Disability Guide
The creation of this disability guide is an education student's effort to create a central resource center to provide basic information pertaining to disabilities present within our school system today. The information found here presents merely a brief overview of various disorders from information gathered from various resources. The disorders may be more thoroughly researched by accessing the links within the disability guide or by contacting Chileda.

Legislation
The Rehabilitation Act of 1973
Individuals with Disabilities Education Act
Voting Accessibility for the Elderly and Handicapped Act
Fair Housing Act
Americans with Disabilities Act (ADA)
National Voter Registration Act
Telecommunications Act
Air Carrier Access Act
Civil Rights of Institutionalized Persons Act
Architectural Barriers Act

Abbreviations

Specific Disabilities
Asperger's Syndrome:
Attention Deficit Hyperactivity Disorder:
Autism:
Behavioral Disorders:
Cerebral Palsy:
Down Syndrome:
Eating Disorders:
Epilepsy:
Fetal Alcohol Syndrome:
Fragile X Syndrome:
Learning Disabilities:  
Spina Bifida:
Tourette's Syndrome:
Turner's Syndrome:
William's Syndrome:


Rehabilitation Act - 1973
The Rehabilitation Act prohibits discrimination on the basis of disability in programs conducted by Federal agencies, in programs receiving Federal financial assistance, in Federal employment, and in the employment practices of Federal contractors. The standards for determining employment discrimination under the Rehabilitation Act are the same as those used in title I of the Americans with Disabilities Act.

Section 501
Section 501 requires affirmative action and nondiscrimination in employment by Federal agencies of the executive branch. To obtain more information or to file a complaint, employees should contact their agency's Equal Employment Opportunity Office.

Section 503
Section 503 requires affirmative action and prohibits employment discrimination by Federal government contractors and subcontractors with contracts of more than $10,000. For more information on section 503, contact:

Section 504
Section 504 states that "no qualified individual with a disability in the United States shall be excluded from, denied the benefits of, or be subjected to discrimination under" any program or activity that either receives Federal financial assistance or is conducted by any Executive agency or the United States Postal Service.

Each Federal agency has its own set of section 504 regulations that apply to its own programs. Agencies that provide Federal financial assistance also have section 504 regulations covering entities that receive Federal aid. Requirements common to these regulations include reasonable accommodation for employees with disabilities; program accessibility; effective communication with people who have hearing or vision disabilities; and accessible new construction and alterations. Each agency is responsible for enforcing its own regulations. Section 504 may also be enforced through private lawsuits. It is not necessary to file a complaint with a Federal agency or to receive a "right-to-sue" letter before going to court.

Section 508
Section 508 establishes requirements for electronic and information technology developed, maintained, procured, or used by the Federal government. Section 508 requires Federal electronic and information technology to be accessible to people with disabilities, including employees and members of the public.

An accessible information technology system is one that can be operated in a variety of ways and does not rely on a single sense or ability of the user. For example, a system that provides output only in visual format may not be accessible to people with visual impairments and a system that provides output only in audio format may not be accessible to people who are deaf or hard of hearing. Some individuals with disabilities may need accessibility-related software or peripheral devices in order to use systems that comply with Section 508.
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Individuals with Disabilities Education Act - 1975
The Individuals with Disabilities Education Act (IDEA) (formerly called P.L. 94-142 or the Education for all Handicapped Children Act of 1975) requires public schools to make available to all eligible children with disabilities a free appropriate public education in the least restrictive environment appropriate to their individual needs.

IDEA requires public school systems to develop appropriate Individualized Education Programs (IEP's) for each child. The specific special education and related services outlined in each IEP reflect the individualized needs of each student.

IDEA also mandates that particular procedures be followed in the development of the IEP. Each student's IEP must be developed by a team of knowledgeable persons and must be at least reviewed annually. The team includes the child's teacher; the parents, subject to certain limited exceptions; the child, if determined appropriate; an agency representative who is qualified to provide or supervise the provision of special education; and other individuals at the parents' or agency's discretion.

If parents disagree with the proposed IEP, they can request a due process hearing and a review from the State educational agency if applicable in that state. They also can appeal the State agency's decision to State or Federal court.
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Voting Accessibility for the Elderly and Handicapped Act - 1984
The Voting Accessibility for the Elderly and Handicapped Act of 1984 generally requires polling places across the United States to be physically accessible to people with disabilities for federal elections. Where no accessible location is available to serve as a polling place, a political subdivision must provide an alternate means of casting a ballot on the day of the election. This law also requires states to make available registration and voting aids for disabled and elderly voters, including information by telecommunications devices for the deaf (TDDs) which are also known as teletypewriters (TTYs).
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Fair Housing Act -1988
The Fair Housing Act, as amended in 1988, prohibits housing discrimination on the basis of race, color, religion, sex, disability, familial status, and national origin. Its coverage includes private housing, housing that receives Federal financial assistance, and State and local government housing. It is unlawful to discriminate in any aspect of selling or renting housing or to deny a dwelling to a buyer or renter because of the disability of that individual, an individual associated with the buyer or renter, or an individual who intends to live in the residence. Other covered activities include, for example, financing, zoning practices, new construction design, and advertising.

The Fair Housing Act requires owners of housing facilities to make reasonable exceptions in their policies and operations to afford people with disabilities equal housing opportunities. For example, a landlord with a "no pets" policy may be required to grant an exception to this rule and allow an individual who is blind to keep a guide dog in the residence. The Fair Housing Act also requires landlords to allow tenants with disabilities to make reasonable access-related modifications to their private living space, as well as to common use spaces. (The landlord is not required to pay for the changes.) The Act further requires that new multifamily housing with four or more units be designed and built to allow access for persons with disabilities. This includes accessible common use areas, doors that are wide enough for wheelchairs, kitchens and bathrooms that allow a person using a wheelchair to maneuver, and other adaptable features within the units
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Americans with Disabilities Act (ADA) - 1990
The ADA prohibits discrimination on the basis of disability in employment, State and local government, public accommodations, commercial facilities, transportation, and telecommunications. It also applies to the United States Congress.

To be protected by the ADA, one must have a disability or have a relationship or association with an individual with a disability. An individual with a disability is defined by the ADA as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment. The ADA does not specifically name all of the impairments that are covered.

ADA Title I: Employment
Title I requires employers with 15 or more employees to provide qualified individuals with disabilities an equal opportunity to benefit from the full range of employment-related opportunities available to others. For example, it prohibits discrimination in recruitment, hiring, promotions, training, pay, social activities, and other privileges of employment. It restricts questions that can be asked about an applicant's disability before a job offer is made, and it requires that employers make reasonable accommodation to the known physical or mental limitations of otherwise qualified individuals with disabilities, unless it results in undue hardship. Religious entities with 15 or more employees are covered under title I.

ADA Title II: State and Local Government Activities
Title II covers all activities of State and local governments regardless of the government entity's size or receipt of Federal funding. Title II requires that State and local governments give people with disabilities an equal opportunity to benefit from all of their programs, services, and activities (e.g. public education, employment, transportation, recreation, health care, social services, courts, voting, and town meetings).

State and local governments are required to follow specific architectural standards in the new construction and alteration of their buildings. They also must relocate programs or otherwise provide access in inaccessible older buildings, and communicate effectively with people who have hearing, vision, or speech disabilities. Public entities are not required to take actions that would result in undue financial and administrative burdens. They are required to make reasonable modifications to policies, practices, and procedures where necessary to avoid discrimination, unless they can demonstrate that doing so would fundamentally alter the nature of the service, program, or activity being provided.

Title II may also be enforced through private lawsuits in Federal court. It is not necessary to file a complaint with the Department of Justice (DOJ) or any other Federal agency, or to receive a "right-to-sue" letter, before going to court.

ADA Title II: Public Transportation
The transportation provisions of title II cover public transportation services, such as city buses and public rail transit (e.g. subways, commuter rails, Amtrak). Public transportation authorities may not discriminate against people with disabilities in the provision of their services. They must comply with requirements for accessibility in newly purchased vehicles, make good faith efforts to purchase or lease accessible used buses, remanufacture buses in an accessible manner, and, unless it would result in an undue burden, provide paratransit where they operate fixed-route bus or rail systems. Paratransit is a service where individuals who are unable to use the regular transit system independently (because of a physical or mental impairment) are picked up and dropped off at their destinations. Questions and complaints about public transportation should be directed to:

ADA Title III: Public Accommodations
Title III covers businesses and nonprofit service providers that are public accommodations, privately operated entities offering certain types of courses and examinations, privately operated transportation, and commercial facilities. Public accommodations are private entities who own, lease, lease to, or operate facilities such as restaurants, retail stores, hotels, movie theaters, private schools, convention centers, doctors' offices, homeless shelters, transportation depots, zoos, funeral homes, day care centers, and recreation facilities including sports stadiums and fitness clubs. Transportation services provided by private entities are also covered by title III.

