Fillable CDA Credential - Preschool, Part 11 (#31727)

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CDA Credential - Preschool, Part 11 (#31727)
Understanding principles of child development and learning
Planning a safe and healthy learning environment
Observing and recording children's behavior
Presenters: Charlotte Hendricks, PhD; Amanda Schwartz, PhD; Tara Warwick, MS, OTR/L; Erika Flores, BS, MEd; Karen
Deerwester, MA, EdS; Heather Olsen, EdD; Cara Koscinski, BS, MOT, MOT, OTR/L; Michelle Lombardo, DC
How to use this handout:
This course handout accompanies Preschool, Part 11, one of twelve courses, that together comprise continued’s
Preschool CDA Credential coursework. The Preschool, Part 11 handout compiles handouts from the 10 course modules
into a single interactive document. Please follow the guidelines below.
§ Click on the title of the course module to quickly navigate to the associated hando
ut.
§ Expand or collapse the bookmarks on the left side pane to navigate to main sections.
§ Look for the icon below a slide to enlarge key images.
§ Click on
i
con to return to List of Course Handouts
§ Watch for knowledge check slides within the slide ha
ndouts to practice for the exam.
§ Preview the exam questions before beginning the coursework.
§ Once you’ve viewed all 10 course modules, review the Next Steps to complete Preschool, Part 11.
If you would like to print handouts specific to one of the ten modules, please use the interactive navigation to print only
the desired pages.
1
CDA Credential - Preschool, Part 11 (#31727)
Course Title
Presenter
1
Nutrition Activities for Preschoolers
Charlotte Hendricks, PhD
2
Active Supervision for Preschoolers
Amanda Schwartz, PhD
3
Five Steps to Create a Functional Behavior Assessment
Tara Warwick, MS, OTR/L
4
Creating a Behavior Intervention Plan
Tara Warwick, MS, OTR/L
5
Strategies for Working with Preschool Dual Language Learners, in
partnership with Region 9 Head Start Association
Erika Flores, BS, MEd
6
Potty Training at School
Karen Deerwester, MA, EdS
7
Outdoor Play: Health and Safety for Preschoolers
Heather Olsen, EdD
8
Down Syndrome - Preschoolers
Cara Koscinski, BS, MOT, MOT,
OTR/L
9
Keeping Preschoolers Safe Throughout the Day: Use Routines-
Based Strategies
Amanda Schwartz, PhD
10
Empowering Kids to be Healthy and Smart from the Inside Out!
Michelle Lombardo, DC
2
Preschool, Part 11 Exam Preview:
Question 1: What is the purpose of a functional behavior assessment?
A: To create a hypothesis about a behavior
B: To implement an intervention plan
C: It is required by state law
D: To determine special education eligibility
Question 2: Which of the following behaviors is measurable and observable?
A: Inattentive
B: Refusal
C: Hitting
D: Meltdown
Question 3: If there is a behavioral intervention plan in place for a child but the target behavior has not changed, what should you do
first?
A: Make a new plan
B: Send a referral to special education
C: Check to make sure plan is being implemented consistently
D: Revise the plan
Question 4: Alternative seating options for children who slouch during mealtimes or activities may include:
A: Propping with foam wedges or pillows
B: Wiggle cushions
C: Bean bags
D: All of the above
Question 5: How can you support peer relationships while reading books with preschool children?
A: Pair children up to explore books together
B: Have all children sit quietly during book reading
C: Encourage children to memorize books
D: Correct children who give the wrong answers to questions
3
Preschool, Part 11 Exam Preview (continued):
Question 6: Which of the following activities is not appropriate for 3 year olds?
A: Placing napkins and forks on table
B: Handing out milk cartons
C: Passing a large serving bowl
D: Discarding trash
Question 7: One strategy you can use to prevent preschool injuries all throughout your day is:
A: Plug protectors in electrical sockets
B: Play classical music all day to keep children calm
C: Active supervision
D: Always use a loud voice so children pay attention
Question 8: One of the most critical times to use active supervision is during:
A: Group times
B: Free play
C: Transitions
D: Mealtimes
Question 9: A positive potty environment for preschool children includes which of the following?
A: Stable and predictable routines, as well as easy to clean clothing and surfaces
B: Use of a timer in the bathroom so children do not dawdle
C: Use of adult bathrooms to help children get used to them
D: A system of reward, bribes and consequences for children who are successful and unsuccessful
Question 10: To facilitate physical development outdoors, include the following activity:
A: Obstacle course
B: Reading
C: Dramatic play
D: Sand and water play
4
Nutrition Activities for Preschoolers
Charlotte Hendricks, PhD
5
Return to Course Module Listing
Knowledge Check
After this course you will be able to answer the following question:
Which of the following activities is not appropriate
for 3 year olds?
A. Placing napkins and forks on table
B. Handing out milk cartons
C. Passing a large serving bowl
D. Discarding trash
Nutrition Activities
for Preschoolers
Presented by: Charlotte Hendricks, PhD
ChildHealthOnline, LLC
www.childhealthonline.org
Learning Outcomes
At the end of the session, the participants will be able to:
§ Discuss appropriate meal service, including family style.
§ List ways to integrate developmentally appropriate
activities within daily routines and curriculum.
§ List safety considerations for young children involved in
food-related activities.
Food-related activities, including
modeling and family-style meal service,
can promote healthy eating habits that
last a lifetime!
6
Nutrition Activities for Preschoolers
Breakfast Today
To the tune of:
“Twinkle, Twinkle Little Star”
Breakfast, breakfast,
On my way,
Breakfast, breakfast,
Every day.
In the morning to start me right,
Breakfast is such a wonderful sight.
Breakfast, breakfast every day,
I eat breakfast once a day.
Family Style
§ Help children to serve themselves and pass food
to others.
§ Offer appropriate portions at least two times.
§ Begin development of table manners.
§ Encourage pleasant conversation.
Mealtime set-up song
To the tune of:
“This is the Way We Wash our Clothes”
This is the way we set the table, set the table, set the table.
This is the way we set the table, ready for a meal.
This is where we put our plate, put our plate, put our plate.
This is where we put our plate, ready for a meal.
This is where we put our glass, put our glass, put our glass.
This is where we put our glass, ready for a meal.
Other verses: Napkin, Fork, Spoon, Knife
Adults provide. Children decide.
§ Adults are responsible for providing nutritious appetizing
food in an appropriate setting.
§ Children are responsible for how much they eat.
§ Serve all foods at one time.
Model healthy eating. Share the same menu.
7
Nutrition Activities for Preschoolers
Children are encouraged to eat or taste
each food.
§
Offer each food at least two times during the
meal.
§
Get the food on the taste buds at least 15 times
during the year!
§
If you don’t like the food, try it; you might like it!
Smile!
Wash hands
§ Wash both big and little hands before handling
food.
§ Wear gloves when handling food.
§ Adults or children who are ill or with open sores
should not handle food.
Share food, not germs!
§
Clean and sanitize eating area before and after
each use.
§
Supervise children to discourage sharing of food
and utensils.
Prevent Choking
Why are young children at risk?
§ Do not chew long enough.
§ May not have back teeth to grind foods.
§ Try to swallow too much food at one time.
§ May have difficulty swallowing liquids and solids
together.
§ Have too much activity during eating.
8
Nutrition Activities for Preschoolers
Chew Chew Slo-o-owly
To the tune of:
“London Bridge is Falling Down"
Chew your food, take tiny bites,
tiny bites, tiny bites.
Chew your food, take tiny bites,
Chew, Chew SLOWLY.
To the tune of: "Row, Row, Row Your Boat”
Chew, Chew, Chew your food,
Chew it very fine.
SLOWLY, SLOWLY, SLOWLY, SLOWLY,
Take your sweet ol' time.
Food Safety
§ Be aware of dietary restrictions such as food
allergy or intolerance, cultural or religious
preference, or food preparations.
§ Avoid restricted ingredients in all food activities.
§ Avoid foods that present choking risk.
Food activities with children
§ Supervise all activities.
§ Match tasks to children’s capabilities.
§ Provide clear simple instructions, and
demonstrate.
§ Repeat instructions before the child begins a
task.
§ Incorporate cleanup with each job.
9
Nutrition Activities for Preschoolers
ENLARGE
Food activities
§ Provide opportunities to explore through the five senses.
§ Provide opportunities to try new foods.
§ Integrate nutrition with other curriculum domains.
Growing, Growing Strong! Fitness and Nutrition
www.redleafpress.org
Nutrition
Education
Where does food come from?
§ Science: count seeds, compare seeds, grow seeds
§ Language: Read stories
§ Growing Vegetable Soup
§ Pancakes, Pancakes!
§ Math: Count fruit and vegetable models
§ Art: Sort fruits and veggies by color, shape, size, and feel.
Two-year-olds can...
Te a r, ro ll , p a t, sp re a d , sha ke , a n d s tir !
§ Cooking activities should allow for taste, touch, sight, and
smell.
§ Use lots of color and texture.
§ Let them explore their own combinations of food.
10
Nutrition Activities for Preschoolers
ENLARGE
Three-year-olds can...
Mix, pour, knead, pound, grate, chop, share, tear, pat, roll,
stir, shake, place, and put!
§ Do things for themselves.
§ Enjoy lots of movement.
§ Use utensils that are not sharp or dangerous.
Two- and three-year-olds can…
§ Wash hands
§ Shuck corn
§ Wash vegetables
§ Snap beans
§ Wipe table
§ Tea r l et tu ce
§ Peel bananas
§ Place items in trash
§ Clear own table setting
Four-year-olds can…
Use recipe cards, sequence, follow directions, measure,
weigh, take turns, cut, mix, pour, knead, pound, grate,
chop, share, tear, pat, roll, stir, place, and put!
§ Have some understanding of time.
§ Begin to look at parts and whole.
§ Learn about opposites.
§ Understand simple graphs.
§ Learn about their community and other cultures.
Orange Sipper
§ Cut a seedless navel orange in half.
§ Place one half in a zipper plastic bag. Remove all air and
seal tightly.
§ Let child squeeze the orange in the bag to release juice.
§ Carefully open one corner of the bag. Insert straw. Drink
and enjoy!
11
Nutrition Activities for Preschoolers
Food preparation
three- and four-year-olds can…
§ Break clean eggs into bowl
§ Measure and mix ingredients
§ Open packages
§ Knead and shape dough
§ Pour cereal, milk, and water
§ Make sandwiches
§ Tos s s al ad s
§ "Wash" baking utensils
Food preparation
five-year-olds can…
§ Make muffins using prepared mixes
§ Use blenders or hand mixers with close supervision
§ Help make pancakes, scrambled eggs, and cereal
§ Set and clear the table
Promoting healthy eating in early
childhood forms the basis for a lifetime
of healthy eating!
References
§ Smith, CJ, Hendricks, C, and Bennett, BS. 2014.
Growing, Growing Strong! Fitness and Nutrition: A Whole
Health Curriculum for Young Children.
www.redleafpress.org
§ Caring for Our Children: National Health and Safety
Performance Standards; Guidelines for Early Care and
Education Programs, Third Edition (CFOC3)
www.nrckids.org
12
Nutrition Activities for Preschoolers
Knowledge Check
Which of the following activities is not appropriate for 3
year olds?
A. Placing napkins and forks on table
B. Handing out milk cartons
C. Passing a large serving bowl
D. Discarding trash
13
Nutrition Activities for Preschoolers
Return to Course Module Listing
Active Supervision for Preschoolers
Amanda Schwartz, PhD
14
Return to Course Module Listing
Knowledge Check
After this course you will be able to answer the following question:
One strategy you can use to prevent preschool
injuries all throughout your day is:
A. Plug protectors in electrical sockets
B. Play classical music all day to keep children
calm
C. Active supervision
D. Always use a loud voice so children pay
attention
Knowledge Check
After this course you will be able to answer the following question:
One of the most critical times to use active
supervision is during:
A. Group times
B. Free play
C. Transitions
D. Mealtimes
Active Supervision for
Preschoolers
Six Strategies that Help You Keep
Children Safe
Dr. Amanda Schwartz
3
Learning Outcomes
§ Describe the 6 steps of active supervision and
why they are important.
§ Identify how to use the 6 steps within daily
routines and preschool environments.
§ Explain how to apply the 6 steps when there are
changes in routines and specific environments.
