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  #11  
Old 08-12-2006, 04:08 PM
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gwat1aw gwat1aw is offline
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Mississippi
I love all of your ideas!!! But I have the feeling that your students are higher functionally than mine are. I also have the multiple-handicapped, medically fragile students (mine not only have feeding tubes, but some also have tracheas and are on oxygen--and I've lost several over the years due to medical complications, luckily all were at home at the time). But I too have a schedule similar to bcblue. Although there isn't alot of time between getting them off the bus, the first diaper changes of the day (all of my students require TOTAL care and we don't have 1:1 aides, just one aide for my classroom) and breakfast before it is time for lunch for the students (they eat EARLY at 10:30 in the morning). We often integrate positioning into the circle time as well--with some in standers or corner chairs or other positioning equipment given to us by the PT and OT. Instead of doing hand massage, we do almost a full body massage on our students. We use lotion and massage the hands, arms, back, legs, feet, sometimes belly area as well. We do this after lunch in our class with lights out, the students on bean bags and soft music playing in the background. It's sometimes tempting for us to fall asleep, but it helps those with contracted muscles to relax and we get a better stretch and ROM exercises with them. As we begin loading buses at 2:00, our day is quickly over. I hope this helps someone out there. Looking forward to seeing other ideas from those of you that teach these severely cognitively impaired, multiple handicapped, visually impaired, TBI, medically fragile kids. I've taught this population for 8 years (total of 20 years teaching in sped areas) now and I'm really looking for new ideas! I do try to integrate one of the best suggestions I've ever received: Work on things and units that YOU like to do. You may not get any response from your students about some of the activities, but if you enjoy doing it, they have a better chance enjoying it as well. If you have fun, they will pick up on the enthusiasm you have. If you hate the unit, they will pick up on that as well and will dread working that day for you.

 
  #12  
Old 08-12-2006, 05:00 PM
PKPLAY PKPLAY is offline
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Texas
Have you heard of Dr. Lilli Nielsen and the active learning approach for working with severely impaired students? Our district has opened up Active Learning Classrooms(ALC) and Experiential Learning Classrooms (ELC) . Dr. Nielsen's theories are based on her experiences working with the visually impaired population and can be used with students with significant motor and cognitive impairmments. Very good stuff!!!
  #13  
Old 08-12-2006, 11:53 PM
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gwat1aw gwat1aw is offline
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Mississippi
PKPLAY,
I had not heard of Dr. Nielsen and the active learning approach; but be sure I'll be doing my "homework" to check it out! Thanks!
gwat1aw
  #14  
Old 08-14-2006, 04:17 PM
bcblue bcblue is offline
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Massachusetts
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gwat1aw,
Have you ever done story boxes? This I picked up from a vision therapist I worked with during my student teaching. She would have a book on tape, and a box full of various items that were in the story, with as many sensory components as possible. First she would play the story and show the pictures, then she would go back through, reading a page at a time, and using the object props--something to smell, to feel, an action to do, something to taste--having each student touch it, smell it, perform the action, etc. I saw her do this with classes like yours, and it went over well. I've also used it in modified versions in my class, which is probably a little less involved than yours.
  #15  
Old 08-14-2006, 06:06 PM
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gwat1aw gwat1aw is offline
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Mississippi
BC:
Thanks so much for the idea. I'm not real sure if I'm imaginative to do all that, but I will definitely have to see if I can figure it out to try
  #16  
Old 08-15-2006, 01:04 PM
bcblue bcblue is offline
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Massachusetts
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"If You Give a Mouse a Cookie" is a good one to start with, or any of that series.
  #17  
Old 08-20-2006, 12:57 PM
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Illinois
Finally!

SO glad to have found this group! I don't remember what I Googled to get here, but thank goodness I did!

Every forum or website out there seems to say it's about "severe" disabilities, but usually turns out to be about students who are far higher functioning than mine.

I, too teach medically fragile students with severe and profound disabilities, some with g-tubes and trachs, most w/ seizure disorders. Most are unable to bear weight, a few can ambulate with assistance or gait trainers.

I think we can learn a lot from each other!

I love the sensory ideas, the massage leading to better ROM.

Other than the usual diapering/toileting and ROM/hygiene/medical activities,my students are positioned in a variety of equipment throughout the day: Tumbleform seat, Rifton chair, mobile prone stander, standing table, wedge, sidelyer, Advancement chair.

While in those positions they engage in a variety of activities: switch use with computer or electronic "toys" (always w/ choicemaking integrated into this), group social times (bring Step-By-Steps from home w/ messages to relay), home ec. cooking activities w/ switches. For P.E. time they are in the gym in various positioning equip. w/ peer tutors or swimming at the h.s. with staff. Community trips occur 2x/weekly with an emphasis on choice-making for items bought and using Big Mac or Step by Step switches to interact with store personnel.

What I would like to know is
1)what kind of medical support/staff do your students with medical issues receive?

2) Toileting issues: have you attempted habit training and if so, how is it going?

Again, SO glad to be here!!!! I feel like I hit the jackpot!
  #18  
Old 08-20-2006, 01:41 PM
PKPLAY PKPLAY is offline
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Texas
One thing that I am going to be making in my classroom this year is an area against a wall with a handrail attached to the wall at student height. Behind the hand rail I am going to attach a mirror and mount some peg board so I can attach various textured/visually stimulating, &/or noisy items for the student to explore while they are in a standing position. I have one student in mind in particular for this, ( who has a Trach. and g-tube, but is able to support herself with some assistance), but I think many others that I have
had could have benefitted from this area to help motivate them to gain strength and independence in standing. With the peg board mounted on 2x4's (?) I think I'll be able to change out the hanging items ( hanging with elastic)...it's a work in progress, so we'll see.

AS far as support staff for medically fragile students, in our district we do offer school heath services ( a nurse) for students that potentially life threatening issues, especially if they are riding on the bus toand from school ( the nurse rides with them and stays in class with them).
Some have private duty nurses at home that the family may opt to send instead.We also have a school nurse for all of the students who can assist with tube feedings, treatments, etc.
Then we have the other related service staff, PT, OT, assistive technology ( provides assessment, switches, cause and effect toys and software, and communication devices such as springboards or techtalks). We also have music therapy, but the age group that I work with usually does not seem to qualify for this service. Our staff in the vision and auditory impairments have been a wealth of information for me as well.
  #19  
Old 08-20-2006, 09:11 PM
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Illinois
[I]"One thing that I am going to be making in my classroom this year is an area against a wall with a handrail attached to the wall at student height."

I like that- I have 3 students out of 7 that would benefit from an activity bar- great idea.

How about toileting....has anyone attempted habit training?

School starts this week!! I never feel prepared enough!
  #20  
Old 08-21-2006, 05:42 AM
PKPLAY PKPLAY is offline
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Texas
What I usually do for toileting is very individual. If they have the trunk support to sit up with little assistance I do start them on the toilet and have them do as much of the toileting routine as they can do, at the least to acclimate them to the whole idea and get them comfortable in that area. I have had the most success when families are actively working together with us on this skill and when we share what works ,what doesn't work...
I do try to go with the student's natural schedule for toileting to help increase the likeliness for success in the toilet.
Not sure if this is at all like habit training...can you go into what that is?
 

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