Idecide Toolkit

iDecide Toolkit

Printout version of iDecide

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Table of Contents

Generic Tips for All Categories ...... 5 Pupils with Health Issues ...... 10 Asthma ...... 10 Obesity ...... 16 Diabetes ...... 21 Anaemia ...... 26 Epilepsy ...... 30 Myopia ...... 35 HIV – AIDS ...... 39 Cancer ...... 44 LGBT ...... 49 Refugees, Asylum Seekers, Unaccompanied Minors and Migrant Pupils ...... 60 Generic Tips for Migrants, Asylum Seekers and Refugees...... 60 Refugees, Asylum Seekers and Unaccompanied Minors ...... 65 Migrant Pupils ...... 71 Deprived Backgrounds ...... 75 Pupils coming from single-parent families ...... 75 Pupils coming from poor families ...... 79 Pupils coming from families with many children ...... 84 Pupils coming from homeless families ...... 89 Pupils coming from violent and dangerous families ...... 94 Pupils coming from remote areas ...... 98 Pupils with Mental Health Difficulties ...... 103 Generic Tips for Mental Health Difficulties ...... 103 Addiction ...... 104 Anxiety ...... 111 Depression ...... 117 Eating Disorders ...... 124 Obsessive Compulsive Disorder ...... 132 Bipolar Disorder ...... 141 Schizophrenia ...... 149 Self Harm ...... 154 Stress ...... 161

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Roma Pupils, Travelling Community ...... 167 Pupils with Intellectual Disabilities ...... 174 Cognitive Functioning ...... 174 Adaptive Behaviour ...... 182 Syndromes ...... 186 Social Development ...... 194 Behavioural Excesses & Challenging Behaviour ...... 204 Pupils with Learning Difficulties ...... 210 Generic Tips for Learning Difficulties ...... 210 Dyslexia ...... 214 Reading Problems (Misspelling Sounds) ...... 220 Written Language Deficits ...... 225 Math Underachievement ...... 229 Social Skills Deficits ...... 237 Multimedia resources ...... 238 Attention Deficit Hyperactivity Disorder (generic tips) ...... 247 Attention Deficit Hyperactivity Disorder ...... 247 Low Ratings of Self-Efficacy ...... 254 Autism Spectrum ...... 260 Autistic Disorder (Autism) ...... 260 Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) ...... 269 Pupils with Sensory Disabilities ...... 275 Hearing Impairment ...... 275 Visual Impairment ...... 280 Pupils with Physical Disabilities...... 285 Congenital Malformation ...... 285 Scoliosis ...... 290 Kyphosis ...... 295 Somatic Dysfunctions ...... 300 Spinal Cord Injury ...... 305 Muscular Dystrophy ...... 312 Rheumatoid Polyarthritis ...... 318 Comorbidity ...... 325 Paralysis ...... 330 Cerebral Palsy ...... 337 Pupils from Religious Minorities ...... 344

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Armenians ...... 347 Maronites ...... 348 Latins ...... 349 Catholic Christians ...... 349 Pomaks ...... 353 Irreligion ...... 356 Greek / Christian Orthodox ...... 357 Rastafarians ...... 358 Sikh ...... 359

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Generic Tips for All Categories

Classroom-based tips (focus on instructional methods)

1. Ensure all school policies and procedures are adhered to within the classroom setting.

2. Frame class rules positively.

3. Maintain a consistent classroom culture that is well structured, with clear expectations, smooth transitions and a calm environment.

4. Foster a supportive classroom by checking in regularly with pupils. ‘Check-ins’ can take place before or after lessons, or in whatever medium the pupil is most responsive.

5. Mind your relationship with the pupil: express support, avoid generalisations, be specific in providing feedback and keep tone positive.

6. Monitor pupil progress socially in the class and out of class settings, specifically: social interaction with peers, signs of marginalisation and self-esteem issues.

7. Monitor the progress of pupils academically and provide catch-up work for those pupils who have been absent.

8. Identify shared values and differences in the classroom. Plan for opportunities where pupils can voice their personal values and beliefs to create a sense of belonging.

9. Avoid excessively focusing attention on pupils who are part of potentially marginalised groups.

10. Avoid use of culturally loaded language or potentially offensive references.

11. Avoid a ‘one-size fits all’ approach by adapting to meet the individual or particular group’s needs. Identify individual talents and strengths and utilise them appropriately in the lesson.

12. Emphasise curiosity, engaged learning and problem-solving.

13. Encourage interaction with peers through teamwork and group work.

14. Include pupils in all classroom activities. Encourage them to participate where necessary.

15. Use ICT technology and visual means of presentation of information where possible.

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School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Explain clearly to all pupils and their families, especially those attending the school for the first time, how the specific school unit works, what the school rules are, and its associated culture.

Community 1. Organise awareness and education events with informational sessions, fundraising and social activities, which provide an opportunity for the school and the community to interact. 2. Develop extra-curricular activities as a forum for social integration for all pupils and families in the school community. 3. Make an effort to arrange weekly or fortnightly meetings between parents and staff to discuss the progress of their children, and to enhance the collaboration between home and school. 4. Organise awareness days and education events in which parents and teachers are invited to get information about the diversity of educational needs and abilities of the pupils within their school population.

Curricular Adaptations 1. Support pupils’ educational needs by making curricular adaptations, allowing extra time for homework or exams, setting alternate times, providing opportunities for assessment in different modalities, organising an in-class buddy or teacher, allowing the use of (or provision for) resources such as a laptop or calculator, providing individual teaching sessions whenever necessary. 2. Provide pupils with a condensed form of curriculum that allows them to catch up to their grade levels in core content. 3. Make necessary curricular adaptations, differentiate the resources, allow extra time for pupils from disadvantaged groups to complete their work, make adjustments to their homework and workload, and invest in on-going assessment rather than summative where necessary.

Discipline 1. Ensure that the school is a safe place for all pupils (i.e. reduce asthma triggers in the environment in order to protect pupils suffering from asthma; provide safe storage of insulin needed by pupils with diabetes; store emergency kits; assign staff to provide help or supervise) as well as at an emotional level (i.e. draft policies on issues such as diagnosis, disclosure and privacy, racism, and bullying). 2. Implement, if existing, or create, an antiracist or anti-bullying policy which deals with any incidents of racism or bullying towards any pupils because of their background,

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accent, language skills, appearance, legal status in the country of arrival, or religion. Promote a safe environment and antiracist school culture. 3. Be aware of the underpinning factors of the behaviour of pupils when you are implementing the behavioural code in your school. Make sure that before you make a decision about behaviour, you gain more information about the pupil’s background and history from the teacher responsible for the respective person in the school.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad 1. Ensure access to medical facilities is available within the school premises and when conducting off-site activities, excursions and field trips. 2. During excursions or school trips make sure that a teaching assistant is assigned to the pupils who require special assistance.

Food: Canteen / Visits / Camps / Trips Ensure that the school canteen or cafeteria stocks healthy snacks and food appropriate for all pupils, taking into consideration various health issues, and religious or lifestyle dietary requirements.

Homework Support pupils’ educational needs by making curricular adaptations, allowing extra time for homework or exams, setting alternate times, providing opportunities for assessment in different modalities, organising an in-class buddy or teacher, allowing the use of (or provision for) resources such as a laptop or calculator, providing individual teaching sessions whenever necessary.

Other (Extra-curricular activities) Develop extra-curricular activities as a forum for social integration for all pupils and families in the school community.

Parents/Parents’ associations Make an effort to arrange weekly or fortnightly meetings between parents and staff to discuss the progress of their children, and to enhance the collaboration between home and school.

Safety 1. Ensure that the school is a safe place for all pupils (i.e. reduce asthma triggers in the environment in order to protect pupils suffering from asthma; provide safe storage of insulin needed by pupils with diabetes; store emergency kits; assign staff to provide help or supervise) as well as at an emotional level (i.e. draft policies on issues such as diagnosis, disclosure and privacy, racism, and bullying).

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2. Ensure access to medical facilities is available within the school premises and when conducting off-site activities, excursions and field trips. 3. During excursions or school trips make sure that a teaching assistant is assigned to the pupils who require special assistance.

Scheduling Events 1. Organise awareness and education events with informational sessions, fundraising and social activities, which provide an opportunity for the school and the community to interact. 2. Organise awareness days and education events in which parents and teachers are invited to get information about the diversity of educational needs and abilities of the pupils within their school population.

School Celebrations / Events / Activities 1. Organise awareness and education events with informational sessions, fundraising and social activities, which provide an opportunity for the school and the community to interact. 2. Organise awareness days and education events in which parents and teachers are invited to get information about the diversity of educational needs and abilities of the pupils within their school population.

School Purchases (learning resources, school equipment, playground toys, etc.) 1. Support pupils’ educational needs by making curricular adaptations, allowing extra time for homework or exams, setting alternate times, providing opportunities for assessment in different modalities, organising an in-class buddy or teacher, allowing the use of (or provision for) resources such as a laptop or calculator, providing individual teaching sessions whenever necessary. 2. Make necessary curricular adaptations, differentiate the resources, allow extra time for pupils from disadvantaged groups to complete their work, make adjustments to their homework and workload, and invest in on-going assessment rather than summative where necessary.

Pupil support (financial, individual teaching support, counselling support, language support) 1. Ensure that the school is a safe place for all pupils (i.e. reduce asthma triggers in the environment in order to protect pupils suffering from asthma; provide safe storage of insulin needed by pupils with diabetes; store emergency kits; assign staff to provide help or supervise) as well as at an emotional level (i.e. draft policies on issues such as diagnosis, disclosure and privacy, racism, and bullying). 2. Ensure that pupils with psychosocial issues are referred to a counselor or school psychologist. 3. Support pupils’ educational needs by making curricular adaptations, allowing extra time for homework or exams, setting alternate times, providing opportunities for assessment

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in different modalities, organising an in-class buddy or teacher, allowing the use of (or provision for) resources such as a laptop or calculator, providing individual teaching sessions whenever necessary. 4. Provide pupils with a condensed form of curriculum that allows them to catch up to their grade levels in core content. 5. Implement, if existing, or create, an antiracist or anti-bullying policy which deals with any incidents of racism or bullying towards any pupils because of their background, accent, language skills, appearance, legal status in the country of arrival, or religion. Promote a safe environment and antiracist school culture. 6. Provide additional class support, such as with the presence of a teaching assistant, to pupils who require assistance. 7. Ensure that pupils who appear to be anxious, depressed or may present low self-esteem are referred to a counselor or school psychologist based on your country’s educational system and available resources. 8. During excursions or school trips make sure that a teaching assistant is assigned to the pupils who require special assistance.

Teacher Professional Development Invest in training teachers by professional experts or academics into the particularities of the pupils from disadvantaged groups attending the school. Arrange workshops for teachers to which you can invite external agencies (including drama therapists, and educational psychologists) to model teachers how to create experiential learning and support their pupils.

Technology (purchase, maintenance, acceptable use, ie. social media, privacy, copyright, internet behaviour, etc) 1. Support pupils’ educational needs by making curricular adaptations, allowing extra time for homework or exams, setting alternate times, providing opportunities for assessment in different modalities, organising an in-class buddy or teacher, allowing the use of (or provision for) resources such as a laptop or calculator, providing individual teaching sessions whenever necessary. 2. Make necessary curricular adaptations, differentiate the resources, allow extra time for pupils from disadvantaged groups to complete their work, make adjustments to their homework and workload, and invest in on-going assessment rather than summative where necessary.

Timetabling Support pupils’ educational needs by making curricular adaptations, allowing extra time for homework or exams, setting alternate times, providing opportunities for assessment in different modalities, organising an in-class buddy or teacher, allowing the use of (or provision for) resources such as a laptop or calculator, providing individual teaching sessions whenever necessary.

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Pupils with Health Issues

Asthma

Classroom-based tips (focus on instructional methods)

1. Educate pupils about asthma so they will be more understanding (in the context of first aid, science or health projects), without revealing or commenting on a specific pupil’s asthma condition.

2. Allow the pupils with asthma to use their medicine when needed.

3. Use "dustless" chalk or dry-erase boards.

4. Get prepared and be ready to help the pupils with asthma to administer their medicine if they are not old enough to self-administer it or have it readily available (not under lock and key) in the nurse's office.

5. Encourage the pupil with asthma to participate in physical activities, but make sure they follow proper precautions such as appropriate warm-up and cool down exercises and have their reliever medication with them

6. Allow a pupil with asthma to engage in quiet activity if recovery from an acute episode precludes full participation.

7. Control/cover chemicals and volatile materials used in science, art and other classes.

8. Avoid using pens, glue, and paints that emit irritating fumes. Explain the reason to give the class the opportunity to be informed and understand.

9. Understand that a pupil with asthma may feel: drowsy or tired, different from the other pupils, anxious about access to medications and embarrassed about the disruption to school activities that asthma symptoms can cause.

[References: National Heart, Lung and Blood Institute (NHLBI) (2014) Managing Asthma: A Guide for Schools., National Institutes of Health, U.S. Department of Health and Human Services, and the Fund for the Improvement and Reform of Schools and Teaching, Office of Educational Research and Improvement (OERI), U.S. Department of Education.NIH Publication No. 91-2650. Available at: https://www.nhlbi.nih.gov/files/docs/resources/lung/NACI_ManagingAsthma-508%20FINAL.pdf]

Asthma Initiative of Michigan for Healthy Lungs: http://getasthmahelp.org/teacher.aspx

Asthma – UK (2006) Asthma awareness for school staff: http://www.devon.gov.uk/sc- mar1010016.pdf]

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School-based practical tips (focus on instructional methods)

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Make plans for handling treatment of a pupil with asthma during any off-site activities such as field trips and school excursions, or make changes accordingly (i.e. change location if not appropriate due to extreme weather or high pollen).

Other (Health Measures and Facilities Management)

1. Reduce asthma triggers within the school environment to ensure safety: implement pest control; enforce a school-wide no smoking policy; regularly vacuum and dust the classroom; schedule repairs or painting for holiday periods, reduce classroom clutter to reduce the accumulation of dust.

2. Make plans for handling treatment of a pupil with asthma during any off-site activities such as field trips and school excursions, or make changes accordingly (i.e. change location if not appropriate due to extreme weather or high pollen).

3. Equip the school with air conditioners and dehumidifiers, making sure that these are regularly cleaned and maintained, as well as cleaning products without perfumes and bottles of oxygen.

[Reference: National Heart, Lung and Blood Institute (NHLBI) (2014) Managing Asthma: A Guide for Schools., National Institutes of Health, U.S. Department of Health and Human Services, and the Fund for the Improvement and Reform of Schools and Teaching, Office of Educational Research and Improvement (OERI), U.S. Department of Education.NIH Publication No. 91-2650. Available at: https://www.nhlbi.nih.gov/files/docs/resources/lung/NACI_ManagingAsthma- 508%20FINAL.pdf]

4. Provide pupils with asthma with extra support when needed, such as special educational needs and learning support and individual teaching support when a pupil with asthma is taking time off school due to health reasons. Ask for help from a social worker or psychologist if the pupil is showing signs of emotional distress.

[References: Kids Health: http://kidshealth.org/en/parents/asthma-factsheet.html Asthma – UK (2006) Asthma awareness for school staff: http://www.devon.gov.uk/sc- mar1010016.pdf]

5. Develop an emergency protocol in collaboration with the parents and health care providers and designate a teacher to oversee its implementation (prevention, emergencies, communication etc). Assist pupils to self-manage or allow parents to visit the child at school if necessary to monitor and help manage the condition. (i.e. Childhood Asthma Control Test)

[References: National Heart, Lung and Blood Institute (NHLBI) (2014) Managing Asthma: A Guide for Schools., National Institutes of Health, U.S. Department of Health and Human Services, and the Fund

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for the Improvement and Reform of Schools and Teaching, Office of Educational Research and Improvement (OERI), U.S. Department of Education.NIH Publication No. 91-2650. Available at: https://www.nhlbi.nih.gov/files/docs/resources/lung/NACI_ManagingAsthma-508%20FINAL.pdf

Allergy and Asthma Network Available at: http://www.allergyasthmanetwork.org/cms/wp-content/uploads/2014/06/Childhood_ACT.pdf]

Safety

3. Develop an emergency protocol in collaboration with the parents and health care providers and designate a teacher to oversee its implementation (prevention, emergencies, communication etc). Assist pupils to self-manage or allow parents to visit the child at school if necessary to monitor and help manage the condition. (i.e. Childhood Asthma Control Test)

[References: National Heart, Lung and Blood Institute (NHLBI) (2014) Managing Asthma: A Guide for Schools., National Institutes of Health, U.S. Department of Health and Human Services, and the Fund for the Improvement and Reform of Schools and Teaching, Office of Educational Research and Improvement (OERI), U.S. Department of Education. NIH Publication No. 91-2650. Available at: https://www.nhlbi.nih.gov/files/docs/resources/lung/NACI_ManagingAsthma-508%20FINAL.pdf

Allergy and Asthma Network Available at: http://www.allergyasthmanetwork.org/cms/wp-content/uploads/2014/06/Childhood_ACT.pdf]

School purchases (learning resources, school equipment, playground toys, etc.)

Equip the school with air conditioners and dehumidifiers, making sure that these are regularly cleaned and maintained, as well as cleaning products without perfumes and bottles of oxygen.

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Pupil support (financial, individual teaching support, counselling support, language support)

Provide pupils with asthma with extra support when needed, such as special educational needs and learning support and individual teaching support when a pupil with asthma is taking time off school due to health reasons. Ask for help from a social worker or psychologist if the pupil is showing signs of emotional distress.

[References: Kids Health: http://kidshealth.org/en/parents/asthma-factsheet.html Asthma – UK (2006) Asthma awareness for school staff: http://www.devon.gov.uk/sc- mar1010016.pdf]

Supportive literature

Definition of asthma Asthma is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing, chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning. Asthma affects people of all ages, but it most often starts during childhood. Asthma is a condition that affects the airways – the small tubes that carry air in and out of the lungs. When a child or young person with asthma comes into contact with an asthma trigger, the muscles around the walls of the airways tighten so that the airways become narrower. The lining of the airways becomes inflamed and starts to swell. Often sticky mucus or phlegm is produced. All these reactions cause the airways to become irritated, leading to the symptoms of asthma. Children and young people with asthma have airways that are almost always red and sensitive (inflamed). These airways can react badly when they come into contact with irritants that act as asthma triggers (NHLBI, 2014).

Pupils with asthma may at any time:

 have flare-ups that cause coughing, wheezing, and serious breathing problems  need to take oral or inhaled medication, usually in the school nurse's office  feel jittery, anxious, or hyper after using their inhalers (also called bronchodilators)  miss field trips that could aggravate their condition  request the removal of allergens in classrooms that can trigger flare-ups  need to be excused from physical education or other activities when they are having flare-ups (NHLBI, 2014).

Dealing With Triggers at School Pupils are likely to encounter these possible asthma triggers at school:

 mould  pollen  dust mites  cockroaches  chalk dust  perfumes  cleaning products or other chemicals

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 dander, saliva, or urine from animals (NHLB, 2014).  Handling Flare-Ups at School Ideally, quick-relief medicine (also called rescue or fast-acting medicine) should always be immediately available to pupils. This means that for pupils who are not old enough to self-administer the medicine, the teacher will have it in the classroom, or it will be readily available (not under lock and key) in the nurse's office. Pupils who have exercise-induced asthma should have their quick-relief medicine available before any strenuous play or exercise; they might need permission to go to the nurse's office before recess or gym class. It is better for pupils to carry their quick-relief medicine with them (NHLB, 2014). Sometimes young people or children need a gentle reminder to take their medication; always bear in mind that they might be embarrassed to do so in front of other people (Asthma, 2006)

Websites and EU reports

Useful Websites

World Health Organisation (WHO): www.who.int Institute of Child Education and psychology: www.icepe.eu National Heart, Lung and Blood Institute – US (2014) Explore asthma: http://www.nhlbi.nih.gov/health/health-topics/topics/asthma Pediatric / Adult Asthma Coalition: http://pacnj.org/

Relevant Articles and Reports

McGotty, C. Asthma Management in the Classroom: What Teachers Need to Know. Pediatric/ Adult Asthma Coalition. Available at: http://www.pacnj.org/pdfs/PowerPointPDF- AsthmaManagementintheClassroom.pdf

Moorman, J. E., Akinbami, L. J., Bailey, C. M., Zahran, H. S., King, M. E., Johnson, C. A., & Liu, X. (2012). National surveillance of asthma: United States, 2001-2010. Vital & health statistics. Series 3, Analytical and epidemiological studies/[US Dept. of Health and Human Services, Public Health Service, National Center for Health Statistics], (35), 1-58.

Centres for Disease Control and Prevention (CDC) (2011). Vital signs: asthma prevalence, disease characteristics, and self-management education: United States, 2001--2009. MMWR. Morbidity and mortality weekly report, 60(17), 547.

Asthma – UK (2006) Asthma awareness for school staff http://www.devon.gov.uk/sc-mar1010016.pdf

National Heart, Lung and Blood Institute (NHLBI) (2014) Managing Asthma: A Guide for Schools., National Institutes of Health, U.S. Department of Health and Human Services, and the Fund for the Improvement and Reform of Schools and Teaching, Office of Educational Research and Improvement (OERI), U.S. Department of Education.NIH Publication No. 91-2650. Available at: https://www.nhlbi.nih.gov/files/docs/resources/lung/NACI_ManagingAsthma-508%20FINAL.pdf

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References

National Heart, Lung and Blood Institute (NHLBI) (2014) Managing Asthma: A Guide for Schools., National Institutes of Health, U.S. Department of Health and Human Services, and the Fund for the Improvement and Reform of Schools and Teaching, Office of Educational Research and Improvement (OERI), U.S. Department of Education. NIH Publication No. 91-2650. Available at: https://www.nhlbi.nih.gov/files/docs/resources/lung/NACI_ManagingAsthma-508%20FINAL.pdf

Allergy and Asthma Network www.aanma.org

Asthma – UK (2006) Asthma awareness for school staff http://www.devon.gov.uk/sc-mar1010016.pdf

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Obesity

Classroom-based tips (focus on instructional methods)

1. Encourage the social integration of pupils through organising work in small groups for carrying out projects on healthy eating, and exercises in the context of a science or health class. Keep the emphasis on health rather than weight.

2. Promote activities helping pupils express themselves physically and emotionally through dance, music and drama, which allow for body movement with an aim to gain control of the body, and improve body image.

3. Be vigilant in order to recognise signs that a pupil is being bullied so that an appropriate interventions are made.

4. Encourage pupils to talk about feelings and plan activities that will enhance pupils’ emotional intelligence, and encourage feelings of empathy and kindness. Such activities might include ‘circle time’, taking care to avoid discussion or personal comments on pupils or their families and personal issues.

5. Organise activities that promote healthy weight and healthy lifestyle choices in ways that do not embarrass or single out overweight or obese pupils. For example, use healthy treats as rewards, adopt an edible classroom plant, introduce unusual healthy foods in a dedicated lesson, assign a food-related book in book reading, create research assignments and debates on food-related topics.

6. Be mindful about the use of inappropriate language and stereotypes regarding body weight, body image and beauty.

Adapted from: K-12 News, Lessons & Shared resources by teachers for teachers http://www.teachhub.com/fighting-childhood-obesity-your-classroom

School-based practical tips (focus on instructional methods)

Community

Increase pupils’ participation in collective social activities in order to improve ties with their school peers and the community. These activities can place emphasis on physical activity, such as organisation of sports activities.

K-12 News, Lessons & Shared resources by teachers for teachers http://www.teachhub.com/fighting-childhood-obesity-your-classroom

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Curricular Adaptations

Implement a high quality course of study in physical education as part of a school policy on prevention and treatment of obesity

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Arrange more outdoor activities, and excursions in nature as part of a school policy on prevention and treatment of obesity

Food: Canteen / Visits / Camps / Trips

Make sure the school canteen or cafeteria stocks appealing healthy snacks and limits unhealthy snacks. Implement canteen or cafeteria rules wherever these apply.

[Reference: The role of schools in preventing childhood obesity (2004) https://www.cdc.gov/HealthyYouth/physicalactivity/pdf/roleofschools_obesity.pdf]

Other (Health Measures and Policy)

1. Arrange more outdoor activities, and excursions in nature as part of a school policy on prevention and treatment of obesity

2. Implement a high quality course of study in physical education as part of a school policy on prevention and treatment of obesity

Parents / Parents’ Associations

Talk about obesity and its impact on pupils’ psychological wellbeing and academic performance in Parents and Teachers’ Association meetings.

Scheduling Events

1. Increase pupils’ participation in collective social activities in order to improve ties with their school peers and the community. These activities can place emphasis on physical activity , such as organisation of sports activities.

K-12 News, Lessons & Shared resources by teachers for teachers http://www.teachhub.com/fighting-childhood-obesity-your-classroom

2. Liaise with psychologists and health experts to monitor pupils’ mental and physical health. Organise lectures or campaigns to raise awareness among staff and pupils on the issue of obesity and overweight and related issues such as social marginalisation, bullying, body image and mental health issues.

[Reference: The role of schools in preventing childhood obesity (2004)

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https://www.cdc.gov/HealthyYouth/physicalactivity/pdf/roleofschools_obesity.pdf]

School Celebrations / Events / Activities

K-12 News, Lessons & Shared resources by teachers for teachers http://www.teachhub.com/fighting-childhood-obesity-your-classroom

[Reference: The role of schools in preventing childhood obesity (2004) https://www.cdc.gov/HealthyYouth/physicalactivity/pdf/roleofschools_obesity.pdf]

Pupil Support

Liaise with psychologists and health experts to monitor pupils’ mental and physical health. Organise lectures or campaigns to raise awareness among staff and pupils on the issue of obesity and overweight and related issues such as social marginalisation, bullying, body image and mental health issues.

[Reference: The role of schools in preventing childhood obesity (2004) https://www.cdc.gov/HealthyYouth/physicalactivity/pdf/roleofschools_obesity.pdf]

Teacher Professional Development

1. Liaise with psychologists and health experts to monitor pupils’ mental and physical health. Organise lectures or campaigns to raise awareness among staff and pupils on the issue of obesity and overweight and related issues such as social marginalisation, bullying, body image and mental health issues.

[Reference: The role of schools in preventing childhood obesity (2004) https://www.cdc.gov/HealthyYouth/physicalactivity/pdf/roleofschools_obesity.pdf]

2. Talk about obesity and its impact on pupils’ psychological wellbeing and academic performance in Parents and Teachers’ Association meetings.

Timetabling

Allow more breaks during the school day to encourage physical activity as part of a school policy on prevention and treatment of obesity

[References: K-12 News, Lessons & Shared resources by teachers for teachers

www.idecide-project.eu

http://www.teachhub.com/fighting-childhood-obesity-your-classroom

The role of schools in preventing childhood obesity (2004) https://www.cdc.gov/HealthyYouth/physicalactivity/pdf/roleofschools_obesity.pdf]

Supportive literature

Definition

According to the World Health Organisation (WHO) overweight and obesity are defined as ‘abnormal or excessive fat accumulation that may impair health’.

Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person's weight in kilograms divided by the square of his height in meters (kg/m2).

BMI provides the most useful population-level measure of overweight and obesity as it is the same for both sexes and for all ages of adults. Specifically, for children aged 5-19 overweight and obesity are defined as follows:

‘overweight is BMI-for-age greater than 1 standard deviation above the WHO Growth Reference median’

‘obesity is greater than 2 standard deviations above the WHO Growth Reference median’

Charts can be found at: http://www.who.int/growthref/who2007_bmi_for_age/en/

Childhood obesity is associated with a higher chance of obesity, premature death and disability in adulthood. In addition, obese children experience breathing difficulties, increased risk of fractures, hypertension, early markers of cardiovascular disease, insulin resistance and psychological effects.

Literature review

It has been observed and reported in the literature that overweight and obese children have a lower self-esteem (Strauss et al, 1985) and might be suffering from depression (Erikson et al, 2000). Furthermore, it has also been suggested that overweight children and adolescents are more likely to be socially isolated, thus exacerbating the social and emotional consequences of obesity and overweight (Strauss and Pollack, 2003). Other studies have shown that overweight children and adolescents are more likely to be described in contemptuous terms or ranked as the least desirable friends. This phenomenon has been documented since the 1960s and known to appear in all cultures (Richardson et al, 1961). Since peer appearance norms are especially important in adolescents, overweight and obese adolescents might be losing out on friendships, (George & Hartmann, 1996).

Moreover, studies have shown that negative weight-related stereotypes are held by teachers at every stage of the school system, from kindergarten upwards (Puhl & Latner, 2007). A recent study looking at the academic ability of 3,362 children in the US discovered that an increase in BMI was significantly associated with worsening teacher perceptions of both boys and girls. (Kenney et al, 2015).

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Weight-related teasing or bullying, might also contribute lower academic performance of obese or overweight children and adolescents (Krukowski et al, 2009). Bullying ruptures healthy self-esteem and in the long-term can lead to body dysmorphic disorder (an anxiety disorder that causes people to have a distorted view of their appearance and to spend a lot of time worrying about it), social anxiety disorder (an anxiety disorder that causes people to be terrified of socialising with others, fearing harsh evaluation and rejection), depression, self-harm, and suicide ideation. (Eisenberg et al, 2003). A recent study even suggests that bullying has similar or worse long-term effects on young adults’ mental health than abuse or neglect (Lereya et al, 2015).

Websites and EU Reports

World Health Organisation Obesity and Overweight http://www.who.int/mediacentre/factsheets/fs311/en/

World Health Organisation Report on Ending Childhood Obesity (2016) http://apps.who.int/iris/bitstream/10665/204176/1/9789241510066_eng.pdf?ua=1&ua=1

The role of schools in preventing childhood obesity (2004) http://www.cdc.gov/HealthyYouth/physicalactivity/pdf/roleofschools_obesity.pdf

References

Eisenberg, M. E., Neumark-Sztainer, D., & Story, M. (2003). Associations of weight-based teasing and emotional well-being among adolescents. Archives of pediatrics & adolescent medicine, 157(8), 733-738.

Erickson, S. J., Robinson, T. N., Haydel, K. F., & Killen, J. D. (2000). Are overweight children unhappy?: Body mass index, depressive symptoms, and overweight concerns in elementary school children. Archives of pediatrics & adolescent medicine, 154(9), 931-935.

George, T. P., & Hartmann, D. P. (1996). Friendship networks of unpopular, average, and popular children. Child development, 67(5), 2301- 2316.

Kenney, E. L., Gortmaker, S. L., Davison, K. K., & Austin, S. B. (2015). The academic penalty for gaining weight: a longitudinal, change-in- change analysis of BMI and perceived academic ability in middle school students. International Journal of Obesity, 39(9), 1408-1413.

Krukowski, R. A., Smith West, D., Philyaw Perez, A., Bursac, Z., Phillips, M. M., & Raczynski, J. M. (2009). Overweight children, weight-based teasing and academic performance. International Journal of Pediatric Obesity, 4(4), 274-280.

Lereya, S. T., Copeland, W. E., Costello, E. J., & Wolke, D. (2015). Adult mental health consequences of peer bullying and maltreatment in childhood: two cohorts in two countries. The Lancet Psychiatry, 2(6), 524-531.

Puhl, R. M., & Latner, J. D. (2007). Stigma, obesity, and the health of the nation's children. Psychological bulletin, 133(4), 557.

Strauss, C. C., Smith, K., Frame, C., & Forehand, R. (1985). Personal and interpersonal characteristics associated with childhood obesity. Journal of Pediatric Psychology, 10(3), 337-343.

Strauss, R. S., & Pollack, H. A. (2003). Social marginalization of overweight children. Archives of pediatrics & adolescent medicine, 157(8), 746-752.

Richardson, S. A., Goodman, N., Hastorf, A. H., & Dornbusch, S. M. (1961). Cultural uniformity in reaction to physical disabilities. American Sociological Review, 241-247.

www.idecide-project.eu

Diabetes

Classroom-based tips (focus on instructional methods)

1. Be vigilant in order to recognise symptoms of hypoglycemia (shakiness, nervousness or anxiety, sweating, chills, or clamminess, irritability or impatience, dizziness and difficulty concentrating, hunger or nausea, blurred vision, weakness or fatigue, anger, stubbornness, or sadness) and hyperglycemia (lethargy, thirst, frequent urination).

2. Ensure that the pupil knows how to measure blood glucose and use their medication, or knows the staff member to go to for help.

3. Bear in mind that diabetes can affect learning, and if not properly managed, a pupil can have difficulties with attention, memory, processing speed, planning and organising and perceptual skills. Therefore, use clear instructions for planned activities, allow enough time for diabetic pupils to complete tasks, and diversify your teaching methods to include different types of stimuli.

4. Do not focus your attention on pupils with diabetes as it makes them stand out among their peers, affecting their stress levels and psychosocial behavior. Instead, choose more subtle ways of including them in classroom activities and engaging their attention.

5. Include pupils with diabetes in all school activities after taking appropriate safety measures, for example use of the emergency kit for hypoglycemia in physical education classes.

[References: Diabetes UK: https://www.diabetes.org.uk/Guide-to-diabetes/Your-child-and- diabetes/Schools/School-staff/

Vermont Department of Health. Recommendations for the Management of Diabetes at school. Available at: healthvermont.gov/prevent/diabetes/SchoolDiabetesManual.pdf]

School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

Arrange for the child’s access to and safe storage of food, insulin and supplies. Ensure that the pupil has a clean, private space with adequate time for blood glucose monitoring and insulin administration, and safe disposal of sharps and test strips.

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Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Talk about diabetes to the Teachers Association and offer training (CPD) on special health issues. Assign school staff to provide care on field trips and at all school-sponsored activities.

Food: Canteen / Visits / Camps / Trips

Ensure the school canteen or cafeteria stocks healthy snacks and snacks appropriate for diabetics.

Other (Health Measures)

1. Enable pupils with diabetes to check their blood sugar at school. When a pupil with diabetes has low blood sugar (hypoglycemia), he or she must be given access to emergency glucose (or snacks prescribed by their doctor) to treat the low blood sugar. When a pupil with diabetes has high blood sugar (hyperglycemia), he or she must be allowed free access to water and the bathroom.

2. Prepare, in collaboration with the child’s parents and doctors, an individualised Health Care Plan which will include how diabetes care will be managed in the school setting. This should include measures on how to recognise and treat hypoglycemia or hyperglycemia, what to do in an emergency, contact persons and designated staff member (preferably trained in the absence of a school nurse) that the pupil can go to for help related to his/her diabetes care.

3. Arrange for the child’s access to and safe storage of food, insulin and supplies. Ensure that the pupil has a clean, private space with adequate time for blood glucose monitoring and insulin administration, and safe disposal of sharps and test strips.

Parents / Parents’ Associations

1. Talk about diabetes to the Teachers Association and offer training (CPD) on special health issues. Assign school staff to provide care on field trips and at all school-sponsored activities.

2. Arrange a meeting between the parents and the pupil’s teachers to talk about class rules, signs of hypoglycemia and hyperglycemia, exercise and other related concerns.

[Reference: American Association of Diabetes Educators (2016) Management of Children with Diabetes in the School Setting: https://www.diabeteseducator.org/docs/default- source/practice/practice-resources/position-statements/management-of-children-with- diabetes-in-the-school-setting.pdf?sfvrsn=0

Safety

www.idecide-project.eu

School Breaks

Keep in mind that pupils who experience high or low blood glucose levels may not be able to participate in exams so that alternative arrangements are made. Also, pupils who inject insulin before lunch might need a little extra time before lunch to accommodate their injection.

Pupil Support

4. Make sure that pupils with psychosocial issues are referred to a counselor or school psychologist.

5. Keep in mind that pupils who experience high or low blood glucose levels may not be able to participate in exams so that alternative arrangements are made. Also, pupils who inject insulin before lunch might need a little extra time before lunch to accommodate their injection.

Teacher Professional Development

Talk about diabetes to the Teachers Association and offer training (CPD) on special health issues. Assign school staff to provide care on field trips and at all school-sponsored activities.

www.idecide-project.eu

Timetabling

Supportive literature

1. Definition Diabetes is a chronic disease in which blood glucose (sugar) levels are above normal. Type 1 diabetes or juvenile diabetes is a disease of the immune system. In people with type 1 diabetes, the immune system attacks the insulin-producing cells of the pancreas and destroys them. Because the pancreas can no longer produce insulin, people with type 1 diabetes must take insulin daily to live. Type 1 diabetes occurs most often in children and young adults. Although there is no cure, diabetes can be managed with insulin injections, blood sugar monitoring, proper diet and exercise (CDC). Children with diabetes face two serious problems:

 Hypoglycemia, or low blood sugar, occurs when the blood sugar level is too low, due to too much insulin, too little food, or too much exercise. Children with low blood sugar sometimes behave erratically or act sleepy, and are often very hungry and shaky. Low blood sugar must be treated immediately by giving the child foods with simple sugars, such as fruit juice. If you suspect that a pupil has low blood sugar, do not leave the pupil unattended because s/he can lose consciousness (Henderson, 2005).

 Hyperglycemia, or high blood sugar, occurs when the blood sugar level is too high, due to too little insulin or too much food. Children with high blood sugar can become lethargic and sleepy, and are often very thirsty and need to go to the bathroom frequently. High blood sugar is treated by giving additional insulin and sugar-free drinks, such as water. Pupils with diabetes must be given free access to water and the bathroom (Henderson, 2005). Prolonged hyperglycemia due to insufficient insulin can lead to a very serious condition called diabetic ketoacidosis, which can lead to coma and death.

2. Psychosocial issues of pupils with diabetes Diabetes is a complex chronic disease that affects every facet of life. The fact that pupils with diabetes have to regularly perform their blood sugar monitoring and their insulin injections can set them apart and make them feel different to their peers. This can lead to considerable distress, especially if pupils are left out from activities such as excursions or sleepovers, and their self-image can suffer. This can make them feel angry or resentful or become depressed. Furthermore, some pupils can be accepting and open to discussing their condition, while others attempt to hide it. Sometimes, pupils cannot comply with the regimen but feel pressured to please their family and health care providers and report fictitious blood glucose levels. Conversely, sometime they use their diabetes to assert their independence and control and do not comply with their diabetes care plan. Diabetes may compromise independence, because the parents/guardians are concerned about their child’s ability to perform self-care tasks and take responsibility for their diabetes. This parental concern can lead to increasing struggles with dependence, oppositional behavior, and rebellion (ADA).

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3. Diabetes and learning Diabetes can affect learning, and if not properly managed pupils can have difficulties with attention, memory, processing speed, planning and organising and perceptual skills, and might not achieve their full academic potential. The challenges of properly managing diabetes may also impact on a child’s life. Some pupils with diabetes may have frequent absences due to hospital appointments or feeling unwell because of their diabetes (Diabetes UK).

Websites and EU Reports

American Diabetes Association: www.diabetes.org

Center for Diseases Control and Prevention: www.cdc.gov

Diabetes UK: www.diabetes.org.uk

Vermont Department of Health. Recommendations for the Management of Diabetes at school. Available at: healthvermont.gov/prevent/diabetes/SchoolDiabetesManual.pdf

American Association of Diabetes Educators (2016) Management of Children with Diabetes in the School Setting. Available at: https://www.diabeteseducator.org/docs/default-source/practice/practice-resources/position- statements/management-of-children-with-diabetes-in-the-school-setting.pdf?sfvrsn=0

References

Henderson, G. (2005). Standards of care for students with type 1 diabetes: Ensuring safety, health and inclusion in school. Paediatrics & Child Health, 10(1), 25–27.

