MODULE - Learners with Additional Needs

Learners with Difficulty in Self care

INTRODUCTION

In the special needs world, the most basic skills are called
adaptive living skills, or ADLs. More advanced skills, such as doing
laundry, catching a bus, or following a daily schedule, are
sometimes called "life skills" or "skills of daily living." While these skills
aren't critical for survival, they are extremely important for anyone
who plans to work and recreate in a modern community.

Young children with disabilities often demonstrate delays in many

areas of development. Because of these delays, they may need
additional help. In order for children to receive acceptance and
acquire as much independence as possible, it is important that self-
care skills be a focus during the preschool years.

LEARNING OUTCOMES

After working through this module you should be able to :

a. identify learners who have difficulty in self care;
b. describe learners who have difficulty in self care;
c. recognize the uniqueness of various learners who have difficulty in self care
and implications for supports and teaching strategies ;
d. develop a training program for a person with who have difficulty in self care
in personal care, home living, social or community skills;

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 A. ACTIVATE PRIOR KNOWLEDGE
Please click the link below and watch the whole video
https://www.youtube.com/watch?v=YOwDfnoek6E

"DON'T LIMIT ME!"- Powerful message from Megan with Down Syndrome

B. Analysis

1. What makes Megan Powerful?

2. What would you feel if you have a classmate/schoolmate like Megan?

3. How do students like Megan manage to get an education in the

regular school? What adaptation are introduced to make inclusion
work for them?

C. Abstraction

Everyone needs certain skills to simply get through the day. Skills related to
eating, dressing, and personal hygiene are absolute requirements for anyone
wishing to live even a semi-independent life. In addition to these very basic
skills are the many skills we use each day to navigate life at home and in the
community

Learners with intellectual disabilities and learners with autism spectrum and
can be referred to such disorders. Learners with intellectual disabilities and
learners with autism spectrum of cognitive processes, disorders of sensory and
motor functions, thereof, the formation of specific social adaptation means is an
important direction of work. Moreover, Learners with intellectual disabilities and
learners with autism spectrum require special individual-oriented approach
including the development of self-dependence skills, optimization of parental-
children interaction.

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 Learners who have difficulty in self care

A. Intellectual Disability
The term 'intellectual disability' refers to a group of
conditions caused by various genetic disorders and
infections. Intellectual disability is usually identified during
childhood, and has an ongoing impact on an individual’s
development. Intellectual disability can be defined as a
significantly reduced ability to understand new or complex
information, learn new skills and to cope independently
including social functioning. As with all disability groups, there are many types of
intellectual disability with varying degrees of severity. These include considerable
differences in the nature and extent of the intellectual impairments and
functional limitations, the causes of the disability, the personal background and
social environment of the individual. Some people have genetic disorders that
impact severely on their intellectual, social and other functional abilities. Others
with mild intellectual impairment may develop adequate living skills and are able
to lead relatively independent adult lives. Approximately 75 per cent of people
with intellectual disability are only mildly affected, with 25 per cent moderately,
severely or profoundly affected.

Impact of intellectual disability

The characteristics and impact of a person’s intellectual disability will vary

depending on the cause. There are a number of common characteristics that
may have a significant impact on an individual’s learning, including:

• difficulty understanding new information

• difficulties with communication and social skills
• slow cognitive processing time
• difficulty in the sequential processing of information
• difficulties comprehending abstract concepts.

Austed discussions during 2014 highlighted the challenges that students with an
intellectual disability can experience at university level. Students may cope well
with the 'hands-on' components of post-secondary study, but find it difficult to
understand complex information.

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Teaching strategies

It is important to know that despite difficulties

in a learning environment students with
intellectual disability can and do have the
capacity to acquire and use new
information. There is a range of inclusive
teaching strategies that can assist all students
to learn but there are some specific strategies
that are useful in teaching a group which
includes students with intellectual disability:

Provide an outline of what will be taught -

•
highlight key concepts and provide opportunities to practise new skills and
concepts.
• Provide reading lists well before the start of a course so that reading can
begin early.
• Consider tailoring reading lists and provide guidance to key texts. Allow work
to be completed on an in-depth study of a few texts rather than a broad
study of many.
• Whenever you are introducing procedures or processes or giving directions,
for example in a laboratory or computing exercise, ensure that stages or
sequences are made clear and are explained in verbal as well as written
form.
• Students may benefit from using assistive technology.
• Use as many verbal descriptions as possible to supplement material
presented on blackboard or overhead
• Use clear, succinct, straightforward language.
• Reinforce learning by using real-life examples and environments.
• Present information in a range of formats – handouts, worksheets, overheads,
videos – to meet a diversity of learning styles.
• Use a variety of teaching methods so that students are not constrained by
needing to acquire information by reading only. Where possible, present
material diagrammatically - in lists, flow charts, concept maps etc.
• Keep diagrams uncluttered and use colour wherever appropriate to
distinguish and highlight.
• Ensure that lists of technical/professional jargon which students will need to
learn are available early in the course.

