level of communication it takes to handle a case where a child has multiple disabilities. A transdisciplinary approach is useful in allowing professionals to collaborate and ask for help should the client or the client’s parent require it. Handling a child with multiple disabilities is an arduous process. It involves use of equipment, proper handling, and consistent therapy that cannot be done in a multidisciplinary setting. Well, it can be done, but not as successfully as in a transdisciplinary setting.

Connecting the material back to earlier information read, open-ended interview questions help collect information from a parent more than simple questions. It is so important during the initial stage of a case to understand what the child goes through each day and how the parent handles the child. While this part may seem difficult by asking open-ended questions, it provides the kind of information that will be needed by everyone in the transdisciplinary team. The more information, the more informed everyone is and will be able to better understand what to do for the child. By reading this module, it reinforced my already clear beliefs that an interview is an important aspect of quality healthcare delivery and communication is the most important aspect of any task, especially when working in a team and with multiple individuals.

The future will see more integration of children with special needs with children in schools. Teachers will have to learn to deal with the needs of special needs children. One thing I observed from the reading was the incorporation of the use of touch by occupational therapists. By using key word signs, object cues, as well as exaggerated intonation, this can help children with special needs learn and understands things in an easier way (Chen, 2008). Collecting information is important, but so is approaching teaching and therapy in different ways.

Mai Ling and Her Family

Mail Ling lives with her paternal grandmother and parents. The mother and grandmother do not speak English, only Mandarin while Mai Ling’s father speak English and Mandarin. With Mai Ling being hospitalized shortly after her birth in Taiwan, Mail Ling proved to be a baby with fragile health. The Lee family quickly immigrated to America thanks to Mr. Lee’s proficiency in computers and upon arriving in southern California, Mai Ling was hospitalized again for pneumonia.

Due to her feeding difficulties, she received a G tube and was later diagnosed with Goldenhar syndrome. Mai Ling also suffers from eye abnormalities and was diagnosed with a bilateral moderate conductive hearing loss, considered legally blind and partially deaf. Mai Ling also demonstrates delays in motor and cognitive development. The case appears to be handled via a multidisciplinary approach. There are multiple medical professionals but no one is working together or communicating with each other. The only connecting factor is the Mandarin-speaking translator. This translator should work with a supervisory nurse that will coordinate treatment goals with all the other medical professionals to ensure Mai Ling gets the care she needs. Since early intervention is crucial due to all her medical problems, the Lee family has to understand the necessity for the multiple visitors. That is where the supervisory nurse comes in with the translator to inform the parents of a cooperative plan to improve Mai Ling’s condition.

Jennifer and Brittany

Jennifer is a foster care teen that likes to drink and party. She got pregnant and the child was born with Down syndrome and developed cataracts. While Jennifer thought it was fun to have a baby, now she does not want to take care of Brittany. The strength of the family lies in the foster mother providing a good home for Jennifer and Brittany but that challenges lie in Jennifer not being a suitable parent. Brittany needs to be reassessed for cognitive and motor development delays because she cannot crawl or pay attention. Jennifer needs the child removed and the child placed in a program that treats children with special needs.

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Achievement discrepancies or discrepancies in achievement help school staff identify children with learning disabilities. However, another thing to note is sometimes children that are just having a difficult time learning can be misdiagnosed with a learning disability when in reality, that child may just need a different approach. I remember I was talking to a parent with a 4-year-old son. She said her son is autistic and that he attends a special education program. The school noticed he did not socialize in the way normal kids do. I noticed he was able to socialize and could read and understand complex social cues.

Now that he is enrolled in a special education program, he will learn at a slower rate than normal children all because his mother was told he is autistic. I just think achievement discrepancies are not the definitive mark in telling if a child is disabled or not. For example, a child that stutter may not sound like he or she can read well out loud, but when tested about the material does well. In that case, the appearance gives off of someone that cannot read, however, everyone knows stuttering is not necessarily associated with learning difficulties. Charlotte Danielson’s Framework for Teaching helps in recognizing an individual student’s learning needs while also helping to develop strategies to address such needs.

Individualized education program or IEP is another concept covered in the chapter and consists of a written document developed per public school student eligible for special education. It is reviewed at least annually and is done through collaboration between professionals and parents. By a child having an IEP, that child may get the help he or she needs in terms of learning and services the school may offer as well as measuring any progress made. Since an IEP is a legally binding document, it must be done and is something parents need to plan well in order to get the best for his or her child.

