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Special Education- Law and Policies SN, Adult Attention Deficit…

- - - - What you might notice: avoids eye contact, shows difficulty with back and forth communication, overstimulated easily in new/loud environment, hard time predicting or understanding others feelings or emotions,
        
        Along with challenges, these students often: excel in math, art, music, and science, strong visual and auditory learners, able to learn quickly and retain information, and have above average or high intelligence
    - - Laws: "The child who is physically, mentally or socially handicapped shall be given the special treatment, education and care required by his particular condition." (This term appears in Principle 5 of the United Nations' "Declaration of the Rights of the Child" (1959).
        
        Treatment: medication to treat anxiety, depression, OCD, hyperactivity, aggression, repetitive behavior, and impulsivity
        
        involve student in social situations
        
        create groups/partnerships to encourage socialization
        
        create classroom "show respect" rules to learn more about social appropriateness
        
        assign student a tutor or guide
        
        create small goals
        
        model expected behavior
        
        encourage student to be themselves
        
        open communication about feelings student to student and student to teacher
        
        distinguish "nice" words to say when someone is making you uncomfortable
        
        "Recent federal support and new local interest has served to energize special education for the emotionally and socially handicapped."
        
        Their new focus was on attending to matters of misconceptions, overall orientation, problems with identification, training teachers, educating schools on their role, and new procedures.
- - - - Factors include genetics; parental health and behaviors (such as smoking and drinking) during pregnancy; complications during birth; infections the mother might have during pregnancy or the baby might have very early in life; and exposure of the mother or child to high levels of environmental toxins, such as lead. For some developmental disabilities, such as fetal alcohol syndrome, which is caused by drinking alcohol during pregnancy, we know the cause. But for most, we don’t.
    - - WHO: parents, grandparents, other caregivers
      - WHAT: Look for developmental milestones
      - WHEN: From birth to 5 years
    - - WHO: Healthcare provider, early childhood teacher
      - WHAT: Look for developmental milestones
      - WHEN:
      - Developmental Screening at 9, 18, 30 months of age
      - Autism Screening at 18 and 24 months of age
    - - WHO: Developmental pediatrician, child psychologist, or other trained provider
      - WHAT: Identify and diagnose developmental delays and conditions
      - WHEN: Whenever there is a concern
  - - - Early intervention services help children from birth through 3 years of age (36 months) learn important skills.
      - For children age 3 and older with an identified developmental delay or disability, special education services may be needed.
        
        At least 25% of hearing loss among babies is due to maternal infections during pregnancy, such as cytomegalovirus (CMV) infection; complications after birth; and head trauma.
        
        Some of the most common known causes of intellectual disability include fetal alcohol syndrome; genetic and chromosomal conditions, such as Down syndrome and fragile X syndrome; and certain infections during pregnancy.
        
        Children who have a sibling with autism are at a higher risk of also having autism spectrum disorder.
        
        Low birthweight, premature birth, multiple birth, and infections during pregnancy are associated with an increased risk for many developmental disabilities.
        
        Untreated newborn jaundice (high levels of bilirubin in the blood during the first few days after birth) can cause a type of brain damage known as kernicterus. Children with kernicterus are more likely to have cerebral palsy, hearing and vision problems, and problems with their teeth. Early detection and treatment of newborn jaundice can prevent kernicterus.
  - - - In 1970, the term "developmental disability" was introduced, and neurological conditions, such as cerebral palsy and epilepsy, were included under the protections upheld by these laws. Intellectual disabilities, as well as learning disabilities and ADHD, are now defined as separate subsets under developmental disabilities.
        
        Over the decades, amendments and new regulations have expanded the legal definition of developmental disabilities with the current definition defined by the Developmental Disabilities Assistance and Bill of Rights Act of 2000.
        
        Additional protection for individuals with disabilities is found under the Americans with Disabilities Act of 1990. This act prohibits the discrimination on the basis of disability applicable to employment, state and local government, public accommodations, commercial facilities, transportation, and telecommunications. While specific impairments are not identified within the ADA, the laws extend to individuals with physical and mental impairments that impacts one or more major life activities
        
        Educational services for individuals with developmental disabilities are regulated by the Individuals with Disabilities Education Act (IDEA). First signed in 1975, IDEA ensures that children with disabilities are provided with the “least restrictive environment appropriate to their individual needs.”119 The act distinguished the types of government and public agency intervention into two parts, Parts B and C. IDEA’s Part B applies to school-age children (three to 21 years old) and outlines Individualized Educational Programs (IEPs). Regulating the services available to infants and toddlers, IDEA’s Part C describes early intervention service requirements.120 More than 6.5 million children are eligible for services under IDEA nationwide. For more information regarding IDEA please refer to Disability.gov’s Individuals with Disabilities Education Act (IDEA).
  - - - Use boundary markers such as barriers (e.g., bookcases or other furniture), rugs, and colored tape on the floor to represent boundaries between spaces that are used for different functions. Marked boundaries make it easier for children to know when they are in a space that is dedicated to play, one that is set aside for study, etc. The reality, of course, is that most classroom space is used for multiple purposes. In multi-use spaces, you can employ signs or other visual cues to mark that the space is being used for a particular purpose at a specific time. For example, you might create a sign with a picture of children eating snacks along with the words 'Snack time,' and post that sign on a table to signify that snacks are about to be served.
      - tore common classroom materials (e.g., school supplies, games) on accessible shelves or in see-through storage containers. When needed, provide labels for these materials (using pictures paired with words). Train students in the procedures that you want them to use in accessing the materials (e.g., first raise hand, then request teacher permission, then go to supplies shelf to get a pencil.)
    - - For a child who cannot read and does not recognize pictures as depictions of actual objects and events, the 'schedule' would consist of objects that represent schedule entries. A wrapped snack bar, for instance, can represent snack time, while a book can represent circle time-when the teacher reads a story to the class.
      - For a non-reader who recognizes pictures, the schedule can include a picture to represent each scheduled event. A picture of the Occupational Therapist, for instance, might signify a weekly pullout OT session.
      - For the beginning reader, the schedule can pair pictures with the words describing the events to the day.
      - The fluent reader can use a written schedule, with words selected at the child's reading level.
    - - Alternate preferred and less-preferred activities (Volmer, 1995). Students are likely to put more intense (and more sustained) effort into challenging assignments when they know that they can take part in a fun or interesting activity at the end of it. (This technique is known as the Premack Principle.)
      - Vary the pace and duration of academic activities.
      - Provide meaningful choices that give the child some autonomy and control in the classroom. For example, you may encourage the student to select a reading book for an assignment, decide what assignment she or he will work on first, choose a place in the room to study, or pick a peer to help as a study buddy. Make an effort to build choices into school activities whenever possible.
      - Use verbal prompts ('pre-correction') before the student engages in a task to promote success Koegel, Koegel & Carter, 1999). Phrase your prompt to reflect what you would like to see the child do (e.g., 'Ronald, please get your math journal and a sharpened pencil and join our math group at the back table.') rather than what you would like the student to stop doing. Choose vocabulary and syntax appropriate the child's developmental level.
    - - ive the child 'helping roles' such as handing out snacks or distributing work materials to other students. Coach the child to use socially appropriate speech (e.g., "Would you like a snack?") with peers. The more frequently that other students experience neutral or positive interactions with the identified child, the more that they will feel comfortable with that student and the more positive their perceptions of the child will probably be.
      - If the child is preoccupied with a particular topic that is relevant to classwork, the teacher may be able to use the student as a resource for peers. For example, a child with autism who has an encyclopedic knowledge of astronomy or geography may attend a review session and answer questions from other students who are studying for a quiz.
      - If the child is assigned a teaching assistant, have that assistant train peers in the room to provide academic support while the assistant observes from the background. 'Sign up' children on a rotating basis to serve as peer learning helpers for the identified child. This strategy will encourage the identified child to see many people in the room as possible supports.
    - - Teach only a small number of 'key' skills at one time so that you will have enough time to work with the student on generalizing each mastered skill. After the student has mastered a skill in one setting, list other settings or situations in which you would like the student to show the skill. Then create a training plan to help the student to use the skill in these novel settings.
      - Keep other members of the child's teaching team (e.g., parent, speech pathologist, regular-education teacher) informed about what skills the identified student has mastered. Provide ideas to them about how they can encourage the student to use the skill in a new setting and/or with different people and how to reinforce the child for doing so.
- - - - Students with difficulties in movement, manipulating objects, communicating, eating, and even accessing the learning environment.
      - Students who are hearing impaired may have trouble receiving information and those who are visually impaired may also have problems receiving or seeing information.
      - Students with neurological conditions may have speech and language difficulties.
    - - Students with mobility problems
        