Public accommodations must comply with basic nondiscrimination requirements that prohibit exclusion, segregation, and unequal treatment. They also must comply with specific requirements related to architectural standards for new and altered buildings; reasonable modifications to policies, practices, and procedures; effective communication with people with hearing, vision, or speech disabilities; and other access requirements. Additionally, public accommodations must remove barriers in existing buildings where it is easy to do so without much difficulty or expense, given the public accommodation's resources.

Courses and examinations related to professional, educational, or trade-related applications, licensing, certifications, or credentialing must be provided in a place and manner accessible to people with disabilities, or alternative accessible arrangements must be offered.

Commercial facilities, such as factories and warehouses, must comply with the ADA's architectural standards for new construction and alterations.

Complaints of title III violations may be filed with the Department of Justice. In certain situations, cases may be referred to a mediation program sponsored by the Department. The Department is authorized to bring a lawsuit where there is a pattern or practice of discrimination in violation of title III, or where an act of discrimination raises an issue of general public importance. Title III may also be enforced through private lawsuits. It is not necessary to file a complaint with the Department of Justice (or any Federal agency), or to receive a "right-to-sue" letter, before going to court. For more information, contact:

ADA Title IV: Telecommunications Relay Services
Title IV addresses telephone and television access for people with hearing and speech disabilities. It requires common carriers (telephone companies) to establish interstate and intrastate telecommunications relay services (TRS) 24 hours a day, 7 days a week. TRS enables callers with hearing and speech disabilities who use telecommunications devices for the deaf (TDDs), which are also known as teletypewriters (TTYs), and callers who use voice telephones to communicate with each other through a third party communications assistant. The Federal Communications Commission (FCC) has set minimum standards for TRS services. Title IV also requires closed captioning of Federally funded public service announcements.

National Voter Registration Act - 1993
The National Voter Registration Act of 1993, also known as the "Motor Voter Act," makes it easier for all Americans to exercise their fundamental right to vote. One of the basic purposes of the Act is to increase the historically low registration rates of minorities and persons with disabilities that have resulted from discrimination. The Motor Voter Act requires all offices of State-funded programs that are primarily engaged in providing services to persons with disabilities to provide all program applicants with voter registration forms, to assist them in completing the forms, and to transmit completed forms to the appropriate State official.
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Telecommunications Act -1996
Section 255 and Section 251(a)(2) of the Communications Act of 1934, as amended by the Telecommunications Act of 1996, require manufacturers of telecommunications equipment and providers of telecommunications services to ensure that such equipment and services are accessible to and usable by persons with disabilities, if readily achievable. These amendments ensure that people with disabilities will have access to a broad range of products and services such as telephones, cell phones, pagers, call-waiting, and operator services, that were often inaccessible to many users with disabilities.
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Air Carrier Access Act
The Air Carrier Access Act prohibits discrimination in air transportation by domestic and foreign air carriers against qualified individuals with physical or mental impairments. It applies only to air carriers that provide regularly scheduled services for hire to the public. Requirements address a wide range of issues including boarding assistance and certain accessibility features in newly built aircraft and new or altered airport facilities. People may enforce rights under the Air Carrier Access Act by filing a complaint with the U.S. Department of Transportation, or by bringing a lawsuit in Federal court.
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Civil Rights of Institutionalized Persons Act
The Civil Rights of Institutionalized Persons Act (CRIPA) authorizes the U.S. Attorney General to investigate conditions of confinement at State and local government institutions such as prisons, jails, pretrial detention centers, juvenile correctional facilities, publicly operated nursing homes, and institutions for people with psychiatric or developmental disabilities. Its purpose is to allow the Attorney General to uncover and correct widespread deficiencies that seriously jeopardize the health and safety of residents of institutions. The Attorney General does not have authority under CRIPA to investigate isolated incidents or to represent individual institutionalized persons.

The Attorney General may initiate civil law suits where there is reasonable cause to believe that conditions are "egregious or flagrant," that they are subjecting residents to "grievous harm," and that they are part of a "pattern or practice" of resistance to residents' full enjoyment of constitutional or Federal rights, including title II of the ADA and section 504 of the Rehabilitation Act.
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Architectural Barriers Act
The Architectural Barriers Act (ABA) requires that buildings and facilities that are designed, constructed, or altered with Federal funds, or leased by a Federal agency, comply with Federal standards for physical accessibility. ABA requirements are limited to architectural standards in new and altered buildings and in newly leased facilities. They do not address the activities conducted in those buildings and facilities. Facilities of the U.S. Postal Service are covered by the ABA.
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Abbreviations
ABC Analysis: Antecedent Behavior Consequence (Evaluating before and after the behavior)
ADA: American with Disabilities Act
ADD: Attention Deficit Disorder
ADHD: Attention Deficit Hyperactivity Disorder
ASL: American Sign Language:
CBA: Curriculum Based Assessment
CBM: Cognitive Behavior Management (Talking a student through a behavior)
CD: Cognitively Disabled
E/BD: Emotional/Behavioral Disorder
EHA: Education of all Handicapped Act -1975
FAPE: Free Appropriate Public Education
FAS: Fetal Alcohol Syndrome
HI: Hearing Impaired
IDEA: Individual with Disabilities Education Act
IEP: Individualized Education Plan
LD: Learning Disabled
LEA: Local Education Agency
LRE: Least Restrictive Envirionment
LSA: Learning Support Assistant
MDT: Multi-Disciplinary Team
MR: Mental Retardation
OCD: Obsessive Compulsive Disorder
ODD: Oppostional Defiant Disorder
OHI: Other Health Impairment
OT: Occupational Therapy
PBS: Positive Behavior Support
PT: Physical Therapy
PLOP: Present Level Of Performance
PDD: Pervasive Developmental Disorder
SPL: Speech and Language
TBI: Traumatic Brain Injury
VI: Vision Impaired

Asperger's Syndrome

What is Asperger's Syndrome?
Diagnosis Characteristics?
Teaching Strategies
Resources

What is Asperger's Syndrome?
Asperger's Syndrome is characterized by a severe and sustained impairment in social interaction and the development of restricted and repetitive patterns of behavior, interests, and activities. The result is a significant impairment in social, occupational, or other important areas of functioning.  There are no significant delays in language, cognition, self help skills or adaptive behavior, other than social interaction.  The presence of Aspergers syndrome is more common among males and the treatment of the disorder is designed individually with no single medication working for all students.

DSM IV Diagnostic Criteria for Asperger's Disorder
A. Qualitative impairment in social interaction, as manifested by at least two of the following:
1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
2. Failure to develop peer relationships appropriate to developmental level
3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g. by a lack of showing, bringing, or pointing out objects of interest to other people)
4. Lack of social or emotional reciprocity

B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. apparently inflexible adherence to specific, nonfunctional routines or rituals
3. stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
4. persistent preoccupation with parts of objects

C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning

D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years)

E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than social interaction), and curiosity about the environment in childhood

F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia

Teaching Strategies
13 Ideas for Teachers and Parents to keep in mind when working with childern with Asperger syndrome.

1. Foster a classroom atmosphere that supports the acceptance of differences and diversity.
2. Asperger's children respond to positive and patient styles of teaching.
3. Learning by individuals with Asperger's syndrome ranges greatly with some things being learned at age-appropriate levels, while learning in other areas may not exist.
4. The student may learn something in one situation, but does not mean they will remember or can generalize the learning to new situations.
5. Students may get over stimulated by loud noises, lights, strong tastes or textures, resulting from their heightened sensitivity.
6. The processing time necessary for Asperger's syndrome children is greater and requires teachers and others to be patient when answering questions.
7. Asperger children have a difficult time transitioning between activities.  Thus, the use of visual cues such as picture schedules, written directions, and hand signals are helpful
8. Provide advance notice when changing activities and allow for ample transition time when both expected and unexpected changes in the schedule occur.
9. Break directions down into simple steps and speak slowly and clearly.
10. Asperger students may hear and understand you better if not forced to look directly at your eyes.
11. Making friends for Asperger students is extremely difficult and social arrangements within the classroom can make the classroom much more welcoming. 
12. Establishing a routine for Asperger children is extremely important!!!!!!!
13. Asperger Syndrom Children think very literally and use of sarcasm and various types of humor are often not understood. 

Resource Link
http://www.aspergerinfo.com/
http://www.udel.edu/bkirby/asperger/

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Attention Deficit Hyperactivity Disorder

What is ADHD?
Diagnostic Criteria?
Teaching Strategies
Resources

What is ADD/ADHD?
Attention-Deficit/Hyperactivity Disorder (AD/HD) is characterized by impulsivity, inattention, and in some cases, hyperactivity. Despite the research into AD/HD the cause remains unknown, but a majority of research suggests a neurobiological basis relating to an imbalance or deficiency in certain chemicals that regulate the efficiency in behavior control. Research also shows that a component may exist.

