Inclusion Strategies That Work!: Research-Based Methods for the Classroom


Toby J. Karten

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  • Copyright


    This book is dedicated to all of my students throughout the years.

    Together we have learned so much.

    The world awaits, welcomes, and applauds your brilliance and perseverance to succeed.

    Continue to connect with me on LinkedIn.

    List of Inclusive Activities and Worksheets: for Teachers and Students


    Teachers and students are sometimes caught up in the special education paradigm, with a San Andreas Fault separating effective research practices from classroom implementation. I hope this book facilitates learning for students with and without disabilities by jump-starting teachers with research-based strategies for inclusive classrooms. As you proceed through the chapters and activities, please note that I often italicize the base word abilities in the word disabilities to highlight that it is not about what students cannot do; instead, the focus in inclusive classrooms must be on students’ strengths—what they can do. Educators owe students the opportunity to achieve their maximum potential. This need not be a complicated process if professionals are trained and equipped with the right tools that focus on students’ abilities. Step-by-step practices are explained in each chapter, with guided student and teacher activities for internalizing strategies. This text explains what research says about the inclusion of children as well as inclusive content, focusing on the achievement of productive student outcomes in diverse classrooms. Knowledge is retained by doing, so the words in this text leap off their pages with activities for inclusive classrooms, as shown below. A goal of this book is to help you tackle your list of inclusionary concerns.

    The first chapter begins by establishing the reason for inclusion. Research and legal considerations are detailed and examined with text and cooperative assignments to help readers understand more about the impact of the Individuals with Disabilities Education Act (IDEA) amendments and response to interventions (RTI) entering classrooms. The impact on the classroom made by the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act of 1973, and the Common Core State Standards (CCSS) is also investigated. The second chapter explains some of the special terminology along with the negative effects that labeling has on students with and without disabilities. Experiential simulations and resources for more disability awareness are included. The third chapter delineates how knowledge of special education strategies benefits students with and without exceptionalities. Expansive interactive strategies and techniques ask the reader to process strategic concepts through varied activities.

    The text moves on to discuss the individualized education program (IEP), demystifying the document with practical guidelines that include basic IEP elements and ways for teachers to provide and document goals with classroom modifications that accommodate and honor individual needs. The text also addresses social issues as an integral part of the curriculum, including ways for teachers to improve student behavior. Emotional intelligences, self-advocacy, functional behavioral assessments, and interpersonal reflections are all major components of successful inclusive classrooms, as shown with academic and social connections.

    None of these inclusive principles would work without teachers co-planning structured lessons with clear-cut objectives, universal design for learning (UDL), differentiated instruction (DI) principles, and thinking about assessments through understanding by design (UbD). Sample collaborative classroom dilemmas are examined. The chapter on co-teaching tries to blur the lines between special and general education teachers to merge their sometimes separate worlds. The longest chapter in the book, Chapter 7, is about using the three Rs of reading, ’riting, and ’rithmetic, with an abundance of student templates that focus on teaching the basics. Content areas of physical education, art, music, science, and social studies complement this chapter, along with thematic interdisciplinary lessons. Learning more about study skills is next, along with retention, comprehension, and accountability issues with assessments. Teachers can reflectively examine classroom scenarios, questioning whether fair translates to equal and how effort, progress, and achievement factor into the grading and overall assessment process.

    Chapter 10 focuses on how parents and families need to be part of the inclusive team, communicating and working together with teachers. Parents, families, and guardians are teachers’ allies who should be valued as members of the school planning team. Establishing an ongoing system of home–school communication benefits all.

    The technology chapter includes sample classroom activities and resources that teachers and students can use to maximize inclusive performance. Examples include how technology assists students with varying disabilities in leading more productive lives and how technology does not replace but augments curriculum topics.

    The last chapter of the book reiterates the benefits of revisiting concepts to ground learning in memory. Reflections direct educators to plan lessons with clear-cut objectives in which they teach, move on, and then review. Reviewing is not taking a step backward but cementing or concretizing student learning. Educational mirrors benefit all!

    At the end of the book, readers are given descriptive, clear, and informative disability tables that delineate possible causes, characteristics, and educational strategies that work with many disabilities, from attention deficit hyperactivity disorder to autism spectrum, physical disabilities, emotional disorders, and more, with the changes from DSM-5 offered. A compilation of acronyms is given for quick reference. There are also many organizations and references offered in the bibliography to seek out for further investigation.

    This third edition of Inclusion Strategies That Work! Research-Based Methods for the Classroom offers updated research-based practices and connects them to inclusive classrooms to reflect ongoing changes in the special education (SE) and general education (GE) fields with a greater thrust toward high student outcomes in a digitally connected world. Hence, it includes access to many interactive documents for instruction, documentation, assessment, and professional practice. It is no ordinary book that is intended to collect dust on your shelf. It is a book whose binding will be well worn, since it is meant to be used and reused. Existing materials touch upon many of these topics, but this compilation of materials houses not only the characteristics and dynamics of disabilities, but also vital and feasible strategies and good practices that teachers of all students can use in their classrooms. The text pragmatically explains how research meshes with inclusion when prepared teachers are at the helm.


    I would like to acknowledge all of my colleagues, friends, and family who answered countless questions and offered endless encouragement to complete this text.

    Specific acknowledgment is given to the teachers whose dedicated collaboration is making inclusion a successful reality for all very abled students!

    More specifically, thanks to Marc and Adam, the two sources of my personal inspiration and the rocks I can lean on. Life has purpose with the two of you by my side. Zelda, Al, and Stephan, I love you as well and always will.

    Thanks to all the professionals at Corwin who are part of the production team as well as to the peer reviewers at distinguished universities who carefully scrutinized the text. The first edition was made possible with the assistance of my first editor, Robb Clouse, who read an electronic query and tastefully acted upon it. Thank you to Jessica Allan, senior acquisitions editor, who is a constant supporter of my work to share the best practices. Additional thanks to these Corwin liaisons, associate editor Kimberly Greenberg, editorial assistant Cesar Reyes, production editor Melanie Birdsall, copy editor Jared Leighton, proofreader Caryne Brown, indexer Beth Nauman-Montana, cover designer Michael Dubowe, and marketing manager Stephanie Trkay.

    About the Author

    Toby J. Karten is an experienced educator who has worked in the field of special education since 1976. She has taught students who received a continuum of services throughout the years, ranging from residential settings to self-contained classrooms and inclusive environments. She has an undergraduate degree in special education from Brooklyn College, a master’s degree from the College of Staten Island, a supervisory degree from Georgian Court University, and an honorary doctorate from Gratz College. Being involved in the field of special education for four decades has afforded Ms. Karten an opportunity to help many children and adults from elementary through graduate levels around the world. Along with being an author of several inclusion resources, inclusion coach, and educational consultant, Ms. Karten has designed face-to-face and online graduate courses entitled “Skills and Strategies for Inclusion and disAbility Awareness,” “From Challenge to Success: ADHD, LD, and the Spectrum,” “Interventions for Students With Dyslexia and Other Reading Differences,” and “Collaborative Practices for Inclusive Schools.” She is an adjunct professor at Monmouth University and works with the Regional Training Center in New Jersey, Pennsylvania, and Maryland as a course trainer and graduate instructor for The College of New Jersey and Gratz College. She has presented at local, state, national, and international workshops and professional conferences. Ms. Karten has been recognized by both the Council for Exceptional Children and the New Jersey Department of Education as an exemplary educator, receiving two “Teacher of the Year” awards. Ms. Karten is married and has a son as well as a few dogs. She enjoys teaching, reading, writing, artwork, and—most of all—learning. As the author of this book, she believes that inclusion does not begin and end in the classroom but is a philosophy that continues throughout life. Hence, inclusion is not only research-based but life-based as well!

  • Resource A

    The disability tables list possible causes of certain common disabilities/syndromes/disorders, characteristics of people who have these syndromes, educational strategies to use with students, and resources. As with all groups, please note that disabilities are heterogeneous and that each of these tables describes a syndrome, not a specific child. In addition, some characteristics and strategies may be shared and overlap with others, with comorbidity existing. The purpose of the information in the tables is to broaden knowledge, and it does not make anyone informed enough to diagnose. Remember that clinicians make diagnoses. Diagnoses and labels are serious things! Information for the tables in Resource A was obtained from field experts, the individual disability organizations listed, professional conferences, journals, the Center for Parent Information and Resources, and diagnostic criteria from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association. DSM-5 has changes from the prior version (DSM-IV) that replace a multiaxial system of disorders with relatedness of disorders aligned with practices by the World Health Organization’s (WHO) International Classification of Disease (ICD-11). As examples, DSM-5 folded the diagnosis of Asperger syndrome into autism spectrum disorder (ASD) and added a childhood disorder known as disruptive mood dysregulation disorder (DMDD) to account for too many children being diagnosed as bipolar who are prescribed medications. Like the Individuals With Disabilities Education Act (IDEA), DSM-5 changed the term mental retardation to intellectual disability. DSM-5 uses a dimensional system, with many diagnoses given a level of functioning (LOF) rating of mild, moderate, and severe (e.g., types of anxiety or depression). Additional differences from the prior edition can be reviewed in the DSM-5. Disorder sections include neurodevelopmental, psychotic, bipolar and related, depressive, anxiety, obsessive-compulsive disorder (OCD) and related, trauma and stressor-related, dissociative, somatic symptom and related, feeding and eating, elimination, sleep-wake, gender dysphoria, disruptive, impulse control and conduct, substance-related and addiction, neurocognitive, personality, and paraphilic. The following tables list information, resources, strategies, and more knowledge about specific disabilities.

    Feeding and Eating Disorders
    Anorexia Nervosa

    Severely restricting food intake even if a person’s body weight is way below normal

    • Low self-confidence
    • Feeling of inadequacy
    • Possible genetic and environmental influences
    • Hormone imbalances or incorrect neurotransmitter levels
    • Fear of gaining weight
    Possible Characteristics
    • Usually appears in early to mid-adolescence
    • Restriction of food intake to the extreme, such that the person fears any weight gain and has a constant obsession with thinness
    • Mild, moderate, severe, or extreme—coded by body mass index (BMI) ranges
    • May even use excessive exercise, diuretics, and laxatives to prevent any weight gain
    • Muscle loss and weaknesses
    • Unrealistic body image
    • Can fatally affect other body systems
    Bulimia Nervosa

    Disorder in which the person purges food consumed in order to not gain any weight

    • May be unable to deal with emotional situations and uses food as a vehicle for control
    • Genetic and environmental influences
    Possible Characteristics
    • A person with bulimia can eat large quantities of food within a short time frame and will then purge
    • May use exercise, laxatives, diuretics, or extreme diets to vigorously control weight
    • Mild, moderate, severe, or extreme—coded by purging/compensatory episodes each week
    • Purging is usually done secretively
    • Calluses on hands and fingers from sticking fingers down their throat
    • Fixation on body weight
    • May be depressed but not necessarily
    • Can also have fatal results
    Binge Eating

    Bulimia without purging/compensation

    Eating more than usual for a time period with a feeling of not being able to stop or control the amount of food intake, leading to excessive food consumption

    Avoidant/Restrictive Food Intake

    Those who exhibit some symptoms of anorexia but do not meet all criteria (e.g., low weight, distorted body image)

    • Lack of interest in eating or food
    • Nutritional deficiency
    • Excludes anorexia/bulimia
    Compulsive Overeating
    • Poor body image
    • General feelings of unhappiness
    • Environmental/genetic influences
    • May have conflicting and unsettling emotions in response to stress, using food as a panacea to pacify those negative feelings, rather than eating from hunger
    Possible Characteristics
    • Will usually be a closet eater
    • Binge eating is sometimes followed by guilt and depression for dietary overindulgences
    • Health complications may fatally spiral

    Ingestion of nonnutritive substances over a period of at least one month that is severe enough for clinical attention and developmentally inappropriate

    May present comorbidity with ASD and intellectual disability

    Rumination Disorder

    Repeated regurgitation of food that may be rechewed, reswallowed, or spit out



    Kirberger, K. (2003). No body’s perfect. New York: Scholastic.

