Meeting the Needs of Children and Families-EpilepsyECEP 233 063- Inclusion of Children with Special NeedsNadia Quest300653498April 4, 2013Lisa McCaie
Needs of the child• Mom was told that Zenna has epilepsy• I observed that Zenna has atypical development in many
areas of development
Needs of the family• Zenna’s mother was recommended to stay on complete bed
rest because she has a difficult pregnancy and is at risk of delivering the unborn baby prematurely.
• Her mother was told that she has epilepsy and doesn’t know what to do
What is epilepsy?• “a chronic disorder of the
brain resulting in the tendency to have reccurent seizures” (Haugen, H. p.42)
• This disorder affects how the cerebral cortex functions, causing the neurons to fire off faster than normal in little bursts of electricity sending the body mixed up messages, which results in an epileptic seizure (Haugen, H. p.4)
• A pattern of chronic seizures over a long period
Understanding epilepsy videoDr. Fisher, MD, Professor of Neurology and Director of the Stanford Epilepsy Center
http://www.youtube.com/watch?v=MNQlq004FkE
Symptoms of a seizure
Minor
• Staring into space• Lip smacking• Arm and leg jerking• Blurry vision or a brief
loss of hearing
Worst
• Fall to the ground in convulsions and pass out (unconsciousness)
What causes it?• 50-70% is unknown• 8% is inherited from parent, there’s a higher risk if parent has
epilepsy• Males are more likely to have epilepsy• It can develop at any age, most common under twenty • It can happen as a result of trauma to a baby during birth from
the lack of oxygen to the brain• Poisons like lead in paint, mercury in thermometers and
carbon monoxide in gasoline can also cause epilepsy
Some common triggers• Flashing or flickering
lights• Stress (too much)• Not enough sleep• Poor diet
Categories of seizures
Partial Seizures
• Occurs in one area of the brain
• Only one area of the body is affected, if occurs in the area that controls vision is affected causing it to be blurry
Generalized Seizures
• Spreads throughout the brain affecting more than one area at a time
• Grand mal-loss of consciousness, contraction of muscles, last from three to five minutes, longer recovery
• Petit mal-stare into space, pause during conversation, lasts thirty seconds, no recovery time needed
Adaptations to the Physical Environment
Removal of Barriers• The classroom should
have some open space with wider paths just in case she were to fall to the ground, there would be less objects to hit into
Physical Space• Have a “rest area”
available for when she is recovering from a grand mal seizure because she will feel tired and confused
• Or a “safe spot” for the her to lie down if she can tell when a seizure is coming
Adaptive DeviceWorking Service Dog: Seizure-Alert Dog• A specially trained seizure-
alert dog is very helpful to have because it can alert Zenna to let her know she’s about to have a seizure so she can get to a safe spot
• This dog will “react to this by circling the owner, pawing at the ground, or barking” (Wright,S. p.39)
Flexibility in Routines, Schedules & Activities
• If I was a caregiver at a center or in a school the daily schedule will follow an order but flexible with time because if Zenna has seizures throughout the day she will require extra attention
• She may need time to rest and recover after, so I would tell her to join in when she’s ready
• If she misses out on an activity or didn’t finish I can make some time in the schedule to make it up
Safety & Safe Risk taking• Depending on what
type of epilepsy Zenna has, she may not be able to take part in all sports activities so I will always take precautions against possible dangers when Zenna is bike riding, climbing and doing contact sports, and have a helmet available
• Baby proof the corners of shelves and tables with cushioning material to reduce injury if she were to pass out
Collaborative Planning• Make sure that all the
staff are aware of Zenna’s special need and share ideas, working together to help her and to promote an inclusive environment
• Work with other professionals to support and guide Zenna
Staff Support & Training• The caregivers in the
room should have a workshop to learn about what happens during a seizure and trained in first aid procedures for grand mal seizures, if Zenna has this type of seizure
• Staff should be aware of the signs of a seizure and triggers to avoid
Parents of the Child with Special Needs
• I will warmly greet her mother each day and give her verbal support
• I can have resources available like brochures for Zenna’s mother to gain more information about epilepsy and learn about the services and agencies that can support them
Inclusion of the Child• Modifications to the physical environment can be made to
support Zenna’s development, encourage participation and independence
• Zenny will be treated with respect and fairness from the staff and other children in child care setting
• Teaching the other children about Zenna’s special need could reduce some of their fears and to gain an understanding and acceptance
How to involve the other children
Depending on the age of the other children:• Teach the other children in the room about epilepsy using
books and role play so that they can help if needed• The other children can learn the signs/symptoms of a seizure
to call a teacher and know what the triggers are• Let the children know where to find cushions in the case of a
seizure• If the seizures may be too traumatizing for the other children
the caregiver can make arrangements to bring the children to another room
Inclusion of the Family• One thing I could do is advise Zenna’s mother to sign a form
14 to get access to services that are available to help her and give relief to the family with support.
