Learn Your Special Education Laws, Special Education Rights, and Share IEP Goal Ideas

If you are a parent of a child with special needs, the thought may have crossed your mind as to how you could create a fun, effective and sensory rich environment in your home. Space and budget are often reasons that may hinder families from doing so.  The great news is that there are so many creative and affordable sensory solutions to bring much needed sensory input into your home.  The suggestions provided below can help your child with sensory processing and modulation difficulties to better regulate their arousal state and activity level. Read the rest of this entry →

Occupational therapists, physical therapists, and speech therapists all provide essential services to help individuals recover or manage their disability. It’s apparent to these professionals, or students specializing in this field, that to be able to give the highest quality of care requires extensive education to enter professions as well as continuing education throughout the subsequent career. But what is the special recipe to maximize your lifelong learning as a therapy professional? Read the rest of this entry →

Depending upon where you live in the United States, the decision to let your HFASD (High Functioning Autism Spectrum Disorder) child drive could rest solely on the shoulders of parents.

If you are lucky enough to live in a state such as Pennsylvania, then all teens applying for a driver’s permit must have a physician sign off on their potential driving abilities.  And if you live in Michigan, Montana or Illinois (for example)  then all teens also need proof of having a Graduated Driving License certificate.

That teens are impulsive, at times irrational, and often unpredictable is common knowledge.  These characteristics are often even more pronounced in HFASD children.

In addition, a child with HFASD often has issues with communication, motor regulation, and social skills, all of which are factors that can impact driving skills.  Very few studies have been done on these teens to access their abilities and the potential issues regarding their safety and the safety of others on the road.

It is a statistical fact that the incidence of teen deaths and automobile accidents are closely linked.  Some place automobile crashes as the number one cause of teen deaths.  The Center for Disease Control reports that in 2009 8 teens ages 16-19 died everyday from motor vehicle injuries.  The report goes on to state that per mile driven, “teen drivers ages 16-19 are four times more likely than older drivers to crash”.  Therefore, investigating how teens learn to drive and specifically how HFASD teens learn is a significant safety issue.

Occupational therapists often teach driving to adults who have had injuries that change the way they drive: spinal cord injuries for example.  With the exponential increase of those being diagnosed with Autism, the role of the OT in teaching and assessing driving abilities should be a essential part of therapeutic interventions when addressing the functional capacities of teenagers in treatment.

While not all teens with autism will become drivers, it is important to note that many will.  Patty Huang, MD, a developmental pediatrician at the Children’s Hospital of Philadelphia (CHOP), has devised a list of predictive factors of HFASD teens who will want to and who are most likely to become drivers.  This list includes but is not limited to:

• At least 17 years old
• Enrollment in full-time regular education
• Planning to attend college
• Having held a paid job outside the home
• Having a parent who has taught another teen to drive
• Inclusion of driving-related goals in his or her individualized education program (IEP)—this is where OT’s can have a lot of input!

Occupational therapy, while common with the elementary school aged child, is less so with the high school teen.  The OT’s role in the IEP Plan would be to assess and set the driving related goals.

Research supports that teens that have participated in Graduated Drivers Licensing (GDL) programs are 38%-40% less likely to have accidents than teens that were taught by family members or by other individuals.  With a GLD rights and privileges for operating a vehicle are slowly gradually graduated into a program that eventually leads to fully independent driving.

It is during that period that the occupational therapist can work on increasing rate of motor response speed, visual scanning, peripheral visual awareness, midline issues (turning the steering wheel with both hands), integrating the concept of attention concerns (radio/tape player/friends, etc.) and reciprocal motor movements both upper and lower extremities.

Creating a pre-driving competency checklist may be helpful for starting such a program in your state.  Be sure add specific laws that are essential for the driver to know, process and understand.

Dr. Vanessa M. Dazio, OTD, OTR has a checklist for aging drivers that I slightly altered for the teen driver. You can read more from Dr. Dazio at: http://www.safeaging.com/information/SkillsDriving

Driving is multi-tasking taken to an “art form”.  Driving engages the total person: physically, mentally and emotionally.  Being able to not only be aware of yourself, but everything around you requires practice as well a patience while learning to coordinate multiple tasks with multiple skills. 

