Special needs education

“The Revised National Curriculum Statement adopts an inclusive approach by specifying minimum requirements for all learners. The special educational, social, emotional and physical needs of learners will be addressed in the design and development of appropriate Learning Programmes.” (Department of Education of South Africa. 2009)

 The highlight of my day was holding a 27 day old baby boy! Whilst I was holding him, I realised what a miracle small people are but that I am FAR from ready to take on the responsibility of having a little child of my own...I am becoming a godmother soon (stocked!) so I will hopefully learn more about the ins and outs of small people J Besides having to talk baby language and rocking from side to side, we reported back to the therapist at the clinic about the ideas for a new progamme that we had gathered during the past two days. They seemed as if they liked what they were hearing which got us all excited J The therapists at the clinic are giving us the feeling as if we are one of them which we really appreciate. They try to include us on all levels and are always suuuper friendly. Once we received the ‘go ahead’ from them, we prepared a slide show for the staff at the day care clinic in order to ‘sell’ (as Kirsty would say) our new programme ideas to them. In the beginning of the meeting I got the impression that the staff members were not really interested in what we were suggesting. They kept asking about who was going to pay for all of these adaptations that we were suggesting. Another sore point was, that previous students had suggested similar changes to ours which they never implemented! This (and I fully understand) made them sceptical when they heard what we were trying to put across to them. Preparing a new programme for the day care centre and visiting schools for the disabled has got me thinking about what the legislations and policies have to say about educational programmes for the ‘special’ kids. In other words, does everyone have to apply pen and paper skills or is it ok to change the curriculum to more functional activities pertaining to everyday life, based on the special kids capabilities. Let’s have a look at what the sixth White Paper has to say...*I will stick to the original words from the document that I found as I do not think that I will be able to do it justice if I do otherwise*

“Education White Paper 6 emphasizes partnerships between schools and parents who need information, counselling and other skills to be able to participate more effectively in the planning and implementation of inclusion activities. Parents need to play a more active role in learning and teaching of their own children regardless of their child’s limitations due to disabilities or illness. Training will assist educators to identify and address barriers to learning and to prepare lessons that are responsive to individual learner needs. This includes curriculum enrichment, curriculum and assessment differentiation, multi-level classroom instruction, co-operative learning, inclusive learning programmes and the development of learner strengths rather than a focus on shortcomings.” (KZN Department of Education and MIET Africa.2009)

What I am gathering from this paragraph is that it is integral to include the parents in the learning program of the child, so that the programme is reinforced at home.

“In essence, the model outlined in Education White Paper 6 is child-centred and aimed at
ensuring that every child receives the required support to overcome any barriers to learning and development. This requires that we look at each child within his/her context to see how the child’s behaviour is impacting on effective learning and teaching. That will determine the support that the child receives. Providing additional support will therefore be tailored to the child’s support needs rather than in terms of a label of disability – it could mean adapting the physical environment (like wheelchair friendly toilets), providing access to specialized physical facilities, providing assistive devices (like hearing aids) or specialized learning and teaching support material, adapting the curriculum and/assessment, providing access to specialized professional services like counselling or to other government support services (like grants, food programmes, health services).The identification of a disability or impairment in itself does not mean that a learner has extremely high support needs and requires placement at a special school. Ideally, each child will receive the required support at the local mainstream school as far as it is reasonably practical.” (KZN Department of Education and MIET Africa.2009)

 Furthermore, it is important that the child’s context is taken into account when working on a child’s individual needs, which our programme is steering towards. Changes that are allowed to be made in order to accommodate the child’s limitations are in terms of the environment, assistive devices, specialized learning material & services and ADAPTING THE CURICULUM (which is what our aim is with regards to adapting the programme of the day care centre). Children with special needs, that is only if their limitations allow this, have a right to be integrated in a main stream school.

 

Our short term aim for the day care centre that we are working on, is to bring in more functional based activities for the moderately to mildly impaired children. Part of our goal is to structurally adapt the one room that two of the groups will be making use of. We are very excited to work together with the speechies and the staff of the day care centre on starting a revised programme!  

