Return to Newsletter | Revised 2-20-02
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Bureau for Students with
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A project funded by the Georgia State Improvement Grant
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On-Line - Spring 2001
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For teachers of students with physical impairments, determining a student's literacy abilities can be challenging, especially if the student is non-verbal. However, if a student has a reliable yes/no response or can make a selection (by pointing, touching, eye gazing, or some other means) this student can be assessed using literacy tests that are constructed with a multiple choice format. In this article, several tests will be discussed that can be adapted for students who are non-verbal. Although this is not a comprehensive list, these tests cover the range of pre-literacy skills, reading, comprehension, spelling, and vocabulary knowledge. The tests are as follows:
Pre-Literacy Skills: * Metropolitan Reading Readiness Test In-depth Reading Assessments: * Gates-MacGinite Reading Tests* Stanford Diagnostic Reading TestVocabulary Knowledge: * Peabody Picture Vocabulary Test (PPVT-III) Overview of Reading/Spelling: * Peabody Individualized Achievement Test-Revised (PIAT-R)Each of these tests will be discussed in detail below. The target age and ability level of the student, concepts tested, format, ease of administration and ease of scoring will be included in the review of the tests. Also, general guidelines for adapting the test based upon the individual being assessed will be included.
Metropolitan Reading Readiness Test Hartcourt Brace & Co. 1-800-211-8378 www.hbem.comGates-MacGinite Reading Tests Riverside Publishing Company 1-800-323-9540 www.riverpub.comThis test covers a range of pre-literacy skills including visual discrimination, beginning consonants, sound-letter correspondence, and story comprehension. The test is easy to give as well as score. It is presented in a format that most children will find entertaining and is designed for students in pre-K through first grade. Although this test assesses critical pre-literacy skills that students need in order to succeed in reading, it is not recommended to use with older students due to the juvenile appearance of the test.
Stanford Diagnostic Reading Test Harcourt Brace & Co. 1-800-232-1223 www.hbem.comThis test is designed to measure literacy concepts, reading instruction, relational concepts, oral language concepts, letter and letter-sound correspondence, initial consonants, and consonant clusters, final consonants, vowels, use of sentence context, vocabulary and comprehension. The test is available for pre-readers up through grade twelve. Administration is very simple, as a script is provided for the teacher. The test provides information on the student's raw score, percentile rank, normal curve equivalent, and stanine. In order to determine how well a student scored, the teacher has only to find the raw score (number correct) and follow across a chart that provides a conversion to percentile rank, normal curve equivalent and stanine. The appearance of even the prereading assessment is not overly juvenile; thus, this test becomes an appropriate measure to use with students who are functioning on a literacy level below that of their chronological age.
Peabody Picture Vocabulary Test (PPVT-III) AGS Publishers 1-800-328-2560 www.agsnet.comThis test is designed to measure phonetic analysis, vocabulary and comprehension of students in first grade through grade twelve. Administration is quite simple due to the script provided for the examiner. The types of scores that can be determined through the administration of this test include content-reference scores, raw scores, progress indicators, scaled scores, norm-referenced scores, percentile ranks and stanines. The examiner has only to determine the raw score. The other scores are pre-calculated and presented on a chart based upon the raw score. The examiner's manual includes a section on determining appropriate level of instruction based upon the student's score. The format of the test contains black and white pictures and words and is also appropriate for students whose literacy level is below that of their chronological age.
Peabody Individualized Achievement Test-Revised (PIAT-R) AGS Publishers 1-800-328-2560 www.agsnet.comThis test is designed to measure vocabulary knowledge of students in elementary school. A script is provided, making administration quite simple. Scoring, however, is more involved in this particular test. In order to accurately score the test, the student's exact chronological age is determined and once this information is obtained, a standard score can be obtained from the raw score. It is at this time that the examiner must be careful to locate the chronological age correctly in the norms booklet and match it up with the student's raw score to determine the appropriate standard score. Due to the black and white presentation of the pictures used, and the easel format of the test itself (the test opens up to form an easel with the teacher's script on one side ant the student's choices on another), this test is appropriate for students whose literacy level is below that of their cognitive age.
This test is an achievement test designed to measure academic achievement in students ages 5-22. Although the test contains subtests that measure general information, reading comprehension, written expression, mathematics, and spelling; only the reading comprehension and spelling subtests are appropriate for the purpose of assessing literacy skills in students with physical and health impairments. A script is provided for the examiner to use during administration of the test. By using the student's raw score, the examiner can easily determine grade equivalence, standard score by age or grade, percentile rank, standard score, and normal curve equivalent. Due to the presentation of the test items and easel format of the test, it is appropriate for use with students whose literacy level is below that of his or her cognitive level.