    National Association of Anorexia Nervosa and Associated Disorders (ANAD):

    National Eating Disorder Association (NEDA):

    Emotional Disturbances
    General Overview
    • Not determined
    • Contributing factors include the following:
      • Heredity
      • Brain disorder
      • Diet
      • Stress
      • Family functioning
      • Neurological impairment
      • Brain injury
      • Chemical imbalance
      • Nutritional deficiency
      • Alcohol or drugs used by the parents
      • External factors, such as divorce, the death of a loved one, moving, and trauma, are situational and do not cause the actual disturbance. Environment may contribute to diagnosis but does not justify the classification

    Dr. Mac’s Behavior Management Site:

    National Alliance on Mental Illness:

    National Federation of Families for Children’s Mental Health:

    Possible Characteristics
    • These behaviors are evidenced over long periods of time and adversely affect a child’s performance. According to IDEA, intellectual, sensory, or health factors cannot explain these behaviors. Review IDEA Sec. 300.8, Child with a disability, for exact language. Examples of emotional disturbance include the following:
      • Hyperactivity—impulsiveness, short attention span
      • Aggression or self-injurious behavior—acting out, fighting
      • Withdrawal—excessive anxiety, failure to initiate interaction with others, intimidated by social interaction
      • Unsatisfactory interactions—inability to maintain satisfactory interpersonal relationships with peers and teachers
      • Immaturity—poor coping skills, inappropriate crying, temper tantrums
      • Learning difficulties—academically performing below grade level due to behavior issues
      • More severe emotional disturbance—distorted thinking, excessive anxiety, bizarre motor acts, abnormal mood swings; can include schizophrenia
    Educational Strategies
    • Behavior modification, charting frequency of desired behavior
    • Establish a reason for the behavior (a functional behavior assessment, or FBA) to extinguish the motive and inappropriate desired result and to help develop a behavior intervention plan (BIP)
    • Conflict resolution
    • Psychological or counseling services
    • Coordination of services among home, school, family, and therapeutic community with consistent communication
    • Help student develop academic as well as social skills
    • Establish rapport and trust with the student by disliking the behavior, not the child
    • Let the student know that you are listening to him or her
    • Smile, praise, trust
    • Eye contact
    • Structure with limits and consequences
    • Yoga, breathing exercises
    • Constructive outlets such as art or music
    • Find ways for students to feel good about themselves
    • Promote more self-awareness and self-evaluation with immediate positive reinforcement

    Unusual and extreme shifts in mood disturbance with increased activity/energy and behavior that interfere with normal, healthy functioning

    Separated from depressive disorders in DSM-5

    Manic episode may be sandwiched between hypomanic or major depressive episodes

    • Possible genetic predisposition or chemical imbalance
    • Not caused by drugs, medication, or bereavement
    Possible Characteristics
    • Children can have highly volatile, short swings of mood; adults can have mood fluctuations that may last for days or weeks.
      • Inflated self-esteem
      • More talkative, changes topics frequently, cannot be interrupted
      • Racing thoughts
      • Distractibility
      • Decreased need for sleep
      • Psychomotor agitation
      • Increase in activities that could be harmful
      • Excessive pleasurable activities (e.g., buying spree)
      • School impairments in academics and social functioning with peers, along with home and family difficulties
      • Increased energy with little sleep
      • Physical complaints such as stomachaches, tiredness, headaches, or muscle pains
      • Disruptive outbursts with sensitivity to failure or rejection, or may be overly silly or elated, talking excessively
      • May evidence risk-taking behavior with alcohol, drugs, or by being sexually active
      • If depressed, may show more sadness, with low tolerance for failure
      • May also exhibit extremes with sleeping or eating
    Educational Strategies
    • Psychiatrists, individual/group counseling with supportive nonjudgmental adults who demonstrate concern by listening to child
    • Behavior intervention plans
    • Increase self-awareness
    • Awareness of prescribed medication
    • Individual educational support (tutoring)
    • Positive attention or rewards for appropriate behavior with programs to increase self-esteem and guided peer relationships
    Depressive Disorders (may be mild, moderate, or severe)

    Disruptive Mood Dysregulation (DMDD)—with symptoms of outbursts and negative mood, diagnosed between ages six and eighteen, with outbursts and negative moods evidenced before age ten; can coexist with ADHD and CD (conduct disorder)

    Persistent Depression (Dysthymia)—depression is severe but not episodic

    Major Depression—depressed mood or anhedonia (lack of pleasure)

    Anxiety Disorders—includes separation, selective mutism, specific phobia, panic, agoraphobia, social anxiety, generalized, substance/medication-induced, other medical conditions-psychotic

    Selective Mutism—child does not speak in select social settings, not because the child is unable but because of internal feelings

    • Possibly a psychiatric disorder related to anxiety
    • Noncommunication is not caused by any other disorder, including a communication disorder
    • Definitive cause unknown; can start at a young age, usually before age five
    • Rare; fewer than 1 percent of children have selective mutism
    • Slightly more common in girls than boys

    Anxiety and Depression Association of America:

    The Balanced Mind and Parent Network:

    Bipolar Child Support:

    Mental Health America:

    Selective Mutism Foundation:

    Selective Mutism Group:

    Social Anxiety:

    Possible Characteristics
    • No language or speech difficulties
    • Consistent failure to speak in some social situations, such as school, but willingness to speak in other situations, such as home environment
    • Language impairment with duration lasting more than a month
    • Difficulty with relationships
    • Problem may be related to anxiety or a social phobia since the children have the ability to both speak and understand language but fail to use this ability
    • Social isolation/withdrawal
    • Clinging behavior, compulsiveness, negativism, or temper tantrums with controlling or oppositional behavior, especially at home
    • Can become peer scapegoat
    • Usually lasts for only months but can continue for years
    Educational Strategies
    • Offer supportive, nonthreatening environment
    • Enlist more outgoing peer to be buddy
    • Seat student off center
    • Use discrete task analysis to encourage speaking (e.g., reward small steps whenever the child makes sounds or words)
    • Offer appropriate channels for communication and expression (e.g., tactile, visual, technology)
    • Speech and language therapy with encouragement for family and child
    • Be patient and calm
    • Do not speak for the child!
    • Do not try to force student to speak
    • Include the child socially as an integral part of the classroom, regardless of lack of vocalizations
    • Introduce other forms of communication (e.g., gestures, signs, written expression, communication board)
    • Include more nonspeaking activities such as writing, using the computer, drawing, or silent reading
    • Digitally record and note when child speaks to gain more understanding of speech patterns
    • Have child speak in smaller setting (e.g., one to one, with a speaking buddy, or into a digital recorder) and then gradually add more people to conversations
    • Keep a chart of gains that can be coordinated with a reward system in home and school environment, involving parents and families. Gradually phase out rewards as child speaks more.
    Obsessive-Compulsive Disorder (OCD)
    • OCD has multiple types and causes:
      • Research is investigating neurobiological factors and environmental influences that contribute to this anxiety disorder.
      • OCD is not due to a substance disorder (medicine, alcohol, or drug) or other medical condition.
      • Genetic studies are being conducted to discover the molecular basis of OCD.
      • Sometimes linked with Tourette syndrome and ADHD.
      • Positron emission tomography (PET) scanning involving brain imaging suggests different patterns of neurochemical activity in the brain.
      • National Institute of Health and other researchers believe strep throat and bacterial infections to be triggers of some types of obsessive-compulsive disorder as well as symptoms of Tourette syndrome (e.g., nervous tics).

    International OCD Foundation:

    Possible Characteristics
    • Repetitive, excessive, and unreasonable behavior (e.g., hand washing/fear of contamination, counting, rechecking, rearranging, repeated doubts)
    • Obsessions and compulsions cause marked distress and significantly impact functioning
    • Anxiety evidenced
    • Inability to control thoughts, worries, panic, and compulsiveness
    • Difficulty concentrating
    • Cannot effectively follow school schedules and transitions
    • Fear of contamination or a serious illness
    • Sometimes behavior is hidden in front of classmates due to embarrassment
    • May repeatedly erase and redo assignments, which can result in incomplete work
    Educational Strategies
    • Communicate consistently with parents
    • Watch for side effects from some medication or drug combinations, such as nervousness or fatigue from insomnia
    • Use behavioral plans and progress reports to control impulsivity
    • Use cognitive behavioral therapy (CBT) to challenge and extinguish faulty compulsions
    • Increase self-awareness, frequent and consistent self-monitoring
    • Cue students for key points and signal classroom changes
    • Establish an assignment book with a long-range calendar; use checklists to keep student organized
    • Provide a model of desired outcome
    • Have student repeat directions for understanding
    • Establish trusting relationship
    • Use cooperative learning
    • Educate other school personnel and help develop positive social interactions
    OCD and Related Disorders

    In DSM-5 this chapter includes obsessive-compulsive disorder, trichotillomania (hair pulling), body dysmorphic, hoarding, and excoriation (skin picking) and substance/medication-induced obsessive-compulsive and other related disorders.

    Disruptive, Impulse-Control, and Conduct Disorders
    Oppositional-Defiant Disorder (ODD)

    In DSM-5, ODD is included in the section, “Disruptive, Impulse-Control and Conduct Disorders,” along with the categories of angry/irritable, argumentative/defiant, and vindictive. The number of settings in which symptoms are present indicates the range of mild, moderate, and severe. Intermittent explosive disorder (IED) involves verbal or physical explosions and can coexist with other disorders at age six or older. Conduct disorder needs to specify a childhood, adolescent, or unspecified onset and whether there are limited prosocial emotions, such as lack of remorse or guilt, callous lack of empathy, unconcerned about performance, shallow and deficient affect. Antisocial personality disorder is acknowledged, but criteria are listed in the “Personality Disorders” section. Kleptomania, pyromania, and others are also included in this section of DSM-5. Caution should be exhibited in the ODD diagnosis since oppositional behavior is frequently evidenced in preschool and adolescent children.