Possible Characteristics of AD/HD:

CHILDREN
* Hyperactivity or fidgetiness
* Impulsivity, that is, thoughts racing through the mind
* Inattention for "boring" or "unexciting" experiences, often including school work
* Waking slowly or being disorganized and/or grumpy in the morning unless expecting to participate in a high excitement activity
* Falling asleep slowly at night
* Spatial dyslexia (writing mirror-image reversals of letters, difficulty with left-right discrimination, and difficulty properly sequencing letters, words or numbers)
* Episodic explosiveness (often called temper tantrums), with hitting, biting, kicking and the like
* Bedwetting (primary nocturnal enuresis)
* Unexplained emotional negativity

TEENAGERS
* Fidgetiness or some degree of hyperactivity
* Impulsivity, that is, thoughts racing through the mind
* Inattention for "boring" or "unexciting" activities, including school work
* Waking slowly in the morning unless expecting to participate in a high excitement activity
* Falling asleep with difficulty at night, often staying up late until overwhelmingly tired
* Spatial dyslexia (see above) and sometimes verbal dyslexia (reversing the order of words while speaking)
* Episodic explosiveness with significant physical manifestations such as hitting others, breaking inanimate objects and screaming uncontrollably
* Bedwetting may still be present
* Unexplained emotional negativity, sometimes more appropriately called depression, and even attempted suicide
* Unexplained irritability or easy frustration over minor issues or matters

ADULTS
* Fidgetiness, rarely overt hyperactivity, and often just rhythmic leg-shaking, hand tapping, and restlessness
* Impulsivity with thoughts racing through the mind causing disorganization
* Inattention for "boring" activities such as reading economic reports, putting together tax information, finishing half-finished room repairs, and the like
* Waking slowly in the morning unless unusually excited
* Falling asleep with difficulty often handled by staying up until overwhelmingly tired and able then to easily fall asleep
* Spatial and/or verbal dyslexia (see above)
* Episodic explosiveness which may include spousal and child abuse, self-mutilation, screaming or hitting others
* Bedwetting very rarely at this age
* Unexplained emotional negativity or depression without obvious cause
* Unexplained irritability over little issues or matters.

Diagnostic Criteria
A. Either (1) or (2):

 1. six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
 a. often has difficulty sustaining attention in tasks or play activities
 b. often does not seem to listen when spoken to directly
 c. often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
 d. often has difficulty organizing tasks and activities
 e. often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
 f. often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
 g. is often easily distracted by extraneous stimuli
 h. is often forgetful in daily activities

 2. six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
Hyperactivity
 a. often fidgets with hands or feet or squirms in seat
often leaves seat in classroom or in other situations in which remaining seated
 b. is expected
 c. often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
 d. often has difficulty playing or engaging in leisure activities quietly
 e. is often "on the go" or often acts as if "driven by a motor"
 f. often talks excessively
Impulsivity
 g. often blurts out answers before questions have been completed
 h. often has difficulty awaiting turn
 i. often interrupts or intrudes on others (e.g., butts into conversations or games)

B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.

C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).

D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder,  Schizophrenia , or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

Specify Type:
* Attention-Deficit/Hyperactivity Disorder, Combined Type: if both Criteria A1 and A2 are met for the past 6 months
* Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: if Criterion A1 is met but Criterion A2 is not met for the past 6 months
* Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type: if Criterion A2 is met but Criterion A1 is not met for the past 6 months

Teaching Strategies
1. Identify problem behaviors.
Identify what problems are the biggest impediments to the child’s learning. These may not be the most annoying behaviors or the ones you would most like to correct, so take an unemotional inventory, perhaps involving other instructors or the child’s parents. For each behavioral item, list the behavior, when it most frequently occurs, what triggers it and how disruptive it is on a scale of one to ten. Try to be as specific as possible. For each problem, write down at least one strategy from this report for eliminating or changing the behavior.

2. Identify problems in the class environment.
Look at the way you and other instructors treat the child. Are you overly harsh? Do you “expect” the child to misbehave and punish him more quickly than others? Have you eliminated as many distractions as possible? Is class active and upbeat with lots of short periods of activity and little inactivity? Are the children closely supervised, especially when working in pairs or groups? By looking at the way you teach and the class environment, you may be able to quickly eliminate some undesirable behaviors.

3. Model Healthy Behavior.
Demonstrate behaviors that you want the child to follow such as not speaking when others are speaking, putting equipment away after using it, talking in a polite quiet voice and not being overly critical.

4. Partner for difficult tasks.
If a child is struggling with learning or remembering a skill, partnering him with a responsible older child or an assistant instructor can be very helpful. Remind the older child that his job is to be a role model and a helper so he will be a bit more understanding.

5. Count your feedback.
Try keeping track of the amount of positive and negative feedback you are giving an ADD child in class. Although much of the feedback is negative, actively look for areas to praise so you don’t come across as mean or nagging.

6. Be specific.
Give an ADD child specific action messages and instructions. He does not grasp the subtlety of a statement like “Hanging on the stretching bar is dangerous.” He also does not translate “Pay attention” into “Stop hanging on the stretching bar and get back in line.”

You have to spell out, word for word, what you want him to do in the exact way you want it done. If you want him get off the stretching bar, tell him exactly that. If you want him to stop playing with his toes and look at you when you talk, tell him to look at you. By giving instructions that include specific actions, you remove any room for misunderstanding and misinterpretation.

7. Use rewards correctly.
There is a temptation to “bribe” children with ADD into good behavior by lavishing them with material rewards for every good behavior. While material rewards are often appropriate, look for other options first.

Rewards can include praise in front of the class or the child’s parents, a simple “thank you” or “good job” that is well timed or the opportunity to hold a special position in class, like line leader. Rewards are also more effective when the child has a say in what he gets for good behavior. And you might be surprised at what he asks for. Some children are just as happy with a sticker to wear on their shirt as they would be with a much more expensive reward.

If a child is set on a material reward, stretch it out with interim rewards of stars or tickets, of which the child has to earn a certain number to get the larger material reward. In doing this, each star or ticket becomes a mini-reward.

8. Use a “when…then” sentence.
If a child is not performing a specific behavior like sitting still or practicing quietly, try using a “when…then” sentence like “When you sit down and stop talking, then I’ll explain the rules of the game we’re going to play” or “When you are doing that kick well, then we’ll kick the heavy bag.”

Obviously, the “then” portion of the statement should sound rewarding and hopefully be directly related to the child’s good behavior, a positive natural outcome of his behavior. Always use when, not if, because when implies that child will do something and if implies that he has a choice.

9. Don’t use ADD as an excuse.
Resist the urge to use ADD as an excuse for the child’s behavior. If you exempt a child from punishment, responsibilities and expectations because he has ADD, you are doing him or her a disservice. It may be easier to use ADD as an excuse than to enforce the rules with an ADD child, but that is tantamount to giving up on him. Taking the time and effort needed to help the child is time consuming at first, but pays big dividends in the long run.

10. Speak pleasantly.
If you want an ADD child to listen to you, try speaking slowly, quietly and briefly. Children who are used to getting yelled at tune out the yelling just like instructors tune out children who whine and complain all the time. It also helps to make eye contact before beginning to speak so you know you have the child’s attention.
 
Resource Links
http://www.chadd.org/
Http://www.ADHD.com
Http://www.add.org  

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Autism

What is Autism?
Diagnosis Characteristics?
Teaching Strategies
Resources

What is Autism?
Autistic disorder is a developmental disorder that affects a person's ability to communicate, form relationships with others, and respond appropriately to the environment. Some people with autistic disorder are high functioning, with speech and intelligence intact. Others may be nonverbal and/or mentally retarded.

Today autism is a general term that is often used interchangeably with what health care providers refer to as "pervasive developmental disorders." Individuals with a pervasive developmental disorder (PDD) have a unique set of symptoms that affect three areas or "domains": communication, socialization (interaction with others), and behavior. Within this broad category, there are five currently accepted official diagnoses:

* Autistic Disorder
* Asperger Disorder
* Pervasive Developmental Disorder Not Otherwise Specified
* Rett Disorder
* Childhood Disintegrative Disorder

Diagnosis Criteria
Childhood autism
A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):

 1. Qualitative impairment in social interaction, as manifested by at least two of the following:
 a. marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction.
 b. failure to develop peer relationships appropriate to developmental level
 c. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
 d. lack of social or emotional reciprocity

 2. Qualitative impairments in communication as manifested by at least one of the following:
 a. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
 b. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
 c. stereotyped and repetitive use of language or idiosyncratic language
 d. lack of varied spontaneous make-believe play or social imitative play appropriate to developmental level

 3. Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, as manifested by at least of one of the following:
 a. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
 b. apparently inflexible adherence to specific, nonfunctional routines or rituals
 c. stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole body movements)
 d. persistent preoccupation with parts of objects

B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.

C. The disturbance is not better accounted for by Rett's disorder or childhood disintegrative disorder.

Teaching Strategies for Autism

Communication Issues

Students with autism have significant challenges in understanding and using language for communication.

* Classroom environments must provide students with information on events, activities, and expectations in a manner that students with autism can easily understand.
* Visual activity schedules may be used to provide students with an overview of the instructional day and information on tasks that will be assigned. Many teachers also find mini-schedules helpful; they provide a visual analysis of the steps in a task or assignment that need completion by the student.
* While most students with autism will learn to use speech to communicate, many still have great difficulty in expressing their needs and desires. They may need to use visual systems, sign language, or augmentative devices as an additional form of expressive communication to communicate with others.