        Create a physically accessible environment that is not mobility limited.
        
        Keep your schedule flexible as students may arrive late due to adapted transportation services.
        
        Be sure the student is always included in activities when forming groups and provide appropriate support to ensure the student doesn’t feel excluded or gets frustrated.
        
        Depending of their needs they might beed their own furniture such as ergonomic chairs, sloped writing tables or extra space
      - Students who have difficulties manipulating or grasping objects
        
        Students may not be able to hold a pen or write for extended periods of time so be ready to modify assignments and allow them to provide oral responses.
        
        Use assistive technology such as computers, iPads to record their speech.
        
        Use text-to-speech tools.
        
        Provide them with extra-time to complete assignments
      - Students with Communication Access (Deaf or Hard of Hearing)
        
        limitations include listening to and understanding lectures, taking notes and participating effectively in group work and discussions.
        
        Be sure to face the student when speaking
        
        Provide them with written copies or oral instructions.
        
        Provide them with visual aids
        
        Use captioned videos as needed
    - - Assistive Technologies can provide new learning opportunities for handicapped students. Some examples of assistive technologies are hearing aids, prosthetic limbs, and more.
        
        Steve Hawkins was an example of how AT can change the lives of handicapped people. He suffered from a condition called amyotrophic lateral sclerosis (ALS). As a result, he had almost no mobility to move or speak. Speech-generating AT allowed him to communicate.
      - Speech-recognition software
        
        Allows blind or students with physical limitations that prevent them from typing on a keyboard to compose assignments. The student only needs to speak into a microphone and the words get translated into typed documents.
      - Text-to-speech Software
        
        helps students with visual impairments by allowing them to listen to the text on the screen instead of reading it. Students can participate in online activities with this software and have access to online materials without needing to wait for Braille translation.
      - Physical Aids
        
        Used for students with physical mobility, stability and motor coordination challenges. Examples could be audio books for students who are physically unable to hold books or keyboard adapters to prevent mistyping if the student has tremors or is unable to handle a keyboard.
      - Mobility Aids
        
        To provide mobility for people with physical disabilities. Examples are wheelchairs, walkers, scooters, and crutches.
      - Availability and Limitations of ATs
        
        ATs have been revolutionary for handicapped children. Unfortunately, many are not readily accessible. Most schools have no access to most of these technologies because they might be too expensive. Handicapped students in the United States can be considered fortunate to be protected by laws that require schools to be inclusive and provide an education that meets their needs. Therefore, the US government provides public schools with a number of resources to be able to provide for students with special needs. Most schools and countries in other parts of the world are not required to be inclusive and as a result have no resources to accommodate students with special needs. Most schools would not have access to Assistive Technology for students with medium to severe learning needs.
  - - - Individuals with Disabilities Education Act – In 1990, Education for All Handicapped Children Act law was amended. This law required public schools to provide free education for students with learning disabilities in the least restrictive environment. Public schools had to provide extra assistance to allow these students to participate in the same activities as students without special needs whenever possible.
        
        No Child Left Behind – In 2001, the new Act required schools in every state to develop routine assessments of students’ academic skills to demonstrate progress in students with special needs. The students are able to look for other schools if their academic, social or emotional needs are not being met.
        
        Individualized Education Programs – The IDEA mandates children with special needs to be provided with IEPs to help establish specific education for their individual needs.
- - - - Intelligence is usually normal, but affected individuals experience learning disabilities with directional sense, learning math, nonverbal memory and attention. They may also experience difficulty in certain social situations.
        
        Impairments - Nonverbal Learning Disability
        
        They often have Nonverbal Learning Disorder - they are often extremely verbal but are challenged when it comes to processing non-verbal information
        
        Difficultly in change of routine
        
        Poor Coordination - spatial perception: riding a bike, jumping
        
        Executive Skills - Can't see the "big picture"
        
        Can be concrete - don't understand hidden meanings
        
        No Fluid Social Interaction - can't read facial expressions or recognize social cues.
        
        Hyper Verbal - talk a lot often to relive anxiety
        
        Difficulties following directions
        
        Treatment Strategy
        
        Be Direct with instructions - provide verbally and written.
        
        Watch for signs of early ADHD and start to implement ADHD strategies
        
        Be aware excess talking could be from anxiety, look for problem.
        