    • Uncertain
    • ODD is usually evident before age eight and not later than early adolescence
    • Appears to be more common in families in which at least one parent has a history of mood, oppositional defiant, attention, or a substance-related disorder
    • Criteria for the diagnosis of this conduct disorder are met if behaviors cause significant impairment in social, academic, or occupational functioning

    American Academy of Child & Adolescent Psychiatry:

    Mental Health America:

    Possible Characteristics
    • Pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least six months
    • Negative behavior toward authority figures or adults
    • Deliberately doing things to annoy others
    • Blaming others for his or her mistakes
    • Often touchy or easily annoyed by others
    • Resentment toward authority
    • Refusal to do school assignments or chores at home
    • Underachievement at school
    • Pouting, stubbornness, obstructive behavior (interfering with the plans and activities of others)
    • Easily frustrated
    • Loses temper frequently
    Educational Strategies
    • Communication and consistency between home and school with parent management training (PMT) that advocates brief, nonaversive punishments
    • Listen to the student before giving a reaction
    • Avoid punitive patterns or negative attention for defiance; allow choices/options under teacher’s auspices (e.g., “pick three out of five”) to diminish power struggles and to build on positives
    • Give child meaningful responsibility in the classroom
    • Offer frequent praise and rewards for compliance and improvements, which can also be nonverbal or even quietly whispered to the student
    • Develop individual goal chart or behavioral plan to decrease defiant behavior and increase self-awareness
    • School counseling or group therapy
    • Private discussions to predetermine rules and consequences
    • Opportunities for positive social interaction
    • Emphasis on problem-solving skills
    • Be aware of child’s interests to increase the student’s desire to learn
    • Establish an atmosphere of trust and calmness
    • Dislike the behavior, not the student
    Intellectual Disabilities
    Intellectual Disability (ID)

    IDEA definition: Significantly subaverage general intellectual functioning, existing concurrently with deficits in adaptive behavior (adjustment to everyday life), which are manifested during the developmental period, and adversely affecting a child’s educational performance.

    DSM-5 has ID listed in the section, “Neurodevelopmental Disorders,” with an IQ score no longer required. Diagnosis is made with level of functioning (LOF) in three domains: conceptual, social, and practical.

    • Chromosome abnormalities
    • Birth asphyxia (lack of oxygen when born or soon afterward)
    • Blood incompatibilities between the mother and the fetus or maternal infections, such as rubella or herpes
    • Problems during pregnancy such as not eating right with extreme malnutrition, using certain drugs, alcohol, or smoking (e.g., fetal alcohol syndrome [FAS]), exposure to poisons and environmental toxins such as lead or mercury
    • Down syndrome and Fragile X (with severe mutations) are known genetic causes
    • Malnutrition or inadequate medical care
    • Disease after birth, such as meningitis or encephalitis, that leads to brain damage
    • More than half of ID cases are caused by environmental factors
    • Not a mental illness; cannot be cured

    American Association on Intellectual and Developmental Disabilities (AAIDD):

    The Arc:

    Best Buddies:

    Division on Autism and Developmental Disabilities, Council for Exceptional Children:

    Special Olympics:

    Possible Characteristics
    • Low intellectual functioning or IQ and poor adaptive behavior or skills to live independently (e.g., daily living skills, communication, social, self-help)
    • Different academic, social, and vocational skills, depending on impairment level
    • Difficulties with the following areas:
      • Learning in school (e.g., remembering things)
      • Communication (e.g., receptive and expressive language)
      • Social skills (e.g, consequences, rules)
      • Academic issues (e.g., thinking logically or solving problems)
      • Vocational concerns
      • Personal needs (e.g., hygiene, dressing, eating)
      • Learning occurs but at a slower rate
      • Short-term memory impairment
      • Unable to form generalizations
    Educational Strategies
    • Set realistic and functional goals with family support and coordination
    • Use concrete, age-appropriate materials, avoiding totally abstract levels of presentation but capitalizing on student’s interests and strengths
    • Early infant stimulation, preschool intervention, neighborhood school programs, transitional services, opportunities for schoolwork with emphasis on independent living skills
    • Sensory educational considerations—more visuals, audios, hands-on (e.g., communication boards), interdisciplinary activities, and real-life situations (e.g., restaurant class, shopping in a store, community trips)
    • Break down learning into smaller sequential steps with frequent review, going from simple to complex; honor each student’s instructional level
    • Use consistent, age-appropriate rewards
    • Help students generalize and apply learning from one situation to the next through teacher modeling with immediate realistic feedback
    • Alternate means of assessment, more verbal and less written
    • Teach memory strategies (e.g., chunking, association)
    • Offer lessons with functional and independent-living skills infused (e.g., manners, conversation rules, safety, health, reading street signs, ordering from a menu)
    • Outline transitional goals with preparatory academic and career-oriented courses
    Traumatic Brain Injury (TBI)

    Acquired injury to the brain caused by an external force; does not include congenital or degenerative brain injuries

    • Frequent causes of TBI are related to motor vehicle crashes, falls, sports accidents, physical abuse, assault, and other head injuries
    • Other causes include chemical (insecticides, carbon monoxide, lead poisoning), hypoxia (lack of oxygen), and tumors
    • Types of injuries vary and can range from mild to severe
    • Sudden unexpected onset makes TBI differ from other disabilities since parents and children have not had time to emotionally deal with the disability and must suddenly learn how to manage and accept the changes

    Brain Injury Association of America:

    Brain Injury Survivor’s Guide:

    Traumatic Brain Injury Resources:

    Possible Characteristics
    • Symptoms vary depending on the location and extent of the brain injury. Impairments can be
      • Physical—speech, vision, hearing, sensory impairments, headaches, difficulty with fine and/or gross motor skills, balance, and coordination
      • Cognitive—short- and long-term memory deficits, concentration problems, slowness of thinking/judgment, perceptual issues, and disorganization, with academic difficulties such as trouble learning new information
      • Psychosocial, Behavioral, or Emotional—fatigue, mood swings, denial, self-centeredness, depression, inability to self-monitor, agitation, excessive laughing or crying, difficulty relating to others, poor impulse control
    Educational Strategies
    • Schools need to have appropriate neurological, psychological, speech/language, and educational evaluations to determine accurate classification
    • Careful planning for school reentry
    • Teach compensatory memory strategies
    • Repeated practice
    • Explain figurative language
    • Provide concrete examples to illustrate new concepts
    • Keep the environment as free of distractions as possible
    • Provide student with rest breaks if stamina is low
    • Family support and sharing of educational strategies for reinforcement at home
    Learning/Attention Disorders
    ADHD (Attention Deficit Hyperactivity Disorder)
    • Exact cause is unknown; can be linked to a chemical imbalance in neurotransmitters (chemicals in the brain that help brain cells communicate with each other)
    • Differences in brain activity and structure that help control behavior and attention
    • Might be genetically transmitted (tends to run in families, but this could also be environmental)
    • Evidenced by both sexes; females are sometimes more inattentive than hyperactive
    • Theories exist about poor nutrition or diet

    ADDitude: Strategies and Support for ADHD & LD:

    Attention Deficit Disorder Association (ADDA):

    Centers for Disease Control and Prevention, Attention Deficit Hyperactivity Disorders Homepage:

    Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD):

    Possible Characteristics
    • Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning and development
    • Inattention
      • Daydreaming
      • Inattentive to details
      • Careless in schoolwork (e.g., sloppy handwriting, crumpled homework), forgetful, disorganized, may lose things
      • Memory difficulties
      • Distracted by extraneous stimuli
      • Concentration and listening problems, such as in attending to a teacher while trying to take notes
      • Attention difficulties when initiating actions requiring foresight, sustaining concentration, inhibiting distractions and impulsive reactions, and shifting gears or transitioning to other tasks
      • Difficulties following multistep directions
    • May be predominantly hyperactive-impulsive, which may be characterized by:
      • Frequent motion
      • Fidgeting with hands or feet (rocking in chair, twirling pencils)
      • Missing social cues; getting into fights
      • Difficulty in waiting turn—interrupts others
      • Impulsivity, such as blurting out answers
      • More accidents due to hyperactivity
    • Students diagnosed with ADHD may have combined symptoms of both inattention and hyperactivity–impulsivity, which need to be present for past six months. Students with ADHD may also display a predominantly inattentive or predominantly hyperactive-impulsive behavior. According to DSM-5, symptoms need to be documented prior to age twelve. In addition, there could be a diagnosis of ADHD along with ASD.
    Educational Strategies
    • Structured, predictable environment
    • Daily schedules and assignment pads
    • Clear, concise directions with routines announced and posted; remove all extraneous materials
    • Be aware of any medications as prescribed by child’s physician, due to possible side effects
    • Establish eye contact
    • Have student rephrase or repeat directions
    • Teach organization such as using crates for extra texts from desks or accordion files to hold notes and papers
    • Color-code notebooks, folders, and text covers for different subjects
    • Reinforce study skills
    • Give frequent breaks combined with stretching activities to channel motor excess
    • Write specific, formal behavioral plans with clear expectations, immediate feedback, and rewards
    • Teach problem-solving, conflict-resolution, and peer-mediation skills
    • To increase self-awareness and self-discipline, have student keep a log of impulsive and quieter behaviors
    • Model with guided practice and application and share strategies with home environment
    • Establish a nonthreatening classroom environment, using subtle cues for transitions
    • Be aware of quiet noises in the room. For example, a low humming from the heater or the sounds coming from a nearby classroom may be ignored by most but distracting to a child with ADHD.
    • Dislike the behavior, not the child, using positives before negatives
    Specific Learning Disabilities (SLD)
    • As stated by IDEA, SLD is not primarily the result of visual, hearing, or motor disabilities; intellectual disability; or emotional, economic, environmental, or cultural factors
    • Varied spectrum of causes that may be linked to neurological or genetic factors
    • Learning disability (LD) is a real disability, not laziness!