Motivational Issues

Actively engaging the student within instructional activities is critical to effective instruction.

* The teacher should identify the motivating activities or objects for the student. 
* Use the student's preferred objects and activities within instruction or as reinforcement for activity engagement/completion.
* Opportunities for choice-making should be provided for the student. (i.e. choice of activity, location, or materials for a task)
* Providing frequent and personally meaningful reinforcement to the student is critical to sustaining motivation to engage in instruction and activities.

Instructional Formats

* Discrete trial training is the teaching of specific skills within an intensive, efficient manner.
* Skills are taught within a highly structured, one-to-one format providing clear and concise instruction, an additional prompt (as necessary), and an explicit reinforcer (reward) for performing the skill successfully.
* Discrete trial training typically uses a least-to-most prompting hierarchy, moving from a verbal prompt to physical guidance when verbal and nonverbal prompts are inadequate. Trials of instruction are provided on a single behavior in a massed fashion (one after another) with only a brief pause between trials.
* Activity-based instruction describes the instruction of targeted skills within activities and routines that are meaningful for the student.
* Skills taught within relevant activities and across contexts increases the probability that the student will generalize the skill to non-instructional activities and environments.
* For example, an arrival routine for a student may include putting his backpack away, finding his desk, and taking out his daily work folder. If the student were learning how to greet others, request help, and follow a visual schedule.  Skill instruction could be embedded in the arrival routine and within multiple activities over the day so that an adequate number of instructional trials are provided to the student. Systematic instruction is used within each of those activities to provide instruction on the embedded skill.

Positive Behavior Support

Some students with autism may exhibit excessive passivity, while others display patterns of disruptive or even destructive behaviors. The currently preferred approach is known as positive behavior support (PBS), a proactive, constructive educational approach for resolving behavior problems. It is based on extensive research as well as principles regarding the rights of all students to be treated with dignity and to have access to educational opportunities. The PBS approach is supported by the discipline regulations of the Individuals with Disabilities Education Act (IDEA).

PBS involves a functional behavioral assessment (FBA) and the subsequent development and implementation of an individualized behavior support plan. The FBA process gathers information about the purpose or "function" of the behavior and the circumstances associated with its occurrences and nonoccurrences. The results of the FBA contribute to the individualized behavior support plan, which usually includes procedures for teaching alternatives to the behavior problems, and alterations to the environmental and instructional circumstances most associated with the problems. Such alterations can involve aspects of the curriculum, instructional techniques, social milieu or other feature linked by the FBA to behavior problems. The PBS intervention helps prevent problems from occurring, and helps the student acquire more effective, desirable ways for interacting with the environment.

Age Span Considerations

The focus of instruction shifts as students with autism move from early childhood programs through elementary school to secondary settings. In the early years, instruction focuses on developing communication, social interaction, and adaptive behavior. As the child ages, elementary programs may focus more on academic instruction in addition to teaching language and social interaction skills. In secondary programs, instruction should shift to preparing the student for adulthood.

Instruction for young children should begin as soon as the disability is identified. Effective early intervention programs are ones that directly teach early communication and social interaction skills, use a functional approach in addressing problem behavior, provide intensive and systematic instruction, provide parent instruction and family support, and provide transition support as the child enters preschool.

In elementary school, instruction should support the child's growth in skill areas that are delayed and promote growth in areas of strength. Curriculum adaptations may be used to assist students in progressing in the traditional academic areas. School programs should also focus on helping the student learn how to negotiate social environments and develop friendships.

In the secondary and high school years, instruction should focus on the areas identified in the transition plan. The transition plan addresses post-school outcomes for work, community living, community participation, and recreation activities. Instruction for the transitioning student may include community work experience, using public transportation, and learning skills that will be important for living in the community. In high school, instruction may continue within general education settings although an individual student's schedule may reflect a greater emphasis on the importance of learning relevant post-school skills. For example, a student's schedule may include classes in computer, cooking, and chorus instead of courses in chemistry, algebra, and American literature.

Resources
www.Autism.org
www.Autism-society.org
www.exploringautism.com
www.autisminfo.com

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Behavioral Disorders

What is a Behavioral Disorder?
Diagnostic Criteria?
Teaching Strategies
Resources

What is a Behavioral Disorder?
A behavior disorder is the repetitive and persistent pattern of behavior in which the rights of others or age-appropriate norms or rules are violated.

Diagnostic Criteria?
The DSM-IV categories conduct disorder behaviors into four main groupings:

(a) aggressive conduct that causes or threatens physical harm to other people or animals,

(b) non- aggressive conduct that causes property loss or damage,

(c) deceitfulness or theft, and

(d) serious violations of rules.

Diagnosis
Conduct disorder is diagnosed if there is a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated. In addition, three or more characteristic behaviors must have been present during the past 12 months, with at least one behavior present in the past six months. The disturbance in behavior must also have caused clinically significant impairment in social, academic or occupational functioning. Conduct disorder may also be diagnosed if the individual is aged 18 years or older, and the criteria are not met for antisocial personality disorder (American Psychiatric Association, 1994).

* Children or adolescents with this disorder often initiate aggressive behavior towards other people and animals, or react aggressively to others.
* They will often bully, threaten, or intimidate others, initiate physical fights, and use a weapon that can cause serious physical harm to others.
* They can be physically cruel to people or animals, may steal while confronting their victim, and may force someone into sexual activity.
* The deliberate destruction of property is a characteristic behavior of this disorder, which may involve fire setting, with the intention of causing serious damage, or the destruction of others' property by other means.
* Deceitfulness or threat is not uncommon, and may include breaking into someone else's house, building or car; often there is lying to obtain goods or favors or to avoid obligations, and stealing items of non- trivial value without confronting the victim.
* Serious violations of parental, societal or school rules are common. These may take the form of staying out at night despite parental prohibition, beginning before age 13, or frequent truancy beginning before age 13.
* Running away from home overnight, at least twice, and not returning for lengthy periods, provided that these episodes are not as a direct consequence of physical or sexual abuse.
* In older teenagers frequent absences from work without good reason would also qualify for the diagnosis of conduct disorder (American Psychiatric Association, 1994).

Teaching Strategies?

School and Community Education
A child's' school and home environment play an active role in the treatment of conduct disorders act as a preventative measure. A number of interventions have been developed for schools and the community in relation to conduct disorder, which focus on skill development for the child in the areas of problem solving, anger management, social skills, and communication skills

School based programs

There are various preventative programs devised for schools to focus on developing specific cognitive skills, which encourage the student's development of decision making and cognitive processes. These processes include teaching the children interpersonal problem solving skills, strategies for increasing physiological awareness, and learning to use self talk and self control during problem situations.  Numerous intervention programs have been developed for children to cope with behavioral conduct disorders.  These treatment programs focus on further skill development, including anger management and rewarding appropriate classroom behavior, skill development of the child including the understanding of their feelings, problem solving, how to be friendly, how to talk to friends, and how to succeed in school.
 

Teacher Requirements
Stability
A Student with a behavioral disorder requires a great amount of consistency and stability within the classroom, especially if his or her home life lacks stability.  Predicable structure allows from the student to become more comfortable with both the education system and staff members.

A Sense of Humor
After a rough day the ability to look back and laugh at the events that transpired that day is a valuable asset.  Not only can a sense of humor help you maintain your sanity in working with students that possess behavioral disorders, but can help diffuse situations that arise in the classroom.

Patience and Professionalism
A student with a behavioral disorder can create a great amount of frustration as a result of their behaviors, which range from  inappropriate to degrading to dangerous.  Thus, maintaining your composure and professional attitude is essential.  It is important to remember that the student at times cannot control their behavior and their attacks must not be taken personally.  Instead, establishing a friendship and trust is most important and necessary for the development of the students. 

Caring
Establishing a relationship with the student is the most important step for the student in coming to grips and begin to work to overcome their disorder.  The student must believe that an individual truly cares and takes a sincere interest in them to want to accept help and want to work.  It must be remembered that their is no such thing as a bad child.

Separation of work and home life
After working with children with a behavioral disorder for eight hours a day it is difficult to let go of the teacher mind set and assume a family life demeanor.  Nothing can be more damaging to your home life than bringing your classroom frustrations and anger into your family life.  Instead, upon leaving the classroom leave the excess baggage and frustration at the door.  If possible allow yourself to either relax or exercise between home and school life in order to create the needed separation of work and home life.
 
Resources?
www.pacer.org
www.Healthyplace.com
www.ccbd.net/

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Cerebral Palsy

What is Cerebral Palsy?
Diagnostic Criteria?
Teaching Strategies/Treatment
Resources

What is Cerebral Palsy?
The term cerebral refers to the brain's two halves or hemispheres, while palsy describes any disorder that impairs control of body movement. Thus, the term cerebral palsy is a broad term used to describe a group of chronic disorders impairing control of movement that appear in the first few years of life and generally do not worsen over time. These disorders are not caused by problems in the muscles or nerves, but result from faulty development or damage to motor areas in the brain, which disrupt the brain's ability to adequately control movement and posture.
 