        Talk about changes in schedules/routines well in advance and repeat.
        
        Make sure student is facing teacher
        
        Increased risk of Attention Deficit Hyperactivity (ADHD)
        
        Impairments -Spatial Disorder
        
        Math - can problem solve but difficulty in abstract concepts such as subtraction or trigonometry based.
        
        Treatment Strategy
        
        Use Verbal Counting Strategies. Practice to address short term memory. Use Peer Tutoring
        
        Reading Comprehension - Grammar and sentence structure struggles. Problems with punctuation and pause in speech.
        
        Treatment Strategy
        
        Shorten instructions into sections verbally and in written format. Repeat instructions
        
        Difficulty Concentrating and Energy Level Drops
        
        Short term memory problems but long term is often good.
        
        Treatment Strategy
        
        Shorten instructions into sections verbally and in written format. Repeat instructions
        
        Lack of Stamina
        
        Treatment Strategy
        
        Allow more time and breaks
    - - Reported and named in 1938 by Henry Turner. The most common chromosomal disorders and likely the most common genetic disorder of females.
        
        Henry Turner was treating 7 patients between 15 and 23 for dwarfism and lack of sexual development. He treated them with pituitary extracts unsuccessfully.
        
        Since then many clinical and genetic research studies have be conducted in numerous countries including the Italy, Europe, and the United States to delineate the clinical, pathophysiological, cytogenetic, and molecular features. International multidisciplinary workshops and symposiums have been held.
        
        In the last 10-15 years the emphasis of care shifted from dealing with the growth deficit, to applying advanced reproductive technology allowing live births, detecting and dealing with potential catastrophic cardio-vascular disease (CVD), and addressing long-term health issues.. TS is now diagnosed before birth. Mild cases can remain undiagnosed until later in life or during adulthood but "Growth Awareness" is helping it be diagnosed sooner.
        
        In 2017 US and Europe developed new Care Guidelines for Turner Syndrome Patients, Families and Professionals
        
        Advances in neuroimaging and genetic technologies over the past decade have significant potential to exponentially increase our understanding of cognition and neurodevelopment in Turner syndrome.
      - Laws and Support
        
        There are numerous Foundations around the world advocating for Turners Syndrome
        
        The TSF Legislative Advocacy Working Group communicates with National Lawmakers to raise awareness and influence change
        
        Not all females with Turners Syndrome have a disability. If they are diagnosed with a disability as a result of TS then all the laws apply for the different countries. In the US the American with Disabilities Act (ADA) and for children/students the Individual with Disabilities Education Act (IDEA)
        
        Celebrities with Turners Syndrome
- - - - 1926: Grunya Sukhareva, a child psychiatrist in Kiev, Russia, writes about six children with autistic traits in a scientific German psychiatry and neurology journal.
        
        1938: Louise Despert, a psychologist in New York, details 29 cases of childhood schizophrenia, some who have symptoms that resemble today's classification of autism.
        
        1952: In the first edition of the American Psychiatric Associations's Diagnostic and Statistical Manual of Mental Disorders (DSM), children with symptoms of autism are labeled as having childhood schizophrenia.
        
        1967: Kanner and others theorized that autism stemmed from poor parenting in a child’s early years. According to an article published by Kanner, emotionally cold (or “refrigerator” mothers) may have been responsible for the symptoms of autism in their children.
        
        1970s: Lorna Wing proposes the concept of autism spectrum disorders. She identifies the “triad of impairment,” which includes three areas: social interaction, communication, and imagination.
        
        1970s
        
        1975: The Education for All Handicapped Children Act is enacted to help protect the rights and meet the needs of children with disabilities, most of whom were previously excluded from school.
        
        1980s
        
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        1977: Susan Folstein and Michael Rutter publish the first study of twins and autism. The study finds that genetics are an important risk factor for autism.
        
        1960s
        
        1950s
        
        1940s
        
        944: Austrian pediatrician Hans Asperger publishes an important scientific study of children with autism, a case study describing four children ages 6 to 11. He is also credited with describing a higher-functioning form of autism, later called Asperger’s syndrome
        
        1943: Leo Kanner, a child psychiatrist at Johns Hopkins University School of Medicine, identified autism as a separate psychological disorder in children. Kanner described it as early infantile autism, characterized by symptoms including obsessiveness, deficits in social behavior and a need for sameness.
        
        1930s
  - - - It is important to provide as predictable and as calm an environment as possible. As a general rule, aim for a clutter-free environment to cut down on distraction and confusion.
        
        Organised classroom where there are places for resources, stationary and personal belongings
        
        Set up a calm zone within the classroom. This is not time-out and can be used for short periods of time such as three to five minutes;
        
        Remove or reduce any stimuli in the environment that causes them anxiety. For example, if they become highly distressed by the sound of the school bell, you could allow them to put on noise-cancelling headphones five minutes before it goes off. Make sure you schedule this transition into their routine.
        
        Children with autism have their own specific sensory needs and an occupational therapist can assist with assessing this and implementing strategies. sensory tools that a child with autism might utilize:
        
        Weighted lap pad
        
        Chewy fidget
        
        Body sock
        
        Noise-canceling headphones
        
        Wobble stool
    - - One of the most commonly used strategies to support learning is the use of specialised visual supports. This is an advantage for students with an ASD who have strengths in the visual modality and may experience difficulties dealing with abstract concepts (Attwood, 2007).
        
        Creating a visual timetable is an effective way to make their daily routine clear to them. This involves placing images and simple words on a timetable, in chronological order, to describe the activities and transitions in the student's day.
    - - Simplifying language is necessary
        
        Be very specific when providing instructions to ensure that the student knows what to do, how to do it and when to do it. Use their name in an instruction;
        
        If you need to ask an autistic child to tidy up, you may be tempted to say: “Liam, can you start packing up your pencils and tidy them away into drawers please?” A much clearer instruction for them is: “Liam, put pencils away.” You could also point to the place they need to store the pencils if they respond to simple gestures.
        
