Wednesday, August 29, 2012

How to Help a Student in a Wheelchair--HELP!

This year has been the craziest yet! The challenge of moving to a new building has been magnified by the addition of two more EXTREMELY needy kids!

I have one student in particular I was wondering if any readers could give me some ideas on. I have concerns in several areas of our school day:

The student has a wheelchair, but is able to physically sit in a regular class chair for up to 30 minutes. However, while at the table he bangs his hands on it, kicks the foot support, and grabs at other student materials. Needless to say, this is not ideal table behavior and it makes the other kids very uneasy.

Everything I put in this child's hand either goes straight into his mouth or is thrown across the room. He has also hit other kids with things he has thrown which again makes them uneasy. Mom has been sending in a blanket that he enjoys chewing on which reduces the chewing on everything else. However, this does not address the issue of not being able to put anything in his hand.

A lot of our school day takes place up at the board whether that means placing manipulatives in the pocket chart or on the calendar or using the interactive whiteboard. This poses an additional issue for this child because it is hard for him to physically get to the board either because his wheelchair won't fit or because he really resists walking (with assistance).

I don't have any specific questions beyond WHAT DO I DO?!?! I have never felt this clueless about a student. And I HATE having to resort to a paraprofessional taking him to the other side of the room to work privately. This is just totally not my style! I pride myself on being able to differentiate for all of my kids and this child has really got me stumped! Additionally, with 7 other high-need kiddos being short an aide is awful!

To top it all off I need to write a 30-day review IEP by September 21st and I have NO idea what to do!! The last IEP he had addresses locating his name, matching objects, and receptively identifying colors. None of these things seem realistic at this time.

Any ideas or links to resources would be GREATLY appreciated!

Thanks blog friends!


Sasha Marie said...

What about making a binder with similar 'board' work so he doesn't have to get up? - I do that with some of my students for our morning group (calendar, weather, etc.). Does he like gum? That could reduce the chewing.

I wonder if sitting at the table is uncomfortable for him- maybe that's way he has so many inappropriate behaviors. Maybe you can fade him gradually into sitting at the table once other behaviors decrease.

Did his past teacher say what he likes/will work for? Maybe if he had some strong reinforcers to work for some behaviors may decrease.

Hope this helps! I feel for ya - I had a very challenging student last year and I felt the same way! Good luck!!

- Sasha
The Autism Helper

MissAllison said...

Thanks for your freedback Sasha! I thought about the board work. But since everything is hand-over-hand due to the throwing issue I wasn't sure how meaningful it would be. Hand-over-hand can even be a struggle with him sometimes as well. I found a Rifton chair that may work and I rearranged my classroom to try to move it closer to the board so that he could access the board even while sitting.

I agree that the sitting may be uncomfortable. I guess I need to look at the schedule and pull him away from the group more. He loves sitting in a bean bag chair. It is just hard to pull him away because that also pulls away an aide because he needs constant supervision due to the chewing.

His past teacher did mention a few preferred things as did mom. I was at school late making some very big, very durable PECs cards. I am hoping to use them tomorrow to finally get some meaningful work out of him

Fingers crossed!

Angelia said...

I was going to suggest the gum also as maybe a way to keep his mouth occupied. It sounds like a challenging situation! I hope you're able to come up with something workable!

Extra Special Teaching

Kara said...

For manipulatives, what about attaching some to his chair, clothing or wrist using carabiner clips, retractible ID card holders, stretchy bracelets with a clip attached, etc. We use those type of things a lot for kids who tend to throw objects and/or do not have a strong enough grip to hold onto things for more than a few seconds.

Movement towards the board - I assume if he can walk assisted, he can bear weight to stand? Could you push his wheelchair as close as possible to the board and then either have him stand with support at the board, or sit in the regular chair for board work? If you have access to a stander/standing table that might be a good option, too. Also, if he is able to cross midline, you could position his wheelchair sideways to the board and that usually gets kids close enough to manipulate things on the wall.

Or taking another slant on it - is it essential he physically moves manipulatives and things for board or other work? Part of behavior could be stemming from frustration if he feels like he can't make his body do what the other kids do with manipulatives. Does he have verbal language or eye gaze or a communication device, any way he can communicate a choice or answer to you? You could have a staff member or even another student be a "scribe" for him - he tells them which item to put on the board and they do as he says. For example, if you asked him to report on the weather on the board, and you showed him two picture icons of cloudy and sunny, he points to or looks at or verbalizes the correct weather icon and then someone else physically puts it on the board. He has gotten the concept without needing to overcome the physical barrier. Even if you have to have him choose using hand over hand ("it's sunny today, touch the picture of the sun" with hoh prompting) that's still a way he can definitely participate.

Good luck! I will look forward to hearing more about your challenging friend this year.


MissAllison said...

Angelia and Kara, Thanks for your comments. I am starting to see some small successes with my new friend! The new Rifton chair made a world of difference today. It has wheels so I could pull him over to the table for some activities where the materials were more isolated and then when he needed some space I could pull him away and use his tray. I also put his chair close enough to the board that I could have him access the board. The only bad thing is we don't have actual smartboards. We have interactive projectors which require students to use a special pen to manipulate it (this is a total nightmare since half of my kids have very poor fine motor skills). So the pen is still hand-over-hand but at least I feel I am increasing the expectation of him participating in some capacity.

I would be SUPER scared to give him gum. I think he would most likely choke on it. He does not chew his food and eats mostly soft foods or baby food. I think the blanket will work, but I need to get him onto more of a chewing schedule so he doesn't just have the blanket all day.

He is almost completely nonverbal. I made some HUGE, sturdy PECs cards today and trialed Proloquo2Go on the iPad. I was impressed with how he did on both.

One of the things mom said he loved was music so I am trying to incorporate more music so we can set up a Big Mac or other device so he can participate. We tried a song today during morning meeting and he loved it! The other kids did too!

Thanks again to everyone for your help! I am feeling better about things already! :)

Liz said...

A few suggestions... you mentioned a tray for his Rifton chair. Does he have a tray for his wheelchair? With the tray on his wheelchair he could sit near the table with the other students but out of reach of grabbing their materials. Or if he is sitting in a regular chair, maybe he could sit at his own student desk near the table and gradually work his way to the table. During work at the board... could he participate in other ways, maybe answering questions on his IPad or placing manipulatives in a binder instead of the pocket chart? Or another option would be to place the pocket chart on a stand with wheels. This way you can bring the pocket chart to him. I'm sure you'll get some other great suggestions here. :) I enjoy reading your blog!

Lee in Pre said...

Sometimes when we have biters/chewers our occupational therapist gets a piece of strong medical grade tubing to chew on. It's easier to clean and a little more appropriate than a blanket.