TEA4104 7

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TEA4104 (7)

• Motor and Visual Accommodations

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Objectives Week 10

• 1. Recognise major motor, visual and chronic
  health challenges
• 2. Modify environments to enable participation of
  children with challenges
• 3. Utilize teaching strategies relevant to motor,
  visual and chronic health challenges
• 4. Evaluate assistive technologies

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1. Major Motor Challenges

• Central nervous system challenges (e.g. cerebral
  palsy spasiticty, athetosis, spina bifida, head
  spinal cord injuries)
• Genetic challenges (e.g. muscular dystrophy
  Myotonic, Duchenne, Becker)
• Skeletal challenges (e.g. amputation or
  absent limbs, osteogenesis imperfecta,
  correctable orthopedic impairments)

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Cerebral palsy (spasiticty, athetosis, ataxic)

• Is a medical condition that affects control of
  muscles due to a brain injury
• Injury could occur before, during or shortly
  after birth due to an infection, accident,
  medical condition (diabetes) lack of oxygen,
  difficult birth premature birth
• Can not be caught or develop later in
  life

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• Spastic cerebral palsy stiff jerky movements
  due to tight muscles, difficult to move from
  position to another, 50 of people with CP have
  spastic CP
• Ataxic CP low muscle tone poor coordination
  of movements, very unsteady , very poor balance
  when walking , shaky like a tremor, take longer
  to complete activities e.g. writing
• Athetoid CP muscle tone is mixed (too low too
  high), have trouble holding body upright for
  sitting or walking, lots of involuntary movements
  in face, arms upper body, have difficulty
  keeping a position, may not be able to hold on to
  things

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• Mixed CP muscle tone low in some muscles high
  in others,about a quarter of people with CP have
  mixed CP
• CP affects different parts of the body due to
  which part of the brain was damaged,
  quadriplegia, hemiplegia, diplegia

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Spina Bifida

• SB means cleft spine which is an incomplete
  closure in the spinal column 3 types
• Spina Bifida Occulta opening in or more of the
  vertebrae of the spinal column without an
  apparent damage to the spinal cord, about 40 of
  population may have SBO experience little or no
  symptoms
• About 1 child out of every 1000 are born with
  spina bifida manifesta (meningocele,
  myelomeningocele)

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• Meningocele The meninges or protective covering
  around the spinal cord has pushed out through the
  opening in the vertebrae in a sac called the
  meningocele. Spinal cord remains in tact, can be
  repaired with little or no damage to the nerve
  pathways
• Myelomeningocele most severe form of SB, a
  portion of the spinal cord itself protrudes
  through the back, in some cases can be covered
  with skin, in others tissue nerves are exposed,
  muscle weakness, paralysis, loss sensation below
  the cleft, loss of bowel bladder control,
  sometimes have hydrocephalus

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Muscular Dystrophy

• MD group of genetic diseases characterized by
  progressive weakness degeneration of the
  skeletal or voluntary muscles which control
  movement. Some involuntary muscles e.g. heart,
  can be affected in some forms of MD
• Major forms are Myotonic (affects adults),
  Duchenne (most common in chn mainly boys),
  Becker (have problems as teenagers/adults),
  limb-girdle, etc
• May affect people of all ages

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• No specific treatment for any form of MD
• Physical therapy may prevent contractures of
  muscles, orthoses for support, corrective
  orthopedic surgery to improve quality of life
• Prognosis varies sometimes slowly progressive,
  Duchenne MD causes death in late teens early
  twenties
• Is not contagious

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Minor Gross Motor Challenges

• Delayed or accelerated development
• Low motor tone and reduced strength
• Differences between body sides
• Chronic health conditions
• Motor control e.g. posture, coordination
• Motor planning challenges

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Minor Fine Motor Variations

• Theories about retained reflexes
• Immature development
• Accelerated development
• Low motor tone , extreme fatigue, motor planning,
  motor control
• Intention tremor
• Facial motor control

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Experience 1 Try out and Discuss

• Experience for yourself the challenge of picking
  up objects if your hands have tremor or are
  flexed move jerkily
• Consider adaptations which could be made to
  materials to assist you in using them
• Discuss assistance others could give you to
  ensure you feel successful

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Experience 1 Feedback

• How did you feel trying out movements with these
  challenges? How do you think this would influence
  you each day?
• Did you think some ideas for younger children
  would be suitable, or not?
• What changes and assistance appeared practical
  and would not offend the person?

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Major Visual Sensory Challenges

• Visual acuity from no visual impairment
  partial vision total blindness
• Tunnel vision results in night blindness,
  impaired ability to walk during day/night time
• Loss of central vision - causes difficulty such
  as reading face recognition
• Total Blindness loss of all useful vision even
  though shades of light dark may still be seen.