There are three main types of cerebral palsy:
* Spastic Cerebral Palsy
(stiff and difficult movement)
* Athetoid Cerebral Palsy
(involuntary and uncontrolled movement)
* Ataxic Cerebral Palsy
(disturbed sense of balance and depth perception)
* Mixed Cerebral Palsy
There may be a combination of these types for any one person.

Characteristics of Cerebral Palsy may include:
* Lack of coordination
* Spasticity
* Muscle tightness or spasm
* Involuntary movement
* Different walking patterns
* Speech impairment
* Difficulty with gross & fine motor skills
* Abnormal perception & sensation

Treatment/Teaching Strategies
Cerebral Palsy (CP) is not considered to be a curable condition and the word "management" is used more often than "treatment". However, there is much that can be done to lessen the effects of CP and to help people with CP to lead independent lives.

Therapy:
Physical Therapy (PT): The goal is to help people achieve their potential for physical independence and mobility. Physical therapy includes exercises, correct positioning, and teaching alternate ways of movement such as walkers, bracing or handling a wheelchair.

Occupational Therapy (OT): Occupational therapy designs activities to increase independence through the development of fine motor skills. This includes the teaching the use of adaptive equipment such as feeding, seating and bathroom aids.

Speech Therapy: The range of speech needs may range from an articulation problem to an ability to communicate verbally.  In all cases the goal is to improve an individual's ability to communicate, which may include the use of a non-verbal communication systems. Examples of alternative communication systems include eye-gaze systems, blissymbol boards, and electronic voice synthesizers.

Educational: Many children with cerebral palsy also have some type of learning disability. A proper assessment by a psychologist a school support staff can reduce the effects of an individual's learning disability.  Most children with cerebral palsy in our school systems are integrated within the classrooms, but the commitment to students varies by district.

Teaching Tips:
* The student's educational program should focus on the teaching of functional skills such as throwing, walking, rhythmical movement, and skills that will help them participate more in class.
* Students should learn how to relax affected muscles. This will help control spasms and rigidity..
* The lack of coordination of cerebral palsy students often makes it difficult to learn motor skills. To make the completion of tasks easier and to allow the student more success skills should be broken down into basic components before teaching them to students.
* Slower-paced activities are better than those requiring a fast response. Students will do better catching a bounced ball than a thrown one; kicking a stationary ball than a moving one.
* Activities in water are generally enjoyed by cerebral palsy students as a result of the increased mobility. 
* The development of self-esteem within students with cerebral palsy is essential because these students generally possess a low self-image.  The active incorporation of cerebral palsy students into your "regular ed." classroom with an active role/job will improve their self-esteem and allow them to realize they are an important part of your class.
* Arrange the physical environment of the classroom to limit the distractions for students with cerebral palsy as these students have a tendency to be easily distracted.

Resources:
Http://aacpdm.org  
Http://www.cerebalpalsy.org
Http://www.about-cerebral-palsy.org
Http://www.treatmentofcerebralpalsy.com

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Down Syndrome

What is Down Syndrome?
Diagnostic Criteria?
Teaching Strategies
Resources

What is Down's Syndrome?
Down syndrome, or Trisomy 21, is a genetic condition in which a baby has one extra (47) chromosome in each of the millions of cells in his or her body opposed to the normal of 46 chromosomes. The name trisomy 21 originates from the extra chromosome appearing at the 21st pair. Down syndrome is one of the most common birth defects and appears in approximately the same number of boys and girls and occurs in all ethnic groups, nationalities, races, and social-economic backgrounds.

Diagnostic Criteria
DSM-IV Classification: Severity of Mental Retardation

Mild
* IQ approx. 50-55 to 70
* typically attains 6th grade at school
* accounts for 85% of all cases of mental retardation

Moderate
* IQ approx. 35-40 to 50-55
* typically attains 2nd grade
* e.g., Down syndrome

Severe
* IQ approx. 20-25 to 35-40

Profound
* IQ approx. below 20-25

Teaching Strategies
Inclusion:
Successful inclusion is the first step in a student's effort to become full and contributing members of the community and society. The inclusion process not only benefits a student with down syndrome, but also other students. However, the creation of a successful inclusion program requires a dedicated effort by school and support staff of a student with special needs to create the appropriate school environment and meet the academic and social needs of the student.

Academic benefits for the inclusion of a Down Syndrome student:
* Studies prove that pupils do better academically when working within inclusive classroom settings.

Social benefits for the inclusion of a Down Syndrome student:
* Daily opportunities to mix with typically developing peers provide models for normal and age-appropriate behavior.
* Pupils have opportunities to develop relationships with others from their local community.
* Attending mainstream school is a key step towards inclusion in the life of the community and society as a whole.

Peers:
* Gain an understanding of disabilities, generate tolerance/understanding, and learn how to care for and support a peer with a disability.

Learning by Down's syndrome students
Every student is unique whether they possess a disability or not and so are their leaning needs. Students with Down syndrome cannot be treated just as "slower", but need to be evaluated by the teacher to create learning activities that facilitate meaningful activities based upon their specific needs. These may include accommodations for both physical and cognitive disabilities.

FACILITATE LEARNING
* Strong visual awareness and visual learning skills
* Ability to learn and use sign, gesture and visual support.
* Ability to learn and use the written word.
* Modeling behavior and attitudes on peers and adults.
* Learning from practical curriculum material and hands-on activities.
* Support
* Homework


FACTORS THAT INHIBIT LEARNING
* Delayed motor skills - fine and gross.
* Auditory and visual impairment
* Speech and language impairment.
* Structure and Routine
* Behavior

SUPPORT
A student with Down's syndrome will generally receive support from a Learning Support Assistant (LSA), especially at the secondary level. The support the student receives has a direct impact upon the success of the classroom inclusion. The responsibilities and role of the LSA must be predetermined to define each staff members role within the student's daily routine. Considerations for the student, LSA, and teacher include:

* To ensure the pupil learns new skills.
* To help develop independence.
* To help develop social skills, friendships and age-appropriate behavior.
* To help modify lessons and activities planned by the teacher.
* To provide feedback to the teacher.
* Role of the LSA within the classroom and with other students
* Extent of one-to-one support between LSA and student
* Establish group meetings to exchange ideas, receive feedback, and assign responsibilities.

HOMEWORK
The ability of a student with down syndrome to complete homework is greatly impaired by their limited language, short-term memory, and ability to write. Teachers must accommodate for a student's disabilities and assign appropriate homework for the student. Factors to take into consideration include:

* All homework assignments should be written down in full in a home/school notebook, which includes date, due, and short explanation..
* Add key words, symbols or diagrams - to the assignment to act as visual reminders and to benefit those helping the student.
* Include all relevant information: which book to write in, relevant sources, etc....

Fine and gross motor skills
Many children with Down's syndrome possess hypotonia, poor muscle tone and loose joints, which affects their motor coordination. Pupils may have more difficulty participating in team games and small group or partner activities with set objectives may need to be provided. In the classroom, the lack of motor coordination affects the student's ability and speed in which an individual can write.

Visual / Hearing impairments
Students with Down's syndrome are generally very good visual learners and this strength should be utilized within the curriculum. However, 60-70% of Down's syndrome students use prescribed glasses before the age of seven and accommodation for visual impairment may be necessary. Likewise, approximately 50% of Down's syndrome students experience hearing loss to varying degree.

Strategies for successful inclusion:
* Place pupil near front of class.
* Use larger type.
* Use simple and clear presentation.
* Speak directly to the pupil.
* Reinforce speech with facial expression, sign or gesture.
* Reinforce speech with visual backup print, pictures, concrete materials.
* When other pupils answer, repeat their answers aloud.

Speech and language difficulties
Delays in language development are quite common and result from a combination of factors, which result from both physical and cognitive areas. Any delays in language development will generally result in learning disabilities and work with a speech therapist should begin as soon as delays are detected. Delays in language development and acquisition result in a smaller vocabulary, difficulty in learning grammar, difficulty in learning social language, and difficulties in understanding and following instructions.

STRATEGIES:
* Give time to process language and respond.
* Listen carefully - your ear will adjust.
* Ensure face to face and direct eye contact, which is accompanied by facial expression and gestures.
* Use simple and familiar language and short sentences.
* Check understanding and avoid ambiguous vocabulary.
* Reinforce spoken instructions with print, pictures, diagrams, symbols, and concrete materials to emphasize key words.
* Teach grammar through print- flash cards, games, pictures of prepositions, symbols etc.
* Avoid closed questions and encourage the pupil to speak in more than one-word utterances.
* Encourage pupil to speak aloud in class by providing visual prompts. Allowing the pupil to read information may be easier for them than speaking spontaneously.

Structure and routine
Children with Down's syndrome struggle with unstructured, unfamiliar, and unplanned activities. Thus, the creation and consistency of a routine and schedule allows the student to be more successful within the school setting by not needing to spend time to adapt to daily changes, thereby allowing a student to devote more attention to their physical and cognitive tasks.