Another interesting thing to note is Second language acquisition-associated phenomena or SLAAP. A definition proposed by Brown, what causes SLAAP involves a variety of external factors. These can include one’s homeland to traveling to a different country. Such transitions are happening in the United States with Hispanic/Latin children learning English when their first language was Spanish. Children that try to acquire a second language experience cultural shock, feelings of isolation, just to name a few.

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Serge was not assessed properly. First and foremost, he is a shy child. Therefore, when prompted to continue the test in English or Serbian, he may have not indicated when he should have, which parts should be done in Serbian. The whole test should have been done in Serbian because as his progress indicates in the 5th grade, he appears to learn quickly and has no problem learning new words. Language learners often share what appear to be the same difficulties as those with actual learning disabilities.

As seen in my personal experience, many children coming to America do not speak English. They try to learn it in ESL programs. These children demonstrate the same difficulties with attention, social skills, learning and emotional and behavioral balance as a student with learning disabilities would. Therefore, it is important to perform any assessment in that child’s native language to truly see how well they can perform academically.

The IRIS Podcast included an interview with Ryan Kettler. In it, he discussed the dynamic assessment of testing accommodations, designed by Lynn and Doug Fuchs. When the student takes the test, they take two versions, one with accommodation, one without. The difference in scores will help in assessing a potential disability especially when compared to the scores of a known non-disabled student.

Games are an excellent way to help children learn because it offers them a chance to teach themselves and their peers. Post-assessment often involves re-teaching in a way that allows the student to learn differently making it a formative assessment because it is continual feedback that allows for improve teaching and learning. For example, a student may not understand the meaning of the previous week’s lesson plan because he has a hard time learning from reading. So the lesson plan is adapted to include a hands-on approach and is taught by one of his peers so he can feel comfortable to ask questions and feels more engaged and interested to learn.

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1.) Interview of a Family Member of the Child with a Disability

At what point in your child’s development did you realize your child might have some delays or disabilities?

My son is now 4 years old. When he was a baby, he began exhibiting signs of ADHD. First he would be really fussy. Then he would cry for very long periods of time. Nothing soothed him. When he got older he began fidgeting a lot. I tried to hold him and he would squirm out of the hold and smack me across the face.

Can you describe the process you went through to get a diagnosis?

I did not do anything when he was a baby. When he was a toddler however, I took him to a pediatrician but then I was told to wait. When he was 3 he began a preschool program and went to daycare. There they noticed some hyperactivity and so I went back to the pediatrician who told me to get some notes from the program and daycare and then he performed his own assessment and told me my son fits the signs of ADHD.

What are your recollections of your first experience with either a private, public agency or school system?

I only have a private daycare and private preschool program experience. It was pleasant. They were very attentive to my son and especially after the diagnosis of ADHD, they tried to be more patient with him and began using visual aids.

Have your expectations changed in terms of resources and support you expect from this entity?

I don’t understand exactly, but in terms of schooling, once he is enrolled, I will let them know of his condition and hopefully they will use visual aids like they do in the preschool program. The cards with pictures is his favorite game and he has improved his vocabulary with them.

How have other family members reacted to having a brother, sister, son, etc. in the family that has delays or disabilities?

Nothing is different. He is treated like a normal child. They are more patient with him if he smacks them across the face or screams out of frustration. They don’t really treat him differently otherwise.

What do you think of the individual education planning process? Have you been encouraged to be actively involved in the IEP/IFSP/IIIP process?

I haven’t really started that yet as he is not in regular school. So far, I was told as he gets older I have prescription options and he could go see a psychiatrist weekly. ADHD is not supposed to affect learning too much, but I plan on getting him a private tutor should he have any difficulties concentrating.

Do you believe your child is receiving an appropriate educational experience?

I believe so. He has learned new words. He can identify written words. He could not do that before. I really think the use of visual aids has really helped him and will continue to help him in the future.

Is there anything else you would like to share?

Although the signs were there, it is important to take time in identifying a disorder like ADHD. I just think parents are too quick to diagnose and end up misdiagnosing. The assessments from the preschool program really helped me understand he could have ADHD.

2.) Interview of a Professional Working the Child with a Disability

I interviewed the preschool teacher that helps Todd, the 4-year-old with ADHD. Her name is Sandra. The first thing she noticed about Todd which led her to make notes about him was his behavior. As his mother mentioned, he had a habit of smacking people in the face. He only did that when they sat him on their lap or tried to pick him up or sat next to him. Although he was non-violent most of the time, this was something easily noticeable and added to the potential ADHD diagnosis.

