MODULE 10 - Learners with Additional Needs

Learners with Difficulty in Self care

INTRODUCTION

In the special needs world, the most basic skills are called adaptive
living skills, or ADLs. More advanced skills, such as doing laundry, catching a
bus, or following a daily schedule, are sometimes called "life skills" or "skills of
daily living." While these skills aren't critical for survival, they are extremely
important for anyone who plans to work and recreate in a modern community.
Young children with disabilities often demonstrate delays in many areas of
development. Because of these delays, they may need additional help. In order
for children to receive acceptance and acquire as much independence
as possible, it is important that self-care skills be a focus during the preschool years.

LEARNING OUTCOMES

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 After working through this module you should be able to :
a. identify learners who have difficulty in self care;
b. describe learners who have difficulty in self care;
c. recognize the uniqueness of various learners who have difficulty in self care and
implications for supports and teaching strategies ;
d. develop a training program for a person with who have difficulty in self care in personal
care, home living, social or community skills;

A. ACTIVATE PRIOR KNOWLEDGE

Please click the link below and watch the whole video
https://www.youtube.com/watch?v=YOwDfnoek6E

"DON'T LIMIT ME!"- Powerful message from Megan with Down Syndrome

B. Analysis

1. What makes Megan Powerful?

2. What would you feel if you have a classmate/schoolmate like Megan?

3. How do students like Megan manage to get an education in the regular school? What
adaptation are introduced to make inclusion work for them?

C. Abstraction

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 Everyone needs certain skills to simply get through the day. Skills related to eating,
dressing, and personal hygiene are absolute requirements for anyone wishing to live even a semi-
independent life. In addition to these very basic skills are the many skills we use each day to
navigate life at home and in the community

Learners with intellectual disabilities and learners with autism spectrum and can be
referred to such disorders. Learners with intellectual disabilities and learners with autism
spectrum of cognitive processes, disorders of sensory and motor functions, thereof, the formation
of specific social adaptation means is an important direction of work. Moreover, Learners with
intellectual disabilities and learners with autism spectrum require special individual-oriented
approach including the development of self-dependence skills, optimization of parental-children
interaction.

Learners who have difficulty in self care

A. Intellectual Disability
The term 'intellectual disability' refers to a group of conditions
caused by various genetic disorders and infections. Intellectual
disability is usually identified during childhood, and has an ongoing
impact on an individual’s development. Intellectual disability can be
defined as a significantly reduced ability to understand new or
complex information, learn new skills and to cope independently
including social functioning. As with all disability groups, there are
many types of intellectual disability with varying degrees of severity. These include
considerable differences in the nature and extent of the intellectual impairments and functional
limitations, the causes of the disability, the personal background and social environment of the
individual. Some people have genetic disorders that impact severely on their intellectual, social
and other functional abilities. Others with mild intellectual impairment may develop adequate
living skills and are able to lead relatively independent adult lives. Approximately 75 per cent of
people with intellectual disability are only mildly affected, with 25 per cent moderately, severely
or profoundly affected.

Impact of intellectual disability

The characteristics and impact of a person’s intellectual disability will vary depending on the
cause. There are a number of common characteristics that may have a significant impact on an
individual’s learning, including:

 difficulty understanding new information

 difficulties with communication and social skills

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  slow cognitive processing time
 difficulty in the sequential processing of information
 difficulties comprehending abstract concepts.

Austed discussions during 2014 highlighted the challenges that students with an intellectual
disability can experience at university level. Students may cope well with the 'hands-on'
components of post-secondary study, but find it difficult to understand complex information.

Teaching strategies

It is important to know that despite difficulties in a

learning environment students with intellectual
disability can and do have the capacity to acquire and
use new information. There is a range of inclusive
teaching strategies that can assist all students to learn
but there are some specific strategies that are useful in
teaching a group which includes students with
intellectual disability:

 Provide an outline of what will be taught -

highlight key concepts and provide opportunities
to practise new skills and concepts.
 Provide reading lists well before the start of a course so that reading can begin early.
 Consider tailoring reading lists and provide guidance to key texts. Allow work to be
completed on an in-depth study of a few texts rather than a broad study of many.
 Whenever you are introducing procedures or processes or giving directions, for example in
a laboratory or computing exercise, ensure that stages or sequences are made clear and are
explained in verbal as well as written form.
 Students may benefit from using assistive technology.
 Use as many verbal descriptions as possible to supplement material presented on blackboard
or overhead
 Use clear, succinct, straightforward language.
 Reinforce learning by using real-life examples and environments.
 Present information in a range of formats – handouts, worksheets, overheads, videos – to
meet a diversity of learning styles.
 Use a variety of teaching methods so that students are not constrained by needing to acquire
information by reading only. Where possible, present material diagrammatically - in lists,
flow charts, concept maps etc.
 Keep diagrams uncluttered and use colour wherever appropriate to distinguish and
highlight.
 Ensure that lists of technical/professional jargon which students will need to learn are
available early in the course.