STRATEGIES:
* Teach timetable, routines, and school rules, while allowing ample time and opportunity for the student to learn the routine.
* Provide visual timetables: use the printed word, pictures, drawings, signs and symbols.
* Ensure pupil is aware of the next activity and provide transitional cues.
* Stick to routine as much as possible.
* Prepare pupil beforehand if you know there is going to be a change, and inform parents.

Behavior
No specific behavior problems are unique to children with Down's syndrome. Instead, behavior problems are related to their level of physical and cognitive development and levels of frustration. Students with Down's syndrome have a more difficult time completing tasks than peers as a result of their verbal, memory, and physical delays. Thus, if the same expectations are placed on students with Down's syndrome they are more likely to become easily frustrated, overwhelmed, and act inappropriately out of frustration. This is especially true at the secondary level of school when great cognitive and social demands are expected of students.

STRATEGIES:
* Ensure the rules are clear and enforcement of the rules is fair and consistent.
* Use short, clear instructions and clear body language for reinforcement.
* Investigate any inappropriate behavior, asking yourself why the pupil is acting so. For example: is the task too hard or too easy? is the task too long? is the work suitably differentiated? does the pupil understand what is expected?
* Ignore attention-seeking behavior within reasonable limits: it is aimed to distract.
* Reinforce the desired behavior immediately with visual, oral or tangible rewards.
* Ensure that the LSA (Learning Support Assistant) is not the only adult having to deal with the behavior. The class teacher has ultimate responsibility. -Ensure the pupil is working with peers who are acting as good role models.

Resources?
http://thearc.org/faqs/down.html
http://www.nas.com/downsyn/
http://www.ndss.org
http://www.nads.org
http://www.downsed.org/

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Eating Disorders

What is an Eating Disorder?
Diagnostic Criteria?
Teaching Strategies
Resources

What is an Eating Disorder?
Anorexia Nervosa
Anorexia Nervosa is the inability or the unwilling choice of an individual to maintain their body weight at an age and height appropriate weight. These individuals generally possess a fear or weight gain resulting from unrealistic body image perceptions and minimize/deny the existence of weight issues.

Bulimia Nervosa
Bulimia Nervosa is a loss of control by an individual in which they partake in regular overeating and follow the eating with various methods to avoid weight gain. Attempts to avoid weight gain include inducing vomiting, misuse of laxatives, severe caloric restriction, diuretics, enemas, or excessive exercising. However, at the core of an individual's problems are a self-esteem/self-evaluation problem relating to an individual's self-perceptions of their body image.

Diagnostic Criteria - Anorexia
Early signs may include withdrawal from family and friends, increased sensitivity to criticism, sudden increased interest in physical activity, anxiety or depressive symptoms.
A. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
B. Intense fear of gaining weight or becoming fat, even though underweight.
C. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
D. In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles. (A woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.)

Specify if:
* Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
* Binge-Eating/Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)

Treatment
1. Inpatient:
Indications for hospitalization may include any of the following:
a. Patient's weight less than or equal to 70% of ideal body weight.
b. Persistent suicidal ideation.
c. Need for withdrawal from laxatives, diet pills, or diuretics.
d. Failure of outpatient treatment.

2. Outpatient:
a. Treat the medical complications of starvation.
a. Nutritional counseling to establish a balanced diet, an expected rate of weight gain (up to 2 lbs. per week), and a final goal weight.
b. Use behavioral techniques to reward weight gain.
c. Individual and group cognitive therapy to alter anorexic attitudes, enhance autonomy, and improve self-esteem.
d. Family therapy may also be useful.
e. Treat any associated mood disorder.

Associated Features
* Depressed Mood
* Somatic or Sexual Dysfunction
* Guilt or Obsession
* Anxious or Fearful or Dependent Personality

Diagnostic Criteria - Bulimia Nervosa
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
* eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
* a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.
C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and weight.

The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

Specify if:
* Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas
* Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

Treatment Options:
* Should include medical stabilization, routine monitoring of serum K+ and Mg++, education about medical complications, supportive and cognitive behavioral therapy and nutritional counseling.
* Hospitalization in a minority of patients (admission criteria similar to those of anorexia nervosa except for weight loss).

Teaching strategies/treatment?
Students with eating disorders present a unique challenge for teachers who possess a vital role in both identifying and aiding in the healing process. Students with eating disorders include the model class students who are hardworking, goal oriented, and responsible. This results from a doubt that exists both within educational staff members, parents, and friends that an individual may suffer from an emotional disorder such as anorexia or bulimia

A teacher's opportunity to see students on a daily basis allows for the opportunity to identify warning signs of an eating disorder and take action. As a caring and responsible adult figure within the lives of your students, you possess an obligation to assume a proactive role in promoting healthy lifestyles for all students. Teachers also possess the responsibility to create a classroom environment that is both sensitive to the needs of students with eating disorders and provides information and guidance to all students. However, students who possess eating disorders should not be handled exclusively by a teacher, but instead should be referred to a trained therapist.

Resources
http://www.edreferral.com/
http://www.eating-disorder.org

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Epilepsy

What is Epilepsy Syndrome?
Diagnosis Characteristics?
Teaching Strategies
Resources

What is Epilepsy Syndrome
Epilepsy is neither a disorder nor a disease, but a malfunction of the electrical pathways in the brain's neurons. The result are epileptic seizures, which are trigger by electrical irregularities in the brain neurons. The greatest threat to individuals with epilepsy are the unpredictability of the seizures.

Diagnosis Characteristics
The diagnosis of epilepsy occurs when an individual has more than one seizure without a clear, definite cause. Epilepsy is generally diagnosed by a neurologist, but can also be diagnosed by a family doctor.

EEG (electroencephalograph)
In people with epilepsy, brain waves sometimes show up in uneven or unusual patterns. An electroencephalograph, or EEG, is a painless medical test that measures activity in brain waves and detects any unusual patterns. Although an EEG is not a foolproof way to tell if someone has epilepsy, it is often used in conjunction with other tests to make a diagnosis.

General Strategies
*These general strategies should be observed by all individual when not only working with people with epilepsy, but any individual who has seizures.

During a student's epileptic seizure, the first rule is for you to remain calm.

There is nothing you can do to stop the seizure once it has begun.  

Do not try to restrain the individual.  

When the person regains consciousness, reassure him/her and ask what additional assistance is needed.

If it is a convulsive seizure, lower the person to the ground or floor in a cleared area, if possible, and clear the area of furniture or materials in order to avoid injury.

Loosen ties and shirt collars, and place something soft under his/her head.

If a seizure lasts longer than 10 minutes, or if multiple seizures occur without the person regaining consciousness, treat it as a medical emergency and call 911.

Try not to interfere with movements in any way.

For a non-convulsive seizure, no medical action is typically needed. Stay with the individual and gently guide them away from obvious hazards. Speak calmly and be reassuringly to him/her.

Stay with the person until they are completely aware of the environment around them.

Resources
http://www.aesnet.org/
http://www.epilepsyfoundation.org/
http://www.epilepsy.com/

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Fetal Alcohol Syndrome

What is Fetal Alcohol Syndrome?
Diagnosis Characteristics?
Teaching Strategies
Resources

What is Fetal Alcohol Syndrome?
Fetal Alcohol Syndrome (FAS) occurs in unborn babies when the mother consumes too much alcohol during pregnancy. A baby born with FAS may be seriously handicapped and require a lifetime of special care. Characteristics of babies born with FAS include a smaller body size, lower birth weight, and mental retardation (leading cause).

Diagnosis Characteristics
The diagnosis of fetal alcohol syndrome results from a pattern of facial abnormalities, growth deficiency, and evidence of central nervous system dysfunction. Other neurological disorders besides mental retardation resulting from FAS include deficiencies in motor skills, hand-eye coordination, and behavioral and learning problems, which include difficulties with memory, attention and judgment.

Teaching Strategies
The greatest successes in working with students with FAS is achieved through the establishment of structure, consistency, and persistence. The educator's responsibility is to create predictability within the child's life. Accompanying the need for structure is a limited attention span, which requires activities that grab the attention of the student and a work schedule that allows for short intense periods of work.

Effective teaching strategies:
Academics/social:
* Fostering independence in self-help and play.
* Providing the child with choices and encouraging decision-making.
* Focusing on teaching daily living skills.
* Encouraging the use of positive self talk
* Establish a limited number of rules and use consistent language throughout all rules.
* Establish a firm and predictable routine.
* Break their work down into small pieces so they do not feel overwhelmed.
* Use concrete terms and examples when learning new information.
* Provide as much positive reinforcement as possible

Behavior:
* Set limits and follow them consistently.
* Provide the child with ample advance warning to prepare for change.
* Avoid power struggles and confrontation
* Change rewards often to keep interest in reward
* Review and repeat consequences of behaviors.
* Utilize redirection to avoid behavioral problems
* Have pre-established consequences for misbehavior.