    Council for Exceptional Children Division of Learning Disabilities:

    LD OnLine:

    Learning Disabilities Association of America:

    National Center for Learning Disabilities (NCLD):

    Possible Characteristics
    • Wide range that can include difficulties with the following:
      • Reading comprehension or word decoding
      • Arithmetic calculations or concepts
      • Spoken language
      • Writing (spelling, creative expression, language mechanics, or fine motor)
      • Social skills
      • Reasoning (getting thoughts together)
    • May also exhibit the following traits:
      • Perceptual impairments
      • Inattention
      • Impulsiveness
      • Low tolerance for frustration
      • Poor organizational skills
      • Dyslexia (reading difficulties)
      • Dysgraphia (writing difficulties)
      • Dyscalculia (math difficulties) (These are discussed further on.)
    Educational Strategies
    • Collaboratively design individualized education program (IEP) to address child’s needs, with general education (GE) staff, special education (SE) staff, parents, families, and transitional services for children age sixteen and older, or younger, if appropriate
    • Use concrete, kinesthetic materials that students can see and touch
    • Break up learning into small bites and step-by-step lessons
    • Capitalize on student strengths using multiple intelligences
    • Use redundancy—repeat, restate, reiterate, and relate
    • Vary instruction and assessment with more active involvement and fewer lectures, allowing appropriate motoric releases
    • Offer immediate positive feedback without embarrassment
    • Emphasize consistent expectations with accountability
    • Use computers and digital tools to help with reading, writing, and math issues
    • Shorten assignments based on level of mastery
    • Instructional level should encourage independence with empowerment under teacher’s auspices
    • Secure appropriate accommodations based on individual needs, but have weaning plans in place as well
    • Frequent home communication helps prevent misinformation
    • DSM-5 has specifiers to note the impairment
      • Reading (word reading, reading rate or fluency, reading comprehension)
      • Written Expression (spelling, grammar/punctuation, clarity/organization)
      • Mathematics (number sense, calculation, reasoning, memorization)
    • SLD also has a range of mild, moderate, and severe.
    • Genetic or neurological factors
    • Lack of cerebral dominance
    • Differences in brain function
    • Auditory language deficit

    Academy of Orton-Gillingham Practitioners and Educators:

    Davis Dyslexia Association International:

    The International Dyslexia Association:

    Jolly Learning:

    Learning Ally:

    Wilson Language Training:

    The Yale Center for Dyslexia & Creativity:

    Possible Characteristics
    • Language-based learning disability
    • May experience difficulties with sound-symbol association, fluency, reading comprehension, vocabulary, spelling, written expression, and auditory processing skills
    • May show difficulties in reading and written and spoken language. Some need more help with spelling, grammar, textbooks, and writing essays.
    • Sometimes have difficulties in use of numeric symbols in mathematics such as reversals of numbers or signs (+, –)
    • Visual problems (e.g., eye tracking, eye movements)
    • Lack of organization
    • Reversals of letters or mirror writing may or may not be present
    • Confusing vowels or substituting one consonant for another
    • Clumsiness and awkwardness with hands
    • Often gifted in other areas that do not require strong language skills, such as art, computer science, math, music, sports, and electronics
    Educational Strategies
    • Early diagnosis and interventions to improve phonemic awareness
    • Use multisensory channels to teach with a structured language approach that involves hearing, seeing, and touching (e.g., more manipulatives and kinesthetic approaches, visuals, and sounds to break words into phonemes and syllables)
    • Use colored overlays on texts
    • Capitalize on student strengths and interests to improve weaker areas
    • Activate word processing programs and learning activities with sound animation
    • Allow access to digital tools (e.g., iBooks, LiveScribe, Dragon Naturally Speaking, speech-to-text)
    • Use alternate/embedded assessments as needed with frequent progress monitoring
    • Orton-Gillingham approach, which is language-based, multisensory, sequential, structured, and cumulative. Students start by learning sounds in isolation, then blend sounds into syllables and words with all the elements of language, from consonants and vowels to digraphs, blends, and diphthongs, and then syllable types.
    • Teach structural analysis by breaking longer words into their parts, using index cards to separate syllables, root words, prefixes, and suffixes
    • Use graded, color-coded sight words or flashcards with student, maintaining, adding, and reviewing alphabetical lists
    • Use structured reading, spelling, and phonics programs with controlled text that build on a hierarchy of skills, avoiding small print
    • Make modifications such as helping with note taking or allowing extra time to complete tests
    • Build self-esteem with more positive reflections, including dated portfolios of completed work
    • Allow older or adolescent students to use high-interest, controlled texts and age-appropriate words to practice reading, thereby honoring their dignity in the reading process rather than belittling them!
    • Choral or echo reading for more difficult words within text not yet learned

    Combination of fine-motor and eye–hand coordination problems, which can include improper pencil grip, confused hand dominance, poor wrist control, and illegible handwriting along with general difficulties putting thoughts into writings

    • May involve a brain dysfunction that includes translating mental thoughts into written language
    • Lack of hand strength developed early in infancy that, along with incorrect kinesthetic memory, led to incorrect motor routines and habits
    • Difficulties arising from dysgraphia are compounded by emotional factors if a child is pushed into using handwriting at an early age or overly criticized

    Handwriting Without Tears:

    Keyboarding Without Tears:


    Learning Disabilities Association of America:

    Possible Characteristics
    • Can include memory and attention difficulties or an inability to visualize letters and shapes
    • Written work may be illegible, with related difficulties in spelling, drawing, spontaneous expression, or simply copying letters
    • Writing hand may shake or cramp because of an awkward pencil grip or slower fine-motor speed
    • Student may struggle with writing tasks, spending more time on how he or she forms the letters rather than the writing content
    • Student dislikes writing tasks, showing tension when taking class notes or during other written assignments
    • May be a creative writer but just dislikes the mechanics involved
    • Motor movements are unsequenced and not automatically learned
    • May complain of hand hurting or fatigue
    • Slowness in completing assignments involving writing due to difficulties forming letters, collecting thoughts, and organizing ideas
    • May omit words in sentences and display poor syntax
    • Sometimes the student can’t proofread own written work since he or she is unable to read it
    Educational Strategies
    • Multisensory approaches; value VAKT elements (visual, auditory, and kinesthetic/tactile)
    • Strengthen fine motor skills using various media (e.g., crayons, clay, tactile glue, games, toys, felt boards, sky writing, sorting objects, sponges, pipe cleaners, Legos, stringing beads, scissors, stencils, salt, pencil grips, tracing paper, yarn)
    • Verbalize letter formation steps using configuration strategies, noticing the size, shape, and—later, when ready—the slant of letters
    • Provide student with a sheet that matches and compares manuscript to cursive writing
    • Use purposeful writing such as labeling folders and other items in the classroom; making signs; writing letters, birthday cards, and thank-you notes; and designing bulletin boards
    • Establish rubrics with acceptable writing samples and encourage self-evaluation
    • Check how student is seated with emphasis on good posture, with paper correctly positioned and taped or Velcroed to desk
    • Have students use graphic organizers and computer templates to collect thoughts and minimize writing; use writing strategies that compartmentalize thoughts
    • Assign students a copying buddy to share more legible notes
    • Make use of technology: digital recording pens and devices, electronic spell-checkers, keyboarding programs, laptop computers, distribute electronic copies of notes, allow student to record lessons to then play back at a slower pace
    • Teach step-by-step ways to expand writing thoughts

    Learning disability that affects ability to do math. Students may be math phobic, fearful of activities involving numbers, such as computations requiring addition, subtraction, multiplication, or division. In addition, learning new mathematical concepts or problem solving may be stressful.

    • Can be based on prior negative experiences, poor self-confidence, or instructional synapses, along with genetic or neurological factors
    • Brain imaging studies show different brain pulses in areas dealing with interpretation of numbers and spatial images

    Abeel, S. (2003). My thirteenth winter. New York: Scholastic. (Memoir about dyscalculia)


    Molko, M., Cachia, A., Rivière, D., Mangin, J., Bruandet, M., Le Bihan, et al. (2003). Functional and structural alterations of the intraparietal sulcus in a developmental dyscalculia of genetic origin. Neuron, 40, 847–858.


    Possible Characteristics
    • Weakness with visual processing and memory
    • Learning difficulties may be present in other content areas such as recalling important dates in social studies, or specific science and math formulas
    • May not spell well
    • May have poor fine-motor skills regarding size, spacing, organization, and alignment of letters and numbers
    • Sequencing difficulties
    • Limited organizational skills
    • Difficulty extracting information to solve word problems
    • Math test anxiety; may freeze or forget what is taught and learned, evidencing a flawed test performance
    • If visual processing difficulties are the cause, reading comprehension and writing skills may be strengths, while spelling, applying phonetic rules, and sight-word development may be weaknesses
    Educational Strategies
    • Students need guided and systematic instruction to help them develop compensatory strategies to work with numbers
    • Use specific, step-by-step examples to both explain and review concepts
    • Teach new material, then review prior learning, consistently backtracking to maintain skills
    • Encourage students to peruse and develop helpful visual information such as graphs, charts, tables, and pictures to simplify word problems or computations
    • Allow students an opportunity to use an auditory approach by listening to their own voices, music, computer programs, peers, or teachers as they work
    • Have students immediately apply skills; use less straightforward lecturing and more student doing
    • Interview and conference with students to ensure math understandings and to develop math profiles
    • Use a variety of concrete and online tools to allow students to internalize what they are learning (e.g., TouchMath, algebra tiles, hands-on equations, virtual manipulatives, Cool Math Games, Khan Academy, Purplemath)
    • Try to make math fun by incorporating students’ interests (e.g., batting averages, weather) while meaningfully connecting mathematical skills and concepts to daily life (e.g., food products to learn about metrics, store circulars to teach comparison shopping, eating out in a restaurant)
    • Develop user-friendly, uncluttered worksheets
    • Allow students to hold lined paper horizontally to help keep the place value of numbers in columns
    • Deliver consistent praise and realistic, timely math feedback on levels and progress
    • Incorporate CCSS Standards for Mathematical Practices
    Autism Spectrum Disorders (ASD)
    General Overview

    Diagnosis made from DSM-5 identifies ASD as a broad disorder with severity based on levels of functioning as 1 (lowest), 2, or 3, based on social communication and interactions in multiple contexts along with repetitive behaviors, interests, and activities. DSM-5 folded pervasive development disorders (PDD) and Asperger syndrome under an ASD category. Some individuals who have deficits in social communication but do not meet the criteria for ASD may be evaluated for social (pragmatic) communication disorder (SCD). Specifiers include with or without intellectual impairment, language impairment, association with another medical or genetic condition or environmental factors, association with another neurodevelopmental, mental, or behavior disorder, and catatonia.