All of the tests described can be modified to meet the needs of individual students. For students who require that the test be presented in a yes/no format, the examiner can read the script and then touch the choices, asking the student to respond with "yes" when the examiner points to the student's desired selection. For students who can direct select by pointing or touching, the actual test protocol may be used. In this case, the student would simply point to or touch the desired selection. For students who eye gaze, the pictures, letters or word maybe copied, cut out and placed on an E-tran board (i.e. clear, rectangular board with a hole cut in the middle that allows the teacher to look directly through the hole in the middle of the board to see which answer the student is looking towards).
It may be necessary for the examiner to enlarge the test protocol for students with visual or physical impairments. Some students may need enlarged pictures or text in order to see the information clearly. For students with motor impairments, enlarged pictures or text maybe necessary to give the student a larger target to select. Regardless of the size of the materials, the examiner should take care to see that the student and the materials are placed in a manner that is appropriate for the student.
When administering any of these tests to students with physical impairments, it is important to keep in mind that the student may score lower than expected due to experiential deficits. For example, if a student is expected to select a picture that depicts a circus, and he or she has never seen a circus, the answer given maybe based on the a lack of experience with a circus. While this should not deter a teacher from administering a particular test to a student, the teacher should keep in mind that an experiential error is not the same as a literacy error. Overall, administering one of the tests described above will provide the teacher with valuable information regarding the literacy abilities of the student. This information can then be used to determine appropriate curricula, level and pace of instruction.
Inservicing School Personnel on Orthopedic Impairments by Kathryn Wolff Heller, Ph.D., Bureau director
Students with orthopedic impairments are often in general education classes, learning course content along with their general education peers with support from teachers certified in orthopedic impairments. For general education teachers who have never had a student with an orthopedic impairment, there may be much confusion over the unique educational needs of students with orthopedic impairments and the role played by the teacher certified in Orthopedic Impairments. Sometimes this is addressed through casual explanation, but other times the teacher may be asked to train a group of school personnel. To address this situation, a suggested inservice on orthopedic impairments is provided.
DEFINING ORTHOPEDIC IMPAIRMENTS
The term "orthopedic impairments" includes a wide range of students who require special education due to the impact of the orthopedic impairment on their school performance. The Georgia Department of Education defines Orthopedic Impairment as follows:
Orthopedic Impairment refers to students whose severe orthopedic impairments affect their educational performance to the degree that the student requires special education. This term may include:
(1) Impairment caused by congenital anomalies, e.g., deformity or absence of some member.
(2) Impairment caused by disease, e.g., poliomyelitis or bone tuberculosis.
(3) Impairment from other causes, e.g., cerebral palsy, amputations, and fractures or burns that cause contractions. [refer to 34CFR 300.7 (8)]
Secondary disabilities may be present, including, but not limited to, visual impairment, hearing impairment, communication impairment and/or intellectual disability.
Another way of examining students comprising the orthopedic impairments category is by dividing these disabilities into: a) neuromotor impairments (e.g., cerebral palsy, spina bifida, spinal cord injuries); b) degenerative diseases (e.g., muscular dystrophy); and c) orthopedic & musculoskeletal disorders (e.g., limb deficiency & arthrogyposis). Students with neuromotor impairments often have additional disabilities (e.g., visual impairments, communication disorders) that often result in adaptations to accommodate for the physical disability, as well as further modifications to accommodate for secondary disabilities. Students with degenerative diseases often require ongoing assessment to meet changing modifications that are needed as physical status declines. Also, students with degenerative diseases may have emotional issues of having a terminal illness that may need to be addressed. Students with orthopedic & musculoskeletal disorders often have only a singular disability, but may require adaptations and assistive technology to gain access to the general education curriculum. A brief description is given of a sampling of different types of orthopedic impairments following this article.
GENERAL IMPACT OF ORTHOPEDIC IMPAIRMENTS
Orthopedic impairments can severely impact student's functioning in school. These can be divided into 6 categories and can result in many difficulties. Some sample problems are given in each category as follows:
1. Poor Motor Skills: Lack of arm/hand usage can result in such problems as the inability to use a standard writing tool, turn pages of a book, explore items, or participate in dissection in biology class. Mobility issues may restrict participation in activities and movement from one location to another.
2. Restricted Language: Students who have severe speech impairments with their orthopedic impairment can be affected academically by being unable to fully communicate their questions and ideas, ask for clarification of the teacher's lecture, or fully participate in the learning activity.