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Anaemia

Classroom-based tips (focus on instructional methods)

1. Be vigilant when interpreting a pupil’s behavior. If undiagnosed, pupils may exhibit some or all of the following behaviors: irritability, fatigue, lack of concentration, avoidance of activities, dizziness and other cognitive problems.

2. Ensure that pupil absences are justified; encourage parents to take their children for a full check-up.

3. Include healthy eating and nutrition in the curriculum as a life skill in the context of a module such as health or science.

4. Offer pupils the opportunity to sit at the front of the class to help with concentration.

5. Take an inclusive approach to all activities including physical education; bear in mind that anemic pupils might exhibit signs of fatigue or dizziness or might need extra time to recover from activity.

[Reference: Schools and Health: http://www.schoolsandhealth.org/Pages/iron.aspx]

School-based practical tips (focus on instructional methods)

Food: Canteen / Visits / Camps / Trips

1. Ensure that the school canteen offers foods or snacks that are rich in iron.

[Reference: Schools and Health: http://www.schoolsandhealth.org/Pages/iron.aspx]

2. Ensure that even pupils from a low socio-economic background who might not be receiving adequate nutrition at home can have access to iron-rich foods at school; these efforts can be supported through appropriate actions organised by parents’ associations.

[Reference: Kim, J. Y., Shin, S., Han, K., Lee, K. C., Kim, J. H., Choi, Y. S., ... & Ko, B. J. (2014). Relationship between socioeconomic status and anemia prevalence in adolescent girls based on the fourth and fifth Korea National Health and Nutrition Examination Surveys. European journal of clinical nutrition, 68(2), 253-258.]

Other (School Health Checks)

Have a heart rate monitor available for use in physical education classes and other physical activities, as pupils with anemia may experience an unusually rapid heart rate.

www.idecide-project.eu

[Reference: http://www.hopkinsmedicine.org/healthlibrary/conditions/hematology_and_blood_disorder s/iron-deficiency_anemia_85,P00077/]

Parents / Parents’ Associations

1. Ensure that even pupils from a low socio-economic background who might not be receiving adequate nutrition at home can have access to iron-rich foods at school; these efforts can be supported through appropriate actions organised by parents’ associations.

[Reference: Kim, J. Y., Shin, S., Han, K., Lee, K. C., Kim, J. H., Choi, Y. S. & Ko, B. J. (2014). Relationship between socioeconomic status and anemia prevalence in adolescent girls based on the fourth and fifth Korea National Health and Nutrition Examination Surveys. European journal of clinical nutrition, 68(2), 253-258.]

2. Discuss with the parents the special requirements of the pupil with anemia such as medication and nutritional needs.

[Reference: Mayo Clinic: www.mayoclinic.org]

Safety

2. Discuss with the parents the special requirements of the pupil with anemia such as medication and nutritional needs.

[Reference: Mayo Clinic: www.mayoclinic.org]

3. Have a heart rate monitor available for use in physical education classes and other physical activities, as pupils with anemia may experience an unusually rapid heart rate.

[Reference: http://www.hopkinsmedicine.org/healthlibrary/conditions/hematology_and_blood_diso rders/iron-deficiency_anemia_85,P00077/]

Pupil Support

Ensure that even pupils from a low socio-economic background who might not be receiving adequate nutrition at home can have access to iron-rich foods at school; these efforts can be supported through appropriate actions organised by parents’ associations.

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Technology

Have a heart rate monitor available for use in physical education classes and other physical activities, as pupils with anemia may experience an unusually rapid heart rate.

[Reference: http://www.hopkinsmedicine.org/healthlibrary/conditions/hematology_and_blood_disorder s/iron-deficiency_anemia_85,P00077/]

Supportive literature

Definition of Anemia Anemia occurs when blood has a lower than normal number of red blood cells, or if red blood cells don’t have enough hemoglobin. Hemoglobin is a protein that gives blood its red color and helps those cells bring oxygen from your lungs to the rest of the body. If a person is anemic, the body simply doesn’t receive enough oxygen-rich blood, which makes the person feel tired and weak. Severe anemia can damage the heart, brain and other organs in the body, and may even cause death. Overall, iron deficiency is the most common cause of anemia in the developed world (Sills et al, 2016). Iron deficiency needs to exist for a long time before anemia occurs. Iron deficiency is usually caught early by pediatricians in routine screening as it exhibits very peculiar symptoms such as nailbiting and the desire to chew on ice or soil (pica). In the Western world anemia could be the result of prolonged iron deficiency due to malnutrition as seen in anorexia nervosa.

Symptoms of anemia Difficulty maintaining body temperature, increased likelihood of infections fatigue, weakness, pale skin, fast or irregular heartbeat, shortness of breath, chest pain, dizziness, cognitive problems, cold hands and feet, headaches and irritability.

At risk groups According to the World Health Organisation (2004), children are particularly vulnerable to anemia and an estimated 53% of school-age children suffer from anemia globally. Adolescent girls are at higher risk of iron deficiency because their bodies lose iron during menstruation. Children who have certain health conditions, such as chronic infections or restricted diets, as well as children who are not receiving enough nutrition through their diet are also at higher risk of iron deficiency. Anemia has severe consequences on the cognitive and physical development of children, as indicated by poor school performance due to an inability to learn and concentrate (WHO, 2004).

Websites and EU Reports

Schools and Health http://www.schoolsandhealth.org/Pages/iron.aspx

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Centre for Diseases Control https://www.cdc.gov/mmwr/preview/mmwrhtml/00051880.htm World Health Organisation (WHO) http://www.who.int/topics/anaemia/en/who_unicef-anaemiastatement.pdf

References

Sills R. Iron-deficiency anemia. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 455.

World Health Organization (2004) Focusing on anaemia joint statement. World Health Organization and the United Nations Children's Fund.

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Epilepsy

Classroom-based tips (focus on instructional methods)

1. Be vigilant when interpreting a pupil’s behavior. Sometimes seizure symptoms and difficulties related to epilepsy may be misinterpreted as ‘naughtiness’.

2. Make sure to recap a lesson after a pupil’s epilepsy related absence, so as to ensure they do not feel left behind with regards to material covered.

3. Focus on instructional methods that include more analytical than mnemonic activities, where possible. One of the most prominent cognitive changes that occurs in people with epilepsy is that of memory problems.

4. Do not focus your attention on pupils with epilepsy as it makes them stand out among their peers, affecting their stress levels and psychosocial behavior. Instead choose more subtle ways of including them into classroom activities and engaging their attention.

5. Do not force pupils with epilepsy to perform in all activities, especially physical ones, to the same extent as their peers. As epilepsy is often a “hidden” disability, performance anxiety and pressure could have the opposite effect and could potentially result in seizures. Instead support these pupils in pacing themselves to the extent they feel comfortable with.

6. Check that the pupil is not sitting near visual distractions, such as near a window.

7. Allow the pupil to have access to your lesson notes whenever appropriate.

8. When assigning a task, be clear about the purpose, break tasks down into smaller, achievable steps, and allow pupil to repeat tasks; repetition means they have a better chance of mastering a task or remembering, allow more time for pupil to complete task.

School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

Provide extra instructional support for pupils with epilepsy, if needed, especially in case where their condition results in accumulated absences. Also, alternative teaching methods might be necessary, for example avoidance of using flat TV and computer screens. [Reference: Epilepsy Society - Teaching Children with Epilepsy https://www.epilepsysociety.org.uk/teaching-children-epilepsy#.WBX-qyQbIsc]

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Curricular Adaptations

Although curricular adaptations may not be possible or required, depending on the case, make provisions for different modalities of assessing a pupil’s performance. Also, alternative scheduling of tests and exams might be necessary.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

School excursions should be organised in a manner that include easy access to medical facilities should the need arise.

[Reference: Young Epilepsy (2013) Guide for schools; Understanding epilepsy. UK: www.youngepilepsy.org.uk/307-guide-for-schools-understanding-epilepsy-1/file.html

Homework

Other (Health Measures)

1. Epilepsy often has varied symptoms ranging from learning difficulties to seizures. Have an extended consultation with pupils’ parents and health-monitoring team to understand the particularities of each case and make necessary provisions for safety issues that may arise, including emergency plans, contact persons, first aid.

2. School excursions should be organised in a manner that include easy access to medical facilities should the need arise.

[Reference: Young Epilepsy (2013) Guide for schools; Understanding epilepsy. UK: www.youngepilepsy.org.uk/307-guide-for-schools-understanding-epilepsy-1/file.html

3. Invest in specialised training for teachers by medical professionals into the particularities of epilepsy, its diverse symptoms and on methods of interacting with pupils with epilepsy and reacting in the event of seizures in the appropriate manner, including first aid.

[Reference: CHOC Epilepsy Center, Managing Children with Epilepsy, a school nurse guide, CHOC Children’s: http://www.choc.org/userfiles/file/EpilepsyHandbook.pdf]

Parents / Parents’ Associations

www.idecide-project.eu

2. Following consent from parents of pupils with epilepsy, discuss the subject in Parents’ Association and Teaching Staff meetings. This will help to explain the circumstances and open up the dialogue on the management of epilepsy in the school setting, and discuss issues like diversity and bullying. However, avoid putting the pupil with epilepsy under the spotlight by asking them to discuss their condition in front of the class or other groups.

Safety

2. School excursions should be organised in a manner that include easy access to medical facilities should the need arise.

[Reference: Young Epilepsy (2013) Guide for schools; Understanding epilepsy. UK: www.youngepilepsy.org.uk/307-guide-for-schools-understanding-epilepsy-1/file.html

[Reference: CHOC Epilepsy Center, Managing Children with Epilepsy, a school nurse guide, CHOC Children’s: http://www.choc.org/userfiles/file/EpilepsyHandbook.pdf]

Pupil Support

2. Although curricular adaptations may not be possible or required, depending on the case, make provisions for different modalities of assessing a pupil’s performance. Also, alternative scheduling of tests and exams might be necessary.

3. Provide extra instructional support for pupils with epilepsy, if needed, especially in case where their condition results in accumulated absences. Also, alternative teaching methods might be necessary, for example avoidance of using flat TV and computer screens.

[Reference: Epilepsy Society - Teaching Children with Epilepsy https://www.epilepsysociety.org.uk/teaching-children-epilepsy#.WBX-qyQbIsc]

www.idecide-project.eu

Teacher Professional Development

1. Invest in specialised training for teachers by medical professionals into the particularities of epilepsy, its diverse symptoms and on methods of interacting with pupils with epilepsy and reacting in the event of seizures in the appropriate manner, including first aid.

[Reference: CHOC Epilepsy Center, Managing Children with Epilepsy, a school nurse guide, CHOC Children’s: http://www.choc.org/userfiles/file/EpilepsyHandbook.pdf]

Supportive literature

Definition of Epilepsy Epilepsy is a neurological disorder. The brain contains millions of nerve cells called neurons that send electrical charges to each other. A seizure occurs when there is a sudden and brief excess surge of electrical activity in the brain between nerve cells. This results in an alteration in sensation, behavior, and consciousness. Seizures may be caused by developmental problems before birth, trauma at birth, head injury, tumour, structural problems, vascular problems (i.e. stroke, abnormal blood vessels), metabolic conditions (i.e. low blood sugar, low calcium), infections (i.e. meningitis, encephalitis) and idiopathic causes. Children who have idiopathic seizures are most likely to respond to medications and outgrow seizures. (CHOC)

Characteristics of pupils with Epilepsy One of the most prominent cognitive changes that occurs in people with epilepsy is related to memory (Zemen et al. 2012). Difficulties with memory have been identified as a ‘barrier to learning’, especially in an examination system based on being able to recall information, which may be particularly difficult for young people with epilepsy. As such it is important that teachers and others who have responsibility for supporting pupilswith epilepsy are aware of the possibility but not inevitability of additional learning and behavioral difficulties (Reilly and Ballantine, 2011). Relevant research suggests that teachers lack understanding of epilepsy (Wodrich et al. 2011) and that they may not be aware of the additional difficulties pupilswith epilepsy can have concerning learning and emotional problems (Wodrich et al. 2006). Childhood epilepsy is associated with a higher risk for ‘internalising disorders’ such as depression and anxiety and ‘externalising disorders’ such as attention deficit hyperactivity disorder (ADHD) (Berg et al. 2011). As well as potential difficulties with working memory, pupilswith epilepsy may have specific learning problems such as inattention and processing difficulties, or side effects associated with their antiepileptic medication identified as a barrier that can impact on learning (Reilly and Ballantine, 2011). Tiredness, mood swings, irritability and difficulties concentrating could all be attributed to side effects of medication. Disturbed sleep and resulting tiredness as a result of nocturnal seizures is another factor in relation to the impact of epilepsy on learning.

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Websites and EU Reports

Epilepsy Foundation - Your Child at School and Child Care http://www.epilepsy.com/learn/seizures-youth/about-kids/your-child-school-and-child-care Epilepsy Society - Teaching Children with Epilepsy https://www.epilepsysociety.org.uk/teaching-children-epilepsy#.WBX-qyQbIsc WebMD - Epilepsy and Your Child's School http://www.webmd.com/epilepsy/guide/children-school Epilepsy Ontario - School life for children with epilepsy http://epilepsyontario.org/school-life-for-children-with-epilepsy/ AboutKidsHealth - What teachers and other school personnel need to know about your child’s epilepsy http://www.aboutkidshealth.ca/En/ResourceCentres/Epilepsy/AtHomeandAtSchool/EpilepsyandSch ool/Pages/At-School.aspx Chronic Illness Alliance - School Strategies http://www.chronicillness.org.au/invisible-illness/epilepsy/school-strategies/ Epilepsy Action Australia - Information for Teachers https://www.epilepsy.org.au/about-epilepsy/living-with-epilepsy/information-for-teachers Young Epilepsy - Inclusion in education: what helps? What hinders? http://www.youngepilepsy.org.uk/for-professionals/research/research-projects/inclusion-in- education-research.html Teaching for Inclusion - Epilepsy http://web1.modelfarms-h.schools.nsw.edu.au/disabilities.php?page=epilepsy Bright Hub Education - Creating the Right Environment for Inclusion Classrooms http://www.brighthubeducation.com/special-ed-inclusion-strategies/68102-creating-the-right- environment-in-your-inclusive-classroom/ Teaching Times - Children with epilepsy risk a poorer standard of education http://www.teachingtimes.com/articles/epilepsy-poorer-education.htm Young Epilepsy (2013) Guide for schools; Understanding epilepsy. UK www.youngepilepsy.org.uk/307-guide-for-schools-understanding-epilepsy-1/file.html

References

Berg, A., Caplan, R. and Hesdorffer (2011) Psychiatric and Neurodevelopmental Disorders in Childhood-onset Epilepsy, Epilepsy and Behavior, 20 (3), 550 – 555

CHOC Epilepsy Center, Managing Children with Epilepsy, a school nurse guide, CHOC Children’s http://www.choc.org/userfiles/file/EpilepsyHandbook.pdf

Reilly, C. and Ballantine, R. (2011). Epilepsy in school-aged children: More than just seizures? Support for Learning, 26, 144-151

Wodrich, D.L., Kaplan, A.M., and Deering, W.M. (2006). Children with epilepsy in school: Special service usage and assessment practices, Psychology in Schools, 43, 169-180

Wodrich D., Jarrarb R., Buchhalterb J., Levya R. and Gaya C. (2011) Knowledge about epilepsy and confidence in instructing students with epilepsy,Epilepsy and Behaviour, 20, 2, pp. 360 – 365

Zemen, A., Kapur, N. and Jones-Gotman, M. (2012) Epilepsy and Memory, Oxford, Oxford University Press

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Myopia

Classroom-based tips (focus on instructional methods)

1. Be vigilant when interpreting a pupil’s behaviour. If undiagnosed, pupils may exhibit some or all of the following: holding a book too close; squinting or tilting the head to see better; frequent eye rubbing; losing her/his place while reading; complaining of headaches or tired eyes; avoiding activities which require near vision; sensitivity to light; excessive teariness of the eyes; receiving lower grades than usual.

2. Offer pupils with myopia the opportunity to sit in the front of the class as close to the board as possible.

3. Reduce glare from windows or seat the pupil with her/his back to the window.

4. Bear in mind that pupils with myopia might need extra support or time to copy things down from the blackboard, read from a distance, or complete an assignment.

5. When using printed materials consider contrast, print style, and spacing of letters as these can be more important than print size.

6. Focus on instructional methods that include auditory as well as visual stimuli.

7. Avoid drawing attention to the pupil's eye problem in front of the class and discussing or commenting on a pupil’s myopia condition.

[References: http://www.allaboutvision.com/parents/schoolage.htm Texas School for the Blind and the Visually impaired http://www.tsbvi.edu/program-and-administrative-resources/3277-considerations-for-low- vision-students-in-a-classroom]

School-based practical tips (focus on instructional methods)

Curricular Adaptations

1. Increase time spent outside during breaks or the frequency of outdoor activities.

2. Organise a larger number of field trips, which will allow pupils to spend time outside and be exposed to sunlight.

[References: http://www.allaboutvision.com/parents/myopia-causes.htm

www.idecide-project.eu

http://www.nature.com/news/the-myopia-boom-1.17120]

3. Make provisions for different modalities of assessing a pupil’s performance where appropriate. [Reference: http://www.allaboutvision.com/parents/schoolage.htm]

4. Encourage physical activity and sports as part of a plan to reduce myopia risk and progression. Ask parents for their permission to include pupils in all sports activities, including pupils who wear glasses.

[Reference: http://eyewiki.aao.org/Myopia]

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Organise a larger number of field trips, which will allow pupils to spend time outside and be exposed to sunlight.

[References: http://www.allaboutvision.com/parents/myopia-causes.htm http://www.nature.com/news/the-myopia-boom-1.17120]

Homework

Make provisions for different modalities of assessing a pupil’s performance where appropriate.

[Reference: http://www.allaboutvision.com/parents/schoolage.htm]

Parents / Parents’ Associations

Following consent from parents of pupils with myopia, discuss the subject in Parents’ Association and Staff meetings. This will help open up the dialogue on the management of myopia in the school setting, and discuss issues like diversity and bullying.

[Reference: http://thinkaboutyoureyes.com/articles/kids-vision]

Safety

Encourage physical activity and sports as part of a plan to reduce myopia risk and progression. Ask parents for their permission to include pupils in all sports activities, including pupils who wear glasses.

[Reference: http://eyewiki.aao.org/Myopia]

School Breaks

Increase time spent outside during breaks or the frequency of outdoor activities.

www.idecide-project.eu

Pupil Support

Make provisions for different modalities of assessing a pupil’s performance where appropriate.

[Reference: http://www.allaboutvision.com/parents/schoolage.htm]

Teacher Professional Development

[Reference: http://thinkaboutyoureyes.com/articles/kids-vision]

Supportive literature

Definition of Myopia Near-sightedness, also known as short-sightedness or myopia, is a condition of the eye where light focuses in front, instead of on the retina. This causes distant objects to be blurry while close objects appear normal (NIE). The underlying cause is believed to be a combination of genetic and environmental factors. Risk factors include doing work that involves focusing on close objects, greater time spent indoors, and a family history of the condition. Children rely on their vision in their learning processes. If they have difficulty seeing, this handicap affects academic performance. Near- sightedness can be corrected with eyeglasses, contact lenses, or surgery. The prevalence of myopia has been reported as high as 30–40% in Europe. Indeed, the prevalence of myopia has profoundly increased since 1983 in children aged between 11 and 13 years (Dolgin, 2015). As children spend a lot of time at school, an intervention from the educational system is a direct approach to tackle myopia, a growing public health concern (NIE). Recent studies suggest that increased outdoor activities and reduced long-term near work activities could help to reduce myopia onset and progression. Further studies show that exposure to sunlight can protect against myopia. (Wu et al, 2013; Jin et al, 2015).

Websites and EU Reports

American Academy of Ophthalmology: http://eyewiki.aao.org/Myopia American Optometric Association http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision- conditions/myopia?sso=y Think about your eyes: http://thinkaboutyoureyes.com/articles/kids-vision National Eye Institute: https://nei.nih.gov/

References

Wu, P. C., Tsai, C. L., Wu, H. L., Yang, Y. H., & Kuo, H. K. (2013). Outdoor activity during class recess reduces myopia onset and progression in school children. Ophthalmology, 120(5), 1080-1085.

www.idecide-project.eu

Jin, J. X., Hua, W. J., Jiang, X., Wu, X. Y., Yang, J. W., Gao, G. P., ... & Tao, L. M. (2015). Effect of outdoor activity on myopia onset and progression in school-aged children in Northeast China: the Sujiatun eye care study. BMC ophthalmology, 15(1), 1.

Dolgin, E. (2015). The myopia boom. Nature, 519(7543), 276-278.

National Eye Institute: https://nei.nih.gov/

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HIV – AIDS

Classroom-based tips (focus on instructional methods)

1. Organise informational sessions in class, for example within sex education classes or science classes on HIV to raise awareness and address the misconceptions with regards to transmission of the disease.

2. Keep confidentiality of the pupil’s condition and avoid revealing, discussing or commenting on their condition to anyone that does not need to be made aware of it.

3. Seat pupils towards the front of the class due to possible attention deficit issues.

4. Provide catch-up work in different key learning areas, in case the pupil has been absent due to infections or other physical symptoms.

5. Offer extra tutoring to assist with the known difficulties in cognitive functions.

6. Give verbal prompts and written reminders to help with memory loss issues.

7. Help the pupil organise thoughts using graphic organisers and mind maps.

8. Consider that HIV infected pupils may face spatial difficulties that may affect their participation in physical education classes.

[References: Chenneville, T., & Knoff, H. M. (1998). HIV/AIDS: What educators should know. National Mental Health and Education Center. Available at: http://www.naspcenter.org/adol_HIV_print.html Welch, S., Conway, M., Nicholson, S., & Forni, J. (2015, April). Teachers' awareness of HIV and the needs of children affected by HIV. In HIV MEDICINE (Vol. 16, pp. 10-10). 111 RIVER ST, HOBOKEN 07030-5774, NJ USA: WILEY-BLACKWELL.]

School-based practical tips (focus on instructional methods)

Community

Be upfront with the pupil’s family in terms of the school’s supportive and open role to pupils with diagnosed HIV, as well as other diseases or pathologies, to make families feel safe in disclosing early on. Keep in mind that a pupil’s schooling can be disrupted when a family does not feel comfortable about informing the school of their child’s infection.

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Other (Health Measures / Confidentiality Policy)

1. Make provisions for pupils after disclosure by the family to the school council, supported by trained school nurses.

2. Have a policy in place that respects the privacy of the family while not compromising the pupil’s education.

[Reference: Cohen, J., Reddington, C., Jacobs, D., Meade, R., Picard, D., Singleton, K. & Massachusetts Department of Public Health. (1997). School-related issues among HIV- infected children. Pediatrics, 100(1), e8-e8.]

Parents / Parents’ Associations

1. Make provisions for pupils after disclosure by the family to the school council, supported by trained school nurses.

2. Be upfront with the pupil’s family in terms of the school’s supportive and open role to pupils with diagnosed HIV, as well as other diseases or pathologies, to make families feel safe in disclosing early on. Keep in mind that a pupil’s schooling can be disrupted when a family does not feel comfortable about informing the school of their child’s infection.

3. Have a policy in place that respects the privacy of the family while not compromising the pupil’s education. [Reference: Cohen, J., Reddington, C., Jacobs, D., Meade, R., Picard, D., Singleton, K. & Massachusetts Department of Public Health. (1997). School-related issues among HIV- infected children. Pediatrics, 100(1), e8-e8.]

4. Provide for training, informational events or activities on the implications of living with HIV and the misconceptions as to its transmission, to the parents association and the student body.

[Reference: Welch, S., Conway, M., Nicholson, S., & Forni, J. (2015, April). Teachers' awareness of HIV and the needs of children affected by HIV. In HIV MEDICINE (Vol. 16, pp. 10-10). 111 RIVER ST, HOBOKEN 07030-5774, NJ USA: WILEY-BLACKWELL.]

Safety Celebrations / Event / Activities

1. Provide for training, informational events or activities on the implications of living with HIV and the misconceptions as to its transmission, to the parents association and the student body.

2. Have a policy in place that respects the privacy of the family while not compromising the pupil’s education.

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Pupil Support

1. Make provisions for pupils after disclosure by the family to the school council, supported by trained school nurses.

2. Have a policy in place that respects the privacy of the family while not compromising the pupil’s education. [Reference: Cohen, J., Reddington, C., Jacobs, D., Meade, R., Picard, D., Singleton, K., ... & Massachusetts Department of Public Health. (1997). School-related issues among HIV- infected children. Pediatrics, 100(1), e8-e8.]

Teacher Professional Development

1. Provide teachers with training in order to enable understanding of the implications of HIV on pupils’ academic performance as well as their social interactions. School personnel should seek guidance regarding the medical issues that may arise for the HIV-infected pupil while under their supervision, from the respective medical team treating the child.

2. Provide for training, informational events or activities on the implications of living with HIV and the misconceptions as to its transmission, to the parents association and the student body.

Supportive Literature

AIDS is caused by infection of the individual with a human immunodeficiency virus (HIV) that alters a person's immune system and damages his/her ability to fight off other diseases. AIDS is primarily spread by sexual contact and the sharing of contaminated needles and syringes among users of illegal intravenous drugs. Children generally acquire the disease in one of two other ways:

 the virus can be passed on from infected mothers during pregnancy, at birth, or shortly after birth;  in a small number of cases, the virus has been spread through blood products (clotting factors) and blood transfusions.

It is important to know that "casual, social contact between children and persons infected with the AIDS virus is not dangerous." No cases of AIDS have been identified in which pupils were infected in a school setting (Koop, 1986). There are no documented cases of AIDS transmission due to casual contact, biting, fighting, or contact sports.

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 Physical implications

HIV-infected individuals may experience generalised symptoms associated with immune suppression such as fatigue, diarrhoea, weight loss, fever, and night sweats. HIV infection suppresses the immune system making individuals vulnerable to opportunistic infections and illnesses which include, but are not limited to, certain forms of cancer, pneumonia, and fungal infections (Chenneville & Knoff, 1998).

 Neurological implications

An estimated 75% to 90% of children infected with HIV experience neuropsychological deficits resulting from developmental delays and/or cognitive disabilities. It is known that HIV infection can interfere with the normal brain development of children, resulting in neurological damage. This is especially true for children infected through perinatal transmission, whose central nervous systems are not yet fully developed at the time of infection. Among other cognitive dysfunctions, visual and auditory short-term memory loss, attention deficits, language disorders, spatial ability problems and expressive and receptive language difficulties may be observed in pediatric AIDS cases. (Wolters et al, 1995; Chenneville & Knoff, 1998).

 Social Implications

Many of the symptoms reported by children with AIDS are similar to those experienced by children living with other chronic illnesses. Such symptoms include loss of abilities, physical impairments and the fear of impending death. Each of these may result in psychological reactions, including anxiety and depression. However, the social experiences of HIV-infected children differ from those of children with other chronic illnesses in several ways. First, many HIV-infected children, especially those who contract the virus perinatally, may have to cope with losses associated with AIDS-related illnesses and deaths within their families. Most important is the stigma associated with HIV/AIDS, the result of fear and discrimination. Attempts have been made to deny rights to individuals infected with HIV/AIDS, including the right to a free and appropriate education (Landau et al, 1995).

A systematic review of 23 studies revealed that there are educational disadvantages among pupils affected by AIDS in various educational outcomes, including school enrollment and attendance, school behavior and performance, school completion, and educational attainment (Guo et al, 2012).

Websites and EU Reports

AVERTing HIV and AIDS http://www.avert.org/professionals/hiv-social-issues/key-affected-populations/children National AIDS Trust – UK: http://www.nat.org.uk/ US Government - HIV/AIDS https://www.aids.gov/hiv-aids-basics/just-diagnosed-with-hiv- aids/overview/children/

References

www.idecide-project.eu

Koop, C. E. (1986) Surgeon General's Report on Acquired Immune Deficiency Syndrome. Available at: https://www.nlm.nih.gov/.../Surgeon- Generals-Report-on-AIDS-Transcription.docx

Chenneville, T., & Knoff, H. M. (1998). HIV/AIDS: What educators should know. National Mental Health and Education Center. Available at: http://www.naspcenter.org/adol_HIV_print.html

Landau, S., Pryor, J.B., & Haefli, K. (1995). Pediatric HIV: School-based sequelae and curricular interventions for infection prevention and social acceptance. School Psychology Review, 24, 213-229.

Wolters, P.L., Brouwers, P., & Moss, H.A. (1995). Pediatric HIV disease: Effects on cognition, learning, and behavior. School Psychology Quarterly, 10, 305-328.

Guo, Y., Li, X., & Sherr, L. (2012). The impact of HIV/AIDS on children's educational outcome: A critical review of global literature. AIDS care, 24(8), 993-1012.

www.idecide-project.eu

Cancer

Classroom-based tips (focus on instructional methods)

1. Seat pupils towards the front of the class as cancer or treatment can affect cognitive functions i.e. attention.

2. Encourage the rest of the class to keep in touch with the pupil undergoing cancer treatment through cards, emails, and even visits if appropriate, to maintain contact with the school community and feel supported.

3. Allow pupils undergoing cancer treatment to drink and eat snacks whenever they need to, as some treatments cause dehydration, weight loss and increased hunger. Allow them to leave class five minutes early in order to get to the next class safely and in time, and allow them wear a hat in class, in case the treatment is causing hair loss.

4. During and following radiation and chemotherapy treatments the pupil may process information and respond more slowly than usual, or may feel fatigue. Thus the teacher should:

 Offer extra tutoring  Adapt work so the pupil can manage the load, emphasising quality instead of quantity  Provide a scaffold that shows the steps in a task  Give verbal prompts and written reminders  Help these pupils organise their thoughts using graphic organisers and mind-maps  Allow the pupil to work without interruption or distraction as much as possible

[References: Cancer Council Australia (2015) Cancer in the School Community: A guide for staff members. ISBN 978 1925 1365 55 Cancer Child Foundation (2011) Back to School for children with cancer: Guidelines for teachers. New Zealand http://www.childcancer.org.nz/getattachment/family-support/parent- resources/1731_b2sbrochoct11.pdf.aspx Leukemia and Lymphoma Society (2013) Learning and living with cancer: Advocating for your child’s educational needs. LLS Booklet]

www.idecide-project.eu

School-based practical tips (focus on instructional methods)

Class Divisions

Liaise with parents and the child’s school and home medical teams in order to devise a protocol of response to medical emergencies, adapt to upcoming scheduled absences due to tests or treatments and be made aware of side–effects that might impact on appearance and behavior. Support the rest of the class to be understanding and learn how to best support their classmate. Bear in mind that pupils who are undergoing intensive treatment such as chemotherapy may be unable to come to school; they should be able to exercise their right to home schooling, if this is within the parents’ wishes.

Community

Organise a cancer awareness and education day after consulting with the pupil and her / his parents. This day can include informational sessions, fundraising and other awarness-raising activities. Avoid making specific references to the pupil and their condition as this may cause feelings of discomfort to the child and the family. [Reference: Cancer Council Australia (2015) Cancer in the School Community: A guide for staff members. ISBN 978 1925 1365 55]

Curricular Adaptations

1. Allow extra time for homework and assessment tasks, and increase time limits in tests or exams as discreetly as possible.

2. Revise the number or types of subjects taken by the pupil. For example, consider in collaboration with the parents and the medical team whether the pupil can attend physical education classes post radiotherapy or chemotherapy treatment cycles as s/he may experience fatigue or other side-effects.

3. Liaise with parents and the child’s school and home medical teams in order to devise a protocol of response to medical emergencies, adapt to upcoming scheduled absences due to tests or treatments and be made aware of side–effects that might impact on appearance and behavior. Support the rest of the class to be understanding and learn how to best support their classmate. Bear in mind that pupils who are undergoing intensive treatment such as chemotherapy may be unable to come to school; they should be able to exercise their right to home schooling, if this is within the parents’ wishes.

[References: Cancer Child Foundation (2011) Back to School for children with cancer: Guidelines for teachers. New Zealand: http://www.childcancer.org.nz/getattachment/family- support/parent-resources/1731_b2sbrochoct11.pdf.aspx Cancer Council Australia (2015) Cancer in the School Community: A guide for staff members. ISBN 978 1925 1365 55]

www.idecide-project.eu

Homework

Allow extra time for homework and assessment tasks, and increase time limits in tests or exams as discreetly as possible.

Other (Health Measures)

Parents / Parents’ Associations

Safety

www.idecide-project.eu

School Celebrations / Events / Activities

Pupil Support

Organise an in-class buddy or teacher assistant to help with note-taking or recording assignment due dates. Also, ask for help from a social worker or psychologist if the pupil is showing signs of emotional distress, or is unable to adjust back into school.

Technology

Provide the pupil with, or allow the pupil to use a laptop to avoid motor fatigue and the challenge of handwriting, a tape-recorder to record lessons and help with memory, and a calculator to help with mathematics. [Reference: Leukemia and Lymphoma Society (2013) Learning and living with cancer: Advocating for your child’s educational needs. LLS Booklet]

Supportive Literature

Pediatric or Childhood Cancer The diagnosis and treatment of pediatric cancer has both short- and long-term impacts on children and their families. Cancer affects a child’s physical, psychological, and academic development. Many pediatric cancer survivors develop cognitive impairments and learning difficulties, have extensive school absences, and experience diminished academic performance; these affect the child’s desire to return to school and ability to be successful in school. It is important for teachers and school personnel to recognise that they are in the position to positively impact a child’s quality of life by working together to develop comprehensive and flexible educational and health plans for a pupilundergoing cancer treatment. School personnel should keep in mind that after cancer treatment has been completed, a pupilmay continue to struggle with short- and long-term cognitive difficulties, as well as emotional, social, and behavioral challenges (Hay et al, 2015).

Types of childhood cancer Leukemia is cancer of the blood cells which arise out of the bone marrow and accounts for about 40% of all childhood cancer cases. The most common of these is Acute Lymphoblastic Leukemia (ALL). Acute Myeloid Leukemia (AML) accounts for most of the other cases.

Central Nervous System Tumours of the brain and spinal cord are the most common solid tumours in children.

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Lymphomas originate from cells in the lymph nodes or other lymphatic tissues and include Hodgkins Lymphoma and a number of Non-Hodgkin’s Lymphomas.

Kidney Tumours are more likely to occur in the first five years of life.

Rhabdomyosarcoma is a cancer of the connective tissue that can arise from a number of different locations in the body.

Osteosarcoma is the most common childhood bone tumour, and often affects the long bones of the arms and legs.

Ewings Sarcoma is a tumour that occurs in the bone or the soft tissue. It often occurs in the pelvis or the leg bones.

Neuroblastoma originates in primitive nerve cells in the adrenal gland and a chain of nerves along the spine. While neuroblastoma in infancy usually has good outcomes, in older children it is more aggressive and challenging to treat.

Other Cancers: Children may also develop germ cell tumours, which arise from reproductive cells, or tumours that arise in the liver, as well as other rare forms of cancer.

Websites and EU Reports

American Cancer Society: http://www.cancer.org/treatment/childrenandcancer/whenyourchildhascancer/children-diagnosed- with-cancer-returning-to-school National Cancer Institute - Children’s Oncology Group (COG): https://childrensoncologygroup.org/index.php/school-support Kids with Cancer Society: http://www.kidswithcancer.ca/cancer-in-the-classroom/ Cancer Child Foundation (2011) Back to School for children with cancer: Guidelines for teachers. New Zealand http://www.childcancer.org.nz/getattachment/family-support/parent- resources/1731_b2sbrochoct11.pdf.aspx

References

Cancer Child Foundation (2011) Back to School for children with cancer: Guidelines for teachers. New Zealand http://www.childcancer.org.nz/getattachment/family-support/parent-resources/1731_b2sbrochoct11.pdf.aspx

Cancer Council Australia (2015) Cancer in the School Community: A guide for staff members. ISBN 978 1925 1365 55

Leukemia and Lymphoma Society (2013) Learning and living with cancer: Advocating for your child’s educational needs. LLS Booklet

Hay, G. H., Nabors, M., Sullivan, A., & Zygmund, A. (2015). Students with Pediatric Cancer: A Prescription for School Success. Physical Disabilities: Education and Related Services, 34(2), 1-13.

www.idecide-project.eu

LGBT

Classroom-based tips (focus on instructional methods)

1. Ask pupils to discuss gender stereotypes that they are already familiar with and talk about how there is no such thing as a ‘typical girl’ or ‘typical boy’. Use these discussions as a starting point to explore the different ways we express our gender (for example through our clothes, hair, or the way we walk), what ‘gender identity’ means, and that not everyone identifies as a boy or a girl. Support these discussions by challenging gender stereotypes in the wider school environment. Avoid using language that supports stereotypes, for example: ‘I need a strong boy to help me’ or ‘Jane, that is not very ladylike.’

[Reference: https://www.stonewall.org.uk/sites/default/files/an_introduction_to_supporting_lgbt_youn g_people_-_a_guide_for_schools_2015.pdf]

2. Use inclusive language. Through casual conversation and during classroom time, make sure the language you are using is inclusive for all people. When referring to people in general, try using words like “partner” instead of “boy- friend/girlfriend” or “husband/wife,” and avoid gendered pronouns, using “they” instead of “he/ she.” Using inclusive language will help LGBT pupils feel more comfortable being themselves and coming to you for support.