    • Exact etiology unknown. Some possibilities include the following:
      • Genetic and environmental factors
      • Biochemical imbalance in the brain
      • Metabolic and neurological factors
      • Theories about environmental/toxic influences
      • Not caused by psychological factors
      • Seems to be more prevalent in males
      • Familial heritability—increased frequency in families with members who have ASD

    Autism Research Institute:

    Autism Society:

    Autism Speaks:

    Centers for Disease Control and Prevention:

    Global Autism Collaboration:

    Possible Characteristics
    • Depends on severity along with developmental level and chronological age
    • Social impairment with communications and interactions (e.g., social reciprocity—can be unaware of how their behaviors might affect others)
    • Difficulty relating to people; unusual play; appear unaware of others, negatively affecting peer interactions
    • Restrictive, repetitive patterns of behaviors, interests, or activities that limit everyday functioning may be indicated by fascinations with own desires or idiosyncrasies as well as possible preoccupation with parts of objects
    • Varying verbal and nonverbal deficits depending on age, intellectual level, language ability, and supports
    • IQ can range from lower cognitive level to high intelligence
    • Difficulties sharing interests or enjoyment with others
    • Poor nonverbal behaviors, eye contact, facial expression; inappropriate body language
    • Inflexible attachment to schedules and routines
    • Possible motor delays or clumsiness
    • Ineffective sensory processing with unusual responses to lights, noises, textures
    • Communication difficulty—hard time using and understanding language; may use repetitive speech (echolalia), nonspeech vocalization; receptive language is usually better than expressive language, but both verbal and nonverbal behavior can be impacted
    • Difficulty with abstract and/or unfamiliar concepts and routines
    Educational Strategies
    • Social behavior needs to be modeled, encouraged, practiced, and documented in school and at home with role-playing.
    • Students can keep a social skills notebook or log and read guided social stories
    • Increase self-awareness with concrete rewards, verbal praise, and much patience
    • Adult and peer support needed to emphasize social appropriateness in academic settings, at first in smaller group or setting. Then add positive role models to increase interactions.
    • Direct social skill instruction and prompting with peers
    • Educate other students and adults about ASD
    • Emphasis on routine and structure to reduce stress, using outlines, planners, and monthly calendars to help students deal with transitions and daily happenings
    • If possible, give advance notice of changes in daily schedule (e.g., half day, assembly)
    • Avoid sensory overstimulation
    • Provide visual cues, sound signals, tactile learning, and handouts
    • Use of pictures to outline day’s schedule
    • Allow embedded academic opportunities for motoric movement
    • Be aware of students’ likes and dislikes
    • Teach compensatory strategies
    • Use behavior modification program to reward desired behavior (e.g., more eye contact)
    • Have instructional assistant shadow student if necessary, but encourage independence
    • Provide a nurturing and accepting classroom and other quiet settings to channel behavior
    • Reward social reciprocity
    • Collaborate with related service providers (e.g. speech and language services with classroom and home coordination, occupational therapists, behavioral interventionists) and family
    • Teach and value other ways to communicate if appropriate (e.g., communication boards, gestures, and music)
    • Match visual and verbal presentation with concrete experiences (e.g., field trips, animations)
    • Offer functional academics to enhance daily living if appropriate for level of severity
    • Tactile stimulation such as gentle pats or arm strokes; water therapy can also be soothing
    • Teach academics and socialization with step-by-step methods, focusing on strengths
    • Use behavioral analysis to improve and reward targeted behaviors and verbal behavior (see the Association for Behavior Analysis International at
    Physical Impairments
    General Overview

    Physical disabilities can affect a lot of different areas. Physical relates to the body, and disability means not being able to do something. A child with a physical disability has a body that does not work in some way. A child’s fine-motor skills can be affected, which means that he or she might not be able to hold things such as a spoon, fork, or pencil. Gross-motor skills can also be affected when a child uses his or her feet for things such as walking or riding a bicycle. Communicating with others by moving the lips to talk can be difficult for a child with a physical disability.


    Bright Hub Education:

    Disabled Sports USA:

    National Council on Independent Living:

    Disabled World—Physical and Mobility Impairments: Facts, News, and Information:

    Equal Access: Universal Design for Physical Access, University of Washington:

    Special Olympics:

    Possible Characteristics
    • Can be present at birth (e.g., spina bifida, cerebral palsy)
    • May be caused by accidents (e.g., skiing, car injury, sports, spinal cord injury)
    • Diseases can cause a physical impairment (e.g., polio, multiple sclerosis)
    • Physical disabilities may increase with age as bone structure changes, and mobility can become limited
    • Remember that sensitivities and common sense always apply. Don’t freeze up!
    • Attitudes toward those with a physical impairment are still archaic, since some people inaccurately or subconsciously assume that someone who can’t walk properly cannot have total usage of his or her brain. For example, a person with cerebral palsy can be just as intelligent as an able-bodied individual.
    • Awareness about others is most important; educate peers and staff.
    • Collaborate with families.
    Educational Strategies
    • The environment needs to be physically arranged for optimum usage by those with physical disabilities, not for the convenience of others (e.g., the use of parking spots, dressing rooms, and bathrooms designed for those with disabilities). Some school arrangements and accommodations include the following:
      • Bathroom accessibility to maneuver a wheelchair to turn
      • Lowered sinks, mirrors, and towel holders
      • Wider classroom aisles
      • Elevators for buildings with more than one floor, equipped with lights and bell signals, or tactile Braille for those with hearing and visual needs
      • Structural accommodations to allow access to all facilities, from water fountains to meeting rooms
      • Lowered windows that allow someone who uses a wheelchair to see outside
      • Positioning (e.g., raising or lowering) necessary adaptive equipment to facilitate student’s independence
      • Use of a Velcro mat on a student’s desk to prevent books, papers, pencils, and other materials from slipping, or securing papers to the desk with tape
      • Bean bag for student to sit on during floor activities to be on eye level with peers
      • Occupational therapy can be a related school service, targeting specific physical needs
    • Enlist help of peers
      • A classmate can make copies of notes
      • Learning buddies can help students gather materials and assist with school or homework
      • Remember to try to be on eye level with someone in a wheelchair so he or she does not strain his or her neck by looking up at you
      • Encourage students to exchange cell phone numbers or e-mail addresses to extend peer support and friendship outside of the school environment
      • Set tone in class by example; treat student the same, socially and emotionally, as you would a student without physical impairments, seeing the student as a child first, not only as a child with a disability
    Cerebral Palsy (CP)

    Cerebral refers to the brain. Palsy refers to muscle movement that may be stiff, uncontrolled, or unbalanced, depending upon type of CP.

    • Rarely associated with heredity since the damage to the brain usually occurs before, during, or shortly after birth
    • Neurological in nature
    • Mother’s illness during pregnancy
    • Premature delivery
    • Lack of oxygen supply to the baby or poor blood flow reaching the fetal or newborn brain
    • Can be a result of accident, lead poisoning, viral infection, or child abuse
    • Might involve separation of the placenta, an awkward birth position, long labor, or interference from the umbilical cord
    • Rh or ABO blood type incompatibility between parents may exist
    • Mother infected with German measles during pregnancy
    • Brain injury at birth
    Possible Characteristics
    • Inability to fully control motor functions, ranging from mild to severe (e.g., student moving without assistance to using braces or a wheelchair)
    • Not a disease; it is a nonprogressive condition that is not contagious
    • Impairment may involve sight, hearing, and speech
    • There are different types of cerebral palsy classifications
    • Can be classified based on severity, a topographical distribution (which body parts affected—how and where), motor function (spastic-nonspastic), muscle tone-pyramidal (spastic) and extrapyramidal (nonspastic)
      • Spastic—stiff and difficult movement
      • Athetoid Dyskinetic—involuntary and uncontrolled movement (e.g., facial grimaces, drooling)
      • Dystonia—affects trunk muscles with twisted posture
      • Ataxic—coordinated movements, fine motor, sense of balance, and depth perception affected
      • Gross motor function classification system (GMFCS) refers to extent of ability and impairment limitation
    • Depending on which part of the brain has been damaged and the degree of central nervous system (CNS) damage, characteristics can include the following:
      • Spasms
      • Tonal problems
      • Involuntary movements
      • Seizures
      • Disturbances in gait and mobility
      • Abnormal sensation and perception
      • Impairment of sight, hearing, or speech
      • Individuals may have mixed symptoms
      • Range of intelligence levels from high to lower
    Educational Strategies
    • General or special education with equal academic opportunities
    • Technology with assistive equipment (e.g., electronic communication board, book holder, pencil grip, word processor, tether ball)
    • Community integration opportunities
    • Recreation
    • Consult with occupational therapists (OT) and physical therapists (PT)
    • Educate other students about misconceptions
    • Classroom assistance
    • Involvement and peer support in social and academic activities
    • Teach self-advocacy
    • Life-skills instructions with appropriate activities for daily living
    • Focus on strengths and interests
    • Provide opportunities for success
    • Allow more rest periods
    • Transitional services
    • Physical condition with sudden, brief change in how the brain works that in some cases happens for inexplicable reasons
    • Consciousness, movement, or actions are altered for a short time (epileptic seizure)
    • Repeated seizures can be caused by illness, brain damage, birth trauma, brain infection, head injury, metabolic imbalance in the body, drug intoxication, brain tumor, or disruption of blood to the brain
    • Environmental factors that might bring on a seizure include sudden lighting changes, flashing lights (e.g., photosensitivity), or loud noises
    • Some forms of epilepsy may be inherited
    • A single seizure does not mean that a person has epilepsy; seizures can be caused by fevers, imbalance of body fluids, or alcohol or drug withdrawal.

    Epilepsy Foundation:

    Possible Characteristics
    • Types of seizures—depends on which part of the brain is affected; types include primary generalized, partial, nonepileptic, and status epilepticus.
      • Primary Generalized—all brain cells are involved; might involve a convulsion with a complete loss of consciousness or might look like a brief period of fixed staring
      • Partial—occurs when brain cells are not working properly and is limited to one part of the brain; may cause periods of automatic behavior and altered consciousness with repetitive behavior that is usually not remembered
      • Nonepileptic—not caused by epilepsy
      • Status epilepticus—persistent seizures
    • Other possible symptoms:
      • Involuntary movements of arms and legs
      • Blackouts or periods of confused memory, with episodes of staring or unexplained periods of unresponsiveness. Teachers should keep an eye out for this inattentive behavior as being a possible sign of a seizure if the child is known to have epilepsy.
      • Fainting spells with excessive fatigue following
      • Odd sounds, distorted perceptions, and episodic feelings of inexplicable fear
    Educational Strategies
    • Provide staff and students with information on seizure recognition and first aid with specific directions written into IEP (e.g., clear away dangerous objects, do not restrain the student, make the student comfortable by loosening clothing, never put anything in mouth—may bite hard)
    • Be aware of effects of antiseizure or antianxiety medications
    • Ensure good communication between school and home to gain more understanding for staff and parents
    • Teacher should observe and keep accurate anecdotal logs
    • Encourage other students/adults to treat someone with epilepsy with respect by educating peers about possible behaviors
    • Provide student with downtime; he or she might be exhausted after a seizure
    • Help students lead independent lives by teaching transitional skills
    Multiple Sclerosis (MS)
    • Neurological disorder
    • Multiple means many, while sclerosis means a thickening or hardening of tissue
    • The majority of people are diagnosed between the ages of twenty and fifty, but MS can also be found in the school-age population. Although no definitive cause is known, evidence suggests MS results from an autoimmune process in which immune cells (T cells) mistake myelin, the fatty coating around nerve cell fibers in the brain and spinal cord, for a foreign invader and attack it. Other theories of causation consider environment, infection, viruses, and genetics.

