Approach to school placement and support for children with special

needs

Dr. Mark Richards

Going to school…

Introduction

Parents

Extremely difficult and a source of great anxiety and potential discontent

Child

Ostracism, low self-esteem, sense of failure

Doctors

Lack of definition, awkward, maze of therapists and process

Existential concepts of worth and meaning

Functional vs. relational

Introduction

School for a South African child

History

Where have we come from?

The Constitution, Access and Inclusion

Idealism, Symbolism and Pragmatism

White papers and White elephants

Where are we going?

….to the full circle of course

Disabilities and Definitions

Can be confusing… Specific Learning disability- Chronic difficulties in learning to read,

write, spell, or calculate, which are believed to have a neurological origin in the absence of a more global intellectual disability.

E.g.. Dyslexia, Visuo-motor incoordination Intellectual disability- characterized by significant limitations both in

intellectual functioning and in adaptive behaviour, which covers many everyday social and practical skills

Borderline, mild, moderate, severe, profound Communication Disorders Sensory abnormalities- (Vision, Hearing) Others…dyspraxia, DCD, MR, Cerebral palsy

Vision- Acuity in best eye <6/18 Hearing (with/without assistance) >80-90 dB

Disabilities and Definitions

Can be confusing… Specific Learning disability- Chronic difficulties in learning to read,

write, spell, or calculate, which are believed to have a neurological origin in the absence of a more global intellectual disability.

E.g.. Dyslexia, Visuo-motor incoordination Intellectual disability- characterized by significant limitations both in

intellectual functioning and in adaptive behaviour, which covers many everyday social and practical skills

Borderline, mild, moderate, severe, profound Communication Disorders Sensory abnormalities- (Vision, Hearing) Others…dyspraxia, DCD, MR, Cerebral palsy

….the value of categorising

Assessing children

A fraught area

Can be very informative, particularly when applied before school going age…

E.g. JSAIS, Griffiths tests, Reynell Language Scales, Vision, Hearing

Educational Psychologist assistance

Two different approaches:

Response to Intervention (RTI) vs. Comprehensive Testing

School Readiness

School Readiness

Two views

A child focus

The concept of readiness?

Ways of understanding

•emotional maturity •knowledge base •a community’s values •the ongoing interaction between a school and a child

School Readiness

Two views

A child focus

The concept of readiness?

What teachers endorse-

84% ability to communicate wants, needs, thoughts verbally 76% enthusiastic and curious 60% follow directions, not be disruptive 21% use a pencil or paintbrush 10% know several letters 7% count to twenty (US National Center for Education Statistics)

School Readiness

Two views

A child focus

The concept of readiness?

What teachers endorse-

Can you test for it? Should you? Which test?

School Readiness

Two views

A School Focus

What about the school?

A better question? Not whether a child is ready, but, what is the child ready to learn?

School Readiness Two views

A School Focus

What about the school?

Delayed entry?

Interventions

Before school The importance of early diagnosis and intervention ‘Grade 1 is too late’ The team Other Professions Speech Therapists, Occupational therapists, Physiotherapists,

Audiologists, Ophthalmologists, Educational Psychologists A good pre-school Preliteracy skills Home and the “5 R’s”

Interventions

Before school The importance of early diagnosis and intervention ‘Grade 1 is too late’ The team Other Professions Speech Therapists, Occupational therapists, Physiotherapists,

Audiologists, Ophthalmologists, Educational Psychologists A good pre-school Preliteracy skills Home and the “5 R’s” –

Vocabulary, Print Awareness, Narrative Skills, Letter Knowledge, Phonological Awareness

Interventions

Before school The importance of early diagnosis and intervention ‘Grade 1 is too late’ The team Other Professions Speech Therapists, Occupational therapists, Physiotherapists,

Audiologists, Ophthalmologists, Educational Psychologists A good pre-school Home and the “5 R’s”

Interventions

Before school The importance of early diagnosis and intervention ‘Grade 1 is too late’ The team Other Professions Speech Therapists, Occupational therapists, Physiotherapists,

Audiologists, Ophthalmologists, Educational Psychologists A good pre-school Home and the “5 R’s” –

Reading together, praise as Reward, Regular times and routines, Reciprocal and nurturing relationships, Rhyming, playing and cuddling together.