        Children who have difficulty understanding language may respond better to pictures telling them what is expected, rather than verbal directions. For example, if you want the child to work on math and then have a play activity, you can show them a “first/then” board rather than saying “First we will do math and then play a fun game.” See an example of a “first/then” board below.
    - - Provide as much advanced warning of change as possible through visual representation. This may include a reminder of an upcoming event or change written on the board or a photo of the setting for an excursion coming up or a supply teacher coming in (Kluth, 2010);
        
        Prepare the student for change by discussing it in advance using a Social Narrative such as a Social Story (Gray, 2000);
  - - - Of the 102 genes, 60 had not been previously linked to ASD and 53 appeared to be primarily connected to ASD as opposed to other types of intellectual disability or developmental delay. It is expected that this newfound genetic knowledge will serve to improve understanding of the complex biological mechanisms involved in ASD, ultimately paving the way for new approaches to diagnosis and treatment.
- - - - Phonological Deficit
        
        Implicates a core problem in the phonological processing system of oral language.
      - Language Comprehension
        
        Often coincides with the first two types of problems, but specifically found in children with social-linguistic disabilities (autism spectrum), vocabulary weaknesses, generalized language learning disorders, and learning difficulties that affect abstract reasoning and logical thinking.
      - Fluency/Naming Speed
        
        Affects speed and accuracy of printed word recognition (also called naming speed problem or fluency problem).
    - - A below-average reading level
        
        Signs to watch for:
        The child has difficulty reading material assigned at his or her grade level. He or she is consistently behind the level of his or her peers.
      - Difficulty sounding out words
        
        Signs to watch for:
        The child has trouble pronouncing words that he or she should know or confuses the sounds of certain letters.
      - Difficulty recognizing words
        
        Signs to watch for:
        The child doesn’t recognize words that he or she should know or easily confuses similar-looking words.
      - A lack of fluency when reading
        
        Signs to watch for:
        When reading aloud, the child takes frequent pauses between words and lacks expression in his or her tone.
      - Problems understanding what was just read
        
        Signs to watch for:
        The child has a low level of comprehension when it comes to reading. He or she also has trouble understanding, recalling, or summarizing what he or she has just read.
      - Problems connecting what is read to previous knowledge
        
        Signs to watch for:
        THe child has trouble connecting ideas from what he or she has read to other concepts he or she has previously learned.
      - Anxiety about reading
        
        Signs to watch for:
        The child is overcome with anxiety when reading, especially if he or she is asked to read aloud. He or she frequently says “I can’t do it” or “I don’t understand”.
      - Avoiding reading altogether
        
        Signs to watch for:
        The child avoids reading as much as possible. He or she approaches reading with a negative or defeated attitude, refusing to pick up books or read aloud.
      - Difficulty with spelling and writing
        
        Signs to watch for:
        The child has trouble spelling many words correctly. He or she may also struggle with writing comprehensive sentences.
      - Tasks involving reading or writing take an unusually long time to complete
        
        Signs to watch for:
        The child spends a large amount of time working on reading or writing assignments or has trouble completing them at all.
      - Easily distracted when reading
        
        Signs to watch for:
        The child has a lot of difficulty focusing on reading assignments or abandons the task before he or she has finished.
  - - - 1877
        
        Adolph Kassmaul created the phrase "word blindness" for individuals who lose the abilit to read. Today this is known as "alexia" (Carlson, 2005).
        
        1896
        
        John Hinshelwood studied the difference between alexia and dyslexia (Carlson, 2005). During his research, he found where the brain processes reading: angular gyrus (Hallahan & Mercer, 2001).
        
        1921
        
        Grace Fernald published a report on the positive effects of kinesthetic and visual teaching methods on word recognition, including finger tracing difficult words (Carlson, 2005).
        
        1963
        
        Samuel Kirk first uses the term "learning disabilities" while speaking with a group of parents. Despite the fact the Kirk did not like labels, his term has become the most used label in special education (Hallahan & Mercer, 2001)
        
        1965
        
        Barbara Batemen reintroduced the discrepancy model to determine if students have a reading or other learning disability (Hallahan & Mercer, 1965).
        
        1969
        
        The federal government passed the Children with Specific Learning Disabilities Act. This act supported services for students with reading disabilities (Hallahan & Mercer, 2001).
        
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  - - - Germany
        
        The Federal Association for Dyslexia and Dyscalculia (Bundesverband Legasthenie und Dyskalkulie; n.d.) references the International Classification of Diseases (ICD-10) (World Health Organization [WHO], 2005) for information on the definition and diagnosis of specific learning disorder. The ICD-10 defines specific reading disorder as a significant impairment of reading skills as compared with the expected reading level based on the child’s age, grade placement, and general intelligence.
        
        Mexico
        
        The General Education Law (Secretaría de Edu-cación Pública, 1993) was the first federal law that obliged Mexican states to serve all students with disabilities. In Mexico, the term LD is used interchangeably with reading disability or dyslexia in the literature (Poblano, Borja, Elias, & Garcia-Pedroza, 2002; Zambrano-Sánchez, Martinez-Wbaldo, & Poblano, 2010). Students who demonstrate difficulty learning grade-level content as compared to their peers and who need adaptations to achieve curricular benchmarks are entitled to receiving supports within the general education setting (Fletcher & De Lopez, 1995).
        
        Netherlands
        
        Two provisions of educational law in the Netherlands provide language directly related to dyslexia. Specifically, the Law on Secondary Education provides funding for remedial support and the statutory order on final exams provides accommodations such as extended completion time although these provisions within the law are interpreted differently depending on the school (van den Bos, 2004).
        
        Singapore
        
        In Singapore, the term LD refers to students who have difficulties in reading, writing, spelling, remembering, and organizing information (Ministry of Education, 2012). Specifically, dyslexia and ADHD are recognized as two of the most common disabilities that impact student learning; both categories are specifically addressed in the Ministry of Education’s Professional Practice Guidelines for Psycho-Educational Assessment and Placement of Students with Special Educational Needs (2012).
        Students with mild disabilities, including dyslexia are likely to receive special education services in mainstream primary schools.
        
        United Kingdom
        
        The Rose Report (2009) provides this definition of dyslexia: “Dyslexia is a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling. Characteristic features of dyslexia are difficulties in phonological awareness, verbal memory, and verbal processing speed. Dyslexia occurs across the range of intellectual abilities” (p. 30). Regarding identification, a Code of Practice is used to guide a multi-stage assessment procedure and intervention process within schools; teachers refer students of concern to a multi-disciplinary team for a statutory assessment called a Health, Education, and Care Plan (DoE & DoH, 2015).
        
