FOUNDATIONS OF SPECIAL AND INCLUSIVE EDUCATION

TOPICS: Learners with Difficulty Walking/Moving (Physical/Ortophedic Impairment)

Learners with Difficulty with Sef-Care

TASK 1: Make a hand written tabular graphic organizer of the 2 topics following this format.

( Use the fact sheets given)

Learners with Difficulty Learners with Difficulty with

Walking/Moving Self Care

Definition

Identification

Learning Characteristics

Types (If there are any)

Causes it

General Educational
Adaptaions/Teaching Strategies

Interventions

TASK 2
1. Why intervention is important for the different impairments?
2. Why teachers' are not allowed to identify some specific impairments and disabilities?
3. Who should identify the types of interventions be applied to a specific impairment? Why?
4. When can parents, teachers and care takers perform the interventions? When are they not
allowed?

Self Care Skills

 What are self care skills?

Self care skills are the everyday tasks undertaken so children are ready to participate in life activities
(including dressing, eating, cleaning teeth). They are often referred to as the activities of daily living
(ADL’s). While these are typically supported by adults in young children, it is expected that children
develop independence in these as they mature.

Why are self care skills important?

Self care skills are one of the first ways that children develop the ability to plan and sequence task
performance, to organise the necessary materials and to develop the refined physical control required
to carry out daily tasks (e.g. opening lunch boxes, drawing or standing to pull up pants). Self care skills
act as precursors for many school related tasks as well as life skills. The term ‘self care’ would suggest
that these skills are expected to be done independently and in many cases it becomes inappropriate for
others to assist for such tasks (age dependent of course). More specifically, many preschools and
schools will have a requirement for children to be toilet trained prior to starting at their centre.

When self care skills are difficult, this also becomes a limiting factor for many other life experiences. It
makes it difficult to have sleep overs at friend’s or family’s houses, to go on school/preschool excursions,
children may standout at birthday parties if they are not comfortable eating and toileting independently,
they may experience bullying or miss out on other social experiences as a result.

What are the building blocks necessary to develop self care skills?

Hand and finger strength: An ability to exert force against resistance using the hands and fingers for
utensil use.

Hand control: The ability to move and use the hands in a controlled manner such as cutlery use for
eating.

Sensory processing: Accurate registration, interpretation and response to sensory stimulation in the
environment and one’s own body.

Object manipulation: The ability to skilfully manipulate tools, including the ability to hold and move
pencils and scissors with control, controlled use of everyday tools such as a toothbrush, hairbrush, and
cutlery.

Expressive language (using language): The use of language through speech, sign or alternative forms of
communication to communicate wants, needs, thoughts and ideas.

Planning and sequencing: The sequential multi-step task/activity performance to achieve a well-defined
result (e.g. dressing and teeth cleaning).
Receptive language (understanding): Comprehension of language.

Compliance: Ability to follow simple adult-directed routines (i.e. doesn’t demonstrate avoidance
behaviours where the child simply doesn’t want to do it because an adult is telling them to do it and
interrupting what they were doing).

How can you tell if my child has problems with self care skills?

If a child has self care difficulties, they might:

Be unable to feed themselves independently.

Require more help than others of their age to get dressed or undressed.
Find it difficult to tolerate wearing certain clothes.
Struggle to use cutlery.
Need adults to open food packaging in their lunch box.
Refuse to eat certain foods.
Be unable to coordinate movements to brush teeth.
Require extensive help to fall asleep.
Choose to toilet only at home where there is adult support.
Be late to develop independent day time toileting.
Show limited motivation for independence in self care, sot hey wait for adults to do it for them instead.

What other problems can occur when you see difficulties with self care skills?

When a child has self care difficulties, they might also have difficulties with:

Following instructions: The ability to understand and be able to initiate the tasks to be done as per
requested by others.
Receptive language (understanding): Comprehension of language.
Eating: The physical skill of using cutlery in an age appropriate manner as well as eating a good range of
food.
Sleeping: Being able to independently settle and resettle to get to sleep.
Dressing and undressing or assisting with dressing to an age appropriate level and recognising what
articles of clothing go where and in what order.
Social skills: Determined by the ability to engage in reciprocal interaction with others (either verbally or
non-verbally), to compromise with others, and be able to recognize and follow social norms.
Fine motor skills: Finger and hand skills such as opening lunch boxes, tying shoelaces, doing up buttons.
Gross motor skills: Whole body physical skills using the ‘core’ strength muscles of the trunk, arms, legs
such as getting on and off the toilet and standing to dress.
Organisation: The ability to know what a task involves, the materials required, how to collate them such
as packing the bag for preschool or even getting dressed.
Learning new tasks and retaining that information for the next time the task is done again.
Executive functioning: Higher order reasoning and thinking skills.