Suggested Checklist for the Teen Driver:

Physical Skills

• Focus constantly on the task of driving even in the presence of minor distractions
• Twist and turn body quickly (to see motorists or pedestrians coming from the far right and far 
left
• Move the head and neck side to side, up and down, back and forth and use visual scanning techniques

• Good joint range of motion and coordination are needed to: 
hold, control and turn wheel
 reach and manipulate knobs/buttons/controls
use turn signals and wipers
 adjust mirrors
 quickly move the foot from the accelerator to the brake

Visual Skills

• Good distance vision for checking intersections, highway changes, signs
determine distances needed for merging into lanes, making turns, lane changing look at highway and even weather conditions
look for other approaching cars
observe and scan far ahead for potential safety threats or hazards
observe road conditions
watch for pedestrians
• Close vision is needed to: Judge the closeness of other cars, pedestrians, walkways distinguish curbs, ramps, roadways, etc.
distinguish details
read road signs, maps, inside car features
• Fluid peripheral vision is needed to see a moving object (like a person stepping off a curb) Hearing is used to detect:
• Determine closeness of approaching cars (by the sound of tires and engines)
inside car sounds for “empty gas tank” or “check oil”.
odd engine sounds suggesting maintenance problems
outside sounds of life: such as children playing, distracted pedestrians
outside warning sounds such as car horns, trains, ambulances, sirens, screams threatening weather conditions, etc.
• Touch: The awareness of touch is needed to gage how hard to tap the brakes or press the accelerator. It is also important to be aware of gripping the steering wheel.  Fluid use of palmar and pincer grasp with and without associated reaching.

Mental/emotional Skills

• The brain is “Central Control”. It directs the body to do everything when driving. Driving requires a clear and alert mind. The new driver should not have the radio/tape player or other auditory distractor on when driving
• Quickly and correctly choose the best options in constantly changing situations quickly and correctly react to prevent or reduce accidents or injuries.  To be able to 
quickly make the best decisions given the set of circumstances
 quickly recall and apply driving rules and regulations at all times.

Teens, inclusive of those with HFASD, and the desire to drive are most probably inevitable.  The current statistical rate of teen automobile fatalities does not have to be.  OT’s can make an impact here and the sooner the better!!

Originally submitted to Advance for OT 2012

Susan N. Schriber Orloff, OTR/L is the author of the book. “Learning RE-Enabled” a guide for parents, teachers and therapists,(a National Education Association featured book) as well as the CEO/Exec. Director of Children’s Special Services, LLC an occupational therapy service for children with developmental and learning delays in Atlanta, GA.  She can be reached through her website at www.childrens-services.com or at sorloffotr@aol.com 

Additional references:

• Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS) [Online]. (2010). National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (producer). [Cited 2010 Oct 18].
• NHTSA[2009]. Fatality Analysis Reporting System (FARS), 2009. Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration, National Center for Statistics and Analysis.
• Finkelstein EA, Corso PS, Miller TR, Associates. Incidence and Economic Burden of Injuries in the United States. New York: Oxford University Press; 2006.
• Insurance Institute for Highway Safety (IIHS). Fatality facts: teenagers 2008. Arlington (VA): The Institute; 2009 [cited 2009 Nov 3]. 
• Chen L, Baker SP, Braver ER, Li G. Carrying passengers as a risk factor for crashes fatal to 16- and 17-year old drivers. JAMA 2000;283(12):1578–82.
• Jonah BA, Dawson NE. Youth and risk: age differences in risky driving, risk perception, and risk utility. Alcohol, Drugs and Driving 1987;3:13–29.
• Simons-Morton B, Lerner N, Singer J. The observed effects of teenage passengers on the risky driving behavior of teenage drivers. Accident Analysis and Prevention
• National Highway Traffic Safety Administration (NHTSA), Dept. of Transportation (US). Washington (DC): NHTSA; 2000a [cited 2009 Nov 6].  
• National Highway Traffic Safety Administration (NHTSA), Dept. of Transportation (US). Washington (DC): NHTSA; 2008b [cited 2009 Nov 6 ].
• Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2007 [Online]. (2009). National Center for Chronic Disease Prevention and Health Promotion (producer). [Cited 2009 Nov 6 ].