    Friends with MS:

    National Multiple Sclerosis Society:

    Multiple Sclerosis International Federation:

    Possible Characteristics
    • Can impair movement, vision, coordination, and other functions
    • Depending on type and severity, MS is categorized in the following ways:
      • Benign MS—Condition does not worsen over time, and there is little or no permanent disability. This type cannot be identified until ten to fifteen years after onset; otherwise it falls under relapsing–remitting type. Approximately 5 percent of the 20 percent initially diagnosed stay with this type.
      • Relapsing–Remitting—Episodes followed by remissions (accounts for about 25 percent of patients with MS). Disappearing and reappearing of neurological functioning.
      • Primary–Progressive—Continuous worsening with some variations in rate and progression, but no remissions (affects about 15 percent).
      • Secondary–Progressive—Type that half of people with relapsing–remitting experience within ten years of initial diagnosis. Steady worsening with occasional flare-ups and minor remissions or plateaus. About 40 percent occurrence out of total diagnosed with MS.
    • Many MS patients experience unpredictable day-to-day symptoms. Advances in treatment offer hope for future success in managing MS, especially when caught at an early stage.
    Educational Strategies
    • Occupational therapy to help with daily living activities
    • Physical therapy to help patients with MS stand, walk, and maintain a range of motion with appropriate exercise
    • Educational support and awareness to give people with MS an opportunity to learn more about how to help themselves and how to gain support from others
    • Community–school connections and experiences
    • Individual educational programs to address present and future academic and social needs
    Muscular Dystrophy

    Neuromuscular disease that involves both the nerves and muscles

    • Can be X-linked recessive gene (female carriers) or autosomal dominant (defective gene is inherited from one parent’s chromosomes in nonsex pairs 1 through 22)
    • Flaws in muscle protein genes
    • In general, genetic diseases can be related to these factors:
      • Types of Chromosomes—(a) autosomal (nonsex pairs 1–22) and (b) sex-linked (X-chromosome)
      • Traits—(a) dominant (caused by genes from one parent) and (b) recessive (caused by genes from both parents)

    National Library of Medicine National Institutes of Health:

    Muscular Dystrophy Association:

    Possible Characteristics
    • Onset can be from early childhood to adulthood
    • Severity and types vary from weakening and wasting of muscles in the hands, forearms, or lower legs to muscle cramps, twitches, or stiffness
    • Some progression is slow with periods of rapid deterioration
    • Can affect throat muscles or swallowing
    • May include weaknesses in leg, hip, shoulder, or respiratory muscles
    • Brain is sometimes involved with seizures, deafness, loss of balance and vision, and loss of lower cognitive abilities
    • May need a wheelchair at any time
    • May show signs of fatigue
    • May be frustrated by immobility
    Educational Strategies
    • Emphasis on mobility and independent daily living
    • Accessibility to and inclusion in all school facilities and functions
    • Structured exercise program, with avoidance of intense physical demands
    • Be alert for any physical changes
    • Eliminate obstacles such as long note taking
    • Assign peer buddy to help with arduous physical tasks such as lifting heavy books or maneuvering about in crowded halls
    • Modified physical education program
    • Technology to augment educational strategies might include the following:
      • Eye tracking to help those who lack physical power or dexterity to manually operate a keyboard or mouse (camera is employed to focus on the user’s eye movement)
      • Voice-recognition technology for word processing
      • Cyberlink—band strapped around the forehead, offering a hands-free, alternative, augmentative type of communication that can detect both muscle and brain impulses to operate a computer mouse, video games, and more
    • Staff should not lift or pull a student by the arms, since it could cause dislocation of limbs
    • Peer support system for academic help and social inclusion
    • Teach self-help skills
    • Transitional planning
    Spina Bifida
    • Failure of the spinal cord to completely close up into one piece during early months of mother’s pregnancy
    • Congenital defect
    • Affects newborns

    Spina Bifida Resource Network:

    Possible Characteristics
    • People born with spina bifida are not all alike
    • Types of spina bifida include the following:
      • Closed Neural Tube Defects (with malformation of fat, bone, or membranes)—symptoms vary from few or none to incomplete paralysis with urinary and bowel dysfunction
      • Spina Bifida Manifesta—includes the following two types:
        • Meningocele—meninges (protective covering around the spinal cord) pushed out through an opening in the vertebrae in a sac called the meningocele, but the spinal cord is intact and can be repaired with little or no damage to the nerve pathways
        • Myelomeningocele—severe form in which the spinal cord itself is damaged
    • Nervous system (brain and spine) can be affected
    • Muscle weakness or paralysis below the area of the spine where the cleft (incomplete closure) occurs with weak bones and joints
    • Difficulty with bowel and bladder control in excretory system
    • May have buildup of fluid in the brain (hydrocephalus), which can be surgically drained with a shunt; without a shunt implanted, the extra fluid can cause brain damage, seizures, or blindness
    • Attention difficulties
    • Need help with eye–hand coordination (e.g., perceptual activities)
    • Language expression deficits
    • Varying academic, physical, and social needs, with characteristics dependent on type and severity
    Educational Strategies
    • Placement in the least restrictive environment with nondisabled peers
    • Adaptations in location and structure of the learning environment to meet physical needs, including fine- and gross-motor ones
    • Early intervention for school preparation
    • Communication with teachers concerning catheterization needs (tube inserted to allow passage of urine), with development of a school bladder management program if necessary
    • Related services such as speech, physical, and occupational therapy
    • Address emotional and social development by involving student in positive peer relationships (e.g., cooperative learning, community integration)
    • Focus on positives and student’s strengths
    • Transitional services
    Sensory Involvements
    Communication Disorders
    • Acquired or developmental:
      • Hearing loss
      • Brain injury
      • Drug abuse
      • Physical impairments such as cleft lip or palate
      • Vocal abuse or misuse
      • Hearing loss
      • Neurological disorder
    • Cause is frequently unknown
    • Some disorders are common in families
    • Apraxia is a motor-speech disorder in which child has difficulties saying sounds, syllables, and words, along with difficulties transmitting brain messages to body parts (e.g., lips, jaw, tongue)
    • Language disorders can be related to or overlap with other disabilities (e.g., developmental, intellectual, autism spectrum disorder, cerebral palsy)

    American Speech-Language-Hearing Association (ASHA):

    Division for Communicative Disabilities and Deafness (DCDD) of the Council for Exceptional Children (CEC):

    Possible Characteristics
    • Articulation
      • Distortions (e.g. “bud in yard” for bird)
      • Additions (e.g, “brook I read” for book)
      • Omissions (e.g., “we are see you” instead of seeing—can be ending sounds of words)
      • Substitutions (e.g., “wabbit wunning” for rabbit running)
    • Voice quality
      • Intensity—softness or loudness
      • Resonance—nasality
      • Pitch—high or low tone
      • Onset fluency disorder (formerly called stuttering)—rhythm and flow
      • Interjections—repeats, hesitates, prolongs, or blocks sounds (e.g., well, um, you know)
      • Language disorders include reduced vocabulary and or sentence structure, limitations in social communication and conversations, and overall discourse
      • Impairment in understanding (receptive) and using/speaking (expressive) words in context
      • Difficulties with word retrieval, expressing ideas, grammar, reduced vocabulary, following directions, understanding a word’s meaning; improper usage of words
    Educational Strategies
    • Timely intervention, since language and communication skills are easier to learn by age five
    • Speech counseling and coordination with classroom teacher to develop communication goals for class and home, with consistent practice
    • Communication boards with pictures (e.g., PECS—Picture Exchange Communication System)
    • Technology for nonspeaking or severely disabled students
    • Computer programs to link speech with writing
    • Digital recorders
    • Let speech relate to children’s experiences, with instruction through conversation as well
    • Mirrors
    • More visuals
    • Categorization of words
    • Modeling, since children learn from others
    • Patience (wait time)—do not talk for the child
    • Praise for approximations
    Deafness and Hearing Loss
    • Hereditary and environmental factors
    • Total deafness can be congenital
    • Partial deafness may be attributed to loud noises, rubella, ear injury, or illness during pregnancy
    • Types of hearing loss:
      • Conductive—caused by diseases or obstructions in the ear canal, eardrum, or middle ear
      • Sensorineural—results from damage to delicate sensory hair cells of the inner ear or the nerves
      • Mixed—combination of conductive and sensorineural loss (in both the outer or middle and the inner ear—cochlea or auditory nerve)

    American Society for Deaf Children (ASDC):

    Hearing Loss Association of America:

    Listening and Spoken Language Knowledge Center:

    Possible Characteristics
    • Slight, mild, moderate, severe, or profound hearing loss
    • Conductive hearing loss is usually not severe and can be helped medically, surgically, or with a hearing aid.
    • Sensorineural losses range from mild to severe and can affect a person’s ability to hear certain frequencies. Amplification does not help since a person might still hear distorted sounds. Hearing aids are also sometimes ineffectual.
    • Frustration from not hearing can lead to behavioral outbursts.
    Educational Strategies
    • Sensitivity training for classroom peers with emphasis on social inclusion of students with hearing loss or deafness
    • Appropriate speech services by trained professionals
    • Amplification systems
    • Note takers, sticky notes, communication boards, and interactive whiteboards
    • Favorable seating
    • Finger spelling or cued speech where hand signals and lip movements represent sounds
    • Captioned films, videos
    • Text telephones (TTY), CapTel (captioned telephone)
    • More visuals, handouts, and outlines
    • Interpreters to bridge communication between people who do not share same language (e.g., using sign language for a person who is deaf, then voicing it to a hearing person, such as with ASL) or transliterators to change one form of language to a different form of that same language (e.g., Cued Speech, see with phonemes associated with language or Conceptually Accurate Signed English (CASE), which uses ASL concepts to sign words in proper English language order
    • Oral transliteration has spoken words silently mouthed to the person with hearing loss or deafness, along with hand gestures and facial expressions. People should communicate with each other, not with the oral interpreter or transliterator, establishing eye contact and body language between parties having a conversation.
    • C-print, a translation of classroom lecture in which instructional assistant, aide, or even an assigned classmate types the lecture/notes on a computer in the back of the room that is then immediately sent to and read by the student at his or her own desk/laptop computer, can be a way to see the words. See
    • Language development (help with idiomatic expressions, vocabulary, and grammar) with frequent monitoring
    • Face the student when reading and giving directions, speaking slowly and clearly in conversational voice, not overemphasizing lip reading
    • Eliminate background noises
    Processing Disorders: Auditory
    • Not a result of hearing loss

    American Speech-Language-Hearing Association:

    Bellis, T. J. (2002). When the brain can’t hear: Unraveling the mystery of auditory processing disorder. New York: Atria.