[Reference: http://www.healthysafechildren.org/sites/default/files/Safe_Space_Kit_2013.pdf]

3. Make no assumptions. When engaging with pupils, or even other staff and parents, do not assume you know their sexual orientation or gender identity. Don’t assume that everyone is heterosexual or fits into your idea of gender roles; be open to the variety of gender identities and ways in which gender identities can be expressed . In our society, pupils constantly receive the message that everyone is supposed to be straight. Through expressing your own openness and awareness, show pupils that you understand there is no one way a person “should” be. [Reference: http://www.healthysafechildren.org/sites/default/files/Safe_Space_Kit_2013.pdf]

School-based practical tips (focus on instructional methods)

Announcement / Sign at School

1. Invest in teachers training to develop knowledge on sexual education. Proper training gives all school community members a thorough understanding of the part they play in making their school an environment that welcomes all pupils.

www.idecide-project.eu

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf] 2. Make your school a safe place for all pupils by adopting an anti-bullying policy or establishing a school-wide Code of Conduct, with explicit guidance on safeguarding LGBT pupils. Given that bullying often occurs when adults aren’t present, identify “hot spots” in and around the school premises where bullying often occurs; take immediate corrective actions to eliminate these hot spots, such as training and assigning pupils or staff to monitor these locations and/or adding surveillance cameras.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

3. Use gender-inclusive language on all event communications, including invitations.

4. Publicly praise staff members who actively promote an inclusive environment. This practice both affirms their positive action and creates a culture in which other staff members are unafraid to be allies to LGBT and gender-nonconforming pupils. At end-of-the-year award ceremonies, present special “Diversity Leader” certificates to educators who actively promoted an inclusive school environment throughout the year.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

5. Communicate effectively and often with pupils, parents and guardians and the community about your school’s zero tolerance of bullying. Post the name and contact information for your schools’ anti-bullying coordinator in the office, on the school website and in the student handbook.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

6. Ensure that parents/carers understand that homophobic, biphobic and transphobic bullying is not tolerated and that all pupils are welcome, regardless of their sexual orientation or gender identity. [Reference: https://www.stonewall.org.uk/sites/default/files/an_introduction_to_supporting_lgbt_youn g_people_-_a_guide_for_schools_2015.pdf]

Class Divisions / Arrangements

1. Help pupils whose gender is incorrectly listed on paperwork to correct the situation and ensure school staff and pupils address these individuals using their preferred pronouns.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

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2. Designate a gender-neutral restroom. Binary (male / female) restrooms are not inclusive and can be unsafe spaces for transgender and intersex pupils. Allow each transgender or intersex pupil to use the restroom in which that pupil is most comfortable, whether it is the gender- neutral restroom or the restroom that corresponds with the pupil's self-identified gender. [Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

3. Evaluate your administrative forms and communications and update them if necessary so that they use gender-neutral language or allow space for pupils to communicate their gender identity. [Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

Community

1. Communicate effectively and often with pupils, parents and guardians and the community about your school’s zero tolerance of bullying. Post the name and contact information for your schools’ anti-bullying coordinator in the office, on the school website and in the student handbook.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

Ensure that parents/carers understand that homophobic, biphobic and transphobic bullying is not tolerated and that all pupils are welcome, regardless of their sexual orientation or gender identity [Reference: https://www.stonewall.org.uk/sites/default/files/an_introduction_to_supporting_lgbt_youn g_people_-_a_guide_for_schools_2015.pdf]

2. Arrange regular meetings with educational counsellors, psychologists and teachers to support pupils who are coping with the emotional side-effects of being bullied or coming out.

Discipline

1. Make your school a safe place for all pupils by adopting an anti-bullying policy or establishing a school-wide Code of Conduct, with explicit guidance on safeguarding LGBT pupils. Given that bullying often occurs when adults aren’t present, identify “hot spots” in and around the school premises where bullying often occurs; take immediate corrective actions to eliminate these hot spots, such as training and assigning pupils or staff to monitor these locations and/or adding surveillance cameras.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

2. Evaluate the effectiveness of your school’s anti-bullying program annually using pupil and staff surveys.

www.idecide-project.eu

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

3. Designate an anti-bullying coordinator as well as an anti-bullying task force. Provide training for staff members to specifically prevent and respond to bullying incidents.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

4. Communicate effectively and often with pupils, parents and guardians and the community about your school’s zero tolerance of bullying. Post the name and contact information for your schools’ anti-bullying coordinator in the office, on the school website and in the student handbook.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

5. Ensure that parents/carers understand that homophobic, biphobic and transphobic bullying is not tolerated and that all pupils are welcome, regardless of their sexual orientation or gender identity

[Reference: https://www.stonewall.org.uk/sites/default/files/an_introduction_to_supporting_lgbt_youn g_people_-_a_guide_for_schools_2015.pdf]

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Build an inclusive school climate through creating an LBGT alliance club to educate pupils about diversity and support to LGBT pupils. An LGBT club should be no different than any other school club and cannot be subjected to any extra regulations to avoid discrimination.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

Other (School Policy & Confidentiality)

2. Never reveal, in public (such as in school assemblies), a pupil’s sexual orientation or gender identity without the pupil’s permission - even to the pupil’s family. [Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

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Other (School Adaptations - Facilities)

1. Designate a gender-neutral restroom. Binary (male / female) restrooms are not inclusive and can be unsafe spaces for transgender and intersex pupils. Allow each transgender or intersex pupil to use the restroom in which that pupil is most comfortable, whether it is the gender- neutral restroom or the restroom that corresponds with the pupil's self-identified gender.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

2. Consider making changes across the school to ensure that trans pupils feel safe and comfortable, for instance by providing toilets, changing rooms and school uniform items that are not gender specific. Some young people don’t identify as ‘male’ or ‘female’, or may not feel happy using either ‘male’ or ‘female’ facilities. Take steps to provide ‘gender neutral’ facilities, irrespective of whether there are trans pupils in school, as this will help create a more inclusive environment for everyone.

[Reference: https://www.stonewall.org.uk/sites/default/files/an_introduction_to_supporting_lgbt_youn g_people_-_a_guide_for_schools_2015.pdf]

Other (Administration)

Evaluate your administrative forms and communications and update them if necessary so that they use gender-neutral language or allow space for pupils to communicate their gender identity.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

Other (School Associations & Clubs)

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

Parents / Parents’ Associations

1. Dress codes should be applied to all pupils equally and pupils’ dress codes should be checked regularly, in order to be inclusive towards transgender pupils. Dress codes should be flexible so as to fit the gender that pupils feel most comfortable in, regardless of the gender they were assigned at birth.

www.idecide-project.eu

2. Communicate effectively and often with pupils, parents and guardians and the community about your school’s zero tolerance of bullying. Post the name and contact information for your schools’ anti-bullying coordinator in the office, on the school website and in the student handbook. [Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

3. Ensure that parents/carers understand that homophobic, biphobic and transphobic bullying is not tolerated and that all pupils are welcome, regardless of their sexual orientation or gender identity.

[Reference: https://www.stonewall.org.uk/sites/default/files/an_introduction_to_supporting_lgbt_youn g_people_-_a_guide_for_schools_2015.pdf]

Safety

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

3. Consider making changes across the school to ensure that trans pupils feel safe and comfortable, for instance by providing toilets, changing rooms and school uniform items that are not gender specific. Some young people don’t identify as ‘male’ or ‘female’, or may not feel happy using either ‘male’ or ‘female’ facilities. Take steps to provide ‘gender neutral’ facilities, irrespective of whether there are trans pupils in school, as this will help create a more inclusive environment for everyone.

[Reference: https://www.stonewall.org.uk/sites/default/files/an_introduction_to_supporting_lgbt_youn g_people_-_a_guide_for_schools_2015.pdf]

4. Designate an anti-bullying coordinator as well as an anti-bullying task force. Provide training for staff members to specifically prevent and respond to bullying incidents.

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[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

[Reference: https://www.stonewall.org.uk/sites/default/files/an_introduction_to_supporting_lgbt_youn g_people_-_a_guide_for_schools_2015.pdf

School Breaks

Designate an anti-bullying coordinator as well as an anti-bullying task force. Provide training for staff members to specifically prevent and respond to bullying incidents.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

School Celebrations / Events / Activities

1. Use gender-inclusive language on all event communications, including invitations.

2. Build an inclusive school climate through creating an LBGT alliance club to educate pupils about diversity and support to LGBT pupils. An LGBT club should be no different than any other school club and cannot be subjected to any extra regulations to avoid discrimination.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

3. Publicly praise staff members who actively promote an inclusive environment. This practice both affirms their positive action and creates a culture in which other staff members are unafraid to be allies to LGBT and gender-nonconforming pupils. At end-of-the-year award ceremonies, present special “Diversity Leader” certificates to educators who actively promoted an inclusive school environment throughout the year.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

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School Uniform

Dress codes should be applied to all pupils equally and pupils’ dress codes should be checked regularly, in order to be inclusive towards transgender pupils. Dress codes should be flexible so as to fit the gender that pupils feel most comfortable in, regardless of the gender they were assigned at birth.

Student Council

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

2. Ensure that parents/carers understand that homophobic, biphobic and transphobic bullying is not tolerated and that all pupils are welcome, regardless of their sexual orientation or gender identity.

[Reference: https://www.stonewall.org.uk/sites/default/files/an_introduction_to_supporting_lgbt_youn g_people_-_a_guide_for_schools_2015.pdf]

Pupil Support

1. Help pupils whose gender is incorrectly listed on paperwork to correct the situation and ensure school staff and pupils address these individuals using their preferred pronouns.

2. Evaluate the effectiveness of your school’s anti-bullying program annually using pupil and staff surveys.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

3. Designate an anti-bullying coordinator as well as an anti-bullying task force. Provide training for staff members to specifically prevent and respond to bullying incidents.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

4. Arrange regular meetings with educational counsellors, psychologists and teachers to support pupils who are coping with the emotional side-effects of being bullied or coming out.

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Teacher Professional Development

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

2. Publicly praise staff members who actively promote an inclusive environment. This practice both affirms their positive action and creates a culture in which other staff members are unafraid to be allies to LGBT and gender-nonconforming pupils. At end-of-the-year award ceremonies, present special “Diversity Leader” certificates to educators who actively promoted an inclusive school environment throughout the year.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

3. Evaluate the effectiveness of your school’s anti-bullying program annually using pupil and staff surveys.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

4. Designate an anti-bullying coordinator as well as an anti-bullying task force. Provide training for staff members to specifically prevent and respond to bullying incidents.

[Reference: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf]

5. Arrange regular meetings with educational counsellors, psychologists and teachers to support pupils who are coping with the emotional side-effects of being bullied or coming out.

Supportive Literature

European Union Agency for Fundamental Rights. (2014). European Union LGBT survey: Main results. Vienna: FRA – European Union Agency for Fundamental Rights.

Council of the European Union (17 June 2010): Toolkit to Promote and Protect the Enjoyment of all Human Rights by Lesbian, Gay, Bisexual and Transgender (LGBT) People. Luxembourg. Available at (http://www.consilium.europa.eu/UEDOCS/CMSUPLOAD/ST11179.EN10.PDF ).

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Council of the European Union (24 June 2013). Guidelines to promote and protect the enjoyment of all human rights by Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) persons. Luxembourg. Available at https://eeas.europa.eu/sites/eeas/files/137584.pdf

GLEN: Gay and Lesbian Equality Network: Report on Including Lesbian, Gay & Bisexual Students in School Policies, Guidelines for Principals. Available at http://www.glen.ie/attachments/Guidelines_for_Principals.PDF

Gordon, L. (1994). What do we say when we hear 'faggot'. Rethinking our classrooms, 86-87.

LGBT Helpline: What is it LGBT. Available at http://www.lgbt.ie/about/what-is-lgbt Stonewall Education Guides: Challenging Homophobic Language. The Lehman Brothers Foundation. Available at http://www.ilga-europe.org/sites/default/files/challenging_homophobic_language.pdf

Teaching Tolerance: A project of the southern poverty law centre. Best Practices Creating an LGBT- inclusive School Climate: A Teaching Tolerance Guide for School Leaders. Available at: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf

University of Michigan, Spectrum Centre: LGBT Terms and Definitions. Available at https://internationalspectrum.umich.edu/life/definitions

Definition of LGBT: The acronym LGBT describes a diverse group of persons who do not conform to conventional or traditional notions of male and female gender roles. LGBT people are also sometimes referred to as “sexual, gender and bodily minorities” (https://eeas.europa.eu/sites/eeas/files/137584.pdf).

The sex of a person is usually assigned at birth and becomes a social and legal fact from there on. However, some people do not feel that their correct sex has been assigned to them at birth. This can also be the case for intersex people whose bodies incorporate both or certain aspects of both male and female physiology, and at times their genital anatomy. For others, problems arise because their innate perception of themselves is not in conformity with the sex assigned to them at birth. These persons are referred to as ‘transgender’ or ‘transsexual’ people. They also include cross-dressers, transvestites and other people who do not fit the narrow categories of ‘male’ or ‘female’. Transgender persons are a particularly vulnerable group within the LGBT community. (http://www.consilium.europa.eu/UEDOCS/CMSUPLOAD/ST11179.EN10.PDF).

Lesbian: A lesbian woman is one who is romantically, sexually and/or emotionally attracted to women. Many lesbians prefer to be called lesbian rather than gay.

Gay: A gay man is one who is romantically, sexually and/or emotionally attracted to men. The word gay can be used to refer generally to lesbian, gay and bisexual people but many women prefer to be called lesbian. Most gay people don't like to be referred to as homosexual because of the negative historical associations with the word and because the word gay better reflects their identity.

Bisexual: A bisexual person is someone who is romantically, sexually and/or emotionally attracted to people of both sexes.

Transgender or Trans: This is an umbrella term used to describe people whose gender identity (internal feeling of being male, female or transgender) and/or gender expression, differs from that

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usually associated with their birth sex. Not everyone whose appearance or behaviour is gender- atypical will identify as a transgender person. Many transgender people live part-time or full-time in another gender. Transgender people can identify as transsexual, transvestite or another gender identity. [Reference: These definitions are adapted from More Than a Phase (Pobal, 2006), For a Better Understanding of Sexual Orientation (APA, 2008) and Answers to Your Questions About Transgender Individuals and Gender Identity (APA, 2006). Available at: http://www.lgbt.ie/about/what-is-lgbt]

Asexual: A person who generally does not feel sexual attraction or desire to any group of people. Asexuality is not the same as celibacy.

Intersex: A person whose sexual anatomy or chromosomes do not fit with the traditional markers of "female" and "male." For example: people born with both "female" and "male" anatomy (penis, testicles, vagina, uterus).

Homophobia: A range of negative attitudes and feelings toward homosexuality or people who are identified or perceived as being lesbian, gay, bisexual or transgender (LGBT). Homophobia can be expressed as antipathy, contempt, prejudice, aversion, or hatred, may be based on irrational fear, and is sometimes related to religious beliefs. LGBT people across the EU often encounter discrimination, harassment and bullying from childhood and at school (European Union Agency for Fundamental Rights, 2014).

[Reference: These definitions are adapted from the LGBT Terms and Definitions of the International Student Spectrum at the University of Michigan. Available at https://internationalspectrum.umich.edu/life/definitions]

Websites and EU Reports Teaching Tolerance: A project of the southern poverty law centre. Best Practices Creating an LGBT- inclusive School Climate: A Teaching Tolerance Guide for School Leaders. Available at: http://www.tolerance.org/sites/default/files/general/LGBT%20Best%20Practices_0.pdf University of Michigan, Spectrum Centre: LGBT Terms and Definitions. Available at https://internationalspectrum.umich.edu/life/definitions https://www.stonewall.org.uk/sites/default/files/an_introduction_to_supporting_lgbt_young_peopl e_-_a_guide_for_schools_2015.pdf http://www.healthysafechildren.org/sites/default/files/Safe_Space_Kit_2013.pdf http://uktrans.info/70-topic-overviews/328-resources-for-schools http://tgeu.org/wp-content/uploads/2015/06/Malta-Education-Policy.pdf https://eeas.europa.eu/human_rights/lgbt/docs/toolkit_en.pdf http://eeas.europa.eu/human_rights/lgbt/index_en.htm http://www.consilium.europa.eu/uedocs/cms_data/docs/pressdata/en/foraff/137584.pdf http://www.schools-out.org.uk/STK/Guidance.htm http://www.glen.ie/attachments/Guidelines_for_Principals.PDF https://www.education.ie/en/Publications/Education-Reports/Being-LGBT-in-School.pdf

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Refugees, Asylum Seekers, Unaccompanied Minors and Migrant Pupils

Generic Tips for Migrants, Asylum Seekers and Refugees

Classroom-based tips (focus on instructional methods)

1. Develop and implement an antiracist policy, which deals with any incidents of racism towards migrant, refugee or asylum-seeker pupils because of any aspect of their identity, such as their background, accent, language skills, appearance, legal status in the country of arrival or religion.

2. Report clearly on pupils’ academic profiles, with special emphasis on their prior academic accomplishments, so as to avoid them repeating a grade they have already completed. A great challenge for migrant, refugee and asylum-seeker pupils lies in getting their educational achievements recognised.

3. Put special emphasis on teaching the language of the host country (extra personalised teaching, remedial teaching).

4. Encourage social integration between all pupils through organising work in small groups for doing common learning activities and cross-cultural events. In such small groups, make sure that minimum linguistic communication is guaranteed; for example you may use translators, or make sure at least two members of the group speak the same language.

5. Avoid any potentially offensive stereotypical references to cultural, religious, ethnic or other groups when teaching.

6. Identify shared cultural values and differences in the classroom. Plan for opportunities where pupils can voice their personal values and beliefs to create a sense of belonging.

7. Teach topics that touch upon other cultures, countries and religions in an objective way, challenging stereotypes and deconstructing essentialist views about culture and religion.

8. Provide pupils with various opportunities and ways in which to express their life experiences. Art and storytelling are particularly effective techniques.

School-based practical tips (focus on instructional methods)

Announcement / Sign at School

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Explain clearly how the specific school unit works, what the school rules are, and its associated culture. This applies mostly to first-generation migrant, pupils.

Community

1. Explain clearly to both pupils and parents how the national system works in a comparative way, if possible, to the national system of the countries of origin. Specifically, explain how expectations, norms, and behaviours in your schools may be different from those in the new arrivals’ home country.

2. Collaborate with settled, or second-generation immigrant families from the same national or linguistic communities as those of the newcomers to your school, asking them to act as cultural mediators and even translators to facilitate parental involvement in their children’s education and the integration process. This applies mostly to first-generation migrant pupils.

Curricular Adaptations

1. Provide pupils with a condensed form of the curriculum that allows them to catch up to their grade levels in core content. This applies mostly to first-generation migrant pupils.

2. Put particular emphasis on teaching the language of the host country in extra teaching periods.

3. Develop extra-curricular activities to facilitate the two-way process of social integration throughout your school community.

Discipline

Develop and implement an antiracist policy, which addresses incidents of racism towards migrant, refugee or asylum-seeking pupils because of any aspect of their identities, such as their background, accent, language skills, appearance, legal status in the country of arrival or religion.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Organise school events, projects and visits that promote intercultural understanding and take into account the cultural sensitivities of migrant pupils. Avoid events of the “folklore” approach (e.g. multicultural festivals with traditional cooking, dancing and singing by the ‘foreigners’), as these may lead to the intensification of stereotypes by putting migrant or refugee children under the spotlight because of their backgrounds. Such events also promote an essentialist view of cultures, which takes identities as fixed and permanent rather than fluid and changing.

Food (Canteen / Visits / Camps / Trips)

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Provide a culturally tolerant atmosphere that allows all pupils to maintain their individual cultural and religious habits. For example, it might be very difficult for some new pupils to find time and appropriate space to pray during school hours, or find snacks in the school canteen that are allowed according to their religion, or to follow the dress code of their cultural or religious group.

Other (Education / School System)

2. Explain clearly how the specific school unit works, what the school rules are, and its associated culture. This applies mostly to first-generation migrant, pupils.

Other (Extracurricular Activities)

Develop extra-curricular activities to facilitate the two-way process of social integration throughout your school community.

Parents / Parents’ Associations

1. Enhance teachers’ cultural awareness through discussions with the parents of migrant, refugee or asylum-seeking pupils, and systematic training about the dominant cultural values of the newcomers joining the school community, involving experts from the corresponding communities. [Reference: McBrien, J. L. (2005). Educational needs and barriers for refugee students in the United States: A review of the literature. Review of educational research, 75(3), 329-364.]

2. Explain clearly to both pupils and parents how the national system works in a comparative way, if possible, to the national system of the countries of origin. Specifically, explain how expectations, norms, and behaviours in your schools may be different from those in the new arrivals’ home country.

3. Explain clearly how the specific school unit works, what the school rules are, and its associated culture. This applies mostly to first-generation migrant, pupils.

4. Collaborate with settled, or second-generation immigrant families from the same national or linguistic communities as those of the newcomers to your school, asking them to act as cultural mediators and even translators to facilitate parental involvement in their children’s education and the integration process. This applies mostly to first-generation migrant pupils.

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5. Enhance teachers’ cultural awareness through discussions with the parents of migrant pupils or systematic training about the dominant cultural values of the new families joining your school.

Safety

2. Explain clearly how the specific school unit works, what the school rules are, and its associated culture. This applies mostly to first-generation migrant, pupils.

Scheduling Events

School Breaks

1. Develop and implement an antiracist policy, which addresses incidents of racism towards migrant, refugee or asylum-seeking pupils because of any aspect of their identities, such as their background, accent, language skills, appearance, legal status in the country of arrival or religion. 2. Provide a culturally tolerant atmosphere that allows all pupils to maintain their individual cultural and religious habits. For example, it might be very difficult for some new pupils to find time and appropriate space to pray during school hours, or find snacks in the school canteen that are allowed according to their religion, or to follow the dress code of their cultural or religious group.

School Celebrations / Events / Activities

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School Projects

School Uniform

Pupil Support

2. Explain clearly to both pupils and parents how the national system works in a comparative way, if possible, to the national system of the countries of origin. Specifically, explain how expectations, norms, and behaviors in your schools may be different from those in the new arrivals’ home country.

3. Collaborate with settled, or second-generation immigrant families from the same national or linguistic communities as those of the newcomers to your school, asking them to act as cultural mediators and even translators to facilitate parental involvement in their children’s education and the integration process. This applies mostly to first-generation migrant pupils.

4. Assign teachers with specialisation in intercultural education the role of school counselors with the duty of helping newly arrived migrant pupils to adjust to the new environment and culture, but also to process any trauma, if encountered. [Reference: Banks, J. A. (1994). An introduction to multicultural education. Needham Heights: Allyn and Bacon]

Teacher Professional Development

1. Enhance teachers’ cultural awareness through discussions with the parents of migrant, refugee or asylum-seeking pupils, and systematic training about the dominant cultural values

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of the newcomers joining the school community, involving experts from the corresponding communities.

[Reference: McBrien, J. L. (2005). Educational needs and barriers for refugee students in the United States: A review of the literature. Review of educational research, 75(3), 329-364.]

2. Enhance teachers’ cultural awareness through discussions with the parents of migrant pupils or systematic training about the dominant cultural values of the new families joining your school.

Refugees, Asylum Seekers and Unaccompanied Minors

Classroom-based tips (focus on instructional methods)

1. Promote therapeutic interventions given that refugee pupils often suffer from post- traumatic stress disorder; these may include activities that help them in externalising their painful experiences through writing, story-telling, poetry, dance, music, drama, or any art form from the pupils’ own culture and heritage.

[Reference: Eisenbruch, M. (1991). From post-traumatic stress disorder to cultural bereavement: diagnosis of Southeast Asian refugees. Social Science & Medicine, 33(6), 673- 680.]

2. Avoid making references to issues that might cause pupils to recall traumatic experiences, such as war, violence, family separation, bombs, guns.

[Reference: Eisenbruch, M. (1991). From post-traumatic stress disorder to cultural bereavement: diagnosis of Southeast Asian refugees. Social Science & Medicine, 33(6), 673- 680.]

3. Avoid separating younger pupils from older brothers and sisters, especially if they are of close age. This is additionally important for unaccompanied minors.

[Reference: Rutter, J., & Jones, C. (1998). Refugee Education: Mapping the Field. Sterling: Stylus Publishing.]

School-based practical tips (focus on instructional methods)

Curricular Adaptations

1. Put special emphasis on teaching the pupils’ native language and the English language as well

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as the language of the host country through extra personalised teaching and remedial teaching.

School Uniform

Provide pupils with any material support they may need, including clothes, school uniforms, stationery, schoolbags and books.

Pupil Support

1. Provide pupils with any material support they may need, including clothes, school uniforms, stationery, schoolbags and books.

2. Put special emphasis on teaching the pupils’ native language and the English language as well as the language of the host country through extra personalised teaching and remedial teaching.

3. Ask for the help of school psychologists or other relevant professionals for addressing extreme cases of refugee pupils suffering from loss, grief and trauma.

4. Appoint experienced teachers as mentors of these pupils, with the main responsibility of representing their best interests and monitoring their academic progress and social adjustment.

[Reference: McBrien, J. L. (2005). Educational needs and barriers for refugee students in the United States: A review of the literature. Review of educational research, 75(3), 329-364.]

5. Collaborate with the parents’ association so as to find families volunteering to offer interim care (even for a few hours per week) to these children as foster parents (refers to unaccompanied minors).

6. Use school psychologists for interviewing unaccompanied minors to help reveal their traumas and support them in overcoming these experiences (refers to unaccompanied minors).

[Reference: Rutter, J. (2001). Supporting Refugee Children in 21st Century Britain: A Compendium of Essential Information. Sterling: Stylus Publishing.]

Class Divisions / Arrangements

Group unaccompanied minors coming from the same region together where possible to attend the same school (refers to unaccompanied minors).

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Community

1. Collaborate with the parents’ association so as to find families volunteering to offer interim care (even for a few hours per week) to these children as foster parents (refers to unaccompanied minors).

2. Collaborate with local authorities, agencies, the church or charities and relevant NGOs, so as to help provide these pupils with a safe and caring domestic environment (refers to unaccompanied minors).

Food (Canteen / Visits / Camps / Trips)

Ensure that these pupils get nutritious meals during school mealtimes (refers to unaccompanied minors).

Other (Health Provisions)

1. Regularly check the health of these pupils. Immunisation must be arranged for all unaccompanied minors (refers to unaccompanied minors).

Parents / Parents’ Associations 1. Collaborate with the parents’ association so as to find families volunteering to offer interim care (even for a few hours per week) to these children as foster parents (refers to unaccompanied minors).

Supportive literature

Definition of Refugees: According to the 1951 U.N Refugee Convention, which is the key legal document that outlines the status and the rights of refugees, signed by 144 state parties, “a refugee is someone who owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his (her) nationality, and is unable to or, owning to such fear, is unwilling to avail (himself) of the protection of that country”.

According to article 22 of the same Convention:

1. The Contracting States shall accord to refugees the same treatment as is accorded to nationals with respect to elementary education.

2. The Contracting States shall accord to refugees treatment as favourable as possible, and, in any event, not less favourable than that accorded to aliens generally in the same circumstances, with respect to education other than elementary education and, in particular, as regards access to studies, the recognition of foreign school certificates, diplomas and degrees, the remission of fees and charges and the award of scholarships.

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Definition of Asylum seekers: According to U.N Refugee Agency an asylum-seeker is someone whose request for sanctuary has yet to be processed. At the end of 2014, there were approximately 1.8 million people around the world waiting for a decision on their asylum claims.

Definition of Unaccompanied minors: An unaccompanied minor is a person who is under the age of eighteen, unless, under the law applicable to the child, majority is attained earlier and who is separated from both parents and is not being cared for by an adult who by law or custom has responsibility to do so (UN, “Refugee Children: Guidelines on Protection and Care”, p.121).

Literature review Schools play significant roles in pupils’ socialisation processes. For a refugee child this process is often violently disrupted in the home country, until the child's education begins again with a new socialisation process in a school in the host country; this process is frequently at odds with the child's home environment and previous experience of school. For example, there may be differences in discipline, school culture and processes of learning, which place additional pressure on a child who has already experienced multiple changes, trauma and loss.

One of the main tasks for refugee pupils within the school environment is adapting and developing socialisation skills in a new cultural and social context. Refugee flight almost always disrupts this process in two ways; first it breaks the continuity of the socialisation process, and second it prevents the child from progressing normally in learning information and skills (Ahearn & Athey, 1991).

Schools additionally have a part to play in this process by:  Helping refugee pupils to feel less invisible through creating a safe, validating environment, where they feel supported and understood;  Orchestrating learning experiences within the school curriculum that include refugee pupils’ experiences and reinforce positive ways of handling problems;  Offering therapeutic and social support so as to help these pupils to acculturate and become a part of the school, without losing their own cultural identities.

In terms of refugee pupils’ classroom behaviour and teacher response, it is important for teachers:  Not to pathologise responses to multiple loss and change.  To be responsive to the ways refugee pupils may be affected as well as the ways in which their trauma, loss and grief may appear within the classroom setting.  To participate in appropriate training and in-service activities related to refugee education and the effects of trauma on pupils within the classroom.

Restoration of a sense of safety is a top priority for refugee children. The school needs to create a safe environment within the school and the individual classrooms. One approach within classrooms is the use of small groups, so pupils can learn from each other in an intimate and supportive environment. In addition, the implementation or strengthening of cross-cultural curricular topics and projects within schools could help increase levels of understanding, acceptance and mutual respect. Also, integrating a focus on human rights and refugees will both inform all pupils of the needs and experiences of the refugee children, and validate the importance of their experiences.

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Finally, increased positive and culturally appropriate liaisons between schools and families, which includes programmes for parents participating in school enterprises or school forums are needed in order to foster cultural diversity and communication among the school community. Parental involvement is critical to ensuring the academic success of refugee children. [Reference: Adapted from “Interventions for Refugee Children in New Zealand Schools: Models, Methods, and Best Practice” accessed at http://www.educationcounts.govt.nz/publications/schooling/5463/chapter-1]

Websites and EU Reports

The U.N Refugee Agency website includes interesting teachers’ materials, toolkits and other resources for Refugee Education: http://www.unhcr.org/education.html

The International Network for Education in Emergencies website: http://www.ineesite.org/en/

Report on the global trends of refugee education. UNHCR, 2011: Refugee Education: a Global Review

The website of the Alberta Government in Canada including multiple resources and ideas for refugee education: http://teachingrefugees.com/

Report prepared for the Ministry of Education of New Zealand entitled “Literature Review: Interventions for Refugee Children in New Zealand Schools: Models, Methods, and Best Practice”: http://www.educationcounts.govt.nz/__data/assets/pdf_file/0016/12139/interventions.pdf

Report prepared by the International Committee of Red Cross containing guidelines for working with unaccompanied and separated children: http://www.unhcr.org/protection/children/4098b3172/inter-agency-guiding-principles- unaccompanied-separated-children.html

Report prepared by the Office of the U.N High Commissioner for Refugees in Geneva containing guidelines on Policies and Procedures in dealing with Unaccompanied Children Seeking Asylum: http://www.unhcr.org/publications/legal/3d4f91cf4/guidelines-policies-procedures-dealing- unaccompanied-children-seeking-asylum.html

Useful Journals

Race, Ethnicity and Education: http://www.tandfonline.com/loi/cree20#.Vo5mHfeTvIU

Intercultural Education: http://www.tandfonline.com/loi/ceji20#.Vo5oMPeTvIU

Diaspora, indigenous and minority education: http://www.tandfonline.com/toc/hdim20/current

References European Union Agency for Fundamental Rights. (2014). European Union LGBT survey: Main results. Vienna: FRA – European Union Agency for Fundamental Rights.

Ahearn, F. L., & Athey, J. L. (1991). Refugee children: Theory, research, and services. Johns Hopkins Univ Press.

Beiser, M., Dion, R., Gotowiec, A., Hyman, I., & et al. (1995). Immigrant and refugee children in Canada. Canadian Journal of Psychiatry, 40(2), 67-72.

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Bolloten, B., & Spafford, T. (1998). Supporting refugee children in east London primary schools. In C. J. J. Rutter (Ed.), Refugee education: Mapping the field. London: Trentham.

Dryden-Peterson, S. (2011). Refugee education: A global review. Geneva: UNHCR.

Eisenbruch, M. (1991). From post-traumatic stress disorder to cultural bereavement: diagnosis of Southeast Asian refugees. Social Science & Medicine, 33(6), 673-680.

Hattam, R., & Every, D. (2010). Teaching in fractured classrooms: refugee education, public culture, community and ethics. Race Ethnicity and Education, 13(4), 409-424.

Hyder, T. (1998). Supporting refugee children in the early years. In C. Jones & J. Rutter (Eds.), Refugee education: Mapping the field. London: Trentham Books.

Matthews, J. (2008). Schooling and settlement: Refugee education in Australia. International Studies in Sociology of Education, 18(1), 31- 45.

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Migrant Pupils

Classroom-based tips (focus on instructional methods)

1. Promote therapeutic interventions Develop and implement an antiracist policy, which deals with any incidents of racism towards migrant students because any aspect of their identity, such as their background, accent, language skills, appearance, legal status in the country of arrival or religion.

[Reference: Gibson, M. A. (1987). The school performance of immigrant minorities: A comparative view. Anthropology & education quarterly, 18(4), 262-275.]

2. Adjust the curriculum in order to reflect the phenomenon of migration throughout history, and to include the work of authors, historians, artists and theorists of diverse backgrounds.

3. Challenge and deconstruct stereotypes about migrants whenever these are met in the curriculum, including in songs, poems, literature, maths and other areas.

4. Decorate your classroom or school walls with photos of diverse role models, including those of migrants. You can use material published by UNICEF or other national and international agencies and NGOs.

[Reference: Suárez-Orozco, C., Suárez-Orozco, M. M., & Todorova, I. (2009). Learning a new land: Immigrant students in American society. Harvard University Press.]

5. Make room for storytelling, one of the most powerful ways to create empathy. Integrate immigration stories through literature you read as a class, or by creating a family history and/or digital storytelling project, where pupils can see that people from their own country have also emigrated to other countries. It is highly advisable to lead pupils to tell immigration stories about people as close as possible to their own social environment, without, however, targeting specific pupils because of their migrant background. Often, despite the best of intentions, migrant pupils are placed under the spotlight because of their background while all they wish for is to integrate.

[Reference: Sfard, A., & Prusak, A. (2005). Telling identities: In search of an analytic tool for investigating learning as a culturally shaped activity. Educational researcher, 34(4), 14-22.]

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School-based practical tips (focus on instructional methods)

Discipline

Provide after-school programs, evening classes, or summer school programs that can lend linguistic, academic, and social support to migrant pupils in a safe, enjoyable and supervised environment. [Reference: Lucas, T., Henze, R., & Donato, R. (1990). Promoting the success of Latino language-minority students: An exploratory study of six high schools. Harvard Educational Review, 60(3), 315-341]

Safety

Supportive literature

Definition of Migrants: The UN Convention on the Rights of Migrants defines migrants as follows: "The term 'migrant' in article 1.1 (a) should be understood as covering all cases where the decision to migrate is taken freely by the individual concerned, for reasons of 'personal convenience' and without intervention of an external compelling factor."(1) This definition indicates that migrant does not refer to refugees, displaced or others forced or compelled to leave their homes. Migrants are people who make choices about when to leave and where to go, even though these choices are sometimes extremely constrained. The Special Rapporteur of the Commission on Human Rights has proposed that the following persons should be considered as migrants: (a) Persons who are outside the territory of the State of which their are nationals or citizens, are not subject to its legal protection and are in the territory of another State; (b) Persons who do not enjoy the general legal recognition of rights which is inherent in the granting by the host State of the status of refugee, naturalised person or of similar status; (c) Persons who do not enjoy either general legal protection of their fundamental rights by virtue of diplomatic agreements, visas or other agreements.2 Migrants can be distinguished into first- and second-generation groups. The term first-generation can refer to either people who were born in one country and relocated to another at a young age, or to their children born in the country their families have relocated to. The term second-generation refers to children of first-generation migrants. First generation migrant children are faced with difficult and pressing educational challenges.

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[References: (1) http://www.coe.int/t/democracy/migration/default_en.asp (2) Gabriela Rodríguez Pizarro, Special Rapporteur of the Commission on Human rights in A/57/292, Human rights of migrants, Note by the Secretary-General. 9August 2002.]

Literature review The integration of pupils with a migrant background has been a central objective of many education systems around the world over the last two decades, especially after the fall of the Communist block and the wars in the Middle East (Simon, Malgorzata & Beatriz, 2007).

Both national and international studies of education often show that the performance of migrant pupils is substantially lower than that of non-migrant pupils. However if the contribution of socio- economic, sociocultural and school factors to the relative performance of first- and second-generation migrant pupils is explored, in most countries, it is found that socio-economic factors substantially account for the weaker performance of migrant pupils, whereas sociocultural factors contribute little and school factors are important in only a limited number of instances. Thus, migrant pupils underperform compared to native pupils either due to their low socio-economic background (as their native peers from similar backgrounds) or due to linguistic barriers (Schleicher, 2006). Moreover, for all countries it seems that for pupils with a migration background a key to catching up is the language spoken at home. Therefore educational policy should focus on integration of migrant pupils in schools and preschools, with particular emphasis on language skills at the early stage of childhood (Entorf & Minoiu, 2005).

Websites and EU Reports

Website of the European network for the education of students with migrant background with many policy documents and teachers resources: http://www.sirius-migrationeducation.org/

OECD Report presenting PISA results concerning migrant students’ performance in various countries and lessons drawn from the relevant data analyses: https://www.oecd.org/education/Helping- immigrant-students-to-succeed-at-school-and-beyond.pdf

Eurydice Report about how European countries integrate migrant students into their school systems: http://eacea.ec.europa.eu/Education/eurydice/documents/thematic_reports/101EN.pdf

Website of the European funded project TIES-The integration of the European Second Generation: http://www.tiesproject.eu/content/view/20/35/lang,en/

Report of the conference of the European Network of Education Councils, held in Larnaca, 15-17 October 2012 with central theme “Migration and Education”: http://www.eunec.eu/sites/www.eunec.eu/files/attachment/files/report.pdf

Useful Journals

Race, Ethnicity and Education: http://www.tandfonline.com/loi/cree20#.Vo5mHfeTvIU Intercultural Education: http://www.tandfonline.com/loi/ceji20#.Vo5oMPeTvIU Diaspora, indigenous and minority education: http://www.tandfonline.com/toc/hdim20/current

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References

Banks, J. A. (2015). Cultural diversity and education. London: Routledge.

Entorf, H., & Minoiu, N. (2005). What a difference immigration policy makes: A comparison of PISA scores in Europe and traditional countries of immigration. German Economic Review, 6(3), 355-376.

Gay, G. (2010). Culturally responsive teaching: Theory, research, and practice. New York: Teachers College Press.

Gitlin, A., Buendia, E., Crosland, K., & Doumbia, F. (2003). The production of margin and center: Welcoming–unwelcoming of immigrant students. American Educational Research Journal, 40(1), 91-122.

Mitchell, N., & Bryan, J. (2007). School-family-community partnerships: Strategies for school counselors working with Caribbean immigrant families. Professional School Counseling, 10(4), 399-409.

Rong, X. L., & Preissle, J. (2008). Educating immigrant students in the 21st century: What educators need to know. Corwin Press.

Simon, F., Malgorzata, K., & Beatriz, P. (2007). Education and Training Policy No More Failures Ten Steps to Equity in Education: Ten Steps to Equity in Education. OECD Publishing.

Schleicher, A. (2006). Where immigrant students succeed: a comparative review of performance and engagement in PISA 2003. Intercultural Education, 17(5), 507-516. Thomas, T. N. (1995). Acculturative stress in the adjustment of immigrant families. Journal of Social Distress and the Homeless, 4(2), 131- 142.

Valdés, G. (1998). The world outside and inside schools: Language and immigrant children. Educational researcher, 27(6), 4-18.

Villegas, A. M., & Lucas, T. (2007). The culturally responsive teacher. Educational Leadership, 64(6), 28.

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Deprived Backgrounds

Pupils coming from single-parent families

Classroom-based tips (focus on instructional methods)

1. Be alert to behaviour changes such as a drop in grades, inattentiveness or excessive daydreaming in class, absenteeism, sadness or anxiousness.

2. Look for signs of stress in pupils, including personality and behavioural changes.

3. Make a point of integrating words like stepmother, stepfather, remarry and divorce into classroom examples and conversations so that these terms are as common as grandmother, uncle or cousin.

4. Create and maintain an atmosphere of openness and respect for non-traditional families.

5. Provide ample and safe opportunities for pupils coming from monoparental families to share feelings about their current or former family situation without being judged negatively by others.