There are many muscles that are responsible for the movements in the hand. To be exact, there are a total of 34 muscles that move the palm, fingers, and thumb. Our fingers actually do not have any muscles inside; their movement comes from the tendons of all the muscles in the palm and forearm. Nine individual muscles control the thumb alone! Many children naturally develop adequate strength in all of these muscles to learn the fine motor skills needed to manipulate toys, dress themselves, and use a pencil and scissors. There are some children however, that do not acquire this strength as easily and need extra attention to gain that necessary strength.

Here are some activities designed to help children with weak hand muscles and poor fine motor skills.  Read the rest of this entry →

I love this App! Write My Name by Injini is an addicting app that helps develop a child’s writing skills. Since Write My Name was just released Injini is offering this App for the introductory price of $1.99. The price will only be good for a few more days and then will go up to its normal price of $4.99 next week. I highly encourage everyone to go out and buy this app at the introductory price. According to the Write My Name App page, “In the same tradition as Injini Child Development Game Suite and My First AAC, Project Injini was inspired to create Write My Name to help children with special needs practice emerging writing skills in a fun and playful way. Mastering writing your own name is often an IEP (Individualized Education Programs) goal but the other tracing apps in the app store don’t make this activity easily accessible AND achievable.” Read the rest of this entry →

Handwriting is a complex skill that can be very difficult for children with sensory processing challenges. Consequently, these children tend to avoid writing because it can be quite frustrating for them. There are different types of writing tools that offer sensory solutions for these children to help make writing an easier task. Here are some tools that may be helpful in exploring ways to best suit your child’s writing & sensory needs.

Mechanical pencils

Children with proprioception problems often have difficulty modulating the pressure they use on items. If a child presses too hard when writing their hands fatigue quicker, mistakes are harder to clear away when erasing, and they are more apt to rip the paper (very frustrating!). Mechanical pencils can aid to teach modulation of pressure, as the lead will break if too much pressure is applied. Each time the lead breaks it will give the child feedback and the desired result is to help them monitor the pressure they are using.

Weighted pencils

While some children with proprioception difficulties press too hard, others press too light when writing making their strokes very hard to decipher. A weighted pencil can help to make their pencil steadier and give them the extra weight they need to press more firmly resulting in darker strokes. There are pencil weight kits that you can purchase or you can easily make one from using rubber washers and rod shaped coupling nuts found in a hardware store for a few dollars.

Vibrating Pencils

Children with low muscle tone generally have poor fine motor strength and have difficulties sustaining their grasp on a pencil, which impacts their written production. Vibration is a sensory technique that can be used to “wake up” or stimulate muscles and allow for more efficient muscle use. The vibration pencil also seems to entice children with sensory seeking behaviors, as it gives them sensory feedback to their fingers and helps to keep them focused on the task. Based on my experience, the vibration pencil, more specifically the Ark Z-Vibe*, has been so useful in motivating so many children to write. I often recommend using for homework, as the slight buzz can be distracting to classmates. On the flip side, the constant light hum (like white noise) can be somewhat soothing to the writer. I have noted that children with tactile sensitivity have said it “tickles” their fingers and they do not prefer to use it.

Tactile Writing Tools

Tactile seekers love textures. The three options below can help offer sensory feedback to satiate tactile needs during writing tasks by giving them textures right there on their own pencil.

Gel Squish Grips

Musgrave Pencil Fidgets

Faber-Castell GRIP Writing Pencils

Pencil Toppers

Some children seek intense oral input. These are the children that chew on the collars or sleeves of their shirts, suck on their fingers, or bite off the eraser tips of their pencils. The mouth is a powerful organizing center, just think of how a baby soothes himself by sucking on a pacifier. The actions of chewing, biting, and sucking are excellent ways to help increase focus and concentration and often decrease anxiety. CHEW STIXX PENCIL TOPPERS (BPA and Phathalate free) fit right on the top of the pencil and are an excellent sensory strategy to use in the classroom.