3. Lack of experiences: Students with physical impairments may lack knowledge of common places due to problems in mobility and lack of experience of common items (e.g. ants) due to motoric restriction. This may be apparent in a lack of comprehension of literature readings and material in other content areas.
4. Individual Factors: Students may have several individual factors occurring as a part of their orthopedic impairments that affect education performance. Some of these include: pain & discomfort, fatigue and endurance problems, effects of medications, and absenteeism.
5. Psychological Factors: If the student has any cognitive or learning issues, this will affect performance. Also, some students may have motivational issues such as leaned helplessness or depression which will also impact on performance. A poor self-concept or poor self-advocacy skills can also affect performance.
6. Ineffective Learning Environment: Some school personnel have very low expectations for students with orthopedic impairments. When this is the case, the student is being set up for failure.
EDUCATIONAL TEAMS & OI TEACHERS
Students with orthopedic impairments often have a team of individuals working together to meet their needs. The composition of the team can vary greatly. A typical team may be composed of the OI teacher, general education teacher, occupational therapist (OT), physical therapist (OT), speech language pathologist (SLP), parents, student, and others.
The teacher certified in orthopedic impairments is trained to meet the needs of students with orthopedic impairments in the school setting. Teachers certified in orthopedic impairments have specialized knowledge & skills in such areas as:
1. Implications of the orthopedic impairment and how to meet the specific implications of the student's particular disorder in the school setting.
2. Specialized instructional strategies (e.g., teaching phonics to nonverbal students).
3. Specialized expanded curriculum areas (e.g., teaching student to use a piece of assistive technology, teaching a student to tube-feed independently).
4. Modifications and adaptations (e.g., modifying a test).
5. Assistive technology.
The OI teacher will work with the general education teacher and the educational team to devise and implement modifications necessary for the student to succeed.
CLASSROOM MODIFICATIONS
A wide range of modifications may be needed to help the student who has an orthopedic impairment succeed in the general education classroom. General areas include:
1. Implications of the type of orthopedic impairment
2. Physical/health monitoring
3. Environmental Arrangement
4. Augmentative & Alternative Communication (AAC)
5. Instructional & Curricular modifications
6. Assistive technology for content areas
7. Class participation
8. Assignments/Tests
9. Other modifications for motoric problems
10. Sensory & perceptual modifications
The Classroom Modification Checklist (on this website under Products) may be distributed during the inservice which addresses each of these areas. Examples of modifications, AAC devices, or assistive technology may be shown to demonstrate how material may be modified or accessed. Using a case study may be helpful, as well as stressing the support the general education teacher will be receiving from the OI teacher and the educational team.
In closing, the presenter will want to stress the positive impact of having a student with an orthopedic impairment in the classroom. Not only will he student benefit from the general education teachers instruction, but can succeed with appropriate modifications. It is also positive academically for students without disabilities. Some students may benefit from modification used by the OI student. Overall, it is a wonderful learning experience for teachers and students alike.
HANDOUT: EXAMPLE ORTHOPEDIC IMPAIRMENTS
Cerebral Palsy refers to a variety of nonprogressive disorders of voluntary movement or posture that is caused by malfunctioning of or damage to the brain occurring before birth, during birth, or within the first few years of life. Students with cerebral palsy typically have abnormal and uncoordinated motor movements, ranging from very mild (e.g., walks with a little difficulty) to very severe (e.g., unable to walk, talk, eat without assistance, or pick up an item). Even through cerebral palsy does not progress, the symptoms may get worse. For example, movement may become more inhabited over time. Often other disorders are present such as seizures and visual impairments.
Spina bifida (myleomeningocele type) is a birth defect in which the neural tube (that forms the brain and spinal cord) does not completely close during the first 28 days of gestation, resulting in damage to part of the spinal cord. Characteristics depend upon the level of the incomplete closure and associated conditions (e.g. hydrocephalus). Children will often require a walker, crutches, or a wheelchair. Learning problems may be present such as visual-perceptual deficits and organizational problems. Some students have language abnormalities that give false impression of their intelligence (e.g., cocktail party language).
Spinal Cord Injury refers to damage to the spinal cord that can be caused by a wide range of disorders and traumatic events. Typically there is impaired or no sensation and movement below the level of injury. Depending on the location and severity of the injury, the child may have symptoms ranging from weakness of a limb (e.g., leg) to paralysis of all parts of the body below the neck.
