Saturday Seminar: Providing Optimal Services and Supports for Students with Down Syndrome in Educational Settings

Anne Howard“Meaningful inclusion” is a term that supports the premise that all children should receive an education in the least restrictive environment.  To achieve this goal, social barriers must be hurdled and meaningful instruction must occur.  Anne Howard, PT, PhD tackled this issue in her Therapro Saturday Seminar last week entitled: Providing Optimal Services and Supports for Students with Down Syndrome in Educational Settings.

Dr. Howard’s extensive educational background, beginning as a physical therapist, then becoming an educator, to receiving her doctorate in disability policy, has provided the background for pursuing her interest in those with Down syndrome now as a college professor and consultant to families and school systems.  In addition, Anne serves on the Massachusetts Down Syndrome Congress (MDSC) Education Task Force and contributed to the MDSC Educator’s Manual. This manual provides a comprehensive look at the complex learning profile of students with Down syndrome, as well as provides information around educational considerations that are based upon research-proven best practices.

Anne is also the President of the Board of Directors for the Federation for Children with Special Needs.  With her glowing credentials and experience, Anne proved to be a formidable speaker and expert on Down syndrome.

Attendees at the seminar received a comprehensive review of common learning characteristics and associated physical and health care needs specific to students with Down syndrome.   Dr. Howard provided an interactive seminar, inviting attendees to share their perceptions of students with Down syndrome and asking them to determine what they wanted to learn about students with Down syndrome. She discussed strategies to facilitate independence using visual supports and self-management.  Anne reviewed some basics on Down syndrome with some surprising issues that have come to light.  For example, she noted that children with Down syndrome have a greater prevalence of ASD, with some statistics cited that up to 18% of children with Down syndrome have a co-occurring diagnosis of Autism.

Anne discussed encouraging research that shows that fully inclusive education, special teaching approaches that address areas of weakness, and providing opportunities for success can change the typical profile of a child with Down syndrome, citing studies by Buckley, Bird, and Sacks in Down Syndrome Research and Practice, 2006. A chart with “Characteristics of a typical learning profile” with areas defined as Communication, Socialization, Learning and Memory, and Motor was presented along with strategies to address the targeted areas.  For example, if a student has motor weakness characterized by decreased muscle tone which makes writing difficult, along with having shorter fingers, strategies for learning might include providing adequate postural support, with Pencil gripsappropriate seating, motor breaks with tone building activities, and use of adapted materials for handwriting including a slant surface, hand grips, or keyboarding. In addition, she advocated the use of visual supports, which are available for a longer time period for the student, versus using verbal or auditory cues alone. For example, sticky notes, diagrams on the board, photos, calendar, clock /timer, decrease the need for verbal cues. Visual supports are readily available to the student without the need for use of working memory or retrieval of information, which may be difficult for some students.

Finally, Anne provided a Behavior Profile associated with Down syndrome enumerating strengths, learned behaviors, and then identified strategies that support productive behavior in students with Down syndrome. Students can be taught to self-manage with strategies like self monitoring/self-recoding, self-evaluation, and self-reinforcement.  She suggested that the key is to empower the student by letting him/her know what is expected.  By being proactive, negative behaviors can be averted and targeted behaviors can be reinforced.  She noted that the key to developing acceptable and positive behaviors is to build desired behaviors, versus just responding to negative behavior.

Considering the student with Down syndrome and how to help him/her succeed in an inclusion model involves a number of factors.  Understanding the common characteristics and challenges of this diagnosis is a good starting point.  From there, a wide variety of positive strategies can be implemented to help make the educational process meaningful and fulfilling for the individual student.

Anne has generously provided this link to her PowerPoint slides: click here.

Here are some remarks from attendees:

“I really appreciated Anne’s diverse background. She was able to present the information from a different perspective than I might normally consider.”  Micaela C., Physical Therapist

“Helpful as a student to hear real-world application from professionals in practice who were in attendance.  Also great to see theory learned in the classroom reinforced.”  Sam J., OT student

“Clear, relevant, evidence based info/treatment strategies.”  Mary T., Occupational Therapist

“Dr. Howard provided & presented the basic background info for DS well. She provided useful examples for behavior management for children with DS that I hope to implement with my students.”  Anonymous, PT

Thank you, Anne!

Filomena Connor, MS, OTR/L

Massachusetts District Determined Measures

District Determined Measures (DDMs) is a hot topic in Massachusetts’ school districts. DDMs are defined by the Massachusetts Department of Elementary and Secondary Education as:

“measures of student learning, growth, and achievement related to the Massachusetts Curriculum Frameworks, Massachusetts Vocational Technical Education Frameworks, or other relevant frameworks, that are comparable across grade or subject level district-wide. These measures may include, but shall not be limited to: portfolios, approved commercial assessments and district-developed pre and post unit and course assessments, and capstone projects.”