 Reference

KZN Department of Education and MIET Africa. (2009). Education for all: A guide to building schools as inclusive centres of learning, care and support. Retrieved on 26 February 2014, from www.miet.co.za/site/search/downloadencode/nLa8aaWMqp2zp4Sx

What kind of education do you mean?!

"An individual's perception of hislher position in life in the context of the culture and

value systems in which he/she lives, and in relation to his/her goals,

expectations, standards and concerns. It is a broad-ranging concept,

incorporating in a complex way the person’s physical health psychological

state, level of independence, social relationships, and their relationship to

salient features of their environment" (WHO QoL Group, 1994, p. 43).

Yesterday started off with a hand client that we saw together with the OT at the clinic! We learnt so many helpful techniques that will hopefully boost up our splinting skills. I feel that we have not been exposed to enough splinting in order to put it successfully into practice, which is a little concerning. After seeing the hands client, we packed our bags and headed to Brown’s school, which accommodates learners with all sorts of disabilities that hinder the children from entering a main stream school. The OT's there started the meeting by asking us what our needs were. Once they had heard about our plans for the day care centre that we are hoping to assist in drawing up a more appropriate programme for, they all agreed that setting up a whole new programme would be asking a little much of students. Never the less, they gave us ideas and material which we are planning on implementing, even if it means that the programme will only be applied by the second group of students. We gathered some awesome ideas for therapy from the school.

Today, we paid RP Moodley a visit, which is a school for cognitively and physically impaired children. Many of the children there have ADS (autism). I was totally amazed at the programme that they are running. So many times we think that the typical ‘main stream’ education system is the way forward BUT what about all of the ‘disabled’ or ‘different’ children who do not poses the capacity to take part in the  ‘normal’ school work?! I must admit that I did not enjoy school! I felt restricted in so many ways and if I have to be completely honest with myself, I did not like the subjects that the school had to offer. Do not get me wrong, I do not regret going to school. I strongly believe that school lays down a very good foundation for life BUT what schools tend to do is to try and mould kids according to the requirements of a perfectly, according-to-the-books school child instead of trying to adapt the system according to the strengths and needs for everyday living of the child. This I realized as I was walking through the corridors of RP Moodley.   
I believe that everyone has the right to some sort of education. I say ‘some kind’ of education as this may not be the same kind of education that you and I grew up with. Pat Smart, in ‘Occupational Therapy beyond boarders’ expresses the same thoughts by saying that, “Teachers’ need to be more aware that often just a different approach is needed. (Kronenberg, et al, 2005, p.46)

 

 

At RP Moodley, the kids are taught suitable activities that they need for everyday life. Today we witnessed a teacher doing the basic task of eating breakfast with an autistic child! To them this is a huge achievement as they need to be taught, what seems to us the most simple of act over and over again in order to achieve the slightest level of independence possible.

Reference

Kronenberg et al (2005). Occuaptaional Therapy without borders, Elseve Publishers
WHO QoL Group (1994), The development of the World Health Organisation Quality of Life Assessment Instrument (the WHOQoL). In: Orley, J. & Kuyken, W. (eds.). Quality of Life Assessment: International Perpespectives, Heidelberg: Springer-Verlag.

Dreams do come true!!

The value of a man resides in what he gives and not what he is capable of receiving.    – Albert Einstein

 I will admit that I am a big dreamer J haha, It’s probably what I do best! Two of my biggest dreams came true in the last four years. My first dream was finding and being accepted to study my dream carrier (OT of course) and my second dream was having had the opportunity to travel across my counties boarders. When a dream comes true, one’s life is filled with joy and hope. I felt refreshed and received reassurance that life has got so much more in store for me!  

You know what is even greater than your own dream coming true?!....it’s being part of making someone else’s dream come true!...which is what happened yesterday! We took Daniel, a 30 year old guy who is diagnosed with athetoid CP sky diving yesterday. He is cognitively fully functional and has got such a great personality! The story went a viral! He was in the news last night and on the front cover of today’s news paper! What a true hero.

 This experience however made me think of one of my clients in the community that also suffers from possible CP. He is twenty one years of age and presents ten times worse than Daniel, as he has got fixed dysfunctional contractures in his ankles, knees, hips, elbows, shoulders and neck. On top of being severely contracted, his cognition is also severely impaired and he suffers from cortical blindness. It breaks my heart to know that we will never be able to take him sky diving. I guess that he has got different needs and that we could attempt to make him as comfortable as possible and to stimulate him as best as we can. I will also have a look at the family’s needs. The speechies and audios are also prepared to get plugged into his intervention plan which I am excited about!