What can be done to improve self care skills?

Visual schedule of the steps involved.

Reward chart for independent completion of tasks (or attempt at, in the early stages).
Small steps: Breaking down self-care skills into smaller steps and supporting the child through each step
so that, in time, they can do more for themselves.
Routine: Use the same routine or strategy each time you complete the same task to help them learn it
faster.
Consistency: Be consistent with the words and signs used to assist the child, and keep instructions short
and simple.
Allow enough time: Ensure that there is enough time available for the child to participate in self care
activities without feeling rushed (e.g. practice dressing on the weekend to start with before then doing it
before rushing to preschool or school).

What activities can help improve self care skills?

Small parts of activities: Practice doing a small part of a task each day as it is easier to learn new skills in
smaller sections.
Observation: Have your child to observe other family members performing everyday self care skills.
Role play self care tasks such as eating, dressing or brushing teeth with teddy bears. Doing it on others
can help learning it before then doing it on yourself.
Take care of others: Allow the child to brush your hair or teeth first, before brushing their own.
Timers to indicate how long they must tolerate an activity they may not enjoy, such as teeth cleaning.

Why should I seek therapy if I notice difficulties with self care skills in my child?

Therapeutic intervention to help a child with self care difficulties is important as:

Self care skills are the every day practice of the foundations skills for academic performance not just life
skills.
The more these tasks are performed incorrectly (i.e. often daily) the more the bad habits are reinforced.
To support age appropriate independence before these skills become a problem such as at school camps
for older children or much desired sleep overs for kind aged children.

If left untreated what can difficulties with self care skills lead to?

When children have self care difficulties, they might also have difficulties with:

Reluctance to attempt not only self care skills, but many other skills that require planning and
sequencing. This is then likely to impact on academic tasks and potentially a child’s transition into
preschool or school.
More difficulty resolving the difficulties as it becomes harder to change.
Reliance upon an adult helper: A child may become accustomed to having a parent or carer assisting
with self care skills to the point it becomes an expectation, so when a helper is not there, they might
display behavioural challenges.
As the child gets older and the gap between them and their peers increases, they are more likely to
become aware of this gap, resulting in lowered self esteem and possible reluctance to attempt activities
for fear of failure. This is a difficult cycle to break so the earlier it is resolved the easier it is to make
forward progress.

What type of therapy is recommended for self care skill difficulties?

If your child has difficulties with self care skills, it is recommended they consult an Occupational
Therapist.

Physical Disability

Physical activity and mobility may be impaired by a number of conditions, some of which are
permanent, others of a temporary or intermittent nature. These conditions include cerebral palsy,
arthritis, muscular dystrophy, multiple sclerosis (MS), Parkinson’s disease and repetitive strain injury
(RSI). Back or neck injuries may also affect general mobility. A stroke may result in temporary or
permanent loss of feeling or movement of part of the body – frequently on one side. Speech and vision
may also be affected in students with cerebral palsy and multiple sclerosis for example, and in those
who have suffered a stroke.

Coordination and balance may be mildly or severely affected by any of these conditions. Movement may
be impaired by muscle spasms, numbness or pain. As a consequence, both manipulation of equipment
and writing may be difficult. Some students use wheelchairs to enhance their mobility whilst others will
walk with the aid of callipers, crutches or walking stick. Some students may experience chronic fatigue
and for others there will be extreme fluctuations of energy from day to day.

Physical disability may also result from head injury (ABI – acquired brain injury). Increasing numbers of
students are returning to education following vehicle or sporting accidents in which they have sustained
some degree of brain injury. Resulting impairment may affect speech, vision or coordination, and the
injury may also be responsible for personality disorders or depression.

In providing accommodations for students with physical disabilities we need to remember that some
conditions are characterised by periods of remission, so the disability will not always be visible and will
not always impact on the student’s ability to function in the educational environment in the same way.
Each learner with a physical disability should be assessed individually and accommodations should be
implemented based on the unique needs of each student.

