Meeting the Needs of Children and Families-EpilepsyECEP 233 063- Inclusion of Children with Special NeedsNadia Quest300653498April 4, 2013Lisa McCaie

Needs of the child• Mom was told that Zenna has epilepsy• I observed that Zenna has atypical development in many

areas of development

Needs of the family• Zenna’s mother was recommended to stay on complete bed

rest because she has a difficult pregnancy and is at risk of delivering the unborn baby prematurely.

• Her mother was told that she has epilepsy and doesn’t know what to do

What is epilepsy?• “a chronic disorder of the

brain resulting in the tendency to have reccurent seizures” (Haugen, H. p.42)

• This disorder affects how the cerebral cortex functions, causing the neurons to fire off faster than normal in little bursts of electricity sending the body mixed up messages, which results in an epileptic seizure (Haugen, H. p.4)

• A pattern of chronic seizures over a long period

Understanding epilepsy videoDr. Fisher, MD, Professor of Neurology and Director of the Stanford Epilepsy Center

http://www.youtube.com/watch?v=MNQlq004FkE

Symptoms of a seizure

Minor

• Staring into space• Lip smacking• Arm and leg jerking• Blurry vision or a brief

loss of hearing

Worst

• Fall to the ground in convulsions and pass out (unconsciousness)

What causes it?• 50-70% is unknown• 8% is inherited from parent, there’s a higher risk if parent has

epilepsy• Males are more likely to have epilepsy• It can develop at any age, most common under twenty • It can happen as a result of trauma to a baby during birth from

the lack of oxygen to the brain• Poisons like lead in paint, mercury in thermometers and

carbon monoxide in gasoline can also cause epilepsy

Some common triggers• Flashing or flickering

lights• Stress (too much)• Not enough sleep• Poor diet

Categories of seizures

Partial Seizures

• Occurs in one area of the brain

• Only one area of the body is affected, if occurs in the area that controls vision is affected causing it to be blurry

Generalized Seizures

• Spreads throughout the brain affecting more than one area at a time

• Grand mal-loss of consciousness, contraction of muscles, last from three to five minutes, longer recovery

• Petit mal-stare into space, pause during conversation, lasts thirty seconds, no recovery time needed

Adaptations to the Physical Environment

Removal of Barriers• The classroom should

have some open space with wider paths just in case she were to fall to the ground, there would be less objects to hit into

Physical Space• Have a “rest area”

available for when she is recovering from a grand mal seizure because she will feel tired and confused

• Or a “safe spot” for the her to lie down if she can tell when a seizure is coming

Adaptive DeviceWorking Service Dog: Seizure-Alert Dog• A specially trained seizure-

alert dog is very helpful to have because it can alert Zenna to let her know she’s about to have a seizure so she can get to a safe spot

• This dog will “react to this by circling the owner, pawing at the ground, or barking” (Wright,S. p.39)

Flexibility in Routines, Schedules & Activities

• If I was a caregiver at a center or in a school the daily schedule will follow an order but flexible with time because if Zenna has seizures throughout the day she will require extra attention

• She may need time to rest and recover after, so I would tell her to join in when she’s ready

• If she misses out on an activity or didn’t finish I can make some time in the schedule to make it up

Safety & Safe Risk taking• Depending on what

type of epilepsy Zenna has, she may not be able to take part in all sports activities so I will always take precautions against possible dangers when Zenna is bike riding, climbing and doing contact sports, and have a helmet available

• Baby proof the corners of shelves and tables with cushioning material to reduce injury if she were to pass out

Collaborative Planning• Make sure that all the

staff are aware of Zenna’s special need and share ideas, working together to help her and to promote an inclusive environment

• Work with other professionals to support and guide Zenna

Staff Support & Training• The caregivers in the

room should have a workshop to learn about what happens during a seizure and trained in first aid procedures for grand mal seizures, if Zenna has this type of seizure

• Staff should be aware of the signs of a seizure and triggers to avoid

Parents of the Child with Special Needs

• I will warmly greet her mother each day and give her verbal support

• I can have resources available like brochures for Zenna’s mother to gain more information about epilepsy and learn about the services and agencies that can support them

Inclusion of the Child• Modifications to the physical environment can be made to

support Zenna’s development, encourage participation and independence

• Zenny will be treated with respect and fairness from the staff and other children in child care setting

• Teaching the other children about Zenna’s special need could reduce some of their fears and to gain an understanding and acceptance

How to involve the other children

Depending on the age of the other children:• Teach the other children in the room about epilepsy using

books and role play so that they can help if needed• The other children can learn the signs/symptoms of a seizure

to call a teacher and know what the triggers are• Let the children know where to find cushions in the case of a

seizure• If the seizures may be too traumatizing for the other children

the caregiver can make arrangements to bring the children to another room

Inclusion of the Family• One thing I could do is advise Zenna’s mother to sign a form

14 to get access to services that are available to help her and give relief to the family with support.