6. Provide reading and research opportunities that enable pupils to acquire information regarding divorce such as storybooks, novels and research-based literature.

7. Set healthy boundaries so that pupils from monoparental families do not slip into manipulative behaviour, using their parents’ divorce as an excuse for irresponsibility or misbehaviour.

8. Be consistent in your approach to pupils from monoparental families, but also flexible at times when they may be facing added pressures at home.

9. Ensure equal opportunities for classroom roles and responsibilities.

10. Teach about diversity and differences by presenting or referring to different types of families that exist all over the world, without making references to specific individuals in the class, or their families. Emphasise that there are many different types of families: some with a few children, some with many children; some with both parents present, some with one parent present; and some with grandparents or aunts and uncles.

[Reference: http://www.education.udel.edu/wp-content/uploads/2013/01/Divorce.pdf]

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School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

Include pupils of single-parent families in events and activities by differentiating their roles and contributions. For example, instead of asking all pupils to uniformly memorise a poem for Mother’s Day, take advantage of individual pupils’ talents in acting, theatre and role-play.

Curricular Adaptations

1. Involve all your pupils in school projects and make sure you provide a wide range of themes.

2. Be conscious and sensitive when organising school events. For example, instead of preparing gifts for “Mom” and “Dad” you might refer instead to gifts and events for a “Special Someone”.

3. Include pupils of single-parent families in events and activities by differentiating their roles and contributions. For example, instead of asking all pupils to uniformly memorise a poem for Mother’s Day, take advantage of individual pupils’ talents in acting, theatre and role-play.

Discipline

Provide consistency in schedules and discipline to help provide a sense of security for pupils whose families are going through a divorce.

Food (Canteen, Visits, Camps, Trips)

Provide school canteen discounts for pupils coming from single-parent families in cases where the family also faces economic difficulties. These should be offered discreetly.

Parents / Parents Associations

Arrange meetings between parents (together or separately) and the staff to discuss pupils’ progress, and to enhance the collaboration between home and school. This will help to monitor progress and to discuss also issues that might be related to pupils’ social life, such as marginalisation, social interactions with peers, behaviour at home, and self-esteem.

Safety

Provide consistency in schedules and discipline to help provide a sense of security for pupils whose families are going through a divorce.

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School celebrations / Events / Activities

1. Be conscious and sensitive when organising school events. For example, instead of preparing gifts for “Mom” and “Dad” you might refer instead to gifts and events for a “Special Someone”.

2. Include pupils of single-parent families in events and activities by differentiating their roles and contributions. For example, instead of asking all pupils to uniformly memorise a poem for Mother’s Day, take advantage of individual pupils’ talents in acting, theatre and role-play.

School Projects

1. Involve all your pupils in school projects and make sure you provide a wide range of themes.

Pupil Support

1. Offer pupils extra support if possible, including counselling support. This can help them deal with such feelings of being unworthy of love, worthlessness, rejection, anger, conflicting loyalties, loneliness, and sadness.

2. Arrange meetings between parents (together or separately) and the staff to discuss pupils’ progress, and to enhance the collaboration between home and school. This will help to monitor progress and to discuss also issues that might be related to pupils’ social life, such as marginalisation, social interactions with peers, behaviour at home, and self-esteem.

3. Provide school canteen discounts for pupils coming from single-parent families in cases where the family also faces economic difficulties. These should be offered discreetly.

Supportive Literature

Definition: A single parent is an uncoupled individual who shoulders most or all of the day-to-day responsibilities of raising a child or children. A mother is more often the primary caregiver in a single- parent family structure that has arisen due to death of the partner, divorce or unplanned pregnancy.

Families play an important role in every society: “Generally, a family provides a child with opportunities to develop into a stable and independent person, for instance, through enabling the child to attend school. The future success of children thus greatly depends on the household they grow up in. Nevertheless, a child is not in the position to choose [her/his] own family and has to accept if its family is not capable of offering him or her the best opportunities” (Lange, Dronkers, Wolbers 2014-331).

Disadvantages of growing up in single-parent families include: - lower educational attainment

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- greater psychological distress - poor adult outcomes in areas such as employment, income, and marital status. [Reference: Woessmann, 2015]

Children of single-parent families face greater risks than those growing up in other types of families. Statistics suggest that children of single-parent families are three times more likely to drop out of high school than those from two-parent families. There are some obstacles hindering effective academic performance such as:  Emotional scarring left by separation that disrupts the child’s development and performance  Absence of the other parent may interrupt a child’s natural growth and development  Children may be inadvertently forced to grow up as they take on the duties of the absent parent  Limited time and income become an issue as in how much time is focused on homework or whether money is spent to enjoy cultural activities  Educational goals and aspirations may not be set as high.

Useful websites

Family Influence on Education: https://www.insidehighered.com/news/2015/02/25/report-marks-growing-educational-disadvantage-children-single-parent-families Academic Achievement of Children in Single Parent Homes: A Critical Review: http://scholarworks.wmich.edu/cgi/viewcontent.cgi?article=1044&context=hilltopreview Teens From Single-Parent Families Leave School Earlier: http://www.nyu.edu/about/news-publications/news/2015/february/teens-from-single-parent-families-leave-school-earlier.html

References

Creemers, B. P. M., Kyriakides, L., & Sammons, P. (2010). Methodological advances in educational effectiveness research. Abingdon, UK: Routledge.

Dronkers, J. (2010). Features of educational systems as factors in the creation of unequal educational outcomes. In J. Dronkers (Ed.), Quality and inequality of education: Cross-national perspectives.

Frisco, M. L., Muller C., & Frank, K. (2007). Parents’ union dissolution and adolescents’ school performance: Comparing methodological approaches. Journal of Marriage and Family

Rindermann, H., & Ceci, S. J. (2009). Educational policy and country outcomes in international cognitive competence. Perspectives on Psychological Science

Marloes de Lange, Jaap Dronkers, Maarten H. J. Wolbers, Single-parent family forms and children’s educational performance in a comparative perspective: effects of school’s share of single-parent families, in School Effectiveness and School Improvement, 2014, Vol. 25, No. 3, 329–350

Ludger Woessmann (2015), U.S. Students from Two-Parent Families Achieve a Grade Level Higher than Peers from Single-Parent Families, External Relations, (707) 332-1184. tion Next. Patrick B. Kapuwa (2015), Single Parenting and Academic Performance of Children in Primary Schools in Sierra Leone, Research Journal of Commerce and Behavioural Science, Volume: 04, Number: 03.

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Pupils coming from poor families

Classroom-based tips (focus on instructional methods)

1. Establish a Code of Conduct (if the school does not provide one) and zero tolerance policy in your classroom to safeguard against discriminatory or racist incidents towards pupils living in poverty because of issues related to their living conditions.

2. Create new experiences for learners in your classroom to enhance all pupils’ awareness and sensitisation on issues of diversity.

3. Incorporate art into instruction of other curriculum areas.

4. Keep expectations equally high for all your pupils to motivate learning among all classroom members; poverty does not imply ignorance.

5. Identify learning gaps and choose appropriate interventions.

6. Teach pupils to speak in formal register and to behave formally in various school situations to give them opportunities to learn about formal and informal settings and appropriate behaviours.

7. Provide access to computers, magazines, newspapers, and books so pupils living in poverty can see and work with printed materials. School may be the only place where they have access to these learning resources.

8. Assign work requiring costly devices and resources such as a computer and internet access only when you can provide the opportunity of completing the work during school hours where resources are available and accessible.

9. Encourage class discussions on topics like classism, consumer culture, environmental pollution and other injustices affecting people living in poverty; develop their awareness and sensitivity to encourage your pupils to value and work for equality in the world.

10. Become aware of your own stereotypes about pupils living in poverty and consciously work to resolve them.

11. Be careful about the school supplies you expect your pupils to purchase – the list should be as simple as possible for all pupils.

12. Create a stock of shared supplies for your pupils to borrow when they temporarily run out of various materials for class activities.

13. Act quickly to end any forms of harassment/discrimination against pupils living in poverty.

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School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

Include pupils living in poverty in events and activities by differentiating and emphasising their role, irrespective of their economic status. For example, consider giving them access to new opportunities usually reserved for economically advantaged pupils.

Community

Organise educational visits and school excursions. Trips are essential for every pupil’s development and interaction with the surrounding environment. Take advantage of grants and funding that can help a whole classroom of pupils visit unexpected places.

Curricular Adaptations

1. Organise educational visits and school excursions. Trips are essential for every pupil’s development and interaction with the surrounding environment. Take advantage of grants and funding that can help a whole classroom of pupils visit unexpected places. 2. Include pupils living in poverty in events and activities by differentiating and emphasising their role, irrespective of their economic status. For example, consider giving them access to new opportunities usually reserved for economically advantaged pupils. 3. Develop curricula that are equally relevant and meaningful to the lives of pupils living in poverty.

Educational visits / field trips / camps / school exchanges / trips abroad

Food (Canteen, visits, camps, trips)

Provide school canteen discounts for pupils coming from low-income families. These should be provided discreetly.

Parents / Parents’ Associations

1. Build relationships; provide supportive relationships with pupils and their families, irrespective of their financial and educational background.

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2. Arrange meetings between the parents and the staff to discuss pupils’ progress, and to enhance the collaboration between home and school. This will help to monitor progress and to discuss also issues that might be related to pupils’ social life such as marginalisation, social interactions with peers, behavior at home and self-esteem.

School Celebrations / Events / Activities

School Purchases

Equip the classrooms with computers for each pupil so as to offer equal learning opportunities for those who do not have a computer at home.

Pupil Support

1. Build relationships; provide supportive relationships with pupils and their families, irrespective of their financial and educational background.

2. Offer pupils extra support if possible, including individual teaching support and language support;

3. Provide school canteen discounts for pupils coming from low-income families. These should be provided discreetly.

4. Arrange meetings between the parents and the staff to discuss pupils’ progress, and to enhance the collaboration between home and school. This will help to monitor progress and to discuss also issues that might be related to pupils’ social life such as marginalisation, social interactions with peers, behavior at home and self-esteem.

Teacher Professional Development

Provide training for teachers, such as educational psychologist services related to the main difficulties that pupils living in poverty may encounter in their schooling.

Technology

Equip the classrooms with computers for each pupil so as to offer equal learning opportunities for those who do not have a computer at home.

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Supportive literature

Definition: People living in poverty are “those who are considerably worse off than the majority of the population – a level of deprivation heavily out of line with the general living standards enjoyed by the majority of the population in one of the most affluent countries in the world” (Joseph Rowntree, 2009).

European Commission’s definition: “People are said to be living in poverty if their income and resources are so inadequate as to preclude them from having a standard of living considered acceptable in the society in which they live. Because of their poverty they may experience multiple disadvantages through unemployment, low income, poor housing, inadequate health care and barriers to lifelong learning, culture, sport and recreation.” (Eurostat's Concepts and Definitions Database, http://ec.europa.eu/eurostat/ramon/nomenclatures/index.cfm?TargetUrl=DSP_GLOSSARY_NOM_D TL_VIEW&StrNom=CODED2&StrLanguageCode=EN&IntKey=27697332&RdoSearch=&TxtSearch=&Cb oTheme=&IntCurrentPage=1)

Characteristics:

Pupils in poverty are a diverse group. They present a wide range of values, beliefs, experiences and backgrounds. Poverty affects learning and academic achievement (Duncan & Brooks-Gunn, 1997) due to factors such as pupils' health and well-being, literacy and language development, access to material resources and level of mobility.

Health and Well-Being Substandard housing, inadequate medical care, and poor nutrition can affect a child's physical and cognitive development. Living in daily economic stress can also seriously affect pupils' mental health, self-efficacy (Conrath 2001), self-image (Ciaccio 2000), and motivation to do well in school (Beegle, 2006).

Language and Literacy Development Children who live in poverty usually have problems in point of literacy and language development. Neuman (2008) states that "children who are poor hear a smaller number of words with more limited syntactic complexity and fewer conversation-eliciting questions, making it difficult for them to quickly acquire new words and to discriminate among words."

Material Resources Lacking material resources may mean limited access to high-quality day care, limited access to before- or after-school care and limited physical space in homes to create private or quiet environments for study, and limitations on out-of-class projects that may, for example, require access to a computer.

Mobility Poverty means also an important constraint on families - the ability to provide stable housing. Pupils often move from one location to another because their parents are in search of work or are dealing with other issues that require them to move. Frequent moves almost always have a negative academic and social impact on pupils.

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Useful Websites

The World Health Organisation: www.who.int The Institute of Child Education and Psychology: www.icepe.eu http://www.eapn.eu/images/docs/povertyexplainer_ http://www.edutopia.org/discussion/5-ways-help-students-affected-generational-poverty http://www.edchange.org/publications/PDK-Pedagogy-of-Engagement.pdf http://www.edutopia.org/blog/how-does-poverty-influence-learning-william-parrett-kathleen- budge https://www.edutopia.org/blog/what-can-schools-do-to-address-poverty-william-parrett-kathleen- budge

Relevant Articles and Reports

Berliner, D. (2009). Poverty and potential: Out-of-school factors and school success. Tempe, AZ: Education and the Rouse, C.E. & Barrow, L. (2006). U.S. elementary and secondary schools: Equalising opportunity or replacing the status quo? The Future of Children, 16(2), 99-123. Bhattacharya, A. (2010). Children and adolescents from poverty and reading development: A research review. Reading & Writing Quarterly, 26, 115-139. Robinson, J.G. (2007). Presence and persistence: Poverty ideology and inner-city teaching. Urban Review, 39,541-565 Gorski, P.C. (2012). Perceiving the problem of poverty and schooling: Deconstructing the class stereotypes that mis-shape education policy and practice. Equity & Excellence in Education, 45 (2), 302-319. Gorski, P.C. (2013). Building a pedagogy of engagement for students in poverty, http://www.edchange.org/publications/PDK-Pedagogy-of-Engagement.pdf

References

Beegle, D. M. (2006). See poverty… be the difference! Discover the missing pieces for helping people move out of poverty. Tigard, OR: Communication Across Barriers.

Ciaccio, J. (2000). "A teacher's chance for immortality." Education Digest, 65(6), pp.44-48.

Conrath, J. (2001). "Changing the odds for young people: Next steps for alternative education." Phi Delta Kappan, 82(8), pp.585-587.

Duncan, G.J., & Brooks-Gunn, J. (1997). Consequences of growing up poor. New York: Russell Sage Foundation.

Joseph Rowntree Foundation (2009): What is meant by Poverty, https://www.jrf.org.uk/sites/default/files/jrf/migrated/files/poverty- definitions.pdf

Neuman, S. B. (2008). Educating the other America: Top experts tackle poverty, literacy, and achievement in our schools. Baltimore, MD: Paul H. Brookes.

William H. Parrett and Kathleen M. Budge, Turning High-Poverty Schools into High-Performing Schools, http://www.edutopia.org/blog/how- does-poverty-influence-learning-william-parrett-kathleen-budge

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Pupils coming from families with many children

Classroom-based tips (focus on instructional methods)

1. Create new experiences for learners. Most pupils from large families may not have ever left their town or county. It is up to educators to offer pupils new learning and cultural experiences; encourage them to watch videos about other parts of the world, invite guest speakers to your class to talk about their experiences, and take your class on field trips.

2. Challenge stereotypes about large families or parents who have many children that may become apparent in the curriculum or in discussions in the classroom.

3. Teach about diversity and differences by presenting or referring to different types of families that exist all over the world, without making references to specific individuals in the class, or their families. Emphasise that there are many different types of families: some with a few children, some with many children; some without children; some with both parents present, some with one parent present; and some with grandparents or aunts and uncles and so on.

4. Become aware of your own stereotypes about pupils from large families and consciously work to resolve them.

5. Share your thoughts and findings about pupils from large families with your colleagues, to encourage them to reflect upon the issue as well.

6. Present the advantages of large families, without referring to individual pupils or their families by name: e.g. cooperation, sharing, taking initiative, self-reliance, assuming responsibility.

7. Ensure all pupils in your class feel they belong to a team, in which everyone has a responsibility, giving them opportunities to be positive role models in your classroom. Children from large families quickly learn to work together as a team. They understand that being part of a larger group requires everyone to do their share and that trying to skip out on their chores or responsibilities may have a negative effect on others.

8. Provide time during the school day for homework completion; pupils may be more able to complete homework at school rather than at home, in the presence of many siblings and distractions.

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School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

Include pupils from large families in events and activities by differentiating and emphasising their roles. For example, consider giving adequate parts to pupils coming from large families and emphasise their capacity for flexibility and taking initiative.

Community

Curricular Adaptations

2. Include pupils from large families in events and activities by differentiating and emphasising their roles. For example, consider giving adequate parts to pupils coming from large families and emphasise their capacity for flexibility and taking initiative.

Food (canteen, visits, camps, trips)

Provide school canteen discounts for pupils coming from low-income families. These should be provided discreetly.

Educational visits / field trips / camps / school exchanges / trips abroad

2. When organising school trips, provide gratuity or reductions for pupils from families with financial challenges. These should be provided discreetly.

Parents / Parents Associations

1. Build relationships; provide supportive relationships with pupils and their families, irrespective of their financial and educational background.

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2. Arrange meetings between the parents and the staff to discuss pupils progress, and to enhance the collaboration between home and school. This will help to monitor progress and to discuss issues that might be related to pupils’ social life, such as marginalisation, social interactions with peers, behaviour at home and self-esteem.

School Celebrations / Events / Activities

School Purchases

Equip the classrooms with computers for each pupil so as to offer equal learning opportunities for those who do not have a computer at home.

Pupil Support

1. Build relationships; provide supportive relationships with pupils and their families, irrespective of their financial and educational background.

2. Offer pupils extra support if possible, including individual teaching support, and language support;

3. Provide school canteen discounts for pupils coming from low-income families. These should be provided discreetly.

4. Arrange meetings between the parents and the staff to discuss a pupil’s progress, and to enhance the collaboration between home and school. This will help to monitor progress and to discuss issues that might be related to the pupil’s social life, such as marginalisation, social interactions with peers, behaviour at home and self-esteem.

5. When organising school trips, provide gratuity or reductions for pupils from families with financial challenges. These should be provided discreetly.

Teacher Professional Development

Provide training for teachers, such as educational psychologist services related to the main difficulties that pupils from large families may encounter in their schooling.

Technology

Equip the classrooms with computers for each pupil so as to offer equal learning opportunities for those who do not have a computer at home.

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Supportive Literature

Definition: According to the European Large Family Confederation, “the term ‘large family’ shall have the meaning determined in its Statutes or by the legislation of its respective country. Since this size is not the same in all member organizations, a large family is considered to be one that is raising three or more children.” (http://www.elfac.org/fileadmin/user_upload/PDF/STATUTES_ELFAC.pdf)

Characteristics: According to Livia Sz. Olah, “large families with 4 or more children are rare in Europe, ranging between 0.6-1.5 per cent in Southern Europe (with higher prevalence in Cyprus and Greece), to 3- 4 per cent in Anglo-Saxon countries and Western Europe, and more than 5 per cent in Hungary and Finland.

We find for countries of high-fertility regions that a relatively large portion of family benefits was spent on services. This is seen only for the most recent years for Southern - and Central-East European countries, except for Hungary where mothers with very young children have extremely low labour force participation rate, hence the service-expenditures probably reflect care-services for older children, which may have less impact on fertility levels.” (http://www.un.org/esa/socdev/family/docs/egm15/Olahpaper.pdf)

Important factors to support families: 1. Financial support for families through benefits, allowances, grants or benefit supplements. Special attention was given namely if it is about family poverty or large families. 2. The reconciliation of work and family life: this objective also covers the promotion of gender equality in access to employment and the creation of conditions so that working parents, especially mothers, can improve their daily life). 3. Although service provision is in many ways tied in with policies related to reconciliation of work and family life, it emerged as an autonomous category that includes references to governmental investment in new facilities and/or improving service provision to families in order to increase coverage rates. 4. The definition of policies aimed at the strengthening of family life. This category includes a broad range of objectives related to parenting itself (in terms of the relationship between parents and children), but also to the family institution in general and its role in society (for instance, the fight against increasing divorce rates in the Russian Federation is one example of the general concern over the family as an institution). 5. The last major category which emerged is related to legislative and/or political measures to protect women and children. This includes, namely, the improvement of existing legislation, or the introduction of new laws, with the purpose of enhancing the protection of children living in institutions.” (http://www.leavenetwork.org/fileadmin/Leavenetwork/Links_publications/Family_Policy_in_Coun cil_of_Europe_member_states_en.pdf, p.22, 23)

Useful Websites

World Health organization www.who.int Institute of Child Education and psychology www.icepe.eu http://www.leavenetwork.org/fileadmin/Leavenetwork/Links_publications/Family_Policy_in_Counci l_of_Europe_member_states_en.pdf

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http://www.edchange.org/publications/PDK-Pedagogy-of-Engagement.pdf http://www.edutopia.org/blog/how-does-poverty-influence-learning-william-parrett-kathleen- budge http://www.elfac.org/fileadmin/user_upload/PDF/STATUTES_ELFAC.pdf http://www.un.org/esa/socdev/family/docs/egm15/Olahpaper.pdf https://files.fm/u/cccbx88s

Relevant Articles and Reports

EU Reports

European Commission (2007). Europe’s Demographic Future: Facts and figures. European Commission (2008). Demography Report 2008: Meeting social needs in an ageing society. European Commission (2010a). Lisbon Strategy evaluation document. European Commission (2010b). Europe 2020: A strategy for smart, sustainable and inclusive growth. European Commission (2011). Demography Report 2010: Older, more numerous and diverse Europeans. European Commission (2013). Barcelona objectives: The development of childcare facilities for young children in Europe with a view to sustainable and inclusive growth.

References

Beegle, D. M. (2006). See poverty . . . be the difference! Discover the missing pieces for helping people move out of poverty. Tigard, OR: Communication Across Barriers.

Ciaccio, J. (2000). "A teacher's chance for immortality." Education Digest, 65(6), pp.44-48.

Conrath, J. (2001). "Changing the odds for young people: Next steps for alternative education." Phi Delta Kappan, 82(8), pp.585-587.

Daly, M. & J. Lewis (2000). The concept of social care and the analysis of contemporary welfare states, The British Journal of Sociology 51(2), 281–298.

Duncan, G.J., & Brooks-Gunn, J. (1997). Consequences of growing up poor. New York: Russell Sage Foundation.

Joseph Rowntree Foundation (2009) : What is meant by Poverty, https://www.jrf.org.uk/sites/default/files/jrf/migrated/files/poverty- definitions.pdf Neuman, S. B. (2008). Educating the other America: Top experts tackle poverty, literacy, and achievement in our schools. Baltimore, MD: Paul H. Brookes.

Olah, Livia, Changing families in the European Union: trends and policy implications, analytical paper, prepared for the United Nations Expert Group Meeting, “Family policy development: achievements and challenges”, New York, May 14-15, 2015

William H. Parrett and Kathleen M. Budge, Turning High-Poverty Schools into High-Performing Schools, http://www.edutopia.org/blog/how- does-poverty-influence-learning-william-parrett-kathleen-budge

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Pupils coming from homeless families

Classroom-based tips (focus on instructional methods)

1. Establish a Code of Conduct (if the school does not provide one) and zero tolerance policy in your classroom to safeguard against discriminatory or racist incidents towards pupils from homeless families because of their living conditions.

2. Provide activities that challenge stereotypes and racism related to social class and material wealth, and that promote respect for diversity.

3. Maintain a relationship when the pupil leaves home, by providing self-addressed stamped envelopes and stationary.

4. Avoid TV-related assignments, as pupils living in shelters may not have access to TV.

5. Ensure pupils of homeless families feel welcomed and supported in your classroom as they transition to a new environment.

6. Provide school supplies if necessary (pencil, paper, etc.) that may be shared with pupils of homeless families discreetly to avoid drawing negative the attention of the other pupils in the class.

7. Make sure pupils of homeless families have equal opportunities for classroom jobs and roles.

8. Avoid the removal of pupils’ possessions as a disciplinary measure when dealing with pupils coming from homeless families.

9. Maintain the privacy of the pupil; avoiding disclosure of their living conditions to other pupils or their families.

10. Do not ask pupils with insecure housing to bring food items or treats, photographs or favourite toys to school. Pupils who are homeless are often embarrassed to admit that they do not have these things. If the teacher is aware of such pupils in the classroom, it is best to avoid such practices for all pupils, in order to avoid causing feelings of isolation to those not able to contribute.

[Reference: Barbara Driver, Paula Spady, What Educators Can Do: Homeless Children and Youth, 2013: https://education.wm.edu/centers/hope/publications/infobriefs/documents/whateducatorscando2 013.pdf]

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School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

Include pupils of homeless families in events and activities by differentiating their role and contribution, for example by assigning roles they are comfortable with.

Community

Curricular Adaptations

1. Include pupils of homeless families in events and activities by differentiating their role and contribution, for example by assigning roles they are comfortable with.

2. Organise educational visits and school excursions. Trips are essential for every pupil’s development and interaction with the surrounding environment. Take advantage of grants and funding that can help a whole classroom of pupils visit unexpected places.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

2. When organising school trips, provide gratuity or reductions for pupils from families with financial challenges. These should be provided discreetly.

Food (canteen, visits, camps, trips)

1. Provide school canteen discounts for pupils coming from low-income families. These should be provided discreetly.

2. Stabilise the pupil’s basic needs. Work to ensure food, clothing, shelter, medical care, basic hygiene, and transportation needs are resolved. Provide a community resource list to the family or youth. If necessary, find a place for pupils to shower (Evers, 2011).

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Other (Social Welfare)

Stabilise the pupil’s basic needs. Work to ensure food, clothing, shelter, medical care, basic hygiene, and transportation needs are resolved. Provide a community resource list to the family or youth. If necessary, find a place for pupils to shower (Evers, 2011). Parents / Parents’ Associations

1. Build relationships; provide a supportive relationship with pupils and their families, irrespective of their financial and educational background.

2. Arrange meetings between the parents and the staff to discuss pupils’ progress, and to enhance the collaboration between home and school. This will help to monitor progress and to discuss issues that might be related to pupils’ social life such as marginalisation, social interactions with peers, behaviour at home and self-esteem.

School Celebrations / Events / Activities

Include pupils of homeless families in events and activities by differentiating their role and contribution, for example by assigning roles they are comfortable with.

School Uniform

1. Stabilise the pupil’s basic needs. Work to ensure food, clothing, shelter, medical care, basic hygiene, and transportation needs are resolved. Provide a community resource list to the family or youth. If necessary, find a place for pupils to shower (Evers, 2011).

Pupil Support

1. Build relationships; provide a supportive relationship with pupils and their families, irrespective of their financial and educational background.

2. Provide school canteen discounts for pupils coming from low-income families. These should be provided discreetly.

3. Ensure that pupils in homeless situations have easy access to assistance and support in case of personal difficulties (e.g., counsellors). Allow pupils to express fears and frustrations through various means such as through drawing and building activities.

4. Arrange meetings between the parents and the staff to discuss pupils’ progress, and to enhance the collaboration between home and school. This will help to monitor progress and to discuss issues that might be related to pupils’ social life such as marginalisation, social interactions with peers, behaviour at home and self-esteem.

5. Stabilise the pupil’s basic needs. Work to ensure food, clothing, shelter, medical care, basic hygiene, and transportation needs are resolved. Provide a community resource list to the family or youth. If necessary, find a place for pupils to shower (Evers, 2011).

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6. When organising school trips, provide gratuity or reductions for pupils from families with financial challenges. These should be provided discreetly.

School Purchases

Equip classrooms with computers for each pupil so as to include those who do not have access to one outside of school, and provide books or other material resources needed during classes.

Technology

Equip classrooms with computers for each pupil so as to include those who do not have access to one outside of school, and provide books or other material resources needed during classes.

Supportive Literature

Definition: Homeless pupils are not only those who live in shelters or on the street, but also those living in motels, vehicles or who are forced to temporarily “double-up” with family members or friends. The effect of homelessness on pupils’ schooling experiences varies by age, setting, and duration of the period of homelessness. (Miller / Pavlakis / Samartino / Bourgeois, 2014-15, 10).

Research shows that homeless pupils may face twice as many learning disabilities as other schoolchildren.

Recognising who is homeless remains a difficult task. Some families choose not to describe themselves as homeless. Families may be reluctant to share their homeless condition due to discomfort with their current living situation. They may fear that their children will be moved to another school or stigmatised by discriminatory remarks (Driver / Spady, 2013).

There are two types of homeless pupils: those who are homeless when entering school and those who become homeless while already in attendance.

Homeless pupils:  come from varied backgrounds and for varied reasons  have difficulty in establishing and maintaining relationships  have difficulty in accessing education-related resources , such as getting a library card  are unfamiliar with finding and accessing resources available through the school itself  are ashamed of where they live  feel ashamed when teased by other pupils, for example about homelessness and hygiene  are misunderstood by parents  have difficulty adjusting to a new school  are more likely to develop feelings of failure

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Useful Websites www.irp.wisc.edu/publications/focus/pdfs/foc312b.pdf (educational opportunity for homeless pupils) National Centre for Homeless Education at SERVE (NCHE), http://www.serve.org/nche Virginia Department of Education, Education for Homeless Children and Youth Program (Project HOPE-Virginia), http:www.wm.edu/hope http://wamu.org/programs/metro_connection/14/05/30/dc_public_schools_scramble_to_serve_gr owing_numbers_of_homeless_students https://www.nlchp.org/youth_resources http://www.naehcy.org/sites/default/files/dl/toolkit.pdf (College Access and Success for Students Experiencing Homelessness)

References

National Center for Homeless Education, “Education for Homeless Children and Youth Program Data Collection Summary,” U.S. Department of Education, June 2011.

D. H. Rubin, C. J. Erikson, M. San Agustin, S. D. Cleary, J. K. Allen, and P. Cohen, “Cognitive and Academic Functioning of Homeless Children Compared With Housed Children,” Pediatrics 97, No. 3 (1996): 289–294

Evers, Tony, 2011, How Teachers Can Help Students Who Are Homeless, https://dpi.wi.gov/sites/default/files/imce/homeless/pdf/teach_help_hmls_stud.pdf http://www.onlinecolleges.net/for-students/homeless-student-guide

Peter Miller, Alexandra Pavlakis, Lea Samartino, Alexis Bourgeois, Educational opportunity for homeless students, in Focus, Vol. 31, No. 2, Fall/Winter 2014–15 Barbara Driver, Paula Spady, What Educators Can Do: Homeless Children and Youth, 2013, https://education.wm.edu/centers/hope/publications/infobriefs/documents/whateducatorscando2013.pdf

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Pupils coming from violent and dangerous families

Classroom-based tips (focus on instructional methods)

1. Create a safe and low-stress environment that promotes respect, and helps any pupil exposed to domestic violence feel secure and appreciated in the school context.

2. Teach and reward non-violent conflict-resolution and cooperation.

3. Establish simple rules and routines so that pupils exposed to domestic violence know what to expect. For example, give advance notice of upcoming lessons, events or activities that may touch on difficult experiences.

4. Provide positive experiences and activities to promote security, self-esteem and learning; assist pupils to recognise their strengths and to experience success.

5. Repeat information as needed in a calm manner.

6. Use cooperative learning strategies that allow for more immediate feedback, occasions to share, and small group learning opportunities.

7. Allow pupils to naturally express themselves through talk, play and written assignments.

8. Give straightforward explanations where possible for things that may trigger worry or anxiety, such as sirens, or the presence of police in school.

9. Increase positive connections to school. For example, try to find a match between pupils’ interests and strengths and the course you are teaching through a special assignment or class project.

[Reference: Baker, L., Jaffe, P., Ashbourne, L., Children Exposed to Domestic Violence, A Teacher’s Handbook to Increase Understanding and Improve Community Responses, Sponsored by the David and Lucile Packard Foundation, 2002, p. 11]

School-based practical tips (focus on instructional methods)

Community

Build relationships with shelters, legal advocacy programs, counselling services, police services and NGOs dealing with domestic violence protection and prevention. This way, the school can provide accurate information to families about possible solutions to the situation faced at home.

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Educational visits / field trips / camps / school exchanges / trips abroad

Organise school activities and programs that provide a safe, supportive and nurturing environment for pupils facing violence at home

Other: Family Counselling

Organise counselling programs that range from vocational skills training to substance abuse counselling.

Other: Assessment of Individual Pupil’s Needs

Diagnose and assess a variety of issues or conditions, including academic, learning, behaviour, health, and social adjustment problems.

Parents / Parents Associations

1. Inform all staff, pupils and their families of the law(s) and relevant procedures that the school is obliged to follow in case it is detected, suspected or reported that a child or children attending the school experience violent behaviours at home. Implement these procedures whenever necessary.

2. Organise counselling programs that range from vocational skills training to substance abuse counselling.

3. Arrange meetings between the parents and specialised staff such as school psychologists to discuss pupils’ progress and to tackle any problems they are facing in their development.

4. Build relationships with shelters, legal advocacy programs, counselling services, police services and NGOs dealing with domestic violence protection and prevention. This way, the school can provide accurate information to families about possible solutions to the situation faced at home.

Safety

Organise school activities and programs that provide a safe, supportive and nurturing environment for pupils facing violence at home.

School Celebrations / Events / Activities

Organise school activities and programs that provide a safe, supportive and nurturing environment for pupils facing violence at home.

School projects

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Organise school activities and programs that provide a safe, supportive and nurturing environment for pupils facing violence at home.

Pupil Support

1. Create a safe, supportive school climate, for example by setting school-wide behavioural expectations and values, positive interventions and support mechanisms, and psychological and counselling services.

2. Inform all staff, pupils and their families of the law(s) and relevant procedures that the school is obliged to follow in case it is detected, suspected or reported that a child or children attending the school experience violent behaviours at home. Implement these procedures whenever necessary.

3. Organise school activities and programs that provide a safe, supportive and nurturing environment for pupils facing violence at home.

Teacher Professional Development

2. Provide training for teachers, such as educational psychology training related to the main difficulties that pupils belonging to violent families may encounter in their schooling.

3. Diagnose and assess a variety of issues or conditions, including academic, learning, behaviour, health, and social adjustment problems.

Supportive Literature

Domestic violence refers to the abuse and/or assault of children or adolescents by their parents, or adults by their intimate partners. The term is used interchangeably with intimate partner abuse and inter-parental violence. Battering is often used to refer to domestic violence or frequent and severe abuse.

Children exposed to domestic violence “refers to children and adolescents seeing, hearing or being aware of violence against one parent figure that is perpetrated by another parent figure. It is used interchangeably with children living with violence.” (Baker, Jaffe, Ashbourne, Children Exposed to Domestic Violence, A Teacher’s Handbook to Increase Understanding and Improve Community Responses, p. 3)

Domestic violence - “occurs in all age, racial, socio-economic, educational, occupational and religious groups;

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- occurs within an intimate relationship; - typically involves repetitive behaviour including different types of abuse – physical assault, psychological, emotional and economic abuse, and abuse of children; - is used to intimidate, humiliate or frighten victims as a systematic way of maintaining power and control over them;”

Signs a pupil is having difficulties as a consequence of domestic violence: - “physical complaints; - tiredness; - constant worry about possible danger and/or the safety of loved ones; - sadness and/or withdrawal from others and activities - low self-esteem and lack of confidence, especially for trying new things (including academic tasks); - difficulty in paying attention in class; - outbursts of anger directed toward peers, teachers or self; - bullying.”

[Reference: L. Baker, P. Jaffe, L. Ashbourne, Children Exposed to Domestic Violence, A Teacher’s Handbook to Increase Understanding and Improve Community Responses, p. 9]

Useful Websites

Domestic Violence and Violence Related Research Resources http://www.growing.com/nonviolent/research/dvlinks.htm Unicef Innocenti Research Centre Digest no 6 June-2000 http://www.unicef-icdc.org/publications/pdf/digest6e.pdf Classroom Behaviour https://www.counseling.org/docs/default-source/vistas/the-effects-of-violence-on-academic- progress-and-classroom-behavior.pdf?sfvrsn=12 The effect of family violence on children's academic performance and behavior: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2625936/ State of Domestic Violence in the South of Europe: http://www.apav.pt/home.html Domestic Violence: http://www.domesticviolenceroundtable.org/effect-on-children.html

References

Baker, L., Jaffe, P., Ashbourne, L., 2002, Children Exposed to Domestic Violence, A Teacher’s Handbook to Increase Understanding and Improve Community Responses, Sponsored by the David and Lucile Packard Foundation

Crosson-Tower, C., 2003, The Role of Educators in Preventing and Responding to Child Abuse and Neglect, CHILD ABUSE AND NEGLECT-USER MANUAL SERIES, U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families Children’s Bureau Office on Child Abuse and Neglect

Crosson-Tower, C., 2002, When children are abused: An educator’s guide to intervention (pp. vii–viii). Boston, MA: Allyn and Bacon

Farrell AD, Bruce SE, 1992, Impact of exposure to community violence on violent behavior and emotional distress among urban adolescents. J Clin Child Psychology, 26:2. [PubMed]

MacDonald, L. & Frey, H. E., 1999, Families and schools together: Building relationships. Juvenile Justice Bulletin, 1998, Washington, DC: U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention; Cotloff, P.

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Pupils coming from remote areas

Classroom-based tips (focus on instructional methods)

1. Make an effort to get to know your pupils so that you understand their living conditions, family backgrounds, and the expectations they hold of the school. Such information can help you find the best possible ways to manage your classroom and shape an environment that facilitates learning for all (UNESCO, 2015).

2. Develop activities in the classroom that promote empathy and understanding of different living conditions (Stokes, Stafford & Holdsworth, 2000).

3. Adapt the curriculum, if necessary, in order to include references to families and communities in remote areas, challenging stereotypes about them and implementing methodological approaches such as projects or research about specific areas (UNESCO, 2015).

4. Take advantage of the talents and strengths of pupils living in remote areas. For example, if a pupil is talented in theatre, introduce more role-playing activities into the lesson (UNESCO, 2015).

5. Use technology to facilitate the provision of support materials and to improve pupil participation, access and outcomes (NSW Government, 2013).

6. Stay in touch with the pupils living in remote areas using online forums, email and telephone calls (Macintyre & Macdonald, 2011).

7. Provide a supportive relationship with each of your pupils, irrespective of their residence area (Sigsworth & Solstad, 2001).

8. Enable pupils to link their curriculum knowledge to the world they know outside school and their daily lives (Sigsworth & Solstad, 2001).

School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

Create materials for practice and spare time activities. Organise pupils in mixed groups in order to produce the materials. Involve them in developing ideas for other resources e.g. designing and adapting a “local” reading book for younger pupils; inventing mathematical practice games for use by individuals, pairs and groups (Sigsworth & Solstad, 2001).

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Community

1. Encourage the community to be involved in school life and activities. Ask people from different groups how they would like to be involved, and ensure that activities are fun, social and held at a time of day and in locations that are convenient for people (Sigsworth & Solstad, 2001).

2. Develop Educational visits – provide study visits to historical centres, museums, the cinema and the theatre, in order to mitigate the lack of opportunity faced by pupils living in remote areas (Sigsworth & Solstad, 2001).

3. Develop school projects mainly from community funds, including events such as science fairs, aimed at enhancing pupils’ learning, opportunities and quality of life.