Considerations: Using writing tools that give sensory feedback can be very beneficial to a child with sensory needs. It is, however, important to remember that physically holding a pencil properly with a comfortable, efficient grasp is fundamental to developing good handwriting skills.

Sari Ockner, OTR/L received her degree in Occupational Therapy at from the University of Wisconsin – Madison in 1998, in their extended Occupational Therapy program with an emphasis in her fieldwork studies in the scope of pediatrics. Sari began her practice in New York City and is currently living and practicing in the Los Angeles area. She has over 13 years of experience working with children with a variety of special needs in school, clinic, and home-based settings. Sari is certified in Sensory Integration Theory and Practice (SIPT) and specializes in handwriting and child development.

Follow Sari on Facebook at Kidz Occupational Therapy or on Twitter at Sari_KidzOT for on-going information to support children in school, at home, and in the community. For further information visit : www.KidzOccupationalTherapy.com

* Please note that in addition to the Z-vibe you need to purchase the pencil attachment pack and batteries.

A couple of months ago I gave a presentation on Individualized Education Programs (IEPs) for my local Parent Training Center. All of the Staff for this organization are parents of children with special needs. When I arrived early to set up I was met by a staff member and her son who has autism. As I was setting up I couldn’t help noticing the staff member’s son writing on the blackboard. In about ten minutes he had written down the names of all of the United States Presidents in order. I stopped what I was doing and walked over to his Mom and asked if he was learning about the Presidents in School. I don’t know about you but I can’t remember most of the Presidents names let alone their order. I know all of the early Presidents, the ones that led during specific events in U.S. History and all of the Presidents during my lifetime but the rest I have forgotten. To my amazement she said her son had learned all of the U.S. Presidents from an iPad app. She went on to explain that this was the third app her son had played from this particular developer. The first app had taught him all about the States in America, the second had taught him about all of the Countries in each Continent and this latest app the Presidents. I was hooked, who is this developer and what are the names of the apps. Read the rest of this entry →

Children with special needs very often present with sensory integration difficulties, where their neurological systems are not organizing and responding appropriately to the multitude of sensory information that is entering their system. Intact sensory integration is important for all activities a child does, especially participating and being available for learning in a classroom environment. When a child’s sensory system is dysregulated we may see behaviors such as hyperactivity, poor attention, low arousal/energy, emotional outbursts, or inappropriate social interactions. Many of these children are in classrooms of twenty-five students (or likely more ) with one teacher. How can we support these children in school to better ensure their sensory needs are met in order to be successful students? Working in collaboration with teachers I have found these strategies to be effective and practical in general education settings.  Read the rest of this entry →

Last week I attended a workshop about Apps for kids with Special Needs. We reviewed many Apps, but the one that everyone seemed to like the most was Cookie Doodle. You begin by selecting your cookie recipe. The next screen is a list of ingredients, including the measurements, along with pictures of each one. You move each ingredient into the mixing bowl, thus exercising the child’s fine motor, language and sequencing abilities. Read the rest of this entry →

What is Occupational Therapy in Schools?

Occupational therapy can help students succeed in academic performance and social participation. Occupational therapy practitioners use their unique expertise to help children with and without disabilities be prepared for and perform important learning and school-related activities to fulfill their roles as students. In the school setting, occupational therapy practitioners support academic and non-academic outcomes, including social skills, math, reading, writing, recess, participation in sports, self-help skills, prevocational or vocational participation, and more. They are particularly skilled in facilitating access to curricular and extra-curricular activities for all students through support, design planning, promoting healthy routines, and other methods. The goal is for students to build upon their strengths while developing academic and social skills necessary for future independent living.

* From the American Occupational Therapist Association

Below is a list of popular Social Skills and Life Skills apps for the iPad:

If you are the creator or developer of a Special Education Product, App, Book or Assistive Technology Device and you would like Special Education Advisor to review your product please contact us via the contact us form.  We will be putting together both App Lists by category similar to this one as well as doing more in depth App Reviews on individual apps.