    National Coalition on Auditory Processing Disorders:

    Possible Characteristics
    • Symptoms similar to ADHD; must distinguish between the two
    • Trouble hearing similarities and differences in sounds
    • Blending word parts/decoding/phonics
    • Expressive and receptive language difficulties
    • Difficulties with any or all of the following:
      • Listening to lectures
      • Grammatical structure
      • Oral directions
      • Understanding music and lyrics
      • Spelling
    • May involve the following:
      • Auditory discrimination—hearing whether sounds of letters are the same or different
      • Auditory memory—repeating a clapped sequence, following a band’s rhythm, remembering sounds of familiar objects, following more than one direction
      • Auditory localization—determining the source or direction of a sound
      • Auditory figure-ground—paying attention in a noisy room
    Educational Strategies
    • Give brief, concise directions at a student’s level of comprehension
    • Accompany verbal directions with written ones
    • Use more gestures when speaking
    • Intermittently check student’s understanding by asking simple questions, or request him or her to repeat or paraphrase what was said; use appropriate grade-level vocabulary
    • Reduce the amount of background noises—place old cut-up tennis balls on bottom of desk and chair legs
    • Ask school nurse to check student’s hearing to rule out any medical concerns
    • Increase student’s self-awareness of type of mistakes made with words
    • Make more eye contact with student before speaking
    • Teach the student how to take notes while listening for main ideas presented; give the student a graphic organizer to follow
    • Use more technology that offers audible learning, such as word processing programs with speech capabilities
    • Have student connect with a partner or peer who can model and consult
    • Utilize speech/language therapy and audiological services as necessary
    • Teach phonetic rules vs. just sight-word programs or strict memorization to develop automaticity with linguistic skills
    Processing Disorders: Visual Impairments

    Can include disorders that lead to vision impairments such as retinal degeneration, albinism, cataracts, glaucoma, corneal disorders, diabetic retinopathy, infections, muscular problems that result in visual disturbances, and other congenital disorders

    • Environmental or genetic
    • Birth injuries, heredity, illness with fever, muscle problems

    AccessWorld Magazine:

    American Foundation for the Blind:

    Concordia Learning Center at St. Joseph’s School for the Blind:

    Learning Ally:

    National Center on Accessible Instructional Materials:

    Possible Characteristics
    • Vary with the age of onset, severity, type of loss, and overall functioning of the child
    • May not explore things in the environment and may miss opportunities to imitate social behavior or understand nonverbal skills
    • May involve difficulties with the following:
      • Easily understanding and remembering what is seen
      • Picturing words or concepts in their heads
      • Matching like shapes
      • Doing art activities
      • Reproducing patterns
      • Working on puzzles
      • Noticing the differences between objects, words, numbers
      • Spelling accurately
      • Poor handwriting
      • Organizational or neatness issues
    • Accurate proofreading of writing, checking accuracy of computational problems, aligning columns in math, writing words and letters on lines
      • Dislikes learning when seeing it alone as the only method of presentation; students need kinesthetic (body) and tactile (touch) connections along with auditory input
    • May involve the following:
      • Visual motor—may work close to a paper or desk, rotate papers and books
      • Visual figure-ground—completing work on crowded pages
      • Visual discrimination—matching shapes or forms, or distinguishing similar words, such as hundreds and hundredths
      • Visual closure—doing simple puzzles, not able to see objects or their functions in their entirety
      • Visual memory—for example, retelling three visual acts in sequence: close a door, sharpen a pencil, sit down
    • Terminology:
      • Hyperopia (farsightedness)—when a person sees faraway objects better than objects that are nearby
      • Myopia (nearsightedness)—when objects close by can be seen, but there is difficulty seeing objects at a distance
      • Strabismus—eyes are not straight; each eye sends a different message to the brain
      • Astigmatism—blurred or distorted images
      • Ocular motor—muscles of the eye working together (e.g., fixate, follow, converge)
      • Partially Sighted (Visually Impaired)—some type of vision problem with sight ranging from 20/70 to 20/200 after correction with glasses. Signs of eye trouble include blinking a lot; rubbing eyes; squinting, shutting or covering one eye; red or swollen, watery eyes; and headaches
      • Low Vision—severe visual impairment
      • Legally Blind—less than 20/200 vision in better eye or limited field of vision
      • Totally Blind—complete darkness
    Educational Strategies
    • Support visual information with verbal instructions
    • Reduce amount of work on pages, or block off part of the work
    • Use stronger modalities (auditory or kinesthetic-tactile paired with auditory)
    • Strengthen memory by associating how and where students originally saw learning material
    • Use highlighters on worksheets and colored overlays on texts
    • Compartmentalize information in student-friendly graphic organizers that visually separate information
    • Provide more manipulatives, such as puzzles, tangrams, and geoboards; and sorting activities, such as categorizing words on index cards into syllable types
    • Reduce clutter in the room, including extra materials by student’s desk
    • Use copiers to enlarge print
    • Gradually increase time and difficulties of visual tasks
    • Praise accomplishments
    • Early intervention programs
    • Technology—using computers with talking text programs
    • Low-vision and optical aids for the partially sighted
    • Magnification pages
    • Audiobooks
    • Large-print materials; Braille books
    • Interdisciplinary approach, with learning through all subjects taught using more auditory and kinesthetic-tactile presentations
    • Emphasize independent daily living and self-care skills (e.g., hygiene, mobility training, using kitchen tools, and following routines)
    • Participation in regular classroom activities with appropriate support, understanding, and encouragement
    • Adaptations in lighting
    • Encourage positive peer social interactions
    Angelman Syndrome (AS)
    • Genetic disorder with a deleted region of genes on chromosome 15
    • Children with AS were formerly called puppet children, named after an oil painting (Boy With a Puppet) seen by Dr. Harry Angelman, which depicted a boy with similar characteristics as his patients. The name was later changed to Angelman syndrome
    • Estimate of 1 in 15,000 to 1 in 30,000 are affected; exact numbers are unknown
    • AS appears equally among all races and in both sexes

    Angelman Syndrome Foundation:

    Possible Characteristics
    • Not usually detected at birth or in infancy, since there are nonspecific developmental delays
    • Usual age of diagnosis is when features and characteristic behaviors become most evident (ages three to seven)
    • Range of gait disorders with uncoordinated movements that affect walking, feeding, and reaching for objects
    • Hypermotoric activity with short attention span
    • Difficulty attending to social cues
    • Excessive, often contagious laughter, with lots of smiling and a happy disposition
    • Difficulty with conversational speech along with varying nonverbal skills
    • Skin and eye hypopigmentation—no pigment in the retina
    • Strabismus—eye coordination problem in which eyes do not concurrently focus on the same point, but may look in different directions
    • Sleep disturbances
    Educational Strategies
    • Early training and enrichment programs
    • Physical therapy for gross-motor difficulties
    • Occupational therapy for oral-motor and fine-motor control
    • Structured classroom design and environment to accommodate hypermotoric needs
    • Speech and communication therapy including augmentative aids such as communication boards and more visuals
    • Individualization with flexibility
    • Behavior modification
    • Peer support and awareness of syndrome
    • Training of all staff working with children
    • Home-to-school communication with coordination of physical, academic, and behavioral programs
    Down Syndrome
    • A chromosomal disorder that occurs from an accident in cell development that leaves 47, instead of the usual 46, chromosomes. It is determined by a karyotype (visual chromosome study).
    • Most people with Down syndrome have an extra No. 21 chromosome
    • Uncertain what causes this extra genetic material that happens at conception
    • One of the leading clinical causes of intellectual disability
    • Does not correlate to race, nationality, or socioeconomic status
    • Higher incidence for mothers who give birth over age thirty-five

    American Association on Intellectual and Developmental Disabilities:

    The Arc:


    GiGi’s Playhouse: Down Syndrome Achievement Centers:

    National Down Syndrome Congress:

    National Down Syndrome Society:

    Possible Characteristics
    • Slower physical and intellectual growth
    • Health-related problems could include heart defects, gastrointestinal tract problems, visual and hearing impairments (crossed eyes, farsightedness or nearsightedness, mild to moderate hearing loss), speech difficulties, atlantoaxial instability (misalignment of top two vertebrae of the neck), and respiratory difficulties, since they might have a lower resistance to infection. A cardiogram is needed at birth to identify heart concerns and appropriate medical care.
    • Physical signs can include a smaller head; slanting eyes (epicanthal folds); short, broad hands, feet, and toes; flat bridge of the nose; short neck; low-set ears; and poor muscle tone (hypotonia). There is a wide range of mental abilities, from mild to severe cognitive impairments.
    • Difficulties understanding directions and abstract concepts
    • Receptive language better than expressive language (understanding more than communicating through speech)
    • Memory affected
    Educational Strategies
    • Early educational and developmental services and therapies beginning in infancy
    • Speech therapy
    • Nutritional/hygiene counseling
    • Peer education and sensitivity to reinforce acceptance, since children all have certain social/emotional needs in common; necessary whether or not children are placed in inclusive classrooms
    • Increase usage of visuals, manipulatives, and concrete learning experiences
    • Physical exercise program, including more wrist- and finger-strengthening activities such as cutting and sorting as well as activities to strengthen individual stamina
    • Teach in a step-by-step manner with consistent, positive feedback, drill, and repetition
    • Encourage independence under teacher’s auspices with realistic but high expectations
    • Concentrate on potentials, not limitations
    • Consistent family communication of progress with home reinforcement of learned academic/social skills
    • Transitional plans with planned community involvement and functional training for daily living skills with participation in supported employment with job shadowing and mentoring
    • Relate new content to previously learned subjects and real-life situations
    Prader-Willi Syndrome (PWS)

    Complex rare genetic disorder that can cause cognitive disabilities, behavior problems, short stature, poor muscle tone, incomplete sexual development, and a chronic hungry feeling that if uncontrolled may lead to excessive eating and life-threatening obesity.

    • Genetic cause is loss of unidentified genes (defect of chromosome 15) contributed by the father that occurs at or near time of conception for unknown reasons
    • DNA analysis confirms PWS diagnosis
    • Prevalence: 1 in 12,000 to 15,000 (both sexes, all races); one of the most common conditions seen in genetic clinics and leading genetic cause of obesity
    • PWS-like disorder can occur after birth if the hypothalamus portion of the brain is damaged during surgery or injured

    Prader-Willi Syndrome Association USA:

    Possible Characteristics
    • Excessive or rapid weight gain between ages one and six with possibility of obesity if not vigilantly monitored and nutritionally controlled
    • Short stature by age fifteen
    • Range of IQ from 40 to 105, with learning problems evident in those with average IQ
    • May have short-term auditory memory problems, attention difficulties, and weak abstract thinking
    • Good visual perception skills, long-term memory, reading ability, and receptive language
    • Deficits in speech articulation, motor coordination, strength, and balance
    • Habit of skin-picking
    • Younger children usually do not exhibit behavioral problems, but most older children and adults with PWS have difficulties regulating behavior and dealing with transitions and unexpected changes
    • May have outbursts of stubbornness; may steal money or items to buy/trade food; may be prone to lying
    • Sleep disorders/fatigue
    Educational Strategies
    • Behavior plans that emphasize positive rewards, clear rules, limits, structure, and daily routines
    • Physical and occupational therapies
    • Exercise and sports-related activities that are less competitive (to accommodate poor muscle tone and fatigue)
    • Social skills training
    • Speech therapy
    • Early infant stimulation
    • Full range of appropriate services in least restrictive environment
    • Peer support system
    • Communicate with family to coordinate behavioral plans
    • Food restriction plan in school and home; structured diet plan and lifelong diet supervision
    • Transitional plans with preparation for adult living and maximum community involvement based on varying cognitive levels
    Tourette Syndrome (TS)
    • Genetic predisposition
    • Neurological disorder
    • Abnormal metabolism of neurotransmitters (chemicals in the brain), which might cause the tics
    • Early diagnosis and treatment, since some children require medication

