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Hello and thank you for joining us today. My name is Shawna Benson and I am a Regional Coach for OCALI and former classroom teacher of students with low incidence disabilities . Presenting with me in today’s session is Jan Rogers, who is also a Regional Coach with OCALI and a school-based occupational therapist.

This webinar is the second in a four part series entitled Low Incidence Disabilities: Access to the Curriculum. Low Incidence disabilities are also known by several other names including multiple disabilities, intensive disabilities & severe/profound disabilities. For the purposes here today we will follow the state licensure categories that include mild, moderate and intensive disability types focusing on intensive disabilities.

In today’s webinar we will focus on the planning for implementation.
Planning is the foresight that acknowledges that all students are valuable to our learning communities so much so that we devote time and attention to their individual needs. This attention to detail is what makes it possible for students who experience challenges to access the curriculum and environment.
In the first webinar in this series we were inspired by how we might have an opportunity to play a pivotal role in helping individuals with low incidence exceptionalities follow their dreams to an enviable life.

Let us transition now from our first webinar in the series where we have gained an understanding of low incidence disabilities, and the recognition that all of these students, like all students, have individual needs and strengths that must be considered as we strive to help them build their enviable lives.

Our learning objectives for today’s session are as follows:

  • Participants will learn that assessment data drives instruction and materials for individual students.
  • Participants will learn how to plan for the use of modified materials and differentiated instruction.
  • Participants will gain an understanding of how to access the general curriculum as a foundation for age appropriate instruction.
  • Participants will be able to evaluate and plan for changes in their own environments, moving toward universal access.

Let’s begin today’s webinar with a short video clip.

The video we have just seen offers a snapshot into the lives of individuals who have varied needs and abilities. The majority of them would be classified as having a low incidence disability and as you can see they all have dreams and future plans. What is our role as educators, service providers, community members and families in helping them to prepare for their dreams?

Students with low incidence exceptionalities generally makes up approximately 1-2% of the school age population in local school districts.
Because of the rarity, many of these students and their families are educating teachers and other students, administrators and others in the district about these diagnoses and exceptionalities. Often students with low incidence disabilities encompass a broad spectrum of diagnoses with a full continuum of cognitive function requiring a full continuum of educational placements.

To tap into each student’s greatest potential we first must tap into their present levels of knowledge and abilities. Assessments will enable all of us to plan together to develop access to our curriculums, classrooms, homes and communities.

Assessments should be universally designed so that all students can show what they know, even if they have limitations in verbal language, physical challenges and cognitive differences.

Assessments can be used to help educational staff know a student’s strengths and match those strengths with instructional practices and tools, which could include technology. To begin this assessment process we must seek information in new and unique ways.

Because students with low incidence disabilities often times have very complex needs, it may be necessary to include a wide range of specialists in the evaluation and planning process. While some of the specialists may only be a part of the student’s assessment team, many others may go on to become a part of the student’s ongoing intervention services. An assessment team may simply consist of an educator and/or a school psychologist, or as is often the case with students with complex needs, it may also include any of the following specialists depending upon the students specific needs: a speech and language pathologist, occupational therapist, physical therapist, adaptive physical education teacher, audiologist, vision specialist, orientation and mobility specialist, behavior specialist and nursing services.

Each of the various educational specialists brings a unique, yet in some cases, overlapping area of knowledge for the assessment process. For example, the speech and language pathologist can provide assessment about a student’s communication and language skills, but teachers can also be knowledgeable about aspects of a student’s communication skills while in the classroom. The speech language therapist might also address eating and feeding issues. These areas can also be addressed by an occupational therapist. The occupational therapist may provide information about sensory processing and motor skills as related to functional school activities particularly school tool use. Where as, the physical therapist also looks at motor skills but often with a particular emphasis on mobility. The physical therapist may find that their assessment of gross motor functional skills may also overlap somewhat with the adaptive physical education specialist’s assessment. These are just a few examples and are not intended to be exhaustive representations of each discipline’s scope of practice. The examples are to demonstrate the need for teams to understand each other’s practice scopes, the areas of overlap and the areas of unique personal expertise that each team member might bring to the table

Parents are also a critical member of any student’s assessment team, however, their input is particularly important for teams assessing students with low incidence disabilities. These students often have disabilities that may be unique to the educational team and in some cases the parent may need to help familiarize the team about the student’s disability as was mentioned earlier. Sometimes students with Low Incidence disabilities may also have extensive involvement with the medical community and parents may be able to provide information and links with these services for the school team.