4
15
Active Supervision for Preschoolers
What do we know about
preschoolers?
§ Developmental skills are getting more
sophisticated
§ Social interactions support learning
§ Rules and routines are part of life
§ Learning new boundaries
5
What can
happen
when we
don’t pay
attention?
2016 CDC Data
on Unintentional
Death
6
What can
happen
when we
don’t pay
attention?
2015 CDC Data
on Unintentional
Injury
(Total: 1,625,080)
0
50 , 00 0
10 0, 0 00
15 0, 0 00
20 0, 0 00
25 0, 0 00
30 0, 0 00
35 0, 0 00
40 0, 0 00
45 0, 0 00
50 0, 0 00
Cu t/ p i er c e
Drown ing/Submersion
Fall
Fir e
In halla tio n/Suf fo cati on
Po i s on i ng
St ru ck by/ag ainst
3 to 5
3 t o 5
7
What can
happen
when we
don’t pay
attention?
2015 CDC Data
on Unintentional
Injury
(Total: 1,625,080)
0
50 , 00 0
10 0, 0 00
15 0, 0 00
20 0, 0 00
25 0, 0 00
30 0, 0 00
35 0, 0 00
40 0, 0 00
45 0, 0 00
50 0, 0 00
Cu t/ p i er c e
Drown ing/Submersi on
Fall
Fir e
In halla tio n/Suf fo catio n
Po i s on i ng
St ru ck by/ag ainst
3 to 5
3 t o 5
0
10 , 00 0
20 , 00 0
30 , 00 0
40 , 00 0
50 , 00 0
60 , 00 0
Cu t/ p i er c e
Drown ing/Submersi on
Fir e
In halla tio n/Suf fo catio n
Po i s on i ng
3 to 5
3 t o 5
8
16
Active Supervision for Preschoolers
ENLARGE
ENLARGE
ENLARGE
INJURIES ARE
PREVENTABLE!
9
What are you required to do?
§ Know your State Licensure Requirements
§ Meet adult-child ratios at all times
§ Supervise preschoolers during all times of the
day including rest times, meal times, transition
times, and play times
10
Active Supervision is:
§ Focused attention
§ Intentional observation
§ Face-to-name recognition
§ Based on child development
§ Individualized for each child
11
Active and positive supervision
involves:
§ Knowing each child’s abilities;
§ Establishing clear and simple safety rules;
§ Being aware of and scanning for potential safety
hazards;
§ Placing yourself in a strategic position so you are
able to adapt to the needs of the child;
§ Scanning play activities and circulating around
the area;
From Caring for Our Children, 3
rd
Edition, Standard 2.2.0.1. Methods of Supervision
12
17
Active Supervision for Preschoolers
Active and positive supervision
involves:
§ Focusing on the positive rather than the negative
to teach a child what is safe for the child and
other children;
§ Te a c hing chi l d ren the d evelopmen t a l l y
appropriate and safe use of each piece of
equipment (e.g., using a slide correctly – feet
first only – and teaching why climbing up a slide
can cause injury, possibly a head injury).
From Caring for Our Children, 3
rd
Edition, Standard 2.2.0.1. Methods of Supervision
13
Steps For Active
Supervision of
Preschoolers
14
Steps for Active Supervision
Set Up the
Environment
Position Staff
Scan and
Count
Listen
Anticipate
Children's
Behaviors
Engage and
Redirect
15
§ Use low furniture
§ Consider accessibility
§ Remove clutter
§ Place small or toxic
supplies high and
locked away
§ Design spaces for
active and quiet play
Set Up the Environment
16
18
Active Supervision for Preschoolers
ENLARGE
§
Use proximity (zones)
§
Stay close for sleeping, toileting, and
transitions
§
Create activities that support independent,
peer-to-peer, and adult-led play
§
Design outdoor experiences intentionally
Position Yourself
17
§ Scan constantly
§ Count:
§ During transitions
§ When outside of normal
learning environment
(classroom/home-based
setting)
§ During rest and toileting
times
§
Work together
§ Use redundant systems
Scan and Count
18
What do
you see?
Source: wikimedia
19
§ Defining normal noises
§ Setting up auditory
cues
§ Individualizing for each
child
§ Knowing what quiet
means
Listen
20
19
Active Supervision for Preschoolers
ENLARGE
§
Use what you know
from assessment
§
Consider
temperament,
strengths, and
challenges
§
Talk wi t h f a mily
members and
colleagues
Anticipate children’s behavior
21
§ Know when children
need help
§ Consider the function
of the behaviors
§ Provide alternatives
that meet children’s
needs
§ Always share what
you did with others
Engage and Redirect
22
Developmental Considerations
for Preschoolers
§ Preschoolers are
§ Building developmental skills
§ Interacting more with each other
§ Learning rules and routines
§ Seeking independence
§ Experimenting with boundaries and consequences
§ Ways to support them
§ Offer safe natural consequences
§ Create consistent rules, routines, and boundaries
§ Explain what keeps them safe and why
§ Work closely with families to support consistency
23
Try It Out!
§ You are setti ng up your environment. Which of the
following things would you consider most
important?
§ Access to toys and books
§ Low furniture to provide a good view of their movement
and behavior
§ Freedom to move in and out of the room
24
20
Active Supervision for Preschoolers
Try It Out!
§ You are setting up your environment. Which of the
following things would you consider most
important?
§ Access to toys and books
§
Low furniture to provide a good view of their movement
and behavior
§ Freedom to move in and out of the room
25
Try It Out!
§ As you consider ways to support the preschoolers
in the classroom, how do you decide to position
yourself?
§ Make sure children are always within arms reach
§ Stay in the high traffic areas where children always want
to play
§ Design zones where you both can always see and hear
what is going on and quickly move to support a child if
you need to
26
Try It Out!
§ As you and your co-teacher consider ways to
support the preschoolers in the classroom, how
do you decide to position yourself?
§ Make sure children are always within arms reach
§ Stay in the high traffic areas where children always want
to play
§
Design zones where you both can always see and hear
what is going on and quickly move to support a child if
you need to
27
Try It Out!
§ When you develop your plan for scanning and
counting, your system includes
§ Ways to make sure you are counting each child
correctly all of the time
§ A schedule for scanning and counting that occurs more
frequently during transitions and when you are out of
your classroom or home-care setting
§ A quick way to respond if you discover a child is
missing
28
21
Active Supervision for Preschoolers
Try It Out!
§ When you develop your plan for scanning and
counting, your system includes
§
Ways to make sure you are counting each child
correctly all of the time
§
A schedule for scanning and counting that occurs more
frequently during transitions and when you are out of
your classroom or home-care setting
§
A quick way to respond if you discover a child is
missing
29
Try It Out!
§ When you are in your setting with preschoolers,
you listen for…?
§ You listen to every soun d, using wh at you know abo ut
your environment and the children in your program to
know when to double check visually
§ Typ ic al le ar ni ng no is es li ke ch ild ren ta lk in g a nd u sin g
toys
§ You listen for atypical soun ds like exten ded quiet,
excessive screaming, or fighting/wrestling noises
30
Try It Out!
§ When you are in your setting with young infants,
you listen for?
§
You listen to every sound, using what you know about
your environment and the children in your program to
know when to double check visually
§ Typ ic al le ar ni n g no ise s lik e c hi ld re n t alk in g a nd u sin g
toys
§ You lis ten for atypical sound s like extended quiet,
excessive screaming, or fighting/wrestling noises
31
Try It Out!
§ How do you know what to anticipate from a
preschooler?
§ You talk with the fam ily abou t wha t they see a t hom e
§ You use and a n alyz e child ass e ssm en t data tha t
includes information from families and your own
observations
§ You know typical child de velo pm en t and ca n gue ss
what they will do next
32
22
Active Supervision for Preschoolers
Try It Out!
§ How do you know what to anticipate from a
preschooler?
§ You talk with the family about wh a t they see at hom e
§
You use and analyze child assessment data that
includes information from families and your own
observations
§ You know typica l child develop ment and can gue ss
what they will do next
33
Try It Out!
§ How do you know when to engage and redirect a
preschooler?
§ You alway s enga ge and redirec t
§ You only eng a ge and red ire ct wh e n som eone is going
to get hurt
§ You enga ge a n d re direct using wha t you kno w a bou t
the child to help them learn safer and healthier ways to
interact with peers and explore
34
Try It Out!
§ How do you know when to engage and redirect a
mobile infant?
§ You always en gag e an d re d ire c t
§ You only enga g e an d re dire ct whe n som eo ne is going
to get hurt
§
You engage and redirect using wha t you know about
the child to help them learn safer and healthier ways to
explore
35
Playgrounds
or outdoor
spaces
§ Use proximity and
zones
§ Stay focused on where
and what children play
§ Have all
staff/volunteers scan
and count on a
schedule
§ Use face-to-name
counting
§ Create a simple system
for staff to
communicate with
each other
36
23
Active Supervision for Preschoolers
Transitions
§
Create a plan for how to
scan and count
§
Use face-to-name
transitions
§
Know how to handle
challenging behaviors
§
Train all staff in the plan
§
Have a system for
reporting missing children
while maintaining active
supervision for all others
37
A note about
changes in staff
or routines
§ Keep detailed instructions
about individualization
§ Make active supervision
plan available
§ Have clear directions for
active supervision
techniques
§ Request a summary and
feedback at the end of the
day
38
Free Active
Supervision
Resources
https://eclkc.ohs.acf.hhs.gov/s
afety-practices/article/keep-
children-safe-using-active-
supervision
39
How Will You Actively
Supervise Preschoolers
In Your Program?
40
24
Active Supervision for Preschoolers
ENLARGE
Questions
Dr. Amanda Schwartz
a_l_schwartz@yahoo.com
41
Knowledge Check
One strategy you can use to prevent preschool injuries all
throughout your day is:
A. Plug protectors in electrical sockets
B. Play classical music all day to keep children calm
C. Active supervision
D. Always use a loud voice so children pay attention
Knowledge Check
One of the most critical times to use active supervision is
during:
A. Group times
B. Free play
C. Tra nsitions
D. Mealtimes
25
Active Supervision for Preschoolers
Return to Course Module Listing
Five Steps to Create a
Functional Behavior Assessment
Tara Warwick, MS, OTR/L
26
Return to Course Module Listing
Knowledge Check
After this course you will be able to answer the following question:
What is the purpose of a functional behavior
assessment?
A. To cre ate a hy p o t h esis about a behavior
B. To implement an intervention plan
C. It is required by state law
D. To determine special education eligibility
Knowledge Check
After this course you will be able to answer the following question:
Which of the following behaviors is measurable
and observable?
A. Inattentive
B. Refusal
C. Hitting
D. Meltdown
Creating a Functional
Behavior Assessment
Tara Warwick, M S , OTR/L
Today’s Co n s u lting Solu t i o n s
3
Learning Outcomes
§ Identify the steps for a Functional Behavior
Assessment.
§ Name three types of data collection
procedures.
§ List the components of a hypothesis.
4
27
5 Steps - Functional Behavior Assessment
FBA Description
§
A systematic method of assessment for
obtaining information about the purposes
(functions) a problem behavior serves for a
person; results are used to guide the design of
an intervention for decreasing the problem
behavior and increasing appropriate behavior.
(Cooper, Heron, Heward 2007)
5
FBA is not...
§ A form to fill out
§ A step for determining special education
eligibility
§ Only for students who receive special education
services.
§ Intervention plan
§ www.pbis.org (Horner et al)
6
Informal vs Formal Assessment
Informal
Formal
Quick,
implement immediately and
evaluate changes
Patterns are more obvious
Behaviors not endangering others
(Sensory or Behavior Presentation)
Data collection over period of time
Dangerous behaviors
Strategies
not effective
Litigation involved
3 or more routines
Patterns are not apparent
7
Potential Team
§ Parents
§ Psychologist
§ Counselor
§ Special Educator
§ General Educator
§ Administration
§ Related Services Provider
§ Other?