4. Generate mutually educative activities that involve the school and the community, such as developing shared facilities like community libraries and online facilities. (Sigsworth & Solstad, 2001; Stokes, Stafford & Holdsworth, 2000).

5. Develop community support groups to provide teachers with information about the community customs and traditions (Stokes, Stafford & Holdsworth, 2000).

Curricular Adaptations

2. Create materials for practice and spare time activities. Organise pupils in mixed groups in order to produce the materials. Involve them in developing ideas for other resources e.g. designing and adapting a “local” reading book for younger pupils; inventing mathematical practice games for use by individuals, pairs and groups (Sigsworth & Solstad, 2001).

Educational visits / Field trips / Camps / School exchanges / Trips abroad

1. Develop Educational visits – provide study visits to historical centres, museums, the cinema and the theatre, in order to mitigate the lack of opportunity faced by pupils living in remote areas (Sigsworth & Solstad, 2001).

2. Enable pupils living in remote areas to participate in excursions to experience sports activities not available in their residential areas (Sigsworth & Solstad, 2001).

Other (Transport)

Ensure free access to school buses for pupils living in remote areas, and more vehicles and direct routes to reduce travel time (Stokes, Stafford & Holdsworth, 2000).

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Parents / Parents’ Associations

1. Arrange meetings between the parents and the school staff to discuss children’s progress, and to enhance the collaboration between home and school. This will help to monitor progress and to discuss issues such as those related to pupils’ social life, social interactions with peers, behavior at home and self-esteem (UNESCO, 2015).

2. Establish a free call number for parents to enable them to talk more easily with teachers and the school community (Stokes, Stafford & Holdsworth, 2000).

School Celebrations / Events / Activities

Encourage the community to be involved in school life and activities. Ask people from different groups how they would like to be involved, and ensure that activities are fun, social and held at a time of day and in locations that are convenient for people (Sigsworth & Solstad, 2001).

School Projects

1. Create a toolkit with information about working with pupils living in remote areas (Queensland Government, 2011).

2. Develop school projects mainly from community funds, including events such as science fairs, aimed at enhancing pupils’ learning, opportunities and quality of life.

3. Generate mutually educative activities that involve the school and the community, such as developing shared facilities like community libraries and online facilities. (Sigsworth & Solstad, 2001; Stokes, Stafford & Holdsworth, 2000).

Pupil Support

2. Ensure free access to school buses for pupils living in remote areas, and more vehicles and direct routes to reduce travel time (Stokes, Stafford & Holdsworth, 2000).

Teacher Professional Development

1. Provide training for teachers, school leaders and administrative and support staff about the main difficulties that pupils living in remote areas may encounter at school (Queensland Government, 2011).

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2. Create a toolkit with information about working with pupils living in remote areas (Queensland Government, 2011). Technology

1. Equip classrooms with computers for each pupil so that they can create email addresses, access online support materials, and participate in forums (NSW Government, 2013).

2. Establish a free call number for parents to enable them to talk more easily with teachers and the school community (Stokes, Stafford & Holdsworth, 2000).

Supportive Literature

There are many different and potentially conflicting definitions of ‘rural’, using criteria of population density, economic factors, socio-cultural characteristics and location or remoteness from larger cities.

While the Australian Bureau of Statistics (ABS) defines rural as all residences and settlements of less than 1000 people, the Commonwealth Government recently defined the term as all non-metropolitan places with fewer than 100,000 people.

‘Remote’ is similarly subject to different interpretations. Its link in the Remote, Rural and Metropolitan Classification (DPIE and DHSH, 1994) to “Aboriginal communities and very low population densities”, also locates it within economic activity, specifically mining and broadacre farming. The term also implies: distance from neighbours and distance from large towns and cities and the goods, services, facilities and opportunities offered by large towns and cities (DPIE and DHSH, 1994: 6).

The classification then uses distance from large towns and cities, and distance from other people (i.e. population density) to develop an ‘index of remoteness’. It draws on both distance to urban centres and “personal distance”, i.e. the average distance between residents.

The terms ‘rural’ and ‘remote’ therefore have very different meanings in different contexts. Decisions about location are neither solely economic nor work related, nor are they seen as definitional in terms of disadvantage. “Remoteness can bring advantage”, says the DPIE and DHSH classification report (1994: 6); many people strive to maintain a “rural” lifestyle and will argue strongly about the advantages of such a lifestyle in terms of closer community links, increased safety, a more friendly, sharing and supportive community and so on. Access to rural schooling is part of this intention, and is often linked positively to the closer relationships between pupils and teachers that are attributed to smaller rural schools.

References

Aikman, S., & Pridmore, P. (2001). Multigrade schooling in ‘remote’ areas of Vietnam. International Journal of Educational Development, 21(6), 521-536. Available from: http://www.vnseameo.org/zakir/MSRA%20in%20VN.pdf Hargreaves, E., Montero, C., Chau, N., Sibli, M., & Thanh, T. (2001). Multigrade teaching in Peru, Sri Lanka and Vietnam: an overview. International Journal of Educational Development, 21(6), 499-520.

Kilpeläinen, A., Päykkönen, K., & Sankala, J. (2011). The use of social media to improve social work education in remote areas. Journal of Technology in Human Services, 29(1), 1-12.

Macintyre, R., & Macdonald, J. R. (2011). Remote from what? Perspectives of distance learning students in remote rural areas of Scotland. The International Review of Research in Open and Distributed Learning, 12(4), 1-16.

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NSW Government. Education & Communities. (2013). Rural and Remote Education – A blueprint for action. Available from: https://www.det.nsw.edu.au/media/downloads/about-us/our-reforms/rural-and-remote-education/randr-blueprint.pdf

Queensland Government. Department of education and Training. (2011). Action Plan for Rural and Remote Education 2011-2015. Available from: http://education.qld.gov.au/ruralandremote/pdfs/action-plan-rural-remote-education-2011-15.pdf

Sigsworth, A., & Solstad, K. J. (2001). Making small schools work: A handbook for teachers in small rural schools. UNESCO International Institute for Capacity Building in Africa. Available from: https://eric.ed.gov/?id=ED473553

Stokes, H., Stafford, J., & Holdsworth, R. (2000). Rural and remote school education. Victoria, 90(10), 298.

UNESCO. (2015). Practical Tips for Teaching Multigrade Classes. Available from: http://unesdoc.unesco.org/images/0022/002201/220101e.pdf

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Pupils with Mental Health Difficulties

Generic Tips for Mental Health Difficulties

Classroom-based tips (focus on instructional methods)

1. Foster a Supportive Classroom. Checking in regularly with students will help to reassure them that someone does care, and that they are not alone in their battle with mental health issues. Check-ins can take place after school, during lunch or over email — in whatever medium the student is most responsive. The important thing is to develop a relationship, to express unconditional support, to avoid generalisations and singling out the student for criticism, to be specific in providing feedback, and to keep the tone positive.

2. Emphasise Curiosity, Engaged Learning and Problem Solving. Shifting the instructional focus away from test-based learning is a bigger job than a single teacher can tackle on his or her own. However, to whatever extent possible, it is important to allow more time for curious, creative and engaged learning, whether through independent projects, self-chosen paper topics, or encouraging students to pick up extracurricular activities purely for reasons of interest and passion. Teaching general problem-solving strategies can also be effective.

3. Consistent Classroom Culture. A well-structured classroom with clear expectations, smooth transitions and a calm environment is helpful for most children. Offer and create a supportive environment where it is okay to make mistakes, to express emotions positively and to ask for help when needed.

4. Frame Rules Positively. Ensuring that rules are phrased in a positive way can help reinforce a constructive and healthy mind-set.

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Addiction

Classroom-based tips (focus on instructional methods)

1. Refer the pupil that you have concerns about to the appropriate member of staff or the Student Support Team. When pupils have issues that are beyond our professional areas of expertise we must refer them to those who have the experience and resources to help. This may be the most important step to help a pupil on their way to recovery. (Lang, E., 2011).

2. Talk to your supervisor, as you would over any pupil medical issue. Be sure to speak with your Student Support Team; they will give you specific advice and direction as you help the pupil re-enter the classroom. Working according to their advice and guidance is the best way to proceed so you can be certain that you’re not overstepping boundaries, and that you’re doing the best possible job on behalf of the pupil. (Gartens, B., 2015).

3. Encourage the pupil and highlight the areas where s/he is achieving. Building confidence helps pupils overcome the negative, self-deprecating thoughts many pupils in recovery have. (Lang, E., 2011).

4. Reflect with pupils and help them to understand time management. Addiction interrupts personal development and so those in recovery from addiction may have a tendency for impulsivity and poor boundaries. They may also take on too much at one time, resulting in becoming discouraged by failure and overwhelmed. A useful tool in visualising is a calendar or planner to mark down how much time is spent on various tasks. (Lang, E., 2011).

5. Make allowances for pupils suffering addiction to attend appointments and be absent for long periods of time. Pupils suffering from addiction often need to attend outside counseling sessions, or spend time at a residential treatment centre to give their recovery a strong and intense focus. Having the pupil get the necessary help outweighs all school-related matters. Extend deadlines, offer extra help and be giving of your time and patience. (Gatens, P., 2015).

6. Plan for the possibility of a pupil recovering from an addiction having a relapse. Some pupils do slip back into the throes of addiction, so it is important to communicate with your school’s Student Support Team to monitor their progress. All schools have strict policies regarding pupil drug and alcohol use and you must communicate your concerns to your school’s administration. (Gatens, P., 2015).

7. Work with pupils who are attempting to recover from their disease, even though it is often difficult and frustrating. You cannot guarantee pupils dealing with addiction will get clean and sober and stay that way, but you can ensure that the help you give in your class gives them the best possible chance. (Gatens, P., 2015).

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School-based practical tips (focus on instructional methods)

Community

1. Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively. Student Support Teams are responsible for ensuring that systems, policies and procedures to help pupils with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (Educator Toolkit, NEDA, 2016 & Department of Education and Skills, Ireland Guidelines).

2. Form open collaborative relationships with appropriate local treatment facilities and providers to support young people in their recovery. Establish a system of referral provide space for treatment professionals to meet with young people where necessary (Wood, J., Drolet, J., Fetro, J., Synovitz, B., Wood, A., 2002).

3. Ensure that school counsellors work closely with treatment counselors, and that treatment staff also provide progress reports to school staff. Have the needs of the young person identified in conjunction with all stakeholders and appropriate provisions put in place. If the young person is receiving treatment in a residential setting and discharge is approaching, make a re-integration plan to allow for as smooth a transition as possible. (Wood, J., Drolet, J., Fetro, J., Synovitz, B., Wood, A., 2002).

Curricular Adaptations

1. Ensure a robust social, physical and health education is delivered as part of the school curriculum. As in other areas of personal and social education – such as sex and relationship education, health education, bereavement and child protection – prevention, wherever possible, is better than cure. As a school, ask: What can we do to promote a healthy self- concept and equip young people with the confidence and skills necessary to handle problematic situations without experiencing overwhelming levels of anxiety? (Wood, J., Drolet, J., Fetro, J., Synovitz, B., Wood, A., 2002).

2. Prevention, and particularly drug-related prevention, only makes sense if provided as part of a comprehensive programme that addresses the health and well-being of young people within a school. Train and support those teaching, or providing the specific learning, for the “prevention” curriculum. Provide support for development, monitoring, review and refinement to the school staff. (Ljubljana, 2012).

Discipline

1. Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively.

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Student Support Teams are responsible for ensuring that systems, policies and procedures to help pupils with support needs are in place.

2. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (Educator Toolkit, NEDA, 2016 & Department of Education and Skills, Ireland Guidelines).

Parents / Parents’ Associations

Safety

3. Develop a Mental Health Policy within the school to promote mental health and well-being. This policy should inform all relevant decisions on procedures and systems relating to pupil wellbeing. Ensure that the needs of pupils suffering from addiction are reflected in these policies and procedures.

4. Establish a Safe Person and Safe Place in the school for times when the pupil feels overwhelmed. Ideally this person should be a school counselor or another suitably qualified person. Choose a location that is adequately private to be away from the unnecessary attention of other staff and pupils.

5. Develop Policies and Procedures for the use of this space and inform all relevant stakeholders.

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6. Ensure that school counsellors work closely with treatment counselors, and that treatment staff also provide progress reports to school staff. Have the needs of the young person identified in conjunction with all stakeholders and appropriate provisions put in place. If the young person is receiving treatment in a residential setting and discharge is approaching, make a re-integration plan to allow for as smooth a transition as possible. (Wood, J., Drolet, J., Fetro, J., Synovitz, B., Wood, A., 2002).

School Breaks

Provide supervision at all times for pupils who are recovering from addiction.

Scheduling Events

Ensure a robust social, physical and health education is delivered as part of the school curriculum. As in other areas of personal and social education – such as sex and relationship education, health education, bereavement and child protection – prevention, wherever possible, is better than cure. As a school, ask: What can we do to promote a healthy self- concept and equip young people with the confidence and skills necessary to handle problematic situations without experiencing overwhelming levels of anxiety? (Wood, J., Drolet, J., Fetro, J., Synovitz, B., Wood, A., 2002).

Pupil Support

3. Ensure a robust social, physical and health education is delivered as part of the school curriculum. As in other areas of personal and social education – such as sex and relationship education, health education, bereavement and child protection – prevention, wherever possible, is better than cure. As a school, ask: What can we do to promote a healthy self- concept and equip young people with the confidence and skills necessary to handle problematic situations without experiencing overwhelming levels of anxiety? (Wood, J., Drolet, J., Fetro, J., Synovitz, B., Wood, A., 2002).

4. Develop a Mental Health Policy within the school to promote mental health and well-being. This policy should inform all relevant decisions on procedures and systems relating to pupil wellbeing. Ensure that the needs of pupils suffering from addiction are reflected in these policies and procedures.

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5. Establish a Safe Person and Safe Place in the school for times when the pupil feels overwhelmed. Ideally this person should be a school counselor or another suitably qualified person. Choose a location that is adequately private to be away from the unnecessary attention of other staff and pupils.

6. Develop Policies and Procedures for the use of this space and inform all relevant stakeholders.

7. Form open collaborative relationships with appropriate local treatment facilities and providers to support young people in their recovery. Establish a system of referral provide space for treatment professionals to meet with young people where necessary (Wood, J., Drolet, J., Fetro, J., Synovitz, B., Wood, A., 2002).

8. Ensure that school counsellors work closely with treatment counselors, and that treatment staff also provide progress reports to school staff. Have the needs of the young person identified in conjunction with all stakeholders and appropriate provisions put in place. If the young person is receiving treatment in a residential setting and discharge is approaching, make a re-integration plan to allow for as smooth a transition as possible. (Wood, J., Drolet, J., Fetro, J., Synovitz, B., Wood, A., 2002).

9. Prevention, and particularly drug-related prevention, only makes sense if provided as part of a comprehensive programme that addresses the health and well-being of young people within a school. Train and support those teaching, or providing the specific learning, for the “prevention” curriculum. Provide support for development, monitoring, review and refinement to the school staff. (Ljubljana, 2012).

10. Provide supervision at all times for pupils who are recovering from addiction.

Teacher Professional Development

Prevention, and particularly drug-related prevention, only makes sense if provided as part of a comprehensive programme that addresses the health and well-being of young people within a school. Train and support those teaching, or providing the specific learning, for the “prevention” curriculum. Provide support for development, monitoring, review and refinement to the school staff. (Ljubljana, 2012).

Timetabling

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Supportive Literature

Addiction is defined by a compulsion to use a substance, or continue with certain behaviour that makes you feel good or avoid bad feelings. There are two types of addiction: physical and psychological.

The pattern doesn’t have to be severe to be considered an addiction; there are mild addictions as well.

Physical addiction This occurs after a substance is used so much it actually alters the body’s chemistry. The body develops a hunger for a particular drug that needs to be constantly fed. If the hunger is not fed, the body goes into withdrawal, leading to a range of unpleasant symptoms until the hunger is fed again.

Psychological addiction This occurs when the brain gets addicted to a particular substance or behaviour that ‘rewards’ it, i.e. creating a sense of ‘feeling good’. The mind is powerful and therefore an addicted brain can produce physical manifestations of withdrawal, including cravings, irritability, insomnia and depression.

When it comes to alcohol, nicotine and illegal drugs, it is possible to develop a physical addiction, a psychological addiction, or a mixture of both.

What are the signs?

Even though different people can develop any kind of addiction, the warning signs are quite similar and include:  An unhealthy focus on pursuing the substance/behaviour  Excluding other activities that are not related to using the substance  Going out mainly with the aim of using the substance  Needing more of the substance/behaviour to get the same feelings of elation  Neglecting other areas of life, including relationships, health, or work.

(Reachout.com)

Websites and EU reports

ReachOut.com is an online youth mental health service. www.reachout.com/inform-yourself/alcohol-drugs-and-addiction/other-addictions/what-is- addiction/

References

Lang, E., (2011) Advising Students in Recovery from Addiction, Academic Advising Today, 34(4)

Gatens, B., (2015) Helping Students Cope with Addiction: Tips for Teachers, From the Principal’s Office (http://education.cu-portland.edu/category/blog/principals-office/)

Wood, J., Drolet, J., Fetro, J., Synovitz, B., Wood, A., (2002) Residential Adolescent Substance Abuse Treatment: Recommendations for Collaboration Between School Health and Substance Abuse Treatment Personnel, Journal of School Health, 72(9), 363-367

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Sussman, S., (2011) Preventing and Treating Substance Abuse Among Adolescents, The Prevention Researcher, 18(2), 3-7

Guidelines and Recommendations for School-Based Prevention, Ljubljana (2012)

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Anxiety

Classroom-based tips (focus on instructional methods)

1. Make accommodations When working with pupils with anxiety, consider making accommodations in the following areas:  Homework – Establish a time limit for homework and reasonable homework content as pupils with anxiety can be overwhelmed by homework load and worry that homework is not of required standard. Consider asking the pupil about feelings and thoughts regarding the quantity and quality of homework. Sometimes reducing homework might create more stress, depending on the pupil.  Testing – Consider exam settings: is the testing environment quiet and distraction free? The anxious pupil may be better served sitting exams separately to other pupils. Is the anxious pupil aware that testing will occur and prepared? Consider the use of multiple choice testing, word banks or cloze testing as the anxious pupil may become overwhelmed and struggle to recall rote learning. Always be flexible; testing depends on the abilities of and difficulties experience by the pupil.  Assignments – Consider breaking assignments down into individual steps and introducing intermediate deadlines with continuous progress reviews.  Presentations – Consider allowing the pupil to present only to the teacher and not to a large class group, or perhaps use audio recording techniques. Gradually help the pupil to present to a bigger audience when you think s/he is ready.

2. Be Proactive Pupils with anxiety may be very reluctant to ask questions or contribute in class for fear of unwanted attention. This does not mean that they do not have something to say, it is therefore very important that teachers:  Don’t wait for the pupil to ask for help  Check how the pupil is doing  Ask the pupil for her/his opinion  Check the pupil understands as s/he may be unable to ask questions

3. Encourage Participation Encourage the pupil to take part in class activities based on their strengths and knowledge. Engage with the anxious pupil on topics that they are confident in. Consider using a ‘signal’ so that the anxious pupil knows her/his turn is coming to contribute to class discussion and group participation.

4. Give Positive Reinforcemnet and Validation Let the anxious pupil know that you understand their feelings of anxiety, fear and worry. By creating a supportive, safe and positive classroom environment the anxious pupil will be more comfortable. Gently encourage the anxious pupil to try new things and positively reinforce the areas they are confident in as this will allow them to shine. Ensure feedback to the anxious pupil is positive but challenge them in a supportive way if they are not performing to their potential.

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5. Create a Safe Environment Ensure the anxious pupil is seated away from dominant classmates so as to engage fully in the class. Consider seating the pupil with a classmate s/he feels comfortable and confident with. Consider talking to the whole class about stress and its consequences with the cooperation of your school counsellor/psychologist.

6. Make Appropriate Referrals Make appropriate referrals to the principal, parent, school counsellor, school psychologist, doctor, or mental health specialist according to school policy. Ensure written parental consent where necessary.

Adapted, in part, from http://www.heysigmund.com/anxious-kids-at-school-how-to-help-them-soar/ http://www.worrywisekids.org/node/40

School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Change in Routine Let the anxious pupil and her/his family know of any planned changes to routine, such as time tabling changes or staff changes.

Class Divisions / Arrangements

1. Assemblies In large group assemblies consider seating an anxious pupil at the back or at the end of a row so that the pupil can easily be excused if a comfort break is needed. At a suitable moment, ask the pupil discreetly if s/he is comfortable attending assemblies.

2. Change in Routine Let the anxious pupil and her/his family know of any planned changes to routine, such as time tabling changes or staff changes.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Change in Routine Let the anxious pupil and her/his family know of any planned changes to routine, such as time tabling changes or staff changes.

Homework

1. Exam Management / Accommodations

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Develop modifications and accommodations to respond to the pupil's fluctuations in mood, ability to concentrate, or side effects of medication. Assign an individual to serve as a primary contact and coordinate any necessary interventions. A pupil suffering from anxiety may be better served sitting exams separately to other pupils. Check in with the pupil to ensure s/he is aware that testing will occur and is prepared.

2. Missed Time Management Ensure the anxious pupil is furnished with any subject material covered when absent due to illness. Ensure the anxious pupil is given adequate time to catch up on any work missed.

Parents / Parents’ Associations

Change in Routine Let the anxious pupil and her/his family know of any planned changes to routine, such as time tabling changes or staff changes.

Safety

Mental health Policy, Anti-Bullying Policy, Healthy Eating Policy Develop and implement health policies, which can be of great benefit to an anxious pupil. Healthy eating has been shown to reduce levels of anxiety and stress. Having a clearly defined school Mental Health Policy will provide your school with clear guidelines when dealing with mental health issues. A stringent Anti-Bullying policy may reduce the possibility of an anxious pupil becoming the victim of bullying.

Scheduling Events

Change in Routine Let the anxious pupil and her/his family know of any planned changes to routine, such as time tabling changes or staff changes.

School Breaks

Break Times Consider the use of peer mentors and assigned seating at break times, so the anxious pupil has someone to sit beside, to limit the opportunity of exclusion taking place and feeling ‘left out’. Create an organised environment and consider providing structured activities or games for all pupils during break times.

School Celebrations / Events / Activities

Assemblies In large group assemblies consider seating an anxious pupil at the back or at the end of a row so that the pupil can easily be excused if a comfort break is needed. At a suitable moment, ask the pupil discreetly if s/he is comfortable attending assemblies.

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Pupil Support

Time Out Consider allowing the anxious pupil the opportunity to take time out from a stressful class environment by getting a drink of water or having a short walk; a pre-agreed signal can be used. Consider the use of a ‘safe person’ such as the school counsellor or year head for the anxious pupil to engage with if feelings of anxiousness become overwhelming. Consider the use of relaxation exercises during time outs that may help the pupil destress.

[Reference: http://www.worrywisekids.org/node/40]

Timetabling

1. Exam Management / Accommodations Develop modifications and accommodations to respond to the pupil's fluctuations in mood, ability to concentrate, or side effects of medication. Assign an individual to serve as a primary contact and coordinate any necessary interventions. A pupil suffering from anxiety may be better served sitting exams separately to other pupils. Check in with the pupil to ensure s/he is aware that testing will occur and is prepared.

2. Change in Routine Let the anxious pupil and her/his family know of any planned changes to routine, such as time tabling changes or staff changes.

Supportive Literature

Health is defined as “A complete state of physical, mental and social well-being, not just the absence of disease or infirmity.” World Health Organisation (WHO)

“Mental Health is a balance between all aspects of life – social, physical, spiritual and emotional. It impacts on how we manage our surroundings and make choices in our lives – clearly it is an integral part of our overall health. Mental Health is far more than the absence of mental illness and has to do with many aspects of our lives including: How we feel about ourselves, how we feel about others, how we are able to meet the demands of life.” Mental Health Ireland

Definition of anxiety: “Anxiety disorders cover a range of disorders related to feelings of panic, worry or fear. They include specific phobias (an irrational or excessive fear of a specific object or situation, often leading to avoidance behaviour), social phobia (the experience of intense feelings of fear in social situations), panic disorder, post-traumatic stress disorder, obsessive compulsive disorder (engaging in repetitive behaviours or rituals and/or having obsessional or intrusive thoughts) and generalised anxiety disorder.”

Royal College of Surgeons in Ireland, retrieved at http://epubs.rcsi.ie/

General signs of Anxiety:

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 Demonstrating excessive distress out of proportion to the situation: crying, physical symptoms, sadness, anger, frustration, hopelessness, embarrassment  Easily distressed, or agitated when in a stressful situation  Repetitive reassurance questions, "what if" concerns, inconsolable, won't respond to logical arguments  Headaches, stomach aches, regularly too sick to go to school  Anticipatory anxiety, worrying hours, days, weeks ahead  Disruptions of sleep with difficulty falling asleep, frequent nightmares, difficulty sleeping alone  Perfectionism, self-critical, very high standards that make nothing good enough  Overly-responsible, people pleasing, excessive concern that others are upset with him or her, unnecessary apologising  Demonstrating excessive avoidance, refuses to participate in expected activities, refusal to attend school  Disruption of child or family functioning, difficulty with going to school, friend's houses, religious activities, family gatherings, errands, vacations  Excessive time spent consoling child about distress with ordinary situations, excessive time coaxing child to do normal activities- homework, hygiene, meals

Source: The Children's and Adult Center for OCD and Anxiety

The Children’s Center on OCD and Anxiety (2009) believes that students with ASD do their best work in a classroom that is calm, supportive and organised.

Characteristics of pupil suffering from anxiety:

 Inattention and restlessness  Attendance problems and clingy kids  Disruptive behaviour  Trouble answering questions in class  Frequent trips to the nurse  Problems in certain subjects  Not turning in homework  Avoiding socialising or group work

Websites and EU Reports http://www.worrywisekids.org/ http://childrenscenterocdanxiety.blogspot.ie/ http://socialanxietyireland.com/ http://www.hse.ie/eng/health/az/A/Anxiety/Treating-anxiety.html http://ie.reachout.com/ http://europa.eu.int/comm/health/ph_information/information_en.htm http://www.euro.who.int/

European Pact for Mental Health and Well-being (2008) Available at: http://ec.europa.eu/health/ph_determinants/life_style/mental/docs/pact_en.pdf

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WHO (2005) Mental health action plan for Europe. Copenhagen: WHO Regional Office for Europe. World Health Organisation

WHO (2008) Policies and practices for mental health in Europe. Copenhagen: World Health Organisation Regional Office for Europe

Cannon M, Coughlan H, Clarke M, Harley M & Kelleher I (2013) The Mental Health of Young People in Ireland: a report of the Psychiatric Epidemiology Research across the Lifespan (PERL) Group Dublin: Royal College of Surgeons in Ireland

McLoone, J., Hudson, J. L., & Rapee, R. M. (2006). Treating Anxiety Disorders in a School Setting.Education and Treatment of Children, 29(2), 219–242. Retrieved from http://www.jstor.org/stable/42899883

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Depression

Classroom-based tips (focus on instructional methods)

1. Make accommodations When working with pupils with depression, consider making accommodations in the following areas:

 Homework – Establish a time limit for homework and reasonable homework content as pupils suffering from depression can be overwhelmed by homework load and worry that homework is not of required standard. Consider asking the pupil about feelings and thoughts regarding the quantity and quality of homework. Sometimes reducing homework might create more stress, depending on the pupil.  Assignments – Consider breaking assignments down into individual steps and introducing intermediate deadlines with continuous progress reviews.  Presentations – Consider allowing the pupil to present only to the teacher and not to a large class group, or perhaps use audio recording techniques. Gradually help the pupil to present to a larger audience when you think s/he is ready.

2. Ensure Check-in Time It is important that pupils suffering with depression are aware that someone cares and that they are not alone. Ensure that pupils receive regular supportive ‘check-ins’ in whatever medium the pupil is confident and responsive, such as before/after class, during break times or via email. Give frequent feedback on academic, social, and behavioural performance. Frequently monitor whether the pupil has suicidal thoughts. In case pupils express suicidal thoughts always refer them to the Mental Health Services, School Psychology Services or the School Counsellor. Remember that in case of suicidal thoughts you can refer, even without the consent of parents.

3. Practice Engagement and Effective Communication There are specific interpersonal skills a teacher can use to engage with a pupil experiencing depression that will allow for clearer communication and understanding. Ensure that you make eye contact with pupil and demonstrate an empathetic understanding of the pupil by nodding and repeating, this will help the pupil know that they are being listened to. If the pupil divulges anything about their emotional state of mind or worries ensure that you understand exactly what the pupil is relating to you by asking the pupil for clarification. Be open for discussion during breaks and encourage the pupil to communicate thoughts and feelings with you. Do not encourage discussion in front of class. When difficult emotional issues arise always consult the school psychologist/counsellor.

4. Create a Safe Environment Give the pupil opportunities to engage in social interactions with classmates. Seat the pupil with fellow pupils that s/he is confident and comfortable with. Wherever possible allow the pupil to engage with creative learning, projects, group work and assignments that s/he demonstrates an interest or talent for, as this will help to engage the pupil and build self-

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confidence and participation. Consider arranging, with the cooperation of your school psychologist/counsellor, a presentation regarding differences and acceptance for the whole class.

5. Teach Self-Regulating and Coping Skills Teach the pupil how to set goals and self-monitor. Teach problem-solving skills. Coach the pupil in ways to organise, plan, and execute tasks demanded daily or weekly in school. Making these skills part of your subject material will allow the pupil to learn coping mechanisms for self-regulation.

6. Make Appropriate Referrals Make appropriate referrals to the principal, parent, school counsellor, school psychologist, doctor or mental health specialist according to school policy. Ensure written parental consent where necessary.

References:

Adapted, in part, from Accommodating Students with Mood Lability: Depression and Bipolar Disorder Leslie E. Packer PHD, (2002). Available at www.schoolbehavior.com

Adapted, in part, from http://www.heysigmund.com/anxious-kids-at-school-how-to-help-them-soar/ http://www.worrywisekids.org/node/40

School-based practical tips (focus on instructional methods)

Community

Promote Knowledge and Awareness Establish and maintain appropriate links to mental health organisations in your area. Recognise and promote National Mental Health awareness through school-wide events. Provide literature and contact details in school of appropriate mental health therapeutic centres and interventions.

[References: Adapted, in part, from the American National Association of School Psychologists, the National Institute of Mental Health, and Interventions That Work in Educational Leadership, A. Crundwell and K. Killu Responding to a Student's Depression Available at http://www.ascd.org/]

Food: Canteen / Visits / Camps / Trips

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when dealing with mental health issues. A stringent Anti-Bullying policy may reduce the possibility of a depressed pupil becoming the victim of bullying.

Other (Health and Wellness)

Mental Health Policy, Anti-Bullying Policy, Healthy Eating policy Develop and implement health policies, which can be of great benefit to a pupil suffering from depression. Healthy eating has been shown to reduce levels of anxiety and stress. Having a clearly defined school Mental Health Policy will provide your school with clear guidelines when dealing with mental health issues. A stringent Anti-Bullying policy may reduce the possibility of a depressed pupil becoming the victim of bullying.

Parents / Parent Associations

Develop Home-School Communication Develop an effective home–school communication system to share information on the pupil's academic, social, and emotional behaviour and any developments concerning medication or side-effects. Safety

Ensure Supervision Ensure any pupil identified as suffering from depression is supervised at all times

Scheduling Events

School Breaks

Ensure Supervision Ensure any pupil identified as suffering from depression is supervised at all times

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Pupil Support

1. Develop Home-School Communication Develop an effective home–school communication system to share information on the pupil's academic, social, and emotional behaviour and any developments concerning medication or side- effects.

2. Make Accommodations Develop modifications and accommodations to respond to the pupil's fluctuations in mood, ability to concentrate, or side-effects of medication. Assign one member of staff to serve as a primary contact and coordinate interventions.

School Celebrations / Events / Activities

Pupil Support

1. Promote Knowledge and Awareness Establish and maintain appropriate links to mental health organisations in your area. Recognise and promote National Mental Health awareness through school-wide events. Provide literature and contact details in school of appropriate mental health therapeutic centres and interventions.

2. Mental Health Policy, Anti-Bullying Policy, Healthy Eating policy

Develop and implement health policies, which can be of great benefit to a pupil suffering from depression. Healthy eating has been shown to reduce levels of anxiety and stress. Having a clearly defined school Mental Health Policy will provide your school with clear guidelines when dealing with mental health issues. A stringent Anti-Bullying policy may reduce the possibility of a depressed pupil becoming the victim of bullying.

Teacher Professional Development

Provide Continuous Professional Development

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Ensure all staff in contact with pupils faced with depression receive adequate, relevant and appropriate Continuous Professional Development for staff and teachers in mental health awareness and intervention.

Supportive Literature

DEPRESSION “is a common mental disorder, characterised by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration.

Depression can be long-lasting or recurrent, substantially impairing an individual’s ability to function at work or school or cope with daily life. At its most severe, depression can lead to suicide. When mild, people can be treated without medicines but when depression is moderate or severe they may need medication and professional counselling treatments.

Depression is a disorder that can be reliably diagnosed and treated by non-specialists as part of primary health care. Specialist care is needed for a small proportion of individuals with complicated depression, or those who do not respond to first-line treatments. (World Health Organisation)

“Some young children with this disorder may pretend to be sick, be overactive, cling to their parents and refuse to go to school, or worry that their parents may die. Older children and adolescents with depression may sulk, refuse to participate in family and social activities, get into trouble at school, use alcohol or other drugs, or stop paying attention to their appearance. They may also become negative, restless, grouchy, aggressive, or feel that no one understands them. Adolescents with major depression are likely to identify themselves as depressed before their parents suspect a problem. The same may be true for children. (Center for Mental Health Services, Washington, DC, 1998).

Symptoms of depression

According to AWARE, a depression support organisation based in Ireland, depression has eight main symptoms. If a person experiences five or more of these symptoms, lasting for a period of two weeks or more, they should speak to a GP or mental health professional. The symptoms of depression are:

 Feeling sad, anxious or bored  Low energy, feeling tired or fatigued  Under-sleeping or over-sleeping, waking frequently during the night  Poor concentration, thinking slowed down  Loss of interest in hobbies, family or social life  Low self-esteem and feelings of guilt  Aches and pains with no physical basis, e.g. chest, head or tummy pain associated with anxiety or stress  Loss of interest in living, thinking about death, suicidal thoughts www.aware.ie

Signs of depression in pupils

 Complaints of feeling sick, school absence, lack of participation

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 Irritability  Isolation from peers, problems with social skills, defiance  Difficulty concentrating on tasks/activities  Poor quality of schoolwork  Forgetting to complete assignments, difficulty concentrating  Difficulties with planning, organising, and executing tasks  Refusing to complete work, missing deadlines  Facial expressions or body language indicating depression or sadness  Easily hurt feelings, crying, anger  Poor performance and follow-through on tasks  Inattention  Distractibility, restlessness  Forgetfulness  Frequent absences  Decreased self-esteem and feelings of self-worth  Self-deprecating comments  Defiance with authority figures, difficulties interacting with peers, argumentativeness  Pessimistic comments, suicidal thoughts  Isolation and withdrawal,  Frequent change in friends  Lack of interest and involvement in previously enjoyed activities  Boredom  Theft, inappropriate / risky sexual activity, alcohol or drug use, truancy  Substance abuse  Acting out of character, sleeping in class

Websites and EU Reports

Useful Websites

International Association of Youth Mental Health www.iaymh.org World Health Organisation www.who.int Institute of Child Education and psychology www.icepe.eu

Relevant Articles and Reports

Child and Adolescent Mental Health in Europe: Infrastructures, Policy and Programmes. Luxembourg: European Communities. Braddick, F., Carral, V., Jenkins, R., & Jané-Llopis, E. (2009). Available at http://ec.europa.eu/

Comparing Child Well-Being in OECD Countries: Concepts and Methods Jonathan Bradshaw, Petra Hoelscher and Dominic Richardson (2006) Available at https://www.unicef-irc.org/publications/464/

Changing attitudes: supporting teachers in effectively including students with emotional and behavioural difficulties in mainstream education, Geraldine Scanlona and Yvonne Barnes-Holmes,

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School of Education Studies, Dublin City University, Glasnevin, Dublin 11, Ireland; Department of Psychology, The National University of Ireland, Maynooth, Co. Kildare, Ireland http://dx.doi.org/10.1080/13632752.2013.769710

Comorbidity of anxiety and depression in children and adolescents Brady, Erika U.; Kendall, Philip C. Psychological Bulletin, Vol 111(2), Mar 1992, 244-255. http://dx.doi.org/10.1037/0033-2909.111.2.244

Mental Health Promotion and Prevention Strategies for Coping with Anxiety, Depression and Stress Related Disorders in Europe (2001-2003) http://www.enwhp.org/fileadmin/downloads/8th_Initiative/Mental_Health_BAUA_Report_2001_2 003.pdf

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Eating Disorders

Classroom-based tips (focus on instructional methods)

1. Educate yourself on the signs and symptoms of eating disorders. As a teacher you are strategically placed to recognise potential problems. See Supportive Literature for more information. (Eating Disorders: Information for Teachers and Youth Workers, Bodywhys, 2008)

2. Take positive steps as preventative measures against the onset or development of an eating disorder. As a whole-class or whole-school approach, developmentally appropriate emphasis should be given to: • Improving general health, nutrition, and psychological well-being, including self-esteem and positive body image • Enhancing media literacy and promoting critical evaluation of media messages • Helping children learn how to manage the socio-cultural influences linked to the development of body image dissatisfaction • Reducing teasing, including weight-based teasing and using preventive programs regarding bullying (Educator Toolkit, NEDA, 2016)

3. If you have concerns about a pupil, keep clear and concise accounts of the incidents and behaviours that have led you to become concerned. You should not try to diagnose conditions, but rather state facts based on observations. Denial is often the first response from the young person so a factual record of events is important. You should then make your concerns known to the relevant personnel in the school and to the pupil’s parents, according to school procedures. (Eating Disorders: Information for Teachers and Youth Workers, Bodywhys, 2008)

4. Focus on the pupil’s feelings rather than on their food and weight. Eating disorders can be a way of coping with unmanageable feelings or a symptom of emotional distress. (Eating Disorders in School, NEDC 2016)

5. Don’t discriminate or play favorites on the basis of appearance. In particular, watch out for favoritism of girls who fit the cultural definition of “pretty”. Whenever possible, see that pupils of diverse body shapes and sizes are chosen as leaders for a variety of tasks, such as school reps, or in theatrical productions. (C. Steiner-Adair, L. Sjostrom, 2006)

6. Avoid weighing of pupils and BMI measurement as part of class. Weigh-ins should also be avoided in sports programmes. (Educator Toolkit, NEDA, 2016)

7. Review posters, books and other class materials to ensure that a broad range of body shapes, sizes and ethnicities are represented. (Educator Toolkit, NEDA, 2016)

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8. Refrain from discussing food, weight, exercise and dieting in class if you have a pupil who is suffering with an eating disorder. (Educator Toolkit, NEDA, 2016)

9. Evaluate the pupil’s strengths and limitations together with the pupil and the parents/guardians; this will help the pupil to accept these and set realistic goals. It will also help to guide a pupil who suffers from an eating disorder away from perfectionist thinking and behaviour. (Eating Disorders: Information for Teachers and Youth Workers, Bodywhys, 2008)

10. Ensure that the pupil is involved in any decision-making processes so that s/he is given as much responsibility as possible for the choices made. As eating disorders are often about the young person exerting control when s/he feels s/he has none, giving the pupil opportunities to have input into plans is important. (Eating Disorders: Information for Teachers and Youth Workers, Bodywhys, 2008)

11. Set time limits on how long the pupil is to spend on school work. Inadequate nutrition and the psychological characteristics related to eating disorders will generally have an effect on pupil’s cognitive and physical abilities in the school setting. Perfectionist traits may lead these pupils to spend excessive amounts of time completing homework, as well as class-work and examinations Work with the parents to set reasonable limits on the time pupils can allocate to their work tasks. (B. Hellings and T. Bowles, 2007)

12. Be supportive of the pupil’s friends and fellow pupils by providing information and opportunities to talk. The friends of a pupil with an eating disorder can be supportive by learning basic information about eating disorders and encouraging a culture of body positivity within their social circles. (Educator Toolkit, NEDA, 2016)

School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Review posters, books and materials in the school to ensure they represent a wide variety of body shapes, sizes, and ethnicities. (Educator Toolkit, NEDA, 2016)

Community

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3. Make up-to-date printed information available about how parents can support their child to develop a positive body image and a healthy relationship with food. Provide parents with links to information about body image and eating disorders on the school website. Present talks and information nights for parents about eating disorders and related issues. (Eating Disorders in School, NEDC 2016)

Curricular Adaptations

1. Ensure no weighing, measuring or anthropometric assessment of pupils takes place in school in any class or group context but is only conducted in private, perhaps during routine health examinations or by the school nurse (if available). (Eating Disorders in School, NEDC 2016)

2. Provide an opportunity for all pupils to engage in regular physical activity in a noncompetitive, safe and secure environment, avoiding focus on weight loss. (Eating Disorders in School, NEDC 2016)

3. Ensure that the curriculum provides body image topics at every year level and ensure all materials presented as part of your prevention program are age appropriate, as follows: Primary— focus on positive body image, self-esteem and healthy eating patterns Early high school—focus on peer interventions and media literacy Mid-high school—focus on cognitive dissonance and peer programs Late high school—focus on early identification of body image, eating problems and mental health literacy (Eating Disorders in School, NEDC 2016)

Discipline

Update school anti-harassment and antidiscrimination policies to ensure they include provisions about physical appearance and body shape. Ensure that a protocol is in place for pupils to report teasing, bullying, or harassment based on weight or appearance. Consequences for bullying behavior should be clearly outlined and communicated to pupils. (Educator Toolkit, NEDA, 2016)

Food: Canteen / Visits / Camps / Trips

Provide a range of affordable, fresh, nutritious foods. Work with school food providers to provide consistency between food choices in the cafeteria and nutrition information taught in health class. Eliminate vending machines, or stock them with healthier choices. (C. Steiner-Adair, L. Sjostrom, 2006)

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Parents / Parents’ Associations

Safety

3. Develop a Mental Health Policy within the school to promote mental health and well-being. This policy should inform all relevant decisions on procedures and systems relating to pupil well-being. Ensure that the needs of pupils suffering from an eating disorder are reflected in these policies and procedures.