Medical personnel such as neurologists, orthopedists, optometrists, ophthalmologists, geneticists, physiatrists, psychiatrists, etc. may all play a significant role with students with severe challenges. This medical information may be needed by the school assessment team to understand a student’s medical prognosis and how it might impact the student’s learning. It might also be necessary for the team to understand the needed medical interventions that may occur during the course of a school day such as tube feedings, suctioning, medication administration, etc. Some students’ medical needs are so severe that they may need to be educated in the home environment and the assessment team would evaluate the student at home. The student’s medical doctor would make the determination on home-based needs.

There are typically a wide-range of assessments that are used to measure student performance. Assessments can be norm-referenced, criterion-referenced, checklists, rubrics, work samples, portfolios, observational, and there are many others. Each specialist has their own assessment instruments. Assessments are selected based upon student strengths, needs, level of performance and types of information needed by the team to make placement and instructional decision. Most students participate in some type of norm-referenced testing which requires participation in specially requested tasks which often rely on motor or verbal responses. Many students with low incidence disabilities are unable to participate fully in these types of assessments. However, students should never automatically be excluded from this type of testing based on their perceived inability to verbally or motorically respond to the testing situation. Sometimes simple modifications can be provided to gain the information needed about the student. For example if a student is unable to point they may be able to eye gaze their response. If a student is unable to handwrite a response, they may be able to type the response. If modifications are used the evaluator must note the type and extent of modifications and also indicate that the scoring would be impacted in terms of standardization. Other types of assessments often provide more flexibility in terms of methods and tasks.In contrast to initial assessments, which are often a snap shot of student performance at a given point in time, ongoing assessments provide a collection of comparable data over time that we hope shows growth and change in student skill and knowledge. Ongoing assessments could include portfolios, running record assessments, work samples, checklists, IEP goals and objectives.

For those students who are not able to participate in assessments even with modifications it may be necessary to think about other ways to gain information about the student’s performance. Some students demonstrate little outward signs of engagement and interaction with people or objects. You may need to look for patterns in behavior for opportunities to develop basic skills. Look for times when students are the most neurologically alert. This could be displayed as an emotion, attentiveness, recognition of person or object, a cessation of behavior or reflexive movement. Use these events to gain a better picture of the student’s skills. This will be your assessment data that drives planning. By looking at the details of the student’s behavior you can limit “can’t do” statements with “can do” statements in assessment narratives and the assessment process.

Many, but not all students with low incidence disabilities also participate in alternate assessments. While most students participate in grade level standardized tests of student achievement, some students with low incidence disabilities are not able to effectively demonstrate what they know with this type of assessment using allowable accommodations. Students who take the alternate assessment are participating in a modified curriculum, focusing on applications of state standards with an emphasis on functional and life skills. For these students an alternate assessment is given in place of the grade level standardized achievement test. It is important for teams to use the alternate assessment “Decision Framework” as shown on the slide in making the determination for individuals who will be taking the alternate assessment.

Let’s take a moment to meet one young learner who we may be planning for in our near future.

Aden’s assessment profile describes him as a young child who is very bright. He had a muscle condition that required that he use eye gaze as his access for communication and choice making. Based on what we know about Aden we will be planning for him as a learner who needs access to age appropriate standards without any modifications to the content. He will be using assistive technology for school tasks and activities. Aden will need positioning options during the school day as well as many special services including OT, PT, Speech, APE, an aide and nursing care.

During Aden’s IFSP, and IEP when he is older, many areas of consideration will be discussed by his team. Because of his high academic skill Aden should maintain access to the general curriculum. Therefore, his LRE should be in the general education environment unless his medical condition were to require a more restrictive placement. His future planning should be used to determine the path, curriculum, environments (LRE) and materials used in educational training.

Aden may be among many learners in your class. Remember our assessment profile of Aden looks at his cognitive strengths and needs. In the area of cognition we know he is very high and he has the potential to do extraordinary things in his life. He needs an educational path to lead him to that outcome with an LRE that is designed for his specific needs and supports.

How can we plan to meet his learning needs and the needs of others in your class at the same time?

Just because we advocate for inclusion does not mean that we believe that all students can be fully included. Each student needs their own LRE designed with their needs and services in mind. Some students may still need direct instruction and modified curriculum, while maintaining some inclusive activities and curricular exposure – a full continuum of services and supports are needed.
Remember inclusion means more than just a placement or even specific classroom.

