Category Archives: Filomena’s Corner

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

Saturday Seminar: A Sensory Perspective on Helping Adolescents and Young Adults Learn to Deal with Difficult Emotions

Karen_MooreKaren Moore, OTR/L presented a superb seminar on Saturday entitled: A Sensory Perspective on Helping Adolescents and Young Adults Learn to Deal with Difficult Emotions. Working in the area of mental health has been Karen’s passion and career focus.  She is a highly respected and renowned therapist in her area of practice. In her seminar, Karen shared information from her most recent publication of The Sensory Connection Program called The Sensory Connection Program: Curriculum for Self-Regulation, which teaches self-regulation skills through the use of sensory strategies and social engagement. It was evident from her creative and heartfelt approach that her clients benefit greatly from her knowledge and experience. Today she focused on the emotionally charged years of middle and high school, when students benefit from learning fun and engaging strategies to help them deal with emotions. She described how to teach adolescents to recognize signs that they are having emotional difficulty, how to teach them to seek help, and how to help them learn to use effective self-regulation skills.

Karen’s discussion of the value of mastering self-regulation made good sense; when an individual is able to cope with emotions, he/she is able to “tune back in” to the self, which in turn results in being back in control and greater self-confidence.  She emphasized that without mastery of self-control, it would be difficult for an individual to explore new adventures including higher education, travel, or entering the job market. When applied to adolescents, whose pre-frontal cortex and cerebellum are still developing, the need for learning self-regulation strategies is crucial.

Sensory Connection ProgramWhen Karen reviewed the evolution of the stress response, it was easy to see that the vagal level of “freezing” when confronted by a stressor is not a useful response because it results in being overwhelmed by fear.  In the next level in the hierarchy she explained how the sympathetic “fight or flight “ response is more effective than the “freeze” response, but has a long recovery time.  The optimal response to stress involves appraisal of the situation and communication, which promotes a calm state. She shared research evidence that shows that adolescents who have experienced trauma respond with more primitive responses, have difficulty with communicating verbally, and are more reliant on sensory responses than cognitive strategies for coping. Teaching adolescents self-regulation skills prevents them from resorting to the dangerous lower levels of the hierarchy when responding to stress.

Karen employed some of techniques for calming with her audience today, including several different ways of using deep breathing as a group activity, resulting in a feeling of socialization and engagement.  The pneumonic “Pause – Connect – Engage” helps adolescents to “short-circuit” fear by signaling them to stop and think what made him/her upset, make a social connection by reaching out to someone trusted, and then do something positive that helps, which may be tool-based or non tool-based, i.e. squeeze a ball, do deep breathing, exercise, use a fidget, etc. The group tried out several calming strategies, but one called “seaweed” which involved rooting the feet on the floor and swaying gently and slowly with body and arms, was simple and effective immediately.

Karen guided us in learning how to avert a crisis by helping adolescents gain self-control with the use of a variety of sensory strategies that can be personalized.  The strategies are highly effective for the teen population, but can be valuable tools for any individual who is in a state of emotional distress.

Here’s what attendees had to say about Karen’s seminar:

“As a pediatric OT at elementary school level, learning about sensory curriculum at adolescent level guides me in treatment.  Really enjoyed Karen’s stories/real examples to associate to curriculum.” Jen M., Occupational Therapist

“This topic is relatable to everything I do as a COTA. It ties emotions and sensory input. Every student I work with will benefit!” Beth M., COTA

“Very informative.  Wonderfully explained with explanations in brief & practical exercises to experience.”  Rajini K., Parent

“I would recommend this seminar to a colleague because of the scientific/physiological information, therapeutic activities, and hands on demonstrations.  Very knowledgeable speaker.  Excellent examples.” Joann W., Occupational Therapist

“Useful information for sensory techniques to calm/alert children effectively. New concept/less traditional routes for sensory strategies.” Megan Z., OT student

Thank you, Karen!

Filomena Connor, MS, OTR/L