Module 6 - Other Health Impairments

Evaluation of the Impact of a Diabetes Education Curriculum for School Personnel on Disease Knowledge and Confidence in Caring for Students. 

This week for Other Health Impairments I chose to find an article about diabetes. I came across a very interesting article about how one district chose to create implement a diabetes education session for school personnel. According to this article from the Journal of School Health approximately 215,000 individuals younger than 20 years of age have been diagnosed with some  form of diabetes. 1.54 of every 1000 of those children have type 1. Children with diabetes must learn to effectively manage their medication, diet, exercise and blood glucose levels in order to prevent from serious outcomes. These children must be able to attend to their own needs both at home and at school. Caring for their diabetic needs at school can be difficult. 

Children with diabetes are protected under Section 504 of the Rehabilitation Act of 1973. These children are guaranteed that their health related needs will be met without compromising their education. However, it is noted that school personnel may not be prepared to meet a students needs with diabetes. School nurses are often placed in charge of caring for a student with diabetes, but other educational personnel need education when regarding diabetes in order to best support the student. 

A study was conducted through Purdue University in order to see the impact of a diabetes curriculum for school personnel. The study was designed to test their disease knowledge and their rate of confidence in caring for these students. The study was conducted at the New Albany-Floyd County Consolidated School Corporation in Indiana. This school district consists of 9 elementary schools, 3 middle schools, 2 high schools and 1 vocational school. There are nearly 12,000 students enrolled and out of those 12,000 students there are an estimated 60 students with diabetes. School personnel who were at least 18 years of age were invited to participate in this project. 

There were two different programs that were created. The first program was a voluntary, after-hours educational program on type 1 diabetes. 5 of the 7 self-care behaviors according to the American Association of Diabetes Educators were selected to be included in the educational programs. These 5 self care behaviors are: healthy eating,  being active, diabetic monitoring, taking medication and problem solving. This basic program was created to provide school personnel with a needed introduction to diabetes. Their knowledge was tested both pre and post the program. During the 60 minute program personnel attended 4 sessions. The second program was an expanded program that was intended for volunteer health aides and this program provided more in depth information. This program was a 3-hour session. Participants in this program participated in 5 different activity stations that consisted of: counting school lunch carbohydrates, administering insulin, assessing and treating hyperglycemia and hypoglycemia, using blood glucose meter and using written diabetes care plans. 

These programs were offered after school hours from February to December of 2010. A total of 81 people participated. 44 participated in the basic program. Both programs were given different questionnaires. The basic program had 12 items and the expanded had 20 items. In the basic program overall knowledge improved between the pre and posttest assessments. 37 school personnel participated in the expanded program, all of which were volunteer health aides. There was a significant difference in overall knowledge found between the pre and posttests for the expanded program group. 

Overall it was found that these programs improved the knowledge and confidence in school personnel in caring for students with diabetes. Many participants felt that other schools should consider implementing similar diabetes trainings. 

The reason that I chose diabetes as my other health impairment was because when I was a paraprofessional in a fourth grade classroom it was part of my responsibility to keep and eye on a little boy in the classroom with diabetes. I was given a a 20 minute quick “check-in” with the school nurse at the beginning of the year. I felt completely unprepared. I knew nothing about diabetes. All I was basically told was that this little boy was very responsible and would be able to tell us when he needed something. He knew how to test, when to test and what to do based on his testing numbers. However, that wasn't enough for me. I wanted to know more. I went home and started researching diabetes and learned all that I could. I also started picking up on more and more of this little boys actions and how he looked and acted based upon where his blood sugar level was at. I also caught on pretty quickly when he would lie about his blood sugar level so that he could participate in gym class! 

I would have LOVED to have gone through a training like this. It would have been so valuable. I think that more districts need to consider having trainings like these for other health impairments that we see daily in our classrooms. 

Citation:

Smith, C. T., Chen, A. M., Plake, K. S., & Nash, C. L. (2012). Evaluation of the impact 

         of a diabetes education curriculum for school personnel on disease knowledge and 

        confidence in Caring for Students. Journal of School Health, 82(10), 449-456.    

        doi:10.1111/j.1746-1561.2012.00721.