8
28
5 Steps - Functional Behavior Assessment
ENLARGE
Steps for Conducting FBA
1. Collect background information
2. Identify the target behavior
3. Collect data
4. Analyze data
5. Create hypothesis
9
1. Background information
10
Background Information
§
Emotional factors
§
Reinforcement
§
Impact of others on behavior (Modeling)
§
Family issues
§
Academics
§
Discipline referrals
§
Past assessments
11
2. Identify the Target Behavior
§ No more than 2-3 target behaviors
§ Specifically address one behavior at a time
§ Specific and measurable
§ Stranger test
§ Dead man's test
12
29
5 Steps - Functional Behavior Assessment
Instead of this
Use
this
Meltdown, aggressive
Hits other people, tears up work
Refusal
Does
not complete work within
time allowed; Does not answer
question within five seconds
Hyperactive
Runs
around room; Gets out of
seat; Talks during teacher
instruction
13
3. Collect Data
§ Data helps us create a hypothesis
§ Helps us set baseline data for behavior
§ All this helps design our intervention plan
14
Typ es o f Da ta
§
Indirect
§ Records review
§ Behavior checklists
§ Behavior interviews
§
Direct
§ ABC data
§ Interval data
§ Journaling
15
Record Reviews
§ Current schedule and routines
§ Any recent changes
§ Relevant health or medical information
§ Attendance history
§ When was the last time student did not demonstrate
significant challenging behavior?
§ Previous interventions
§ Have any strategies been effective in preventing the
challenging behavior?
§ Strengths
§ Possible reinforcers
16
30
5 Steps - Functional Behavior Assessment
ENLARGE
Behavior Interviews
•
Define behavior (describe what you see)
•
Describe frequency and intensity
•
Explore possible setting events
•
Identify predictors
•
Identify maintaining consequences
•
Identify current communicative functions
•
Describe efficiency of the behavior
•
Describe previous efforts
•
Identify possible reinforcers
17
Behavior Questionnaires
§ Motivation Assessment Scale
§ Problem Behavior Questionnaire
18
Motivation Assessment Scale
19
MAS Scoring
20
31
5 Steps - Functional Behavior Assessment
ENLARGE
ENLARGE
Problem Behavior Questionnaire
21
PBQ Scoring
22
Direct Data
§
ABCs
§
Interval
§
Frequency
§
Journaling
23
A
(Antecedent)
B
(Behavior)
C
(Consequence)
Antecedent
Behavior
Consequence
Response?
Gave math
worksheet
Tore i t up
Put in time
out
Behavior stopped
Tea ch er ta lk ing i n
large group
Student saying
inappropriate
words
Tea ch er ve rb all y
reprimanded him
Stopped for short
amount of time and
then started again
Child waiting for
centers
Throws
toys
Puts in time out
and then
gives him
a puzzle
Behavior stopped
when given a
puzzles
24
32
5 Steps - Functional Behavior Assessment
ENLARGE
ENLARGE
ENLARGE
Tips for ABC Data
§
Create a coding system, easier to analyze
§
Avoid open ended
§
Make the system as easy as possible
§
Date, person, environment, time, A, B, C,
response
25
26
Frequency Data
§
Number of times within a given period
§
Best for behaviors with a distinct end
§
Note time observation starts and ends
§
Number of occurrences of the behavior
§
Calculate rate by number of times/length
27
Frequency Recording
Time started
Time ended
Tally
Length
Rate
8:00a.m.
8:15a.m.
IIIIIIIIII
15 minutes
10/15minutes
8:45
8:55
IIIII
15 minutes
5/15 minutes
28
33
5 Steps - Functional Behavior Assessment
ENLARGE
ENLARGE
Interval Recording
§
Documents whether a behavior occurred during
a particular period
§
Divide the observation into equal intervals (5-15
minutes long)
§
At the end of each interval, record whether or
not the behavior occurred.
§
Count the number of interval which the behavior
occurred
§
Divide by total number of intervals and multiply
by 100 to determine percentage
29
Interval Recording
Interval
Behavior
1
Yes
2
No
3
Yes
Tota l in ter va ls
which target
behavior occurred
2
To t a l
intervals coded
3
%
66%
30
Journaling
§
Can be subjective
§
Timely
§
Emotionally driven
§
Have a structure
§
Be careful with type of writing
31
4. Analyze the Data
§ Triangulate the data in order to create a
hypothesis
§ Step often missed
§ Antecedents
§ Consequences
§ Other: Location, time, person, day of the week
32
34
5 Steps - Functional Behavior Assessment
ENLARGE
Analyze the Antecedents
Antecedents that prevent the behavior
Antecedents that trigger the behavior
Using a schedule
Choices
Modified
work
Tel li ng hi m "n o"
Taking away an item
Wait
time
Unstructured time
Difficult work
33
Analyze the Consequences
Consequences
Stop or get
better
Stay same or intensify
Time out
Stops
Attention
Intensifies
Ignores
Intensifies
34
5. Create a Hypothesis
“There are two possible outcomes:
1.
If the result confirms the hypothesis, then
you've made a discovery.
2.
If the result is contrary to the hypothesis, then
you've made a discovery.”
Enrico Fermi
35
Purpose of the Hypothesis
§ "Why" behind behavior
§ Guide your intervention (Behavior Intervention
Plan)
§ Never start an intervention without a hypothesis
(why)
§ More data, stronger the hypothesis
§ Can have multiple hypotheses for one behavior
§ Can have one hypothesis for multiple behaviors
36
35
5 Steps - Functional Behavior Assessment
ENLARGE
ENLARGE
Hypothesis Should Contain
§
Setting events, immediate antecedents, and
consequences that surround the behavior
§
Behavior that is occurring
§
Purpose of the behavior
37
Writing a Hypothesis
§ When _________________, the student
may__________________ in order to
________________.
§ When presented with difficult math, Jacob might
pinch until the teacher removes the work.
§ In order to gain attention from his teacher, Jacob
might run around the room until she attends to
him.
38
Case Study
John is a 4-year-old boy who attends an early
childcare center. John is having challenging
behaviors that are concerning the team and
interfering with his ability to be in the classroom
with other children. John does not have a medical
diagnosis and has not had any previous testing.
However, the team is concerned and have
suggested to the family further testing due to his
challenging behavior and developmental skills.
The team stated that the behaviors seem
unpredictable, occur all the time, and see no
apparent trigger for the behaviors.
39
Questions?
twarwick@ tod ays the rap ysolu tions.c om
40
36
5 Steps - Functional Behavior Assessment
ENLARGE
References
§ https://iris.peab ody.vanderbilt.edu/wp-
content/uploads/pdf_activities/independent
/IA_F reque nc y _a n d_ Inte rv a l_R e co rding.p d f
§ www.pbis.org
41
Knowledge Check
What is the purpose of a functional behavior
assessment?
A. To cre at e a h yp oth es is ab ou t a b eh av io r
B. To im pl em en t a n int er ve nti on p lan
C. It is required by state law
D. To d e te rm in e s pe ci al ed uc at io n e li g ib ili ty
Knowledge Check
Which of the following behaviors is measurable and
observable?
A. Inattentive
B. Refusal
C. Hitting
D. Meltdown
37
5 Steps - Functional Behavior Assessment
Return to Course Module Listing
Creating a Behavior Intervention Plan
Tara Warwick, MS, OTR/L
38
Return to Course Module Listing
Knowledge Check
After this course you will be able to answer the following question:
If there is a behavioral intervention plan in place for
a child but the target behavior has not changed,
what should you do first?
A. Make a new plan
B. Send a referral to special education
C. Check to make sure plan is being implemented
consistently
D. Revise the plan
Creating a Behavior
Intervention Plan
Tar a Wa rwi ck , M S , O TR /L
Tod ay ’s C on su lti ng S olu ti on s
2
Tod ay ’s Ob je ct iv es
§
Identify the steps for creating Behavior
Intervention Plan (BIP).
§
List the components of a quality goal.
§
Describe three strategies for changing the
antecedents and three strategies for changing
the consequences.
3
Purpose of Behavior
Intervention Plan
§ Based on the hypothesis, creates a plan
that addresses:
§ Environmental changes
§ Antecedent changes
§ Replacement skills for challenging behavior
§ Consequences
4
39
Creating a Behavior Intervention Plan
Common misconceptions
Comprehensive
approach
•
Just more paperwork
•
Form filled out for compliance,
sometimes per request of family
•
Only used by the special education
teacher
•
Primarily contains disciplinary
procedures
• Often thought of as only a plan for ways
student needs to change
•
Focus on teaching new skills
•
Plan is based on data collected during FBA
•
Process involves all members of the team
• Entire team understands the plan and how
to implement
•
Plan is monitored and revised based on
ongoing data
Misconceptions about BIPs
5
§ All targeted behaviors are addressed
§ Implemented across all relevant settings and
times of day
§ Blends multiple strategies and procedures
§ Needs to be sustainable
§ Needs to be taught
(Heron et al.)
Comprehensive BIP
6
1.
Summarize FBA findings
2.
Determine environmental/antecedent changes
3.
Determine replacement skills
4.
Responding to replacement skills
5.
Responding to challenging behavior
6.
Determine evaluation procedures
Steps for Developing a BIP
7
1. Summarize FBA findings
§ Summarize how you collected data
§ State hypothesis
8
40
Creating a Behavior Intervention Plan
ENLARGE
2. Determine replacement skills
§
What should they do instead of the challenging
behavior?
§
Socially and developmentally appropriate
§
Serves same function, based on the hypothesis
§
More effective than challenging behavior with
less effort
§
Across settings
§
Teach!
9
Examples
§ Waiting
§ Giving up preferred item
§ Social skills
§ Communicating needs
§ Asking for a different activity
§ Asking for a break
§
Occupying time
§ Taking a b reak
10
Writing a Goal for Skill
SMART Goals
§
Specific
§
Measurable
§
Achievable
§
Relevant
§
Time limited
11
Writing goals on behavior
§ S-Specific
§ M-Measurable
§ A-Attainable
§ R- Relevant
§ T – Time-Framed
Replacement
Skill
Goal
Asking
for help
When
Johnny needs help in class, he will
raise his hand and wait for assistance 4
out of 5 opportunities.
Break
When Sara needs a break, she will
give
her break icon to an adult, go to her break
area for no more than 5 minutes 4 out of
5 opportunities.
Asking for an alternative activity or
assignment
When James is presented with written
assignment, he will ask for other options
to complete assignment 4 of 5
opportunities.
12
41
Creating a Behavior Intervention Plan
ENLARGE
3. Determine
environmental/antecedent changes
§
Rituals and routines
§
Visual supports
§
Modify expectations
§
Changing the expectations
§
Sensory supports
§
Structure
13
4. Determine consequences
14
Consequences
§
Not good or bad
§
Just what happened after the behavior
15
Consequences
§
Reinforcement
– Behavior increases
Positive reinforcement (adding something)
Give math – Child does math – give child iPad
Negative reinforcement (taking something away)
Give math – child tears up math – take math away
§
Punishment
– Behavior decreases
Child talks back to parent – parent puts in time
out – child stops talking back
16
42
Creating a Behavior Intervention Plan
Response to replacement skill
§
Natural reinforcement
§
Positive reinforcement
§
Token e c o n o my system
17
Reinforcement
§ Positive reinforcement – Adding something to
increase that causes the behavior to continue
(Give iPad to reinforce sitting)
§ Negative reinforcement – Taki ng away
something that makes the behavior continue
(scream to get out of math – take away math)
18
5. Responding to challenging
behavior if occurs
19
Punishment
§ Process to decrease the likelihood of behavior
occurring
(When child screams, I put in time out to stop
screaming – screaming stops)
ONLY PUNISHMENT IF THE BEHAVIOR
DECREASES!
20
43
Creating a Behavior Intervention Plan
Examples of punishment
§
Corrections
§
Time owed
§
Loss of an activity
§
Time out in class
§
Positive practice
21
If behavior escalates
§ Identify a team leader
§ Keep environment safe
§ Consistent and calm response (talk quietly)
§ Give no eye contact or other response
§ Offer assistance with task or activity
22
If behavior escalate
§
Provide verbal praise or tangible reward to
students who are meeting expectations
§
Prompt student to return to desired activity
(verbal prompts, your proximity, modeling, etc.)
§
Encourage peers to ignore problem behavior
§
Consistent across all team members
23
6. Determine evaluation
procedures
§ Is the behavior decreasing in frequency or
duration? How you keeping data?
§ If no,
§ Is the plan consistently implemented?
§ Do we wait longer?
§ Do we modify?
§ Do we need to change the hypothesis?