4. Update school anti-harassment and antidiscrimination policies to ensure they include provisions about physical appearance and body shape. Ensure that a protocol is in place for pupils to report teasing, bullying, or harassment based on weight or appearance. Consequences for bullying behavior should be clearly outlined and communicated to pupils. (Educator Toolkit, NEDA, 2016)

5. Establish policies and protocols that relate specifically to eating disorders. Establish a standard protocol for approaching and referring pupils with possible eating problems. Establish guidelines for contacting parents and liaising with outside health professionals. Referrals should be made with the informed consent of parents to school supporting services where necessary.

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(C. Steiner-Adair, L. Sjostrom, 2006)

Scheduling Events

1. Provide an opportunity for all pupils to engage in regular physical activity in a noncompetitive, safe and secure environment, avoiding focus on weight loss. (Eating Disorders in School, NEDC 2016)

2. Make up-to-date printed information available about how parents can support their child to develop a positive body image and a healthy relationship with food. Provide parents with links to information about body image and eating disorders on the school website. Present talks and information nights for parents about eating disorders and related issues. (Eating Disorders in School, NEDC 2016)

School Projects

1. Ensure that the curriculum provides body image topics at every year level and ensure all materials presented as part of your prevention program are age appropriate, as follows: Primary— focus on positive body image, self-esteem and healthy eating patterns Early high school—focus on peer interventions and media literacy Mid-high school—focus on cognitive dissonance and peer programs Late high school—focus on early identification of body image, eating problems and mental health literacy (Eating Disorders in School, NEDC 2016)

2. Review posters, books and materials in the school to ensure they represent a wide variety of body shapes, sizes, and ethnicities. (Educator Toolkit, NEDA, 2016)

Pupil Support

3. Develop a Mental Health Policy within the school to promote mental health and well-being. This policy should inform all relevant decisions on procedures and systems relating to pupil well-being. Ensure that the needs of pupils suffering from an eating disorder are reflected in these policies and procedures.

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4. Establish policies and protocols that relate specifically to eating disorders. Establish a standard protocol for approaching and referring pupils with possible eating problems. Establish guidelines for contacting parents and liaising with outside health professionals. Referrals should be made with the informed consent of parents to school supporting services where necessary. (C. Steiner-Adair, L. Sjostrom, 2006)

Teacher Professional Development

Train all relevant teaching staff in the early identification and referral of students with serious body image concerns and eating disorders. Ensure that training also includes information about eating disorders, their impact on the well-being of young people and ways that risk factors are reinforced by social environments. (Eating Disorders in School, NEDC 2016)

Timetabling

2. Ensure that the curriculum provides body image topics at every year level and ensure all materials presented as part of your prevention program are age appropriate, as follows: Primary— focus on positive body image, self-esteem and healthy eating patterns Early high school—focus on peer interventions and media literacy Mid-high school—focus on cognitive dissonance and peer programs Late high school—focus on early identification of body image, eating problems and mental health literacy (Eating Disorders in School, NEDC 2016)

Supportive Literature

The term eating disorder refers to a complex, potentially life-threatening condition, characterised by severe disturbances in eating behaviours. Eating disorders can be seen as a way of coping with emotional distress, or as a symptom of underlying issues. (Bodywhys, The Eating Disorders Association of Ireland)

Eating disorders amongst children and adolescents are a cause of serious concern. A working definition of these disorders, as they are manifested in school settings, defines sufferers of these disorders as being significantly preoccupied with food, weight, and shape, and possibly engaging in disturbed eating behaviours (Gowers & Bryant-Waugh, 2004).

Many sufferers are forced to defer their education whilst they seek treatment, thus furthering the potential negative impact of their condition on their social and cognitive development. (B. Hellings and T. Bowles, 2007)

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Anorexia Nervosa  A person will make determined efforts to attain and maintain a body weight lower than the normal body weight for their age, sex and height  They will be preoccupied with thoughts of food and the need to lose weight  They may exercise excessively and may engage in purging behaviours.

Bulimia Nervosa  A person will make determined efforts to purge themselves of any food eaten, sometimes following a binge, and often following ‘normal’ food intake.  They will engage in high-risk behaviours that can include fasting, excessive exercising, self- induced vomiting, and/or the misuse of laxatives, diuretics or other medications  They may maintain a body weight within the normal range of their age, sex and height. As a result, bulimia is often less obvious than anorexia and can go unnoticed for longer.

Binge Eating Disorder  A person will engage in repeated episodes of bingeing without purging  They will likely gain considerable amounts of weight over time  They find themselves trapped in a cycle of dieting, bingeing, self-recrimination and self- loathing. (Bodywhys, The Eating Disorders Association of Ireland)

Eating disorders are marked by a variety of emotional, physical, and behavioral changes. If a pupil consistently shows one or more of the signs or symptoms listed below, it is cause for concern.

Emotional • Changes in attitude/performance • Expresses body image complaints/concerns • Incessant talk about food, weight, shape, exercise and cooking • Displays rigid or obsessive thinking about food, eating and exercise • Appears sad, depressed, anxious, ashamed, embarrassed, or expresses feelings of worthlessness • Emotions are flat or absent • Intolerance for imperfections in academics, eating and social life • Is target of body or weight bullying currently or has been in the past • Spends increasing amounts of time alone and pulls back from friends • Is obsessed with maintaining unhealthy eating habits to enhance performance in sports, dance, acting, or modeling • Overvalues self-sufficiency; reluctant to ask for help • Unable or unwilling to acknowledge recent changes

Physical • Sudden loss, gain, or fluctuation of weight in short time • Complaints of abdominal pain • Feeling full or “bloated” • Feeling faint, cold, or tired • Dark circles under the eyes or bloodshot eyes or burst capillaries around eyes • Calluses on the knuckles from self-induced vomiting • Dry hair or skin, dehydration, blue hands/feet • Lanugo hair (fine body hair)

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• Fainting or dizziness upon standing; frequent fatigue • Thinning, dry hair

Behavioral • Diets or chaotic food intake; pretends to eat, then throws away food; skips meals • Creates rigid dietary rules or observes strict diet without medical or religious reason • Exercises for long periods and with obsessional attitude • Constantly talks about food; unwilling to share food; hoards food; refuses to eat food prepared by others, or without knowing exact ingredients • Difficulty sitting still: hovers over chair instead of sitting, constantly jiggles legs, gets up from desk at every opportunity, offers to run errands • Makes frequent trips to the bathroom • Wears very baggy clothes to hide a very thin body (anorexia) or weight gain (binge eating disorder) or to hide a “normal” body because of concerns about body shape and size • Avoids cafeteria, works through lunch and eats alone • Shows some type of compulsive behavior, such as compulsive hand washing, hoarding, repetitive movements or speech or a need for constant reassurance • Denies difficulty with food or body image despite evidence that it is an area of concern (Educators Toolkit, National Eating Disorders Association)

Websites and EU Reports

The Eating Disorders Association of Ireland www.bodywhys.ie

Eating Disorders Victoria, Australia www.eatingdisorders.org.au

National Eating Disorders Association, US www.nationaleatingdisorders.org

References

Hellings B. and Bowles T., (2007). Understanding and Managing Eating Disorders in the School Setting, Australian Journal of Guidance & Counselling 17(1), 60–67

Steiner-Adair C. and Sjostrom L., (2006). The School Guide:Full of Ourselves. Teachers College Press

Educator Toolkit (2016). National Eating Disorders Association.

Eating Disorders in Schools: Prevention, Early Identification and Response (2nd Ed.)(2016). National Eating Disorders Collaboration

Eating Disorders: Information for Teachers/Youth Workers (2008). Bodywhys, The Eating Disorders Association of Ireland.

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Obsessive Compulsive Disorder

Classroom-based tips (focus on instructional methods)

1. Assign optimal seating for the pupil with Obsessive Compulsive Disorder (OCD). For example, if your classroom is off a busy corridor, then you might not want to have pupils with OCD sit by the door; you might have them sit in the front, where they are less able to hear the noise and can stay more focused on their work instead. On the other hand, for pupils with obvious symptoms, and who may not want other classmates to see them fidgeting with their hands, rocking or getting up a lot, it is advisable to seat them closer to the door, toward the back of the room. (ocdeducationstation.org)

2. Have a well-structured classroom with clear expectations, smooth transitions and a calm environment. This is helpful for most children, but particularly for the pupil with OCD. Offer a supportive environment where it is safe and acceptable to make mistakes, to express their emotions positively and to ask for help when needed. (Chaturvedi, A., Murdick, N., Gartin, B., 2014)

3. Maintain an organised and tidy classroom to help those pupils with OCD who might suffer from an orderly and symmetry obsession. Ensure that there is adequate storage for resources and items are kept stored and tidy until needed. Adopt a culture of tidying-as-you-go.

4. Accommodate the late arrival of pupils with OCD. Lateness can be caused by time consuming morning compulsions and routines. Be careful not to draw attention to this however, as it may result in embarrassment. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

5. Frame classroom rules in a positive way. Pupils with OCD often dwell on the negative and repeat expectations often. Ensuring that rules are phrased in a positive way can help reinforce a constructive and healthy mind-set. Offer a supportive environment where it is safe and acceptable to make mistakes, for pupils to express their emotions positively and to ask for help when needed. (Rogers Memorial Hospital)

6. Establish predictable classroom routines. If there is a change, provide as much notice ahead of time as possible. Allow extra time for transitions between tasks; pupils with OCD frequently cannot begin a new task until completing the current task. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

7. Establish a Safe Person (mentor) or Safe Place that the pupil can go to when feeling overwhelmed. This safe place should be a private location away from peers or other staff. Make arrangements in advance that do not call undue attention to the pupil. Have a cue or signal that the pupil with OCD may use to alert you that they need to go to a predetermined “safe” place if the pupil develops increased anxiety or panic attacks. This will allow the pupil

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the space that needed, and avoids any potentially embarrassing episodes in front of other classmates. (Adams, G., 2004)

8. Reassure the pupil on their efforts to avoid feelings of self-doubt and self-criticism. Pupils with OCD need a classroom environment where they feel welcomed, safe, accepted, and understood. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

9. Give instructions and assignments in manageable, easy-to-follow steps. Children with OCD often become overwhelmed when confronted with large bodies of work. Depending on each pupil’s individualised needs, breaking this work into smaller manageable packages will help the pupil remain focused. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

10. Extend time for tests and assignments as the pupil may need to write then rewrite pieces of work to find the ‘perfect’ way to say something. The types of tests given should also be considered. Depending on each pupil’s individualised needs, difficulties and abilities open- ended questions may a be source of stress. Short answer questions or multiple choice may be more suitable. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

11. Give the pupil the option of typing their work if possible. If writing and rewriting/erasing is really problematic, consider allowing the use of a laptop for taking notes, and having assignments be typed instead of handwritten. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

12. Accommodate Children with OCD who may have difficulty reading. They may have a compulsion to go back and reread sentences or whole paragraphs over and over to make sure they have read them correctly. Reading becomes a very laborious task, and reading in front of the class can become very stressful. Accommodations may include assigning shorter reading assignments, highlighting the most important sections to read, or having someone else read the text to her/him. (Adams, G., 2004)

13. Be aware of events or scenarios that may trigger OCD symptoms of the pupil. It is very important for teachers to know what kind of things might trigger the symptoms. Fatigue and medication can have a big impact on the pupil. Liaising with parents for this information is important. Keeping a log of changes in behaviour that can be shared with parents and other stakeholders. (Adams, G., 2004)

14. Together with the cooperation of your school psychologist or Student Support Team, educate class peers on OCD to help them have a greater understanding of the condition and encourage them to be supportive. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014) (Adams, G., 2004)

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School-based practical tips (focus on instructional methods)

Announcement / Sign at School

1. Give as much prior notice as possible for exams, trips or unusual events and activities. Advance notice should be given for any changes to usual routine. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

2. Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and staff on mental health issues to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

Community

1. Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and staff on mental health issues to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

2. Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively. Student Support Teams are responsible for ensuring that systems, policies and procedures to help the pupil with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

Curricular Adaptations

Exam time can be an immensely stressful time for pupils suffering from OCD. Ensure that as much prior notification is given to pupils regarding exams. Depending on the needs of the pupil, a private exam room may be required for written or practical exams. (Adams, G., 2004)

Discipline

1. Develop an Individual Student Behaviour Management Strategy to be agreed with all relevant school stakeholders. This strategy should inform actions to be taken and supports to be provided for the pupils specific to their needs. Ensure the strategy is reviewed regularly to adapt to the needs and challenges of the OCD pupils.

2. Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively.

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Student Support Teams are responsible for ensuring that systems, policies and procedures to help the pupil with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Parents / Parents’ Associations

1. Establish effective communication with parents/guardians. It is critical to work closely with the pupil’s family to understand the symptoms and course of the illness. Teachers and school personnel also need to know about changes in the child’s home life or medication in order to work around them constructively at school. (Adams, G., 2004) (Paige, L., 2007)

2. Develop an Individual Student Behaviour Management Strategy to be agreed with all relevant school stakeholders. This strategy should inform actions to be taken and supports to be provided for the pupils specific to their needs. Ensure the strategy is reviewed regularly to adapt to the needs and challenges of the OCD pupils.

3. Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively. Student Support Teams are responsible for ensuring that systems, policies and procedures to help the pupil with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

Safety

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2. Establish effective communication with parents/guardians. It is critical to work closely with the pupil’s family to understand the symptoms and course of the illness. Teachers and school personnel also need to know about changes in the child’s home life or medication in order to work around them constructively at school. (Adams, G., 2004) (Paige, L., 2007)

3. Develop an Individual Student Behaviour Management Strategy to be agreed with all relevant school stakeholders. This strategy should inform actions to be taken and supports to be provided for the pupils specific to their needs. Ensure the strategy is reviewed regularly to adapt to the needs and challenges of the OCD pupils.

4. Make Child Protection Policies and Procedures available to all Teachers and staff and ensure they are followed at all times.

5. Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively. Student Support Teams are responsible for ensuring that systems, policies and procedures to help the pupil with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

Scheduling Events

1. Exam time can be an immensely stressful time for pupils suffering from OCD. Ensure that as much prior notification is given to pupils regarding exams. Depending on the needs of the pupil, a private exam room may be required for written or practical exams. (Adams, G., 2004)

2. Give as much prior notice as possible for exams, trips or unusual events and activities. Advance notice should be given for any changes to usual routine. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

3. Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and staff on mental health issues to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

School Celebrations / Events / Activities

2. Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and

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staff on mental health issues to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

School Projects

Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and staff on mental health issues to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

Pupil Support

1. Establish a Safe Person and Safe Place in the school for times when the pupil feels overwhelmed. Ideally this person should be a school counsellor or another suitably qualified person. The location should be adequately private to be away from the unnecessary attention of other staff and pupils. Develop Policies and Procedures for the use of this space and inform all relevant stakeholders. (Adams, G., 2004) 2. Exam time can be an immensely stressful time for pupils suffering from OCD. Ensure that as much prior notification is given to pupils regarding exams. Depending on the needs of the pupil, a private exam room may be required for written or practical exams. (Adams, G., 2004)

3. Establish effective communication with parents/guardians. It is critical to work closely with the pupil’s family to understand the symptoms and course of the illness. Teachers and school personnel also need to know about changes in the child’s home life or medication in order to work around them constructively at school. (Adams, G., 2004) (Paige, L., 2007)

4. Develop an Individual Student Behaviour Management Strategy to be agreed with all relevant school stakeholders. This strategy should inform actions to be taken and supports to be provided for the pupils specific to their needs. Ensure the strategy is reviewed regularly to adapt to the needs and challenges of the OCD pupils.

5. Make Child Protection Policies and Procedures available to all Teachers and staff and ensure they are followed at all times.

6. Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and staff on mental health issues to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

7. Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively. Student Support Teams are responsible for ensuring that systems, policies and procedures to help the pupil with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators,

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year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

Teacher Professional Development

1. Train your teachers in ways of coping with the challenges presented by pupils with mental health issues and in ways of engaging with these pupils in a positive, constructive manner. Training should include nonviolent crisis prevention, focusing on verbal de-escalation techniques, to avoid crises and special educational needs. Consult school psychologist or Student Support Team for their input. (McIntosh, D. and Trotter, J., 2006)

Timetabling

3. Make appropriate changes to the school timetable to ensure smooth transition between activities and subjects. These are the times that may be most stressful to the pupil. For example, allowing pupils with OCD to leave for their next class a few minutes early to avoid busy school corridors could work to avoid unnecessary stress. (Chaturvedi, A., Murdick, N.,Gartin, B., 2014)

Supportive Literature

Obsessive Compulsive Disorder (OCD) is a mental health disorder that affects people of all ages and walks of life, and occurs when a person gets caught in a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease his or her distress. [Reference: International OCD Foundation]

Obsessive Thoughts The sufferer of this anxiety disorder may have unwanted and repeated thoughts, feelings, ideas and sensations, which are known as the obsessions. Some common obsessions that affect people with OCD include:

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 fear of deliberately harming themselves or others  fear of harming themselves or others by mistake or accident  fear of contamination by disease, infection or an unpleasant substance  a need for symmetry or orderliness

Compulsive Behaviour Compulsions arise as a way of trying to reduce or prevent the harm of the obsessive thought. However, this behaviour is either excessive or not realistically connected at all. Most people with OCD realise that such compulsive behaviour is irrational and makes no logical sense, but they cannot stop acting on their compulsion. Some common types of compulsive behaviour that affect people with OCD include:  cleaning and hand washing  constant checking  counting  ordering and arranging  hoarding  asking for reassurance  repeating words silently  avoiding places and situations that could trigger obsessive thoughts

Symptoms of Childhood and Adolescent OCD Symptoms of childhood-onset OCD vary widely from child to child. Some common compulsions experienced by children and adolescents with OCD include:

 Compulsive washing, bathing, or showering  Ritualised behaviors in which the child needs to touch body parts or perform bodily movements in a specific order or symmetrical fashion  Specific, repeated bedtime rituals that interfere with normal sleep  Compulsive repeating of certain words or prayers to ensure that bad things don’t occur  Compulsive reassurance-seeking from parents or teachers about not having caused harm  Avoidance of situations in which they think “something bad” might occur

Some examples of how OCD symptoms may affect a child in the classroom include:  Seeking reassurance from the teacher due to self-doubt and self-criticism of his or her efforts.  Appearing inattentive because s/he is focused on an obsessive thought.  Seeming agitated because s/he wants to perform a compulsive behavior, but also wants to comply with classroom rules to stay seated.  Does not finish homework because s/he needs to cross-out, rewrite, or check and re-check work.  Has trouble arriving on time because s/he needs to get ready for school in a certain way to avoid harm.  Asks to leave the classroom to avoid certain activities, places, objects or persons.

[Reference: http://ocdla.com/ and rogershospital.org]

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Websites and EU Reports

ReachOut.com is an online youth mental health service. http://ie.reachout.com/inform-yourself/anxiety-panic-and-shyness/obsessive-compulsive-disorder/

The Child Mind Institute advice for teachers of children with OCD http://childmind.org/article/how-teachers-can-help-kids-with-ocd/

National Health Service of the UK http://www.nhs.uk/Conditions/Obsessive-compulsive-disorder

The Health Service Executive of Ireland http://www.hse.ie/eng/health/az/O/Obsessive-compulsive-disorder

US National Institute of Mental Health information on OCD https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

References

Roger’s Memorial Hospital, Managing OCD Symptoms in School: Strategies for Parents and Educators

Paige, L., (2007). Obsessive-Compulsive Disorder, Principal Leadership (High School Ed.) 8(1), 12-15

Adams, G., (2004). Identifying, Assessing, and Treating Obsessive Compulsive Disorder in School-Aged Children: The Role of School Personnel, Teaching Exceptional Children, 37(2), 46-53.

Chaturvedi, A., Murdick, N., Gartin, B., (2014). Obsessive Compulsive Disorder: What An Educator Needs To Know, Physical Disabilities: Education and Related Services, 33(2), 71-83.

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Bipolar Disorder

Classroom-based tips (focus on instructional methods)

1. Work with the parents to identify behaviour patterns that can help in handling specific situations. Teachers need to know of changes in home life and medication as these may cause a change in the pupil’s behaviour in class. Any mention by the pupil of wishing to do harm to themselves must be reported immediately to parents and mental health services.

2. Give pupils with Bipolar Disorder preferential seating near model pupils or friends, and with few nearby distractions. They may also need extra space to allow them to pace or move around. They should also be seated close by the teacher to allow for frequent checking in to help keep them on track.

3. Shorten assignments and homework to focus on quality and not quantity. Pupils who suffer from Bipolar Disorder often have co-occurring learning disabilities. Even in stable moods pupils may have difficulty paying attention, recalling information, problem-solving and with hand-eye coordination. Large assignments should be broken into smaller segments and more time given if required. Always take into consideration individual difficulties and abilities and always consider the opinion of the individual pupil.

4. Schedule the most challenging tasks at a time of the day that best allows the pupil to perform. Bipolar Disorder can cause issues with tiredness and hunger. Organising stimulating activities early in the day can help peak interest.

5. Be flexible in your approach as many tried and tested strategies may not work consistently with pupils suffering Bipolar Disorder. This is due to the frequent mood shifts that the pupil may experience. Be prepared to employ a variety of approaches as this will improve the likelihood of success.

6. Assign physical tasks and hands-on projects at times the pupil presents as manic. Having an intervention strategy like this can help employ the pupil’s energy in a constructive manner. Provide opportunities for the pupil to move around during class, work on computers and participate in interactive projects.

7. Give pupils with Bipolar Disorder permission to be late if necessary. Pupils may over sleep at times of depression. Many children experience side effects from medication, including sleepiness, thirst, frequent urination or constant hunger. These can also lead to timekeeping issues.

8. Stay in regular contact with parents on their child’s progress. This can be done via a notebook that goes back and forth to school with the pupil, or a daily chart or e-mail that records successes, progress, difficulties, and mood information. Parents can then reinforce and support the teacher and the child. Parents can also spot trends in the child’s

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illness and respond before problems reach a crisis. They should inform teachers of any unusual stressors at home, and of any changes in medication.

9. Be aware of some of the side effects that medications may cause. Medications to manage the illness can cause cognitive dulling, sleepiness, slurring of speech, memory recall difficulties and physical discomfort such as nausea and excessive thirst. There may also be times of adjustment for the pupil when medications are changed.

10. Reward positive behavior with praise and privileges but do not set up a reward system in advance. Programs that reward the pupil for positive behavior, while punishing negative behaviors set the pupil up for failure, raising stress. Punishing a pupil with bipolar disorder for a fit of anger is akin to punishing an asthmatic pupil for an asthma attack. Present to your class a lesson about differences and acceptance with the cooperation of your school psychologist or Student Support Team.

11. Establish a Safe Person/Place that the pupil can go to when feeling overwhelmed. This safe place should be a private location away from peers or other staff. Sometimes the pupil may simply need to take a walk, allowing for the time and space needed for self- composure. Make arrangements in advance that do not call undue attention to the pupil. Designate a mentor, preferably a specialised staff member, a staff member that the pupil feels comfortable with, or even a fellow or older pupil.

12. Modify tests to multiple-choice or matching rather than open-ended questions. It might also help to offer an alternative type of assignment to reduce the stress of test-taking. Keep in mind that these depend on the pupil’s abilities and difficulties.

[Reference : CABF, 2007]

School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and staff on Bipolar Disorder to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

Class Divisions / Arrangements

Make special accommodations if necessary for pupils with Bipolar Disorder at exam time in order to provide them with additional time to complete what is required. Suitable accommodations may include modified times constraints, oral testing or a scribe, use of multiple-choice questioning, testing away from other pupils or offering an alternative type of assignment to reduce the stress of testing. (Calhoun and Dickerson Mayes, 2005)

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Community

1. Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively. Student Support Teams are responsible for ensuring that systems, policies and procedures to help pupils with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (CABF 2007 & Department of Education and Skills, Ireland Guidelines)

2. Establish an effective system of communication with parents/guardians. It is critical to work closely with the pupil’s family to understand the symptoms and course of the illness. Teachers and school personnel also need to know about changes in the child’s home life or medication in order to work around them constructively at school. (CABF 2007)

3. Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and staff on Bipolar Disorder to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

Curricular Adaptations

Discipline

Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively. Student Support Teams are responsible for ensuring that systems, policies and procedures to help pupils with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (CABF 2007 & Department of Education and Skills, Ireland Guidelines)

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

1. Ensure supervision of pupils with Bipolar Disorder at all times. It may be necessary to have one-to-one supervision, not only in class but also at breaks and during trips. (CABF 2007)

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2. Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and staff on Bipolar Disorder to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

Parents / Parents’ Associations

1. Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively. Student Support Teams are responsible for ensuring that systems, policies and procedures to help pupils with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (CABF 2007 & Department of Education and Skills, Ireland Guidelines)

Safety

2. Ensure supervision of pupils with Bipolar Disorder at all times. It may be necessary to have one-to-one supervision, not only in class but also at breaks and during trips. (CABF 2007)

3. Develop a school Mental Health Policy to ensure that mental health and wellbeing are promoted. This policy should inform all relevant decisions on procedures and systems relating to pupil wellbeing. Ensure that the needs of pupils suffering from Bipolar Disorder are reflected in these policies and procedures.

4. Make Child Protection Policies and Procedures available to all teachers, staff, pupils and parents, and ensure that they are followed at all times.

Scheduling Events

Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and staff on Bipolar Disorder to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

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School Breaks

Ensure supervision of pupils with Bipolar Disorder at all times. It may be necessary to have one-to-one supervision, not only in class but also at breaks and during trips. (CABF 2007)

School Celebrations / Events / Activities

Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and staff on Bipolar Disorder to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

School Projects

Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and staff on Bipolar Disorder to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

Pupil Support

2. Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively. Student Support Teams are responsible for ensuring that systems, policies and procedures to help pupils with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (CABF 2007 & Department of Education and Skills, Ireland Guidelines)

3. Ensure supervision of pupils with Bipolar Disorder at all times. It may be necessary to have one-to-one supervision, not only in class but also at breaks and during trips. (CABF 2007)

4. Establish an effective system of communication with parents/guardians. It is critical to work closely with the pupil’s family to understand the symptoms and course of the illness. Teachers and school personnel also need to know about changes in the child’s home life or medication in order to work around them constructively at school. (CABF 2007)

5. Develop a school Mental Health Policy to ensure that mental health and wellbeing are promoted. This policy should inform all relevant decisions on procedures and systems relating

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to pupil wellbeing. Ensure that the needs of pupils suffering from Bipolar Disorder are reflected in these policies and procedures.

6. Make Child Protection Policies and Procedures available to all teachers, staff, pupils and parents, and ensure that they are followed at all times.

Teacher Professional Development

1. Train your teachers in ways of coping with the challenges presented by pupils with Bipolar Disorder and in ways of engaging with these pupils in a positive, constructive manner. Training should include nonviolent crisis prevention, focusing on verbal de-escalation techniques, to avoid crises and special educational needs. Consult with the Student Support Team for their input. (David E. McIntosh and Jeffrey S. Trotter, 2006 & CABF 2007)

2. Include mental health awareness and education campaigns as a regular feature of school life, utilising national campaigns and the expertise of outside agencies. Educate peers and staff on Bipolar Disorder to help destigmatise and encourage understanding of the condition, while facilitating the needs of the child to be met.

Timetabling

2. Make special accommodations if necessary for pupils with Bipolar Disorder at exam time in order to provide them with additional time to complete what is required. Suitable accommodations may include modified times constraints, oral testing or a scribe, use of multiple-choice questioning, testing away from other pupils or offering an alternative type of assignment to reduce the stress of testing. (Calhoun and Dickerson Mayes, 2005)

Supportive Literature

Bipolar disorder is a biological brain disorder causing severe fluctuations in mood, energy, thinking and behavior. It was previously known as manic depression, as it causes moods to shift between mania and depression.

It affects men and women equally. It can occur at any age but is usually seen in late teens to early adulthood, and affects people from all walks of life.

The exact cause of bipolar disorder is not known; however, research has indicated that genetic, biological and environmental factors all seem to play a part.

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Children, whose symptoms present differently than those of adults, can experience severe and sudden mood changes many times a day. Symptoms of mania and depression can also occur simultaneously.

Young people with this disorder are frequently anxious and have very low frustration tolerance.

Depressed children may not appear to be sad. Instead symptoms that they present with may include:  being withdrawn  not wanting to play  needing more sleep than usual  displaying chronic irritability  crying for no obvious reason  Children may also talk of wishing to die and may need to be hospitalised to prevent harm to themselves or others.

Symptoms of mania in a child may include:  elation  grandiose thinking  racing thoughts  pressured speech  hypersexuality  decreased need for sleep

Since hyperactivity can be seen in both bipolar disorder and ADHD, a growing number of researchers believe that many children who are diagnosed with “severe ADHD” may actually have undiagnosed bipolar disorder.

Bipolar disorder is a chronic, lifetime condition that can be managed, but not cured, with medication and lifestyle changes. Because the symptoms wax and wane on their own, and children’s bodies change as they grow, managing medication to ensure continued stability is a complex and ongoing challenge.

Other commonly seen behaviours in children with Bipolar Disorder may include:

 Rapidly changing moods lasting a few minutes to a few days  explosive, lengthy, and often destructive rages  separation anxiety  defiance of authority  hyperactivity, agitation and distractibility  sleeping too little or too much  night terrors  strong and frequent cravings, often for carbohydrates and sweets  excessive involvement in multiple projects and activities  impaired judgment, impulsivity, racing thoughts and pressure to keep talking  dare devil behaviours  inappropriate or precocious sexual behaviour  delusions and hallucinations  grandiose belief in personal abilities that defy the laws of logic

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 knows more than the teacher or principal  extreme irritability

Medications to manage the illness can cause cognitive dulling, sleepiness, slurring of speech, memory recall difficulties and physical discomfort such as nausea and excessive thirst.

Source: Educating the Child with Bipolar Disorder (CABF, 2007)

Websites and EU Reports

Educating the Child with Bipolar Disorder, CABF 2007 https://www.mysciencework.com/publication/download/8a6c4ee4e80941d27444c6e6332feddc/6e 668b61617fe2e48892afd81763d88b

Bipolar Disorder in Children and Teens, National Institute of Mental Health https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens/index.shtml

ReachOut.com is an online youth mental health service. http://ie.reachout.com/inform-yourself/depression/bipolar-disorder/

Aware: Bipolar Disorder https://www.aware.ie/help/information/literature/bipolar-disorder/

References

Calhoun, S. and Dickerson Mayes, S., (2005) Processing Speed In Children With Clinical Disorders, Psychology in the Schools, 42(4), 333-343

Mcintosh, D. and Trotter, J., (2006). Early Onset Bipolar Spectrum Disorder: Psychopharmacological, Psychological, And Educational Management, Psychology in the Schools, 43(4), 451-460

Schlozman, S., (2002). An Explosive Debate: The Bipolar Child, Educational Leadership, 60(3), 89-90

Noggle, C., (2009). Atypical And Typical Antipsychotics In The Schools, Psychology in the Schools, 46(9), 869-884,

Useful Documents Behaviour Support Classroom: Best Practice Guidelines National Behaviour Support Service

Student Support Teams in Post-Primary Schools: A Guide to Establishing a Team or Reviewing and Existing Team Department of Education and Skills & National Educational Psychological Service

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Schizophrenia

Classroom-based tips (focus on instructional methods)

1. Accommodations Use accommodations for pupils with schizophrenia, that is, use alternate ways of teaching and providing instruction. Pupils with schizophrenia often have problems with comprehension and memory recall. Graphic organisers are a visual map of ideas or concepts that help a pupil comprehend complex issues. They are worksheets used to organise thoughts. They help a pupil to comprehend what they are reading. Pupils are first taught how to use the graphic organiser, and then practice using it during study or lessons. The pupil can then use these in later assignments to help with comprehension.

Provide alternative modified ways of learning. A modification is a change to what the pupil is expected to learn and how they will be tested and graded. If a pupil is placed in a regular classroom, there will be little, if any, modifications. The pupil will learn what other pupils are learning. A modification has more value in a special education classroom. Pupils who are schizophrenic will have modifications which include working on a lower grade level book. A pupil who takes a different, easier standardised test, would also be taking advantage of a modification.

2. Environment Stress is a factor that can worsen the schizophrenic pupil's chances for success. Reduce stress from the environment, for example by allowing the pupil to have a quiet secluded place to complete assignments and tests. Consider seating the pupil near the door to allow the pupil to leave the class more easily for needed breaks. Assign a classmate as a volunteer assistant. [Reference: http://www.articlesforeducators.com/]

Have clear rules and consequences to help to give the pupil a highly structured learning environment. Another problem that pupils with schizophrenia might face is selective attention. Ways to increase selective attention include seating a pupil in a desk free of distractions, and breaking down longer assignments into shorter ones. Social problems such as difficulties developing and maintaining a friendship, can often be a challenge for pupils with schizophrenia. Offer help by engaging in frequent interactions to gain trust, and facilitating the pupil in practicing how friends interact with one another (Riester, 1986).

3. Communication Reduce stress by going slowly when introducing new situations. The pupil may be reluctant or unable to ask questions so be proactive in your communication.  Don’t wait for the pupil to ask for help  Check how the pupil is doing  Ask the pupil for his/her opinion  Check the pupil understands as; s/he may not be unable to ask questions

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4. Goal Setting and Engagement Help pupils set realistic goals for academic achievement and extra-curricular activities. Obtaining educational and cognitive testing can be helpful in determining if the pupil has specific strengths that can be capitalised upon to enhance learning.

[Reference: http://www.prairie-care.com/files/5913/3173/1960/schizophrenia.pdf]

5. Class Displays

Put up schedules in the class and keep the classroom organised as pupils with schizophrenia might have poor organisational skills and not be capable of setting appropriate programs and schedules. (Riester 1986)

School-based practical tips (focus on instructional methods)

Curriculum Adaptations

1. Create an Individual Educational Plan (IEP) specifically for each pupil with a disability, including pupils with schizophrenia. Arrange a meeting with all the pupil’s teachers, the school psychologist, therapists, guidance counsellor(s), parents, and the pupil if s/he is of an appropriate age. At this meeting, create a plan for the pupil including any accommodations or modifications that will help the pupil’s learning. Some of these changes might include using graphic organisers, mnemonic devices or using a different text book. Parents / Parents’ Associations

2. Establish regular meetings with the family for feedback on health and progress. Because the disorder is so complex and often debilitating, it will be necessary to have team meetings with the family, with mental health providers, and with the medical professionals who are treating the pupil to discuss the various aspects of the child’s education and development. These individuals can provide the information you will need to understand the pupil’s behaviors, the effects of the psychotropic medication, and how to develop a suitable learning environment.

From “Schizophrenia: Youth’s Greatest Disabler,” produced by the British Columbia Schizophrenia Society, available at http://mentalhealth.com/home/dx/schizophrenia.html

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Pupil Support

From “Schizophrenia: Youth’s Greatest Disabler,” produced by the British Columbia Schizophrenia Society, available at http://mentalhealth.com/home/dx/schizophrenia.html Teacher Professional Development

Establish regular meetings with the family for feedback on health and progress. Because the disorder is so complex and often debilitating, it will be necessary to have team meetings with the family, with mental health providers, and with the medical professionals who are treating the pupil to discuss the various aspects of the child’s education and development. These individuals can provide the information you will need to understand the pupil’s behaviors, the effects of the psychotropic medication, and how to develop a suitable learning environment.

From “Schizophrenia: Youth’s Greatest Disabler,” produced by the British Columbia Schizophrenia Society, available at http://mentalhealth.com/home/dx/schizophrenia.html

Supportive Literature

In Text reference

Reister, A. E., & Rash, J. D. (1986). Teaching the schizophrenic child. The Pointer, 30(4), 14 – 20.