Sandra also noticed that he did not pay attention when the group was reading something. When she introduced visual aids like a sign or a picture that was big enough for him to see, he would become more interested. Visual aids helped Todd improve, especially in regards to reading and vocabulary. Sandra used cards with words and pictures in order to help him learn, identify and read words. She would also use dolls to help act out a story.

She saw that his motivation to learn was greatly increased also when he was allowed to participate more in the lesson. When he was asked questions directly, he would stay more focused. It is hard a child with a potential learning disability as Sandra noted, but she feels rewarded that she could grow as a teacher by helping someone like Todd learn and grow.

3.) Observation of the Child with a Disability

I observed Todd for 4 hours while he was playing with his sister, watching a movie, and eating a snack. When he was playing with his sister, he was a bit rough with her. He kept changing his mind on what to do. First they played with some Legos. Then he tossed some Legos and decided to play tag with her. The sister is 8. She was annoyed with the changing and wanted to focus on building her bridge and decided to back to her Legos after he decided he wanted to watch TV. The mother intervened and asked him if he and his sister wanted to watch a movie. This was all for 2 hours.

Todd was very excited and proceeded to run to the couch. When the movie started, he was focused for 15 minutes, but when the movie turned stagnant, he proceeded to grab the remote to change the channel. His mother took back the remote and told him he had to watch the movie. He did not want to and threw a small tantrum by getting off the couch and running to the kitchen. The mother went after him and picked him up. He slapped her in the face. He was scolded and put on time out in the corner of his room. He stayed there for 30 minutes. When the door was opened, he was found playing with some action figures.

His mother let him go to the kitchen and a snack was given. He ate some chicken nuggets and ketchup with some Cheetos and a cup of soda. He felt tired and his mother decided to give him a nap. He did not feel any better after the nap as it was only for an hour and told his mother he needed to use the bathroom. That was the end of the observation.

4.) Summary of Information and Recommendations

The child seems to display characteristics of inability to focus, impulsivity, and hyperactivity. He is getting all the help he needs for now. However, when he enters school, that is when an IPE will be formed and he will get more options. I learned visual aids are a great tool for children with ADHD. They provide an additional way to keep the child engaged while learning. I also saw the importance of observing behaviors.

He does not eat well. Nutrition is an important aspect of well-being. Eating processed foods like chicken nuggets and ingesting soda is never good for a growing child. There is hardly any nutrition in these kinds of foods. Although diet alone will not improve a child’s ADHD symptoms, it can help the child by providing the child with essential nutrients that will help someone like Todd stay focused and feel good throughout the day.

Energy is one thing that is a side effect of an improper diet. When eating too much or not eating enough or eating junk food, a child may exhibit signs of chronic fatigue. I asked the mother if Todd took naps throughout the day and she stated Todd take 4 naps throughout the day. Sometimes it is for 15 minutes, other times like when he was observed, it was for an hour. Processed foods can affect the energy levels of people, especially children, as they may be more sensitive and are still developing.

A randomized, double-blind, placebo-controlled study attempted to test the effects of sodium benzoate as well as 6 artificial food colorings on 153 preschoolers and 144 elementary students to see if these ingredients affected hyperactivity. The children were a mix of healthy children, not diagnosed with ADHD. They were assessed for six weeks with the additives added to a juice and then six additional weeks where some of the additives were added. “Mix A contained the preservative plus the colorings sunset yellow, carmoisine, tartrazine, and ponceau 4R; mix B contained the preservative plus sunset yellow, carmoisine, quinoline yellow, and allura red AC” (Harvard, 2009). The teachers and parents were asked by the researchers to assess hyperactivity in the children. “The investigators found a mild but significant increase in hyperactivity in both age groups of children — across the board, regardless of baseline hyperactivity levels — during the weeks when they consumed drinks containing artificial colors” (Harvard, 2009).

This study provides insight into children and their inability to function properly on a diet of junk food. Although it seems like common sense, many parents in the United States have turned to processed foods and fast food to feed their children. I asked the mother if she had any problems with preparing food and she told me she does not cook often and microwaves a lot of her meals and her kids’ meals. A simple recommendation came in the form of meal prep.

Busy parents like her can buy a rice cooker, prepare a large bowl of rice and keep it in the refrigerator along with baked chicken, fish, steak, or even cooked tofu and some steamed veggies or frozen veggies and place the portioned meals in the microwave to reheat. One day of cooking can make 6-7 days of already prepped meals. The children get whole cooked foods and some of the hyperactivity and fatigue Todd experienced could be alleviated by just making a dietary change.