24
44
Creating a Behavior Intervention Plan
Case Study
25
Questions
twarwick@ tod ays the rap ysolu tions.c om
26
Knowledge Check
If there is a behavioral intervention plan in place for a
child but the target behavior has not changed, what
should you do first?
A. Make a new plan
B. Send a referral to special education
C. Check to make sure plan is being implemented
consistently
D. Revise the plan
45
Creating a Behavior Intervention Plan
Return to Course Module Listing
Strategies for Working with Preschool Dual Language
Learners, in partnership with Region 9 Head Start
Association
Erika Flores, BS, Med
46
Return to Course Module Listing
Knowledge Check
After this course you will be able to answer the following question:
How can you support peer relationships while
reading books with preschool children?
A. Pair children up to explore books together
B. Have all children sit quietly during book reading
C. Encourage children to memorize books
D. Correct children who give the wrong answers
to questions
Strategies for Working with Preschool Dual
Language Learners, in partnership with
Region 9 Head Start Association
Presented by Erika Flores, MEd
ChildrenFlow, LLC
www.childrenflow.com
Learning Outcomes
After this course, participants will be able to:
§ Explain strategies to create culturally responsive systems and
environments while reading books with PreK dual language learners.
§ Describe strategies to provide social-emotional support to PreK dual
language learners while reading books.
§ Describe strategies to support the language and cognitive
development of dual language learners while reading books.
Other stories
Xochitl
Growing up as a Dual Language Learner
47
Working with Preschool Dual Language Learners
Code-Switching
§ When a person alternates languages.
§ Children who are learning two or more languages code-
switch to express their thoughts based on the vocabulary
they know. This is a normal aspect of DLL’s development.
Code-Switching
Role of Adults:
• Accept code-switching amongst DLLs as part of their
language development.
• Be a strong language model.
Pause and Reflect
Think about children who are are
Dual Language Learners (DLLs) in
your program. How do you make
sure they are learning and developing
while reading books?
Reading Books with Preschoolers
Integrated Dual Language Learners
©
(I-DLL)
BODY I-DLL
Culturally responsive systems and learning
environments to support DLLs
HEART I-DLL
Social-emotional strategies to support DLLs
MIND I-DLL
Language and cognitive strategies to help DLLs thrive
48
Working with Preschool Dual Language Learners
Integrated Dual Language Learners
©
(I-DLL)
Developmentally Appropriate Strategies for each age group:
Infants, Toddlers, Preschoolers
I
-DLL BODY
I
-DLL HEART
I
-DLL MIND
Systems
Intentional Teacher
-Child
Relationships
Language
Culturally
Responsive Learning
Environments
Social Emotional Development
of DLLs
Cognition
Routines and Organization
Peer Relationships
Assessment
Curriculum
Family Collaborations
Individualized Instruction
PAUSE AND REFLECT
Think of a storybook that children enjoy in your classroom. What makes
them like this storybook? What strategies would you need to implement
next time you read this book so that DLLs will learn and develop?
Integrated Dual Language Learners
©
(I-DLL
©
)
BODY I-DLL
Culturally responsive systems
§ Know your classroom language model and
use that as you read books with DLLs
§ Communication systems with families about
the importance of reading books in the home
language
Integrated Dual Language Learners
©
(I-DLL
©
)
BODY I-DLL
Culturally responsive systems
§ Books to send home to share with families
in their home language
§ Collaboration with families regarding books
that reflect their culture and language
49
Working with Preschool Dual Language Learners
ENLARGE
Integrated Dual Language Learners©
(I-DLL©)
BODY I-DLL
Culturally responsive and engaging
learning environment
• Culturally responsive books
• Use different modalities and materials to
support books that are being read
Integrated Dual Language Learners©
(I-DLL©)
BODY I-DLL
Culturally responsive and engaging
learning environment
• Facilitation to increase engagement during
book reading
• Expand book topic to other areas of the
classroom environment to support key
vocabulary words and concepts
Integrated Dual Language Learners©
(I-DLL©)
BODY I-DLL
Routines and behavior support
• Intentionality in communicating routines
while reading books
• Intentionality in communicating behavioral
expectations while reading books
Integrated Dual Language Learners©
(I-DLL©)
BODY I-DLL
Curriculum and lesson planning
• Intentionally select key vocabulary words and
concepts
• Plan questions that vary in difficulty
• Plan ahead hints you can give to support children if
they are unable to answer questions
• Plan what different modalities or materials can help
support the objective of the book you will be reading
50
Working with Preschool Dual Language Learners
Integrated Dual Language Learners©
(I-DLL©)
BODY I-DLL
Pause and reflect
Think of a storybook that you selected.
What Body I-DLL strategies can you
implement next time you read this book so that
DLLs will learn and develop?
Integrated Dual Language Learners©
(I-DLL©)
HEART I-DLL
Intentional teacher-child relationships with
DLLs
§ Awareness of DLLs while reading books
§ Share positive emotions
§ Attentive and responsive of DLLs
specific needs
Integrated Dual Language Learners©
(I-DLL©)
HEART I-DLL
Intentional teacher-child relationships with
DLLs
§ Choose books that interest DLLs
§ Explore books with DLLs individually
Integrated Dual Language Learners©
(I-DLL©)
HEART I-DLL
Peer relationships
§ Pair peers to explore books together
§ Encourage peers to act out stories
§ Support peers to build relationships
while reading books
51
Working with Preschool Dual Language Learners
Integrated Dual Language Learners©
(I-DLL©)
HEART I-DLL
Family collaborations
§ Invite families to read books
§ Encourage families to share traditional
folk stories from their cultures
§ Invite families to create books
Integrated Dual Language Learners©
(I-DLL©)
HEART I-DLL
Pause and reflect
Think of a storybook that you selected.
What Heart I-DLL strategies can you implement
next time you read this book so that DLLs will
learn and develop?
Integrated Dual Language Learners©
(I-DLL©)
MIND I-DLL
Language
§ Know key words or concepts in DLLs
home language
§ Focus on key words or concepts as you
read the book
§ Label images as you read books
Integrated Dual Language Learners©
(I-DLL©)
MIND I-DLL
Language
§ Emphasize key words
§ Use objects to support book reading
§ Act out actions
52
Working with Preschool Dual Language Learners
Integrated Dual Language Learners©
(I-DLL©)
MIND I-DLL
Language
§ Ask questions
§ Modify questions when needed
§ Provide hints and support
Integrated Dual Language Learners©
(I-DLL©)
MIND I-DLL
Cognition
§ Support DLLs prediction as you read the
story
§ Help DLLs connect story to their lives and
previous experiences
§ Expand book reading to other creative
experiences
Integrated Dual Language Learners©
(I-DLL©)
MIND I-DLL
Pause and reflect
Think of a storybook that you selected.
What MIND I-DLL strategies can you
implement next time you read this book so
that DLLs will learn and develop?
Integrated Dual Language Learners© (I-DLL)
Developmentally Appropriate Strategies for each age group:
Infants, Toddlers, Preschoolers
I
-DLL BODY
I
-DLL HEART
I
-DLL MIND
Systems
Intentional Teacher
-Child
Relationships
Language
Culturally
Responsive Learning
Environments
Social Emotional Development
of DLLs
Cognition
Routines and Organization
Peer Relationships
Assessment
Curriculum
Family Collaborations
Individualized Instruction
53
Working with Preschool Dual Language Learners
ENLARGE
References and Additional Resources:
§ Office of Head Start Early Childhood Learning and
Knowledge Center
https://eclkc.ohs.acf.hhs.gov/
§ Ta b o rs , P., & Sn ow, C . (2 00 8) . O ne C hil d Tw o La ng ua ge s
(2nd ed.). Baltimore, MD: Brookes Publishing.
§ Castro, D. C., Páez, M. M., Dickson, D. K., & Frede, E.
(2011). Promoting Language and Literacy in Young Dual
Language Learners: Research, Practice, and Policy. Child
Development Perspectives
§ ChildrenFlow www.childrenflow.com
Thank you!
For more information:
Erika Flores
erika@childrenflow.com
www.childrenflow.com
Knowledge Check
How can you support peer relationships while reading
books with preschool children?
A. Pair children up to explore books together
B. Have all children sit quietly during book reading
C. Encourage children to memorize books
D. Correct children who give the wrong answers to
questions
54
Working with Preschool Dual Language Learners
Return to Course Module Listing
Potty Training at School
Karen Deerwester, MA, EdS
55
Working with Preschool Dual Language Learners
Return to Course Module Listing
Knowledge Check
After this course you will be able to answer the following question:
A positive potty environment for preschool children
includes which of the following?
A. Stable and predictable routines, as well as easy to
clean clothing and surfaces
B. Use of a timer in the bathroom so children do not
dawdle
C. Use of adult bathrooms to help children get used to
them
D. A system of reward, bribes and consequences for
children who are successful and unsuccessful
Potty Training at School
Child - Policies – Communication
Karen Deerwester
2
Learning Outcomes
1.
Identify readiness characteristics and individual
strengths for successful potty skill-building.
2.
Define and describe school policies for
respectful and supportive potty learning.
3.
Describe how to communicate effectively with
parents for a positive, supportive home-school
potty partnership.
3
Start with Readiness Transparency
§ Developmental skills &
skill building
§ Scaffolding
§ Make learning visible
§ Make trust visible
4
56
Working with Preschool Dual Language Learners
Potty Training at School
Potty Learning Readiness
§
Physical
§
Verbal
§
Social-Emotional
§
Cognitive
5
Physical Readiness Behaviors
§ Your child stays dry for at least two hou rs du ring the day.
§ Your child wake s up dry fro m na ps.
§ Your child will pee or poop regularly—before bath time, or
an hour after breakfast.
§ You see telltale signs w hen your child is pottying—he
stops playing, makes a certain face, etc.
§ Your child can wa lk to a desig n ate d plac e to ac c om plish a
goal.
§ Your child can re move piece s of clothing to use the po tty.
from The Potty Training Answer Book
6
Social-Emotional Readiness Behaviors
§ Your child asks questions abo u t pottying.
§ Your child wants to follo w o thers into the bathro om .
§ Your child tries to imitate adu lt potty behavior.
§ Your child likes c le a n diap e rs—she asks to be changed at
appropriate times.
§ Your child cares abo ut the outco mes of her a ctions—she
expresses likes or dislikes after she does something and if
reminded will remember those preferences the next time.
§ Your child is w illing to sit still to master a task.
from The Potty Training Answer Book
7
Verbal Readiness Behaviors
§ Your child knows his bo dy pa rts.
§ Your child can tell you, first when he’s pottied in his
diaper, and then before he’s pottied in his diaper.
§ Your child follows simp le dire ction s—“Quick, run to the
bathroom!”
§ Your child tells you what he nee d s.
§ Your child says he wa nts to “do it mys e lf.”
from The Potty Training Answer Book
8
57
Potty Training at School
Cognitive Readiness Behaviors
§ You r ch i l d is curious about how his body wo rks.
§ You r ch i l d se es t he c onnecti on between his body and the pot ty.
9
§ You r ch i l d un ders tand sequen cing – before, during, and after.
§ You r ch i l d lines up his t oys – understands order – things in “right”
places.
§ You r ch i l d thi nks ahea d – he can stop doing something if he needs to
potty.
§ You r ch i l d co mprehends th at p otty boo ks a nd v i deos are rel evan t to his
actions at this time.
§ You r ch i l d un ders tands th e “b i g pi c ture” – “so, this is how things work.”
from The Potty Training Answer Book
Positive Potty Environment
§ Potty training should be fun because children learn
through play.
§ Potty gear should be helpful rather than overly
complicated.
§ Bathrooms should be child-friendly.
§ Routines should be stable and predictable.
§ Schedules should be relaxed.
§ Expectations should be opportunities for success.
§ Choose easy-to-clean clothes and surfaces.
from The Potty Training Answer Book
10
Positive Potty Role Model - Parent
§ How’s your stress level?
§ Do you believe each child will be successful in his or her own time?
§ Is potty training a genuine priority or do you fit it in when it’s convenient
for you?
§ Do you talk about a child’s potty abilities to other adults in front of the
child?
§ Do you talk about dirty diapers or soiled clothes as “icky,” “yucky,” or
“nasty”?
§ Can you appreciate potty training through each child’s experience to
prevent your own boredom and burn-out?
