Down Syndrome

1. Down Syndrome By Janet Sobczyk • Strategies and • Considerations • For Helping • Students with DS • in the Classroom

2. Most students with Down Syndrome have mild to moderate cognitive delays, and can fully participate in public or private educational programs, with varying amounts of accommodation, modification, and support. Some students with DS have severe delays and require much more support in a small class setting.

3. Classroom Considerations • These are some of the topics which educators need to consider in order to • address the needs of students with DS: • Collaboration • Health Concerns • Climate of Acceptance • Social Skills • Scheduling and Routines • Behaviors and Management • Pacing, Differentiation, and Adaptations

4. Collaboration • A student with DS will need a team of professionals to help him/her be • successful in school. This team will include some or all of the following: • Parents - who are the child’s first educators, know the child best, and can give tremendous support • Regular and Special Education Teachers – who will teach and assess the child in a variety of settings • Speech-Language-Pathologist – who will assist the child with communication and literacy skills • Occupational Therapist – who will help the child with activities of daily living (fine motor skills) • Physical Therapist – who will help the child to develop muscular and orthopedic abilities (gross motor skills) • Psychologist – who will conduct a variety of psychological and intellectual evaluations • School Nurse – who will help with health issues that may arise • Administrator - who will assist with communication among the team members, with scheduling, and with accountability • Paraprofessionals – who will help the child one-on-one or in small groups in many ways throughout the day

5. Examples of Speech-Language assistance: • Using Sign Language or a communication board if needed • Practicing correct phoneme production • Practicing emergent literacy skills • Correctly repeating phrases and sentences • Producing complete sentences independently • Improving oral reading skills • Improving reading and listening comprehension • Practicing writing to convey meaning

6. Examples of Occupational and Physical Therapy assistance: Occupational Physical Building strength and coordination in limbs for: ascending and descending stairs skipping and running balancing and hopping throwing and catching activities in PE class participation in sports • Building strength and • coordination in hands for: • buttoning, zipping, tying • sign language • feeding skills and opening food packages • handwriting • keyboarding

7. Health concerns Other conditions that may accompany Down Syndrome: Keep in Mind that children with DS… …get dehydrated easily, so allow students to keep a water bottle nearby. …get fatigued easily, so give rest and/or snack breaks if needed. …often need glasses, so watch for signs of vision problems, especially if a student with DS does not wear glasses. …may have a low level hearing loss that is undiagnosed, so consider seating near the front of class. …are more susceptible to colds and may be absent often due to illness. …may experience pain differently (high threshold) or not verbalize it well. …may need to be on a special diet. …may get easily discouraged and become upset or anxious. • Heart defects • Vision problems • Hearing loss • Infections • Hypothyroidism • Blood disorders - anemia and leukemia • Hypotonia – poor muscle tone • Sleep disorders • Gum and dental problems • Epilepsy • Digestive problems • Celiac disease • Mental health & emotional problems – anxiety, depression, ADHD

8. Climate of acceptance • Regardless of the type of classroom (regular, resource, or self-contained), a comfortable atmosphere must be established by the teachers so students feel welcomed and able to learn. Here are some general guidelines: • Diversity of all kinds is valued and celebrated • Use student- first language for any student with a disability (ie: “a student with Down Syndrome”, not a “Downs student”) • Every student is verbally and emotionally supported by their peers and school staff • There is a zero tolerance policy for bullying, and anti-bully programs are provided for students, staff, and parents • There is access to extracurricular activities for all students with appropriate support from staff and parent volunteers • Parents/caregivers are viewed as equal partners in the education of their children and are encouraged to be involved at school

9. Social skills • Students with Down Syndrome learn from and mimic their peers. They • need to be taught and shown appropriate social skills so they learn to • discriminate between good and poor choices in social interactions, for example: • Greeting others and making friends • Sharing and taking turns • Asking for help and helping others • Accepting “no” for an answer • Being honest • Saying “I’m sorry” • Using manners, including “please”, “thank you”, and “excuse me” • Identifying and handling emotions like anger and frustration

10. Scheduling and routines • Children with DS like routines, but usually have trouble with abstract • concepts like time. Teaching them to follow schedules and keep a calendar • gives them the tools to be in control. Those tools also build independence, • competence, and self-esteem. Here are some ideas: • Establish consistent classroom routines. • Post a large wall schedule of the day’s activities with visuals. • Attach a small desk schedule so student may X off activities as they are done. • Use a timer that tells it is time for the next activity. Better yet, have student set it. • Use a classroom helper chart to encourage cooperation with cleaning up. • Encourage the family to use a large wall calendar at home for their activities and a chore chart with stickers. Remind them that visuals are needed on both. • For independent skills in the classroom and at home, provide visual sequencing of the steps (using Boardmakersoftware or other computer graphics).

