Inclusion

TACA Talk About Curing Autism Education, Support, & Hope

Topic - Inclusion 

A parent’s detailed journey of Autism, biomedical & traditional therapies and a fully included child

Disclaimer This presentation is not medical, legal or educational advice for your child.  This presentation is an outline of how inclusion worked for one child on the spectrum.  My back ground?  Part of this presentation is from Cathy Beier and me 

First Some Definitions – according to Webster’s 

Inclusion 1.the act of including. 2.the state of being included. 3.something that is included.  According to IEP’s: A child with disability who receives education in a regular education setting. 

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Mainstream 6.to place (handicapped students) in regular school classes. –verb (used without object) 7.to join or be placed in the mainstream.  Typically this is “part” of the education day – not the “entire” day 

Inclusion “schools of thought” 

Some experts believe: A

leaning towards typical kids being placed with their peers – with no outside disruptions or children with disabilities  A leaning towards EVERY child should be included on some level with no exceptions  I don’t like either. I would say the child’s unique needs & capabilities should dictate the setting + what the parents see for their child = placement

Prerequisite General Understanding 

Rick Clemens – Inclusion specialist:  There

are no cookie cuter approach to including children with ASD, but rather conceptual understandings & principles that should be applied in the analysis, development & on-going evaluation of each child’s education program.  Children with ASD can learn incidentally & will model from their peers given the right learning environment & interventions.

Prerequisite General Understanding

– continued  IDEA does not require that a student demonstrate achievement of a specific performance level as a prerequisite for placement into a regular classroom. 64 Fed Reg. 12371 (3/12/99) 34 C.F.R. Part 300. App A. Q. 1

Whose Child can be included?

YOURS!!!

Why Choose Inclusion? 

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By law, every child is entitled to “access the general education curriculum” – full inclusion is the most/least your child is due May be easier to negotiate NPA services for a child in general education Setting a bar for your child to “rise” to Inclusion is NOT to deny the reality of autism – but create a plan around the issues

Recommendations for Inclusion  

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Where the child can benefit & reach goals Optimally where the child has: some observational learning, imitation, problemsolving skills, & low to average I.Q. Absence of severe, self-injurious, assaultive behaviors Adequate self-help skills including independent toileting Decent and safe local public school Qualified & trained shadow aide Independent assessments identifying recommended placement  For more reading http://www.tacanow.org/evaluations.htm

THESE ARE NOT REQUIREMENTS FOR A CHILD TO BE INCLUDED !!!

Parties to the Inclusion Relationship

Child with Autism

Parent(s )

Shadow Aide

Classmate s

Teacher

Evaluate Conditions for Inclusion The Big FOUR 1. Assessments 2. Environment 3. Teacher 4. Support

The big four: Assessments 

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Assessments are the key to identifying the child’s unique needs, complete assessment outlining intelligence / capabilities, goals & recommendations with PLACEMENT designation Assessments should address: behavioral, speech, occupational, academic & psychological needs. For more reading please see: http://www.tacanow.org/evaluations.htm

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It is typical for children on the to can have academics “scatter skills” Note: Academics in SDC (Special Day classes) do not always follow the state academic standards

The Big Four: Environment 

All of the factors play a key role in the placement recommendations and training considerations for the staff working with the child

The Big Four: Environment 

The classroom, playground & other areas should be studied & reviewed for the needs of the child

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SDC & Regular education settings typically include a multitude of children with a variety of disabilities 1

in 6 children in U.S. school have a neurological disability

The Big Four: Environment 

Some areas to review: How distracting is the classroom?  How busy is the classroom?  How many children are currently in the classroom?  Where is the location of the classroom? (relative to exits, restrooms, cafeteria, etc.)  How is the “friendliness” of the peers?  What type of playground & recess areas are available to all children? (who will be on the playground in your child’s designated recess times?) 

The Big Four: Teacher 

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The teacher is one of the most important players in the team His/her involvement, teaching style, (such as visual supports,) willingness to adjust learning presentations as needed, & willingness to learn is crucial to the solution.

The Big Four: Teacher 

Some clues for success: A

good ways of two-way communication from the regular education teacher and the “team”  Regular attendance of the child’s IEP’s  Occasional attendance of the child’s clinic meetings  Additional training received (if needed)  Parent & team support of their efforts

The Big Four: Teacher  

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Make them feel an Important part of the team Support their efforts (be in the classroom to help or help in different ways) Assist them in obtaining necessary training or additional materials Provide ongoing support input & troubleshooting if need be Responsibility of the IEP goals is not just on their shoulders

The Big Four: Support 

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The school site & staff play a pivotal role in a inclusion experience This includes: school resource workers, principal, on site assessors, & administrative staff These people should look at inclusion as something to grow to & believe in for all children on campus

The Big Four Add up – now what? 