Adapted from The Potty Training Answer Book
11
Tem p e r a m ent M atters !
§ Easy
§ Slow-to-Warm-Up
§ Difficult
12
58
Potty Training at School
Potty Training Strengths: Easy Temperament
13
1. She is less frenetic and able to sit for short lengths of time.
2. She adapts well to schedules. Feeding schedules and nap schedules are
predictable, which also leads to a predictable pottying schedule.
3. She isn’t easily distracted from a task. So, if she sees a new toy on her
way to the bathroom, she will remember to come back to it after she goes
potty.
4. She can listen to verbal encouragement and support without a strong
emotional reaction.
5. The sensory experience of sitting on a cold potty or of a naked bottom is
not overwhelming.
6. She will respond easily to pottying in a variety of situations under a variety
of conditions. She is more likely to pause one activity if she needs to take
a potty break.
7. Her frustration may be expressed more mildly. Mistakes and setbacks will
be small blips to success rather than major pitfalls.
8. She may be eager to embrace new potty expectations.
9. Overall, the potty process is more likely to be light-hearted.
from The Potty Training Answer Book
Potty Training Strengths: Slow-to-Warm-Up Temperament
1. The child with a slow-to-warm-up temperament is often described as
watchful. She likes to be prepared before taking action.
2. This child’s mild disposition complements the predictability of a potty
training routine.
3. The child with a slow-to-warm-up temperament is the classic tortoise
moving steadfastly toward a goal.
4. You won’t h ave lo ud po wer struggle s w ith a c hild w ho ha s a slo w-to-
warm-up temperament.
5. The child with a slow-to-warm-up temperament may seem very sensitive
to the physical sensations of potty training.
6. The slow-to-warm-up child likes learning new skills.
7. The slow-to-warm-up child may need a hand to hold along the way as she
learns.
8. This child tends to linger on the sidelines rather than jump forward with
both feet (until you really get to know her, that is).
9. Her mood is cautious more than negative or positive.
14
from The Potty Training Answer Book
1. Potty training is a physical activity. This child may not love sitting still but
she may love running to the potty or pulling the toilet paper when she’s
finished.
2. The child with a difficult temperament can be unpredictable in her
schedule.
3. All children believe adult attention is the raison d’etre, especially the child
with the difficult temperament.
4. The child with a difficult temperament likes to do things in “a big way.”
5. The child with a difficult temperament will experience every nuance of the
potty training experience.
6. The child with a difficult temperament likes to feel in control.
7. The child with a difficult temperament hates to give up.
8. The child with a difficult temperament will vehemently protest change.
9. This child may say “NO!” when she really means “maybe.”
15
Potty Training Strengths: Difficult Temperament
from The Potty Training Answer Book
Potty Learning - not one size fits all
16
59
Potty Training at School
ENLARGE
ENLARGE
ENLARGE
Learning Strengths: Meet each child
where they are
§
Verbal - Stories, songs, rhymes, games
§
Physical - Movement, action, games
§
Imagination - Themes, characters, rituals, games
§
Social - Peers, the “club,” partners, games
§
Cognitive - Peers, the “club,” partners, games
17
Accidents, Mistakes & Fears:
Generalizing skills takes time!
18
Define School Policy
§
General – before potty
training begins!
§
Clarity
§
Transparency
§
Consistency
§
Flexibility
§
Problem Solving
19
School Policy Issues
1. List of developmental signs/behaviors
2. Child leads
3. Potty vocabulary
4. Parent readiness and child readiness -
eagerness and resistance
5. Address non-readiness factors –
convenience, peer pressure or parent
stress
20
60
Potty Training at School
School Policy Issues
6. Food rewards – rewards in general
7. Diaper free weekends at home – first?
8. Routines – Reminders - Frequency
9. Accidents are ok – how many?
10.Back-up plans – what ifs
11.Last word? Can teachers say “not
ready”?
21
Differences Home – School
§ Naked time
§ No-diaper naptime
§ Time constraints
§ Rewards - bribes
§ Individual potty seats
§ Coercion
§ Potty training coaches and boot camps
* Add or revise as needed.
22
School Policy – Personalized (what
schools CAN accommodate)
§
Reminder styles
§
Pull-ups, commando
§
Follow-through in older classrooms
§
Communication - potty tracking apps
§
Celebrations
23
Writing Policy: School Potty-Learning
Statement
1. Best ECE practices
2. Readiness traits
3. Regulations
4. Goals (“3 strikes”?)
5. Communication options
6. Additional support – orientation, workshops,
one-on-one with teacher/director/social worker
24
61
Potty Training at School
Parent Support - Partnerships
§
A need for more praise and feedback
§
Peer and tech connected
§
Less loyalty if pushed, criticized or challenged
§
Silence mistaken for disapproval
§
Expectations are misinterpreted (judgyness)
§
Mentoring is continuous and on-going
25
Relationship-Based Communication:
§ Head and heart
§ Voice and choice
§ Stories and values
§ 360 degree communication
§ Value mistake-making
§ Timing and timeliness
§ Stress, busyness, anxiety
§ FOMO and JOMO
§ 1+1=3 (but not free-for-all)
26
Increase understanding & decrease unrealistic expectations
Potty Power – Success!
§
Everyone is successful
§
Frame success in Developmentally Appropriate
Practice and research
27
Potty Training is about the child,
not the potty
1. A child makes a personal leap of faith every
time he tries something new.
2. A child can say goodbye to diapers when she
feels safe and confident with change.
3. A child has to make a deliberate choice about
that physical sensation that he might need to
pee or poop.
28
62
Potty Training at School
Potty Training is about the child,
not the potty
4. A child is relying on her body, her mind,
and her will to cooperate to reach the
same desired goal.
5. A child has the final say about his own
body and so power struggles will always
be detrimental to a positive potty
experience.
29
Potty Training is about the child,
not the potty
6. A child is still young enough to misjudge a
sequence of events, to under or over estimate
the time needed to accomplish a task, or to get
completely thrown off course by
inconsequential circumstances.
7. A child needs a hand to hold when she’s
uncertain and someone to show her the way
over or around tricky situations.
30
Potty Training is about the child,
not the potty
8.
A child is learning how other people react to his
mistakes and accidents.
9.
You can help a child by making potty lear ning
as fun and as funny as “underwear.”
10.
Being a potty partner with a child will give you
and the child a strong foundation to grow and
learn together for years to come.
31
References
§ Guidelines for Supporting Toilet Learning, State
Education Department Albany NY (March 2016)
§ Oh Crap, Potty Training, Jamie Glowacki (2015)
§ “Our Preschool Potty Training Policy,” Carolyn Rabin,
Brain,Child (July 2013)
§ Potty Training Answer Book, Karen Deerwester (2007)
§ Potty Training, ZerotoThree.org
§ Toi le t Tra in ing G ui de lin es : D ay C are P ro vi de rs—The Role
of the Day Care Provider in Toilet Training, Pediatrics,
American Academy of Pediatrics (June 1999)
32
63
Potty Training at School
Knowledge Check
A positive potty environment for preschool children
includes which of the following?
A. Stable and predictable routines, as well as easy to
clean clothing and surfaces
B. Use of a timer in the bathroom so children do not
dawdle
C. Use of adult bathrooms to help children get used to
them
D. A system of reward, bribes and consequences for
children who are successful and unsuccessful
64
Potty Training at School
Return to Course Module Listing
Outdoor Play: Health and Safety for Preschoolers
Heather Olsen, EdD
65
Return to Course Module Listing
6/11/21
1
Outdoor Play:
Health and Safety for
Preschoolers
Dr. Heather Olsen
1
1
Learning Outcomes
After this course, participants will be able to:
§ Describe four reasons why outdoor play is important for
preschoolers.
§ Identify four safety hazards found in preschool outdoor
environments.
§ Identify four appropriate preschool activities for outdoor
play.
2
2
Outdoor Play is an Important
Part of Childhood
§ Young childre n
learn and develop
through play!
3
3
Preschoolers Benefit
4
Outdoor Play is Important
Reason #1
§
Health & well-being
§
Imaginative play
§
Peer relationships
§
Motor skills
§
Communication skills
§
Developing
appropriate challenges
4
6/11/21
2
Teac her s B ene fit
5
Outdoor Play is Important
Reason #2
5
Outdoor Play is Important
Reason #3
§ Sight
§ To uc h
§ Ta ste
§ Smell
§ Hearing
6
Five Senses
6
Outdoor Play is Important
Reason #4
§ Value outdoor time
§ Make outdoor time a
priority
§ Allow for plenty of time
7
Happiness
7
Outdoor Play Promotes Physical
Development
Gross Motor Skills
§
Running
§
Skipping
§
Riding a bicycle
§
Catching objects
§
Jump roping
§
Hopscotch
§
Hide and Seek
8
8
6/11/21
3
Outdoor Play Promotes Physical
Development
§ Writing, tracing, drawing
§ Cutting
§ Modeling clay
§ Painting
9
Fine Motor Skills
9
Outdoor Play Promotes Cognitive
Development
§ Intellectual capability is
becoming sophisticated
§ Capable of solving
problems
§ Thinking and reasoning
emerges
10
10
Outdoor Play Promotes Social and
Emotional Development
§ Forming relationships
§ Peer play
11
11
Outdoor Play Promotes
Communication Development
§ Language skills are
rapidly developing
§ Children enjoy
reading, writing, and
story telling
12
12
6/11/21
4
Review
§ Outdoor play is important because preschoolers and
teachers benefit.
§ Outdoor play is important because it helps physical,
cognitive, social/emotional, and communication
development.
13
13
Outdoor Safety
14
14
Playground Standard
15
15
4 Safety Hazards
§ Safety Hazard #1: Strangulation
§ Safety Hazard #2: Falls
§ Safety Hazard #3: Environmental
§ Safety Hazard #4: Equipment Related
16
16
6/11/21
5
Safety Hazard: Strangulation
§ Strangulation is one of the
leading causes of death for
young children.
17
17
Safety Hazard: Strangulation
§ Jump ropes and loose
parts are perfect for
preschoolers
BUT….
§ It is critical they are
supervised and used
appropriately
18
18
Safety Hazard: Falls
§ 70% of emergency room playground injuries are due to
children falling
§ Equipment over 12 inches should have proper surfacing
material under and around the equipment
19
19
20
Safety Hazard: Falls
20
6/11/21
6
Safety Hazard: Falls
Appropriate surfaces:
§ Wood products
§ Shredded rubber
§ Pea gravel
§ Sand
§ Unitary surfacing
§ Synthetic grass
§ Poured-in-place rubber
§ Rubber tiles
21
21
Safety Hazard: Environmental
1.
Playground temperature
2.
Avoiding pesticides
3.
Avoiding poisonous plants
22
22
Safety Hazard: Environmental
Shade Protection
23
§
Shade protection is important for the safety of
preschoolers and teachers.
23
Safety Hazard: Equipment Related
§ Broken & missing
pieces of equipment
24
24
6/11/21
7
Safety Hazard: Equipment Related
Open S-Hooks
25
§ S-hooks should be
completely closed so
a dime can not pass
through the opening.
25
Safety Hazard: Equipment Related
Crush & shearing mechanisms
26
Places to look:
§ Moving parts
§ Loose parts
§ Riding toys
26
Review
§ Safety Hazard #1: Strangulation
Supervise loose ropes, jump ropes, etc.
§ Safety Hazard #2: Falls
Elevated equipment should have a surfacing material
underneath to protect a fall.
27
27
Review
§ Safety Hazard #3: Environmental
Check playground temperatures and consider offering
natural or man-made shade.
§ Safety Hazard #4: Equipment Related
Check for open S-hooks, broken & missing equipment,
and crush & shearing points.
28
28
6/11/21
8
Summary
29
29
References
§ Olsen. H., Hudson, S., & Thompson, D. (2016). SAFE
and fun playgrounds: A handbook. St. Paul, MN: Redleaf
Press
§ Consumer Product Safety Commission (CPSC). (2010).
Playground safety handbook.
www.cpsc.gov/PageFiles/122149/325.pdf
30
30
Down Syndrome - Preschoolers
Cara Koscinski, BS, MOT, MOT, OTR/L
74
Return to Course Module Listing
Knowledge Check
After this course you will be able to answer the following question:
Alternative seating options for children who slouch
during mealtimes or activities may include:
A. Propping with foam wedges or pillows
B. Wiggle cushions
C. Bean bags
D. All of the above
Down Syndrome –
Preschool Children
Mother to two children who have autism and sensory processing
disorder. Younger son has mitochondrial disease and Tourette’s
disorder. He’s GJ tube fed.