On September 10th, Jan Hollenbeck, OTD, OTR/L tackled the complex and evolving subject in her Saturday seminar entitled: Accepting the Challenge: Developing Meaningful District Determined Measures (DDMS). Jan is an authority on the subject as the Special Education Coordinator responsible for related services, assistive technology, 504, and secondary transition services for Medford Public Schools.

Dr. Hollenbeck shared her experiences with DDMs in an honest and clear way. She provided numerous references and guides to clarify the subject. Because DDMs are designed for teachers, applying them to therapists and other support school personnel is challenging. OTs and PTs are included in the Specialized Instructional Support Personnel (SISP). This group earns individual ratings in two areas: Summative Performance Rating and Student Impact Rating (what’s the therapist’s impact on student learning). We as therapists need to demonstrate that we have impact on student learning, but Jan raised the question of whether DDMs are the right way to do this.

Attendees were all occupational therapists or OT grad students. The seminar generated much discussion among attendees about how OTs fit the model of DDMs and what is happening with DDMs in various school systems where the therapists practice. All enjoyed the opportunity to engage in a lively brainstorming session with colleagues. They were asked to identify their key roles and functions on the school team and designate what data is currently being collected. Quantitative data is required for DDMs. Further in this exercise, therapists generated possible DDMs, decided why they were meaningful, and whether they would be direct or indirect measures of student impact. One interesting idea was to do a survey to ascertain how helpful OT consultation is on a 5 point rating scale, tabulate the results, and use them to arrive at a performance rating.

Jan reminded us that developing DDMs is a “work in progress.” Stay tuned…

Take a look at some remarks from attendees:

“This is the first time I feel like I have a meaningful baseline understanding of the DDM process/expectations.” Anonymous, Occupational Therapist

“Jan presents in an organized & concise manner. She is effective in moving the audience through issues. Considerations presented in a positive manner.” Anonymous, Occupational Therapist

“Very informative – this is a very complicated subject and Jan helped to simplify some of the major points.” Beth M., Occupational Therapist

“I would recommend this seminar to a colleague to get a better understanding of DDMs and how it is still a ‘work in progress.’ Makes you feel less isolated!” Anonymous, Occupational Therapist

Thank you, Jan!
Filomena Connor, MS, OTR/L
September 10, 2016

Task Boxes: A Hands-On Approach to Life Skills

by Angela Mahoney

The importance of pre-vocational planning and opportunity is ever growing, yet when and where to begin can be so overwhelming for both educators and parents! Task boxes are a great way to introduce as well as develop a wide range of hands-on life and vocational activities for a range of diverse learners.

Task boxes are compartments that contain material for a certain activity. The activities are typically short and structured and they offer a nice blend of familiarity and challenge. Any activity that fits in the compartment may be used as part of the young adult’s curriculum both at school and home as well as in a therapy session such as OT, PT and Speech. Task boxes offer much more than organization for the young adult working on the activity:

  • Activities address various skills.
  • They encourage independence, as the young adult takes the task out of the box, completes it, and puts it away with minimal or no guidance.
  • They serve as excellent sequencing activities.
  • The boxes are visual, and the single-unit presentation is easy to understand.
  • They break down activities into small steps, which is an important aspect of applied behavioral analysis (ABA).

Task Boxes for Life SkillsTask Boxes for Life Skills

To create a task box you need to first gather a limited number of materials (10-20) related to the activity as well as a compartment with lid large enough to store materials.


Next you will need tocreate a visual guide showing each step of the task in the compartment. This allows the young adult to visually see each step of the variety of task boxes and encourages independence when working.


After the materials have been placed in the compartment, adhere the steps to the lid, number the box and add it to your task box area for future practice and success with a wide range of skills!

Below are some examples of task box ideas broken down by Module, adapted from the I Can Work! Program.

Clerical: Folding paper in thirds, Addressing envelopes, Filing by numbers or words

Task Boxes for Life SkillsTask Boxes for Life Skills

Retail: Folding t-shirts, Pairing and Sizing shoes, Buttoning Shirt

Task Boxes for Life SkillsTask Boxes for Life Skills

Food Service: Folding napkins, Setting a table, Assembly of place settings

Task Boxes for Life SkillsTask Boxes for Life Skills

Grocery: Sorting hard and soft groceries, Stocking shelves

Task Boxes for Life SkillsTask Boxes for Life Skills

By creating task boxes that apply to life utilizing vocational materials, young adults are building a stronger foundation and confidence for future success!