• Make a written document (log) from observations I made of Zenna throughout the day to share with her mother.

• Have open communication with her mother about Zenna’s progress and be available to talk with her when needed in person or by phone.

First Aid for seizures

• http://www.youtube.com/watch?v=rW4ThDRvzcE&feature=player_embedded

Teaching Strategies• As an ECE I could record observations

to work with a Resource Consultant to make and implement Individual Program plans, if she was in a child care centre, and Individual Education Plans, if she is in school, to help her reach her full potential and implement the IPP’s

• If Zenna has seizures she will miss out on learning so the “IEP is a written plan and is a working document that describes the strengths and needs of an individual exceptional student, the special education program and services established to meet that student’s needs, how the program and services will be delivered and how the student is progressing” (tdsb glossary, website)

• The IPP’s and IEP’s “include thoughts, ideas, observations, strategies and solutions” (Class notes, week5 )

Agencies & Resources

Resource Teacher or Consultant• The Resource Teachers

can help provide schools an opportunity to meet the needs of Zenna while maintaining a traditional environment.

• It will give Zenna an opportunity to interact and learn with the other children

Toronto District School BoardGeneral tel: 416-397-3000 Email:communications@tdsb.on.ca

Paediatrician• The “Paediatrician

specializes in child development and medical care for children” (Week 9 notes)

• He will be able to help Zenna’s mother monitor her development

Dr. Peter Azzopardi3030 Lawrence Ave EToronto, ON M1P 2T7

(416) 431-5292

Neuropsychologist• Zenna’s mother can

talk to this specialist about any concerns she may have about her learning abilities she may have

• Conducts assessments and provide family treatment and support

Dr. Elizabeth KerrThe Hospital for Sick Children555 University AvenueToronto, ONM5G 1X8Canada

Social Worker• The social worker can

refer Zenna’s mother to services that are provided and direct her to community supports and services (Week 9 notes)

• They can help Zenna’s family to adjust to any problems they may have in their lives

Malvern Social Services Office (OW)325 Milner Avenue, 9th Floor, TorontoPhone: 416 397-1000, 416-397-1010

Psychiatrist• This specialist could

provide assessments, monitor medications she may receive or treatments

• They can also offer family councelling

Dr. Susan BradleyThe Hospital for Sick Children555 University AvenueToronto, ONM5G 1X8Canada

Tel:416-813-8150

Family Doctor• Zenna’s mother can

bring her for regular check ups

• The doctor can help them find support

• If Zenna wasn’t diagnosed by her family doctor her mother could bring her to get diagnosed and referrals for accessing and diagnosis

Dr. Naznin LalaniScarborough Medical2680 Lawrence Avenue EastScarboroughOntarioM1P 4Y4Tel: 416-755-2242

Public Health Nurse• A nurse can “provide

information on healthy growth and development of children, immunization and resources, supports and services in their community” (Week 9 class notes)

• The nurse can also help Zenna’s mother to receive care at home while she’s on bed rest

• Call 3-1-1 for information and referrals

Relief Worker• A Relief Worker “works

with the child with special needs within the home to allow relief for the parent” (Week 9 class notes)

• Zenna’s mother has difficult risky pregnancy and should be on bed redt so a Relief Worker is important because he/she will be able to work with Zenna at home so that there is less travelling

St. Elizabeth2 Lansing SquareSuite 600Toronto, ONM2J 4P8

Phone: 416-498-8600Fax: 416-498-0213TorontoCentralSDC@saintelizabeth.comhttp://

www.saintelizabeth.com/About-Saint-Elizabeth.aspx

Special Education Teacher• “Specialty teacher who oversees and may also implement the

education and development of children with special needs” (Class notes, week9)

• If Zenna is in school this teacher would help her to plan an education program for her