This just goes to show again how different every case is and how different the needs are of our clients....even with the same or similar diagnosis.  

I am really looking forward to making or assisting with making other peoples dreams come true.

 

 

 

All I want to say at the end of the day is, “I did my best”!

Wow, what an amazing first week of community work! I am not exaggerating when I say that everyday has been an absolute adventure without a real compass to guide our way J There is little planning involved as something will always come along out of nowhere or something may not happen at all. Those are enough reasons to make it an adventure. We have also been given a lot of freedom which we are trying to utilize as best and ethically as possible

One of our biggest concerns we had entering this block was our safety. I have had the unfortunate experience of being mugged at knife point which I must admit leaves behind its traces. To tell the truth, I think if it weren’t for OT and being taught about learning to look for the source of a problem, I would have probably held onto a deep grudge or hate. Now in retrospect walking along the sandy roads of a struggling community and having worked in a substance rehab, a great deal seems to be falling into place. Who really help us, are the CCG’s who accompany us to every home visit. One senses that they are well respected by the community members.

Then the group as well as the fieldwork supervisors that I am working with are great to work with as I get the impression that I can be myself and that there is room for learning. A huge measure of respect can be felt in the department, which I love. The OT student group that I am part of works together so so well! Everyone thrives on their strengths and supports the other in different ways possible. The OT in charge of the clinic even offered to accompany me to meet my client who is so severely contracted. On Wednesday we came across an elderly lady who defaulted her treatment years ago which means that she could still have TB. When we shared our concerns with the TB consultant at the clinic, he immediately scheduled a home visit and the very next day we were back at the client’s home, taking sputum tests of her whole family. We also got tested for TB as well as for HIV. We did the HIV test because the two tests are usually conducted together. It was my first HIV test so you can imagine how nervous I was...whilst I was sitting there and waiting for my results to show, a wave of emotions hit me. I put myself into the shoes of those people that might be at the risk of possibly having the virus, like Yesterday (from the movie ‘Yesterday’).

 

I don’t think that I am in the position to begin to feel and understand the motions that these people go through! We should approach our clients suffering from the virus with understanding and respect!

My current client is a very difficult case as he is physically severely contracted and cognitively severely impaired! I am however not giving up on him as so many have already done. We need to understand that as OT’s, we need to run all sorts of programmes, even palliative if the need arises! At the end of the day I always ask myself, did I give of my best?!

  You must accept that you might fail; then, if you do your best and still don't win, at least you can be satisfied that you've tried. If you don't accept failure as a possibility, you don't set high goals, you don't branch out, you don't try - you don't take the risk.   – Rosalynn Carter

 

Look life straight in the eye, not to avoid it or wish it away. When we don’t accept the true nature of our existence here then we find ourselves trying to control this tumbling universe to suit us, to make it predictable and safe, dodging the uncomfortable bits and holding onto the pieces we like. Attachment.                                                                                      - Antony Osler

Sleep deprivation is my biggest enemy at the moment! A combination of lack of food and sleep results in impatience and entering a stage of adopting a lousy attitude. I love jogging and was on the verge of giving it up due to the work load, when someone told me that if I do that, I am not going to have a balanced lifestyle....but OT is really important!! This I guess is true BUT it should not consume you in such a way that the work load is going to drain every cell of joy out of your body.

This morning I read a chapter from the book called ‘You’re Awesome’ by Di Smith. It was all about living in the moment. This really spoke to me as ‘attachment’ was the key word here. We sometimes depend too much on certain people, routines or things, that when they are absent, our whole world becomes chaotic.

That is how I feel about the inadequate punctuality and slow pace with which things are being done in the community. This makes me thing, that maybe we have missed the true meaning of community and developing relationships due to the fast pace of life that we have had to adapt to in order to keep up! We tend to oversee the little things in life. Constantly rushing from one place to the next makes us miss the beauty in life.

“There is so much to celebrate in the world, just open your eyes and look.” (Smith, D, 2001, p.30 -31)

Reference

Smith D, 2001. You’re Awesome. Awesome SA Publishers.