Independence is a life goal for all of us, but it may look different as we are all individuals with various skills and challenges. In some cases independence may be making choices throughout the day. For others it may be working or living independently. And still others may strive to independently control movement in one part of their body. All of these levels of independence are equally enviable and achievable with the help of many skilled professionals and the caring and support from family and friends. If we take a moment to look at the planning and preparation that makes all levels of independence possible we may need to look at the environment first. Laws now support access to environments that enable people with challenges to navigate and function independently in the community.

The principles of universal design have emerged from architecture and the design of physical environments for individuals with disabilities. Perhaps the best example of the success of universal design principles is the curb cut. Originally designed to improve mobility for people with disabilities within our communities, curb cuts not only accomplished that, but also improved access for people with baby strollers, roller blades, grocery carts and bikes. Picture Sources: http://www.cast.org

Many schools buildings were built at a time when there were no laws regulating universal design and physical access. Think through your building and grounds. Is every environment accessible to ALL students? Think about the parking lot, the entries, the doors, the hallways, the playground, outside eating areas, the auditorium and the gymnasium. Tour your school in your mind in a wheelchair, or with crutches, or blind; how would it be for you?

Although we may first think about a student’s classroom there are many other environments where students engage in school activities throughout the day. Restrooms need to be accessible for all students. Some students with low incidence disabilities may need a private changing area for toileting needs. Other students may need special seating in the cafeteria because their wheelchair does not fit under the cafeteria tables. Lockers can be challenging for even the most dexterous student. For students with motor limitations lockers that are at the end of the bank of lockers may make it easier to maneuver items into and out of the locker. These are just a few examples of things to consider in planning for a student accessible environment.

To increase access to groups student placement at the table should be investigated…no one wants to be joining a group and find out that they cannot fit up under a table. It is embarrassing to create a mad rush of movement at the onset to an activity, especially in an inclusive setting. This makes the student stand out at the onset.

Environments that have universal accessibility have open access to destinations such as counters and doors. They have counter heights that seated individuals can reach and move right up to.

If you were an individual joining this group and you happened to use a wheelchair or a walker what would you hope the teacher thought of in advance? Students should only be positioned into seats that are recommended by a licensed professional. Generally transition and positioning training is given by those same professionals to other members of the student’s team.

It is best to include students with physical challenges in purposeful and functional positioning whenever possible. For example, when others are lining up, standing for a presentation, transitioning, are on the playground or gym is the perfect time to embed therapy equipment such as standers and gait trainers. If students are seated on the floor for an activity it is the perfect time to transition student to a Tumbleforms or a floor sitter.

It is important for ALL students to be able to independently access ALL areas of the school and school related activities that pertain to them. Often times some relatively simple modifications can help to improve accessibility for a student. For example rearranging the desks in a classroom may allow for a wider aisle-way for a student who uses a wheelchair for mobility. Automatic door openers can be retrofit on most doorways to assist individuals who are not able to push or pull a heavy door.

Sometimes the environment creates not only difficulties with access but also can pose a school safety concern for some students with limited mobility. For example,
being able to move in a crowded hallway for a student with balance challenges
or being able to exit the building during fire drills when no elevator is available for a student in a wheelchair.

How have you handled situations where safety can be an issue such as a cluttered classroom, student fatigue, or limited time to get from one place to another?

All school activities require mobility! There are some though that do take extra planning. Let’s not forget about field trips, field days, recess, P.E. class as well as art and music classes.

Just like universal design laws mandate environmental access for people with exceptionalities so too should our curriculum and classroom.

Now let’s take a look specifically at the access needs in a classroom environment. We need to plan for positioning of students for greatest participation.
Where will we place materials that students will need to have access to on a daily basis? What scaffolding will we need to facilitate independent retrieval and replacement of those materials? Where will we convene our group instruction, our independent work and our assisted work? Is there enough space for students to navigate and transition from one location to another? Is there a space for paraprofessionals to assist with material preparation? Can students access voice output if they need assistance from all areas of the classroom?

Let’s look at some of the options we may use to promote access. In these classrooms students can access materials independently because there are labels on containers, shelves that are low to the ground for the learners who are seated and there are containers that can travel to other locations in the room. Most of these spaces have adequate aisles and floor areas that could accommodate larger mobility equipment.

