Chapter Eighteen Special-needs Students

Handicaps Classified Physical Medical Sensory Intellectual Attention Learning Speech Cultural Emotional Constitutional Aspects United States Canada Special–education Requirements Zero Reject Appropriate Evaluation Individualized Education Programs Mainstreaming Longer Programs Procedural Fairness Provincial Provisions Special-needs Pupils Ministerial Responsibilities Special Education Programs Advisory Committee Administrative Bodies and Appeals Mainstreaming Litigation Procedural Fairness Mainstreaming Medical Problems in Schools Types of Problems Special Situations Administering Medication Medical Procedures School Organization Residential Schools Segregated Day Schools Segregated Classes Resource Rooms and Centres Itinerant Teachers Regular Classes Conclusions Chapter Eighteen Special-needs Students

Handicaps Classified • Special-needs students are different enough from the majority of students that the school must make special accommodation for them. • . . . handicaps or disabilities . . . may be physical, medical, sensory, intellectual, attention, learning, speech, cultural, emotional, or some combination of these. • Special-needs students may be called exceptional students, • The educational accommodations made for them result in what is termed “special education” (inclusion in NB).

Progressively changing vocabulary I was a “crippled child”. In adolescence I was “handicapped”. In college I was “disabled”. I guess I'm still disabled unless some new word has taken hold. A friend tells me that there's a new fad in social work and that we are now called “the physically challenged”. That makes me gag. I hope no one calls me that to my face. (Robert J. De Felice, in Newsweek) • An organization previously known as the Canadian Association for the Mentally Retarded has changed its name to the Canadian Association for Community Living. . . . • Parents of exceptional children have avenues for involvement in the education of their children that are not open to the parents of ordinary children.

Classification. Physical • Physical handicaps, sometimes called orthopedic impairments, include loss of, or loss of the use of, part of the body and various motor handicaps. Paraplegia, quadriplegia, cerebral palsy, spina bifida, and muscular dystrophy are included here. Medical • Medical handicaps include asthma, diabetes, epilepsy, and heart conditions, among others that impair physical and intellectual performance. Many such conditions can be treated, or at least be controlled, with drugs, some of which may have to be administered at school.

Sensory Common impairments of the senses affect vision and hearing. They range in severity from minor refractive errors to blindness and from sub clinical hearing losses at specific frequencies to complete deafness. Relatively minor errors of refraction are so common and so easily corrected with lenses that they are usually not thought of as handicaps. Deafness and impaired hearing may be associated with delayed or incomplete language development.

The American Association on Mental Deficiency defines mental retardation as “significantly sub-average general intellectual functioning resulting in, or associated with, impairments in adaptive behaviour, and manifested during the developmental period” (Winzer et al., 106). . . Mentally retarded children are sometimes referred to as developmentally delayed . . . The degree of retardation is measured by the relationship between developmental age and chronological age. Although giftedness is not normally thought of as a handicap, gifted children are sometimes considered special-needs and are placed in the intellectual category Intellectual

Attention The term “attention deficit disorder” describes an especially significant classroom problem (Nichamin and Windell). frequently associated with hyperactivity in young children and the inability to pay attention for a sustained time cause is not well understood but appears to be biochemical in nature and genetic in origin. hyperactivity creates problems for teachers but inattention creates problems for pupils the non-hyperactive child with this disorder may go unrecognized or be misclassified. drugs like Dexedrine or Ritalin control the problem but do not cure it. drugs may be administered in the school under the supervision of a school staff member. Considerable controversy now surrounds the use of Ritalin because of its alleged side effects, particularly over the long term.

Learning “Learning disabled” is a residual label frequently attached to specific problems that are often not well understood. Learning disabilities are characterized by achievement levels that fall well below measured ability. Specific learning disabilities include the inability to communicate (aphasia), the inability to read without other known cause (dyslexia), specific handwriting impairments, and other similar problems. A learning disability is suspected when other known potential causes such as sensory problems or mental retardation are ruled out.