        United States
        
        The ADA (Americans with Disabilities Act) is a broad law that provides civil rights protections to all individuals with disabilities in the US in many different aspects of life.
        IDEA (Individuals with Disabilities Education Act) is not an anti-discrimination law; it is a statute that mandates free appropriate public education (FAPE) in the least restrictive environment (LRE) for students with disabilities eligible under IDEA.
        IDEA provides federal funding to schools to support IDEA-eligible students.
        These laws overlap in their coverage, their definitions of disability, their eligibility, and their planning requirements. These laws also overlap in the types of services, modifications, and accommodations they support.
- - - - Research
        
        Cutting-edge research is leading to new insights about the workings of the brain in language and spatial processing, and may also contribute to greater understanding of common problems like hypertension and anxiety. Early detection and better medical care are increasing survival rates and improving life for people with WS.
        
        Early intervention, the right medical care and continuing social and enrichment activities make an immeasurable difference in the quality of life for people with WS. Because Williams syndrome is genetic, it’s possible that findings from research will pinpoint genes affecting certain medical conditions (cardiovascular disease, diabetes); developmental challenges (visual-spatial problems, ADHD); and even personality traits (affinity for music, anxiety).
        
        “Williams Syndrome Research Acceleration Study”, Boston Children's Hospital is led by members of the Department of Cardiology, & Division of Genetics at BCH and the Departments of Pediatrics and Genetics at Harvard Medical School, BCH is conducting a multi‐disciplinary study involving four complimentary projects, with an aim towards better understanding the cardiovascular pathophysiology of patients with Williams syndrome, and improving the overall health and well‐being of patients with Williams syndrome.
        
        Barbara Pober, MD, Massachusetts General Hospital is conducting studies to help describe the body composition of adults with WS, and its effects on overall health.
        
        Bonnie Klein-Tasman, PhD, University of WI-Milwaukee conducts research centered around the development of approaches to reduce anxiety and fear in children with Williams syndrome.
        
        Marisa H. Fisher, PhD, BCBA-D, MI State University conducts studies on characteristics of internet use of individuals with Williams syndrome.
        
        Daniel Dilks, PhD, Emory University conducts research to learn how adults with Williams syndrome understand their physical environment (i.e., recognize and navigate places), and their social environment (e.g., whether another person might be considered a friend or foe).
        
        Eric Joyce, PhD, PENN School of Medicine is conducting research which is focused on new techniques for diagnosing WS via specialized FISH probes.
        
        Marilee Martens, PhD, Nationwide Children's Hospital, conducts research which is focused on musicality and anxiety management in individuals with Williams syndrome.
    - - Williams syndrome is a contiguous gene syndrome, which means that all of the deleted genes "line up" within the Williams syndrome "critical region" of 26-28 genes. There are two DNA tests that can determine if a person has Williams syndrome. The diagnosis of Williams syndrome may be confirmed by a thorough clinical evaluation that includes a detailed patient history and specialized blood tests that may detect elevated levels of calcium in the blood. Another test, known as fluorescent in situ hybridization [FISH], may be used to determine whether a deletion of one elastin gene on chromosome 7 is present. This deletion is believed to occur in the majority of individuals with Williams Syndrome.
        
        Cardiovascular Concerns
        Cardiovascular concerns are common - affecting seventy-five percent of individuals with WS. The severity of issues varies widely, from benign murmurs to more complicated issues requiring one or more surgical interventions.
        
        Gastrointestinal Concerns
        Most individuals with Williams syndrome experience GI issues at some point, especially abnormal bowel movement patterns (mainly constipation and related problems such as rectal prolapse & hemorrhoids) and bouts of abdominal pain. Common issues include: reflux, abdominal pain, constipation, diarrhea, irritable bowel syndrome, and dysmotility.
        
        Neurodevelopment and Behavioral Health
        Individuals with Williams syndrome are often described as hyper-sociable, talkative and friendly, with very empathetic, polite, and happy personalities. People with WS may also display behavior issues and anxiety beginning at a very young age, and some may have specific phobias and fears.
    - - Attending difficulties (often distractible & impulsive but not necessarily hyperactive)
        
        Visual-spatial & visual-motor integration difficulties and memory deficits
        
        Difficulty with abstract concepts and abstract reasoning
        
        Perseveration on "favorite" topics.
        
        Difficulty processing nonverbal information than verbal information. When administered the WISC-III (or the earlier edition WISC-R) they score significantly lower on the nonverbal (performance) subtests than the verbal subtests.
        
        Strategies to help students with Williams Syndrome
        
        Students with WS learn best with consistency, structured instructional routines, clear and realistic expectations, social stories, scripts and visual schedules, and technology. In particular, students with WS are often very effective users of computers and iPads/tablets.
        
        They also benefit from “chunking” material into manageable parts, audio and dynamic visual supports, rhyme, rhythm and cadence, music and/or performing, finding materials that they have an emotional connection with, and specific praise.Adapting strategies to pre-teach, teach, and then re-teach, in order to enforce concepts, can be very helpful.
        
        The educational profile for a student with Williams syndrome is a unique blend of strengths language and nonverbal reasoning and weakness in visuospatial construction (the ability to see an object or picture as a set of parts and then to construct a replica of the original from these parts).
        
        Direct instruction can be helpful. As the name implies, it involves directly teaching each aspect of a skill. It also engages the student orally, to ensure that they become an active part of the process. Direct instruction programs are very sequential in nature, progressing in a building block way until the target skills are acquired and mastered.
        
        Reading Comprehension
        Ensure that decoding skills have been mastered first (the student must be able to read words accurately before he/she can understand meaning). A phonics based reading curriculum is most effective.Teach reading comprehension skills directly, e.g. making inferences, deductions, understanding cause and effect, etc. Teach the organization and structure of paragraphs.
        
        Writing
        Provide brief daily practice to improve handwriting rate and legibility. Teach students to use verbal self-directions to guide those practices. Address posture, position of hand and paper, grasp of pencil, directions for forming individual letters. Teach keyboarding and word processing skills to the student at a young age.Focus on only one aspect of writing at a time (e.g. pre-writing, writing, editing).
    - - Physical characteristics
        broad forehead, small upturned nose, wide mouth with full lips, small chin, puffiness around the eyes, low muscle tone and loose joints – joint stiffness sometimes develops as children get older, short stature compared with other people in the family, although children sometimes catch up a bit in later childhood, dental problems like small, widely spaced teeth, or crooked or missing teeth.
      - Intellectual ability signs
        speech delay – a child’s first word might come as late as three years old. The child then usually develops relatively good verbal abilities, which can be used to help other areas of learning, developmental delays – for example, with walking and toilet training, difficulties with fine motor skills, difficulty with tasks like drawing or doing puzzles.
      - Behavioural signs
        a very friendly nature and readiness to trust stranger, fewer inhibitions in social situations, anxiety and phobias, attention deficit hyperactivity disorder, difficulty reading social cues – for example, when people are annoyed, tantrums.
      - Medical concerns linked to Williams syndrome
        problems with their hearts or blood vessels, which can range from minor to severe and needing surgery, low birth weight and failure to thrive, feeding problems including colic and reflux, an underactive thyroid gland, increased risk of diabetes, vision problems, elevated blood calcium levels in childhood, sensitive hearing.
- - - - 1980
        introduced to the world by British psychiatrist Lorna Wing
        
        1980s
        first systematic studies appeared
        Tantam (1988) in the UK
        Gillberg and Gilbert in Sweden (1989)
        and Szatmari, Bartolucci and Bremmer (1989) in North America.
        
