Teaching Marty

The following information will be taken from Supporting the Student with Down Syndrome in Your Classroom, an educator manual put together by Families Exploring Down Syndrome, our local Down syndrome support group. They gleaned their information from various sources which are included in the manual's appendix.

I know this is an educator manual, but I couldn't help but jump on here and share all the helpful information that I found useful from this awesome booklet. The manual covers many areas but I pulled out the parts I felt applied to Marty specifically. He goes to different therapies and is in various classroom settings during his week so those who teach him, have him in a playgroup, or are a caregiver will also find this information insightful.

HYPOTONIA:
A medical term for decreased muscle tone; some symptoms: problems with mobility and posture, speech difficulties, poor reflexes. To understand the physical demands placed on children with Down syndrome by low muscle tone, imagine cooking dinner while wearing socks on your hands. Students can get frustrated when their abilities to complete tasks are hindered by low muscle tone.

Tips for the classroom:

• allow extra time for completing tasks
• give more opportunities for practice

SPEECH INTELLIGIBILITY

Because of low muscle tone there can be problems with jaw movement. Imagine trying to communicate your needs while your mouth is full. There is usually a great difference between how much language they understand and how much language they actually speak and thus their intelligence is often underestimated.

Tips for the classroom:

• use simple questions with Who? What? Where? When? Why? How?
• learn basic sign language and teach them to the class

MEMORY

Most students with Down syndrome will have short term or working memory difficulties. This makes it harder for them to access, understand and process information at the same speed as other students, but does not prevent them from learning the same information. Individual motivation is the key to learning!

Tips for the classroom:

• give information in a clear, ordered manner
• allow more time to learn and more practice to apply knowledge

COMPACT STRUCTURE OF THE EAR, NOSE AND THROAT

Compact bone and soft tissue structure increases their susceptibility to and the severity of upper respiratory and sinus infections.

MODIFYING CURRICULUM 

Students with Down syndrome are visual learners. 

Tips for the classroom: 

• use teaching methods that involve cues and objects
• pair pictures with spoken words
• present information visually (posters, charts, use the chalk/white board).

Students with Down syndrome are not proficient in auditory processing and auditory memory. They sometimes have difficulty in retaining directions or information that is only processed verbally. They have a slower rate of learning than their peers and need time to process new skills they have learned before moving on to others. 

Tips for the classroom: 

• assign fewer problems at a time
• give students freedom to choose their work activities
• foster independence and self-reliance
• divide independent work into smaller segments
• allow extra time to complete tasks 
• reduce the length of your assignments

Students with Down syndrome work best with one-on-one or small group instruction. Working with an aide or an assistant on a certain project can be effective but is not always necessary or beneficial for every task, especially when trying to build peer relationships.

Tip for the classroom: 

• Avoid large group or whole class instruction (least effective method of communication)

READING

For many students with Down syndrome reading is strength. It enhances and facilitates language development because they are typically visual learners. As their reading ability increases, so does articulation and vocabulary. It is the ideal means of helping a student with their expressive language. The ability to read and the praise it elicits from others correlates with higher self-esteem and independent performance. It is also beneficial for the development of functional skills required for personal development, community life, and recreation. Reading positively impacts language development and is often a catalyst for increased intelligibility and sentence length. 

Tips for the classroom (to prepare students for success in reading):

• Fostering visual discrimination (grasping the concept of same/different and sorting ability based on size, shape, color, etc.) for pre-readers:
• simplify choices 
• use meaningful visual aids (photos of real objects that interest the student)
• progressively make problems more difficult as the student is ready
• Auditory memory - ability to recall sounds and words and to imitate them on request
• expose student to music and beat; music is an invaluable speech tool and a powerful motivator for many students with Down syndrome
• encourage singing, clapping, dancing
• speak slower, enunciate or emphasize key words
• use music during opening and closing circle times and during daily routines (like clean-up) 
• repeat finger plays, nursery rhymes and songs for retention and recollection of vocab
• seek creative and active ways to build their vocab of meaningful words
• use visual and sensory cues (pair actions with words, finger cues, pacing)
• use tactile approaches (sandpaper words, draw in finger paints or sand)

COMMUNICATION

For many students with Down syndrome the inability to communicate with others can have a devastating effect on an individual's social and personal skills. Research shows that their language comprehension skills are almost always better than their language production. 