Module 5 - Autism Spectrum Disorder

The Effects of Video Self-Modeling on Children with Autism Spectrum Disorder

The article I read for this week’s posting was about video self-modeling on children with autism spectrum disorder. I have to admit, I was very excited when I came across this article and it didn’t let me down! It was a great read. I recently learned about video modeling as an evidence based practice for children with autism and has been something that I have wanted to incorporate into my classroom. 

In this article the authors first explained that autism spectrum disorder comes with a wide range of impairments. Individuals with autism are noted to have impairments that include verbal and non-verbal communication, social interactions, resistance to environmental change and restricted behaviors and interests. In addition to this children with autism can have deficits in attention behavior, eye contact and processing of social stimuli. The deficit in communication is by far the most prominent. There are many effective strategies to working with children with autism and for many years others as models has made a huge impact. Bandura (1977) stated in research that children are most likely to attend to a model they view as competent and who is similar to themselves in some way. 

With the advancement of technology modeling has also taken on quite an advancement and now includes the use of video and using video modeling with children with autism has proven to by fairly successful. There are four main reasons why video modeling has become so successful in working with children with autism. First of all, video modeling will use a competent and similar model. Second, video modeling decreases the need for attention and language. The child only needs to view a small spatial area and listen to a minimum amount of language. Another reason is because video modeling  reduces the importance of social interactions and finally, the motivation of watching a video may be inciting enough in itself to help the child.  

However, like with any strategy when working with children, video modeling can have its disadvantages. Some disadvantages to using video modeling is that you need to use children when presenting to children and parents may not sign off rights to this. Also when filming for desired behaviors it requires a lot of time and follow ups may be needed. Because of these disadvantages Bandura concluded that seeing oneself perform tasks successfully will provide the best feedback and will strengthen self confidence. These is referred to as “self-as-model”. This modeling is also referred to as Video Self-Modeling (VSM). 

The process of VSM is to record the child maximizing a specific skill and then edit the videos to remove unwanted behaviors or errors. When showing the video repeatedly you are showing the child only the desired behavior. Studies on VSM have shown that that this type of modeling can be linked to successful communication, behavior and academic performance in children with autism spectrum disorder. 

While reading this article it has really inspired me to team up with our school behavior specialist and work on possibly using video self-modeling. I have student who has a very difficult time walking down the hallway at times and not performing compulsive rituals. However, there are times that he can walk down the hall just fine with his hands and his sides and continue to move forward all the way to his destination. I believe that videoing the positive, desired way of walking down the hallway, and showing him this before we leave the classroom each time, can lead to a decrease in the compulsive rituals he takes part in. 

Citation: 

Schmidt, C., & Bonds-Raacke, J. (2013). The effects of video self-modeling on children with autism spectrum disorder. International Journal of Special Education, 28(3), 121-     

                132.

Module 4 - Emotional and Behavioral Disorders

How We Might Make Special Education for Students with Emotional or Behavioral Disorders Less Stigmatizing.

In this article the authors suggest four ways in order to make special eduction less stigmatizing particularly for those with emotional or behavioral disorders. In the United States there are many negative views on education, special education, educational disabilities, and emotional/behavioral disabilities. The stigma of being labeled “special education” or having a “disability” is a real fear of most parents and is what keeps many students from receiving the much needed services that special education could provide for them.  “The term emotional or behavioral disorder (EBD) means a disability characterized by behavioral or emotional responses in school so different from appropriate age, cultural, or ethnic norms that they adversely affect educational performance.” This quote is quoted within the article and comes from  Forness and Knitter (1992) (p.13). 