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  Recording lectures will assist those students who have handwriting or coordination
problems and those who write slowly as well as those who have a tendency to mishear or
misquote.
 Students will be more likely to follow correctly the sequence of material in a lecture if they
are able to listen to the material more than once.
 Wherever possible, ensure that key statements and instructions are repeated or highlighted
in some way.
 One-to-one tutoring in subjects may be important; this can include peer tutoring.
 Students may benefit from having oral rather than written feedback on their written
assignments.
 It may be helpful for students with intellectual disability to have an individual orientation to
laboratory equipment or computers to minimize anxiety.

Assessment strategies

Students with intellectual disability may need particular adjustments to assessment tasks. Once
you have a clear picture of how the disability impacts on learning, you can consider alternative
assessment strategies. In considering alternative forms of assessment, equal opportunity is not a
guaranteed outcome, it is the objective. You are not expected to lower standards to accommodate
students with disability but rather are required to give them a reasonable opportunity to
demonstrate what they have learned:

 Allow extensions to assignment deadlines

 Use technology to record students work, e.g. digital photography, tape and video.
 Students may take longer to organize thoughts and sequence material. They will benefit
from discussing their outlines, with particular attention being paid to appropriate
relationships and connections between points.
 Encourage the student to submit an early draft of assignments to allow the opportunity for
feedback to the student as a formative process.
 Students with an intellectual disability will need extra time in an examination for reading
and analyzing questions and for planning their answers. Some students will request that
examination questions be read to them. Some students may prefer to dictate their answers to
a scribe. They will need a venue which is quiet and distraction-free.
 Keep short your written examination instructions and sentences within examination
questions. Questions using bullet points, lists or distinct parts are more likely to be correctly
interpreted.
 Because students with intellectual disability find it difficult to read multiple choice
questions in a way that allows them to appreciate subtle changes in the arrangement of
words, short answer questions will be a better test of their knowledge.
 Students may benefit from an exam timetable that features a number of days between exams
to assist in exam preparation.

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  Many students with intellectual disability are chronic misspells and use dictionaries only
with great difficulty.

B. Autism Spectrum Condition

Autism Spectrum Condition (ASC) is a life-long

developmental disability. The cause or causes of autism are, as yet,
unknown. The developmental disability impairs (to varying
degrees) a person's understanding of what he or she sees, hears and
senses. This results in problems with social relationships,
communication and behaviour.

People with ASC may have average or above-average intelligence

but they can find the post-secondary education experience daunting and challenging. However,
many students have successful experiences in a range of subjects, most commonly in
mathematics and computing.

Impact of ASC

Whilst the condition varies considerably for each and every student with ASC, there are a
number of characteristics that may be evident. These include:

 ability for extensive factual information

 development of a specialised interest in a specific topic
 advanced vocabulary in a particular topic
 exceptional memory for detail
 a natural affinity for computers
 original and creative thought patterns
 very independent learners.

However, they may also exhibit the following characteristics in the learning environment:

 weakness in comprehension and abstract thought, problem solving, organizational skills,

concept development, and in making inferences and judgments
 difficulty with cognitive flexibility, tending to think in a more linear way; their thinking
tends to be rigid, they have difficulty adapting to change or failure and do not readily learn
from their mistakes
 tendency to take language literally. Confused by non-literal sayings (e.g. 'get off my back',
'pull your weight') and responding in a way that seems rude
 difficulty coping with change; preoccupation with a particular subject of interest which may
have been learnt by rote, or obsessions or routines which interfere with learning

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  anxiety - even minor stress may cause increase in coping mechanisms, such as repetitive
behaviors (muttering, other verbal habits), panic, incessant questioning
 problems with social relationships, and difficulty in making and keeping friends. In group
situations may behave in ways that seem ‘odd’ to others and may come across as arrogant,
rude or withdrawn
 inability to pick up on non-verbal cues and showing poor eye contact; lack of understanding
of sarcasm or irony, or people’s moods and feelings
 difficulty in understanding or communicating feelings - may be unable to predict or
understand others’ behavior (in group work may not naturally consider other people’s
wishes or needs)
 difficulty interpreting and understanding social situations and communication cues
 poor organizational skills, poor coordination, clumsiness, odd postures and poor gross
motor skills
 speech which is pedantic and monotonic
 Overly sensitive to sounds, tastes, smells and sights, even sensory stimuli that others may
not perceive.