Tools should be accessible for learners who need them without always having to go through the teacher or paraprofessional. Ideally, we want to promote independent access to classroom and student specific tools including assistive technologies.
Word walls can be a wonderful tool, if they are grade and learner appropriate. The word wall in the top left has added features to increase access such as pictures, letters, letter blends, phonemes (hard and soft consonant sounds, short and long vowel sounds), mobility (the learner can take the word to their seat to copy and return and thus practicing dictionary phonemic and onset skills in the process). Some word walls have sign symbols with hand signed letters to organize the space.
In the third webinar in this series we will specifically look at the vast array of tools that students with low incidence exceptionalities will need in order to achieve equal access to the curriculum, work place and community.

In addition to physical access we need to plan for curriculum access. Some learners will need supports that allow them to access text. Like emersion for English language learners, print rich environments surround students who are learning to read, write and spell with purposeful applications to text. Images are also used to support the meaning of text.

A young man who uses a wheelchair enters this library. How would he access what he needs? What changes would the library need to pre-plan if he or another individual with blindness came in to gather information?

This physical environment inventory, used with permission from Kathy Staugler, is one way we can take a critical look at accessibility in our buildings, classrooms, workplace and communities.

The survey shown here can be used as a self-evaluation tool for districts, classrooms, and other environments where students with exceptionalities may be learning and working. Once completed, the assessor could use the data that is collected to focus efforts on updating environments for access. This and all documents and forms will be available on the OCALI website along with this webinar in an archived format.

What is curriculum? State Standards? School District Scope and Sequence? Power Standards? Vocational/Life Skills Standards? IEP and transition plans?
In fact all of these and more come together to build an educational package for students with low incidence disabilities.

We first accept that Educational Indicators are commonly defined for all students. In spite of the diversity that exists among the student population, we have Common Indicators and a very diverse gathering of students.

Indicators are specific to grade level and content and are not changeable.
Some would argue that state standards are not appropriate for individuals with low incidence exceptionalities.

Only one thing is clear. We need to offer more than what we think is possible.

If we never allow students to do things we think they can’t, we will never know what they do know and how they can learn.

Most curricular objectives are written with a core concept in mind. These core ideas are what must remain intact even if we change the methods and materials to accommodate for all types of learners. If general education classrooms would provide instruction with this flexibility in mind from the start, also known as universal design for learning, many more students could participate with equal access. If flexibility is not offered at the onset a student could feel like the woman sitting behind the desk in the picture above. If the task is a written assignment related to poetry some learners with physical, spelling, and visual challenges may be excluded if only traditional instruction and tools are provided. Now imagine that that same general education environment were to offer technology of all kinds and picture supports at the onset of this instruction. All students, even those who before would have been excluded from writing poetry, can now demonstrate this skill, even using choice making to create that poem.

Imagine if Chan Ton-Mooe were excluded from art because people presumed she could never hold a brush.

When we look at an inclusive class the majority of students are clustered in the middle section representing grade level readiness, however, we also have students that fall outside of the majority with high or low skill levels. These students could be learners who read at a lower level or students who need specialized tools to complete instructional tasks. All too often we plan and teach to the middle leaving some of our students behind. The key is to offer more flexibility in instructional methods and materials thus picking up some of the unique needs of our learners prior to their inability to complete the tasks successfully. Pre-planning for flexible options in tools, instruction and assessment is what we know as universal design for learning.

This planning can take many forms. This is an example of a leveled plan for diverse groups of learners after pre-assessment determinations are made as to student levels based on their pre-knowledge data. At the top of the plan is where the state level standards would be placed. If the state standards had to be task analyzed for individual performance of that specific skill, it could also be included in that section. Once pre-assessment is completed, which again could take multiple forms, some with more intensive modifications and others with lesser accommodations, those accommodations and modifications could also be placed in a pre-plan form in this template. From that information, differentiated materials including technology and differentiated instructional strategies could also be planned for in the array of learners that you have for your class.

Individuals who need specific tools for access should have those tools available at the time of instruction. This means that planning, programming, set-up and creation must be planned and completed in advance. Instruction should not stop to prepare materials at the last minute and students should not wait in the wings for participation opportunities.

If the student is included in general education classes, content teachers need to provide lesson plans that include indicators and materials in advance for intervention specialists to complete the materials preparation prior to instruction or better yet, collaboratively plan all lessons together.

In this example the content specialist is teaching The Call of the Wild. In order for a few students to participate in this instruction the content specialist must share their plans for the unit in advance so that the intervention specialist can produce the text with picture supports prior to starting the book read for some of the students. Some of these students, given flexible versions of the text, including picture supports, digital text and audio text can answer all of the grade appropriate indicator-driven questions.