Speech Speech impairments are treated by speech therapists . . . often employed by school boards. Cultural children whose cultural and language background are unfamiliar to the school and therefore handicap the child in the school. Children who are denied the cultural and linguistic experiences normally available to preschool children because of inadequate parenting or a generally bad environment are referred to as culturally or socially deprived. Emotional Emotional handicaps include depression, hyperactivity, the inability to form satisfactory interpersonal relationships, a variety of behavioural difficulties, and some impairments that border on the medical, such as anorexia nervosa and bulimia. Autistic children are included in this category because of their unusual behaviour.

Constitutional Aspects • Provision in the Canadian constitution [under] the “Equality Rights” clause (sec. 15) of the Constitution Act, 1982, came into effect three years after the rest of the act The act - • provides generally for the equal benefit and protection of the law • disallows discrimination based on named grounds, including physical and mental disability. A second subsection • allows for . . . affirmative action (discriminatory practices that favour a disadvantaged group0 • What the American courts found to be implicit in their constitution has been made very explicit in the Canadian version. • Canadian provinces have moved to conform to these constitutional requirements.

Special–education Requirements • The requirements for meeting the needs of special-needs students as interpreted by a number of jurisdictions, American and Canadian, are listed and defined here. • This list contains all the major program modifications that are commonly made for special-needs students as a group. • Many jurisdictions have not legislated all of them, but they do represent what is widely considered to be good practice in this area.

Zero Reject • The principle of zero reject requires that no resident child of school age be turned away from school, regardless of any disability. • All handicapped children are entitled to a free and appropriate education. • The education can be in a public or private school but must be at public expense.

Zero Reject • In many provinces, specialized private schools were catering to handicapped children when the public schools were excluding them, and some of these private schools still exist. • This form of specialization. . . brings about the segregation of the handicapped, • [it] violates the mainstreaming principle discussed later in this list. • education must be appropriate to the needs of the individual child and will necessarily differ from child to child.

Appropriate Evaluation The evaluation of a child • must be culturally and linguistically fair, • consistent with any perceptual or motor handicaps that the child has, • conducted by a team of experts, and • repeated at intervals. • tested in their mother tongue with a variety of tests that are appropriate to their cultural background. • Special testing arrangements must be made for children who may be of normal intelligence but who are blind or deaf • must be re-evaluated periodically to monitor progress and avoid any possible misclassification or misplacement.

Individualized Education Programs An individualized education program - (IEP), prepared yearly for each special-needs child includes: • Documentation of the student's current level • Annual goals/ attainments expected by the end of the school year, • Short-term objectives, - the intermediate steps leading to the mastery of annual goals, • Documentation of the particular special education and related services that will be provided to the child, • An indication of the extent of time a child will participate in the regular education program, • Projected dates for initiating services and the anticipated duration of services, • Appropriate objective criteria, evaluation procedures, and schedules for determining mastery of short-term objectives, at least on an annual basis.

Individualized Education Programs The IEP will be written by a special-education teacher or a small team of specialists. • Parents at minimum, are provided with a copy of the document on request, and in many jurisdictions they will be asked to approve it. • Parents or even the student, if mature enough, may become part of the IEP team and be involved in the meetings necessary to write and revise the document. • The IEP is a quasi-contract that commits the school to implement a program for the child with the necessary human and material resources needed to accomplish it. • It acts as a formalized vehicle of communication between the school and the home and provides a basis for discussing the child's problems and progress. • Progress actually made can be monitored by reference to the IEP.

Mainstreaming • Placing special-needs children into the mainstream implies integrating them as much as possible with children who have no special needs. • The term “least restrictive environment” has been employed to describe this form of integration. • The child's placement should be as close to the regular class as is appropriate for that child's needs and abilities. • Mainstreaming ensures that special-needs children have role models that include children without serious handicaps.