Toronto District School BoardGeneral tel: 416-397-3000 email: communications@tdsb.on.ca

Early Childhood Educator• An Early Childhood Educator “observes, participates in creating and

implementing IPP’s, make adaptations in the environment, supports families, links with other professionals, etc” (Class notes, week9)

• An ECE understands the importance of teamwork and collaboration with other professionals to meet the needs of that child and promote inclusive environments

• An ECE knows the importance of being connected with the families as partners in their child’s learning and development and supports the needs of the families using resources

Epilepsy Toronto • Epilepsy Toronto “prioritizes

individual needs, the importance of living as independently as possible and the benefits of community engagement. Our programs address all aspects of epilepsy from the first diagnosis of a child, to the struggles that young people face, to adult needs such as employment and relationships” (Epilepsy Toronto website).

• They are a non-profit agency that supports people with epilepsy

• Free programs and services are offered, and they provide information about epilepsy

• Services are available to people who have and don’t have epilepsy

• They have a support group for parents of young children with epilepsy, to share their experiences and talk about challenges and happy times raising children with epilepsy

• Child, parent and family counselling services are available to provide information on issues surrounding epilepsy and the impact seizures have on their development

• A counselor works with parents, school and agencies to help the child adjust

Epilepsy Toronto468 Queen St. EastSuite 210Toronto, ONM5A 1T7

Phone: (416) 964-9095Fax: (416) 964-2492E-mail: infoepilepsytoronto.orgWebsite: www.epilepsytoronto.org

http://epilepsytoronto.org/index.php

Canadian Epilepsy Alliance• Canadian Epilepsy Alliance

mission is “The CEA/ACE is a partnership between grassroots epilepsy organizations Canada-wide dedicated to the promotion of independence, quality of life, and full community participation of persons with and affected by epilepsy, through innovative support services, advocacy, education and public awareness”.

• Linked with Epilepsy Toronto and Epilepsy Ontario

http://www.epilepsymatters.com/english/index.html

Epilepsy Ontario• Epilepsy Ontario “is dedicated

to promoting independence and optimal quality of life for children and adults living with seizure disorders. Through a network of local agencies, contacts and associates across the province, Epilepsy Ontario reaches out to people with epilepsy and their loved ones. We do this by providing client services including counselling and referrals, information education and advocacy services” (Epilepsy Ontario website).

• Charitable non-profit non governmental health organization

• provides client services, counselling and referral services

• “funding is entirely from the general public, including contributions from corporations, foundations, patrons, individuals and generated from special events”(Epilepsy Ontario)

Epilepsy OntarioSuite 8033100 Steeles Avenue East Markham, ON Canada L3R 8T3

Tel: 905-474-9696 Tel: 1-800-463-1119 (toll free in Ontario)Fax: 905-474-3663 Website: info@epilepsyontario.orgHours of operation: Monday to Friday 9am – 4pm (EST)

http://epilepsyontario.org/

Sick Kids Epilepsy Classroom• The Epilepsy Classroom

“caters to the individual learning and social-emotional needs of children who have intractable Epilepsy, that is, ongoing seizure activity despite maximal medical treatment, as well as children who have recently undergone brain surgery for intractable Epilepsy” (Sick Kids website)

• Partners with local schools like the TDSB to provide programming

• Onsite consultants such as Clinical Neuropsychologist, Social Worker, Developmental Paediatrician, Clinical Nurse, Neurologist, Psychiatrist

• Sick Kids Epilepsy Classroom has “a multidisciplinary team which incudes a special education teacher, educational assistants, development paediatrician, neuropsychologist and social worker to better understand the interplay between epilepsy and each student's learning profile and social-emotional needs”(Sick Kids website).

• A referral can be made by a parent, teacher/school, neurologist, paediatrician, family physician or other professional.