Interventions In School

Teaching methods

sequential mastery of subjects vs. direct instruction,

Classroom adjustments- seating, more time, modified assignments

Special equipment- computers, hearing aids, calculators, visual aids

Remedial break-away classes

Teaching assistants

Specialised Education

Other Countries

Example…UK

Teacher initiated adjustment

School Action and an IEP

School Action Plus

Formal Statutory Assessment of needs

The Special School

A changing concept- a geographic place or a the array of services available in school?

Centres of expertise

Wide array catering for a specific disability or a wide array of disabilities (e.g. Autism, physical handicap, Intellectual disability, Specific learning disabilities)

Defined criteria for admission

The Special School

Variable distribution

Some have boarding facilities

Variations on the theme

Mainstream class

Unit Class/Remedial Class

Full Services School

“Special School” (LSEN School)

Trade Schools/Training Centres

‘Alternative approach Schools’ (e.g. Waldorf)

Distinct from Special Care Centre for severely or profoundly disabled children

Accessing Specialised Education

Private and State (and ex-Model C)

Accessing Specialised Education

Before Grade 1

Referral routes to you- Pre-school teacher, Parental concern, therapists

By you- office based testing

From you- Speech and Language assessment, Occupational therapy, Developmental Paediatrician, Educational Psychologist

…..Collate a comprehensive report

Then…

school decision and refer…

(know your schools or speak to Mrs. Brink)

Accessing Specialised Education

After grade 1

State Sector

• Teacher intervention,

• Remedial teacher

• Liaison with Specialised Education Support Services (local education management services)

• Formal testing (ideally)

• Provision of extra help within school class, Unit Class

or provision of place at School for Learners with Special Educational Needs (LSEN)

Accessing Specialised Education

After grade 1

State Sector

Private and Model C less defined

place for

activist parents

schools with inclusion policies

motivated paediatrician/doctor

Accessing Specialised Education

Understand

-defined mandate of a Special Education school

-huge pressure on places

-a field of significant change and evolution

Role of Paediatrician

Define the disability and co-morbidities (or get someone to help you do this)

Have some basic screening tools at hand-

Goodenough-Harris Draw-a-Person

Beery for VMI

Some blocks!

Walk with the child and parents

Be an advocate for change

Know your referral therapists and coordinate inputs

Be clear, tell the truth, encourage

A packet of Doritos

Pitfalls

Territory ripe for over-servicing

Poorly defined interventions and outcomes

Lack of collaboration

Untruths and half-truths

The child as project

Real life

The Autistic Child

Down’s Syndrome

The child with Dyslexia

The child with William’s Syndrome

The Autistic Child

Language delay but with significant behavioural and relational challenges Variable degrees of cognitive impairment School access determined by cognition ability to self-care Early diagnosis and intervention (SL) very important Facilities available Dedicated schools (e.g. Vera School) Private pre-schools Special Care Centres Long waiting times,

but there is good news

Trisomy 21

Moderate to severe intellectual disability the norm

Generally gregarious and headstrong

Notable delays in expressive language

Options

delayed entry into Mainstream foundation phases

Schools for intellectually disabled children

Dyslexia

When phew! isn’t few and fewer Finns are füssed

Late diagnosis, delayed reading-writing skills

Develop cognitive strengths

Need comprehensive psychological or neuropsychological profile

Options

mainstream with remedial help and adaptation

Speech and language therapy

Assistive devices

If severe- School with expertise in SLD’s

William’s Syndrome (del 7q11.23)

A genetic disorder with a distinctive developmental phenotype

– Variable intellectual range

– High distractibility

– Retained language skills

– Poor visuo-spatial skills

Assess comprehensively and liaise with an educational psychologist