        1989
        The diagnostic criteria for Asperger's syndrome were outlined by Gillberg and Gillberg
        
        1991
        the first book in English on Asperger syndrome was written by Uta Frith
        
        1992
        the condition was subsequently recognized and included in the 10th published edition of the World Health Organization’s diagnostic manual.
        
        1994
        added to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as Asperger's Disorder
        
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  - - - early detection and intervention may help
        
        small setting with ample opportunities for more individualized attention
        
        adequate opportunities for social interaction and formation of social relationships.
        
        Communication based interventions
        
        Occupational and physical therapies
        
        Dietary and lifestyle changes
        
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    - - * Psychotherapy has not been shown to be effective in the management of Asperger syndrome
      - * at present no cure and no specific treatment for Asperger syndrome.
  - - - Asperger’s Association of New England
      - ASPEN (Asperger Syndrome Education Network)
      - Autistic Self Advocacy Network
      - GRASP – The Global and Regional Asperger Syndrome Partnership
      - OASIS (Online Asperger’s Syndrome Information and Support)
      - US Autism & Asperger Association
    - - Under IDEA, students who have ASD are entitled to receive the services or educational modifications necessary to complete their free and appropriate educational career.
      - As a general rule, an individual with ASD, who has a record of ASD, or is regarded as having ASD, will be protected from employment discrimination under Title I of the ADA.
      - could also be eligible to receive services from vocational rehabilitation programs which coordinate and provide counseling, evaluation and job placement services for people with disabilities
      - If you require a certain amount of supports as a result of your ASD diagnosis, you also may be eligible for social security benefits.
      - Section 504is a national law that protects qualified individuals from discrimination based on their disability.
  - - - The researchers looked for sequence variations (called single nucleotide polymorphisms or SNPs) in the gene known as GABRB3. The team found that certain SNPs in GABRB3 were significantly more common in people with AS.
- - - - Teaching Strategies
        
        Begin each lesson with a review of previous material.
        
        Link lesson to personal experiences and visuals.
        
        Teach in a variety of formats with and without technology.
        
        Use verbal description and narrative to supplement written material.
        
        Always gain the student’s attention prior to giving important information.
        
        Break assignments and activities into smaller, manageable chunks.
        
        Encourage students to follow checklists and record due dates in diaries.
        
        Repeat and rephrase important information.
        
        Encourage students to ‘think aloud’ during problem solving.
        
        Allow them a movement break by changing areas of the classroom or delivering an errand.
      - Feedback & Assessment
        
        Choose only one or two behaviour goals to work on at a time.
        
        Give assignments with as much notice as possible. Allow student to submit parts in stages.
        
        Reward task completion by acknowledging each step of a process.
        
        Explicitly tell student to check for errors before submitting test papers.
        
        Refer to the student’s IEP or Behaviour Plan for further information.
        
        Avoid timed tests.
      - Treatment
        
        Treatment includes medical, educational, behavioral and psychological intervention. This comprehensive approach to treatment is sometimes called “multimodal”. Depending on the age of the individual with ADHD, treatment may include:
        
        parent training
        
        medication
        
        skills training
        
        counseling
        
        behavioral therapy
        
        educational supports
        
        Advancements and current trends
        
        Research and development of drug-free treatments for ADHD. Treatments for children through medical devices and digital health have entered the market and received clearance from the U.S. Food and Drug Administration (FDA). Last year, the prescription-only device, Monarch external Trigeminal Nerve Stimulation (eTNS) System®, was authorized by the FDA for children aged 7 to 12 years.
        
        A virtual reality (VR) therapy application for children (age 8+) and adults with ADHD. The application is aimed to improve well known ADHD cognitive functioning, such as attention, impulsivity, and higher, more complex thinking functions, like initiating, organizing, planning, and fully executing daily tasks. Based on the brain plasticity principle, which is the brain’s ability to restructure itself in an attempt to overcome existing challenges, the VR solution closely monitors user progress based on sustained focus while distractions are present.
      - Parent support
        
        Create a routine.
        
        Get organized
        
        Manage distractions.
        
        Use clear, brief directions.
        
        Break down complicated tasks into simpler, shorter steps.
        
        Use goals and praise or other rewards.
        
        Create positive opportunities.
        
        Provide a healthy lifestyle. Nutritious food, lots of physical activity, and sufficient sleep are important; they can help keep ADHD symptoms from getting worse.
    - - CAUSES OF ADHD
        
        The causes of Attention Deficit Disorders are not fully understood although a strong genetic link has been noted. The levels of neurotransmitters in the brain may be different in these students.
        Up to 1 in 20 students diagnosed with ADHD. More boys than girls are identified.
      - Signs/ symptoms of ADHD
        
        Hyperactive: fidgety and unable to sit still, talking constantly, having difficulty doing quiet activities, talking constantly and noisy
        
        Impulsive: speaking without thinking about the consequences, interrupting other people, unable to wait or take their turn
        
        Inattentive: unable to concentrate for very long or finish a task, easily distracted and forgetful, unable to listen when people are talking, disorganised, often losing things
    - - 493 BC - Greek physician Hippocrates observes individuals with “quickened response to sensory experiences, but also less tenaciousness because the soul moves on quickly to the next impression.”
        
        1700 - 1900
        
        1902
        English pediatrician George Still publishes lectures about children whose behavior problems include a quite abnormal incapacity for sustained attention. He believes this “clefect of moral control” to be hereditary.
        
        1917-1928
        The encephalitis lethargica epidemic affects approximately 20 million people worldwide. Many surviving children display problematic behaviors, including hyperactivity, distractibility, and emotional instability. Studies lead to broader interest in hyperactivity in children and influence the developing concept of what is now known as ADHD.
        