Tips for the classroom: 

• provide appropriate motivation
• keep expectations high
• let students realize that all communication is valuable
• if the students use sign language but have mastered the word orally, you can phase out the sign

IN THE CLASSROOM

The goal of most parents is for their child with Down syndrome to be able to talk to and befriend classmates, ask for help, be a part of classroom discussions and activities, and to communicate needs/feelings/ideas. They can take longer to adjust to changes and learn routines. It is common for them to be reserved in group settings, especially if they do not feel confident about their speech and may even "shut down." 

Focus on efforts rather than results. Praise and positive reinforcements are powerful tools. You can tell when a student is is demonstrating effort when: 1.) initiates and maintains eye contact, 2.) willingly faces the speaker, 3.) watches the speaker's face intently, 4.) imitates the speaker's words/phrases spontaneously, 5.) displays pride when praised by others, usually by smiling or clapping. Positive or specific reinforcement is key since praise is more powerful when it is a reminder of what they have accomplished ("I like the way you ______" is more meaningful than "Good talking").

Students with Down syndrome will need more time, practice, consistency and reinforcement to learn communication skills. Group acceptance is a big motivator for all students. Teachers can facilitate this relationship by fostering tolerance and understanding in the classroom, as well as refusing to allow teasing or mimicking of the student. Provide ample opportunities for buddy activities.

Tips for the classroom:

• model the behavior you want to see by getting down to the student's level and initiating eye contact; use prompts like "look at me" and wait for eye contact to be returned
• use visual aids and hold them up next to your face 
• use strategies at transition times (like flickering the lights)
• repeat instructions slowly and clearly
• use peer buddies and remind the student to follow their buddy's lead ("Look at your friend. What do you need to do?")
• use action songs 
• model turn-taking behavior ("My turn," "Wait for your turn," "Raise your hand")
• model concepts of quiet and loud teaching "inside" versus "outside" voice
• use "feeling" words when they are upset ("You look happy/sad/mad") and cue them to use words rather than actions perhaps by a visual aid such as a feelings chart
• help them problem solve ("What upset you?")

FACILITATING FRIENDSHIPS AND SOCIAL LEARNING
To promote social inclusion, make sure the child has learned how to behave appropriately in social situations; they need to understand rules and routines and be able to cooperate with their peers. 

CLASSROOM STRATEGIES
In order to make progress in cognitive areas, it is crucial to interact with others in a socially acceptable way and respond appropriately to their environment. Classmates can be role models for appropriate social behavior and are a powerful motivator for learning. 

Students with disabilities exhibit deficits in age-appropriate social skills and find it difficult to establish and maintain reciprocal friendships (ex. many play alone rather than engage in group play). They are also less likely to initiate interactions with other children. Students can develop real friendships with early intervention. Developing social skills at a young age is critical (as students get older, the opportunities to form friendships with typically-developing classmates diminish). 

Students engaged in cooperative learning demonstrate higher levels of reasoning, generate new ideas and solutions and transfer learned skills appropriately to different situations.

Tips for the classroom:

• Students with Down syndrome must be directly taught socially appropriate behaviors
• Daily review is beneficial 
• Students must have opportunites to make choices and decisions
• They must be able to communicate with their classmates effectively (use of sign language or pictures)
• Too much one-on-one support from an aide can impair the student's ability to benefit from his peer group models, to learn to work cooperatively and to develop social relationships with their classmates

SENSORY PROCESSING

Refers to the normal neurological process of organizing and interpreting information from the environment. Can affect academics, attention, balance, coordination, body awareness, emotional and gravitational security, fine and gross motor skills, hand preference, self-comforting, self-esteem, social skills, speech and tactile discrimination. 