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The assessment I use with my students is a simplified version of Dynamic Learning Maps Alternate Assessment. English language learners often find it difficult to learn the material provided for them because it is not in their native tongue. With language acquisition, there is often a ‘silent phase’ which may be confused with a potential learning disability. In fact, there is a widespread overrepresentation of ELLs in special education programs. For example, Latino ELLs were 70% more likely to be placed in a special education program in San Diego vs. Latino students not taking English-language curriculum (Smith, 2014). However, once districtwide reforms were introduced, English learners were assessed differently, able to follow through with regular curriculum through newly perceived problems English learners commonly experience that are not attributed to learning disabilities. Thus making assessments like DLM-AA a useful tool in screening.

DLM-AA allows a teacher to track a student’s progress throughout the year and allows for more effective understanding of any potential hurdles. People learn in different ways, by tracking continual progress or lack thereof, the child will be differentiated from someone who is has no learning disability and someone who does. Any modifications made with this kind of assessment comes in changing the assessment to suit the need for a one-time assessment, for early Special Education Early Childhood, and changing the language of the assessment to Spanish and not English since the majority of the ELL students are Hispanic/Latino.

Results from the assessment should reveal certain results according to four standards: emerging, approaching target, at target, and advanced. With emerging, students will be able to understand words for people or absent objects, recognize different or similar physical characteristics of objects, attend to object characteristics when verbally cued, identify personal emotions, notice new objects, and make a selection among two objects. When approaching the target, a student identified facts and details by understanding and recognizing relationships among concrete details, answering who or what questions about pictures, recognize words with different, similar, or same meanings, recognize the emotions of characters, identify pictures from familiar texts, connect two or more words. When at the target level, the student can identify personal emotions, character emotions, determine which event comes first within a text, identify the beginning, middle, and end of a familiar text, express more than one idea. When at the advanced level, the child can answer who, what, when, where, and/or why questions, can associate concrete details with events, can identify temporal order of events in a text or information, compare elements of two text, understand definitions for unambiguous words within a text, and express complete thoughts.

I tried to incorporate as many visual aids as I could along with Spanish language. I also let the child write in Spanish and worked with a translator to help me understand if the child understood the questions. The tasks were varied and involved simple things like identifying objects from a picture card with a tangible object. For example, I had a picture of a red car and a red car toy along with other colored cars. I asked the students to say what the card meant in Spanish and if possible, in English. I also asked them to pick up the corresponding toy.

Then I had the children put the cars in a small area and proceeded to read a short story using a picture book. I asked them to remember what color the car was on the card and to bring it back to me. I also asked what happened within the story that was read to them. I asked them to identify what happened in the beginning, middle, and end. They were quizzed on what the characters felt in the story, what time it was in the story, (there was a clock that said 9:40am and that was repeated twice). I also tested basic math skills like addition and subtraction with the toy cars as examples.

Memory and concentration are often key indicators for learning disability. “In sum, children with reading disability and those with spelling disability seem to be characterized by different working memory profiles. Thus, it is important to take both reading and spelling into account when investigating cognitive factors of literacy difficulties in transparent orthographies” (Brandenburg et al., 2014, p. 622). By asking about the time and the color of the toy car, that helped me assess memory. Because I used a lot of visual aids like the picture book, the toys, the cards, I think it was easy to understand. These are young children and regardless of their understanding of English, pictures are easy to interpret. The fact I included Spanish in the assessment made it easier for the children.

While the assessment was easy to administer and the children responded well, it may not be that easy to get a translator to come and help. Unless teachers know Spanish or another language that the child knows like some children’s native language is Chinese, it may be hard to administer the test in native tongue. That is why use of visual aids may help along with letting children touch and place items. Including tangible things in the assessment helps children uncomfortable with talking or writing to still express themselves. Because this is a modified version of a much more complex assessment, it is not as valid as it is not standardized.

Different types of assessments exist to suit the needs of the student population. Some students learn differently from others, some have trouble with language and cultural barriers. That is why it is important to assess an individual student in a way that is both meaningful and allows for effective communication for student and teacher. Creativity is a key in generating quality assessments as well as improving assessment practices.

Creativity allows for assessments to be tailored to suit the needs of the student. It also provides different avenues of learning from which the student may respond positively to, or negatively. Because language acquisition can be hard to manage, it always best to consider what will work and what will not in identifying strengths and weaknesses of a student. Students without the proper tools will stay quiet and may be placed in a program that he or she does not belong in. My students performed well in the assessment and were in the very least, able to participate fully.