Proposed in this article are the following four suggestions as to how special education can be come less destructive of student’s identities in particular for those with EBD. The first suggestion is “Talk about Differences in Plain Language”. This portion of the article speaks of how we become label obsessed and how we are always in search of finding labels to carry less of a stigma. In reality it’s not the label that is the issue, it is the misunderstanding of what the label and the words that go along with the label mean. We are often trying to “rebrand” and that often just create more of a mess. The article uses the example of a medical disease. If we all of a sudden start calling cancer something else to make it seem better, people will eventually figure out that our new word still means the dreadful disease of cancer. Therefore we need to further educate people on the meanings of the words that go along with disabilities rather than constantly trying to change the names of the disabilities. The next suggestion is to “Accept the Reality of What EBD Means for Education”.  Here the article talks about how education should not be a one size fits all approach and that regular education classrooms need to look different based upon student needs and similarly special education classrooms need to be different based upon student needs. Meeting every students needs will not mean that every student needs the same education given in the same manner. Just like not all sicknesses can be treated with the same antibiotic. In order to reduce the stigmas of EBD we need to embrace the differences that go along with these students and what those differences mean for their education. The third suggestion is “Emphasize Benefits and the Skills Needed to Provide Them”.  This section speaks of how we need to celebrate the positive impacts that special education makes on students lives and not focus on what is not being achieved by special education. Our biggest thrills as teachers need to come from what our students DID accomplish over the school year and not focus in on the skills that they are still lacking. We need to celebrate progress! Finally, the fourth suggestion is “Try to Make Special Education for Students with EBD What it Should Be”. The educational system is a system that will always need improvement and this is much the same in the field of special education. Special education for students with EBD needs improvements in their practice. This realm of special education needs to be focusing on the evidence based practices that will help to reach success for students with EBD. 

I personally found this article very interesting and very practical to all areas of special education, not just working with students with emotional or behavioral disabilities. I think that as special educators it is very important for us to understand that meanings and vocabulary that go along with our profession. We need to help educate those around us on our special education vocabulary so that we can start to eradicate the stigmas that go along with special education. I also think that it is highly important for us to find those evidence based strategies that will help us in working with the specific population that we do and use them! We need to continually educate ourselves as educators in order to help our students! 

Overall the negative stigma that goes along with disabilities and special education is one that makes me very sad. I know that the negative thoughts and ideas are not something that will disappear over night but I do feel that if well all worked just a little harder to educate others  maybe people wouldn’t be so quick to misjudge those with disabilities. 

Kauffman, J. M., & Badar, J. (2013). How we might make special education for students with emotional or       

          behavioral disorders less stigmatizing. Behavioral Disorders, 39, 16-24.

Module 3 - Intellectual Disabilities

The article that I chose for this week is called ‘Attitudes Towards People with Disabilities - What do People with Intellectual Disabilities Have to Say?’. This article was published in The Official Journal pf the British Institute of Learning Disabilities and was written by Sandra Corr McEvory. 

At the time of publication Sandra was a woman in her late forties with an intellectual disability. She had a life long dream of doing research and her research became a reality and her reality is this article. 

In September of 2008 Sandra had the chance to conduct research with the Inclusive Research Network  and she chose to do her research on peoples attitudes towards those with intellectual disabilities. In order to conduct her research Sandra found seven focus groups. She found focus groups through the disability agency that supports her. There are three centers in this agency and she had different focus groups from each center. Each group consisted of 5-6 participants all with intellectual disabilities. In order to determine how people with intellectual debilities view other peoples attitudes towards themselves, the participates were asked a series of 10 questions. Questions ranged from what does a disability mean, do you have a disability, to how they had been treated by others. It was the hope that participates would share stories and examples from their own life. 

Looking at the answers to the questions there were a wide range of answers for each question. When first asked what a disability was, participates answered  by saying that it was being unable to speak,  having a hard time learning new things, and even saying it means getting mixed up. Some participates knew what their disability was and others were unsure if they had a disability. When participates who stated that they did have a disability were asked how they knew they had a disability most answered with they realized they couldn't keep up when they were in school or because an assessment told them that they had a disability. 

Out of the group of 41 members, 31 participants stated that people with intellectual disabilities are not treated fairly. They recited examples of people calling them names, making fun of them, and noting getting a job because of their disability. People even shared accounts of being short changed, rushed or not served at shops, restaurants and pubs because of their intellectual disability. 

Overall, she found that there is a strong mix of how people with intellectual disabilities feel when it comes to how they are being treated  and if they are respected. 

I found this article extremely interesting and I enjoyed it even more because someone with an intellectual disability wrote it. When I came across the part of the article where she acknowledges that she too has an intellectual disability I felt so proud of the writer. I was proud that she as able to fully and openly admit. She was not ashamed, she was not hiding behind her disability, but rather shedding light upon the fact that people with intellectual disabilities can still work hard and produce quality work. It made me frustrated the think that there are probably people who come across they fact that she has an intellectual disability and completely discredit this article and move on to something else. I am sure that there are also other people who then scour this article looking for mistakes. 