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 • Recording lectures will assist those students who have handwriting or
coordination problems and those who write slowly as well as those who have
a tendency to mishear or misquote.
• Students will be more likely to follow correctly the sequence of material in a
lecture if they are able to listen to the material more than once.
• Wherever possible, ensure that key statements and instructions are repeated
or highlighted in some way.
• One-to-one tutoring in subjects may be important; this can include peer
tutoring.
• Students may benefit from having oral rather than written feedback on their
written assignments.
• It may be helpful for students with intellectual disability to have an individual
orientation to laboratory equipment or computers to minimize anxiety.

Assessment strategies

Students with intellectual disability may need particular adjustments to

assessment tasks. Once you have a clear picture of how the disability impacts on
learning, you can consider alternative assessment strategies. In considering
alternative forms of assessment, equal opportunity is not a guaranteed outcome,
it is the objective. You are not expected to lower standards to accommodate
students with disability but rather are required to give them a reasonable
opportunity to demonstrate what they have learned:

• Allow extensions to assignment deadlines

• Use technology to record students work, e.g. digital photography, tape and
video.
• Students may take longer to organize thoughts and sequence material. They
will benefit from discussing their outlines, with particular attention being paid
to appropriate relationships and connections between points.
• Encourage the student to submit an early draft of assignments to allow the
opportunity for feedback to the student as a formative process.
• Students with an intellectual disability will need extra time in an examination
for reading and analyzing questions and for planning their answers. Some
students will request that examination questions be read to them. Some
students may prefer to dictate their answers to a scribe. They will need a
venue which is quiet and distraction-free.
• Keep short your written examination instructions and sentences within
examination questions. Questions using bullet points, lists or distinct parts are
more likely to be correctly interpreted.

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 • Because students with intellectual disability find it difficult to read multiple
choice questions in a way that allows them to appreciate subtle changes in
the arrangement of words, short answer questions will be a better test of their
knowledge.
• Students may benefit from an exam timetable that features a number of days
between exams to assist in exam preparation.
• Many students with intellectual disability are chronic misspells and use
dictionaries only with great difficulty.

B. Autism Spectrum Condition

Autism Spectrum Condition (ASC) is a life-long

developmental disability. The cause or causes of autism
are, as yet, unknown. The developmental disability
impairs (to varying degrees) a person's understanding of
what he or she sees, hears and senses. This results in
problems with social relationships, communication and
behaviour.

People with ASC may have average or above-average intelligence but they can
find the post-secondary education experience daunting and challenging.
However, many students have successful experiences in a range of subjects, most
commonly in mathematics and computing.

Impact of ASC

Whilst the condition varies considerably for each and every student with ASC,
there are a number of characteristics that may be evident. These include:

• ability for extensive factual information

• development of a specialised interest in a specific topic
• advanced vocabulary in a particular topic
• exceptional memory for detail
• a natural affinity for computers
• original and creative thought patterns
• very independent learners.

However, they may also exhibit the following characteristics in the learning
environment:

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 • weakness in comprehension and abstract thought, problem solving,
organizational skills, concept development, and in making inferences and
judgments
• difficulty with cognitive flexibility, tending to think in a more linear way; their
thinking tends to be rigid, they have difficulty adapting to change or failure
and do not readily learn from their mistakes
• tendency to take language literally. Confused by non-literal sayings (e.g.
'get off my back', 'pull your weight') and responding in a way that seems
rude
• difficulty coping with change; preoccupation with a particular subject of
interest which may have been learnt by rote, or obsessions or routines which
interfere with learning
• anxiety - even minor stress may cause increase in coping mechanisms, such
as repetitive behaviors (muttering, other verbal habits), panic, incessant
questioning
• problems with social relationships, and difficulty in making and keeping
friends. In group situations may behave in ways that seem ‘odd’ to others
and may come across as arrogant, rude or withdrawn
• inability to pick up on non-verbal cues and showing poor eye contact; lack
of understanding of sarcasm or irony, or people’s moods and feelings
• difficulty in understanding or communicating feelings - may be unable to
predict or understand others’ behavior (in group work may not naturally
consider other people’s wishes or needs)
• difficulty interpreting and understanding social situations and
communication cues
• poor organizational skills, poor coordination, clumsiness, odd postures and
poor gross motor skills
• speech which is pedantic and monotonic
• Overly sensitive to sounds, tastes, smells and sights, even sensory stimuli that
others may not perceive.