Placement considerations & preparation should include:  Behavior

plan  Visual or auditory support plan  “Primer” to prepare child for all aspects of their day  Social Stories  A Dedicated Shadow Aide

Placement: Behavior Plan 

But you said inclusion consideration should be “Absence of severe, selfinjurious, assaultive behaviors” 

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This will NOT preclude a child from being included

Sometimes behaviors crop up and their should be a way to address them Team should be “experts” on identifying behaviors and protocols on addressing them Review the behavior plan regularly with updates as necessary

Placement: Visual or auditory support (or other area) 

Some ASD children have strengths or deficits in Visual processing  Auditory processing 

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Visual supports 

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Smart boards / teaching materials with a visual flare

Auditory supports 

FM Device

http://www.tacanow.org/auditory%20_processing.htm 

Modified curriculum requirements should be made based on the childs needs

Placement: “Primer” 

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What is the curriculum or Standards for the year? What does your child require assistance with? 

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i.e. abstract concepts, writing, etc

Do you need materials at home for reinforcing what is taught during the day? Prepare your child for the classroom schedule 

Then shake it up after they are used to it! Flexibility is an important item to teach!

Placement: Social Stories  

Carol Gray created Social Stories www.thegraycenter.org What is a social story? The Social Story™ describes a situation, skill, or concept in terms of relevant social cues, perspectives, and common responses in a specifically defined style and format. The goal of a Social Story™ is to share accurate social information in a patient and reassuring manner that is easily understood by its audience. Half of all Social Stories™ developed should affirm something that an individual does well. Although the goal of a Story™ should never be to change the individual’s behavior, that individual’s improved understanding of events and expectations may lead to more effective responses.

Social story samples

More social stories

And more social stories

And more

And more

A Dedicated Shadow Aide 

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Throwing the ASD child in the “deep end of the pool” without support is a recipe for failure A dedicated, trained one-on-one aide needs to be part of the solution Preferred solution is provided by an NPA (non public agency) that is managed, receives on going training & support The guide

Child and Shadow Aide 

The shadow’s job is to compensate for the child’s deficits of autism  Keep

child on task  Keep child safe 

Watch out for dietary infractions, teasing

 Provide

extra positive/negative reinforcement as needed  Break down and/or re-teach academics  Make child a desirable playmate!

Child and Shadow Aide 

The shadow’s job is not:  To

come between the child and teacher/classmates  To babysit the child off in a corner  To spy, tattle, gossip, speculate, or cause trouble  To keep self amused and entertained at all costs!

Child and Shadow Aide 

Great Shadow!  Has

the heart, and the head, for the job  Continuously adjusting degree of interaction depending on child’s needs moment-to-moment  Knows your child’s ability/disability and helps child optimize school performance  Liked and trusted by you, your child, the teacher, and the classmates  Understands that ultimate job is to get rid of self!

Child and Shadow Aide 

Bad Shadow!  Overbearing,

intrusive, possessive of child  Lazy, indifferent, bored by job and can’t sustain attention  Drama queen/king, highmaintenance, political  Acts superior to other adults at school, dismissive to classmates, disruptive or unpleasant in any way

Helpful Shadow Aide! 

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Shadow should help the teacher and classmates whenever child’s needs permit No teacher likes to feel spied-on, upstaged, criticized or just annoyed in his/her classroom Your goal: When the teachers meet to assign classes for next year, they should argue about who GETS to have your child, not who HAS to have your child

A Note on Proper Rewards   

Going to school, learning, keeping it together & being social is TOUGH Proper motivation is key Samples of Motivation Charts

http://www.tacanow.org/tantrum.htm

Preparing for the First Day 

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When should the child start? (first day for everyone or a period after school starts & calms down) How often should they attend & grow to? (three days in the morning to full time) Several visits to play on the playground, visit the new classroom and meet the new teacher is recommended

What do you say to his peers? 