Nothing changes, if nothing is done to change

...by now we should very well know, that when working together with people, only very seldom do things run according to plan! The biggest lesson I learnt today was, that if you don’t do anything or follow up on something, things will not materialize. I noticed how important it is to be proactive as an OT and not to fall into the trap of institutionalization!

As I approached the university, big, dark clouds of smoke rose up to meet me. I decided not to let the strike get the better of me today, so I forced a smile as I greeted the other OT’s. It turned out that all of the buses were able to safely get out of the university gates without being harassed by fire and stones. So did ours, even though it took us a little longer than all the others. Our driver seemed to be in no rush at all! We on the other hand, had a morning of meetings to get to, which we had scheduled last week already.  Even the councillor was on our list of meetings for the day!

The first meeting went well and we got to learn more about a disability organization, which we may use to refer clients to when we are on home visits. The organization has 95 members. They run support and educational groups every Tuesday. The second meeting was scheduled with the councillor who sadly never showed up. Look, I understand that upholding an important position such as the councillors, can be a tough and busy job but letting us wait there for 45 minutes without a word from him to us or his secretary, I found was a little indecent. So we decided to get his contact details from his secretary and to reschedule another meeting. The third meeting was with the OT working at the clinic. What a lovely team of professionals! She is a real inspiration because due to her fair amount of practical experience, she has found and is still discovering, means and ways of working with and within the government system in a more efficient way. She has build up the clinic together with the physiotherapist. To me, the two professionals are truly proactive! The most exciting part of our day however, was the screens that we got to order on the government tender, for the day care centre. This was done to separate the room that the children in the day care centre use to work in, so that they can work with as little distraction as possible J  

The days happenings reminded me of the third principle that the book, ‘Occupational therapy without borders’ speaks about, when working in the community. ‘Nothing changes, if nothing is done to change.’ It is important to view every person and community as a whole and to find out what the community is carrying with it from the past which may explain the way things are being done. These factors should be closely examined and if need be, changed or adapted. As a health professional it is important to ‘practice what you preach’ as people mostly judge by performance. ‘Sticking’ to ones word will gain you respect and TRUST. There is no productive working together with people if ‘trust’ is not present in a relationship. Keeping the person in the centre of the intervention is risky but worth it. Only with real trust will we be able to ‘change’ things were the need arises.   (Kronenberg, et al, 2005, p.7)

Reference

Kronenberg et al (2005). Occuaptaional Therapy without borders, Elseve Publishers

What does it mean to be truly human!? – Inspired by Jefferson Bethke

 

When I think about this phrase, “What does it mean to be truly human?” I immediately know what my answer at this point in time would be! It would be, wanting to know everything, especially what the future holds!  Today we had our mock practical, which is the equivalent to a briefing about how the things will be running during the upcoming weeks. This briefing ALWAYS brings with it an enormous amount of tension and anxiety. To make matters worse, a gentlemen who is part of the board for next years community service placements, came to give us a talk on the selection process of next years placement procedure... 

 I am currently seeing a huge mountain in front of me and am therefore questioning my energy levels and capabilities for the journey ahead! What I am forgetting is that we, according to Bethke's words,"...weren't created to do it all by ourselves". The journey, in my opinion is about smelling the flowers and enjoying the company of the people along the way instead of reaching the top of the mountain without having grown stronger as a person and as a community. OT entails having a lot of love for people, even the ones that you can not stand. C.S. Lewis once said, “Loving - is to be vulnerable”. This to me means; admitting that you don't know it all and are willing learn, showing emotion by empathising with others and respecting ones clients whom are vulnerable by preserving their dignity in every way possible. (You see, even some ethical principles are based on LOVE;))

 Community life requires a great amount of love for one another as finding the source of a problem means digging deep in order to find the source. I believe with love which will automatically result in respect for the community members, it can be done in a dignified manner. This is easier said than it is done!!!!

 

In our OT community life, we are starting to open up more and more about our deeper feelings, fears and doubts however there are still many that somehow see owning up to ones feelings, as a weakness which I find sad. Like  Bethke said, "...we were created to need each other, to be honest with each other, to encourage each other..."  We only start understanding people, once they start opening up about their inner feelings and emotions that they are facing.