Teaching Strategies

Despite being very intellectually able, students with Asperger's syndrome often
show characteristic behaviors that can disrupt their learning. However, students
with this condition can excel academically if appropriate support and
awareness is in place. There are a number of strategies that can assist these
students to learn effectively:

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 • Get to know the student’s particular needs in advance - meet them before
the course starts to discuss needs.
• Provide clear, detailed information (oral and written) about the structure of
the course, practical arrangements, assessment requirements and
deadlines.
• Be consistent in approach and keep variations to a minimum. If a change
(e.g. in timetable, room, lecturer) is inevitable, give clear, specific
information as far ahead as possible, e.g. around exam time.
• Use clear, unambiguous language (both spoken and written) and either
avoid or else explain metaphors, irony etc. and interpret what others say.
Give explicit instructions and check that the student is clear about what
he/she has to do.
• If providing feedback, be very clear about what is inappropriate or
appreciated, and why.
• Be patient, encouraging and supportive but guide the student back on task
if necessary.
• Present course materials and instructions in a structured way using literal
language.
• Show how components fit together as a whole. Provide subject word lists,
glossaries of terms and acronyms.
• In group work make clear exactly what is required of students with
Asperger's syndrome and mediate to resolve disputes in a calm, logical
way, providing an opportunity immediately after group sessions to check
that they have understood. If group-work proves too stressful, provide
alternative ways of completing team work.
• Students may have difficulties in motivation for certain parts of their course
due to a particular interest in one aspect of it. Set concrete, realistic goals to
assist motivation, e.g. 'If you want to become an engineer you must
complete all parts of the course, even the essays'.
• Provide access to pastoral support or a particular staff member who can
provide support if the student becomes distressed.
• Provide specialist tuition support, e.g. language skills, structuring work.

Assessment Strategies
• Students may benefit from the opportunity to look at the instructions and
structure of examination papers before the exam so that any confusion can
be dealt with and anxiety minimised.

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 • The language and rubric of examination papers need to be both explicit
and literal. For some students, multiple choice papers can be particularly
confusing and alternative testing modes may be appropriate.

There are four main types of self-care skills:

A. Self-feeding. The best way to build independent

feeding skills is to learn the normal developmental
stages of self-feeding. Encourage children to practice
feeding themselves from infancy on. Begin by offering
older infants finger foods. Introduce a spoon and fork
and give children plenty of time to practice. Let
children be as independent as possible during
mealtimes. Give them the tools they need to be
successful. Consider bowls that attach to the table,
child-sized utensils and small cups with handles and
spouts (such as measuring cups) for pouring.
Encourage children to try for themselves but provide
help and encouragement when needed so they
don't get frustrated.
B. Independent dressing and grooming. Encourage children to dress and
groom by themselves; just provide minimal assistance. Begin with older
infants and toddlers by encouraging them to help pull socks on and off, pull
up pants after diapering and help put their arms through sleeves. As
children get older, encourage them to dress themselves but help with
challenging steps such as zipping and buttoning.
C. Hygiene and toileting. Look for signs of readiness for toileting. Encourage
children learning to use the toilet to climb on and off the toilet seat, pull
clothing up and down, and wash their hands independently. Also teach
children how to brush their teeth after lunch and snacks. Be ready to
provide support and help if they need it. Encouraging children to take care
of everyday hygiene routines and to use the toilet independently helps
them learn how to become more independent and self-sufficient, and frees
up your time to help children with other activities.
D. Helping with daily chores like table setting
and picking up toys. Encourage children to
help with clean-up early on. Give toddlers
responsibility for placing napkins or utensils
on the table. Encourage children to begin
clearing their own plates when they are old
enough to carry them without dropping
them. When children are involved in regular

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 chores starting before the age of 4, they tend to be more independent in
early adulthood than children without the experience of helping out.
E. Self-care skills are worth the time and effort in a child care program. The
secret to success is to give children age-appropriate experiences and
provide the appropriate supports to help children be successful. Child care
providers can offer opportunities for children to develop self-care skills and
give them ample time to work on these important tasks. Remember that
adults are important role models. We model self-care skills; children learn a
great deal from watching us.

Techniques to promote self-care skill acquisition:

