-strategies-blog/how-does-adhd-in-children-impact-academic-performance

Jangmo, A., Stålhandske, A., Chang, Z., Chen, Q., Almqvist, C., Feldman, I., Bulik, C. M., Lichtenstein, P., D’Onofrio, B., Kuja-Halkola, R., & Larsson, H. (2019). Attention-Deficit/Hyperactivity Disorder, School Performance, and Effect of Medication. Journal of the American Academy of Child & Adolescent Psychiatry, 58(4), 423–432. https://doi.org/10.1016/j.jaac.2018.11.014

LibGuides: Attention Deficit Hyperactivity Disorder/Attention Deficit Disorder (ADHD/ADD): Common Assistive Technologies. (n.d.). Illinois Library. Retrieved March 15, 2022, from https://guides.library.illinois.edu/c.php?g=490037&p=3350464#:%7E:text=Scanning%20pens%20help%20people%20with,their%20reading%20comprehension%20and%20speed.&text=This%20text%2Dto%2Dspeech%20software,individuals%2C%20schools%2C%20and%20institutions.

Lombardi, P. (n.d.). Assistive Technologies to Support Students with ADHD – Understanding and Supporting Learners with Disabilities. Pressbooks. Retrieved March 15, 2022, from https://granite.pressbooks.pub/understanding-and-supporting-learners-with-disabilities/back-matter/assistive-technologies-to-support-students-with-adhd/

Schafer, E. C., Mathews, L., Mehta, S., Hill, M., Munoz, A., Bishop, R., & Moloney, M. (2013). Personal FM systems for children with autism spectrum disorders (ASD) and/or attention-deficit hyperactivity disorder (ADHD): An initial investigation. Journal of Communication Disorders, 46(1), 30–52. https://doi.org/10.1016/j.jcomdis.2012.09.002

Stanberry, K., & Raskind, M. H. (n.d.). Attention Required! | Cloudflare. Reading Rockets. Retrieved March 15, 2022, from https://www.readingrockets.org/article/assistive-technology-kids-learning-disabilities-overview

Stanberry, K., & Raskind, M., PhD. (2022, February 18). Assistive Technology for ADHD Challenges at School. ADDitude. Retrieved March 15, 2022, from https://www.additudemag.com/change-the-program/

What is ADHD? (2021, January 26). Centers for Disease Control and Prevention. Retrieved March 15, 2022, from https://www.cdc.gov/ncbddd/adhd/facts.html#:%7E:text=ADHD%20is%20one%20of%20the,)%2C%20or%20be%20overly%20active.

Young, G., & MacCormack, J. (2018, May 4). Assistive Technology for Students with Learning Disabilities. LD@school. Retrieved March 13, 2022, from https://www.ldatschool.ca/assistive-technology/

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

Assistive Technologies:
Assistive Listening Device (ALD) - help amplify sounds. ALDs can be connected to cochlear implants or hearing aids.

Hearing Loop - use electromagnetic energy to transmit sound.

4 parts of a hearing loop are:

A sound source, such as a public address system, microphone, or home TV or telephone

An amplifier

A thin loop of wire that encircles a room or branches out beneath carpeting

A receiver worn in the ears or as a headset

An amplified sound travels through the loop and is picked up by the receiver near the loop, worn by a person with hearing loss.

FM systems - use radio signals to transmit amplified sounds

The teacher uses a small microphone that is connected to a transmitter tuned to a specific FM channel.  The student with the receiver tuned into that channel can hear what the teacher is saying more clearly.  *Students using FM systems in different classrooms will need to be on different channels since the signal can be travel through walls.*

Infrared systems - use infrared light to transmit sound

A transmitter converts sound into a light signal and beams it to a receiver that is worn by a listener. The receiver decodes the infrared signal back to sound.  Since light cannot travel through walls, these systems are useful in classrooms.

Alerting Devices - devices that use lights or vibrations to alert someone with hearing loss that an event is taking place.

Alerting devices are useful to signify to a student that there is a fire drill, that the class is transitioning, or that the teacher is going to speak.  Think pagers and alarm clocks.

Accommodations:  Students who are deaf will rely more heavily on their sight.  Try these simple strategies!
- captioned media (age appropriate)
- interpreters
- extended time for work
- frequent breaks
- ALDs
- provide lots of visuals
- use facial expressions
- minimize background noise
- appropriate lighting
- be aware of anything blocking your face like mustaches, masks, hair, etc.
- never speak with your back turned to the student