Muscular Dystrophy can broadly be defined as a group of inherited diseases characterized by progressive muscle weakness, due to the primary degeneration of muscle fibers. The most common form is Duchenne Muscular Dystrophy in which there is a rapid downward progression of muscle weakness, first seen in the legs, and then moving upward. weakness is often detected by three years of age. Around 10 to 12 years of age the child typically needs a manual wheelchair and when he can no longer push with his arms, an electric wheelchair is needed. Eventually it will be difficult to even hold the head up and the child typically dies in late teens to early twenties.
Limb Deficiencies refer to any number of skeletal problems in which one or more of the limbs (arms & legs) are missing or malformed.
Arthrogryposis is a term used to refer to multiple congenital contractures (a shortening of a muscle so that motion is limited). When infants are born with arthrogryposis, they have multiple contractures in which many joints are fixed in extension (straight) or flexion (bent). After multiple surgeries and treatments, some children may gain the ability to walk, but continue to have limited hand and arm usage.
Scheduling Tips for OI Teachers by Karlene Welty and Noreen Queen
One of the first challenges to hit a new teacher smack in the face, is the nightmare of scheduling. By scheduling we are referring to how is it we can put all of the student's IEP goals into action in an already jam packed day. For OI students who are in the general classroom most or all of the day, it is nearly impossible to find time for things like positioning, technology, toileting, feeding, and anything else that is unique to our population of children. But, it can be done!
At the elementary school level, it is a little easier to schedule all that needs to be done than at the middle and high school level. The main strategies we employ center around combining compatible activities, eliminating non-essential tasks, short cuts, and planned retention.
Combining compatible activities is great when it can be managed. This allows two or more goals to be met while saving precious time. For example. a child that needs alternative positioning may be able to listen to today's story while resting in a sidelyer or standing in a prone standing. Children who spend most of their day in a general education classroom may be more difficult to manage, but the same ideas hold true. This may mean having large pieces of equipment in the classroom, which means considering classroom space limitations.
The idea of eliminating "non-essential tasks" is a touchy subject, but sometimes it may be the only reasonable choice. Anytime we change a child's curriculum, its done with parent support. It seems to work best to present the options to parents and let them help you decide which activities can be dropped to allow for the instruction specific to their child. Some content areas such as science and social studies are based on a spiral curriculum in which information is repeated and expanded at each grade level. A child who has a good grasp on community concepts, for example, may be able to be pulled out during this instruction to work on technology goals that don't fit any other place in their day. In some instance, while working on the technology goals, the student may also learn the main areas being covered in community concepts. For example, if the student is learning a new word prediction program, keyboarding program, or AAC device, the student may be typing about the main concepts of community concepts or practicing using the AAC device with an overlay with these concepts. Some students may be scheduled to make up the missing material the next year in conjunction with that grade's community concept materials.
The elimination of certain subjects may be used in conjunction with planned retention. When we look ahead at a child's future goals for independence and learning, it often becomes obvious that we will need more time to accomplish these things. The family and child must buy into a plan such as this, or it will not be successful. For example, the child and their family must all be aware that this child will repeat 2nd grade, then the team plans the student's goals accordingly. The 2nd grade curriculum can be prioritized. Things we might miss this year will be included next year while something else is skipped. The idea of planned retention must be presented as positive. It may be possible to even address the repeating grade by another name such as Level II, instead of grade two the second time around.
At both middle and high schools we use the same principles, but the logistics are very different. The upper grades have so much more inflexible requirements put into their day as well as "computer scheduling" which makes everything more difficult. Hand scheduling is often required. Middle school has exploratory or elective classes which can be used for a special area of instruction or even a rest break if called for. What needs to be in place is a course title and an approved course description. Most classes can be taught under the description of existing courses. Study skills, technology, adaptive PE, health, life skills, and even good old home economics can cover most of our needs. These courses titles are especially important for students following the regular diploma curriculum because of the credits that are required for graduation. (It is important to note that the courses must follow the QCC standards for the student to get credit, but often this can be accomplished along with what needs to be targeted by the OI student.) The preference will always be to keep a regular schedule and try to work goals into the day in those classes but usually it is not possible to do it every year.
Now few of us ever get to serve one child at a time so you may have 3 or 4 courses going on at a time in the same room. One student who has adaptive PE is working on homework while sitting in a therapeutic position, while another student is using the scanning to transfer an assignment into a workable format in a technology class. This period also allows for a chance to use reinforcement programs, take data, and give the tender loving care they all need occasionally.
It is important to cultivate relationships in order to implement these activities in a supportive environment. I have kids write thank you note and bake cookies for teachers and staff that are helpful. When everyone sees our students the way we see them, as capable, smart, and sensitive, any and everything can be possible.
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