Resources
http://www.nofas.org/
http://www.niaaa.nih.gov/

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Fragile X Syndrome

What is Fragile X Syndrome?
Diagnosis Characteristics?
Teaching Strategies
Resources

What is Fragile X Syndrome?
Fragile X syndrome is the most common cause of genetically-inherited mental retardation and ranges greatly as to the severity. Fragile X syndrome also results in numerous physical and behavioral disabilities. Characteristics of male children with Fragile X syndrome include a long narrow face; large or prominent ears; and macroorchidism (enlarged testicles). Other physical characteristics of males with Fragile X are double-jointed fingers, flat feet, puffy eyelids, and hollow chest. Females with Fragile X syndrome do not exhibit most of the physical characteristics found in males with Fragile X, although they often have large or prominent ears. .

Diagnosis Criteria
Diagnosing and Treating Fragile X Syndrome
Individuals with Fragile X may have a cluster of physical, behavioral, and mental disabilities, which vary in number and degree among affected children.  In the best circumstances, early identification and treatment of a child with Fragile X syndrome may include the involvement of speech and language pathologists, occupational therapists, physical therapists, special education teachers, genetics counselors, and psychologists.

The treatment of Fragile X and the associated behavior problems of attention deficit and hyperactivity is generally done through medication. Medications to treat ADHD in children with Fragile X include Ritalin, Cylert, Dexedrine, Amantadine, and Clonidine. The presence of mood swings and tantrums in Fragile X children results in the use of psychotherapeutic drugs such as Lithium and Prozac.

Teaching Strategies
Characteristics of Children with Fragile X are similar to that of autism (behaviors) and Down's syndrome (mental condition). Children with Fragile X have strong reactions to changes in their environment, and their ability to process external stimuli. Their hypersensitivity to their environment makes is difficult for them to screen out stimuli such as noise, lights, or odors and provokes emotional outbursts or tantrums.

Some of the other behaviors associated with Fragile X are similar to those of autism, including hand flapping, hand biting, poor eye contact, and tactile defensiveness (responding negatively to being touched). However, one strength of males with Fragile X is their great sociability and friendliness, in contrast to autistic children, who appear unable to relate to others. Researchers recommend that autistic children be screened for Fragile X.

Mental retardation associated with Fragile X results in most children affected falling in the middle range of impairment. However, differences exist between males and females in relation to their mental capacities. Many females with Fragile X syndrome are learning disabled in math, but perform exceptionally well in reading and spelling. Males appear to process information in simultaneous fashion; this causes difficulty when they are taught skills that require sequential processing of information, such as reading. For males with Fragile X, learning often involves seeing the whole in order to understand the parts.

Speech and language difficulties for children with Fragile X include speaking in rapid bursts or repeating words. The language difficulties for children with Fragile X include perseveration, the inability to complete a sentence because of continuous repetition of words at the end of a phrase and inappropriately and incessantly talking about one topic. Speech problems are worsened in situations where the child must have eye contact with another person or when the child becomes anxious.

Strategies teachers should use to in the classroom are similar to Down's syndrome and autism and include:
* Teach timetable, routines, and school rules, while allowing ample time and opportunity for the student to learn the routine.
* Provide visual timetables: use the printed word, pictures, drawings, signs and symbols.
* Ensure pupil is aware of the next activity and provide transitional cues.
* Stick to routine as much as possible.
* Prepare pupil beforehand if you know there is going to be a change, and inform parents.

Resources:
Http://www.fragilex.org
http://www.fraxa.org/

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Learning Disabilities

What is a Learning Disability?
Diagnosis Characteristics?
Teaching
Resources

What is a Learning Disability?
IDEA's Definition of "Learning Disability"
". . . a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia."

However, learning disabilities do not include, "…learning problems that are primarily the result of visual, hearing, or motor disabilities, of mental retardation, of emotional disturbance, or of environmental, cultural, or economic disadvantage."
Code of Federal Regulations §300.7(c)(10)

Diagnosis Characteristics
There is no single indicator of learning disabilities. For a learning disability to exist a individual must manifest several warning signs consistently and the problem must persist over time.  Warning signs of learning disabilities include:

Preschool:
- Learning the alphabet
- Rhyming words
- Connecting sounds and letters
- Counting and learning numbers
- Being understood when he or she speaks to a stranger
- Using scissors, crayons, and paints
- Reacting too much or too little to touch
- Using words or, later, stringing words together into phrases
- Pronouncing words
- Walking forward or up and down stairs
- Remembering the names of colors
- Dressing self without assistance

Elementary School:
- Learning new vocabulary
- Speaking in full sentences
- Understanding the rules of conversation
- Retelling stories
- Remembering newly learned information
- Playing with peers
- Moving from one activity to another
- Expressing thoughts orally or in writing
- Holding a pencil
- Handwriting
- Computing math problems at his or her grade level
- Following directions
- Self-esteem
- Remembering routines
- Learning new skills
- Understanding what he or she reads
- Succeeding in one or more subject areas
- Drawing or copying shapes
- Modulating voice (may speak to loudly or in a monotone)
- Keeping notebook neat and assignments organized
- Remembering and sticking to deadlines
- Understanding how to play age-appropriate board games

Adulthood:
- Remembering newly learned information
- Staying organized
- Understanding what he or she reads
- Getting along with peers or coworkers
- Finding or keeping a job
- Sense of direction
- Understanding jokes that are subtle or sarcastic
- Making appropriate remarks
- Expressing thoughts orally or in writing
- Following directions
- Basic skills (such as reading, writing, spelling, and math)
- Self-esteem
- Using proper grammar in spoken or written communication
- Remembering and sticking to deadlines

Teaching Strategies
Teachers are the essential link for children in identifying characteristics of students with learning disabilities and directing students to the proper services. Knowing the warning signs learning disabilities is essential to identifying students with learning disabilities, but always remember that all students have difficulties from time to time with attention, concentration, coordination, language, and social behavior. However, if a student consistently displays difficulties with multiple behaviors, it is a good indication of a possible learning disability.

Teachers need to continue to educate themselves through workshops and courses to create a greater understanding of students with disabilities.  Remember also that great resources exist within your school district in the form of special education teachers and professionals that work in cooperation with the school. 

Teaching techniques must be adapted to meet the needs of students with learning disabilities. Simply slowing down the pace of your teaching will not work. Teaching learning disabled students requires adapting instruction methods and activities to capture student interest and modify the curriculum to teach students the necessary skills and information.

* Always gain a student's attention before giving directions or initiating class instruction.
* Develop self-esteem and self-efficacy in your students
* Call the student by name. This will help alert the child to focus attention upon the classroom activity.
* Provide a highly structured learning environment
* Use visual aids to capitalize on a student's visual processing and to provide the auditory/visual association needed to learn new concepts and language.
* Write assignments on the board so the student can copy them in a notebook or provide the student with the list of assignments.
* Be an advocate for your students
* Make sure that students with learning disabilities have enough time to answer test questions. If necessary, change testing procedures if the testing mechanism itself interferes with a student's ability to demonstrate his or her knowledge.
* Provide individualize instruction
* Develop a positive relationship with the parents/guardians of your students to promote working in cooperation for the greatest good of the student.

Resources
http://www.ldonline.org/
http://www.ld.org/
http://www.dldcec.org/

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Spina Bifida

What is Spina Bifida?
Prevention
Teaching Strategies
Resources

What is Spina Bifida?
Spina Bifida is a fault in the spinal column in which one or more vertebrae fail to form properly, thereby, leaving a gap or split, causing damage to the central nervous system. The onset of spinal bifida occurs early in the womb resulting from the failure of the neural tube to develop properly.

There are three main types of spina bifida :

Spina Bifida Occulta (hidden)
This is a very mild and common form and very rarely causes disability. There is a slight deficiency in the formation of (usually) one of the vertebrae, which may have visible signs of a dimple or small hair growth on the back. However, many people are unaware that they have spina bifida occulta as they have no symptoms or signs.

Spina Bifida Cystica (cyst-like)
The visible signs are a sac or cyst resembling a large blister on the back, which is covered by a thin layer of skin.

There are two forms:

* Meningocele
Meningocele is the least common for and is when the sac contains tissues, which covers the spinal cord and cerebro-spinal fluid. This fluid bathes and protects the brain and spinal cord. The nerves are not usually badly damaged and are able to function, therefore there is often little disability present.

* Myelomeningocele
Myelomeningocele is the most serious and more common of the two forms of cystic spina bifida. The cyst not only contains tissue and cerebro-spinal fluid but also nerves and part of the spinal cord. The result is a damaged or not properly developed spinal cord.  The result is a degree of paralysis and the loss of sensation below the damaged region. The severity of the disability depends upon where the spina bifida is located and the amount of nerve damage involved.

Hydrocephalus
Hydrocephalus is commonly known as 'water on the brain' and is present in babies born with spina bifida.  Hydrocephalus is the build up of cerebro-spinal fluid, which naturally occurs in the brain, but is closely monitored and circulated by the body.  However, if the flow of fluid becomes blocked inside the brain and accumulates the baby's head becomes enlarged.

Prevention
The cause of spina bifida are not yet known, but is thought to be connected with both genetic and environmental factors. Research on the addition of folic acid (vitamin B9) to the diet has shown conclusively that women who have had a pregnancy affected by neural tube defect can reduce their chances of having a second affected pregnancy by 72%.