Occupational Therapy Advisor & Contributing Author for
AutismAsperger’s Digest, Asperkids, and Autism File Magazine
Author of The Pocket Occupational Therapist for Caregivers of
Children with Special Needs; The Special Needs SCHOOL Survival
Guide book; Weighted Blanket Guide; Sensorimotor Interventions, and
Interoception: Sensing My World From the Inside
Founder of Aspire Pediatric Therapy, LLC; Route2Greatness, LLC;
and The Pocket Occupational Therapist
Working toward doctorate in occupational therapy
75
Down Syndrome Preschoolers
ENLARGE
Learning Outcomes
1) Participants will be able to name the characteristics of
preschoolers with Down syndrome including specific
medical and functional concerns.
2) Participants will be able to describe helpful teaching
strategies for preschoolers with Down syndrome.
3) Participants will be able to choose goals for preschool
students with Down syndrome.
§ “In every cell in the human body there is a nucleus, where genetic
material is stored in genes. Genes carry the codes responsible for
all of our inherited traits and are grouped along rod-like structures
called chromosomes. Typically, the nucleus of each cell contains
23 pairs of chromosomes, half of which are inherited from each
parent. Down syndrome occurs when an individual has a full or
partial extra copy of chromosome 21.”
§ “This additional genetic material alters the course of development
and causes the characteristics associated with Down syndrome.
A few of the common physical traits of Down syndrome are low
muscle tone, small stature, an upward slant to the eyes, and a
single deep crease across the center of the palm – although each
person with Down syndrome is a unique individual and may
possess these characteristics to different degrees, or not at all.”
https://www.ndss.org/
Important to Remember:
§ Down vs. Down’s syndrome
§ Down syndrome is named for the English physician John
Langdon Down, who characterized the condition, but did not
have it.
§ While Down syndrome is listed in many dictionaries with both
popular spellings (with or without an apostrophe s), the
preferred usage in the United States is Down syndrome. The
AP Stylebook recommends using “Down syndrome,” as well.
§ ALWAYS use person-first language.
§ The word ‘retarded’ is NEVER appropriate!
§ Use new and accepted terminology such as: intellectual or
cognitive disability.
76
Down Syndrome Preschoolers
ENLARGE
Down syndrome Fast Facts
§ It is the most common chromosomal condition diagnosed in
America.
§ 6,000 babies are born each year.
§ According to the Centers for Disease Control, Down syndrome
occurs in about 1 out of every 700 babies.
(Parker et al., 2010)
§ It is usually caused by an error in cell division called nondisjunction.
§ It occurs at conception and is NOT related to actions of the mother.
§ 80% of children with Down syndrome are born to women under 35
years of age.
§ Life expectancy for people with Down syndrome has increased
dramatically in recent decades – from 25 in 1983 to 60 today.
(National Down Syndrome Society, 2017)
About Chromosome 21
§ The smallest human chromosome, spanning about 48
million base pairs (the building blocks of DNA)
§ It represents 1.5 to 2 percent of the total DNA in cells
§ Was the second human chromosome to be fully
sequenced
§ According to Scientific American: “Down syndrome is
associated with more than 80 physical and mental
problems, including congenital heart disease, an
increased risk for certain leukemias, and immunological
deficiencies.”
About Chromosome 21
§ Mutations in 14 known genes on chromosome 21 play
roles in one form of Alzheimer's disease, amyotrophic
lateral sclerosis, and progressive myoclonus epilepsy,
among other diseases.
§ Also on chromosome 21 are genes that are as yet
unidentified, but known to be responsible for five so-
called monogenic disorders, including two forms of
deafness and Usher and Knobloch's syndromes.
Scientific American
Occurrence Specifics
§ It occurs in people of all races and economic levels.
§ A 35-year old woman has about a one in 350 chance of
conceiving a child with Down syndrome.
§ The chance increases gradually to 1 in 100 by age 40.
§ At age 45 the incidence becomes approximately 1 in 30.
The age of the mother does not seem to be linked to the
risk of translocation.
(National Down Syndrome Society, 2017)
77
Down Syndrome Preschoolers
How is it Diagnosed?
§ Prenatally
§ CVS first trimester between 9 and 14 weeks gestation
§ Amniocentesis during second trimester between 15 and 20
weeks gestation
§ At birth
§ Identification of physical characteristics
such as: flattened facial profile, upward
slant to the eyes, single deep crease in
palm of hand, low muscle tone
§ Completion of karyotype from blood
sample
§ FISH test
Co-Morbid Conditions
§ GERD
§ Celiac Disease
§ Low tone
§ 15% have underactive thyroid gland
§ Vision problems
§ Hearing problems
§ Increased rate of leukemia
§ Autism
§ Half of the population with Down syndrome develop Alzheimer’s
disease by age 50-60
§ ADHD
§ OCD
(National Down Syndrome Congress, 2017)
Cardiac Considerations
§ 40-50% have congenital heart disease
§ Atrioventricular septal defect is most common
§ The atrioventricular (AV) valves are abnormal to varying
degrees ranging from a cleft or gap in the mitral valve to
severe malformation of the valves in which there is a single
common valve entering both ventricles.
§ Ventricular septal defect second most common
§ If severe, damage to pulmonary arteries must be repaired
early via surgery
§ Mitral valve prolapse
§ Arrhythmias
(Lane, 2005)
Medical Problems
§ Hearing problems 75%
§ Vision problems 60%
§ Cataracts 15%
§ Refractive errors 50%
§ Obstructive sleep apnea 50–75%
§ Otitis media 50–70%
§ Congenital heart disease 40–50%
§ Hypodontia and delayed dental
eruption 23%
§ Gastrointestinal atresia 12%
§ Thyroid disease 4–18%
§ Seizures 1–13%
§ Hematologic problems:
§ Anemia 3%
§ Iron deficiency 10%
§ Tra nsien t myeloproli ferat i ve
disorder 10%
§ Leukemia 1%
§ Celiac disease 5%
§ Atlantoaxial instability 1–2%
§ Autism 1%
§ Hirschsprung disease 1%
Bull, 2011 via American Academy of Pediatrics
78
Down Syndrome Preschoolers
AAI (Atlanto-Axial Instability)
§ In the United States, atlantoaxial instability (AAI) with or without
subluxation has been reported in as many as 10-30% of
individuals with Down syndrome (Alvarez et al., 2016)
§ Either congenital absence or laxity of the transverse atlas
ligament (which may be associated with congenital anomalies
of the odontoid bone) must be considered
§ Pain, stiff neck, torticollis, gait disorder,
progressive paralysis
§ Weakness can occur in legs first
§ Compression of cervical roots and/or
spinal cord
§ Tingling, numbness, positive Babinski sign
Developmental Chart
Area
Milestone
Range for Children
with Down
Syndrome
Typical
Development
Gross motor
Sits alone
Crawls
6
-30 months
5
-9 months
Gross motor
Walks alone
1
-4 years
9
-18 months
Language
First words
1
-4 years
9
-18 months
Self
-help
Finger feeding
10
-24 months
7
-14 months
Self
-help
Uses spoon
19
-39 months
12
-20 months
Self
-help
Bowel control
2
-7 years
16
-42 months
Self
-help
Dresses self
unassisted
3.5
-8.5 years
3.25
-5 years
Adapted from www.ndss.org/resources/therapies-development/early-intervention
Transition Plan
§ Usually integrated
§ Can qualify for extra support via IDEA (Individuals with
Disabilities Education Act)
§ Pre-school services usually begin at age three
§ Tak e pic tu re s o f sc ho ol for st ud en t a nd m ak e a b oo k t o
ease transitions
Developmental Considerations
§ Delayed development especially apparent in early years
§ Behavior issues = make learning FUN and engaging
§ Psychologist Jennifer Wishart, states “Could run the risk of
changing slow but willing learners into reluctant, avoidant
learners.”
§ Speech deficits in both receptive and expressive language
§ Will see a difference in what students understand vs what
they are able to actually say
§ Genetic causes of Down syndrome are associated with
characteristic outcomes, such as relative strengths in visual-
spatial skills and relative challenges in motor planning
(Dunhauer &
Fidler, 2011)
79
Down Syndrome Preschoolers
ENLARGE
ENLARGE
Why Low Tone/Laxity?
§ Collagen is a protein that makes up ligaments, tendons,
cartilage, bone, support structure of skin
§ Collagen type VI gene is encoded on chromosome 21
§ Ligaments and laxity are greatly affected
§ Looser joints, hip, knee, and others may require ankle-
foot-orthosis (AFOs) or braces
§ Tee th c o m e in lat er an d m a y b e po int ed o r in co rre ct ord er
What IS Talk?
§ Communication = getting message across
§ Gestures = non-verbal, requests, facial expressions
§ Vocabulary = making meaning out of words
§ Grammar = stringing words together to learning and complex
meaning/communication
§ Speech = how we express ourselves
§ Understanding is ahead of expression
§ Make themselves understood
§ Deficits in speech production, sounding words
Language
§ Underpins social and cognitive development
§ Remembering, thinking, reasoning
§ Emotions, interoception, anxiety
§ Social skills involve language
Cognitive Function
§ Delays become apparent by school-age
§ Nonverbal skills can be a strength
§ Memory skills strong
§ Attention deficits
§ Executive function difficulties
§ Metacognition
§ Concrete thinkers so avoid ‘gray’ or abstract concepts
when teaching
§ Numbers and abstract concept learning may be delayed
80
Down Syndrome Preschoolers
Behavioral Concerns
§ Decreased communication
§ Decreased interoception
§ Increased tendency to show behavioral outbursts as
children
§ Use of visual schedules
§ Consistency across settings with clear rules and
expectations
Visual Learning
§ Use videos, illustrations, and games to learn pre-reading
concepts.
§ Multi-sensory teaching. Use movement, touch, smell,
vision, and sound to increase brain pathways when
learning a new skill.
§ Use of social stories.
§ Use blocks and manipulatives to teach concepts.
§ Hands on (kinesthetic learning) is important and fun!
Sign Language
§ Tea ch s ign s tha t m a tc h c om m on ob je ct s, wa nts , a nd
needs.
§ All caregivers and the treatment team should be
consistent.
§ Encourage use of signing combined with visual picture
boards when child is frustrated.
Reading
§ Use varied vocal tones
§ Usually a strength
§ Decreased auditory short-term memory
§ Matching games
§ Can decode (sound out)
§ Comprehension may lag
§ Read together
81
Down Syndrome Preschoolers
Social Skill Building
§ Use peer groups to encourage modeling.
§ Tea ch c on ce pt s s uc h a s s ha rin g, tu rn -taking, learn rules.
§ Free time or un-structured play may be difficult.
§ Use choices.
§ Give independent play options with visuals such as a
completed model.
Self-Care in Preschool
§ Weak with fasteners (zips, buttons, etc)
§ May need toileting assistance
§ Feeding assistance with small items or due to sensory
issues
§ On/off jacket or sweater
§ Hygiene
§ Eating and drinking delays common
Feeding
§ Give appropriate oral-motor toys for kids who put items
into their mouth
§ Aspiration is common (Comrie, 2015)
§ Silent aspiration
§ Decreased cough
§ Increased risk of infection after aspiration
§ Suck, swallow, breathe coordination (use of adapted cup)
§ Sensory concerns when initiating feeding
§ Reflux can be traumatic (behavior as communication)
Muscle Concerns
§ Ton gu e is no t b ig ge r… … .pro tru de s ou t d ue to lo w to ne
§ Drooling may occur
§ Hands and body joints may be ‘lax’ or have low tone due
to loose ligaments
§ Seating options to increase support
§ Tra nsfers may req uire extra help
§ Grab rails in toilet
82
Down Syndrome Preschoolers
Alternative Seating Options
§ Egg crates
§ Wiggle cushions
§ Bean bags
§ Propping with foam wedges or pillows
§ Never force a child to sit independently before he is ready
to – muscles and joints may be weak.
