Using Observation Skills to Guide Instruction

 

Direct observation is one of the best methods to use, which will help you know how to plan activities for infants and toddlers with special needs. These guidelines will help you know what to observe and how to document the observations:

  1. Select a method for recording your observation that is easy to use and convenient.
  2. Practice observing what the child says, does, and how he acts. Record exactly what you hear and see, not what you feel.
  3. You should write down your observations as close to the time they occur as possible.
  4. Describe the context of the child’s behavior and actions.
  5. While you observe the child, you may see something you want to examine further.
  6. Try to observe the child in a variety of settings and at different times during the day, as this will give you multiple opportunities to document not only what happens but also when it happens.

 

Infant-Toddler Life-Skills Fall into these Categories:

 

Feeding

  • Progressing from bottle feeding to simple finger foods
  • Using utensils to eat
  • Simple table rules
  • Social context of meal time

 

Toileting

  • Recognizing when a diaper change is needed
  • Anticipating the need to go to the bathroom
  • Asking to go to the toilet
  • Taking care of own toilet needs
  • Washing hands after toileting
  • Handling unplanned situations

Daily Routines

  • Brushing teeth
  • Washing and drying face
  • Tolerating a bath

Dressing

  • Getting dressed for school
  • Preparing to go outside (putting on a coat, mittens, etc.)
  • Putting on shoes
  • Taking off clothes 

 

Toileting

 According to Bailey and Wolery (1992), toileting is a unique skill for three important reasons:

 

  1. It is a major developmental accomplishment that not only signals a high degree of independence, but is often a high-priority skill for families and care providers.
  2. Toileting is a skill that has complex physical requirements as well as learned behaviors, such as knowing when and where to release urine and feces.
  3. It is unique from other developmental milestones in that it is primarily controlled by the child.

 

Follow these general guidelines for teaching toileting skills to children with special needs:

  1. After careful observation, decide if the child has the pre-requisite skills needed to begin toilet training.
  2. Collect data about how often the child needs a diaper change and the times when he usually needs a diaper change.
  3. Learn to identify signs, such as facial gestures, noises, or other cues that he is about to go to the bathroom.
  4. Provide opportunities for children to observe others going to the bathroom. For example, if the teacher takes two or three children to the bathroom at the same time, invite the child with special needs to go along and give the child a “turn” at sitting on the toilet, even if nothing happens.
  5. Begin training while the child is sitting on the toilet.
  6. Help the child communicate (signs, gestures, speech, or pointing to a picture) that he needs to go to the bathroom.
  7. Teach each skill the child will need in a toileting routine. Keep in mind that some children may be able to partially participate in the process before they are able to complete a step independently.
  8. Expect accidents to happen and don’t make a crisis out of them when they occur.

Feeding/Eating Issues for Children with Special Needs

Special Need

Feeding/Eating Issues

Suggestions

 Low birth weight/premature infants

 

 

 

 

·         Central nervous system immaturity may lead to the infant’s inability to suck, swallow, or chew.

·         Rooting reflex may be weak, resulting in the infant taking longer to feed.

·         Insufficient sucking patterns often result in poor weight gain.

·         Intake of food may be diminished because of poor motor skills, resulting in a need to feed more frequently.

·         Allow extra time for feeding.

 

 

 Cleft-lip and/or cleft-palate

 

 

 

 

 

 

·         Depending on the location and degree of the cleft, the infant may not be able to coordinate motor movements.

·         Suckling may be diminished.

·         Because of the cleft in the palate, food may collect on the roof of the mouth and be expelled through the nose, resulting in choking, spitting, or vomiting.

·         Most likely, the infant will require a specialized nipple for bottle feeding.

·         Initially, feeding may require assistance from a speech-language pathologist or occupational therapist.

 

 Cerebral Palsy

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

·         Depending on the type of muscle damage, the infant may not be able to swallow, root, suckle, or chew properly.

·         Hypersensitivity to touch may lessen the infant’s ability to take in food, resulting in poor weight gain.

·         If the child has poor voluntary muscle control, self-feeding and chewing may also be affected.

 

 

 

 

 

 

 

 

 

 

 

 

·         A physical therapist or speech pathologist can help your learn to feed a child with cerebral palsy.