Teaching Strategies
While a child with spina bifida may not be considered learning disabled under state or federal guidelines.Individuals with spina bifida do possess learning weaknesses, which include:

1. Poor coordination between eyes and hands (perceptual-motor)
* It is important to stimulate all of the child's senses from an early age and to engage the child in activities that practice hand-eye and fine motor skills such as legos, building blocks, and playing with balls.

2. Hearing or speaking but not necessarily understanding (comprehension)
* During early ages use a visual schedule and cues for directions and while reading encourage the student to summarize the main ideas.

3. Poor attention (attention/distractibility)
* Create a physical setting that limits visual and audio stimulus for the student. When working with a student be sure that you have the individual's attention before beginning work or talking.  Assign numerous short tasks during work time to create more successful opportunities and to build the student's concentration levels.  Finally, create a reward system that the student embraces and will work towards to achieve the reward/goal.

4. Restless/Fidgety (hyperactivity)
* Establish an exercise routine and build activity into the student's daily schedule. Encourage the student to take their time and to think before taking action or responding by either taking 3 deep breaths or counting to 10.

5. Not remembering what is said or seen (memory)
* Utilize aids such as alarms, calendars, computers, or calculators as memory aids to help the student. Work on memory activities that work on and identify the student's strongest areas of memory such as auditory or visual.

6. Disorganization (organization)
* Limit the number of items a child needs both in school and at home and creating a color coding system with school subjects to link a folder, notebook, and textbook for one class with a specific color.

7. Not keeping things is order (sequencing)
* Create working opportunities that have tasks that need to be done in a specific order. Then begin with two step activities and work toward more complicated and more numerous stepped tasks.

8. Poor at making decisions and solving problems (reasoning/problem solving)
* Start early in working with a child in allowing them to make decisions involving snack or clothes and then incorporate the idea of consequences with decision making.

Resources
http://www.sbaa.org/
http://sbawi.org/
http://www.ifglobal.org/
http://the-callahans.com/susete/susete.shtml

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Tourette's Syndrome

What is Tourette's Syndrome?
Diagnosis Characteristics?
Teaching Strategies
Resources

What is Tourette's Syndrome?
Tourette's Syndrome is an inherited, neurological disorder characterized by repeated and involuntary body movements (tics) and uncontrollable vocal sounds. In a minority of cases, the vocalizations can include socially inappropriate words and phrases -- called coprolalia. These outbursts are neither intentional nor purposeful. Involuntary symptoms can include eye blinking, repeated throat clearing or sniffing, arm thrusting, kicking movements, shoulder shrugging or jumping.  Tourette's syndrome usually appears before the age of 18 and is three to four times more likely to effect males than females.

Diagnosis Characteristics
A. Both multiple motor and one or more vocal tics have been present at some time during the illness, although not necessarily concurrently. (A tic is a sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalization.)
B. The tics occur many times a day (usually in bouts) nearly every day or intermittently throughout a period of more than 1 year, and during this period there was never a tic-free period of more than 3 consecutive months.
C. The disturbance causes marked distress or significant impairment in social, occupational, or other important areas of functioning.
D. The onset is before age 18 years.
E. The disturbance is not due to the direct physiological effects of a substance (e.g., stimulants) or a general medical condition (e.g., Huntington's disease or postviral encephalitis).

Teaching Strategies
The presence of a student with Tourette's syndrome within the classroom will necessitate accommodations. The following are ideas and strategies to incorporate into the classroom to benefit both a student with Tourette's syndrome, other students, and yourself.

* Utilize the child's parents, past teachers, and the child to determine what techniques have worked the best in the past.
* Ignore the student's tics -- By calling attention to the tics opens the student to comment from others and a worsening of the tics.
* Create a 'safe' area for the student to remove themselves to relax and compose themselves if their tics become overwhelming or they cannot function within a setting such as study hall or the library.
* Provide extra time for homework and tests if the tics inhibit the student's ability to work.
* Monitor for teasing within the classroom and school and model acceptance for your students to follow.If possible and with permission of the student inform the class about Tourette's syndrome.
* Be creative when working with a student to create assignments, activities, and assessment techniques that accommodate for the student's disability and relate to their strengths.
* Establish a safe and appropriate physical environment for the student within the classroom to accommodate for large motor tics and a location that allows for a degree of privacy.
* Encourage the student to let you know what supports he or she feels are needed to work around the tics. Recognizing the student's struggle and joining with them in a collaborative approach makes a difference.

Resources
http://www.tourettesyndrome.net/
http://www.tourette-syndrome.com/
http://www.tsa-usa.org/

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Turner's Syndrome

What is Turner's Syndrome?
Diagnosis Characteristics?
Teaching Strategies
Resources

What is Turner's Syndrome?
Turner's Syndrome is a genetic disorder in which all or part of one sex chromosome is missing. The result are individuals with short stature and not maturing sexually. A great degree of severity exists within Turner's syndrome, but other problems associated with the disorder include learning difficulties, skeletal abnormalities, hearing loss, liver dysfunction, heart and kidney abnormalities, infertility, and thyroid dysfunction.

Diagnosis Characteristics
People with Turner's syndrome are all unique and each individual's experiences different combination of symptoms. Some characteristics of Turner's syndrome include:

* Short stature (mean height of 4'7")
* Lack of secondary sexual characteristics and infertility
* Medical problems such as ear, eye, heart, kidney or thyroid difficulties, sugar diabetes, high blood pressure and keloid healing
* Secondary features such as low set ears, low hairline, webbed neck, pigmented moles, bending out of the elbows, and puffy hands and feet.

However, with proper medical attention and treatment an individual with Turner's syndrome can live a happy and productive life.

Teaching Strategies
Strategies and ideas to keep in mind and utilize in the classroom include:

* Don't baby or treat differently that any other student. Apply the same rules, expectations, and consequences within reason.
* Create an appropriate physical setting for the student and create modifications to the classroom to accommodate the student's needs.
* Take an active role in establishing an appropriate school relationship to get to know the student's personal and academic needs.
* Adapt classroom activities where height and size play no role in success. This may be most appropriate for gym class, but keep physical size in mind during all activities.
* Provide for opportunities within the classroom for leadership and classroom participation to develop the student's self-esteem and sense of belonging.

Resources
http://www.turner-syndrome-us.org/
http://www.turnersyndrome.ca/
http://www.endo-society.org/pubrelations/patientInfo/turner.htm

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William's Syndrome

What is William's Syndrome?
Diagnosis Characteristics?
Teaching Strategies
Resources

What is Willam's Syndrome?
Williams syndrome is a rare, congenital (present at birth) disorder characterized by physical and developmental problems, which include an impulsive and outgoing (excessively social) personality, limited spatial skills and motor control, and intellectual disability (i.e., developmental delay, learning disabilities, mental retardation, or attention deficit disorder).

Diagnosis Characteristics
The following characteristics may be present within an individual who possesses William's syndrome:

* Elfin-like facial features
* Short stature
* Failure to thrive as an infant
* Congenital heart disease
* Hernia present at birth
* Speech delays
* Intolerance to lactose
* Delays in fine-gross motor skills
* Delays with cognitive learning
* Social skills may be delayed
* Mental retardation
* May have excellent skill levels in math, but suffer in all other areas
* Depressed nasal bridge
* ADHD/ADD
* Cross eyed
* Early tooth degeneration

There is neither a cure for Williams syndrome nor a standard course of treatment. Individuals with Williams syndrome need regular monitoring for potential medical problems, as well as, specialized services to maximize their potential. Professionals who may need to be worked with on a regular basis consist of speech therapists, endocrinologists, cardiologists, and physical therapist

Teaching Strategies
In working with William's syndrome children it is important to work in areas the children excel. However, expectations for the children can not be placed at higher levels in all academic, social, and physical areas despite because a student may excel in one area. These areas include:

Strengths:
* Expressive vocabulary = William's syndrome students generally possess an excellent vocabulary, which results from their excellent auditory skills.
* Long term memory for information = William's syndrome children generally retain information very well. However, the initial teaching of material can be quite difficult.
* Hyperacusis/Sensitive Hearing = The sensitive hearing of William's syndrome students can be advantageous in reading and the learning of letter sounds and the processing of oral material.
* Musical ability = Extraordinary musical ability seems more common in children with Williams syndrome than in other children. A love and sense of music is quite common in these children. Utilizing songs and musical instruments can be ideal for social experiences, leisure time, etc., and can be incorporated into math and language curriculum.
* Heightened awareness of emotions = Children with Williams syndrome are often highly sensitive to the emotions of others.  These children can notice changes in behavior and mood and feel great empathy for others. 

Weaknesses
* Fine motor or visual-motor skills = Motor skills such as writing, drawing, or tying shoes can be difficult for William's syndrome students and curriculum and expectations need to be adjusted accordingly.
* Computer Use =Allowing use of a computer can be both a reward and a tool/aid for students to accommodate for difficulties in small motor coordination. With the ever improving and broadening computer programs the incorporation of academic computer activities can be