        1932
        DSM-1 describes ADHD-like symptoms as characteristic of “minimal brain dysfunction.” The term "brain-damaged child” was in common use during the 1950s and 60s. Brain damage is inferred from behavioral symptoms now associated with ADHD.
        
        1952
        German physicians Franz Kramer and Hans Pollnow report on “hyperkinetic disease of infancy.” They describe children who cannot stay still, but whose constant movement has no goal. These children are also easily distracted, emotionally excitable, and unable to concentrate on set tasks.
        
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        1798
        Scottish physician Alexander Crichton describes a “disease of attention” that becomes apparent early in life, includes extreme sensitivity to stimuli, and makes it difficult to learn.
        
        1775
        German physician Melchior Adam Weikard describes ADHD-like behaviors of "the inattentive person.” He advises cold baths, horseback riding, and keeping the individual “solitary, in the dark, when he is too active.”
    - - Early Intervention - Austria’s early intervention system is based on nine different Provincial Disability Acts. As such, there is no uniform federal legal approach.
        
        Education for learners with special educational needs in Austria - two track system. Parents have the right to choose the kind of schooling (Article 8 of the Compulsory School Act – Schulpflichtgesetz).
        
        Inclusive settings in mainstream schools: the local authority has to make any necessary provisions to facilitate special education in mainstream schools like selecting an appropriate primary or secondary school, organising learner transport, assigning special teachers to mainstream classes.
        
        It is a declared goal that children and young people with physical or sensory disabilities to should have improved access to higher education if they are fundamentally able to attend. According to Sections 39, 55a and 68a of the School Organisation Act, school authorities can establish divergences from the curriculum.
        
        Special schools: Education in special schools covers the whole period of compulsory schooling (nine years). After eight years of academic education, a pre-vocational year takes place in special schools.
        
        Early intervention is organised by the regional institutions of early intervention (non-government organisations).
- - - - Historical perspective for down syndrome
        NADS is the oldest organization in the united states to support people with down syndrome, “founded in Chicago in 1960 by Kay McGee” after her daughter was born with down syndrome. During this time physicians would advice parents to institutionalize their kids with down syndrome and even consider their kids less than human and parents wo do not go with the advice they would take their children home without any service. Kay and Marty McGee chose not to institutionalize their daughter, instead, they searched for support from professionals and other parents with the same situation and that’s how they created an organaization that values children and udults with down syndrome.
        
        treatments for down syndrome / Strategies available to students with down syndrom
        
        Before we say the treatments let’s list some of the health problems
        
        Eye diseases
        
        Ear infections
        
        Heart defects present at birth
        
        Treatments
        
        Down Syndrome is a lifelong condition but the earlier the infant gets services the better to helps improve thier physical and intellectual abilities. The servicies include
        
        Laws for educating down syndrome kids and the impact
        After so many years of hard work by the parents
        
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        Physical therapy
        
        Speech occupational
        
        Hearing loss
- - - - Causes
        
        Environmental Factors
        There are strong implications that extreme poverty, abuse, and neglect early in life may predispose a child to develop CD.
        Homelife
        Children with CD are more likely to come from homes with extreme poverty, food insecurity, inconsistent discipline, excessive punishments, spend little time engaged in prosocial activity with their parent(s), receive little love or affection for good behavior, or have parents that do not monitor their whereabouts or activities.
        School life
        Children with CD often bully school officials or are disruptive until they get what they want. Since children with CD tend to struggle academically anyway, their actions often escalate until the teacher feels defeated and withdrawals the request – often excusing the student from doing the work or preferred behavior. This has worked for the student in the past, so they have continued the behavior.
        Community:
        Since children with CD are often also classified as “high risk,” they are often tempted into gang activity, drug use, deviant sexual behavior, and other illegal activities that contribute to the development of antisocial behavior from an early age.
        
        Biological Factors
        Brain Disorders
        Many individuals with brain disorders have problems processing emotion and behavior. Brain disorders can happen due to abnormal brain development, or traumatic brain injury. Either condition can impair cognitive function – however, in most cases involving CD, there is no evidence of brain disorder or injury.
        Genetics
        There is some debate that, like schizophrenia, CD could follow genetic patterns. For an unexplained reason, relatives of schizophrenics are more likely to develop the disease themselves. Though science cannot yet explain why this is true, there is some speculation this could also hold true for emotional and behavioral disorders.
        
        Treatment
        Treatment for CD is determined by the child’s age and the nature of the behaviors. There is no single prescribed treatment for CD. In the classroom, it can be managed with various behavior plans to vary degrees of success. The teacher will have to work diligently to help these students find strategies that work for them and promote self-regulating behaviors. Often students with these types of disorders also have Behavior Improvement Plans (BIP) included as part of their IEPs.
        Outside the classroom, parents and families may seek therapy or counseling. Often, the entire family is involved in these sessions. Since CD is often diagnosed alongside another disability, medication may be prescribed.
    - - Impact on Learning
        
        Cognitive/Perceptual
        Students with CD are not able to process emotions and stress the way other students are. When presented with a stressful or undesirable situation, a child with CD will begin to show some of the behaviors listed above. The child may become very anxious and simply ignore the directions and the teacher, or the child could have a temper tantrum, yell, curse, or cause physical harm to him/herself, peers, or teacher. The perceived level of stress or undesirableness by the student may cause them to react in a more or less violent manner (Demanchick, Rangan, & Douthit, 2006).
        
        Description: When asked to work as a group, the student may ignore directions or become distracting and/or disrupt his/her peers. When asked to stop and stay on task, the student may become upset and begin yelling or cursing at the teacher. When told this behavior is not appropriate, the student may begin throwing things or destroying classroom property. The student could threaten physical violence toward him/herself or others.
        
        Impact on learning: Not only is the student impacting his/her own learning, but the student is often disruptive toward his/her peers as well. Defiant and disruptive behavior interrupts instruction and limits understanding of directions. Lack of engagement and understanding can lead to failure to learn.
        
        Communication/Language
        Students with CD will often be unable to vocalize their needs and feelings in an appropriate manner.
        
        Description: Student may yell, curse, or talk out in order to try to communicate his/her needs. If this is not responded to, the child may begin to threaten harm to him/herself or others or become disruptive. The student may have a temper tantrum since the student views this as an appropriate reaction to stress or a way to have his/her needs met.
        
        Impact on learning: Students who cannot communicate effectively with peers and teachers will have a difficult time following instructions and staying on task. Since CD is often coupled with another learning disability, impact on learning may be magnified depending on the severity of the disabilities.
        