·         It is important that the child is placed to facilitate symmetry and midline positioning. Try sitting in front of a table with your feet resting on a stool. Place the infant facing you on your lap with her body semi-reclined on a pillow propped against your legs or the table.

·         The teacher can present food from midline to the child while keeping his legs flexed (bent).

·         For older children, it may be necessary to use a specialized chair and facilitate movement of the jaw muscles with your fingers placed on the child’s chin and jaw.

Down Syndrome

 

 

 

 

 

 

 

 

 

 

 

 

 

 

·         Thickened tongue may result in difficulty sucking, chewing, or swallowing.

·         Some children try to eat too fast and consume too much food, which results in upset stomach or choking.

·         Low muscle tone may cause the mouth to hang open, which results in difficulty with drinking from a cup and swallowing.

·         Overall, the muscles of the jaw, tongue, and throat may not be coordinated well, resulting in poor eating and gagging.

 

·         Prepare the child for mealtime by using a consistent routine.

·         Pace the feeding and learn to recognize when the child is full.

·         A child with Down syndrome will need extra help learning to feed himself and in practicing chewing small bites with the mouth closed.

·         The child may require extra encouragement to try such things as holding a cup independently, trying new foods, and learning to stop eating when he is full.

Autism Spectrum Disorder

 

 

 

 

 

 

·         May be picky eaters or only want food of a specific texture.

·         May not be interested in food in the typical way.

 

 

 

 

·         Provide opportunities to encounter new foods and allow him to experiment with food.

·         Allow extra time for eating and have organized plan if the reacts to being fed by having a tantrum or throwing food on the floor.

 Sensory Impairment (vision)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

·         Being unable to see a bottle or nipple may interfere with eating.

·         Because the child may not respond by looking at the caregiver while she is feeding him, typical bonding may take more time.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

·         Being consistent when setting the table and presenting foods fosters independence.

·         Use child-sized utensils and good lighting to help maximize residual vision.

·         Place dishes on a placemat and help child feel the edges, so he can learn boundaries for his dishes. Also, try dishes with suction cups and anchor them to the table.

·         Initially, as new foods are presented, allow the child to touch it, smell it, and experiment with the new food, as this helps the child learn more about that food and its texture.

·         Pouring can be taught as the child gets older, by using a small pitcher and showing the child how to place one finger inside his cup to feel when the liquid is near the top.

These are some general guidelines for feeding infants and toddlers with special needs:

  1. For toddlers who may be resistant to new foods, look for opportunities to learn about new foods, such as playing a smell game. Encourage tasting games where each child takes a small bite of a new or unfamiliar food.
  2. Make mealtime a nurturing, playful, and positive time together. Avoid getting overly concerned if the child does not eat enough. Accept the fact that you may have to allow extra time for the child with special needs to eat.
  3. Offer choices whenever possible. Choice making is a critical skill and reinforces independence. Practice offering the child two different foods on two spoons, let him smell the food, and then honor his choice. Remember, he may not choose the preferred food by vocalization – instead, he might lean his body toward the food.
  4. Use mealtime as an opportunity to communicate. Be positive and talk about what the child is eating. Do not coerce the child to eat, and avoid communicating on how much or how little he eats.
  5. Realize that some infants and toddlers are neophobic (psychologically afraid of new activities) about food and may require extra opportunities before they feel secure enough to try a new food.
  6. Offer opportunities for infants and toddler to practice eating independently and do not be concerned about the “mess.” Remember that the main idea is to eat the food; there will be time, later, to deal with how he eats it.

 

 

Contributed by Clarissa Willis, Ph.D.  Dr. Willis has worked for the past 20 years on behalf of children with autism spectrum disorder and their families. She is the author of five books including the award-winning titles Teaching Young Children with Autism Spectrum Disorder and Inclusive Literacy Lessons for Early Childhood. Her articles on child development and early childhood special education have been published both nationally and internationally. Formerly an Associate Professor of Special Education and the Associate Director of the Center of Excellence in Early Childhood Learning and Development at East Tennessee State University, she currently works as an early childhood consultant and frequent speaker at national and international conferences. Dr. Willis lives in Winston-Salem, North Carolina.