    Tourette Syndrome Association:,

    Tourette Syndrome “Plus” the Associated Disorders:

    tic = sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalization

    Possible Characteristics
    • Symptoms include involuntary tics and rapid motor or vocal movements that can range from simple to complex
    • Onset is before the age of eighteen with most cases being mild
    • Symptoms can decrease as children mature (late teens, early twenties) with possible remission of tic symptoms
    • There are two types of Tourette syndrome:
      • Simple—motor: eye blinking, facial grimaces, shoulder shrugs, head jerking; vocal: noises such as tongue clicking, and other throat sounds
      • Complex—motor: twirling, jumping, touching possessions of others, and—rarely—self-injurious behavior; vocal: coprolalia (use of obscene language, e.g., derogatory remarks, swearing), which is present in less than 15 percent of the TS population
    • Associated with impulsivity, attention problems (ADHD), and learning or perceptual difficulties
    • Easily frustrated
    • Misbehavior due to neurobiological disturbances
    Educational Strategies
    • Give the student more opportunities for movement, with frequent breaks outside of the classroom setting
    • Involve school psychologist
    • Educate peers and other staff (e.g., bus drivers, lunch aides, special subjects teachers)
    • Reduce—break down, sequence, and color-code assignments
    • Avoid front seating since tics can be embarrassing; even allow student a place to work outside of the classroom
    • Try to seat student away from visual distractions
    • Encourage use of a word processor, or allow alternatives to written assignments
    • Allow extra time for class work or shorten assignments based on level of mastery
    • Provide outlines and study guides
    • Cue student about learning expectations before a new lesson; have student repeat directions for a task, and signal student for transitional activities
    • Watch for side effects from medication

    Resource B


    Available for download at

    Resource C

    Alphabetized Acronyms
    • AA-AAS—alternate assessment based upon alternate academic achievement standards
    • AAIDD—American Association on Intellectual and Developmental Disabilities
    • ABA—applied behavior analysis
    • ABC—antecedent, behavior, consequence
    • ABOWA—assessment by observation and walking around
    • ADA—Americans with Disabilities Act
    • ADAAA—Americans with Disabilities Act Amendments Act
    • ADHD—attention deficit hyperactivity disorder
    • ADL—activities of daily living
    • AEIOU’s of Study Skills—attitude, effort, involvement, organization, understanding
    • AIM—accessible instructional materials
    • APA—American Psychiatric Association
    • APD—auditory processing disorders
    • APE—adaptive physical education
    • ARC—The ARC
    • ARRA—American Recovery and Reinvestment Act of 2009
    • ASD—autism spectrum disorder
    • ASL—American Sign Language
    • AT—assistive technology
    • AYP—adequate yearly progress
    • BD—behavioral disorder
    • BIP—behavior intervention plan
    • BOE—Board of Education
    • BOSE—beginning of special education
    • BP—bipolar or “Be positive!”
    • CA—chronological age
    • CAPD—central auditory processing disorder
    • CAST—Center for Applied Special Technology
    • CBA—curriculum-based assessments
    • CBT—cognitive behavioral therapy
    • CC—closed captioning
    • CCR—college and career readiness
    • CCSS—Common Core State Standards
    • CCSSO—Council of Chief State School Officers
    • CD—conduct disorder
    • CEC—Council for Exceptional Children
    • CHADD—Children and Adults with Attention Deficit Disorder
    • CI—communication impaired
    • CNS—central nervous system
    • CP—cerebral palsy
    • CRAFT—communication, resourcefulness, accommodations, flexibility, training
    • CSI—common sense inclusion
    • CST—child study team
    • DA—disability awareness
    • DD—developmental disability
    • DI—differentiated instruction
    • DIBELS—Dynamic Indicators of Basic Early Literacy Skills
    • DMDD—disruptive mood dysregulation disorder
    • DOE—Department of Education
    • DRA—developmental reading assessment
    • DS—Down syndrome
    • DSM—Diagnostic and Statistical Manual of Mental Disorders
    • DVRS—Division of Vocational and Rehabilitation Services
    • EBP—evidence-based practice
    • ED—emotional disturbance
    • ED’S CAR—expand, delete, substitute, combine, and rearrange
    • EHA—Education of All Handicapped Children Act
    • EIS—early intervention services
    • EL—English learners
    • ELA—English language arts
    • ELC—early learning center
    • ELT—extra learning time
    • EPA’S of Grading—effort, progress, achievement, self-awareness
    • ESEA—Elementary and Secondary Education Act
    • ESL—English as a second language
    • ESY—extended school year
    • FAPE—free, appropriate public education
    • FAS—fetal alcohol syndrome
    • FBA—functional behavioral assessment
    • FERPA—Family Education Rights and Privacy Act
    • FSA—Family Support Act
    • GE—general education
    • GT—gifted and talented
    • HEATH—Higher Education and Training for People with Disabilities
    • HI—hearing impaired
    • HQT—highly qualified teacher
    • IAES—interim alternative educational setting
    • ID—intellectual disability
    • IDEA—Individuals with Disabilities Education Act
    • IDEIA—Individuals with Disabilities Education Improvement Act
    • IED—intermittent explosive disorder
    • IEP—individualized education program (or “It’s educationally prudent!”)
    • IES—Institute of Education Sciences
    • IFSP—individualized family service plan
    • IHE—Institutes of Higher Education
    • ILP—independent living plan
    • ILT—increased learning time
    • ISTE—International Society for Technology in Education
    • ITIP—instructional theory into practice
    • ITP—individualized transition plan
    • LD—learning disability or learning differences
    • LDA—Learning Disabilities Association of America
    • LEA—Local Education Agency
    • LOF—level of functioning
    • LRE—least restrictive environment
    • MAAP—more advanced individuals with autism, Asperger syndrome, and pervasive developmental disorder
    • MDR—manifestation determination review
    • MDT—multidisciplinary team
    • MI—multiple intelligences, or massive initializations
    • MS—multiple sclerosis, or master of science, or both!
    • NAEP—National Assessment of Educational Programs
    • NBDC—National Business & Disability Council
    • NCEO—National Center on Educational Outcomes
    • NCES—National Center for Education Statistics
    • NCLB—No Child Left Behind Act
    • NCLD—National Center for Learning Disabilities
    • NCTL—National Center for Technology Literacy
    • NGA—National Governors Association Center for Best Practices
    • NIH—National Institutes of Health
    • NIMAS—National Instructional Materials Accessibility Standard
    • NIMH—National Institute of Mental Health
    • OCD—obsessive–compulsive disorder
    • OCR—Office of Civil Rights
    • ODD—oppositional defiant disorder
    • OHI—other health impairment
    • OI—orthopedic impairment
    • O & M—orientation and mobility
    • OSEP—Office of Special Education Programs
    • OSERS—Office of Special Education and Rehabilitative Services
    • OT—occupational therapy
    • PACER—Parent Advocacy Coalition for Educational Rights
    • PALS—peer-assisted learning strategies
    • PANDAS—pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections
    • PARCC—Partnership for Assessment of Readiness for College and Careers
    • PBL—problem-based learning, project-based learning
    • PBS—positive behavioral supports
    • PECS—picture exchange communication system
    • PET—positron emission tomography, or pupil evaluation team
    • PL—Public Law
    • PLAAFP—present level of academic achievement and functional performance
    • PLEP—present level of educational performance
    • PLOP—present level of performance
    • PNP—personal needs profile
    • PMT—parent management training
    • PS—preschool
    • PT—physical therapy
    • PWS—Prader-Willi Syndrome
    • RF—reading: foundational skills
    • RI—reading: informational text
    • RL—reading: literature
    • RS—related services
    • RTI—response to intervention (or “Remember to include!”)
    • SAS—supplemental aids and services
    • SAT—Scholastic Aptitude Test
    • SB—spina bifida
    • SBAC—Smarter Balanced Assessment Consortium
    • SCD—social communication disorder
    • SDI—specially designed instruction
    • SDM—severe discrepancy model
    • SE—special education
    • SEA—State Education Agency
    • SEL—social and emotional learning
    • SES—supplemental educational services
    • SGO—student growth objective
    • SI or SID—sensory integration dysfunction
    • SIG—School Improvement Grant
    • SLD—specific learning disability
    • SLO—student learning objectives
    • SLP—speech-language pathologists
    • SOARing—scanning, outlining, analyzing, reading
    • SPED—special education
    • SPP—state performance plan
    • SST—student study team
    • TAG—talented and gifted
    • TBI—traumatic brain injury
    • TDD—telecommunication devices for the deaf, and test-driven development
    • TGIF—“Thank goodness inclusion’s feasible!”
    • TIME—Time for Innovation Matters in Education Act
    • TIPS—topic, individuals, planning, setting
    • TLC—tender, loving care (What students in every classroom need!)
    • TPP—transition planning process
    • TS—Tourette syndrome, or transitional services
    • TTY—text telephone
    • UbD—understanding by design
    • UDL—universal design for learning
    • VAKT—visual, auditory, kinesthetic, tactile
    • VI—visual impairment
    • VoIP—voice over the Internet protocol
    • VR—vocational rehabilitation
    • VRI—video remote interpreting
    • WHO—World Health Organization
    • WHST—writing, history, science, and technical subjects
    • WWC—What Works Clearinghouse
    • WWCI—“Ways we can include!”

    Available for download at

    References and Further Readings

    Abeel, S. (2003). My thirteenth winter. New York: Scholastic.
    ADA Amendments Act of 2008, Pub. L. No. 110-325, 122 Stat. 3553, 3554 (2008).
    Adamek, M., & Darrow, A. (2005). Music in special education. Silver Spring, MD: American Music Therapy Association.
    Agassi, M. (2002). Hands are not for hitting. Minneapolis, MN: Free Spirit Publishing.
    Allsopp, D., Kyger, M., Lovin, L., Gerretson, H., Carson, K., & Ray, S. (2008). Mathematics dynamic assessment: Informal assessment that responds to the needs of struggling learners in mathematics. Teaching Exceptional Children, 40(3), 616.
    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (
    ed.). Arlington, VA: American Psychiatric Publishing.
    Americans With Disabilities Act, Pub. L. No. 101-336, 104 Stat. 327 (1990).
    Anderson, O., Marsh, M., & Harvey, A. (1999). Learn with the classics: Using music to study smart at any age. San Francisco, CA: Lind Institute.
    Armstrong, T. (2003b). You’re smarter than you think: A kid’s guide to multiple intelligences. Minneapolis, MN: Free Spirit.
    Armstrong, T. (2009). Multiple intelligences in the classroom. Alexandria, VA: Association for Supervision and Curriculum Development.
    Association for Supervision and Curriculum Development. (2002). ASCD education update. Alexandria, VA: Author.
    Auer, C., & Blumberg, S. (2006). Parenting a child with sensory processing disorder: A family guide to understanding and supporting your sensory-sensitive child. Oakland, CA: Harbinger Publications.
    Baker, J. (2001). The social skills picture book: Teaching play, emotion, and communication to children with autism. Arlington: TX: Future Horizons.
    Baker, J. (2005). Preparing for life: The complete guide for transitioning to adulthood for those with autism and Asperger’s syndrome. Arlington, TX: Future Horizons.
    Beattie, J., Jordan, L., & Algozzine, B. (2006). Making inclusion work: Effective practices for ALL teachers. Thousand Oaks, CA: Corwin.
    Belland, B.R., Glazewski, K.D., & Ertmer, P.A. (2009). Inclusion and problem-based learning: Roles of students in a mixed-ability group. RMLE Online, 32(9), 119.
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