        Academic/Learning
        Students with CD are often low achievers. Two-thirds cannot pass a competency exam for their grade level. Students with emotional and behavioral disorders have the highest rate of absenteeism of any group of students and a whopping 60% will drop out in high school (Heward, 2013, p. 201).
        
        Description: Students with CD are often disruptive to instruction and to the learning environment. This can limit participation in both classroom activities and assignments. Lack of engagement in the classroom can lead to a failure to learn.
        Students with CD often have a dual-diagnosis with another learning disability. This can mean challenges in multiple content areas.
        
        Impact on learning
        In a continued pattern, students fall further and further behind. Teachers becoming increasingly less able to address their deficits and students become frustrated and disenchanted. This decrease in motivation can lead to further academic deficits
        CD coupled with another learning disability can mean compound difficulty in mastering content and skills. This adds to the student’s frustration, which can lead to further acting out and discontent with the school.
        
        Social Skills Students with CD are often rejected by their peers, making it difficult for students with CD to make and keep friends.
        
        Description: Students with CD have reported lower levels of empathy toward others, decreased participation in social activities, less frequent contact with friends, and lower-quality, more transient relationships than their peers.
        
        Impact on learning
        Students know when they are not accepted by their peers. Lack of meaningful relationships in a student’s life can lead to withdrawal, depression, and social anxiety.
        Students with emotional and behavioral disorders are 14 times more likely to be arrested during their school careers than their peers. 47% of incarcerated youth were classified as having an emotional or behavioral disorder (Koning, Webbink, Vujić & Martin, 2010). Students who are frequently arrested and jailed will be transient in the classroom – preventing meaningful intervention and learning.
- - - - Symptomatic Categories
        
        Angry/Irritable Mood
        
        Often loses Temper
        
        Is often touchy or easily annoyed
        
        Is often angry and resentful
        
        Argumentative/Defiant Behavior
        1.Often argues with authority figures or, for children and adolescents, with adults.
        
        Often actively defies or refuses to comply with requests from authority figures or with rules.
        
        Often deliberately annoys others.
        
        Often blames others for his or her mistakes or misbehavior.
        
        Vindictiveness
        
        Has been spiteful or vindictive at least twice within the past 6 months.
  - - - Cognitive Problem-Solving Skills Training
        Teaches children positive ways of responding to stressors. This reduces the occurrence of inappropriate behavior. Helps students view situations less negatively and therefore does not illicit an aggressive response.
      - Social-Skills Programs
        Teaches children positive ways to relate to their peers. These are more effective when conducted in their natural environment and not in a manufactured setting.
      - Medication
        Medication alone is not an effective treatment but can be used to address underlying issues that often coexist with ODD (ex. anxiety or mood). By addressing these disorders with medication it can allow the child to focus on therapies or other programs.
      - Parent-Management Training Programs and Family Therapy
        Families are trained on deesculation techniques and ways to manage child's behavior. This can help prevent defiant behavior and make subsequent discipline more effective
- - - - Disorganization and problems prioritizing
        
        Poor time management skills
        
        Problem focusing on a task
        
        Trouble multitasking
        
        Excessive activity or restlessness
        
        Poor planning
        
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    - - ADHD can not be cured. Standard treatments for ADHD in adults typically involve medication, education, skills training and psychological counseling.
        
        Medications can include stimulants (methylphenidate or amphetamine).
        Medications can also include nonstimulant atomoxetine and certain antidepressants such as bupropion.
        
        Psychological counseling
        
        Cognitive behavioral therapy is a structured type of counseling that teaches individuals skills to manage behavior and change negative thinking patterns.
        
        Marital counseling and family therapy is a type of therapy that can help loved ones cope with living with someone with ADHD by focusing on improving communication and problem solving skills.
- - - - Dr. Charles Bradley stumbled across some unexpected side effects of the medicine Benzedrine shortly after its approval for use by the FDA in 1936.
        
        In 1955, the FDA approved the psychostimulant Ritalin (methylphenidate) which later became popular as an ADHD treatment as the disorder became better understood and diagnoses increased.
        
        The APA released a third edition of the DSM, (DSM-III), in 1980. In that edition, hyperkinetic impulse disorder was changed to attention deficit disorder (ADD). At that time, scientists believed that hyperactivity was not a common symptom of the disorder.
        
        The number of ADHD cases began to climb significantly in the 1990s. Researchers posited that several factors were responsible for the rise in diagnoses:
      - The first example of a disorder that appears to be similar to ADHD was given by Sir Alexander Crichton in 1798.
- - - - Aggression and violence
        
        Breaking rules
        
        Destruction of Property
        
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        Setting fires intentionally to cause serious damage
        
        Deliberately vandalizing or destroying property
        
        Not going to school (frequently, starting before age 13)
        
        Staying out late often, in violation of parental limits
        
        Heavy drinking/drug use
        
        Running away from home overnight more than once
      - Bullying and threatening others
      - Starting fights
      - Physical cruelty to peers, siblings, and animals
      - Using dangerous weapons (such as a bat, broken bottle, knife, or gun)
      - Forced sexual activity
- - - - In 1968, the term conduct disorder was first used in the Diagnostic and Statistical Manual of Mental Disorder (DSM-II) drawn up under the auspices of the American Psychiatric Association (APA).
        
        In 1977-78, the term was taken up by the World Health Organisation (WHO) in its updated International Classification of Diseases (ICD-9).
- - - - Students with CD may need extra time to test, may need a quiet, “safe space,” with little distraction.
        
        Students may need one-on-one direction in order to stay on task and not become frustrated.
        
        May need frequent breaks while testing in order to decrease frustration and stress level.
        
        Students with CD tend to have high verbal IQs. If possible, students should be able to give oral instead of written answers.
    - - Peer tutoring is a great way to include a student with CD – they are able to socialize as well as receive the one-on-one instruction they need.
      - Teachers need to promote inclusion and insist the student be part of group activities and assignments to the best of their ability. Students with CD often feel rejected by their peers and will need teacher intervention to promote positive relationships.
      - Because many students with CD also have ADD or ADHD, it may be appropriate to use differentiation strategies you would use for a child with ADD/ADHD.
      - Be clear that all students are accepted in the classroom community – no bullying or teasing will be allowed of any student. This sets clear boundaries for everyone.
      - It is very important to remember that students with CD will be difficult, but not impossible. Every child struggling with CD is different and will have different needs.
      - It is unlikely that any single strategy will be successful when dealing with students with CD. You will have to find what works with each child.