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Gary Cole – recent interview on Larry King Sutters family – a parents comment at the beginning of school and what Sutter did for her family. Or say nothing! Articles to share:  How

to befriend a special needs child

http://www.tacanow.com/pdf/news_ocparenting_sept2006.pdf

 Their

Own Buddy System (a success story)

http://www.tacanow.com/enewsletters_archive/October_2006_1.htm#3

Case Study of One - Jeff 

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Diagnosed: moderate to severe autism, auditory processing disorder, severe apraxia & reading comprehension disorder – non verbal 15 mos to 5YO Prior to Kindergarten: From age 3 in home ABA – 40 hours, 5 hours speech & 2 hours OT a week Social skills: typical preschool in play times and managed/orchestrated play dates Thousands of in home therapy hours before kindergarten

Biomedical + Traditional Therapies 

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Biomedical Interventions used (based on medical tests!)  Diet! Organic, clean, natural, no dyes / preservatives or additives.  Supplementation: MB-12, TMG, Levocourin, Lipoceutical & Nebulized Glutathione, Methionine, Calcium, Selenium, CoQ10, Vitamin C & E, Zinc, Cod Liver Oil  Chelation: so much – DMSA, EDTA, TTFD & TD-DMPS  IV products: Glutathione, NAC, Vitamin C, Secretin (started w/ topical/oral – then went to nebulized)  Prescriptions: for yeast Ketakonozole & Diflucan (get compounded!! Note: these are pulsed not constant.)  Epsom salt baths Traditional therapies provided – serious 1-on-1 hours!  Applied Behavioral analysis & Social skills training – www.lovaas.com  Speech – www.apraxia-kids.org (Aug communication was used during non-verbal days: www.dynavoxsys.com, www.pecs.com)  Occupation Therapy – www.out-of-sync-child.com  Augmentative: Fast Forword www.fastforword.com , Tomatis www.swaincenter.com , Interactive Metranome www.interative metranome.com , Auditory Trainer for Aud. Processing issues: www.phonak.com

Case Study Placement 

Independent Assessments demonstrated Low average I.Q. (originally diagnosed MR by the school district)  Behaviors were manageable  Desire to be around typical kids & play skills emerging 

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Professionals & Parents identified optimal setting = Plan “A” With a plan B, plan C & plan D  With a definition of “success” and “seek other option” defined by the NPA team & parents 

What Jeff’s Placement Looked like 

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Year 1: Kindergarten – SDC “Language Delay” with 7 children, teacher, teachers aide & Jeffs aide Year 2: Kindergarten – typical with 20 students, teacher & Jeffs aide Year 3: 1st grade – typical with 20 students, teacher & Jeffs aide Year 4: 2nd grade - with 20 students, teacher & Jeffs aide Year 5: 3rd grade - with 20 students, teacher & Jeffs aide

Lessons Learned             

Meet with teacher in advance (provide copy of goals, IEP & books) Jeff meet his new teacher prior to start of school Talk honestly about issues & strengths Regular meetings & calls for input Pre-load curriculum that needed “preloading” Create & follow a schedule & routine (then break it!) Jeff’s FM device was a savior Sometimes paying attention “looks different” Set goals that justify placement & services Provide proper motivation Raise the bar so your kids can rise to it Independent assessments ROCK Trust your instincts

Note for Non Verbal Students 

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Non-verbal students should not be precluded from being fully included Alternative communication strategies:  Letter

boards (Halo-org)  Alternative Communication Devices  PECS (Picture Exchange Communication System)

Resources – Web sites

General Information:  Autism: www.tacanow.org  Applied Behavioral Analysis: www.lovaas.com  Apraxia: www.apraxia-kids.org  Auditory Processing Information: http://www.ncapd.org/  Inclusion web resources:  www.inclusion.org/  www.uni.edu/coe/inclusion/  www.emtech.net/inclusion.htm  www.vvsd.org/avm/inclusio.htm  www.nichcy.org/pubs/outprint/nd24txt.htm  www.newhorizons.org/spneeds/inclusion/information/fro

Resources - Books 

Books for you, teacher & professionals Inclusive Programming For Elementary Students with Autism – Shelia Wagner  Visual Strategies for Improving Communication – Linda Hodgon  You’re Going to Love this Kid! Paula Kluth  Addressing the Challenging Behavior of Children with High-Functioning Autism/Asperger in the Classrom – Rebeccca Moyes  Inclusive Programming for Middle School Students with Autism – Shelia Wagner  The New Social Story Book: by Carol Gray 

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For your aides: 

How to be a ParaPro – Diane TwachtmanCullen

Conclusion 

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Inclusion can be the best, or the worst, placement for your child – your vigilance and support are necessary for success Nothing is forever – stay aware of your child’s placement options and ready to make a change when/if necessary Inclusion is a reality for any child with a disability

Conclusion 

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(really!)

Not only does the special need child benefit from inclusion - EVERYONE benefits from inclusion! The teachers, the typical kids, the school site staff, the community – EVERYONE. Inclusion starts in preschool and continues throughout adulthood.

Questions & Answers 

Thank you

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TACA Article on Inclusion:

http://www.tacanow.com/inclusion_an_editorial.htm