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Experience 2 Try out and Discuss

• Visit the sight and then discuss each activity
• http//www.fjb.org/eng_text_only/et_blindness_visi
  on.php

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Other Visual Sensory Challenges

• Amblyopia (lazy eye) reduced vision because the
  brain does not acknowledge images seen in
  amblyopic eye, usually in one eye, treated with
  glasses, drops, patch or exercises, must be
  treated before the age of 6
• Strabismus (eye turn), 1 or both eyes, constant
  or intermittent, may have double vision,focusing
  effort causes eyes to cross, glasses, drops,
  ointment, exercises can be used to straighten
  eyes
• Nystagmus jerky undulating movement appearance
  which appears when the eyes are unable to
  maintain steady fixation
• Photophobia discomfort of eyes to light,
  abnormal sensitivity to light.

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Minor Visual Sensory Challenges

• Myopia (near sightedness), vision problem
  experienced by a third of population can see for
  close-up tasks but have difficulty seeing objects
  at a distance symptoms are headaches, eye strain
  and squint can be corrected with glasses,
  contact lenses or refractive surgery.
• Hyperopia (far sightedness) usually have
  difficulty seeing close up as well as seeing far
  away symptoms are difficulty seeing close up,
  blurred distance vision, eye fatigue when
  reading, eye strain crossed eyes in chn
  treatment depends on age of person younger
  patients may have the ability to compensate for
  their farsightedness with accommodation

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Minor Visual Sensory Challenges

• Astigmatism is most common vision problem may
  accompany both near far sightedness causes an
  irregularly shaped cornea and is corrected with
  glasses, contact lenses or refractive surgery
  Uncorrected astigmatism can cause headaches, eye
  strain or blurred vision
• Go to http//www.seeclearly.com/astig.cfm to
  experience how a person with an astigmatism sees

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Experience 3 Try Out and Discuss

• Close your eyes until you can see just a little,
  then try to draw or write. Note the influence on
  your skill and feelings.
• Start a drawing using one hand, but draw only on
  that side of the page. Then swap hands, and draw
  on the other side of the page. Stop at the
  midline each time.

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Experience 3 Feedback

• How did you find the reduced visual acuity
  influenced you? What was the feeling?
• What was the effect of midline stopping on the
  flow of your drawing?
• What did you think may have helped you in feeling
  more successful?

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Children with chronic conditions

• Heart conditions two types in chn, congenital
  (present at birth), often surgery is needed
  acquired (develops during childhood e.g.
  rheumatic fever) sometimes treated with drugs
• Asthma- is an inflammatory condition of the
  bronchial airways- appears as cough, rapid or
  noisy breathing or chest congestion, if severe
  causes severe shortness of breath low blood
  oxygen, no cure but treatable

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• EpilepsyWhen the short burst of electrical
  activity between the neurons is disrupted
  symptoms such as atypical body movements, altered
  or loss of consciousness, hallucinations, changes
  in emotions or behaviour may occur called a
  seizure
• Partial seizures (limited to part of the brain),
  generalized seizure (involves the whole brain)
  results in complete loss of consciousness
• Can results in both permanent physical
  intellectual damage to the child
• Seizures can often be managed by use of
  anticonvulsant drugs

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Adaptations to Support Children

• PRACTICAL
• Environment changes e.g.space for wheelchair
  access, equipment e.g. standing frame, splints,
  calipers
• Computer adoptions e.g.. Specialized software,
  specialized keypads, speech synthesizers
• Be aware of limited environmental changes for chn
  with partial or no sight
• Assistive technologies e.g. oxygen
  supplementation, intravenous feeding, mechanical
  waste removal

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Adaptations to Support Children

• ADULT SUPPORT
• Handling/positioning of chn with physical
  disabilities e.g being placed in standing frame
  regularly, change position regularly
• BE ALERT - Observation to note when a child needs
  you - provide subtle assistance
• Therapy needs may be included into daily program
  which is demanding upon the child
• Suit plan to childs actual development e.g.
  allow more time, be aware of other possible
  challenges e.g. learning difficulties

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Dealing with the Feeling

• A child is a child, not a disability
• Sensitive support
• Child frustration
• Other childrens responses
• Adult embarrassment

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Remember Usual Sources of Individual Variation

• Child health and emotional well-being
• Individual child disposition, special interest
• Experience child has at offered at home
• Cultural attitudes of families
• Availability of services and facilities for range
  of experiences in community

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Planning for the Individual Child

• Observe the individual childs development in
  each developmental area. There might be
  considerable variation within the individual
• Reflect on sources of individual variation you
  may need to take into account
• Consider the childs physical status
• Plan for the next step taking the childs own
  circumstances into account

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Key Attitudes of Early Childhood Educators

• The child is not being fixed up i.e. you are
  NOT remediating deficits, you are working from
  their current competency
• The child is NOT defined by their challenge i.e.
  the individual is considered first, not the
  challenge they face due to their diverse needs
• All children present variations
  some more than others may require extra
  support

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Overall Teaching Approach

• Normative sequences ( travel maps) provide a
  frame for assessing current competency and
  planning for childs next step (zpd)
• Modifications to usual experiences and materials
  can be made by trying them as the child does, or
  observing childs
  actual use

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• What is your next step?