• Make a written document (log) from observations I made of Zenna throughout the day to share with her mother.
• Have open communication with her mother about Zenna’s progress and be available to talk with her when needed in person or by phone.
First Aid for seizures
• http://www.youtube.com/watch?v=rW4ThDRvzcE&feature=player_embedded
Teaching Strategies• As an ECE I could record observations
to work with a Resource Consultant to make and implement Individual Program plans, if she was in a child care centre, and Individual Education Plans, if she is in school, to help her reach her full potential and implement the IPP’s
• If Zenna has seizures she will miss out on learning so the “IEP is a written plan and is a working document that describes the strengths and needs of an individual exceptional student, the special education program and services established to meet that student’s needs, how the program and services will be delivered and how the student is progressing” (tdsb glossary, website)
• The IPP’s and IEP’s “include thoughts, ideas, observations, strategies and solutions” (Class notes, week5 )
Agencies & Resources
Resource Teacher or Consultant• The Resource Teachers
can help provide schools an opportunity to meet the needs of Zenna while maintaining a traditional environment.
• It will give Zenna an opportunity to interact and learn with the other children
Toronto District School BoardGeneral tel: 416-397-3000 Email:[email protected]
Paediatrician• The “Paediatrician
specializes in child development and medical care for children” (Week 9 notes)
• He will be able to help Zenna’s mother monitor her development
Dr. Peter Azzopardi3030 Lawrence Ave EToronto, ON M1P 2T7
(416) 431-5292
Neuropsychologist• Zenna’s mother can
talk to this specialist about any concerns she may have about her learning abilities she may have
• Conducts assessments and provide family treatment and support
Dr. Elizabeth KerrThe Hospital for Sick Children555 University AvenueToronto, ONM5G 1X8Canada
Social Worker• The social worker can
refer Zenna’s mother to services that are provided and direct her to community supports and services (Week 9 notes)
• They can help Zenna’s family to adjust to any problems they may have in their lives
Malvern Social Services Office (OW)325 Milner Avenue, 9th Floor, TorontoPhone: 416 397-1000, 416-397-1010
Psychiatrist• This specialist could
provide assessments, monitor medications she may receive or treatments
• They can also offer family councelling
Dr. Susan BradleyThe Hospital for Sick Children555 University AvenueToronto, ONM5G 1X8Canada
Tel:416-813-8150
Family Doctor• Zenna’s mother can
bring her for regular check ups
• The doctor can help them find support
• If Zenna wasn’t diagnosed by her family doctor her mother could bring her to get diagnosed and referrals for accessing and diagnosis
Dr. Naznin LalaniScarborough Medical2680 Lawrence Avenue EastScarboroughOntarioM1P 4Y4Tel: 416-755-2242
Public Health Nurse• A nurse can “provide
information on healthy growth and development of children, immunization and resources, supports and services in their community” (Week 9 class notes)
• The nurse can also help Zenna’s mother to receive care at home while she’s on bed rest
• Call 3-1-1 for information and referrals
Relief Worker• A Relief Worker “works
with the child with special needs within the home to allow relief for the parent” (Week 9 class notes)
• Zenna’s mother has difficult risky pregnancy and should be on bed redt so a Relief Worker is important because he/she will be able to work with Zenna at home so that there is less travelling
St. Elizabeth2 Lansing SquareSuite 600Toronto, ONM2J 4P8
Phone: 416-498-8600Fax: [email protected]://
www.saintelizabeth.com/About-Saint-Elizabeth.aspx
Special Education Teacher• “Specialty teacher who oversees and may also implement the
education and development of children with special needs” (Class notes, week9)
• If Zenna is in school this teacher would help her to plan an education program for her
Toronto District School BoardGeneral tel: 416-397-3000 email: [email protected]
Early Childhood Educator• An Early Childhood Educator “observes, participates in creating and
implementing IPP’s, make adaptations in the environment, supports families, links with other professionals, etc” (Class notes, week9)
• An ECE understands the importance of teamwork and collaboration with other professionals to meet the needs of that child and promote inclusive environments
• An ECE knows the importance of being connected with the families as partners in their child’s learning and development and supports the needs of the families using resources
Epilepsy Toronto • Epilepsy Toronto “prioritizes
individual needs, the importance of living as independently as possible and the benefits of community engagement. Our programs address all aspects of epilepsy from the first diagnosis of a child, to the struggles that young people face, to adult needs such as employment and relationships” (Epilepsy Toronto website).
