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Exceptionality Presentation - Students With Neurological Disabilities

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Adriana Karam

on 25 July 2013

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Transcript of Exceptionality Presentation - Students With Neurological Disabilities

Students With Neurological Disabilities
Describing the Needs
As a teacher, it is important to remember...

A student with a health condition is first and foremost a student.
Teachers should approach medical information from an educational/cooperative perspective, not the perspective of diagnoses or treatment.
It is wise to seek out the specifics of an individual students' case, since conditions can present very differently
Some Issues in the Field
Role of EA and Support Staff – these professionals will have the required specialized knowledge to deal with student’s medical needs that are beyond the qualifications of the classroom teacher. Therefore, collaboration and partnership between classroom teachers and Support staff will help student success

Poor Communication Puts Students at Risk – due to office politics or privacy legislations. Maintain regular and direct communication with parents.

Understand that families often experience practical and emotional havoc when they have a child with neurological conditions – Do not take things personally!

Responsibility by default – when the EA becomes sole teacher, caregiver and companion - it happens but it goes against the idea of inclusive education

Implications for Social Aspects of the Classroom
Teachers need to be sensitive to the fact that:
Students with exceptionalities may have negative feelings about themselves
Other classmates may have negative feelings towards students with exceptionalities

Teachers and support staff must be aware of the profound influence their actions and attitudes have on the class. It is important to model desired behaviours.

Definition of a
Physical Disability
"A condition of such severe physical limitation or deficiency as to require special assistance in learning situations to provide the opportunity for educational achievement equivalent to that of pupils without exceptionalities who are of the same age or development level"

As teachers, it is our role to help
level the playing field.
Neurological Disabilities Include...
Chronic Health Needs
Musculoskeletal Impairments
Acquired Brain Injury
Developmental Coordination Disorder
Tourette Syndrome
(Tourette's or TS)
Spina Bifida
Seizure Disorders
Cerebral Palsy
Agenda for Today
Class Bingo!
Misconceptions (Lily Pad Activity)
Describing the Needs
Class Bingo! Revisited
Case Studies
Teaching Strategies
Current Issues
Acquired Brain Injury
Misconceptions About Neurological Disabilities and Chronic Health Needs
1. Students with special health conditions are automatically candidates for special education.
2. All students with Tourette Syndrome swear and "talk dirty".
3. The physical condition of students with CP cannot be remediated or improved.
4. When chronic health conditions are neurologically based, students have diminished intellectual capacity.
5. Students with Epilepsy and Tourette Syndrome have mental illnesses.
6. Students with Spina Bifida will be incontinent.
7. Arthritis is found only in elderly adults.
8. Medical science is reducing the incidence of physical disabilities and chronic conditions.
Tourette Syndrome is a neurological disorder that usually starts in childhood.

The disorder is named for Dr. Georges Gilles de la Tourette, a French neurologist who first described the condition in an 86-year-old French noblewoman in 1885.
Hallmark Symptom: Tics

Unusual and repetitive movements, or unwanted sounds that cannot be controlled
Can include compulsive or repeated shrugging of the shoulders, jerking of the head or blinking of the eyes
Extreme cases characterized by unintentional blurting out of offensive words (Coprolalia)
Only present in 10-15% of cases)
Can significantly interfere with communication, daily functioning and quality of life
Often worse with excitement or anxiety, and better during calm, focused activities
It is not uncommon for individuals with Tourette Syndrome to also have other neurobehavioral problems that often cause more issues than the tics themselves.

Hyperactivity and ADHD
Academic problems with reading, writing, and math

Tourette Syndrome: Facts
Usually diagnosed in early childhood
Boys are 3X more likely to be diagnosed than girls
Usually only treated when symptoms are affecting daily life
No cure and possibly hereditary: sex-linked?
Diagnosis is often complicated by the lack of clear diagnostic tools for physicians to use (blood tests, scans, etc.)
Often lessens with age and sometimes disappears after adolescence
No "typical" case
The following clip includes children with Tourette Syndrome talking candidly about their symptoms and experiences of living with TS.
The Human Brain
Classification by Number of Limbs Involved
Classification by Movement Disorder
The location of the brain injury will determine how movement is affected:

Spastic Cerebral Palsy
Choreo-Athetoid Cerebral Palsy:
(Athetosis, Ataxia, Chorea, Dystonia)
Mixed-Type Cerebral Palsy
Cerebral = "of the brain"
Palsy = "lack of muscle control"
Development of the brain starts in early pregnancy and continues until approx age three

Injury to the brain during this time may cause CP

As a result of an injury to the brain, CP interferes with messages from the brain to the body, and from the body to the brain
Secondary Complications
Low fitness
Poor functional strength
Pressure sores
Respiratory difficulties
Learning and Perceptual difficulties
Motor functioning seizures
Children with Spina Bifida may also suffer from latex allergies, skin problems, urinary tract infections, gastrointestinal disorders, seizure disorders, depression, and social and emotional problems
Mildest form
Rarely causes disability or symptoms
Malformation or gap in one or more of the vertebrae of the spine
Dimple, hairy patch, dark spot or swelling over affected area
Spinal cords and nerves usually normal
No treatment needed
Rarest form
Cyst or fluid-filled sac pokes through open part of spine
Sac contains membranes that protect the spinal cord, but not spinal nerves
Cyst removed by surgery, usually allowing for normal development
Most severe form
Occurs when the spinal cord is exposed through the opening in the spine, resulting in partial or complete paralysis of the parts of the body below the spinal opening/lesion
Opening is closed surgically after birth
Affected patients have leg paralysis, bladder and bowel control problems
Children with Myelomeningocele may develop learning disabilities
What Causes Spina Bifida?
The exact cause is unknown
Scientists suspect genetic, nutritional, and environmental factors play a role
Folic Acid deficiency and medical conditions such as diabetes and obesity increase the risk of Spina Bifida
A birth defect resulting from the incomplete closure of the embryonic neural tube, leaving the spinal cord lacking in its usual protective skeletal and soft tissue coverings
The vertebrae overlying the open portion of the spinal cord remain unfused and open
Sometimes a portion of the spinal cord sticks out through the opening in the bones
Often accompanied by Hydrocephalus (the accumulation of cerebrospinal fluid surrounding the brain)
This fluid can cause brain injury if not treated immediately; usually a shunt is installed to drain the fluid for re-absorption
1 in every 750 babies born in Canada has Spina Bifida, and 80% of these babies have Hydrocephalus
An ABI occurs after birth and is not related to...

A congenital disorder or developmental disability
i.e. cerebral palsy, muscular dystrophy, autism, spina bifida with hydrocephalus

A process which progressively damages the brain
e.g. dementing processes, multiple sclerosis, Alzheimer’s Disease, Parkinson’s Disease

Leading Causes of ABI
Motor vehicle accidents

Near-drowning events

Sports-related injuries

Possible Causes
e.g. an external force, such as a collision, fall, or assault

A medical problem or disease process that damages the brain
e.g. non-progressive tumour, aneurysm, infection, stroke
An Acquired Brain Injury (ABI) is any type of sudden injury that causes temporary or permanent damage to the brain after infancy.

Effects of ABI
Can affect a student’s cognitive, behavioural/emotional, and physical well-being

Students may experience difficulties with attention, processing, judgement, anticipation, perception, problem-solving, transfer of learning, memory initiation, and fatigue

May cause changes in behaviour, such as agitation, disinhibition, sudden outbursts or anger, impulsivity
Students may have general difficulty controlling emotions

Effects of ABI
Physical difficulties may include central and peripheral nervous system problems, orthopedic complications, paralysis, and impairments in fine and gross motor skills

The period following the injury can be difficult due to the sudden change in the student’s ability as well as the variability of their performance during the recovery period

A team approach involving parents, school, and medical personnel is the most effective way to meet the needs of these students

Cerebral Palsy (CP) is a term used to describe a neurological condition affecting body movement and muscle co-ordination.

CP is considered an non-progressive but not unchanging condition of movement and/or posture, due to an injury of the developing brain.
Developmental Coordination Disorder (DCD), also known as Developmental Dyspraxia, is a...

Chronic neurological disorder that begins in childhood and affects the planning of movements and coordination as a result of brain messages not being accurately transmitted to the body.