11. Behaviors • Most students with DS have some or all of these strengths: • An eagerness to please • A sense of humor • An ability to learn well using visual senses • The ability to communicate either with speech, signs or gestures, or a picture exchange system • A similar series of developmental stages as non-disabled students, just more slowly • An enjoyment of interacting with and imitating peers and adults • Behavior problems can range from • quiet noncompliance to tears to • hiding or running. They may be: • Simply a desire to avoid a task • A resistance to transitions • Learned helplessness • A means of expressing feelings (fatigue, hunger, thirst, boredom, anger, frustration, etc.) • A clue to a physical condition (see Health Concerns)

12. Analyzing misbehaviors • Think before taking action… • Consider what may be causing the behavior (antecedents, health, emotions, sensations, etc.) • Consider what function is served by the behavior (attention getting, avoidance, continuing a pleasurable activity, etc.) and how it could be served in a different, positive way • Consider if the behavior is being reinforced by the consequences • Consider doing a Functional Behavioral Assessment as part of a Positive Behavioral Support plan

13. Managing misbehaviors • Teachers have found these to • be most effective: • Specific praise of efforts as well • as results • Use of humor or silliness to • turn around a bad mood • Calmly explaining what is • appropriate and what is not • Consistent follow-through on • classroom rules for all students • Token system for the whole • class room • Privileges or rewards • Students with DS may not be • able to connect their • behavior with the • consequences, so these are • not effective: • Punishment • Scolding • Ignoring inappropriate behavior • Threats of lower grades • Use of sarcasm

14. Pacing and differentiation • Students with DS take longer to process and respond, so pace accordingly, allow extra time for the student to answer, and omit timed assignments. • Before each new learning activity, include a “success step” that the student can do easily. This will raise confidence and interest. • Focus on major concepts for learning rather than minor details. • Limit distractions in the environment and on printed materials (use more white space). • Reduce paper and pencil tasks. • Utilize technology (calculators, tablets, and computer programs for learning, not just as reward.) • Facilitate short- and long-term memory storage by using music and rhythm, mnemonics, creative practice, visuals, and short review sessions. • Use small groups whenever possible for differentiated instruction and for collaborative projects. • In primary grades, an older buddy or classmate can help the student participate. • In grades 6 and above, the use of peer tutors can be very effective for reviewing skills.

15. Types of adaptations • Size - reduce the number of items • Time - allow more time (for oral answers, tests, and assignments, etc.) • Level of support - provide more assistance (by teacher, para, peer, parent, etc.) • Input – change the way the instruction is given (read problems aloud, provide manipulatives, show visuals, etc. ) • Difficulty - make the assignment easier • Output - adapt how the student shows the learning, especially if handwriting is an issue • Participation - have the student participate in a portion of the activity • Alternate goals - have less complex goals than the rest of the class • Substitute curriculum and goals - student has different instruction and activities for his/her specific goals. • From the Institute for the Study of Developmental Disabilities at Indiana University

16. Participating in the education of children with Down Syndrome is a rewarding experience!

17. References: • Hegde, M.N., (2010). Introduction to Communicative Disorders, 4th ed. Austin: Pro-Ed, p. 455-461 • Horstmeier, DeAnna, Ph.D., (2004). Teaching Math to People with Down Syndrome and Other Hands-on Learners. Bethesda: Woodbine House, p. 17, 25-27. • Isaacs, Sally, Hadler, Pat, (1992). Social Skills Simplified: Being the Best Me. Columbus: Essential Learning Products, p. 1-33. • Oelwein, Patricia Logan, (1995). Teaching Reading to Children with Down Syndrome: A Guide for Parents and Teachers. Bethesda: Woodbine House, p. 11, 22-24, 205, 229-231. • National Down Syndrome Society, (nd). Inclusion: Educating Students with Down Syndrome with their Non-Disabled Peers, cover. • Pierangelo, Roger, Ph.D., (2004). The Special Educator’s Survival Guide, 2nd ed. San Francisco: Jossey-Bass, p. 155-158. • Smith, Tom E.C., Polloway, Edward A., Patton, James R., Dowdy, Carol A., (2012). Teaching Students with Special Needs in Inclusive Settings, 6th ed. Upper Saddle River: Pearson Education, Inc., p. 108-149, 224-247. • Tomlinson, Carol Ann, (2001). How to Differentiate Instruction in Mixed-Ability Classrooms, 2nd ed. Alexandria: ASCD, p. 72-78, 100-101.