a. Rewards: Give rewards to the child each time they perform a self care task,
or a part of a task. Rewards can be edible, social rewards, activity rewards,
material rewards or even privileges. Tokens are another way to teach and
reinforce self care skills. Make a chart where you add a star everyday if the
child has completed the task independently. At the end of the month, the
child gets a reward based of the amount of stars they got. Different children
benefit from different rewards depending on their level of understanding.
Use appropriate rewards. Researched-based rewards are individualized,
age-appropriate, and naturally occurring in the environment. A naturally
occurring reward for drinking from a cup is relieving thirst. When the child
first begins to learn to use a cup, say, “Look at you! You can drink from a
cup!”
b. Forward Chaining: Forward chaining is the process where you break up a
task into small steps, and teach the first step. Then you get the child to do
the first step, and you complete the rest of the task. Then you teach the
second step. After that, you make the child do the first two steps and you
complete the rest of the activity. Forward chaining is usually used to teach
tasks where the last step is very difficult.
c. Backward Chaining: Backward chaining is the opposite of forward
chaining. Here you teach the last step first, then the second last step and
so on. So, you do all the steps except for the last step and get the child to
do the last step. Backward chaining is more fun for the child, because it
helps them feel that they completed the activity. It is used quite often in
training of self care skills.
d. Repetition: Repetition is one of the best ways to reinforce and learn a task.
The best part about self care skills is that you need to do them every day,
and often more than once in a day. Help the child practice his skills every
single time he does that activity.
e. Shaping: Shaping is when you reward and appreciate the child when they
are approximately able to do the task. It means that you don’t look for
perfection. If a child takes the comb to his head n moves the comb, you
reward him and appreciate him for it. It’s ok if he can’t completely comb

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 his hair, or even if he ends up messing up his hair. Shaping is used in the
earlier stages of training.
f. Grading: Grading is when you give a simple activity to start with, and slowly
increase the complexity of the task. Some ideas for grading are – using a
large comb, teaching buttoning on large buttons, teaching dressing with
over-sized clothes.
g. Adaptations: Sometimes planning lessons or an independent living skills
curriculum is not enough. Some children with special needs, especially
children with physical disabilities may need to be taught an adapted way
of performing the task. They may also benefit from some adaptive
equipment.
h. Adapting the environment: Some adaptations in the environment that can
help are a wheelchair accessible toilet, a bath chair, a low sink. Keeping
the clothes and other belongings of the child at an accessible height will
promote independence.
i. Adapting the technique: Sometimes, adapting the technique can help the
child to be independent. For example, stabilizing forearms on the table
before eating, or sitting down on the bed and putting on pants. An
occupational therapist will be able to advise you on techniques based on
the child’s needs.
j. Adaptive equipment: There are a lot of different adaptive equipment that
can help a child with special needs to be independent. Modified spoons,
long handled reachers and modified clothing are some examples.
k. Select appropriate prompts. While teaching a child to eat with a spoon, for
example, the teacher can move from full physical assistance to assisting
the child only when moving the spoon directly into his mouth. You may
need to use hand-over-hand assistance, but this support needs to be faded
as the child becomes more independent.
l. Establish a routine. Routines pay a critical role in the formation of self-care
skills. For example, putting on a jacket before going outside to play is a self-
care skill that is routinely done prior to outdoor play. Brushing teeth after
lunch is another self-care skill that is part of the daily schedule.

Learning, rather than time, should be the focus. It may take longer for a child with
a disability to master these skills. Persistence and consistency are the keys to
success.

Professionals: Get help from professionals as needed is important.

Expectations: Expect positive outcomes. Sometimes we do not attempt to teach

self-care skills to children with cognitive disabilities because we have low
expectations. If we expect children to succeed, there is a higher probability that
they will.

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Integrate: Integrate opportunities to promote self-care skills throughout the day
and during play will provide needed practice for successful mastery of targeted
skills. Having dress-up clothes in the housekeeping center, for example, provides
an excellent opportunity to reinforce buttoning, zipping, snapping, and tying.

Responsibility: Child care providers can help young children become

independent by allowing and encouraging them to take responsibility for
themselves whenever possible. It can be faster and less messy to do things for
children, but they learn so much more from doing things for themselves. When
children practice self-care skills such as feeding and dressing themselves, they
practice their large and small motor skills, gain confidence in their ability to try
new things and build their self-esteem and pride in their independence.

Stories: Talk about various independent living skills through stories. Use stories also
to talk about work, different jobs, and the value of money. All this will help the
child be motivated to be independent, get a job and support themselves when
they grow up.

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REFERENCES

Inciong, T., Quijano, Y., Capulong, Y. & Gregorio, J. (2007). Introduction to

Special Education. Quezon City: Rex Printing Press Company, Inc.

Handbook in Special Education SPED Division

Managing Children with Special Needs. A special Education Handbook

Inciong, T., Quijano, Y., Capulong, Y. & Gregorio, J. (2007)
K.Eileen Allen, G.E. Cowdery (2012). The Exceptional Child. Inclusion in Eary
Chidhood Education. Wadsworth Cengage Learning

https://www.verywellfamily.com/teach-self-care-skills-to-children-with-special-needs-
4128821

https://www.google.com/search?q=intellectual+disability&tbm=isch&chips=q:intellectu
al+disability,g_1:autism:DNTFf31kJAc%3D&hl=en&sa=X&ved=2ahUKEwiMkt6O0r_rAhULBJ
QKHUifBmAQ4lYoAnoECAEQGA&biw=1343&bih=657#imgrc=loqS0rhIVVXoRM

https://www.youtube.com/watch?v=YOwDfnoek6E

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