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Dear Doctor Letter

Provincial Integration Support Program Suggestions

The following are plans written up by the Support team that advised Kayda’s school staff on how to include her. I present them here as an example of what can be done when a child with needs such as Kayda had, is included with typical children, especially at a higher level grade.

 

Excellent Activity List

The following is taken from recommendations for my daughter by the PISP (Provincial Integration Support program) team. I present it here to give families and school personnel a starting point in assessing the relevance of an educational program for a child with severe multiple challenges. Please remember that this information is specifically for my daughter and should be adapted for each individual child. Using your child's goals as stated on his/her IEP you would work to accommodate them into as many activities as possible.

In order for you to understand how the Excellent Activity list was chosen, I have included the goals that have been identified for my daughter. She is very severely physically, mentally, & medically challenged. She is visually impaired with improving but inconsistent vision. She sees best to either side. Although she has no words she communicates fairly clearly with noises, facial expressions & eye movements. She is fully included in her neighborhood school with her age appropriate peers. She has an excellent school based team who have worked very hard at implementing the recommendations given by the PISP team.

The following are the educational goals/skills identified for my daughter:

1. ____will attend to individuals or objects through her peripheral vision (eyes looking down to the side and face tilted away) when approached either on her right or left side no more than 1 or 2 feet away. 

2. _____will keep her head up for longer periods of time when placed in a more upright seating position.

3. _____ will anticipate upcoming activities through physical contact with familiar object cues for routine activities.

4. ____will activate a switch with her head*, with decreased prompting to:

·        provide voice output (when attached to the Big Mack)

·        increase her independence through partial participation

·        provide assistance to others  engage in leisure activities

·        get attention from others (initiate)

*the week she was assessed by the team, ____didn't use her hands much and the team felt she had no purposeful movement of them. For that reason they wanted her to use a head switch. Throughout the year though she used her hands more and more and was very definitely purposefully activating her switches and meeting all of the above goals with her hands. The head switch was rarely used.

5. _____will use vocalizations, gestures, body tone, breathing changes and facial expressions to communicate, (with continued reinforcement through verbal feedback from her personal dictionary. (The personal dictionary is covered in chapter 8 Learning to “Read” your child)

6. ____will relax to allow stretching through reaching with her arms, and

opening her grasp when interacting with people and materials.

Using the above skills/goals a checklist was drawn up to use to see how many of her goals were being used in planning activities for her.

Excellent Activity Checklist

When creating a new activity for _____, try to build in as many of the following components to create an ideal learning environment for her.

1. Object cues & Calendar/Sequence Box: Pair familiar object cues from the Calendar/Sequence Box before/during and upon completion of routine activities to help build anticipation for _____

2. Tilting chair forward: For specific activities and periods of time, encourage _____to work on developing strength in her upper body by sitting in a more upright position in her wheelchair.

3. Expectations for Vision: Assist ____ in sustaining her visual attention to a person/object by positioning in her peripheral visual field (either to her right or left).

4. Switch Use: Build in opportunities for ____to use her switch at some point in each activity (either using the Big Mack or any other electrical appliance, etc.

5. Peers: Incorporate one or more peers interacting directly with _____. They can coach her and reinforce her when working on her skills. Make sure peers are aware of the skills ____is working on.

6. Personal Dictionary: Provide ____ with verbal feedback regarding her vocalizations, gestures, facial expressions, etc. throughout the activity. Let her know when you recognize that she is enjoying an activity or has had enough or the activity. 

7. Multi-Sensory Feedback: Some activities (switch related in particular) may require extra sensory feedback to motivate____. The Powerlink II (ablenet- I think) can be used with 2 devices (sound, lights, or sensation) and this can also be paired with animated voice and physical contact from those working with____. <This wasn't used much as she didn't really seem to need it.>

8. Talk about Anticipated Sensory Experiences: ____is less apt to startle when individuals talk to her about sounds or sensations which may trigger this response. <an over active startle was a big problem at the time of the teams' visit>

9. Meaningful Activities-Motivating Factors: In order for _____ to be motivated to engage, the activity needs to have meaning or "pay-back" for _____. Where possible, try to build in some of the following motivating factors for____.

·        animated voice
contrast of light in a darkened room
 peers
 familiar voices
 music
 fan or air blowing in her face
 children's songs
 touch (e.g., gentle stroking of her arms)
 praise
combination of sensory feedback

10. Purpose and Function: Does the activity have a real purpose and function for either ____ or others?

11. Time to Respond: Provide ____ with adequate time to respond to requests (particularly when using her switch.) Pick and choose the times when you will step in and assist her or provide graduated prompting. Build in opportunities when you have the time to truly wait for ____ to respond in her own time frame.

