D9 Additional Disabilities Flashcards
Cognitive Disability and Brain Injuries
Vision Everything (depth, fixation, focusing, tracking, near, far, discrimination, integration, endurance)
Problem Solving ( concepts, basic life skills, appropriate responses)
Medications - side effects, medical responses, signs/triggers strategies
Expectations - length, exertion, activities, weather, location,
Teaching - task analysis, review/repetition,
Impacts:
Visual skills that can be affected by brain injury include tracking, fixation, focusing, depth perception, peripheral vision, binocularity, maintaining attention, visualization, near vision acuity, distance acuity, and visual perception
Loss of rote memorization of techniques.
Concept development, attention span, memory, abstract thinking, and generalization of skills across environments and problem solving.
Orientation in unfamiliar settings – become disorientated in unfamiliar environments.
Visual perception and auditory motor integration – cannot recognize landmarks..
Problem solving and decision making in the environment where they will travel – unable to figure out solutions to problems encountered.
Basic functional life skills – unable to complete activities of daily living tasks without prompting.
Awareness of and appropriate response to possible signs of danger – unable to determine safe road crossings, or drop offs.
Safe and proper interactions with strangers and community members – be too friendly with strangers and give inappropriate or unnecessary details to strangers.
Physical stamina and basic movement – unable to move for long distances or for a long time with a break leading to collapse or the trigger of some other health condition.
Strategies:
Create materials that give frequent reminders i/e memory aids
Limited use of aids with few prompts, then familiar without aids or prompts
Tape record speech about landmarks on route.
Route shapes.
Prompting – providing an additional cue or directive to achieve desired behaviour This is the providing of an additional cue during instruction. There are 6 types of prompting cues that can be used – Natural cue, position of student to objective, visual gesture or auditory cue, verbal or symbol cue, modelling and physical cue
Time considerations – scheduling for most beneficial time of day, program duration, and frequencyThis looks at the best time of day and length of lesson, also the length of time it takes to learn a skill and the time that it takes to adjust to a new environment or people
task analysis – breaking down whole skills into component parts: number of steps is individually determined is a system for refining curriculum by breaking down whole skills and concepts into their action sequence, parts, or steps. The purpose of task analysis is to simplify and reduce the demands on the student during instruction by teaching attainable units of a skill.
Forward chaining – progressive sequence of steps of a route working on completing a section of the route independently usually the beginning of the route.
Backward chaining – teaching the last section of a route first working on completing the last part of the route independently to begin with.
Sequenced instruction – short term goals are taught to achieve long term goals: narrow in scope may describe the order in which a set of short-term objectives are taught so as to achieve a long-range goal. Sequence may also be used to describe a series of events within a single activity, such as is found in a task analysis.
Interdisciplinary collaboration – working with other professionals to communicate the global needs of the learner. This strategy allows professionals to coordinate their efforts with other professionals and involve the family in strategies being taught. It also allows everyone to reinforce the same strategies. Teams are used to develop programs and strategies as well as identify responsibilities, priorities, and future directions.
Daily Routines, teaching learner in daily routine environments will be most comfortable and open in their daily routine. Fitting into that routine will work best for teaching functional skills. No transfer of skills needed to be figured out.
adapted mobility device (AMD) might be considered for a learner with cognitive disabilities as alternative when cane skills are too difficult (balance difficult) or to prepare for a future decline. It can also be useful in structured play when learning to reach for things. It allows the OMS to teach different skills that the student can feel before switching to a long cane and can be used as perquisite to long cane skills which will make it easier for learning long cane skills later.
Ten general program strategies for teaching students who have visual and cognitive impairments are teamwork, communication, planning and record keeping, time considerations, task analysis, sequenced instruction, environment, motivation, prompting, and choice making.
10 skills that are needed for students/clients with visual and cognitive impairments to participate and succeed in O&M instruction are attention, sensory integration, behavior, memory, concept development, generalisation, problem solving, social skills, orientation strategies, and mobility techniques.
Hearing Disabilities Strategies
Cue cards, tactile maps and body, interpreter, technology (TTY, phone, hearing loop), mini guide, signs/gestures, tactile signing, speaking to preferred side.
Issues:
Additional preparation made by the instructor learner include cue cards representative models, tactile shapes, drawing maps on learner’s backs/hands, scheduling an interpreter if appropriate.
Strategies:
interpreters
TTY (outdated)
Text apps on mobile phones
Sign Language
Computers
Email
Phones and tablets
Hearing loops (easy access to high-quality audio)
Printed material
Teach the use of Electronic aids like miniguide
Adaptations of basic O&M skills like guiding, shorelining
Tactile manipulatives/models
Draw shapes on back
Telecommunications
Cue cards (e.g. bus hailing kit)
Communication cards using keywords
Text to speech
Cell phone text window
Gestures
Recorded voice prompts
Tactile signing
Signs and symbols
Written language
Gestures or body language or facial or vocal expressions or expressions or demonstrations
Spoken voice
Recorded messages
Whistle
Tapping the cane
Looking around
A TTY (teletypewriter) is a communication device used by people who are deaf, hard-of-hearing, or have severe speech impairment. People who don’t have a TTY can communicate with a TTY user through a message relay center (MRC)
Mobility Disabilities
Adaptive Mobility Devices (walker, frame, crutches)
Usual stuff plus increased difficulty with uneven path and obstacles and transitions (doors, steps, turnstile etc).
Longer cane, miniguide, signs and techniques such as sweep and step for crutches.