Impact of a physical disability

The impact of physical disability on learning will vary but for most students the issues of most
significance relate to physical access, manipulation of equipment (e.g. in a laboratory), access to
computers, participation in field trips and the time and energy expended in moving around campus.
Students may be affected in the following ways:

When there is limited time to move between venues, students may miss the beginning of a class.
Fatigue is common for many of these students. Using facilities that others take for granted, such as
toilets, food-outlets, libraries and lecture rooms, may be a major undertaking.

Some students may experience functional difficulties: an inability to write using a pen; reduced writing
speed; involuntary head movements which affect the ability to read standard-sized print; and reduced
ability to manipulate resources in the learning environment. They may have difficulty turning pages or
using standard computers.

Students may have frequent or unexpected absences from class owing to hospitalisation or changes in
their rehabilitation or treatment procedure. Earlier periods of hospitalisation may have meant gaps in
schooling.

Students with a long-standing mobility disability may have experienced gaps in their schooling due to
periods of hospitalisation.This may have affected their confidence in learning.

Students with a mobility impairment may have fewer opportunities for interaction with other students.
Feelings of separateness in the learning environment may have an impact on learning.

Teaching Strategies

There is a range of inclusive teaching strategies that can assist all students to learn but there are some
specific strategies that are useful in teaching a group which includes students with physical impairment.

The fact that students have a mobility disability may not always be immediately apparent. Needs will
vary, and difficulties may fluctuate. Some students will choose to disclose their disability; others will not.
At your first lecture, you might invite any students who have a disability to contact you for a confidential
discussion of their specific learning needs. You might also ask students what, if any, information would
need to be shared with other members of staff, or with other students in the class. Below are some
further suggestions:

Students who use wheelchairs, callipers or crutches, or who tire easily, may find it difficult moving about
within the constraints of lecture timetables. Absence or lateness may be a result of the distance
between teaching venues, so at the end of a lecture you may need to recap any information given at the
beginning.

Check that academic activities which take place off-campus (such as industry visits, interviews or
fieldwork) are accessible to people with a mobility disability. Consider supplementary laboratory
practicals, films or videos as alternative options to field trips.

Students with a mobility disability may sometimes wish to use their own furniture, such as ergonomic
chairs or sloped writing tables. Extra space may need to be created in teaching rooms, but this should be
done unobtrusively.

Some students with back problems may prefer to stand in lectures or classes, rather than sit.
Some students may need to use a tape recorder or note-taker in lectures. Extra time is involved in
processing information acquired in this way. It is common practice in some departments to routinely
tape all lectures. This is a practice which will assist a variety of students, including those who may be
absent from time to time because of their disability.

Students may need extensions to deadlines for work involving locating and using library resources.
Provide reading lists well before the start of a course so that reading can begin early.

Academic isolation may be an issue for students who are unable to participate in some class activities.
One-to-one sessions with a tutor may help fill this gap in participation.

Assessment Strategies

In considering alternative forms of assessment, equal opportunity, not a guaranteed outcome, is the
objective. You are not expected to lower standards to accommodate students with a disability, but
rather are required to give them a reasonable opportunity to demonstrate what they have learned.

Students with a mobility disability may need particular adjustments to assessment tasks. Once you have
a clear picture of how the disability impacts on performance you can consider alternative assessment
strategies, such as those suggested below:

A reader or an oral examination (either presenting answers on tape or participating in a viva) are
alternatives to the conventional written paper. An oral examination is not an easy option for students.
Give the same time for an oral examination as for a written exam, but allow extra time for the student to
listen to and refine or edit responses. In your assessment, allowance should be made for the fact that
spoken answers are likely to be less coherent than written answers.

For some students the combination of written and oral examination will be most appropriate. Allow
students to write answer plans or make outline notes, but then to answer the question orally. Your
assessment should be based on both the notes and the spoken presentation.

Students may need to use a personal computer or a personal assistant in an examination. If so, it may be
necessary to provide extra space for equipment, or a separate examination venue if the noise from
equipment (e.g. a voice synthesiser) is likely to be distracting for other students.

Provide extra time in examinations for students who have reduced writing speed. Some students with a
mobility disability may need rest breaks. Take-home examinations and split papers may be options,
given that some students may need double time to complete examinations.

Allow extensions to assignment deadlines if extensive research involving physical activity (e.g. frequent
trips to the library or collection of data from dispersed locations) is required.