In short: DCD is a motor learning problem that interferes with children's ability to perform common everyday tasks.
A Less Well-Recognized, But More Prevalent Chronic Health Condition

Affects approx 5% of children
Only noticed when students:
Academic achievement is affected (handwriting, note taking and Physical Education activities)
Independence in daily living activities (dressing, opening juice boxes/ lockers)
Appear clumsy/ less physically fit
Have difficulty completing desk work
Children With DCD Have Difficulty...
Learning new motor skills
Performing already learned fine/gross motor skills

This may manifest in:
1. Awkward appearance
2. Appearance of laziness/non motivation
i.e. Avoidance of tasks requiring motor
skills, such as writing/colouring

DCD often co-occurs with...
Attention Deficit/Hyperactivity Disorder
Language disorders
If unrecognized by adolescence, many children experience...
Secondary emotional and behavioural problems
Poor self-esteem
Mental health issues

The Role of a Teacher
If proper accommodations are made, students will often progress through school without much difficulty.
Three Forms of Spina Bifida:
1. Occulta
2. Meningocele
3. Myelomeningocele
No cure
Regular check-ups with physician
Surgery (24 hours after birth)
Assistive Devices

Tips for Supporting Students
Teachers may be asked to watch for signs of headaches, coordination difficulties, vomiting and seizures (indications of shunt blockage)
If the student lacks bladder or bowel control, this can be a barrier to peer acceptance
Teachers can model acceptance and be sensitive to the student’s needs to leave the classroom unexpectedly
Encourage independence and ensure privacy
Be prepared to accommodate extended absences from school that result from skin breakdown, bladder infections or other medical issues
Encourage student to use computers, audiovisual materials, and give them two copies of textbooks (one for school and one for home)
Epilepsy is a chronic, neurological condition characterized by recurrent seizures
A seizure happens when abnormal electrical activity in the brain causes an involuntary change in the person's awareness or behavior
Epilepsy is diagnosed when a person has had two or more seizures that cannot be attributed to some other condition.
Epilepsy is a physical condition, not a mental illness
Anyone can develop epilepsy at any time
Epilepsy affects people of all ages, all nations and all races.
One in every 100 Canadians has epilepsy.

What Causes Epilepsy?
For 70% of people with Epilepsy, the cause is unknown. In the remaining 30%, the most common causes are:
Head trauma
Brain tumor/stroke
Lead poisoning
Infection of brain tissue
Prenatal disturbance of brain development

Epilepsy May Occur With...
Cerebral palsy (20-30 % will also have Epilepsy)
Cognitive impairments
ADD/ADHD (2 to 5 times as likely to have Epilepsy)
Developmental disabilities
Autism (up to 35% may develop some form of epilepsy)
Note: Majority of people who have Epilepsy do not have other impairments

Two Common Types of Generalized Seizures (Involving the Whole Brain)

1. Tonic-Clonic

2. Absence Seizure

Tonic-Clonic Seizure –Formerly Called “Grand Mal”

Loss of consciousness, fall, and stiffening of limbs, followed by shaking
Breathing may stop temporarily
Skin, nails, lips may turn blue
Loss of bladder/bowel control may occur
Generally lasts 1 to 3 minutes
Followed by confusion, sleepiness

Absence Seizure – Formerly Called “Petit Mal”
Brief loss of awareness
Pause in activity
Blank stare
No recollection
Eyelid fluttering

Possible Seizure Triggers
Failure to take medication correctly
Variation in medication effectiveness
Sleep deprivation
Alcohol/drug use or withdrawal
Hormonal fluctuations
Flashing lights/photosensitivity

Types of Treatment
1. Medication
2. Surgery
3.) Non-pharmacological Treatment: Ketogenic Diet
Medications/Common Side Effects
Cognitive side effects:
Slowing / depression, forgetfulness, short term memory problems, word recall problems
Other side effects:
Rash, clumsiness, drowsiness, irritability, nausea, sore throat, mouth ulcers, weakness, fatigue, abdominal pain, lack of appetite, prolonged fever, aggression, hyperactivity
Sleep disorders:
Difficulty falling asleep / staying asleep, or sleeping all the time

Beaker's "Ode to Joy"
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