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.