Longer Programs • lengthening the school program for special-needs students has been an important issue in special education. • . . .involves extending the age range during which school services are available to the child at both the upper and lower ends. • E.g.. early intervention allows more effective remediation, • some special–needs children receive services from the age of three or even earlier. • slow learners benefit from instruction at the elementary and secondary levels well into adulthood )to age 21 in NB)

Special Education Programs • “special education program” means, . . . an educational program that is based on and modified by • the results of continuous assessment and evaluation • includes a plan containing specific objectives and • an outline of educational services that meets the needs of the exceptional pupil; • “special education services” means • facilities and resources, including support personnel and equipment, necessary for developing and implementing a special education program; • Continuous assessment and evaluation is mandated without specific requirements for cultural appropriateness.

Advisory Committee • With a few minor exceptions, every school board must establish a special education advisory committee. • Its membership consists of three school board members and as many as 12 representatives of organized special interest groups other than teacher groups that are concerned with exceptional children or adults. • Organizations such as the Learning Disabilities Association and the Ontario Association for Community Living would qualify.

Administrative Bodies and Appeals • Ontario's special–education amendments provide for a large and complex set of administrative boards, committees, and tribunals. • These are involved in the identification of children as exceptional, the placement of such children, and appeals from identification or placement decisions.

Litigation Special–education litigation in Canada has not yet settled into an established pattern, but there are clearly some types of cases that are possible. • Appeals of placement decisions for either substantive or procedural reasons • The most litigious question? The extent to which an exceptional child is to be integrated with non-handicapped peers. • Administrative bodies such as school boards that make decisions concerning the legal rights of individuals are required, by statute in some provinces and more generally under common law, to act fairly. • Difficult questions about the minority denominational and language rights of exceptional children.

Medical Problems in Schools • The introduction of children with medical and physical handicaps into schools has forced teachers to become familiar with the more common medical problems and has involved schools in medical procedures previously restricted to hospitals, clinics, and homes. • Children now routinely undergo medical procedures in schools that at one time would have been the very reason for their exclusion from school. • Some medical conditions require specific responses from school personnel on a continuing basis.

Types of Problems • Diabetes ;an inability to metabolize sugar, is common in childhood and is routinely treated with injected insulin. • Children can develop acute symptoms in school because of too much or too little insulin given their food intake, amount of exercise, and emotional state. • Insulin reaction, which is caused by an insulin overdose, insufficient food, or excessive exercise, can occur quickly and is serious. • Some board policies have recommended an almost routine administration of sugar to diabetics (Alberta . . ., 20–21), but a teacher with a diabetic child in the class should request specific instructions for that particular child.

Bronchial asthma • Bronchial asthma is characterized by difficulty in breathing. An acute attack is serious, but most asthmatic persons carry medication with them. • Asthma is frequently caused by allergies, • Teachers may wish to avoid exposing asthmatic children to allergens that may be present during field trips, laboratory experiments, and shop activities. • Exercise can also be a factor in bringing on an asthmatic attack. • Teachers should request specific instructions for asthmatic children with respect to participation in physical education, exposure to specific allergens, and self-medication in emergencies.

Anaphylactic reactions In schools, anaphylactic reactions most commonly occur in cases of extreme allergy to bee or wasp stings or to certain foods. • Anaphylactic reaction is an acute condition that requires quick medical treatment. Teachers will often be asked to store the kit (an epi-pen which contains a predetermined amount of a drug that acts as an antidote) and may be expected to inject the drug. • Teachers should be aware of any children in their classes who are subject to anaphylactic reactions and should be especially aware of the offending substances • By far the most common problem food of this type found in schools is peanut butter. • . . . Although an epi-pen can provide quick relief from severe symptoms, BUT a medical emergency still exists and the child must be taken to a hospital as soon as possible.

Hemophiliac childrenand children with AIDS • Prone to episodes of prolonged bleeding, either internally or externally, schools must act to prevent even minor injuries to such children. • Hemophiliac children do not participate in sports or physical education. In elementary schools they are either kept in at recess or are segregated from children who are playing games. • In departmentalized schools they often move from class to class before or after the other students to avoid being bumped.