I really connected this article to how my students are looked at and treated when we go out into the community. A few weeks ago we walked to Costco to get one of their giant pizzas for lunch. Once we were there the students sat down and staff got the pizza, plates, drinks and napkins.  We got a lot of looks. Some were looks that seemed disapproving and others that were looks of pity. One lady even asked us what group we were part of. On the way out one of the students had a tantrum. Yes, it looked odd, but other peoples reactions did not make the situation any better. As we were walking back to school we agreed that we were thankful that our students really did not realize the ways that others were talking about them, looking at them, or feeling about they being in the same space as them. Not all people with disabilities are this “lucky”. It just makes me sad. 

Mcevoy, S. C., & Keenan, E. (2013). Attitudes towards people with disabilities -      

         what do people with intellectual disabilities have to say? Br J Learn Disabil 

         British Journal of Learning Disabilities, 42(3), 221-227. doi:10.1111/bld.\    

         12032

Module 2 - ADHD

ADHD and Adaptability: The Roles of Cognitive, Behavioral, and Emotional Regulation. 

         This article explains how students with executive functioning disorders such as attention deficit/hyperactivity disorder (ADHD) are at a greater risk than “typical” students when dealing with adaptability. The American Psychological Association defines adaptability as “the capacity to make appropriate responses to change or changing situations; the ability to modify or adjust one’s behavior in meeting different circumstances or different people”. ADHD is defined as “a persistent pattern of inattention and/or hyperactivity- impulsivity that interferes with functioning or development.” (American Psychological Association) In other words students with ADHD have a hard time regulating their powerful thoughts, behaviors and emotions and this can effect the task at hand as well as the outcomes of the task at hand. 

When looking at adaptability those with ADHD can pose unique challenges. We can look at three functions of adaptability (planning, temporal discounting, and emotional hyper-responsiveness) to see how students with ADHD can be effected. First, planning is the ability to use hindsight or forethought to regulate a future action/behavior. Students with ADHD are less likely than “typical” students to review their actions and or thoughts based on other outcomes. Therefore, the inability to plan will effect the cognitive regulation for adaptability. Next, temporal discounting was looked at. Temporal discounting is the extent in which someone can see value in a future reward. Temporal discounting takes a lot of impulse control as well as planning. Students with ADHD struggle with tasks that do not have immediate rewards and therefore students with ADHD have trouble looking long term and adjusting their actions according to the long term plan. The last of the three functions of adaptability is emotional hyper-responsiveness or more easily understood is emotional reactivity. We know that students with ADHD are more likely to express frustration, irritability and hostilely in the academic setting and when these academic frustrations become high they may carry over into a students non-academic life. Therefore, due to the impairments of executive functioning and self-regulations that students with ADHD experience it is claimable that students with ADHD will have a greater difficulty adapting to uncertain, novel, or changing circumstances. 

        In addition the article continues on to explain about different interventions that have relevance to adaptability. First looked at where cognitive interventions - more specifically problem-solving interventions. This is a great intervention to help with adaptability by helping a student to look at the long term picture. Next, behavioral interventional were looked at and social skills training, antecedent and consequence interventions and self management interventions are all thought of as great ways to help a students adaptability. Finally, emotional interventional were discussed. These interventions usually focused on comorbid anxiety disorders, depression and oppositional defiant disorder rather than focusing on ADHD itself. Success of emotional regulation is a salient factor in adaptability. 

Reading this article made me think back to a student I had two years ago who was diagnosed with ADHD. We worked a lot on his planning skills. He was always forgetting books, notebooks, homework and other necessary materials in order to complete his homework and school work. He and I worked together to create a materials check-list that he would complete throughout the school day so that at the end of the day everything was written down and he didn't have to think back. Just recently his mother emailed me telling me that this student had asked her for the sheet that I made him. He is in middle school now and has a lot more to keep track of and his regular assignment notebook wasn’t doing it for him. She emailed to see if I still had it saved and if I would mind helping him out! I was thrilled that he remember it and that it truly had helped him. We as adults often take our planning skills for granted and forget that these skills do not come as easily to all children! 

Citation: 

Burns, E., & Martin, A. J. (2014). ADHD and adaptability: The roles of cognitive, behavioural, and

          emotional regulation. Australian Journal of Guidance and Counselling Aust. J. Guid. 

          Couns.,24(02), 227-242. doi:10.1017/jgc.2014.17