Demonstrate a knowledge of dysfunction and interventions in assessing and programming for the development of eating skills SpEd 417/517 Course Objective:

Demonstrate a knowledge of assessing and teaching toileting and dressing skills including positioning techniques and adaptations

Personal Cares Maintain health Enhance acceptability Reduce amount of dependency Increase feeling of self-worth and perception of competency

Cause of dependency Limited motor development Physical or sensory disabilities Reduced social awareness Inadequate learning opportunities Limited cognitive development Combination of the above

Considerations Ethical considerations Family involvement Timing and natural settings Self-determination Collaboration Instructional strategies Self-management

Impact of eating skills on development Nutrition Pleasure Social interaction Independence Eating and Feeding

Typical development Major body systems Skeletal system Muscular system Nervous system Eating and Feeding

Milestones Newborn Sucking Suckling Swallowing Six months Semisolids introduced - suckling Tongue pushes food to back of mouth Lips close to take food from spoon Munching Chewing Drinking from a cup Eating and Feeding

Mealtime skills Finger feeding Reaching Grasping Lifting food from table to mouth Putting food into mouth Chewing and swallowing food

Mealtime skills Drinking from a cup Place cup on lips Tilt gradually During swallowing, tilt cup back but maintain contact Begin with thicker liquids

Mealtime skills Using a spoon or other utensil Picking up and holding spoon Lowering spoon to plate or bowl Scooping food Lifting food from container to mouth Inserting spoon into mouth Removing food with lips

Characteristics of multiple disabilities which cause eating difficulties Disorders of muscle tone Abnormal reflexes Structural abnormalities Learning problems Combination Eating and Feeding

Intervention techniques Modifying positioning Modifying foods Modifying utensils Modifying feeding schedules Modifying food presentation Modifying the mealtime environment Providing physical assistance Providing sensory stimulation Providing specific training Preventing aspiration Eating and Feeding

Feeding skills Passive feeding alternatives Intravenous feeding Enteral feeding Cooperative feeding skills Self-feeding Finger foods Drinking from a self-held cup Eating with a spoon Advances mealtime skills Eating and Feeding

Nutritional concerns Signs and symptoms Nutritional risk factors Diet and behavior Eating and Feeding

Dental care Dental concerns Care and prevention Eating and Feeding

Assessment and Planning Determination of child’s abilities and limitations Nutritional concerns Environmental issues Positioning Use of utensils/equipment Eating and Feeding

Determining readiness Regular pattern of elimination Dryness for 1-2 hours At least 2 1/2 years of age Other characteristics Fine motor ability Receptive language Visual ability Toileting Skills

Teaching toilet use Data collection Sitting on toilet Voiding on toilet Attempt when student is most likely to void Continue to check for dryness “On/off” ratio

Related toileting skills Walking to bathroom Lifting or lowering the seat Lowering garments and undergarments Sitting on toilet Wiping after voiding Standing up Pulling up garments Washing/drying Leaving bathroom

Dressing skills Determining appropriate skills Current and future needs Normal dressing skills sequence Physical ability Assess ability Use instructional strategies Order of instruction Prompting Materials

Partial participation Positioning Task analysis Modified clothing

Related dressing skills Natural opportunities Clothing selection Purchasing Cleaning and maintaining

Grooming and hygiene Assessment of ability and needs Task analysis Format for data collection Systematic instruction Plan for generalization

Functional Academics Never underestimate the learning potential of students If one level of instruction is not successful, try another... Traditional teaching strategies may not be successful, so implementation of modified curriculum is necessary If students are unable to demonstrate what they know, they may still enjoy literary experiences

Levels of curriculum General curriculum Regular-adapted or streamlined curriculum Functional or limited academic curriculum Embedded functional instruction

Teaching Literacy Skills Natural environments Sight words Phonics Oral reading Commercial materials Comprehension & reading in real life Writing skills Spelling

Teaching Arithmetic Basic concepts and skills Counting One-to-one correspondence Addition & subtraction Manipulatives Handling money Calculator Time management tell time manage time

Instruction in the regular classroom Cooperative learning Incidental learning Parallel activities Multilevel curriculum Curriculum overlapping Individual instruction

Community Skills Determine appropriate age to begin community instruction Partial participation Determine appropriate location Determine target sites and skills Determine operational skills

Community Skills Determine associated skills Develop instructional plans Plan for generalization Implement instruction Evaluating community skills Securing funding for community instruction

Community settings Grocery stores Restaurants Vending machines Pedestrian skills Public transportation Safety issues

Domestic skills Preparing meals and snacks Household chores Using a telephone