Sensory Processing Difficulties
§ May be bothered by background noises
§ Sensitive to certain sounds, tastes, textures, clothing,
foods, smells
§ May affect movement ability and knowledge of body
position in space
§ Can affect any classroom skill and is different for each
child
§ Some children are over-sensitive and others are under-
sensitive
Vision
§ More than half have visual deficits
§ Cataracts (even at birth)
§ Crossed eyes
§ Strabismus (squint)
§ May need bifocals
§ Upward slanting of the eyelids
§ Folds of skin between eye and nose
(Woodhouse, 2017)
§ Decreased accommodation, decreased acuity, contrast
sensitivity (may not see pencil lines on paper)
(Watt, et al., 2015)
Fine Motor
§ Bruni’s ‘House’ model:
§ Building blocks (ground) are: stability, motor coordination,
sensation
§ Top fl oor : dext er ity a nd d ai l y l i v ing sk il l s
§ School, self-help, household tasks, leisure activities
§ Hands of children are often smaller and the fingers shorter and
stubbier.
§ Thumb is often set lower down.
§ Some children may not have all of the usual wrist bones. These
factors will inevitably affect the ability to hold and manipulate objects.
(Alton, 2005)
§ Provide stability, hand exercises, strengthening, positional changes.
83
Down Syndrome Preschoolers
Cutting and Motor Skills
§ May need adaptive scissors
§ May see behaviors as skills may be ‘non-preferred’
§ Highlight or use darker lines for
cutting and writing lines
Wrap-up
§ Children can learn
§ Consider visual issues
§ Joint and collagen concerns
§ Consistency across settings
§ Have fun!
www.PocketOT.com
www.facebook.com/PocketOT
E-mail me: ThePocketOT@gmail.com
References
§ Alton, S. (2005). Fine motor skills in children with Down’s syndrome information sheet. DSA
§ UK Education Consortium. http://webfronter.com/greenwich/STEPS/other/DSAInfosheet-
FineMotor[1].pdf
§ Alvarez, N. (2016). Atlanto Instability in Down Syndrome. Neurology.
https://emedicine.medscape.com/article/1180354-overview#a3
§ American Occupational Therapy Association, http://www.aota.org
§ Bruni, M. (2001). Occupational Therapy and the Child with Down Syndrome. http://www.ds-
health.com/occther.htm
§ Bruni, M., Cameron, D., Dua, S., and Noy, S (2010) Reported Sensory Processing of
Children with Down Syndrome, Physical & Occupational Therapy In Pediatrics, 30:4, 280-
293, DOI: 10.3109/01942638.2010.486962
§ Bull, M.J., and the Committee on Genetics. (2011). Clinical Report – Health Supervision of
for Children with Down Syndrome. American Academy of Pediatrics,
http://pediatrics.aappublications.org/content/128/2/393
§ Comrie, J. D.., (2015). Education Series. Carolina Pediatric Dysphagia.
http://feeding.com/wp-content/uploads/2015/10/Down-Syndrome-Feeding-Difficulties-
FAQ_CPD.pdf
§ Daunhauer, L., and Fidler, D., (2011) The Down Syndrome Behavioral Phenotype:
Implications for Practice and Research in Occupational Therapy, Occupational Therapy In
Health Care, 25:1, 7-25, DOI: 10.3109/07380577.2010.535601
§ Dolva, A., Coster, W., Lilja,.D. Functional Performance in Children With Down Syndrome. Am
J Occup Ther 2004;58(6):621-629. doi: 10.5014/ajot.58.6.621.
84
Down Syndrome Preschoolers
ENLARGE
References
§ El-Khouri M, Mourão MA, To bo A, Battistella LR, Herrero CF, Riberto M. Prevalence of
atlanto-occipital and atlantoaxial instability in adults with Down syndrome. World Neurosurg.
2014 Jul-Aug. 82 (1-2):215-8. [Medline]
.
§ Fidler, D.J., Hepburn, S.L., Mankin,G., Rogers, S.J.; Praxis Skills in Young Children With
Down Syndrome, Other Developmental Disabilities, and Typically Developing Children. Am J
Occup Ther 2005;59(2):129-138. doi: 10.5014/ajot.59.2.129.
§ Frid C, Drott P, Lundell B, Rasmussen F, Anneren G. Mortality in Down’s syndrome in relation
to congenital malformations. J. Intellectual Disability Research 1999; 43:234-241.
§ Grieco, J., Pulsifer, M., Seligsohn, K., Skotko, B., & Schwartz, A. (2015). Down syndrome:
Cognitive and behavioral functioning across the lifespan. American Journal of Medical
Genetics Part C: Seminars in Medical Genetics,169(2), 135-149. doi:10.1002/ajmg.c.3143
§ Guralnick, M. J., Connor, R. T., & Johnson, L. C. (2011). The Peer-Related Social
Competence of Young Children with Down Syndrome. American Journal on Intellectual and
Developmental Disabilities, 116(1), 48–64. http://doi.org/10.1352/1944-7558-116.1.48
§ https://ghr.nlm.nih.gov/condition/down-syndrome
§ http://pediatrics.aappublications.org/content/pediatrics/128/2/393.full.pdf
References
§ https://www.ndsccenter.org/programs-resources/health-care/
§ Lane, J. R., M.D., F.A.C.C., Director, Adult Congenital Heart Service, Akron Children’s
Hospital, Akron, Ohio, 2005
§ Parker SE, Mai CT, Canfield MA, et al. Updated national birth prevalence estimates for
selected birth defects in the United States, 2004-2006. Birth Defects Res A Clin Mol Te rat ol .
2010;88:1008-16.
§ Scientific American: https://www.scientificamerican.com/article/mapping-chromosome-21
§ Woodhouse, J. (2017) Eye and Vision Problems in Children with Down’s Syndrome.
Intellectual Disability and Health.
http://www.intellectualdisability.info/physical-
health/articles/eye-and-vision-problems-in-children-with-downs-syndrome
§ Watt, T., Robertson, K. & Jacobs, R.J.(2015) Refractive error, binocular vision and
accommodation of children with Down syndrome: Review. Clinical and Experimental
Optometery, 98, 3-11. http://onlinelibrary.wiley.com/doi/10.1111/cxo.12232/pdf
§ Jennifer G. Wishart (1998) Development in Children With Down Syndrome: facts, findings,
the future, International Journal of Disability, Development and Education, 45:3, 343-
363, DOI: 10.1080/1034912980450309
§ Yod er, P. J ., Woynaroski, T., Fey, M. E., Warren, S. F., & Gardner, E. (2015). Why Dose
Frequency Affects Spoken Vocabulary in Preschoolers With Down Syndrome. American
Journal on Intellectual and Developmental Disabilities, 120(4), 302–314.
http://doi.org/10.1352/1944-7558-120.4.302
Resources for Teachers and Caregivers
§ Down Syndrome Research Foundation
§ Down’s Syndrome Association
§ Global Down Syndrome Foundation
§ National Association for Down Syndrome
§ National Down Syndrome Society
§ National Institute of Health’s Genetics Home Reference
Knowledge Check
Alternative seating options for children who slouch
during mealtimes or activities may include:
A. Propping with foam wedges or pillows
B. Wiggle cushions
C. Bean bags
D. All of the above
85
Down Syndrome Preschoolers
Return to Course Module Listing
Keeping Preschoolers Safe Throughout the Day: Use
Routines-Based Strategies
Amanda Schwartz, PhD
86
Return to Course Module Listing
Keeping Preschoolers
Safe Throughout the Day
Using Routines-Based Strategies
Dr. Amanda Schwartz
1
Learning Outcomes
§ Define injury prevention and why it is important.
§ Identify the typical developmental expectations
and risks or hazards in teaching environments.
§ Describe strategies to keep preschoolers safe
within their daily routines and environments.
2
The Problem:
Causes of Fatal
Injury
2016 CDC Data on Unintentional Death
3
THE
PROBLEM:
TOP 10 Causes of
Nonfatal Injuries
2015 CDC Data on Unintentional Injury
1. Falls
2. Struck By/Against
3. Bite/Sting
4. Foreign Body
5. Cut/Pierce
6. Motor Vehicle
7. Overexertion
8. Dog Bite
9. Pedal Cyclist
10. Other
4
87
Keeping Preschoolers Safe
ENLARGE
CAN INJURIES
BE PREVENTED?
YES!
There is NO such
thing as an
accident.
5
Finding Concerns
Hazard Mapping
1. Identify locations where injuries occur
2. Determine how they occur
3. Develop a Corrective Action Plan
6
Identify locations where injuries
occur
1. Complete injury/incident reports
§ Caring For Our Children, 3
rd
Edition (CFOC3)
Incident Report Form
Child Injury Report Form for Indoor and Outdoor Injuries
2. Remove or prevent access to hazards
3. Analyze results every four months
§ Place dots on a map to mark where injuries occurred
§ Highlight areas where severe injuries occurred
§ Circle areas where injuries occurred most frequently
7
Determine how they occur
1. List circled and highlighted areas
2. Review injury/incident reports to learn:
§ Who was involved and present
§ What happened
§ When did the injury occur
3. Summarize your answers to find
commonalities
8
88
Keeping Preschoolers Safe
Develop Corrective Action Plan
1. Research solutions for common issues
§ Use strategies that have worked
§ Ask staff and families to contribute ideas
2. Develop corrective action plan, including:
§ What
§ Who
§ When
§ Where
3. Establish a “check in” to make sure the plan is
being implemented
9
For more on Hazard Mapping:
10
https://eclkc.ohs.acf.
hhs.gov/sites/default
/files/pdf/hazard-
mapping_0.pdf
What do we know
about preschoolers?
§ Move and play with ease
§ More independent
§ Use cause and effect to understand risk
§ Curiosity is about imagination
§ Experimentation leads to learning
§ Environments should promote learning
§ Nurturing, consistent, caring and responsive
relationships
§ Rules and routines are important
11
Establishing Safe
Everyday Routines
§ All Day
§ Diapering and Toileting
§ Feeding
§ Napping
§ Play
12
89
Keeping Preschoolers Safe
ENLARGE
Things to do all day
§ Use active supervision
§ Set up the environment
§ Position staff
§ Scan and count
§ Listen
§ Anticipate children’s behavior
§ Engage and redirect
§ Create and maintain safe environments
§ Use safety checklist before every use
§ Secure age appropriate furniture
§ Store and lock poisonous products and plants up
and away
13
Diapering and Toileting
§ Be attentive
§ Supervise children in the bathroom
§ Interact and stay “hands on” if diapering
§ Keep a hand on the young preschooler
§ Interact and play
§ Keep diapering/toileting areas clean
§ Disinfect areas after each use
§ Store diaper/toileting supplies safely
§ Place supplies out of child reach
§ Follow state licensing regulations for storing cleaning and
diapering supplies
14
Meal times
§Teach preschoolers how to eat
safely
§ Model use of child-sized eating
utensils
§ Te ac h po r tion c on t ro l
15
Napping
§ Offer child appropriate sleeping furniture
§ Washable cots
§ Close to the floor
16
90
Keeping Preschoolers Safe
Play
§ Use age appropriate equipment and
materials
§ No spaces that can trap head and limbs
§ Consider height and weight restrictions
§ Te ac h sa f e ty t e ch n ique s
§ Wear helmets and safety gear
§ Instruct on use of materials and equipment
§ Offer pedestrian safety lessons
§ Inspect play equipment and spaces before
use
17
Try It Out!
§Identify the following:
§ Tips used
§ Active supervision
§ Age appropriate materials
§ Te a c h safety pr ac t i ces
§ Strengths
§ Te a c h safety pr ac t i ces
§ Areas to improve
§ Active supervision
18
Try It Out!
§Identify the following:
§ Tips used
§ Offer child appropriate sleeping furniture
§ Strengths
§ Clean sleep surface
§ Areas to improve
19
Try It Out!
§Identify the following:
§ Tips used
§ Active supervision
§ Age appropriate materials
§ Te a c h safety pr ac t i ces
§ Strengths
§ Te a c h safety pr ac t i ces
§ Areas to improve
§ Active supervision
20
91
Keeping Preschoolers Safe
Additional Resources
§ Caring for Our Children
National Health and Safety Performance
Standards
Guidelines for Early Care and Education
Programs
http://cfoc.nrckids.org
21
Additional Resources
22
https://eclkc.ohs.acf.
hhs.gov/safety-
practices/article/tips-
keeping-children-
safe-developmental-
guide
Additional Resources
§ Health and Safety Checklist for
Early Care and Education
Programs
https://cchp.ucsf.edu/sites/cchp.ucsf.edu/files/
HS_Checklist.pdf
23
Additional Resources
24
https://www.cpsc.gov
92
Keeping Preschoolers Safe
ENLARGE
ENLARGE
Additional Resources
25
https://www.recalls.gov
You can keep
preschoolers safe!