Teaching Strategies

Despite being very intellectually able, students with Asperger's syndrome often show
characteristic behaviors that can disrupt their learning. However, students with this condition can
excel academically if appropriate support and awareness is in place. There are a number of
strategies that can assist these students to learn effectively:

 Get to know the student’s particular needs in advance - meet them before the course starts to
discuss needs.
 Provide clear, detailed information (oral and written) about the structure of the course,
practical arrangements, assessment requirements and deadlines.
 Be consistent in approach and keep variations to a minimum. If a change (e.g. in timetable,
room, lecturer) is inevitable, give clear, specific information as far ahead as possible, e.g.
around exam time.
 Use clear, unambiguous language (both spoken and written) and either avoid or else explain
metaphors, irony etc. and interpret what others say. Give explicit instructions and check that
the student is clear about what he/she has to do.
 If providing feedback, be very clear about what is inappropriate or appreciated, and why.
 Be patient, encouraging and supportive but guide the student back on task if necessary.
 Present course materials and instructions in a structured way using literal language.
 Show how components fit together as a whole. Provide subject word lists, glossaries of
terms and acronyms.
 In group work make clear exactly what is required of students with Asperger's syndrome
and mediate to resolve disputes in a calm, logical way, providing an opportunity

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 immediately after group sessions to check that they have understood. If group-work proves
too stressful, provide alternative ways of completing team work.
 Students may have difficulties in motivation for certain parts of their course due to a
particular interest in one aspect of it. Set concrete, realistic goals to assist motivation, e.g. 'If
you want to become an engineer you must complete all parts of the course, even the essays'.
 Provide access to pastoral support or a particular staff member who can provide support if
the student becomes distressed.
 Provide specialist tuition support, e.g. language skills, structuring work.

Assessment Strategies
 Students may benefit from the opportunity to look at the instructions and structure of
examination papers before the exam so that any confusion can be dealt with and anxiety
minimised.
 The language and rubric of examination papers need to be both explicit and literal. For
some students, multiple choice papers can be particularly confusing and alternative testing
modes may be appropriate.

There are four main types of self-care skills:

A. Self-feeding. The best way to build independent feeding skills

is to learn the normal developmental stages of self-feeding.
Encourage children to practice feeding themselves from infancy
on. Begin by offering older infants finger foods. Introduce a
spoon and fork and give children plenty of time to practice. Let
children be as independent as possible during mealtimes. Give
them the tools they need to be successful. Consider bowls that
attach to the table, child-sized utensils and small cups with
handles and spouts (such as measuring cups) for pouring.
Encourage children to try for themselves but provide help and
encouragement when needed so they don't get frustrated.
B. Independent dressing and grooming. Encourage children to
dress and groom by themselves; just provide minimal
assistance. Begin with older infants and toddlers by
encouraging them to help pull socks on and off, pull up pants after diapering and help put
their arms through sleeves. As children get older, encourage them to dress themselves but
help with challenging steps such as zipping and buttoning.
C. Hygiene and toileting. Look for signs of readiness for toileting. Encourage children
learning to use the toilet to climb on and off the toilet seat, pull clothing up and down,
and wash their hands independently. Also teach children how to brush their teeth after
lunch and snacks. Be ready to provide support and help if they need it. Encouraging
children to take care of everyday hygiene routines and to use the toilet independently
helps them learn how to become more independent and self-sufficient, and frees up your
time to help children with other activities.

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 D. Helping with daily chores like table setting and
picking up toys. Encourage children to help with
clean-up early on. Give toddlers responsibility for
placing napkins or utensils on the table. Encourage
children to begin clearing their own plates when
they are old enough to carry them without dropping
them. When children are involved in regular chores
starting before the age of 4, they tend to be more
independent in early adulthood than children
without the experience of helping out.
E. Self-care skills are worth the time and effort in a child care program. The secret to
success is to give children age-appropriate experiences and provide the appropriate
supports to help children be successful. Child care providers can offer opportunities for
children to develop self-care skills and give them ample time to work on these important
tasks. Remember that adults are important role models. We model self-care skills;
children learn a great deal from watching us.

Techniques to promote self-care skill acquisition:

a. Rewards: Give rewards to the child each time they perform a self care task, or a part of a
task. Rewards can be edible, social rewards, activity rewards, material rewards or even
privileges. Tokens are another way to teach and reinforce self care skills. Make a chart
where you add a star everyday if the child has completed the task independently. At the
end of the month, the child gets a reward based of the amount of stars they got. Different
children benefit from different rewards depending on their level of understanding. Use
appropriate rewards. Researched-based rewards are individualized, age-appropriate, and
naturally occurring in the environment. A naturally occurring reward for drinking from a
cup is relieving thirst. When the child first begins to learn to use a cup, say, “Look at
you! You can drink from a cup!”
b. Forward Chaining: Forward chaining is the process where you break up a task into
small steps, and teach the first step. Then you get the child to do the first step, and you
complete the rest of the task. Then you teach the second step. After that, you make the
child do the first two steps and you complete the rest of the activity. Forward chaining is
usually used to teach tasks where the last step is very difficult.
c. Backward Chaining: Backward chaining is the opposite of forward chaining. Here you
teach the last step first, then the second last step and so on. So, you do all the steps except
for the last step and get the child to do the last step. Backward chaining is more fun for
the child, because it helps them feel that they completed the activity. It is used quite often
in training of self care skills.
d. Repetition: Repetition is one of the best ways to reinforce and learn a task. The best part
about self care skills is that you need to do them every day, and often more than once in a
day. Help the child practice his skills every single time he does that activity.
e. Shaping: Shaping is when you reward and appreciate the child when they are
approximately able to do the task. It means that you don’t look for perfection. If a child
takes the comb to his head n moves the comb, you reward him and appreciate him for it.

