Strategies for preschoolers with cerebral palsy should be individualized based on the child's IFSP. Child care staff should work with the Early Childhood Special Education Team to embed goals into everyday routines in the classroom. Embedded interventions are strategies that address specific learning goals within everyday activities, and routines either at home or at school.
This activity will enable you to learn about the practice of embedded interventions to help children participate in a variety of early learning opportunities and environments promoting high quality inclusion.
Click on the link below, then go through the 5-steps to learn more about embedding instruction.
Many young children with CP are not developmentally delayed but difficulty with communication can be a huge issue. The inability to communicate can lead to social-emotional concerns. For example, if the child wants to play with a toy but cannot tell his peer, he could become frustrated and act out.
Child care and preschool educators can help out by learning about the child's communication intent. Can the child engage in behavior that shows he is requesting or protesting? Can the child interact socially by greeting, calling, or imitating? What mode does the child use to communicate: eye contact, gestures.
Children with CP need access to the same curriculum as their nondisabled peers. However materials and toys may need to be modified. Child care and preschool educators need to set up their rooms so that children who are wheelchair bound can easily and safely move around in the room. The child's parent is a great resource in this area. What adaptations have been made at home that can be duplicated in the program setting? The early intervention partners can also help with adapting materials and modifying the room.
As stated earlier, children with CP may have difficulty with behavior if they are unable to communicate with others. Check with the IFSP team to see if there is a behavior plan for the child that include positive behavioral supports that could be implemented during daily routines.
One example of a positive behavior support would be using antecedents, behavior, consequesces or "ABC". Antecedents that are the conditions immediately preceding the child's challenging behavior. For example, if a 3-year-old child with cerebral palsy refuses to open his mouth to eat. Then sitting at the snack table may be an antecedent behavior. The behavior is what the child is doing (i.e., what it looks like), how often the behavior occurs, the length of the behavior's occurrence, and the intensity of the behavior. The consequences are the events that immediately follow the behavior. Examples of consequences include the attention paid by adults or peers in response to the child's behavior, as well as the activities the child either avoids or is enable to do as a the result of the behavior.
How does the child care use this support ??? For example, take note of the antecedent to make modifications to the environment or teach social skills. and ensure that the consequences do not reinforce the behavior - that appropriate behaviors are reinforced instead.....Sometimes behavioral concerns are not so obvious. Children with CP are sometimes described as engaging in "learned helplessness". Learned helplessness occurs when a child may become too dependent on others to meet their needs and do not try to explore the environment or show interests in activities and peers. The IFSP teams and parents work hard from the beginning to insure the child has every opportunity to participate fully in his environment in a productive and appropriate way.
Sarah is a 4 year-old with spastic cerebral palsy. She is in a wheel chair and has limited use of her head but can move her hand when it is positioned on her chair table. Her teacher has placed a single switch jellybean device (small circle switch) that Sarah can activate by pressing the switch with her hand. The children are making milk shakes for lunch. The teacher is helping them to follow a recipe by pouring the appropriate amounts of milk, vanilla, and ice cream into a blender. When the children have added the ingredients, they turn to Sarah and ask her to activate the blender. Sarah moves her hand to activate the switch which is set up to the blender and the ingredients begin to whirl and form. The children all jump with glee and Sarah smiles a big wide happy grin. The teacher helps the children pour the milkshake into cups and into Sarah's adaptive cup so she too can enjoy the results of this activity.
Crystal is a 4 year-old with severe spastic cerebral palsy. She is in a wheelchair and wears AFO's on both feet and has hand splints on both hands. She attends a community-based preschool in her neighborhood. Her parents are applying for a communication device through the Shriners.The one that was recommended by the speech therapist is very expensive and insurance will not cover the cost. So, they are hoping to have the device before Crystal starts kindergarten. In the meantime, Crystal uses facial expressions to indicate her wants and needs.
Leslie, the child care teacher, attends Crystal's IFSP meetings when she can and participated in a training session with the Physical Therapist (PT) and Crystal's mother to learn how to put Crystal into a prone stander and side lyer during the day. Crystal enjoys the preschool and interacting with the other children. With help from their teacher, the children know that Crystal communicates by facial expression when asked a question. At snack time, Joey asked Crystal is she wanted some juice and Crystal raised her eyebrows and smiled, her way of saying "yes". Sarah asked her if she wanted some goldfish snacks and Crystal gave the same response. Later, Sarah asked Crystal is she wanted more goldfish. Crystal made a frown with her eyebrows and turned her lips down. All the children know this means "no".
The Teaching Research Institute | 345 N. Monmouth Ave. | Monmouth, OR 97361 | Voice: 503-838-8785 | Fax: 503-838-8150
To increase font size, click "Control" and "+" for PC, "Command" and "+" for MAC.