• They are a non-profit agency that supports people with epilepsy
• Free programs and services are offered, and they provide information about epilepsy
• Services are available to people who have and don’t have epilepsy
• They have a support group for parents of young children with epilepsy, to share their experiences and talk about challenges and happy times raising children with epilepsy
• Child, parent and family counselling services are available to provide information on issues surrounding epilepsy and the impact seizures have on their development
• A counselor works with parents, school and agencies to help the child adjust
Epilepsy Toronto468 Queen St. EastSuite 210Toronto, ONM5A 1T7
Phone: (416) 964-9095Fax: (416) 964-2492E-mail: infoepilepsytoronto.orgWebsite: www.epilepsytoronto.org
http://epilepsytoronto.org/index.php
Canadian Epilepsy Alliance• Canadian Epilepsy Alliance
mission is “The CEA/ACE is a partnership between grassroots epilepsy organizations Canada-wide dedicated to the promotion of independence, quality of life, and full community participation of persons with and affected by epilepsy, through innovative support services, advocacy, education and public awareness”.
• Linked with Epilepsy Toronto and Epilepsy Ontario
http://www.epilepsymatters.com/english/index.html
Epilepsy Ontario• Epilepsy Ontario “is dedicated
to promoting independence and optimal quality of life for children and adults living with seizure disorders. Through a network of local agencies, contacts and associates across the province, Epilepsy Ontario reaches out to people with epilepsy and their loved ones. We do this by providing client services including counselling and referrals, information education and advocacy services” (Epilepsy Ontario website).
• Charitable non-profit non governmental health organization
• provides client services, counselling and referral services
• “funding is entirely from the general public, including contributions from corporations, foundations, patrons, individuals and generated from special events”(Epilepsy Ontario)
Epilepsy OntarioSuite 8033100 Steeles Avenue East Markham, ON Canada L3R 8T3
Tel: 905-474-9696 Tel: 1-800-463-1119 (toll free in Ontario)Fax: 905-474-3663 Website: [email protected] of operation: Monday to Friday 9am – 4pm (EST)
http://epilepsyontario.org/
Sick Kids Epilepsy Classroom• The Epilepsy Classroom
“caters to the individual learning and social-emotional needs of children who have intractable Epilepsy, that is, ongoing seizure activity despite maximal medical treatment, as well as children who have recently undergone brain surgery for intractable Epilepsy” (Sick Kids website)
• Partners with local schools like the TDSB to provide programming
• Onsite consultants such as Clinical Neuropsychologist, Social Worker, Developmental Paediatrician, Clinical Nurse, Neurologist, Psychiatrist
• Sick Kids Epilepsy Classroom has “a multidisciplinary team which incudes a special education teacher, educational assistants, development paediatrician, neuropsychologist and social worker to better understand the interplay between epilepsy and each student's learning profile and social-emotional needs”(Sick Kids website).
• A referral can be made by a parent, teacher/school, neurologist, paediatrician, family physician or other professional.