As previously mentioned the use of visual aids helps, especially in cases of learning disabilities (Gangwer, 2009). Learning disabilities are often characterized by certain behaviors and trouble with memory and language. However, that is not to be confused with ELL students. They may also demonstrate the same problems and not have actual learning disabilities. They may in fact, simply have trouble understanding and adapting a new language and a new culture. Language is an important part of learning and should be assessed in a way that helps the students express him or herself.

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Reflection

Children learn and grow and different rates. I have learned that approaching teaching should come from different perspectives. By experiencing some of the difficulties children have when it comes to learning, I can see that there needs to be some changes made in regards to curriculum and offering options to children to keep them engaged and interested. When children have learning disabilities it makes it harder for them to learn the traditional way. By using visual aids, children can learn without having to focus so much on text or what the person is saying. It can help them make the connection faster when they see what they are learning about rather than merely hearing about it or reading it.

I also learned the importance of proper assessment. ELL students have so many things to contend with when they go to a new school in a new country. They may feel depressed, isolated, and alone when they must learn a new language. Most of the children that are in an ELL program or ESL program are often placed in special education when they do not need it. Maybe they were too shy or anxious when trying to speak English.

Therefore, it is important to learn about a student’s culture, learn about the student and see what can be done to help that student progress and meet their academic goals. It takes more effort and it may not always be practical, but it gets results. I learned it takes a lot to truly connect with a student. It also takes trying to see things from different views and using various strategies just to achieve an end-goal. We are all individual and complex beings. To approach such a difficult issue in a standardized way will not help. Things must be modified in order to make sure students get what they need.

References

Addison, J. (2016). Home. Visualaidsforlearning.com. Retrieved 5 June 2016, from http://www.visualaidsforlearning.com/

Bell, S. & McCallum, R. (2015). Handbook of Reading Assessment: A One-Stop Resource for Prospective and Practicing Educators. Rotledge.

Brandenburg, J., Klesczewski, J., Fischbach, A., Schuchardt, K., Buttner, G., & Hasselhorn, M. (2014). Working Memory in Children With Learning Disabilities in Reading vs. Spelling: Searching for Overlapping and Specific Cognitive Factors. Journal Of Learning Disabilities, 48(6), 622-634. http://dx.doi.org/10.1177/0022219414521665

Chen, D. (2008). Early intervention in action. Paul H Brookes Pub Co.

Gangwer, T. (2009). Visual impact, visual teaching. Thousand Oaks, CA: Corwin Press.

Harvard,. (2009). Diet and attention deficit hyperactivity disorder – Harvard Health. Harvard Health. Retrieved 5 June 2016, from http://www.health.harvard.edu/newsletter_article/Diet-and-attention deficit hyperactivity disorder

Herrera, S., Murray, K., & Cabral, R. (2013). Assessment Accommodations for Classroom Teachers of Culturally and Linguistically Diverse Students (2nd ed.). Pearson.

Holden, S. (1978). Visual aids for classroom interaction. [Oxford, Eng.]: Modern English Publications.

IRIS Center,. (2016). English Language Learners: Is This Child Mislabled?. Retrieved 4 June 2016, from https://iris.peabody.vanderbilt.edu/wp-content/uploads/pdf_activities/case_based/IA_Is_This_Child_Mislabled.pdf

Kettler, R. (2016). IRIS — Transcript: Ryan Kettler, PhD. Iris.peabody.vanderbilt.edu. Retrieved 4 June 2016, from http://iris.peabody.vanderbilt.edu/interview/kettler_acc02/kettler_acc02_trans/

Nobori, M. (2011). 5 Strategies to Ensure Student Learning. Edutopia. Retrieved 4 June 2016, from http://www.edutopia.org/stw-differentiated-instruction-budget-assessment-how-to

Paul, J. (2002). Rethinking professional issues in special education. Westport, Conn.: Ablex Pub.

Sheen, B. (2009). ADHD. Farmington Hills, MI: Lucent Books.

Smith, H. (2014). Assessing ELLs for Special Education: 5 Pitfalls to Avoid. Scientific Learning. Retrieved 5 June 2016, from https://www.scilearn.com/blog/assessing-ells-for-special-education-5-pitfalls-to-avoid

Webber, C. & Lupart, J. (2012). Leading student assessment. Dordrecht: Springer Science+Business Media B.V.