Plan ahead and be consistent
in your routines.
26
Questions?
Dr. Amanda Schwartz
a_l_schwartz@yahoo.com
27
93
Keeping Preschoolers Safe
Return to Course Module Listing
ENLARGE
Empowering Kids to be Healthy and Smart from the
Inside Out!
Michelle Lombardo, DC
94
Return to Course Module Listing
Empowering Kids to be Healthy
and Smart from The Inside Out!
Results and Best Practice from a Childhood Obesity
Prevention Program with Head Start Children
1
Learning Outcomes
§ Appraise their role as a leader in creating a health-
oriented environment that encourages wellbeing for
children, providers and parents.
§ Implement nutrition and healthy living programs that
are aligned with Early Childhood priorities.
§ Plan for the incorporation of movement, nutritious
foods, and food-based education into their day.
2
Obesity Trends* Among U.S. Adults
BRFSS, 1988
(*BMI ≥30, or ~ 30 lbs. overweight for 5
4
person)
No Data <10% 10%–14%
3
www.cdc.gov
Obesity Trends* Among U.S. Adults
BRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5
4
person)
No Data <10% 10%–14% 15%–19%
4
www.cdc.gov
95
Empowering Kids - Healthy & Smart
ENLARGE
ENLARGE
Obesity Trends* Among U.S. Adults
BRFSS, 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5
4
person)
No Data <10% 10%–14% 15%–19% ≥20%
5
www.cdc.gov
Obesity Trends* Among U.S. Adults
BRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5
4
person)
No Data <10% 10%–14% 15%–19% ≥20%
6
www.cdc.gov
Obesity Trends* Among U.S. Adults
BRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5
4
person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
7
www.cdc.gov
Obesity Trends* Among U.S. Adults
BRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5
4
person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
8
www.cdc.gov
96
Empowering Kids - Healthy & Smart
ENLARGE
ENLARGE
ENLARGE
ENLARGE
Obesity Trends* Among U.S. Adults
BRFSS, 2010
(*BMI ≥30, or ~ 30 lbs. overweight for 5
4
person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
9
www.cdc.gov
Obesity Trends* Among U.S. Adults
BRFSS, 1990, 2000, 2010
2000
(*BMI
³
30, or about 30 lbs. overweight for 5
4
person)
2010
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
10
www.cdc.gov
Reference: https://stateofobesity.org/adult-obesity/
Adult Obesity Rate by State, 2016
11
Childhood Obesity –
A National Crisis
§ One out of 3 children in America
today are overweight & obese
§ These kids are 5 times more likely
to be overweight or obese as
adults
12
SOURCE: Pediatric Nutrition Surveillance System, 2008-2011
97
Empowering Kids - Healthy & Smart
ENLARGE
ENLARGE
ENLARGE
Excess Costs Related to
Overweight and Obesity
Estimates
Currently: $254 billion
§ ($208 billion in lost productivity secondary to
premature morbidity and mortality and $46
billion in direct medical costs)
If trends continue: $861 to $957 billion by 2030
§ (Accounting for 16% to 18% of US health
expenditures)
13
SOURCE: American Heart Association, Statistical Fact Sheet Update 2013
Perhaps it’s time to reconsider . . .
14
§ By 1980, the food industry was full steam ahead
producing low-fat, high sugar foods, replacing healthy
saturated fat with harmful fats, industrially processed
vegetable oils, lots of refined sugar AND High Fructose
Corn Syrup.
15
https://vivienveil.com/2012/10/13/why-cant-i-stop-eating/
16
98
Empowering Kids - Healthy & Smart
ENLARGE
ENLARGE
https://cspinet.org/sites/default/files/attachment/combined_infographic.pdf
The American Heart Association recommends that women consume no more
than 6 teaspoons and men no more than 9 teaspoons of added sugars per
day.
17
6 teaspoons
added sugars
for women per
day
9 teaspoons
added sugars for
men per day
15 teaspoons
of sugars in a
20 oz. Coke
23 teaspoons =
Actual added sugars consumed
by average American per day
Outcomes of drinking sugary sodas…
§ Tooth deca y
§ Heart disease
§ Diabetes
§ Obesity
§ Gout
18
§ Metabolic syndrome
§ Higher blood pressure
§ Higher blood sugar
§ Higher triglycerides
§ Lower “good” cholesterol
§ More belly fat
hhttps://cspinet.org/sites/default/files/attachment/combined_infographic.pdf
https://articles.mercola.com/sites/articles/archive/2009/03/24/why-highfructose-corn-syrup-causes-insulin-resistance.aspx
The obesity and diabetes epidemics are no surprise when
you consider the fact that the number one source of calories
in America is high fructose corn syrup in soda.
§ There are about 40 grams of HFCS per can –
more than the American Medical Association’s
recommended daily maximum for ALL caloric
sweeteners.
§ And that’s without adding in all the corn syrup
now found in every type of processed, pre-
packaged food you can think of.
19
Heres what happens
when you eat . . .
When the food arrives in
the intestines, the
carbohydrates get
broken down into
simple sugars. These
simple sugars then go
into the blood stream.
20
99
Empowering Kids - Healthy & Smart
ENLARGE
ENLARGE
Once this sugar is in the
blood, it needs a way to
be delivered into the
trillions of cells in your
body.
21
Peter Pancreas’ job is to help deliver this sugar into the
body’s cells. He does this by making INSULIN.
Insulin is like a key that opens the gate
to every cell of the body.
Lets see how this works . . .
22
Call on Peter Pancreas and the Insulin Keys!
Insulin opens the gate
so the sugar can enter
the cell so your body
can function.
23
If Peter Pancreas can’t
make insulin, a person
will HAVE TO TAKE
medication (insulin) every
day.
(Thank goodness for this
type of medicine!)
Typ e 1 D ia be tes :
But there is another type.
24
100
Empowering Kids - Healthy & Smart
ENLARGE
ENLARGE
ENLARGE
ENLARGE
Typ e 2 D ia be tes :
Peter Pancreas is
making enough insulin,
but the insulin keys are
having trouble doing
their job!
This type of diabetes is
one that can be
prevented AND even
REVERSED by making
healthy food and
exercise choices!
25
Here’s what happens to Peter Pancreas
on a high sugar diet . . .
All this sugar at
once has got to
be stressful!
26
27
28
101
Empowering Kids - Healthy & Smart
ENLARGE
ENLARGE
ENLARGE
ENLARGE
What can help keep the sugar level
in your blood stable and help Peter
Pancreas do his job?
The Fiber
Guys!
Which foods include these Guys?
29
Give him a break by
choosing high-fiber options!
Add in fiber so Peter
Pancreas can easily
handle the job!
30
31
So is fat making us fat (and sick)?
It depends on which kind.
Unhealthy Fats Healthy Fats
32
102
Empowering Kids - Healthy & Smart
ENLARGE
ENLARGE
www.mercola.com
§ Promotes gut inflammation and leaky gut – often causes
heartburn.
§ Omega-6 polyunsaturated fats when taken in large amounts,
cannot be burned for fuel. Instead, they're incorporated into
your cellular and mitochondrial membranes, where they are
highly susceptible to oxidative damage.
§ When heated, vegetable oils tend to oxidize. Oxidized
cholesterol is the real culprit that causes heart disease. By
triggering inflammation, it promotes the clogging of arteries
and associated cardiovascular problems, including heart
attacks.
Why vegetable oils are
so bad for your health . . .
33
www.mercola.com
Load up on these good fats . . .
34
When you replace carbs/sugars with fat
for fuel . . .
§ You optimize your mitochondrial
function
§ You tur n on your body’s ability to
burn body fat
§ Your metabolism runs more efficiently
§ You enjoy long-lasting energy and
stamina
§ Your brain functions more efficiently
and you feel sharper
§ Glucose is a “dirty” fuel while burning
fat is much cleaner
35
Oxidative
Phosphorylation
Tak in g th e ai r we brea th
+ foods we eat to create
energy for our bodies.
36
103
Empowering Kids - Healthy & Smart
ENLARGE
Burning “sugar” for
energy - ATP
A “dirty” way to create energy!
37
www.Mercola.com
A diet high in sugar causes . . .
§ Widespread inflammation and cellular damage
§ Faster aging and a greater risk of all cancers
§ An increase in insulin resistance, cells do not
respond to insulin effectively
§ Overeating due to the loss of control over your
appetite
§ An inability to lose weight because your body is
holding onto fat instead of burning it for fuel
38
Burning healthy fat for
energy - ATP
A better way to create energy!
39
Four healthy habits
for OrganWise kids:
1. Healthy Foods
2. High-Fiber
3. Lots of Water
4. Exercise
40
104
Empowering Kids - Healthy & Smart
Linked to standards in all 50 states!
41
Astounding Health AND Academic Outcomes!
Results published in:
Journal of the American Dietetic Association
Journal of American Public Health
Journal of Healthcare for the Poor and Underserved
42
The Gold Standard: Reducing BMI Percentiles in Children
Change in BMI Percentiles
With OrganWise Program
Fall to Spring
(OneSchool Ye ar )
Change in BMI Percentile
*p=.007
Published in the Journal of the American Dietetic Association
(The Journal of the Academy of Nutrition and Dietetics)
Hollar D, Messiah SE, Lopez-Mitnik G, Almon M, Hollar TL, Agatston AS. Effect of a school-based obesity prevention intervention
on weight and blood pressure in 6-13 year olds. Journal of the American Dietetic Association, 2010;110 (2), 261-267.
43
Published in the Journal of the American Dietetic Association
(The Journal of the Academy of Nutrition and Dietetics)
Hollar D, Messiah SE, Lopez-Mitnik G, Almon M, Hollar TL, Agatston AS. Effect of a school-based obesity prevention intervention
on weight and blood pressure in 6-13 year olds. Journal of the American Dietetic Association, 2010;110 (2), 261-267.
Lowers Blood Pressure in Children
44
105
Empowering Kids - Healthy & Smart
ENLARGE
ENLARGE
ENLARGE
ENLARGE
Published in the American Journal of Public Health
Hollar D, Messiah SE, Lopez-Mitnik G, Almon M, Hollar TL, Agatston AS. Effect of an elementary school-based obesity prevention
Intervention on weight and academic performance among low income children. American Journal of Public Health. 2010;100: 646-653.
Improves Math and Reading Scores
No other program has achieved these results!
45
FIVE STARS in Global Comprehensive
Review of Childhood Overweight &
Obesity Research Publications
46
Whole School, Whole Community,
Whole Child Model
47
Professional Development In-Service
(With a little something extra!)
Helping centers create a culture of health and well-being
for students, families and staff!
Dr. Michelle Lombardo
770-495-0374
48
106
Empowering Kids - Healthy & Smart
ENLARGE
ENLARGE
§ Founded in 1993 by Dr. Michelle Lombardo and Karen
McNamara
§ The
only
large-scale childhood obesity prevention
program that
shows health and academic outcomes.
§ National experts in orchestrating public-private
partnerships for community-wide prevention models
§ OrganWise is a certified Women Owned Business
through the Greater Women’s Business Council
§ Full service project management organization providing
seamless program delivery
Unparalleled Experience and Expertise
32
49
Together We Can Ma ke A Di ff erenc e
Dr. Michelle Lombardo
michelle@organwiseguys.com
www.organwiseguys.com
800-786-1730
33
50
107
Empowering Kids - Healthy & Smart
Return to Course Module Listing
ENLARGE
Con
gratulations
Now
that you have viewed all 10 modules, please take a moment to review the Exam
Questions again. When you are ready, log into your account on continued.com and
click on the ‘Dashboard’ button. You should find CDA Credential - Preschool, Part 11
located in your Pending Courses. Click the ‘Resume’ Button and select the ‘Take
Exam’ option to proceed.
If you have any questions, please call 866-727-1617 or
Contact Us via email for assistance.
108
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