Issues:
Clear pathway
Uneven surfaces
Contrast
Maintained equipment
Weather conditions
Negotiate ramps and buildings
Overhanging obstacles
Opening hinged doors.
Strategies:
Support canes
Walkers
Wheel chairs and scooters use of human guide adaptions, longer long cane. Adapted cane and technique to side.
AMD’s
Crutches
Braces
Scooter.
Prostheses – used to replace amputated body parts
Orthoses - splints or braces that are designed to either support joints during motion or to help maintain alignment of joints and prevent deformity
Wheelchairs and scooters
Walkers can be used with miniguide attached, sign, use of long cane adapted
Crutches use of sweep then step technique.
Canes – support/walking
Chronic Health Impairment
ISSUES - medication side effects, susceptible to illness,
STRATEGIES – short session, appropriate goals, exertion / challenges, location/weather (heat, cold), risk assessment and response.
General:
Wide range of health and systemic disorders, including but not limited to: diabetes, cancer, cardiac conditions, gastro-intestinal conditions, seizure disorders, renal disease, multiple sclerosis, lupus, sickle-cell anemia, fibromyalgia, AIDS
Issues:
shorter sessions in specific weather conditions, side effects of medication
Benefits : motor movement and action, independence and self confidence
Potential limitations – some medications have side effects that cause drowsiness or blood pressure changes or photosensitive or cataracts or blurred/double vision or changes in ocular pressure or nystagmus, Fatigue, ability to walk short distances only, limitations on physical exercise and exertion, seizures. Dizziness, sun sensitivity, endurance, vertigo sun downing (late day confusion, confusion, anxiety, aggression or ignoring directions), numbness, skin conditions. Dizziness, Blurred/double vision, become photosensitive, cause eye conditions such as nystagmus or cataracts or increased ocular pressure, loss of balance, sudden change in blood pressure or a cardiac emergency.
Strategies;
Know the medications and supports. It is important because the O&M Specialist needs to be able to take note of any side effects and when they occur so that steps can be taken to alleviate the symptoms by providing limited first aid or by modifying the lesson. Medications can also impact O&M instruction due to various side effects which may or may not relate to visual side effects.
Multiple Disabilities, ADHD & Behaviour Disorders
ISSUES - verbal, generalisation, memory, conceptual tasks, impulse control, managing feelings / frustrations, sensory triggers, interpersonal skills, communication difficulties, attention, perseveration (repeat/linger idea), impulse control, medication side effects,
STRATEGIES – short session, appropriate goals, exertion / challenges, location/weather, task analysis and chunking, review/repetition, risk assessment and response, practical, key words, learning cues and predictable structure, meaningful reinforcements, trusted support person, signs/triggers strategies
Issues:
Perseveration on idea or repeated body movement
Heightened frustration levels
Difficulty with transition
Impulse control issues
Some common behaviours are – being asocial, engaging in repetitive behaviours, exhibit extreme sensitivity to sensory input (touch, visual and auditory), they may have excellent visual skills but perform poorly on verbal, generalization, memory, and conceptual tasks. They also often have a lack of impulse control, have a heightened frustration level and have difficulty with transitions.
Someone with emotional disturbance is a condition whereby someone’s performance is adversely affected by an inability to build or maintain satisfactory interpersonal relationships with peers and adults and exhibits inappropriate types of behaviour or feelings under normal circumstances.
a learning disability is where one or more of the basic psychological processes involved in understanding or learning language, spoken or written that may manifest itself in an imperfect ability to to listen, think, speak, read, write, spell or do mathematical calculations. It can relate to perceptual disabilities but not specifically directly related to vision impairment.
Autism spectrum disorder (ASD) is a developmental disorder that affects communication and behaviour which can be diagnosed at any age. People diagnosed on the Autism Spectrum are often described as being asocial, have a tendency to perseverate on an idea or engage in repetitive behaviours and may excel at visual spatial skills but perform poorly on verbal, generalization, memory and conceptual tasks and often exhibit extreme sensitivity to sensory input including light/visual stimulus, odours, touch and hearing and a lack of impulse control, heightened frustrated level and difficulty with transitions.
Strategies:
Short repetitive tasks in simplified, mnemonic patterns of hands-on lessons.
Task analysis.
Sequenced instruction.
Familiar environment.
Motivation and prompting.
Choice making.
Visual reminder – use index cards (with pictures) to assist with landmark identification
Auditory reminder – record the route using a step by step sequence.
Coordination between professionals leads to more benefit for the learner. Working together they can accomplish more for the learner.
Instructional strategies for teaching behavior skills are as follows – Review behavioural expectations and responsibilities.
Develop behaviour contracts and reward systems.
Use student/client’s method of communication to provide choices, look at chedule/sequence of instruction, schedule changes.
Give praise and attention to positive behaviours.
Provide time at the beginning and the end of the lesson to assist with transitioning.
Take a structured break which is a non O&M related activity.
Use a predictable lesson structure.
Use different prompts – keywords, nonverbal signals or tactile symbols.
Teach the lesson in the preferred environment.
Support transitions with extra time.
Have a parent/guardian/friend co-teach the lesson if student/client has trouble with transitions.
Use an object cue to signal the beginning or end of a task.
Identify and put support in place that assist with self-monitoring of behaviour.
Let the student/client decide on the reinforcement schedule and reinforcements.
Use note cards or a checklist to convey lesson expectations.
A mnemonic, also known as a memory aid, is a tool that helps you remember an idea or phrase with a pattern of letters, numbers, or relatable associations