As with many disorders, disabilities, and illnesses there can be a variety of associated problems and learning difficulties. Many schizophrenics can have learning disabilities in connection with their mental disorders. Addressing accommodations and modifications for individuals with schizophrenia is as individual as each person. There are many accommodations that can be used to make the schizophrenic pupil's academic experience a positive one. http://www.articlesforeducators.com/

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Schizophrenia is the name given to a group of psychotic disorders associated with significant disturbances in thought, emotion and behaviour. A person must experience these disturbances for a significant period of time to be classified as having schizophrenia, as there are other psychotic disorders which have similar symptoms. A person with untreated schizophrenia can experience sequences of ideas that do not logically relate to one another, disorganised speech, a faulty perception of reality, and unusual motor activity or body movements. Someone who is experiencing untreated schizophrenia will often withdraw from the people around them into what most people would consider a land of fantasy. Schizophrenia does not mean someone has more than one personality or a “split” personality http://ie.reachout.com/

Schizophrenia can cause a person to experience difficulty with activities of daily living as well as possible delusions, hallucinations, and paranoia. Schizophrenic individuals typically demonstrate concrete thought processing and appreciate structure and routines. http://www.articlesforeducators.com/

The symptoms most commonly associated with the disorder are split into two categories:

Psychotic Symptoms

- Hallucinations involve the five senses and affect the way in which a person interprets the world around them. A person with schizophrenia may see, hear, taste, smell and feel things that simply aren't there. These experiences seem so real that they have difficulty believing otherwise.

- Delusions are strange or unusual beliefs that are not based on reality and often contradict real-life evidence. For example, someone with schizophrenia may believe that the reason they're hearing voices nobody else can is that some manner of secret agent is listening to all of their conversations. Another form of delusion could be the belief that someone on a TV show was sending messages to them and them alone, or that passing cars on the street contained hidden messages for them. Delusions can begin suddenly, or may develop over a period of weeks or months.

- Disorganised thinking: Someone who is going through a schizophrenic episode may find it difficult to keep track of their own thoughts. Reading a newspaper article or watching something on TV could be difficult because it is difficult to concentrate properly; thoughts and memories might be described as being misty or hazy.

- Disorganised behaviour: Unpredictable behaviour and appearance can also be a symptom of schizophrenia, such as suddenly beginning to dress oddly or behave in a completely new way. People with schizophrenia might become agitated, shouting and swearing for no reason. If they believe someone else is controlling their thoughts, they might feel as though they are not in control of their own body.

Negative Symptoms

 Losing interest and motivation in life and activities. Someone with schizophrenia may lose interest in/give up on relationships and sex for example.  A lack of concentration  Not wanting to leave the house

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 Changes in sleeping patterns  Being less likely to initiate conversations, feeling uncomfortable with people, or feeling that there is nothing to say

Reference: http://spunout.ie/

Websites and EU Reports http://faculty.frostburg.edu/mbradley/EC/childhoodschizophrenia.html http://spunout.ie/ http://www.articlesforeducators.com/ http://ie.reachout.com/ http://www.schizophrenianet.eu/

The State of Mental Health in the European Union, Directorate General for Health and Consumer Protection Directorate C2 – Health Information, European Commission. Retrieved at http://europa.eu.int/comm/health/ph_information/information_en.htm

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Self Harm

Classroom-based tips (focus on instructional methods)

1. Educate yourself on the signs and symptoms of Self-Harming. As a teacher you are strategically placed to recognise potential problems. See Supportive Literature for more information.

2. Avoid responding to self-harming pupils with disgust, anxiety, or fear. Do not lecture them about the dangers of this behavior, play detective and ask to see their cuts or burn marks, or interrogate and further invalidate them. Instead, strive to understand the meaning of this behaviour with the intention of supporting the self-harming pupil. (Selekman, M., 2010)

If you have concerns about a pupil, keep clear and concise accounts of the incidents and behaviours that have led you become concerned. You should not try to diagnose conditions, but rather state facts based on observations you have made. Forward this information to the Student Support Team in the school.

3. Be mindful not to label self-harming behaviour as “bad behaviour” and consequentially punish the child for it. For example, a pupil who bangs her head on the desk or pulls his hair out could be displaying a self-harming response to stress or frustration. Give help and support rather than punishment. (Simm, R., Roen, K., Daiches A., 2010)

Remember that punishing the pupil for this behaviour will not address the issues that have led up to the incident of self-harming. Report such incidents to the Student Support Team.

4. Promote a healthy self-concept with pupils and work to equip young people with the confidence and skills necessary to handle problematic situations. If self-harm is connected with low self-esteem, lack of confidence and high levels of anxiety, teaching pupils problem solving skills and other social skills can help as a preventative measure.

5. Be mindful that the stress of examinations may be a contributory factor in anticipated and actual instances of self-harm.

[Reference: Best, R., 2006]

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School-based practical tips (focus on instructional methods)

Class Divisions

Provide extra support for self-harming pupils at exam times. The stress of examinations may be a contributory factor in anticipated and actual instances of self-harm. (Best, R., 2010)

Community

Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively. Student Support Teams are responsible for ensuring that systems, policies and procedures to help pupils with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (Educator Toolkit, NEDA, 2016 & Department of Education and Skills, Ireland Guidelines)

Curricular Adaptations

Ensure a robust social, physical and health education is delivered as part of the school curriculum. As in other areas of personal and social education – such as sex and relationship education, health education, bereavement and child protection – prevention, wherever possible, is better than cure. If self-harm is connected with low self-esteem, lack of self- confidence and high levels of anxiety, as a school ask; What we can do to promote a healthy self-concept and equip young people with the confidence and skills necessary to handle problematic situations without experiencing overwhelming levels of anxiety? (Best, R., 2010)

Discipline

Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively. Student Support Teams are responsible for ensuring that systems, policies and procedures to help pupils with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (Educator Toolkit, NEDA, 2016 & Department of Education and Skills, Ireland Guidelines)

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Other (Bring Psychology Expertise Onto the Team)

Provide teachers and other ‘front-line’ workers with the kind of systematic clinical supervision built into the professional structures within which counsellors, psychotherapists and psychiatric social workers are expected to operate. (Best, R., 2010)

Provide training and support to enhance teachers’ and staff’s abilities to respond productively to the needs of pupils who self-harm, and to help them with the variety of difficult emotional responses they may experience from working with children who self-harm. Additionally consider the role of psychologists to work within the whole school system to provide training in relation to mental health issues in children, and supervision to staff working closely with children with mental health issues such as self-harming. Psychologists on the team can enhance the quality of the response which staff give and be a source of emotional support. (Simm, R., Roen, K., Daiches A., 2010)

Parents / Parents’ Associations

Establish a Student Support Team to aid in ensuring that pupils with support needs are able to continue to access a full education, and to assist staff to manage those pupils effectively. Student Support Teams are responsible for ensuring that systems, policies and procedures to help pupils with support needs are in place. Ensure that membership of the Student Support Team includes school management, school counsellor, special needs coordinators, year heads, home-school liaison personnel and teachers with specialist roles. Invite experts from external agencies and parents whenever necessary. (Educator Toolkit, NEDA, 2016 & Department of Education and Skills, Ireland Guidelines)

Safety

2. Develop a school Mental Health Policy to ensure that mental health and wellbeing are promoted. This policy should inform all relevant decisions on procedures and systems relating to pupil wellbeing. Ensure that the needs of the pupil suffering from Self-Harm are reflected in these policies and procedures.

3. Establish a Safe Person and Safe Place in the school for times when the pupil feels overwhelmed. Ideally this person should be a school counsellor or another suitably qualified person. Choose a location that is adequately private to be away from the unnecessary attention of other staff and pupils.

4. Develop Policies and Procedures for the use of this space and inform all relevant stakeholders.

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Scheduling Events

Ensure a robust social, physical and health education is delivered as part of the school curriculum. As in other areas of personal and social education – such as sex and relationship education, health education, bereavement and child protection – prevention, wherever possible, is better than cure. If self-harm is connected with low self-esteem, lack of self- confidence and high levels of anxiety, as a school ask; What we can do to promote a healthy self-concept and equip young people with the confidence and skills necessary to handle problematic situations without experiencing overwhelming levels of anxiety? (Best, R., 2010)

Pupil Support

3. Ensure a robust social, physical and health education is delivered as part of the school curriculum. As in other areas of personal and social education – such as sex and relationship education, health education, bereavement and child protection – prevention, wherever possible, is better than cure. If self-harm is connected with low self-esteem, lack of self- confidence and high levels of anxiety, as a school ask; What we can do to promote a healthy self-concept and equip young people with the confidence and skills necessary to handle problematic situations without experiencing overwhelming levels of anxiety? (Best, R., 2010)

4. Establish a Safe Person and Safe Place in the school for times when the pupil feels overwhelmed. Ideally this person should be a school counsellor or another suitably qualified person. Choose a location that is adequately private to be away from the unnecessary attention of other staff and pupils.

5. Develop Policies and Procedures for the use of this space and inform all relevant stakeholders.

Teacher Professional Development

1. Provide training and education of school personnel in the etiology and recognition of self- harm and the many forms it takes. Combine these efforts with training in basic counselling

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skills, and a clear induction into the established policy and procedures to be followed within the school. [Reference: Best, R., 2006]

2. Provide teachers and other ‘front-line’ workers with the kind of systematic clinical supervision built into the professional structures within which counsellors, psychotherapists and psychiatric social workers are expected to operate. (Best, R., 2010) Provide training and support to enhance teachers’ and staff’s abilities to respond productively to the needs of pupils who self-harm, and to help them with the variety of difficult emotional responses they may experience from working with children who self-harm. Additionally consider the role of psychologists to work within the whole school system to provide training in relation to mental health issues in children, and supervision to staff working closely with children with mental health issues such as self-harming. Psychologists on the team can enhance the quality of the response which staff give and be a source of emotional support. (Simm, R., Roen, K., Daiches A., 2010)

Timetabling

Ensure a robust social, physical and health education is delivered as part of the school curriculum. As in other areas of personal and social education – such as sex and relationship education, health education, bereavement and child protection – prevention, wherever possible, is better than cure. If self-harm is connected with low self-esteem, lack of self- confidence and high levels of anxiety, as a school ask; What we can do to promote a healthy self-concept and equip young people with the confidence and skills necessary to handle problematic situations without experiencing overwhelming levels of anxiety? (Best, R., 2010)

Supportive Literature

Pupil self-harming is one of the most perplexing and challenging behaviors that administrators, teachers, nurses, and counseling staff encounter in their schools.

Mental health and health-care professionals have typically viewed such behavior as a symptom of an underlying psychological or personality disorder, as a possible suicidal gesture suggesting the need for psychiatric hospitalisation or as a symptom of post-traumatic stress disorder caused by sexual or physical abuse.

However, both research and practice-based wisdom indicate that the majority of self-harming adolescents do not meet the criteria for diagnosable psychological or personality disorders, have never had suicidal thoughts or attempted to end their lives, and have never experienced sexual or physical abuse. Most self-harming adolescents use the behavior as a coping strategy to get immediate relief from emotional distress.

(Selekman, M., 2010)

Self-harm is when someone deliberately hurts or injures him or herself. This can take a number of forms, including:

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 Cutting  Taking overdoses of medicines or tablets  Punching oneself  Throwing one’s body against something  Scratching, picking or tearing at one’s skin causing sores or scarring  Pulling out hair or eyelashes  Burning oneself  Inhaling or sniffing harmful substances  Driving dangerously  Excessive use and abuse of alcohol and/or other drugs

Some young people self-harm on a regular basis while others do it just once or a few times. For some people it is part of coping with a specific problem and they stop once the problem is solved. Other people self-harm for years whenever certain kinds of pressures or feelings arise.

[Reference: Deliberate Self-Harm: Information for Young People, HSE]

Self-harm is the fourth most common concern that children and young people contact Childline in the UK about. There were over 19,000 Childline counselling sessions about self-harm in 2014/15.

The exact reasons why children and young people decide to hurt themselves aren't always easy to work out. In fact, they might not even know exactly why they do it.

There are links between depression and self-harm. Quite often a child or young person who is self- harming is being bullied, under too much pressure to do well at school, being emotionally abused, grieving or having relationship problems with family or friends.

The feelings that these issues bring up can include:

 low self-esteem and low confidence  loneliness  sadness  anger  numbness  lack of control over their lives

Often, the physical pain of self-harm might feel easier to deal with than the emotional pain that's behind it. It can also make a young person feel they're in control of at least one part of their lives.

Sometimes it can also be a way for them to punish themselves for something they've done or have been accused of doing.

Young people will go to great lengths to cover self-harm scars and injuries. If you do spot them they might be explained away as accidents.

Young people who self-harm are also very likely to keep themselves covered up in long-sleeved clothes even when it's really hot.

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The emotional signs are harder to spot and don't necessarily mean that a young person is self-harming. But if you see any of these as well as any of the physical signs then there may be cause for concern. Emotional signs include:

 depression, tearfulness and low motivation  becoming withdrawn and isolated, for example wanting to be alone in their bedroom for long periods  unusual eating habits; sudden weight loss or gain  low self-esteem and self-blame  drinking or taking drugs

[Reference: Self-Harm, NSPCC]

Websites and EU Reports

ReachOut.com is an online youth mental health service. http://ie.reachout.com/inform-yourself/suicide-and-self-harm/deliberate-self-harm/#

Irish Society of Prevention of Cruelty to Children http://www.ispcc.ie/advice/advice/self-harm/8571

National Society of Prevention of Cruelty to Children, UK https://www.nspcc.org.uk/preventing-abuse/keeping-children-safe/self-harm/

Deliberate Self-Harm: Information for Young People, Health Service Executive, Ireland

Selekman, M., (2010). Helping Self-Harming Students, Educational Leadership, 67(4), 48-53

Best, R., (2006). Deliberate self-harm in adolescence: a challenge for schools, British Journal of Guidance & Counselling, 34(2), 161-175

Simm, R., Roen, K., Daiches, A., (2010). Primary school children and self harm: the emotional impact upon education professionals, and their understandings of why children self harm and how it is managed, Oxford Review of Education, 36(6), 677-692

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Stress

Classroom-based tips (focus on instructional methods)

1. Make accommodations When working with pupils with stress, consider making accommodations in the following areas:

Homework – Establish a time limit for homework and reasonable homework content as the stressed pupil can be overwhelmed by homework load and worry that homework is not of required standard. Consider asking the pupil about feelings and thoughts regarding the quantity and quality of homework. Sometimes reducing homework might create more stress, depending on the pupil. Testing – consider exam settings; is the testing environment quiet and distraction free? The pupil may be better served sitting exams separately to other pupils. Is the pupil aware that testing will occur and prepared? Consider the use of multiple choice testing, word banks or cloze testing as the pupil may become overwhelmed and struggle to recall rote learning. Always be flexible, testing depends on the abilities of and difficulties experienced by the pupil. Assignments – Consider breaking assignments down into individual steps and introducing intermediate deadlines with continuous progress reviews. Always be flexible according to the abilities and difficulties experienced by the pupil. Presentations – Consider allowing the pupil to present only to the teacher and not to a large class group or perhaps use audio recording techniques. Gradually help the pupil to present to a bigger audience when you think s/he is ready. [Reference: http://www.heysigmund.com/anxious-kids-at-school-how-to-help-them- soar/http://www.worrywisekids.org/node/40]

2. Classroom Environment Monitor the Physical Surroundings - Avoid clutter, including too much visual stimulation in the form of bright colours and other visual distractions. Do have some decoration, and displaying pupil work is a must, but avoid having your classroom space look too “busy”.

Allow for Movement and Fidgeting - Sitting still simply is not an option for some pupils; for many others it is doable, but at a high cost in terms of attention and focus. Some teachers have had great success experimenting with exercise balls instead of seats, disc cushions or simple “fidget toys”.

Reduce Extraneous Noise Some noise is good, when it is productive, and rhythm exercises are great for development. But some pupils shut down in the presence of “disorganised” noise. Reduce the number of hard reverberating surfaces where possible, and keep the music area to one corner of the classroom, with a simple divider where possible, so that those not participating can focus on other tasks.

Ensure the stressed pupil is seated away from dominant classmates so as to fully engage in the class. Consider seating the stressed pupil with a classmate s/he feels comfortable and confident

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with. Consider talking to the whole class about stress and its consequences with the cooperation of your school counsellor/psychologist.

3. Build in Time for Transitions Bulding in time for transitions is something most teachers are aware of, and do intuitively. Remember that sometimes when we try to hurry from one activity to the next pupils who have difficulty transitioning from a “lighter” activity to something requiring more focus, or vice versa, can get lost in the shuffle; therefore it is important to allow time and perhaps provide a little guidance during transitions.

4. Make Your Pupils Aware of Their Own Mind-set Young pupils will always need some guidance and help to self-regulate. Help your pupils to be aware of how they are feeling. Meanwhile as a teacher remain conscious of the effect you and your classroom environment are having on your pupils. In turn these steps will reduce classroom management issues, and improve learning.

[Reference: http://www.teachthought.com/]

5. Be Proactive Keep in mind that a pupil suffering from stress may be very reluctant to ask questions or contribute in class for fear of unwanted attention; this does not mean that they do not have something to say and it is therefore very important that teachers:  Do not wait for the pupil to ask for help  Check how the pupil is doing  Ask the pupil for her opinion  Check the pupil understands as s/he may be unable to ask questions

[References: http://www.heysigmund.com/anxious-kids-at-school-how-to-help-them-soar/ http://www.worrywisekids.org/node/40]

School-based practical tips (focus on instructional methods)

Announcement / Sign at School

1. Promotion Actively promote Mental Health Awareness Campaigns, and programmes in conjunction with local and national campaigns across your whole school.

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2. Change in Routine Let the stressed pupil and their family know of any planned change to routine, such as time tabling changes or staff changes.

Class Divisions / Arrangements

Change in Routine Let the stressed pupil and their family know of any planned change to routine, such as time tabling changes or staff changes.

Community

1. Support Services Ensure any pupil suffering from stress is offered the support of existing services in the school such as those of the school psychologist/counsellor. When applicable make the correct referral to a psychologist or outside support services/agencies. Ensure written parental consent where necessary.

2. Promotion Actively promote Mental Health Awareness Campaigns, and programmes in conjunction with local and national campaigns across your whole school.

Curricular Adaptations

Exam Management / Accommodations Develop modifications and accommodations to respond to the pupil's fluctuations in mood, ability to concentrate, or side effects of medication. Assign an individual to serve as a primary contact and coordinate any necessary interventions. A pupil suffering from stress may be better served sitting exams separately to other pupils. Check in with the pupil to ensure s/he is aware that testing will occur and is prepared.

Homework

Parents / Parents’ Associations

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2. Home/School Communication Develop an effective home–school communication system to share information on the pupil's academic, social, and emotional behaviour, and any developments concerning medication or side effects.

Safety

Mental health Policy, Anti-Bullying Policy Healthy Eating Policy, Develop and implement health policies, which can be of great benefit to an anxious pupil. Healthy eating has been shown to reduce levels of anxiety and stress. Having a clearly defined school Mental Health Policy will provide your school with clear guidelines when dealing with mental health issues. A stringent Anti-Bullying policy may reduce the possibility of a stressed pupil becoming the victim of bullying.

Scheduling Events

1. Promotion Actively promote Mental Health Awareness Campaigns, and programmes in conjunction with local and national campaigns across your whole school.

2. Change in Routine Let the stressed pupil and their family know of any planned change to routine, such as time tabling changes or staff changes.

School Celebrations / Events / Activities

Promotion Actively promote Mental Health Awareness Campaigns, and programmes in conjunction with local and national campaigns across your whole school.

Pupil Support

2. Missed Time Management Ensure a pupil suffering from stress is furnished with any subject material covered when absent due to illness. Ensure the pupil is given adequate time to catch up on any work missed so as to help in lessening the feelings of stress.

3. Time Out Consider allowing the pupil the opportunity to take time out from a stressful class environment by getting a drink of water or having a short walk; a pre-agreed signal can be used. Consider the use of a ‘safe person’ such as the school counsellor or year head for the stressed child to engage

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with if feelings of stress become overwhelming. Consider the use of relaxation exercises during time outs that may help the pupil destress.

Timetabling

Change in Routine Let the stressed pupil and their family know of any planned change to routine, such as time tabling changes or staff changes.

Supportive Literature

Health - “A complete state of physical, mental and social well-being, not just the absence of disease or infirmity.” - World Health Organisation “Mental Health is a balance between all aspects of life – social, physical, spiritual and emotional. It impacts on how we manage our surroundings and make choices in our lives – clearly it is an integral part of our overall health. Mental Health is far more than the absence of mental illness and has to do with many aspects of our lives including: How we feel about ourselves, how we feel about others, how we are able to meet the demands of life.” - Mental Health Ireland Stress is a state of mental tension and worry caused by problems in your life, work, etc. Stress causes strong feelings of worry or anxiety. Stress in pupils may be caused by:

• Exams • Problems at school or at work • Sexual, physical or emotional abuse • Relationships • New responsibilities • Moving to a new place • A traumatic event – such as the death of a loved one • New or chronic illness or disability • Peer pressure or being bullied • Unrealistic expectations from themselves, family, friends or culture • Taking on too many activities

Signs of stress in pupils

Too much stress can impact negatively on young people’s health both emotionally and physically. Emotional signs to look out for are:

 anger or irritability  anxiety  avoiding other people  crying  moodiness – feeling frustrated with things that normally are not a concern  low self-esteem or lack of confidence  depression or sadness

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Physical signs to look out for are:

 upset stomach, diarrhoea or indigestion  headache  backache  inability to sleep  eating too much or too little  raised heart-rate  smoking [Reference: http://ie.reachout.com/]

Websites and EU Reports

Useful Websites

International Association of Youth Mental Health www.iaymh.org World Health Organisation www.who.int Institute of Child Education and psychology www.icepe.eu

Relevant Articles

Changing attitudes: supporting teachers in effectively including students with emotional and behavioural difficulties in mainstream education, Geraldine Scanlona and Yvonne Barnes-Holmes, School of Education Studies, Dublin City University, Glasnevin, Dublin 11, Ireland; bDepartment of Psychology, The National University of Ireland, Maynooth, Co. Kildare, Ireland http://dx.doi.org/10.1080/13632752.2013.769710

Comorbidity of anxiety and depression in children and adolescents. Brady, Erika U.; Kendall, Philip C. Psychological Bulletin, Vol 111(2), Mar 1992, 244-255. http://dx.doi.org/10.1037/0033-2909.111.2.244

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Roma Pupils, Travelling Community

Classroom-based tips (focus on instructional methods)

1. Develop and implement an antiracist/anti-bullying policy, which addresses incidents of racism or bullying towards pupils because of any aspect of their identities, such as socioeconomic or cultural background, ethnicity, accent, language, appearance, legal status in the country of arrival, sexual orientation, gender identity or religion.

2. Support Roma pupils to become integrated in your class by showing interest in their culture and language, without putting them under the spotlight and emphasising their differences. Try to find out as much as possible about the individual pupil’s strengths, interests and linguistic capabilities; always keep in mind that individuals within groups have differences in all these aspects of their identities (www.natt.org.uk). Give new pupils any helpful induction information about the class to help them feel as comfortable as possible in the new classroom environment.

3. Build a working relationship with the families of the Roma pupils in your class by talking openly to parents about your class expectations in a way that demonstrates the shared concern for the welfare and progress of each pupil. An induction DVD and/or welcome packs in the appropriate language will help explain things to families who don’t understand your country’s language and who may have literacy issues. [Reference: www.natt.org.uk]

4. Find the new pupil in your class a 'buddy' and if possible a same language speaker to help them with the daily tasks and communication within the classroom. [Reference: www.natt.org.uk]

5. Maximise beneficial interracial contact by mixing Roma pupils together in diverse groups in daily activities and tasks, in and out of the classroom. [Reference: https://www.unicef.org/ceecis/ROMA_PAPER_FINAL_LAST.pdf]

6. Sit new Roma pupils joining your class close to you and provide basic classroom material as a motivation to participate in the lesson.

7. Prepare some PowerPoint presentations or other type of visual prompts, about school regulations or social norms, that will give additional support as needed to Roma pupils when they are faced with difficult social situations. [Reference: www.natt.org.uk]

8. Organise regular targeted interventions in small groups (ideally 30 minutes every day) for focussed language work. This can improve the language skills of Roma pupils and strengthen their confidence by feeling cared for and appreciated by the teacher. [Reference: www.natt.org.uk]

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9. Differentiate the lesson to suit the pace of the Roma pupils based on their language skills. For example, you might provide appropriate conditions for homework during school hours (e.g. during religious class), which can be very helpful if it is not possible for the pupil to complete work at home due to limited space or ICT access.

School-based practical tips (focus on instructional methods)

Community

1. Organise an induction meeting with all the parents at the beginning of the school year, to highlight the expectations of the school. Many Roma children and families may be unfamiliar with the National Curriculum requirements, or with the subjects taught, and unclear as to what is expected of them. Setting out the school’s expectations and regulations (school uniform, regular attendance, homework) from the outset establishes a good relationship between the school and all the families, including newcomers and Roma families. [Reference: www.natt.org.uk]

2. Employ Roma mediators in schools to act as support for Roma pupils and as liaisons between the Roma community and the school administration and teachers.

[Reference: https://www.unicef.org/ceecis/ROMA_PAPER_FINAL_LAST.pdf]

3. Arrange regular school meetings with specialists from the Educational Psychology Service and the Social Welfare Services (www.moec.gov.cy) who will provide special support and attention not only to Roma pupils, but to their teachers as well. This will help to bridge any differences between the local community and the new Roma population joining the community or the school.

4. Arrange home visits to Roma families to establish trusting relationships. Contact parents directly or with the help of a relevant local authority/social service. Build these relationships by demonstrating a commitment to collaboration, and co-operatively working with colleagues and parents.

[Reference: www.natt.org.uk]

Curricular Adaptations

1. Employ bilingual teachers who will act as mediators/interpreters facilitating and supporting the communication between teachers, pupils and parents (Symeou et al, 2009). These teachers can be also trained to act as Roma Teaching Assistants in the classroom (RTAs) . The pedagogical approach in these classes should be modified to be ‘child-centred’ and multi- lingual. [Reference: https://www.unicef.org/ceecis/ROMA_PAPER_FINAL_LAST.pdf]

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2. Organise extra support lessons or extra-curricular activities to be offered to Roma pupils in the afternoon. Dance and theatre programmes can improve pupils’ behaviour and self- discipline.

[Reference: http://ec.europa.eu/justice/discrimination/roma/eu-framework/index_en.htm]

3. Organise summer schools for Roma teachers that will include training in Romani language, history and culture. These summer schools raise teachers’ level of competency and modify their pedagogy to be culturally sensitive and adapted to the specific needs of Roma pupils.

[Reference: https://www.unicef.org/ceecis/ROMA_PAPER_FINAL_LAST.pdf]

5. Dispense funding for the purchase of books and materials to help with language teaching, depending on the country and context, in order to support the inclusion of Roma children (www.moec.gov.cy).

Discipline

1. Develop and implement an antiracist/antibullying policy, which addresses incidents of racism or bullying towards pupils because of any aspect of their identities, such as socioeconomic or cultural background, ethnicity, accent, language, appearance, legal status in the country of arrival, sexual orientation, gender identity or religion.

2. Organise extra support lessons or extra-curricular activities to be offered to Roma pupils in the afternoon. Dance and theatre programmes can improve pupils’ behaviour and self- discipline.

[Reference: http://ec.europa.eu/justice/discrimination/roma/eu-framework/index_en.htm]

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

1. Celebrate the International Romani Day by organising age-appropriate and playful activities during school hours, for all the pupils in your school to participate. Arrange cultural visits where Roma pupils can act as guides for the rest of the children, or host guest speakers or performers who can present Romani culture to the whole school community.Avoid, however, putting under the spotlight pupils or their families if they do not wish to be involved, as such events, despite the best of intentions, may often exacerbate stereotypes and prejudices.

[Reference: (http://ec.europa.eu/justice/discrimination/roma/eu-framework/index_en.htm)]

Food: Canteen / Visits / Camps / Trips

Organise school fairs, music and food festivals in order for the school community to come closer together. Ensure that in such fairs, all pupils and families are involved, avoiding focusing on one cuisine or one cultural group, as such approaches might lead to essentialist stereotyping of specific groups or individuals within the school, especially the Roma. Promote multi-cultural and inclusive values in your programming of school cultural events.

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Homework

[Reference: www.natt.org.uk]

2. Organise after-school programmes that will help Roma pupils with homework and other issues.

[Reference: https://www.unicef.org/ceecis/ROMA_PAPER_FINAL_LAST.pdf]

Parents/Parent Associations

[Reference: www.natt.org.uk]

2. Arrange home visits to Roma families to establish trusting relationships. Contact parents directly or with the help of a relevant local authority/social service. Build these relationships by demonstrating a commitment to collaboration, and co-operatively working with colleagues and parents.

[Reference: www.natt.org.uk]

Safety

Develop and implement an antiracist/antibullying policy, which addresses incidents of racism or bullying towards pupils because of any aspect of their identities, such as socioeconomic or cultural background, ethnicity, accent, language, appearance, legal status in the country of arrival, sexual orientation, gender identity or religion.

Scheduling Events

Celebrate the International Romani Day by organising age-appropriate and playful activities during school hours, for all the pupils in your school to participate. Arrange cultural visits where Roma pupils can act as guides for the rest of the children, or host guest speakers or

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performers who can present Romani culture to the whole school community.Avoid, however, putting under the spotlight pupils or their families if they do not wish to be involved, as such events, despite the best of intentions, may often exacerbate stereotypes and prejudices.

[Reference: (http://ec.europa.eu/justice/discrimination/roma/eu-framework/index_en.htm)]

School Celebrations / Events / Activities

School Projects

1. Organise extra support lessons or extra-curricular activities to be offered to Roma pupils in the afternoon. Dance and theatre programmes can improve pupils’ behaviour and self- discipline.

[Reference: http://ec.europa.eu/justice/discrimination/roma/eu-framework/index_en.htm]

2. Organise after-school programmes that will help Roma pupils with homework and other issues.

[Reference: https://www.unicef.org/ceecis/ROMA_PAPER_FINAL_LAST.pdf]

School Purchases

Dispense funding for the purchase of books and materials to help with language teaching, depending on the country and context, in order to support the inclusion of Roma children (www.moec.gov.cy).

School Uniform

Organise an induction meeting with all the parents at the beginning of the school year, to highlight the expectations of the school. Many Roma children and families may be unfamiliar with the National Curriculum requirements, or with the subjects taught, and unclear as to what is expected of them. Setting out the school’s expectations and regulations (school uniform, regular attendance, homework) from the outset establishes a good relationship between the school and all the families, including newcomers and Roma families. [Reference: www.natt.org.uk]

Pupil Support

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[Reference: https://www.unicef.org/ceecis/ROMA_PAPER_FINAL_LAST.pdf]

2. Employ Roma mediators in schools to act as support for Roma pupils and as liaisons between the Roma community and the school administration and teachers.

[Reference: https://www.unicef.org/ceecis/ROMA_PAPER_FINAL_LAST.pdf]

4. Organise after-school programmes that will help Roma pupils with homework and other issues.

[Reference: https://www.unicef.org/ceecis/ROMA_PAPER_FINAL_LAST.pdf]

Teacher Professional Development

1. Organise in-service training programmes to empower teachers with methodologies that address classes with pupils from different language groups (www.moec.gov.cy).

2. Organise training for teachers already in the school system to enhance cultural sensitivity and increase pedagogical skills and approaches geared to the needs of Roma pupils, so as to eliminate professional and personal prejudice that may exist.

[Reference: https://www.unicef.org/ceecis/ROMA_PAPER_FINAL_LAST.pdf]

Timetabling

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Supportive literature Roma: The term ‘Roma’ is often used to refer to people of Romani origin; this term has been adopted by many organisations including within the EU and the UK government. It is believed all Romani people originate from Northern India and started to migrate between 500 and 1,000 AD. [Reference: www.natt.org.uk]

The Council of Europe uses ‘Roma’ as an umbrella term. It refers to Roma, Sinti, Kale and related groups in Europe, including Travellers and Eastern groups (Dom and Lom), and covers the wide diversity of the groups concerned, including persons who identify themselves as Gypsies (FRA, 2016, p. 7).

Many Roma live in overwhelmingly poor conditions on the margins of society, and face extreme levels of racism, discrimination and social exclusion, even in their daily lives. Such discrimination is incompatible with the values upon which the EU is founded (FRA, 2012).

Websites and EU reports

National Association of Teachers of Travellers and Other Professionals: www.natt.org.uk Ministry of Education and Culture of Cyprus: www.moec.gov.cy The EU Framework for National Roma Integration Strategies: http://ec.europa.eu/justice/discrimination/roma/eu-framework/index_en.htm

References

Administrative Commissioner (2003). Research of Administrative Commissioner with No AYT/E 3/2003 concerning the circumstances under which Gypsy people who were settled in Makounta live. Nicosia. iDecide project (2016). State of the art for inclusive decision making.

European Union Agency for Fundamental Rights (FRA) (2016). Second European Union Minorities and Discrimination Survey. Roma – Selected Findings, EU-MIDIS II, Luxembourg.

European Union Agency for Fundamental Rights (FRA) (2012). The situation of Roma in 11 EU Member States - Survey results at a glance, Luxembourg.

Symeou, L. Karagiorgi, Y., Roussounidou, E. & Kaloyirou, C. (2009) Roma and their education in Cyprus: reflections on INSETRom teacher training for Roma inclusion, Intercultural Education, 20:6, 511-521.

Towards Roma Inclusion: A Review of Roma Education Initiatives in Central and South-Eastern Europe, United Nations Children’s Fund (UNICEF), 2010: https://www.unicef.org/ceecis/ROMA_PAPER_FINAL_LAST.pdf

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Pupils with Intellectual Disabilities

Cognitive Functioning

Classroom-based tips (focus on instructional methods)

The strategies below can be used for developing pupils’ cognitive functioning:

1. Enhancing memory - Use strategies that are based on pupils’ strengths in visual patterns, including the use of visual organisers. These can be used to compare and contrast two related aspects and help to enhance memory as part of developing pupils’ cognitive functioning, as in the Venn diagram, which compares mammals and reptiles. In this Venn diagram, the information in the centre illustrates the similarities between mammals and reptiles. (Source: http://www.ldonline.org/article/5736/)

A Venn diagram comparing mammals and reptiles:

- Teach mnemonics to enhance memory. For example, ‘My Very Easy Method Just Speeds Up Naming Planets’ helps to remember the planets in order: Mercury, Venus, Earth, Mars, Jupiter, Saturn, Uranus, Neptune, Pluto. - Bear in mind that not all pupils are visual learners. Include other learning resources such as audio materials for pupils to listen to the concepts, or other materials to provide tactile learning opportunities.

2. Improving learning rate: Teach your pupils to ‘go fast’ and improve their learning rates with these techniques:

- Use repeated reading: the pupil orally reads the same passage, usually three to five times during each session. With each successive reading, the pupil tries to increase the number of words read correctly per minute. The pupil first listens to the teacher, who models reading the passage; the pupil may read the passage silently, before

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beginning; and the teacher provides feedback and practice on missed words and phrases. When the pupil achieves the fluency criterion on a given passage, the teacher introduces a new passage. The difficulty level of successive passages gradually increases over time. The set goal is slightly higher than the current reading rate.

- Using time trials: Give pupils the opportunity to perform a skill as many times as they can in a brief period—time trials—in order to build fluency. Practice in the form of 1- minute time trials helps pupils with and without disabilities achieve fluency with a wide range of academic, vocational, and other skills (e.g., Beck, Conrad, & Anderson, 2010; Codding, Burns, & Lukito, 2011; Smith, Marchand- Martella, & Martella, 2011).

- Use ‘Say All Fast a Minute Each Day Shuffled’ (SAFMEDS). SAFMEDS consist of a deck of cards with a question, vocabulary term, or problem on one side of each card and the answer on the other side. A pupil answers as many items in the deck as s/he can during one minute. The pupil looks at the question or problem, states the answer, flips the card over to reveal the correct answer, and puts the card on either a “correct” or “incorrect” pile. [Reference: Eshleman, J. (2000). SAFMEDS on the web: Guidelines and considerations for SAFMEDS . http://standardcelerationcharttopics.pbworks.com/w/page/15573489/SAFMEDSon- the-Web]

3. Improve Attention: Simplify an assignment and focus your pupil’s attention on a particular guideline. For example, break the assignment into smaller tasks. Increase the complexity and difficulty of the task gradually. At the beginning, you can use assignments related to pupils’ interests. Pupil’s selective and sustained attention to relevant stimuli will improve as they succeed (Huguenin, 2000).

4. For generalisation and maintenance:

- Build on your pupils’ previous knowledge and make connections with new concepts. Ask pupils to present the newly acquired information to their peers and think of general future applications. - Use the RAFT approach (Santa, 1998), to differentiate the content for pupils with varying academic skills and knowledge levels.

RAFT is defined as follows:

R: Assume a Role. Who are you as the writer? A: Consider your Audience. To whom are you writing? Who will be reading? F: Write in a particular Format. What type of writing will you be doing? T: Examine a Topic from a relevant perspective. What is the subject or point of your writing?

5. Motivation

- Provide your pupils with positive feedback about the task: you can use a rubric for

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explicit feedback or comments in a written form for implicit feedback. Ask your pupils to give more information. (Brophy, 2010).

➔ Keep in mind that the feedback that teachers give to pupils and the way it is presented is a very important source of self-efficacy. (Klassen & Lynch, 2007 in https://www.rivier.edu/journal/ROAJ-Fall-2013/J783-Bergen.pdf).

- Be aware of the support you offer in the classroom, as the way you approach the pupils can have a positive or negative impact; be positive and inclusive. (Klassen & Lynch, 2007) Available at: (https://www.rivier.edu/journal/ROAJ-Fall- 2013/J783-Bergen.pdf)

- Make your lessons and activities interesting and engaging for your pupils. (Brophy, 2010)

School-based practical tips (focus on instructional methods)

Community

Arrange regular meetings between the parents and the staff to discuss pupil progress and to enhance home-school collaboration. This will help to monitor progress and to discuss other areas such as social skills, interactions with peers and adults within the school setting, marginalisation, behaviour at home and self-esteem. (McCaleb, 2013)

Class Divisions / Arrangements

1. Ask teachers to keep a progress log regarding specific pupils with learning differences. Arrange meetings between teachers and parents to discuss pupils’ progress, and design activities and intervention to support them. If needed, re-organise the school schedule to allow more time for co-teaching activities (Hoppey, & McLeskey, 2013)

2. Εquip the school with tablets and computers to enable teachers to use technology to motivate and engage their pupils. Build on pupils’ confidence in using everyday technology such as mobiles and tablets to enhance their motivation and self-efficacy beliefs.

Curricular Adaptations

2. Εquip the school with tablets and computers to enable teachers to use technology to

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motivate and engage their pupils. Build on pupils’ confidence in using everyday technology such as mobiles and tablets to enhance their motivation and self-efficacy beliefs.

3. Work with teachers to make curricular adaptations in terms of differentiating to the task. (Hall, Meyer and Rose, 2012; BBC active, 2010).

4. Make curricular adaptations in terms of resources – where possible equip the classrooms in which there are learners with cognitive difficulties with different materials and advanced technology, such as tablets or projectors, so as to attain a single learning outcome.