Related to hemophilia . . .is acquired immune deficiency syndrome (AIDS) • Notwithstanding public fears, AIDS is not an easy disease to catch, compared to influenza or the common cold for example. • Court cases to date have recognized this and have generally required the full integration of students with AIDS into regular classes, in the absence of other handicaps (Strope). • Because of the serious consequences of AIDS, teachers frequently take precautions, such as wearing latex gloves when dealing with sick children in school.

Seizures • Seizures usually reflect some neurological problem and may be minor or severe. • Children in school who are prone to seizures are often under medication to prevent them. • The medication itself as well as the underlying neurological problem can cause learning difficulties for the child.

Special Situations • Special precautions must be taken when handling sick or injured children. • . . . in case of uncertainty, the child should not be left alone since minor problems can become serious. • School authorities should attempt to contact the parents and may request that a parent come and get the child, or a school staff member may agree to take the child home. • . . . a school staff member may take the child directly to a hospital, but, especially with injured children, this may not be a good idea. • . . . in case of serious injury is to call for an ambulance to ensure that the injured person is moved properly. Improper handling of an injured person can greatly exacerbate the injuries.

- Immunization - Head lice • teachers play an important role in ensuring that young children enter school for the first time with the immunizations now required by law in many jurisdictions. • When an epidemic of head lice occurs, teachers warn pupils not to share hats, combs, or hairbrushes and to encourage them to shampoo frequently at home. • Teachers may be asked to determine the incidence of head lice in their classes by examining children's hair for nits, the egg cases of head lice.

Administering Medication • Children in schools often require medication during school resulting in pressure on schools and teachers to administer drugs. • School boards have developed policies to handle these situations • Common elements are emerging from these. . . • Most policies disallow the routine dispensing of non-prescription drugs by teachers and school offices. However: • Policies that forbid the routine supply of non-prescription drugs by teachers often require that they dispense far more dangerous prescription drugs to pupils who must receive oral medication during school hours.

Written requests policies • . . . most policies require a written request by a parent and approved by a medical doctor who must also provide instructions on the administration of the drug. School boards frequently have forms for this. • The purpose of the request form is to ensure that the school is administering the drug with parental consent. • It does not absolve teachers or the school of liability for negligence. The form to be filled out by the doctor should indicate the name of the drug, administration time and frequency, dosage, contraindications, side effects, possible dangers, and corrective action. • Teachers are not normally requested to administer medication other than orally.

Medical Procedures • The presence of special-needs students in schools has created a need for certain common medical procedures to be performed in schools. Most will be performed by school nurses or attendants rather than teachers. • Some include feeding, toileting, and administering injected medication. • Physically handicapped students will require lifting and positioning assistance from teachers, teacher aides, or attendants, as well as help with crutches, walkers, and wheelchairs. • three more esoteric procedures are especially common: tube feeding, postural drainage, and catheterization.

Conclusions • Special-needs students are those for whom the regular school program is not entirely satisfactory because of individual personal exceptionalities. • Exceptionalities or special needs can be classified as physical, medical, perceptual, intellectual, speech, cultural, emotional, or some combination of these. • Schools must accommodate these students in an appropriate way, frequently through special–education programs. • The handicapped have asserted their right to publicly funded appropriate education and have received support by equal protection and benefit clauses in constitutions and by court interpretations of these that are favourable to their rights.

In an idealized regime, all school-age children would be accepted into the public schools, and those with special needs would have their programs planned individually in a written education program after having received a fair and appropriate evaluation of their strengths and weaknesses. • They would be entitled to education in the least restrictive or most integrated environment and would have the right to appeal their assessments and placements to an impartial tribunal. • The mainstreaming of special-needs students into regular schools has brought teachers face-to-face with students with serious medical problems.

Teachers need to know how to handle these problems and, in some cases, may be asked to give prescribed oral medication to students. Although teachers cannot become medical specialists, it is important that they understand clearly the problems of their own special-needs students. • Special organizational structures have arisen in educational systems to cater to the needs of a bewildering variety of exceptional pupils. These organizational possibilities range from segregated residential schools through segregated classes in regular schools to integration in regular classes with or without a program of periodic withdrawal.

Chapter Eighteen Special-needs Students