In the leveled plan, students who have physical and/or communication challenges can demonstrate proficiency on grade level indicators and topics if flexibility of materials and expressions are pre-planned. This student is using digital text and switch access choice making to respond to questions about this text. REMEMBER: if the indicator is not measuring oral reading, fluency, or decoding skills students can use any mode of access to read the text. This student can demonstrate proficiency on skills such as main idea, characters, plot, setting, and many more through answering questions using choice making. Students can write using choice making, even if their only voluntary movement is eye gaze or twitch.

Science and Social Studies are subjects in which almost all of the indicators can be measured by various modes of expression. In this example of tiered assessments students could match using an AAC device, switch, scanning, cards, drag and drop on the computer or pencil & paper. Decisions like these need to be varied according to each student’s best mode of expression and planned for and prepared in advance.
Many more tools for access will be shared again in webinar 3 of this series.

The focus for all learners is to prepare them for a life of learning, work, social interactions and as Oprah says “living their best life”. Each student will vary in life goals and therefore will glean different concepts from state standards. Ultimately each student’s work should have purpose. Think back to the video “Including Samuel” where Keith articulated that he didn’t want to “paste popsicle sticks”, he wanted math. I suppose there may be a time in our life where there may have been a purpose in pasting popsicle sticks, but generally it’s not after those early grades in art class. Assess each student’s assignment, instruction and goal you have set and ask yourself, “Is there purpose in this work for each student?” If the answer is no in some cases how will you tweak the instruction to offer relevance related to the topic?

Some students will need modifications to the curriculum as determined through baseline assessments. Students who show extreme cognitive delay may require scaling back of the content as presented at their grade level. This does not mean referring to grades below the student’s age and targeting instruction there; it does mean that indicators on grade level can be broken into prerequisite skills and/or steps that lead to the indicator. These skills can be traced back to pre-kindergarten skills that are part of child development. Student’s present level can be identified from the prerequisite skill list and target instruction and goals can be planned from there. There may be times when the prerequisite skills may be scaffolded over using tools and materials so that grade level content can be targeted.

The image on the slide shows one teacher who used sticky notes to list steps or skills within an indicator to show task analysis. From the list they can be ordered and moved around from early development to the indicator. The student’s skill level can be determined by using each note as a checkpoint. The student’s target instruction begins where the current curriculum and skill left off. Don’t expect students to follow a developmental pattern before moving on to other skills at all times.

Some districts or teachers may choose to document skills within an indicator based on the grade levels that they teach for planning and goal writing purposes. This is an example of 3 levels within the indicators gleaned from task analysis. Remember, final indicator outcomes are only modified for students who are taking the alternate assessment. Other students should always aim for the indicator even if they are not there yet. Task Analysis can be used in both scenarios. Many students, given the materials that match their needs and abilities, can demonstrate proficiency on grade level indicators.

If students are identified as needing a resource room structure as their least restrictive environment, students need a 3-5 year rotation of content topics or themes. These topics of instruction can come from Science and Social Studies standards on grade level per each student or grade band of classroom. Some tools and materials will be determined to be appropriate in certain grade bands. For example Starfall is a great website that may supplement instruction, but only in grades pre-K -3, in that grade band only. Other websites will be selected as appropriate for other grade bands. No two grade bands should be alike in topic or resources. Age appropriateness should always lead the way in making these decisions.

Task analysis should be used to target the skills for each student related to the indicators. Leveled planning should guide teachers and paraprofessionals to tools and instructional supports used with students. Roles and assignments should be defined in plans so it is clear who will be responsible for preparing materials and providing supports. Grade appropriate content should always be driving plans that is age appropriate. Collaborative planning with content specialists, paraprofessionals and therapists will ensure that skills generalize beyond the time and place of therapy.

Active participation is the GOAL no matter what the environment or the curriculum!
Keep in mind that passively taking it all in is not enough. It is not participation.
What is the one skill that the student has that will show engagement? That one skill could become the window into a world of opportunity that awaits each learner.

Thank you for joining us today as we work together to better the education of students with low incidence exceptionalities across the state of Ohio.
Please join us for the next webinar in this four part series entitled Access to the Curriculum for Students with Low Incidence Disabilities, where we will look at tools and assistive technology for access.

Please visit the OCALI website for past and future webinars, additional resources for professional development and general information related to Autism, Low Incidence Disabilities, Assistive Technology and Transition.