 Even though I have my fears and concerns about what lies ahead (being pretty vulnerable here owning up to such feelings) I will try really hard, to take this journey up that mountain step by step even without knowing where the path will take me...

STRIKES!!

Today was not such a pleasant day for our university community! The happenings on campus were a perfect example of inappropriate behaviour of a community...

 

I find it really sad that things have to be dealt with in such a violent way at our university. What I also do not understand is that these strikes are nothing new and happen every year, so why are no adjustments made in the required areas which are the cause of such unhappiness?! It leaves behind a sour taste in the mouths of those that were affected by today’s uproar.

To me it sometimes seems as if there is a little more to the ordeal than we are being told or know. Like Chantal would say, it is vitally important that we examine the ‘source’ of the problem. I personally believe that the root of the problem has not been resolved which is why no correct solution has been found.  

 

Sometimes I think, it is so easy to point out the mismanagement in other communities that we do not see or work the malfunctioning elements in our own.

 

As the world community develops in peace, it will open up great untapped reservoirs in human nature.
-- Emily Greene Balch

 

The roles of OT practitioners in the community

 

This weekend I have had a little bit of time to think and to read up about what our role will be as OT students going into the community! According to Loukas, OT’s do not have a set plan with regards to treatment once they enter the community neither will be provided with treatment plans to follow up (Loukas, 2000)...that leaves us with pretty much with little preparation which creates anxiety within us as we thrive on being prepared and ready for therapy!

In every community, there is work to be done. In every nation, there are wounds to heal. In every heart, there is the power to do it.

Marianne Williamson

Read more at http://www.brainyquote.com/quotes/keywords/community.html#AZdZLfH6HeF3ujZp.99

In every community, there is work to be done. In every nation, there are wounds to heal. In every heart, there is the power to do it.

Marianne Williamson

Read more at http://www.brainyquote.com/quotes/keywords/community.html#AZdZLfH6HeF3ujZp.99

In every community, there is work to be done. In every nation, there are wounds to heal. In every heart, there is the power to do it.       - Marianne  Williamson

In my previous blogs I have written that community consists of individuals that engaged in occupation on a small and big scale. Through doing so, interaction amongst the individuals arises which in return results in the establishment of the augmentation of an unique community ‘spirit’ which lays down the groundwork of a community. (Wilcock, 2006) The other important factor is the organisation of the community. (AOTA, 2008) The OT’s should have a good understanding of how the community is structured, organized and which process is followed in order to ‘run’ it. We can almost call it ‘assessing’ a communityJ Only once we totally understand how a community fully functions, will we be able to ‘treat’ the problematic facets with an OT ‘client centred’ scope. (Brownson, 1998)

 What we can gather from literature, is that there is no specific treatment for a community BUT that does not mean that we should not apply our acquired OT principles in a community milieu. Whilst reading up on this topic, I came across some general characteristics that ‘pave’ our role in the community.

 1.       Advocacy

- Educating the community about relevant health topics.

- Serving the underserved through health-related programmes.

- Promoting the inclusion of a diverse number of people.

- The importance of politics.

 2.       Assessment skills

Assessment is a vital step in individual as well as group OT intervention. The communities occupational engagement as well as performance are two components that need to be closely focused on. Assessment in form of research can be conducted which involves adequate analysis. Ongoing assessment and evaluation must be done to prove the validity and reliability of the research.

 3.       Building community capacity

- Exploring and understanding the potential a community possesses.

- Examining the goals of the community members.

- Making use of the community’s strengths when drawing up a programme.

 4.      Apply OT in community context

Health and well being is affected by the engagement in occupation. When applying treatment to a community the occupations of the individuals as well as that of the community as a whole should be considered by the OT.

 Lastly, let’s have a look at what kind of skills the OT needs for community practice.

• Consultancy
• Education
• Autonomy
• Client centred practice
• Clinical reasoning
• Health promotion
• Networking
• Managerial skills
• Evaluation skills
• Cultural Awareness
• Team skills

 

Take a listen to what this professor has to say about her experience... 