Elizabeth N. Kerr PsychologyThe Hospital for Sick Children555 University AvenueToronto, ONM5G 1X8Canada
Phone: 416-813-6784Fax: 416-813-8839http://
www.sickkids.ca/ProgramsandServices/Epilepsy-Classroom/index.html
References• Haugen, H. (2005).Understanding Diseases and Disorders:
Epilepsy. Farmington Hills, MI:Thomson Gale Corporation• Wright, S. (2004). Health Issues: Epilepsy. Chicago, IL:Raintree• Epilepsy Ontario. Retrived from http://epilepsyontario.org/• Epilepsy Toronto. Retrived from http://
epilepsytoronto.org/index.php• Canadian Epilepsy Alliance. Retrived from http://
www.epilepsymatters.com/english/index.html• Class notes. Week 5. The Role of the Early Childhood Educator. • Class notes. Week 5.Adaptive Learning Environments. Class
notes Week 5.• TDSB Glossary. Retrived from http://
www.tdsb.on.ca/wwwdocuments/about_us/communications/docs/TDSB_glossary.pdf
Image References• Junk food. Retrived from
http://marginalmatters.wordpress.com/2012/05/08/glycemic-index-your-guide-to-healthy-food/• TV with video game. Retrived from http://www.clipartguide.com/_pages/0060-0807-2100-1320.html• Stress. Retrived from http://www.clipartguide.com/_pages/0060-0807-2100-1320.html• Children at window. Retrived from http://
www.shutterstock.com/pic-22463695/stock-vector-cute-illustrated-children-looking-out-the-night-window-at-the-stars.html
• Child on cushions. Retrived from http://www.premiersolutions.co.uk/detail.php?id=19• Children holding hands. Retrived from http://ajonesfamilyfoundation.org/program/helping-kids/• Brains. Retrived from http://www.epilepsycareandresearchfoundation.com/epilepsy-and-children.html• Mother and daughter. Retrived from http://
www.123rf.com/photo_610479_pregnant-mother-and-daughter-embracing.html• Quiet area. Retrived from http://connectability.ca/2010/10/29/classroom-layout-tips/• Epilepsy classroom Sick Kids. Retrived from http
://www.ehphblog.org/2012/in-school-education/sickkids-epilepsy-classroom-program/• Google Maps. Retrived from http://maps.google.ca/maps?hl=en&tab=wl• Family for Epilepsy Toronto. Retrived from http://epilepsytoronto.org/aboutus.php• Canadian Epilepsy Alliance. Retrived from http://www.epilepsymatters.com/english/index.html• Epilepsy Ontario. Retrived from http://epilepsyontario.org/• Nurse. Clip Art.• TDSB logo. Retrived from http://www.tdsb.on.ca/aboutUs/• Children in a circle. Retrived from http://cmascanada.ca/2011/04/20/inclusion-what-does-it-mean/
Image References cont...• Classrooms. Retrived from http://
connectability.ca/Garage/wp-content/themes/connectability/plugin/si_tipsheets/creating-Positive-environment.pdf and http://connectability.ca/Garage/wp-content/themes/connectability/plugin/si_tipsheets/classroom-layout.pdf
• Child with dog. Retrived from http://4pawsforability.org/seizure-assistance-dog/• Service dog. Retrived from http://www.jumpingwaves.com/tag/seizure-alert-dog/• Schedule. Retrived from http://lessonpix.com/articles/9/33/Visual+Schedules• Teacher and child. Retrived from http://
www.123rf.com/photo_9094087_child-painting-in-preschool-teacher-help-by-little-girl.html• Play learn and grow together. Retrived from http://ourlittlesmarties.com/2010/12/meet-the-teachers/• Parent, teacher & child. Retrived from http
://highergrade.ca/resources/parent-resources/effective-parent-teacher-conference/• Three teachers planning. Retrived from http://www.cpblakely.ca/News.php?news_id=1707• Group of teachers in workshop. Retrived from http://www.radiuscentre.com/workplace-workshops.php• What are we doing now schedule. Retrived from http://
www.preschoolplaybook.com/2008/10/visual-schedule.html• Hands. Retrived from http://trailstoglory.webs.com/• Cushioned table corner. Retrived from http://
www.safecareireland.com/products/product/c/safety-cushions-pads/p/table-corner-cushion.html• Resource teacher. Retrived from http://
woman.thenest.com/special-education-resource-teacher-duties-1577.html• ECE holding hands with children. Retrived from http://www.cotr.bc.ca/ECE/• Brain with captions. http://www.ieaecell.org/epilepsy-03.html
Video References• Understanding epilepsy. Retrived from
http://www.youtube.com/watch?v=MNQlq004FkEhttp://youtu.be/MNQlq004FkE• First aid for seizures. Retrived from
http://www.youtube.com/watch?v=rW4ThDRvzcE&feature=player_embedded