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 It’s ok if he can’t completely comb his hair, or even if he ends up messing up his hair.
Shaping is used in the earlier stages of training.
f. Grading: Grading is when you give a simple activity to start with, and slowly increase
the complexity of the task. Some ideas for grading are – using a large comb, teaching
buttoning on large buttons, teaching dressing with over-sized clothes.
g. Adaptations: Sometimes planning lessons or an independent living skills curriculum is
not enough. Some children with special needs, especially children with physical
disabilities may need to be taught an adapted way of performing the task. They may also
benefit from some adaptive equipment.
h. Adapting the environment: Some adaptations in the environment that can help are a
wheelchair accessible toilet, a bath chair, a low sink. Keeping the clothes and other
belongings of the child at an accessible height will promote independence.
i. Adapting the technique: Sometimes, adapting the technique can help the child to be
independent. For example, stabilizing forearms on the table before eating, or sitting down
on the bed and putting on pants. An occupational therapist will be able to advise you on
techniques based on the child’s needs.
j. Adaptive equipment: There are a lot of different adaptive equipment that can help a
child with special needs to be independent. Modified spoons, long handled reachers and
modified clothing are some examples.
k. Select appropriate prompts. While teaching a child to eat with a spoon, for example,
the teacher can move from full physical assistance to assisting the child only when
moving the spoon directly into his mouth. You may need to use hand-over-hand
assistance, but this support needs to be faded as the child becomes more independent.
l. Establish a routine. Routines pay a critical role in the formation of self-care skills. For
example, putting on a jacket before going outside to play is a self-care skill that is
routinely done prior to outdoor play. Brushing teeth after lunch is another self-care skill
that is part of the daily schedule.

Learning, rather than time, should be the focus. It may take longer for a child with a disability to
master these skills. Persistence and consistency are the keys to success.

Professionals: Get help from professionals as needed is important.

Expectations: Expect positive outcomes. Sometimes we do not attempt to teach self-care skills to
children with cognitive disabilities because we have low expectations. If we expect children to
succeed, there is a higher probability that they will.

Integrate: Integrate opportunities to promote self-care skills throughout the day and during play
will provide needed practice for successful mastery of targeted skills. Having dress-up clothes in
the housekeeping center, for example, provides an excellent opportunity to reinforce buttoning,
zipping, snapping, and tying.

Responsibility: Child care providers can help young children become independent by allowing
and encouraging them to take responsibility for themselves whenever possible. It can be faster
and less messy to do things for children, but they learn so much more from doing things for
themselves. When children practice self-care skills such as feeding and dressing themselves, they

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practice their large and small motor skills, gain confidence in their ability to try new things and
build their self-esteem and pride in their independence.

Stories: Talk about various independent living skills through stories. Use stories also to talk
about work, different jobs, and the value of money. All this will help the child be motivated to be
independent, get a job and support themselves when they grow up.

REFERENCES

Inciong, T., Quijano, Y., Capulong, Y. & Gregorio, J. (2007). Introduction to Special
Education. Quezon City: Rex Printing Press Company, Inc.

Handbook in Special Education SPED Division

Managing Children with Special Needs. A special Education Handbook

Inciong, T., Quijano, Y., Capulong, Y. & Gregorio, J. (2007)
K.Eileen Allen, G.E. Cowdery (2012). The Exceptional Child. Inclusion in Eary Chidhood
Education. Wadsworth Cengage Learning

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https://www.verywellfamily.com/teach-self-care-skills-to-children-with-special-needs-4128821

https://www.google.com/search?
q=intellectual+disability&tbm=isch&chips=q:intellectual+disability,g_1:autism:DNTFf31kJAc
%3D&hl=en&sa=X&ved=2ahUKEwiMkt6O0r_rAhULBJQKHUifBmAQ4lYoAnoECAEQGA&biw=13
43&bih=657#imgrc=loqS0rhIVVXoRM

https://www.youtube.com/watch?v=YOwDfnoek6E

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