References

American Occupational Therapy Association. (2008). Occupational therapy practice framework: Domain and process, 2nd ed. American Journal of Occupational Therapy, 62(6), 626-683
 
Brownson, C.A.(1998). Funding community practice: Stage 1. Americna Journal of Occupational Therapy, 52, 60-64

 Jones & Barlett Publications, Community Practice in OT: What is it?, viewed 26 January 2014, from http://samples.jbpub.com/9780763760656/60656_ch01_Doll.pdf

 

Loukas, K.M. (2000). Emerging models of innovative community - based occupational therapy practice: The Vision continues OT Practice. Retrieved Septemeber 30, 2008, from http://www.aota.org/Pubs/OTP/1997-2007/features/2000/f-071700.aspx

 

Wilcock,A.(2006).An occupational perspective on health (2nd.ed.). Thorofare, NJ:Slack 

 

Rule of thumb for life: No one is perfect!

 

I get to experience the feeling of 'not being perfect' nearly daily! Today was another one of those days! We learnt how to make dynamic splints, to be more precise, the KLEINERT protocol! There were times of utter frustration, sadness, anger and the list goes on....In retrospect, I believe that we need to experience such feelings to ground us and to make us feel more human! Learning the many lessons that life throws our way can be really tough and draining but we need to go through life’s motions in order to become better people J  So don’t be shy to keep it real!

One is NEVER too old to learn!

 What a lovely South African commercial showing a father learning to write the English language in order to read his sons famous book! What an amazing message of how the older generation tries, in all ways possible, to keep on ‘learning’ in order to keep up with the times. Here we can see how a father puts in all his effort into trying to understand his son’s context. This, in my opinion, shows great love and respect.

Adaptation is after all, the key to change.

Health & Community

“In a community practice setting, OT practitioners use the same clinical skills to explore determinants of health beyond the physical by taking a systems approach to understanding health and disease.” (Wilcock, 2006)

 

I love this statement that Wilcock made because it underlines the importance of our role in community work. It is crucial that we understand the community’s context, systems and conditions BEYOND any physiological problem that affect the health status of individuals or groups of people. There are some factors that influence our work in the community which are:

·         Socioeconomic status

·         Culture

·         Political infrastructure

·         Public transport

·         Availability of health care services

·         Geographic location

I have stated in one of my previous blogs, that occupation plays a key role in the health status of a community. You see a fundamental belief of OT states that occupation and health go hand in hand. If there is any type of inability of engaging in occupation for community members, problems arise which can affect the entire community. Like Wilcock stated, “occupations demonstrate a community and an individual’s culturally sanctioned intellectual, moral, social and physical attributes. It is only by what they are or what they hope to be.” (Wilcock, 2006) As OT’s it is important to examine the SOURCE of the problem in the community which will be the underlying of the general problems that crop up amongst the members. Political and social decisions and choices that are made by authority can affect communities, which makes it important for us to keep a drift with what is happening in our surrounding communities.   

 Yesterday we went to the Markets of Warwick!!

 

 

This was a classic example of what community life is all about.

Warwick Junction lies on the edge of the Durban’s inner-city and is the primary public transport interchange in the city. It has roughly 5000 – 8000 vendours trading which are spread across the different markets. Richard (one of our tour guides) also mentioned the fact that nearly half a million people pass through the area DAILY! That’s crazy right!

 

There is the bead market, Berea station market, Bovine head cooking market, Brook street market, Victoria street market, Early morning market, Herb market, Impepho market and the Music bridge.

We were also informed that the markets are currently the only informally structured market area in a public space of this particular magnitude!

One could say that this is a community that thrives on occupations and as we could sense and see, it seems (as far as we could see) to be an adequate community system as a whole.

 

Reference

Wilcock,A.(2006).An occupational perspective on health (2nd.ed.). Thorofare, NJ:Slack

PEOPLE HELP THE PEOPLE

By: Simon Aldred

Sung by: BIRDY

 The message that really stood out to me during this song, was that we should not go into our community block with our preconceived idea of poor = uneducated and therefore weak, corrupt & foolish, but rather that we remember that we are working with people who did not get to choose the circumstances that they were born into and that they may possess qualities that other communities of a higher economic statues do not have or lack. There is a whole lot that we can learn from the people in our surrounding communities! 

“Strength lies in differences, not in similarities”  

― Stephen R. Covey