 

Activity Matrix
This following activity matrix is presented here to show another way of making sure that the activities of a child have relevance to their stated goals.

Introduction:
When using the activity matrix and developing future activities, it is important that all individuals understand why they are engaged in various activities and are grounded in the philosophy behind the strategies involved.  When generating activities for ________, her team will look for opportunities to reinforce the following functional skills for _______.

 

_______'s Jobs or skills:

1. _____will respond through the use of vocalizations, facial expressions and/or body gestures to indicate her desire to continue on with an activity.   (Pause periodically and ask her if she wishes to do more of the activity).

2. _______ will activate a switch with verbal (& or physical) prompting for a variety of functional activities to provide social feedback, sensory stimulation and service to herself and others (e.g. Big Mack, Big Red Switch).

 

Subject

Class Activity

Child’s Activity

Language Arts

Writing (Autumn/Harvest)

“Object Scrapbook”: _____could collect souvenirs from her school field trips, which can be placed into a theme related bin.

These can be reviewed with _____ and a classmate for sensory stimulation. Items could include moist and dry leaves to scrunch with hand over hand, a pumpkin to clean out with ____’s bare hands, etc. If____ seems to be enjoying the sensation, stop, look for a response, reinforce verbally with a scripted routine from the personal dictionary and then continue with the activity.

For all activities, engage _____ with her sensory cues before starting each activity, if possible. _____’s  job is to experience the touch, sound or smell of the object and learn to anticipate the upcoming activity.

School trips could involve a visit to the farm when studying about Pilgrims or Harvest.

________could use her switch to blend respie items from various dishes using vegetables from the field. She can also taste, smell and feel each item as it is being introduced to the recipe. Note _____’s response to the various sensory experiences and frequently use the “personal Dictionary” scripted routines, (eg., “I see you……; I think you are telling me:…….”, Respond). This could be set up at a station in the room where classmates would work with ______ and her S.E.A. when they finish their work. Peers should be encouraged to use the scripted routines with ______as well.

Socials

Indian Legends

_____might bring in a salmon to bake for the class as part of an Indian supper. She could use the switch to grind up oion, lemon and herbs to sprinkle over the fish. Expose her to smells and touches of the fish, lemon and onion, etc. (During this sensory experience, utilize the “personal Dictionary” and/or other scripted routines.)

______uses her red dot switch and Able Net control box to activate a blender or other equipment to make a recipe which relates to a theme with peers at a center, (e.g. cookies shaped like Indian Legendary characters, such as the raven, etc.

For story writing, classmates can read their stories about Indian Legends, into the tape recorder. _____ can use a switch (with delay timer) to play it back to the class for sharing time or author’s corner.

______could use her “Big Mack” for voice output in a play about an explorer who became friends with a native Indian group. Some class mates could put on the play with ______ . She could also operate a switch with sounds effects such as the chanting of an Indian tribe.

_____and classmates could color large two sided paper totem poles with paint (finger) or smelly felts, (hand over hand), which can later be stuffed with news paper and stapled together. During the sensory experience, stop and look for a response from ___. Follow through with “Personal Dictionary” and/or other scripted routines.

Science

Mammals

________could use a switch to activate a tape recorder or record with mammal sounds on it (e.g., whales) while the class is working on a writing project about endangered animals. Use the AbleNet delay timer set for a few minutes at a time.

_______could use pudding or finger paint to create interesting pictures on large sheets of paper. Use different parts of her hand and fingers for varied sensations and effects. (Note ___’s reactions and implement ‘personal Dictionary” and/or other scripted routines.) Peers could do this with ____as well. This would be an interesting and fun station in the class. After the painted sheets dry, cut out the shape of various mammals. Classmates have to guess by the shape, which mammal it is. Clues could be posted on ___’s Big Mack.

Use a switch operated mix master for play dough or cookie dough to make models of mammals and their habitats. You may wish to add scents ____responds to.

Use a litebrite to create mystery pictures of mammals which classmates have to guess. The classmates create the pictures and _____could use a switch to illuminate the pictures. Check this activity out with your local vision teacher to see if it would be motivating for ____.

Program ____’s Big Mack with an interesting fact of riddle about mammals for the morning. Use the tactile cues before starting this routine activity each morning, if possible. ____’s job is to feel the object and learn to anticipate the upcoming activity. Classmates will need to reinforce her for this activity as _____will not get much out of the information itself. Reinforcement can be verbal or physical, (e.g., a stroke on her arm or a squeeze of her hand.)

Have _____pop popcorn with a switch before a movie about endangered animal. In this way, she is contributing something enjoyable to her classmates. Place her other hand on the popcorn popper to experience more sensory stimulation.

 

 Other pages in this section:
School
School Experiences
Suggestions For Inclusion
Sample Books


 

 

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