Elizabeth N. Kerr PsychologyThe Hospital for Sick Children555 University AvenueToronto, ONM5G 1X8Canada

Phone: 416-813-6784Fax: 416-813-8839http://

www.sickkids.ca/ProgramsandServices/Epilepsy-Classroom/index.html

References• Haugen, H. (2005).Understanding Diseases and Disorders:

Epilepsy. Farmington Hills, MI:Thomson Gale Corporation• Wright, S. (2004). Health Issues: Epilepsy. Chicago, IL:Raintree• Epilepsy Ontario. Retrived from http://epilepsyontario.org/• Epilepsy Toronto. Retrived from http://

epilepsytoronto.org/index.php• Canadian Epilepsy Alliance. Retrived from http://

www.epilepsymatters.com/english/index.html• Class notes. Week 5. The Role of the Early Childhood Educator. • Class notes. Week 5.Adaptive Learning Environments. Class

notes Week 5.• TDSB Glossary. Retrived from http://

www.tdsb.on.ca/wwwdocuments/about_us/communications/docs/TDSB_glossary.pdf

Image References• Junk food. Retrived from

http://marginalmatters.wordpress.com/2012/05/08/glycemic-index-your-guide-to-healthy-food/• TV with video game. Retrived from http://www.clipartguide.com/_pages/0060-0807-2100-1320.html• Stress. Retrived from http://www.clipartguide.com/_pages/0060-0807-2100-1320.html• Children at window. Retrived from http://

www.shutterstock.com/pic-22463695/stock-vector-cute-illustrated-children-looking-out-the-night-window-at-the-stars.html

• Child on cushions. Retrived from http://www.premiersolutions.co.uk/detail.php?id=19• Children holding hands. Retrived from http://ajonesfamilyfoundation.org/program/helping-kids/• Brains. Retrived from http://www.epilepsycareandresearchfoundation.com/epilepsy-and-children.html• Mother and daughter. Retrived from http://

www.123rf.com/photo_610479_pregnant-mother-and-daughter-embracing.html• Quiet area. Retrived from http://connectability.ca/2010/10/29/classroom-layout-tips/• Epilepsy classroom Sick Kids. Retrived from http

://www.ehphblog.org/2012/in-school-education/sickkids-epilepsy-classroom-program/• Google Maps. Retrived from http://maps.google.ca/maps?hl=en&tab=wl• Family for Epilepsy Toronto. Retrived from http://epilepsytoronto.org/aboutus.php• Canadian Epilepsy Alliance. Retrived from http://www.epilepsymatters.com/english/index.html• Epilepsy Ontario. Retrived from http://epilepsyontario.org/• Nurse. Clip Art.• TDSB logo. Retrived from http://www.tdsb.on.ca/aboutUs/• Children in a circle. Retrived from http://cmascanada.ca/2011/04/20/inclusion-what-does-it-mean/

Image References cont...• Classrooms. Retrived from http://

connectability.ca/Garage/wp-content/themes/connectability/plugin/si_tipsheets/creating-Positive-environment.pdf and http://connectability.ca/Garage/wp-content/themes/connectability/plugin/si_tipsheets/classroom-layout.pdf

• Child with dog. Retrived from http://4pawsforability.org/seizure-assistance-dog/• Service dog. Retrived from http://www.jumpingwaves.com/tag/seizure-alert-dog/• Schedule. Retrived from http://lessonpix.com/articles/9/33/Visual+Schedules• Teacher and child. Retrived from http://

www.123rf.com/photo_9094087_child-painting-in-preschool-teacher-help-by-little-girl.html• Play learn and grow together. Retrived from http://ourlittlesmarties.com/2010/12/meet-the-teachers/• Parent, teacher & child. Retrived from http

://highergrade.ca/resources/parent-resources/effective-parent-teacher-conference/• Three teachers planning. Retrived from http://www.cpblakely.ca/News.php?news_id=1707• Group of teachers in workshop. Retrived from http://www.radiuscentre.com/workplace-workshops.php• What are we doing now schedule. Retrived from http://

www.preschoolplaybook.com/2008/10/visual-schedule.html• Hands. Retrived from http://trailstoglory.webs.com/• Cushioned table corner. Retrived from http://

www.safecareireland.com/products/product/c/safety-cushions-pads/p/table-corner-cushion.html• Resource teacher. Retrived from http://

woman.thenest.com/special-education-resource-teacher-duties-1577.html• ECE holding hands with children. Retrived from http://www.cotr.bc.ca/ECE/• Brain with captions. http://www.ieaecell.org/epilepsy-03.html

Video References• Understanding epilepsy. Retrived from

http://www.youtube.com/watch?v=MNQlq004FkEhttp://youtu.be/MNQlq004FkE• First aid for seizures. Retrived from

http://www.youtube.com/watch?v=rW4ThDRvzcE&feature=player_embedded