The tactile system in sensory processing helps us discriminate between threatening and nonthreatening touch sensations and provides information about objects through touch (texture, shape, size, etc). A person with a hyper-reactive tactile system can dislike certain textures (sticky, slimy, etc)  and might resist washing face or hands, brushing teeth, or washing hair. 

The vestibular system helps with coordination of eyes, head and body movement. It also controls our body's relation to gravity. A person with hyper or hypo-reactive vestibular system frequently falls or trips and can show increased emotional sensitivity (especially where gravity is involved).

The proprioception system consists of components of muscles, joints and tendons that provide us with awareness of our body (sitting properly in a chair, stepping off a curb smoothly, etc). A person with a hypo or hyper-active proprioeption system is often clumsy, may walk very heavily, and seeks deep pressure by placing heavy objects on themselves.

POSITIVE BEHAVIOR SUPPORTS
Generally, the most effective technique for right behavior is praise. The following methods are sometimes effective for behavior management for students with Down syndrome: material rewards, time-out, peer pressure, loss of privileges, contact with parents. A method generally NOT effective for behavior management is ignoring the behavior. 

The most common form of inappropriate behavior in all children is behavior designed to gain attention. Children with Down syndrome may be particularly attention-seeking because: they enjoy being the center of attention and dislike being ignored, they are used to having an adult by their side all the time and resent the adult working with other children, they are used to getting special treatment and object if it is withdrawn. 

Sometimes the child with Down syndrome will misbehave because they are angry or frustrated. They may try to do the same as others, but find they can't cope without help. They may presume that the work they are being given is too difficult or uninteresting. They may get annoyed when other people don't take the time to understand what they are trying to say.

Sometimes children with Down syndrome may appear to misbehave when they are, in reality, just confused or uncertain about what they are supposed to do. They may have failed to understand instructions given to the whole class. They may have forgotten what they have been told. They may be finding it hard to learn new rules and routines and still do things the old way. They may be confused by different adults giving conflicting messages.

Children with Down syndrome are often subjected to a high level of structure and supervision. As a result they may feel the need to exert some control over their lives. They may be difficult if they feel they are given no opportunities to choose their own activities. They may feel under pressure and need a break. 

The child's immaturity may lead to behaviors more appropriate of a younger child. They may not have the concentration or memory skills of their peers. They may have immature play and social skills. 

The management of behavior in students follows the progression from "external locus of control" to "internal locus of control." The goal of behavior management must be to transition from external to internal control. This is a learned activity and can be taught. 

The best form of behavior management is prevention. Three options available to teacher to curb behavior problems: 1.) modify the child, 2.) modify the environment, 3.) modify the interaction. 

The second best method of behavior management is REDIRECTION: simply walking over to the child and directing the child to another activity. It is not necessary to get into a great explanation about what is not acceptable to you--just physically redirect the child to a better place. Redirection requires warmth and genuineness.

The next behavior management technique is to say "no" or better "not" and give the child some way to find a better activity. It does not mean you stand across the room or sit on the couch and shout "NO!" It means you go over to the child, get on the child's level (bend down, squat down or sit on the same level as the child) and get the child's attention in a very quiet way: "No, we don't do that. Let's do this..." You may offer the child an option, not a series of options or undirected choices of doing something else. When children are offered a choice, it needs to be from two options and not more than that. Play to win. The source of personal power is the feeling that you have a choice. Acting out or defying is an illustrated example of a person who feels powerless. You must be smarter than the problem. 

It is a rule of human behavior that being aware of the behavior changes the behavior. "Reactivity," meaning that when a student is asked to keep a record of good behavior that behavior increases. "Behavior that is rewarded will be repeated," and reactivity rewards the behavior that you want. This may also be reinforced with verbal praise: "I really like it when you_______(stay in your seat, listen to the teacher, etc). 

Self-reward is the most powerful behavior management approach we have. Find out what the child likes, wants, desires and have them give themselves a reward for compliance.