5. Include pupils’ varied talents and interests in school events by finding alternative ways with which they can participate, differentiating their role and contribution in an event.

Discipline

Include pupils’ varied talents and interests in school events by finding alternative ways with which they can participate, differentiating their role and contribution in an event.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Assign responsible individuals to accompany and direct pupils with cognitive differences, for example when they need to cross the street during a school trip. Pupils with intellectual disabilities tend to have difficulties in coordination, directionality and orientation.

Other (Assessment)

Ask teachers to keep a progress log regarding specific pupils with learning differences. Arrange meetings between teachers and parents to discuss pupils’ progress, and design activities and intervention to support them. If needed, re-organise the school schedule to allow more time for co-teaching activities (Hoppey, & McLeskey, 2013)

Parents / Parents’ Associations

1. Arrange regular meetings between the parents and the staff to discuss pupil progress and to enhance home-school collaboration. This will help to monitor progress and to discuss other areas such as social skills, interactions with peers and adults within the school setting, marginalisation, behaviour at home and self-esteem. (McCaleb, 2013)

2. Include pupils’ varied talents and interests in school events by finding alternative ways with which they can participate, differentiating their role and contribution in an event.

Safety

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School Celebrations / Events / Activities

Include pupils’ varied talents and interests in school events by finding alternative ways with which they can participate, differentiating their role and contribution in an event.

School Purchases

1. Εquip the school with tablets and computers to enable teachers to use technology to motivate and engage their pupils. Build on pupils’ confidence in using everyday technology such as mobiles and tablets to enhance their motivation and self-efficacy beliefs.

2. Make curricular adaptations in terms of resources – where possible equip the classrooms in which there are learners with cognitive difficulties with different materials and advanced technology, such as tablets or projectors, so as to attain a single learning outcome.

3. Make curricular adaptations in terms of resources – where possible equip the classrooms in which there are learners with cognitive difficulties with different materials and advanced technology, such as tablets or projectors, so as to attain a single learning outcome.

Pupil Support

1. Include pupils’ varied talents and interests in school events by finding alternative ways with which they can participate, differentiating their role and contribution in an event.

2. Ensure that additional classroom support such as a teaching assistant is provided to these pupils (BDA, 2012).

Teacher Professional Development

1. Organise university events/trainings for teachers and pupils. (Ainscow, Booth & Dyson, 2004). Working with academics in this context will acquaint teachers with new materials and practices, which they can apply with their pupils (e.g.training on the use of visual organisers and timetables within the classroom and school, and on problem-solving strategies).

Technology

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Supportive Literature

Definition: Deficits in cognitive functioning and learning characteristics of individuals with intellectual disabilities include poor memory, slow learning rates, attention problems, difficulty generalising what they have learned, and lack of motivation (Heward, 2013)

Memory, Learning Rate, Attention, Generalisation and Maintenance, Motivation

- Pupils with intellectual disabilities have difficulty remembering information (Carlin et al., 2003). - Children with intellectual disabilities take a longer time to automatically recall information and therefore have more difficulty handling larger amounts of cognitive information at one time when compared to same age peers without intellectual disabilities (Bergeron & Floyd, 2006). - The rate at which children with intellectual disabilities acquire new knowledge and skills is well below that of typically developing children. A frequently used measure of learning rate is trials to criterion — the number of practice or instructional trials needed before a pupil can respond correctly without prompts or assistance. For example, while 2 or 3 trials with feedback may be required for a typically developing child to learn to discriminate between two geometric forms, a child with intellectual disabilities may need 20 to 30 or more trials to learn the same discrimination. - Efficient learners attend to critical features of a task (e.g., to the outline of geometric shapes instead of other factors such as their colour or position on the page). Pupils with intellectual disabilities are typically need longer to attend to relevant features of a learning task (Merrill, 2005) and may focus on distracting irrelevant stimuli instead (Carlin, Chrysler, & Sullivan, 2007; Dickson, Deutsch, Wang, & Dube, 2006). In addition, individuals with intellectual disabilities often have difficulty sustaining attention to learning tasks (Tomporowski & Hagler, 1992). These attention problems compound and contribute to a pupil’s difficulties in acquiring, remembering, and generalising new knowledge and skills.

[Reference: Heward, W. L. (2013). Exceptional children: An introduction to special education. Pearson College Div.]

Websites and EU Reports http://www.disabled-world.com/disability/types/cognitive/

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Methods of Differentiation in classrooms http://www.bbcactive.com/BBCActiveIdeasandResources/MethodsofDifferentiationintheClassroom. aspx

References

Ainscow, M., Booth, T., & Dyson, A. (2004). Understanding and developing inclusive practices in schools: a collaborative action research network. International journal of inclusive education, 8(2), 125-139.

Beck, R., Conrad, A. D., & Anderson, P. (2010). One-minute fluency builders series . Longmont, CO: Sopris West

Brophy, J. (2010). Motivating students to learn. New York, NY: Routledge

Bursuck, W. D., & Damer, M. (2011). Teaching reading to students who are at risk or have disabilities: A multi-tier approach (2nd ed.). Upper Saddle River, NJ: Pearson.

Burton, C. E., Anderson, D. H., Prater, M. A., & Dyches, T. T. (2013). Video self-modeling on an iPad to teach functional math skills to adolescents with autism and intellectual disability. Focus on Autism and Other Developmental Disabilities, 1088357613478829.

Cannella-Malone, H. I., Fleming, C., Chung, Y. C., Wheeler, G. M., Basbagill, A. R., & Singh, A. H. (2011). Teaching daily living skills to seven individuals with severe intellectual disabilities: A comparison of video prompting to video modeling. Journal of Positive Behavior Interventions, 1098300710366593.

Codding, R. S., Burns, M. K., & Lukito, G. (2011). Meta-analysis of mathematic basic-fact fluency interventions: A component analysis. Learning Disabilities Research & Practice, 26 , 36–47.

Coyne, P., Pisha, B., Dalton, B., Zeph, L. A., & Smith, N. C. (2012). Literacy by Design A Universal Design for Learning Approach for Students With Significant Intellectual Disabilities. Remedial and Special Education, 33(3), 162-172.

Hoppey, D., & McLeskey, J. (2013). A case study of principal leadership in an effective inclusive school. The Journal of Special Education, 46(4), 245-256

Huguenin, N. H. (2000). Reducing overselective attention to compound visual cues with extended training in adolescents with severe mental retardation. American Journal on Mental Retardation, 111, 447–453

Jolivette, K., Lingo, A. S., Houchins, D. E., Barton- Arwood, S. M., & Shippen, M. E. (2006). Building math fluency for students with developmental disabilities using Great Leaps Math. Education and Training in Developmental Disabilities, 41, 392–400.

Jung, I. (2005). ICT-Pedagogy Integration in Teacher Training: Application Cases Worldwide. Educational Technology & Society, 8(2), 94-101.

McCaleb, S. P. (2013). Building communities of learners: A collaboration among teachers, students, families, and community. Routledge.

Miller, A. D., Hall, S. W., & Heward, W. L. (1995). Effects of sequential 1-minute time trials with and without intertrial feedback and selfcorrection on general and special education students’ fluency with math facts. Journal of Behavioral Education, 5, 319–345.

Mitchell, D. (2014). What really works in special and inclusive education: Using evidence-based teaching strategies. Routledge.

Ruwe, K., McLaughlin, T. F., Derby, K. M., & Johnson, J. (2011). The multiple effects of direct instruction flashcards on sight word acquisition, passage reading, and errors for three middle school students with intellectual disabilities. Journal of Developmental and Physical Disabilities, 23(3), 241-255.

Santa, C. (1988). Content reading including study systems. Dubuque, IA: Kendall/Hunt Publishing.

Smith, C. R., Marchand-Martella, N. E., & Martella, R. C. (2011). Assessing the effects of the Rocket Math program with a primary elementary school student at risk for school failure: A case study. Education & Treatment of Children, 34, 1–12.

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Taber-Doughty, T., Bouck, E. C., Tom, K., Jasper, A. D., Flanagan, S. M., & Bassette, L. (2011). Video modeling and prompting: A comparison of two strategies for teaching cooking skills to students with mild intellectual disabilities. Education and Training in Autism and Developmental Disabilities, 499-513.

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Adaptive Behaviour

Classroom-based tips (focus on instructional methods)

1. Give your pupils direct instructions and support their environment with prompts and simplified routines (Grossi & Heward, 1998). For instance, make sure that you provide visual prompts that remind them that it is time to wash their hands.

2. Create a behaviour support plan. An example can be found here: http://www.pbsc.info/sab/PDFs/m3_u6_manual.pdf

3. Use pictorial self-instruction (Mithaug & Mithaug, 2003). Pupils will learn to complete academic assignments using a picture-based graphic organiser planner. Pupils will plan, complete, and evaluate their work by circling pictures according to the following categories: (a) Subjects to Work, (b) What I Will Do, and (c) What I Did. You can use this strategy to teach self-management skills.

4. Promote self-determination by using Self-Determined Learning Model of Instruction (SDLMI) (Champers, 2007). The SDLMI teaches self-directed learning to pupils in three units: (a) setting a goal, (b) taking action, and (c) adjusting the total or plan (Wehmeyer, Palmer, Agran, Mithaug, & Martin, 2000). Pupils are taught to solve problems using four steps: (a) identify the problem, (b) identify possible solutions, (c) identify possible barriers, and (d) identify consequences of each solution.

5. Promote self-determination by involving pupils in educational planning and decision making. These activities range from teaching pupils to use presentation software, such as Microsoft’s PowerPoint, to present information about themselves during an Individual Education Plan (IEP) meeting, to the implementation of more systematic, curricular efforts that promote self-determination by teaching pupils skills to run their IEP meetings (see Wehmeyer et al., 2007, for a discussion of such programmatic efforts).

6. Use simulations and other visual prompts to teach your pupils daily life skills. For example, you can use your pupil’s tablet to teach him/her about dressing, going to the grocery and other daily tasks.

School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

1. Inform teachers through staff meetings about the importance of keeping records about their pupils’ progress; for example they can keep a record on the progress of pupils who have difficulties in adapting their behaviour; interventions can then be designed based on the needs of the pupils.

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2. Make efforts to arrange weekly or fortnightly meetings between the parents and the staff to discuss the progress of their children and to enhance the collaboration between home and school. This will help to monitor progress and to discuss issues that might be related to the social life of the pupil, such as marginalisation, social interactions with peers, behaviour at home, and self-esteem.

Pupil Support

1. Establish an inclusive culture within your school – This can be achieved through workshops and seminars with academics. It will help teachers to understand aspects of inclusion and apply inclusive practices, which will in turn contribute to helping pupils to learn adaptive behaviour skills.

2. Collaborate with universities and in collaboration organise events/trainings at the university for teachers and pupils. This will help teachers to learn about materials and practices in relation to adaptive behaviour skills, and apply these with their pupils.

3. Inform teachers through staff meetings about the importance of keeping records about their pupils’ progress; for example they can keep a record on the progress of pupils who have difficulties in adapting their behaviour; interventions can then be designed based on the needs of the pupils.

4. Provide training for teachers and SEN teachers from external agencies, such as educational psychologist services and academics and relate these to ways that teachers can help pupils develop their adaptive skills.

5. Provide ICT training to teachers, so they can use the technology with their pupils. Teachers must be experienced in using ICT before they teach those skills to the pupils.

School Projects

1. Use ABAS-2 (Adaptive Behaviour Assessment System) for evaluating the three general areas of adaptive behavior (Conceptual, Social, Practical). This will help to:

 Determine how individual is responding to daily demands  Develop treatment and training goals  Determine eligibility for services and Social Security benefits  Assess individuals with Intellectual Disability (ID), learning difficulties, ADD/ADHD, or other impairments  Assess capability of adults to live independently

[Reference: http://www.pearsonclinical.com/psychology/products/100000449/adaptive-behavior- assessment-system-second-edition-abas-second-edition.html]

Some commercially available tools might not be culturally appropriate for pupils in certain contexts, and adaptations or alternate versions may be more suitable.

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Consider the risks of measuring a pupil’s adaptive behaviour based on standards from the majority culture and failing to take into account the pupil’s own culture. It is important to create a history log in which you record pupil’s overall behaviour, history of family background, other health issues, skills and home background so as to be aware of the pupil’s own culture.

Student Council

Where possible, ensure that further provisions are made for those pupils, such as additional support in the class with the presence of a teaching assistant.

Pupil Support

Make efforts to arrange weekly or fortnightly meetings between the parents and the staff to discuss the progress of their children and to enhance the collaboration between home and school. This will help to monitor progress and to discuss issues that might be related to the social life of the pupil, such as marginalisation, social interactions with peers, behaviour at home, and self-esteem.

Teacher Professional Development

1. Provide ICT training to teachers, so they can use the technology with their pupils. Teachers must be experienced in using ICT before they teach those skills to the pupils.

2. Εquip the school with tablets and personal computers so teachers can use technology to teach to their pupils daily life skills such as going to the grocery store.

Supportive Literature

Definition: Adaptive behaviour is the collection of conceptual, social, and practical skills that all people learn in order to function in their daily lives (https://aaidd.org). By definition, children with intellectual disabilities have substantial deficits in adaptive behaviour. In particular, children with adaptive behaviour tend to have deficits in the following skills areas: Conceptual skills, such as planning and organising and the use of abstract concepts; Social skills, such as overall behaviour, feelings about themselves, understanding others, solving problems, other people’s influence, following rules and obeying the law and Practical skills including managing home and personal care, managing money, using the telephone, getting from place to place, staying safe and healthy, following schedules and routines, and maintaining a work life. These limitations can take many forms and tend to occur across domains of functioning. Limitations in self-care skills and social relationships as well as behavioural excesses are common characteristics of individuals with intellectual disabilities. Individuals with intellectual disabilities who require extensive support must often be taught basic self- care skills such as dressing, eating, and hygiene.

[Adapted from: Heward, W. L. (2013). Exceptional children: An introduction to special education. Pearson College Div.]

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Websites & EU Reports http://aaidd.org/intellectual-disability/definition#.WBD2LS197IU https://www.mentalhelp.net/articles/adaptive-behavior-life-skills/

References

Agran, M., & Hughes, C. (2006). Introduction to special issue: Self-determination re-examined: How far have we come? Research and Practice for Persons with Severe Disabilities, 30, 105–107.

Agran, M., Blanchard, C., Wehmeyer, M., & Hughes, C. (2002). Increasing problem-solving skills of students with developmental disabilities participating in general education. Remedial and Special Education, 23, 279–288.

Agran, M., King-Sears, M., Wehmeyer, M. L., & Copeland, S. R. (2003). Teachers’ guides toinclusive practices: Student-directed learning strategies. Baltimore: Brookes.

Chambers, C. R., Wehmeyer, M L., Saito, Y., Lida, K. M., Lee, Y., & Singh, V. (2007). Self-determination: What do we know? Where do we go? Exceptionality, 15, 3–15.

Grossi, T. A. (1998). Using a self-operated auditory prompting system to improve the work performance of two employees with severe disabilities. Journal of the Association for Persons with Severe Handicaps, 23, 149–154.

Hoppey, D., & McLeskey, J. (2013). A case study of principal leadership in an effective inclusive school. The Journal of Special Education, 46(4), 245-256

Mithaug, D. K., & Mithaug, D. E. (2003). Effects of teacher-directed versus student-directed instruction on self-management of young children with disabilities. Journal of Applied Behavior Analysis, 36(1)

Wehmeyer, M. L. (2006). Self-determination and individuals with severe disabilities: Reexamining meanings and misinterpretations. Research and Practice in Severe Disabilities, 30 , 113–120.

Wehmeyer, M. L., Agran, M., Hughes, C., Martin, J., Mithaug, D. E., & Palmer, S. (2007). Promoting self-determination in students with intellectual and developmental disabilities. New York: Guilford.

Wehmeyer, M. L., Palmer, S. B., Agran, M., Mithaug, D. E., & Martin, J. E. (2000). Promoting causal agency: The Self-Determined Learning Model of Instruction. Exceptional Children, 66, 439-453

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Syndromes

Classroom-based tips (focus on instructional methods)

1. Assess your pupils’ needs: The most useful part of writing for one pupil (e.g., making a grocery list) may not be a functional writing skill for another (e.g., writing the number of items packaged at work). Carefully assess each pupil’s current routines to find those skills that the pupil requires most or could use often (Heward, 2013)

2. Teach your pupils functional skills in addition to academic skills (Browder et al., 2006). Determine whether a particular knowledge area or skill is functional by seeking answers to questions such as:

• Will learning this knowledge/skill help the pupil to be more independent and successful in his home, school, or community? • Will failure to learn this knowledge/skill have any negative consequences to the pupil?

The ultimate approach to determining if a given skill qualifies as functional curriculum is to contemplate this question from the pupil’s perspective: “Will I need it when I’m 21?” (Heward, 2013).

3. Use visual cues to teach everyday skills to your pupils such as meal preparation (Heward, 2013).

4. Use simulations and other visual prompts to teach your pupils daily life skills. For example you can use your pupil’s tablet to teach him/her about dressing, going to the grocery store, and other daily tasks (Mechling, Gast, & Langone, 2002).

5. Use pictorial self-instruction (Mithaug & Mithaug, 2003) to teach self-management skills. Pupils will learn to complete academic assignments using a picture-based graphic organiser planner. Pupils will plan, complete, and evaluate their work by circling pictures according to the following categories: (a) Subjects to Work, (b) What I Will Do, and (c) What I Did.

6. Use time delay in teaching picture and word recognition skills. The prompt is concurrently presented with the target stimulus and then faded with small increments of time over successive trial (Browder et al., 2009).

Note: Individuals with Down Syndrome may require support for their academic success, but not display aberrant behaviours. Aberrant behaviour is defined as the irregular behaviour that deviates from what is considered normal (e.g. a person to behave in a violent way). Some of the pupils may require additional support in this regard comparing to others within the same category.

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School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Organise events/trainings at the local university for both teachers and pupils. (Ainscow, Booth & Dyson, 2004) with academics and departments who are specialised in the field. This will help teachers to learn about materials and practices in relation to cognitive skills and apply these with their pupils. Focus the training on specific areas of interest regarding these pupils. For instance, one part of the training can be on visuals to aid understanding (e.g., sign language, picture symbols), and extra work time (http://www.learnalberta.ca/content/inmdict/html/). Another area can focus on how time trials can be used with pupils with intellectual disabilities (http://www.learnalberta.ca/content/inmdict/html/).

Class Divisions / Arrangements

1. Ask teachers to keep a progress log regarding the specific pupils. If for instance a pupil has difficulties in reading/writing, ask teachers to keep a record of these difficulties. Arrange a meeting among teachers and the parent / guardian to discuss the pupil’s progress and design activities and intervention to provide the support needed.

Note: Based on these data re-organise the school schedule (if needed) for allowing more time for co-teaching activities (Hoppey, & McLeskey, 2013)

2. Work with specialists to arrange for any equipment or classroom modifications needed. Due to short stature, the pupil may need a special desk and chair in order to sit and work more easily in class. a. http://www.learnalberta.ca/content/inmdict/html/down_syndrome.html

3. Make classroom arrangements so as to accommodate pupils’ needs in relation to hearing, vision or attention difficulties.

Be aware if the pupil requires a hearing aid or FM system. i. Note: FM Systems are wireless assistive hearing devices that enhance the use of hearing aid(s), cochlear implants and also assist people who are hard of hearing

[Reference: http://www.learnalberta.ca/content/inmdict/html/down_syndrome.html]

Community

1. Meet with the pupil and parents early in the school year to discuss how the school can support this pupil's individual needs. This could include finding out about:

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- the pupil's strengths, interests and areas of need - specific health concerns that may affect the pupil at school - successful strategies used at home or in the community that also could be used at school

2. Establish an inclusive culture within your school: organise workshops and seminars with academics and contact agencies that can offer training. This will help teachers to understand aspects of inclusion and raise awareness of Down syndrome and apply inclusive practices, which will contribute to enhancing pupils’ social and academic skills (Hoppey, & McLeskey, 2013). Example of inclusive practice: Involve all pupils into the learning process and introduce differentiation strategies into your teaching. One differentiated approach is for all pupils to create a video – make sure the pupil is involved in the task along with his peers.

3. Collaborate with the parents and pupil to consider if, and how, they would like to share specific information on Down Syndrome with peers. If they wish to do so, consultation with health care providers, such as school or community health nurses, may be helpful (http://www.learnalberta.ca/content/inmdict/html/)

Curricular Adaptations

Establish an inclusive culture within your school: organise workshops and seminars with academics and contact agencies that can offer training. This will help teachers to understand aspects of inclusion and raise awareness of Down syndrome and apply inclusive practices, which will contribute to enhancing pupils’ social and academic skills (Hoppey, & McLeskey, 2013).

Example of inclusive practice: Involve all pupils into the learning process and introduce differentiation strategies into your teaching. One differentiated approach is for all pupils to create a video – make sure the pupil is involved in the task along with his peers.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

1. At a school excursion, make sure that the pupils will be accompanied by a teaching assistant – the teaching assistant will need to let the pupils know in advance about the schedule so as to be prepared in case of any changes to their routine.

2. If required, work with the parents to carry out a risk assessment before field trips to determine potential hazards, and to plan for the pupil's safe and successful participation. http://www.learnalberta.ca/content/inmdict/html/down_syndrome.html

Other (Assessment)

Ask teachers to keep a progress log regarding the specific pupils. If for instance a pupil has difficulties in reading/writing, ask teachers to keep a record of these difficulties. Arrange a meeting among teachers and the parent / guardian to discuss the pupil’s progress and design activities and intervention to provide the support needed.

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Note: Based on these data re-organise the school schedule (if needed) for allowing more time for co-teaching activities (Hoppey, & McLeskey, 2013)

Other (Pupil Involvement)

Collaborate with the parents and pupil to consider if, and how, they would like to share specific information on Down Syndrome with peers. If they wish to do so, consultation with health care providers, such as school or community health nurses, may be helpful (http://www.learnalberta.ca/content/inmdict/html/)

Parents / Parents’ Associations

1. Meet with the pupil and parents early in the school year to discuss how the school can support this pupil's individual needs. This could include finding out about: - the pupil's strengths, interests and areas of need - specific health concerns that may affect the pupil at school - successful strategies used at home or in the community that also could be used at school.

2. Arrange weekly or fortnightly meetings between the parents and the staff to discuss the child’s progress and to enhance the collaboration between home and school. This will help to monitor progress and to discuss issues that might be related to the social life of the pupil, such as marginalisation, social interactions with peers, behavior at home, and self-esteem (McCaleb, 2013).

3. In collaboration with parents and healthcare professionals develop a written management plan that aligns with school and jurisdictional policies and protocols. This plan should include specific information, such as: o medical concerns that may affect the pupil at school o the role of school staff in managing the medical concerns o steps for treatment of associated medical concerns o appropriate physical activities o when emergency measures should be taken.

[Reference: http://www.learnalberta.ca/content/inmdict/html/down_syndrome.html]

4. If required, work with the parents to carry out a risk assessment before field trips to determine potential hazards, and to plan for the pupil's safe and successful participation. http://www.learnalberta.ca/content/inmdict/html/down_syndrome.html

Safety

In collaboration with parents and healthcare professionals develop a written management plan that aligns with school and jurisdictional policies and protocols. This plan should include specific information, such as: o medical concerns that may affect the pupil at school o the role of school staff in managing the medical concerns o steps for treatment of associated medical concerns o appropriate physical activities

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o when emergency measures should be taken.

[Reference: http://www.learnalberta.ca/content/inmdict/html/down_syndrome.html]

School Breaks

Make same spaces in the school easily accessible so that certain pupils with particular needs, for example to follow a specific routine for lunch, can be accommodated. Often if a routine is not followed this may have an influence on the child’s mood and behavior. Ensure there is appropriate supervision at these times.

School Celebrations / Events / Activities

Take steps to ensure the pupil does not feel left out during recess, intramural or other school activities. If the pupil has physical limitations, provide the pupil with: - an alternative role, such as equipment manager or coach during intramurals - alternative activities during recess, such as a friendship bench to sit on and meet with peers.

[Reference: http://www.learnalberta.ca/content/inmdict/html/down_syndrome.html] School Purchases

1. Εquip the school with tablets and personal computers so teachers and pupils can use technology to motivate pupils with Down Syndrome and develop their confidence. Most pupils are confident in using everyday technology (mobiles, tablets) so this approach will enhance their motivation.

2. Provide ICT training to teachers, so teachers can use the technology with these pupils. Teachers must be in a position to use ICT before using it to teach their pupils (Jung, 2005) Explore who can be responsible for training the teachers on specific topics and strategies such as software and applications that can assist in helping pupils’ engagement and nurture their social skills. Some examples of useful software tools are the following: Clicker5 and Widgit Software.

3. Equip classrooms with resources and materials that correspond to individual pupils’ needs, such as visual schedules, relaxation music, a radio, sand writing and soft balls.

4. Make classroom arrangements so as to accommodate pupils’ needs in relation to hearing, vision or attention difficulties. Be aware if the pupil requires a hearing aid or FM system. Note: FM Systems are wireless assistive hearing devices that enhance the use of hearing aid(s), cochlear implants and also assist people who are hard of hearing.

[Reference: http://www.learnalberta.ca/content/inmdict/html/down_syndrome.html]

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Pupil Support

2. Provide additional support in the class, for example with the presence of a teaching assistant.

Teacher Professional Development

1. Establish an inclusive culture within your school: organise workshops and seminars with academics and contact agencies that can offer training. This will help teachers to understand aspects of inclusion and raise awareness of Down syndrome and apply inclusive practices, which will contribute to enhancing pupils’ social and academic skills (Hoppey, & McLeskey, 2013). Example of inclusive practice: Involve all pupils into the learning process and introduce differentiation strategies into your teaching. One differentiated approach is for all pupils to create a video – make sure the pupil is involved in the task along with his peers.

2. Organise events/trainings at the local university for both teachers and pupils. (Ainscow, Booth & Dyson, 2004) with academics and departments who are specialised in the field. This will help teachers to learn about materials and practices in relation to cognitive skills and apply these with their pupils. Focus the training on specific areas of interest regarding these pupils. For instance, one part of the training can be on visuals to aid understanding (e.g., sign language, picture symbols), and extra work time (http://www.learnalberta.ca/content/inmdict/html/). Another area can focus on how time trials can be used with pupils with intellectual disabilities (http://www.learnalberta.ca/content/inmdict/html/).

Technology

Εquip the school with tablets and personal computers so teachers and pupils can use technology to motivate pupils with Down Syndrome and develop their confidence. Most pupils are confident in using everyday technology (mobiles, tablets) so this approach will enhance their motivation.

Supportive Literature

Definition: The term syndrome refers to a number of symptoms or characteristics that occur together and provide the defining features of a given disease or condition. Down Syndrome and fragile X syndrome are the two most common genetic causes of intellectual disabilities (Roberts et al., 2005).

Down Syndrome: Caused by chromosomal abnormality; most common of three major types is trisomy 21, in which the 21st set of chromosomes is a triplet rather than a pair. Most often results in moderate level of intellectual disability, although some individuals function in mild or severe range. Affects about 1 in 691 live births; incidence of Down Syndrome increases with age of mother to approximately 1 in 30 for women at age 45.

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Chracteristics of Down Syndrome: Best-known and well-researched biological condition associated with intellectual disability; estimated to account for 5%–6% of all cases. Characteristic physical features: short stature; flat, broad face with small ears and nose; upward slanting eyes; small mouth with short roof, protruding tongue may cause articulation problems; hypotonia (floppy muscles); heart defects common; susceptibility to ear and respiratory infections. Older people are at high risk for Alzheimer’s disease.

Source: Heward, W. L. (2013). Exceptional children: An introduction to special education. Pearson College Div

Websites & EU Reports www.downs-syndrome.org.uk www.nads.org/ www.edsa.eu/ https://aaidd.org www.aamr.org

References

Baylis, P., & Snowling, M. J. (2012). Evaluation of a phonological reading programme for children with Down Syndrome. Child Language teaching and therapy, 28(1), 39-56.

Beck, J., Broers, J., Hogue, E., Shipstead, J., & Knowlton, E. (1994). Strategies for functional community-based instruction and inclusion for children with mental retardation. Teaching Exceptional Children, 26 (2), 44–48.

Browder, D. M. (2001). Curriculum and assessment for students with moderate and severedisabilities . New York: Guilford.

Browder, D. M., & Spooner, F. (2011). Teaching students with moderate and severe disabilities. New York, NY: Guilford.

Browder, D. M., Ahlgrim-Delzell, L., Courtade, G., Gibbs, S., & Flowers, C. (2008). Evaluation ofthe effectiveness of an early literacy program for students with significant disabilities. Exceptional Children, 75 , 33–52.

Browder, D. M., Ahlgrim-Delzell, L., CourtadeLittle, G., & Snell, M. E. (2006). General curriculum access. In M. E. Snell & F. Brown (Eds.), Instruction of students with severe disabilities (6th ed., pp. 489–525). Upper Saddle River, NJ: Merrill/Pearson.

Browder, D. M., Ahlgrim-Delzell, L., Spooner, F., Mims, P. J., & Baker, J. N. (2009). Using time delay to teach literacy to students with severe developmental disabilities. Exceptional Children, 75 , 343–364.

Browder, D. M., Mims, P., Spooner, F., Ahlgrim-Delzell, L., & Lee, A. (2008). Teaching elementary students with multiple disabilities to participate in shared stories. Research and Practice for Persons with Severe Disabilities, 33, 3-12.

Burgoyne, K., Duff, F. J., Clarke, P. J., Buckley, S., Snowling, M. J., & Hulme, C. (2012). Efficacy of a reading and language intervention for children with Down Syndrome: a randomised controlled trial. Journal of Child Psychology and Psychiatry, 53(10), 1044-1053.

Hoppey, D., & McLeskey, J. (2013). A case study of principal leadership in an effective inclusive school. The Journal of Special Education, 46(4), 245-256

Jung, I. (2005). ICT-Pedagogy Integration in Teacher Training: Application Cases Worldwide. Educational Technology & Society, 8(2), 94-101. McCaleb, S. P. (2013). Building communities of learners: A collaboration among teachers, students, families, and community. Routledge.

Mechling, L. C. (2007). Assistive technology as a self-management tool for prompting students with intellectual disabilities to initiate and complete daily tasks: A literature review. Education and Training in Developmental Disabilities, 252-269.

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Mechling, L. C., Gast, D. L., & Langone, J. (2002). Computer-based video instruction to teach persons with moderate intellectual disabilities to read grocery aisle signs and locate items. Journal of Special Education, 35, 224.

Næss, K. A. B., Melby-Lervåg, M., Hulme, C., & Lyster, S. A. H. (2012). Reading skills in children with Down Syndrome: A meta-analytic review. Research in developmental disabilities, 33(2), 737-747.

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Social Development

Classroom-based tips (focus on instructional methods)

1. Use circle time to ask pupils to tell you how they spend their day and the others will have to listen carefully. This will encourage active listening.

2. Encourage empathic thinking with questions such as, “Why do you think he is crying?” This will help pupils to reflect on their own and others’ behaviour.

3. Promote pupils’ confidence and development of new skills by engaging them in problem- solving activities, for example by asking, “Can you think of a way to help you remember to wait for your turn?”

4. Use a natural interaction between a pupil and an adult to practice a skill (Elksnin and Elksnin, 2000). Naturalistic interventions refer to the creation of numerous opportunities for desired child responses. Kaiser and Grim (2006: 455-456) make the following recommendations about naturalistic interventions: • Teach pupils based on their interests. • Teach what is functional for the pupil at the moment. • Stop while both the pupil and the teacher are still enjoying the interaction.

5. Read and discuss literature on social skills, which involve topics such as dealing with new situations, dealing with bullying, making new friends (DeGeorge, 1998).

6. Discuss what the pupil did after a social interaction: what happened, whether the outcome was positive or negative, and what the pupil will do in the same situation in the future (Elksnin and Elksnin, 2000; Lavoie, 2005).

7. Use multimedia to teach social skills. A lot of pupils with learning disabilities tend to be visual learners; thus videos, simulations, virtual environments and other multimedia can be effective teaching tools (Parsons, 2006; Parsons, Leonard and Mitchell, 2006). You can also implement 4-6 (above), i.e., role-playing, social stories, observing others’ behaviour by utilising multimedia.

8. Create your own social skills tools and adapt them to your pupils’ needs. For instance, you can audio/video-record your pupils in class (ensuring necessary and appropriate permissions are given) and then use the video to initiate a discussion of your pupils’ social interactions (NCTI, CITed – Centre for Integrating Technology in Education).

9. Ask from the pupils to create their own stories about social behaviour and discuss these in class, providing feedback about these stories (NCTI, CITed – Centre for Integrating Technology in Education).

10. Use photographs or still images from videos as ‘reminders of social behaviour.’ (NCTI, CITed – Centre for Integrating Technology in Education)

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11. Use peer-tutoring, which involves having pupils interact with one another. For example you can pair up a more able pupil with a disabled pupil in order to share knowledge about social skills. Peer tutoring can also be a useful way to achieve social goals apart from the academic skills (e.g. during a school event or breaks a more able pupil to be paired up with a disabled pupil).

12. Use simulations and other visual prompts to teach your pupils daily life skills. For example, you can use your pupil’s tablet to teach him/her about going to the grocery store, and how to interact with others in these and similar situations and places. (Mechling, Gast, & Langone, 2002).

Multimedia resources - Choices, Choices (K-5) Choices, Choices uses real-world scenarios to help students learn problem-solving and decision-making skills. - Right Choices: A Multimedia Social Skills Training Program for Adolescents (6-12) Right Choices is a 34-week program that uses video to help pupils learn problem-solving and decision-making skills; modules focus on topics such as conflict resolution, negotiating, and dealing with peer pressure.

School-based practical tips (focus on instructional methods)

Announcement / Sign at School

1. Organise events/trainings at a local university for both teachers and pupils. (Ainscow, Booth & Dyson, 2004). Consider who can be responsible for this training, for example, academics specialised in the field. This will help teachers to learn about materials and practices in relation to cognitive skills and apply these with their pupils. Focus the training on specific areas of interest regarding these pupils. For instance: - One part of the training can be on the use of visual organisers related to social skills and timetables within the classroom and within the school areas. - The training may include a unit on how to use peer tutoring with your pupils in order to enhance social development.

2. Have visual prompts within the school area, which demonstrate appropriate social skills, for example how to queue in the school canteen and interact with their fellow peers during lunch breaks.

Class Divisions / Arrangements

Ask teachers to keep a progress log regarding the specific pupils. For instance: if a pupil has social difficulties ask teachers to keep a record of them. Arrange a meeting among teachers and the responsible for the pupil person (e.g. carer/guardian/parent) to discuss her/his progress, and design activities and interventions to offer support. Re-organise the school

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schedule if needed, for allowing more time for co-teaching activities (Hoppey, & McLeskey, 2013)

Community

1. Organise events at your school related to social skills. For instance, through collaboration with teachers, parents and pupils you can ask from the pupils to be part of groups and work together to achieve specific tasks (eg. To plant the garden, or mend things at school).

2. Establish an inclusive culture within your school: organise workshops and seminars with academics. This will help teachers to understand aspects of inclusion and raise awareness of cognitive functioning and apply inclusive practices, which will contribute in enhancing pupils’ cognitive skills (Hoppey, & McLeskey, 2013). Example of inclusive practice: Involve all pupils in the learning process and introduce differentiation strategies into your teaching. One differentiated approach is for all pupils to create a video and make a story which depicts a social situation and how pupils would deal with it – make sure the pupil with social difficulties is involved in the task along with her/his peers.

3. Involve parents and other caregivers, as well as other adults that have an important role in the pupil’s life. Arranging meetings between parents/caregivers and staff helps to build a rapport, which in turn helps the pupil feel supported and improve her/his social skills further.

Curricular Adaptations

1. Establish an inclusive culture within your school: organise workshops and seminars with academics. This will help teachers to understand aspects of inclusion and raise awareness of cognitive functioning and apply inclusive practices, which will contribute in enhancing pupils’ cognitive skills (Hoppey, & McLeskey, 2013). Example of inclusive practice: Involve all pupils in the learning process and introduce differentiation strategies into your teaching. One differentiated approach is for all pupils to create a video and make a story, which depicts a social situation and how pupils would deal with it – make sure the pupil with social difficulties is involved in the task along with her/his peers.

2. Encourage and inform teachers to make curricular adaptations in terms of differentiating to the task. For example, based on one learning objective in the curriculum, they might provide a single worksheet which gets progressively harder and responds to the various learning needs of the pupils and the severity and needs of the individual with social development differences (Hall, Meyer and Rose, 2012; BBC active, 2010).

Discipline

1. Be aware of the underpinning factors of these pupils’ behaviour when you are following the behavioural code at your school. Make sure that before you reach a decision about a pupil’s behaviour you have consulted the pupil’s parent/guardian/teacher and gained more information about her/his history. Some pupils with social development difficulties might overreact in some situations. Give them space to relax. Take time to discuss things with them, and actively listen to what they have to say.

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2. For helping pupils adapt their behaviour provide explicit and specific feedback when the pupil demonstrates positive social skills. Follow the "I FEED" (Immediate, Frequent, Enthusiastic, Eye Contact, Describe) principle. http://www.learnalberta.ca/content/inmdict/html/learning_disabilities.html

3. Create a monitor form with the rest of the teachers to monitor signs of anxiety, such as restlessness, distractibility, physical tension and avoidance.

Other (Assessment)

Other (Pupils’ Involvement for Inclusion)

Involve the pupils in your decisions. This will help them nurture their social skills. For instance, in collaboration with the pupils you can decide that a specific week (eg. A week in November) will be intellectual disabilities/social development awareness week and ask from the pupils to create theatre shows, presentations and other collaborative tasks.

Parents / Parents’ Associations

1. Involve parents and other caregivers, as well as other adults that have an important role in the pupil’s life. Arranging meetings between parents/caregivers and staff helps to build a rapport, which in turn helps the pupil feel supported and improve her/his social skills further.

2. Provide information about social skills by arranging onsite trainings or by using resources and materials related to the following evidence-based social skills programs:

a) "Stop and Think" Social Skills Program: Part of Project ACHIEVE (Knoff and Batsche, 1995). Project ACHIEVE is an innovative, evidence-based school effectiveness and improvement program focusing on all pupils' academic and social, emotional, and behavioural progress and success. The program uses strategic planning, professional development, and on-site consultation and technical assistance to address pupil achievement, positive school and classroom climates, effective teaching and instruction, and parent and community outreach and involvement. This program has demonstrated success in reducing pupil discipline referrals to the principal's office, school suspensions, and expulsions; fostering positive school climates and pro-social interactions; increasing pupils' on-task behaviour; and improving academic performance. [Reference: http://www.projectachieve.info]

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errors, and pro-social skills. Youth involved in the EQUIP training program participate in two types of group sessions - Equipment Meetings (in which the leader teaches specific skills) and Mutual Help Meetings (in which the leader coaches pupils as they use the skills they have learned to help each other). The EQUIP program received the 1998 Reclaiming Children and Youth Spotlight on Excellence Award. EQUIP has been adapted for use in Canada, the Netherlands, and several other countries.

c) The ACCEPTS Program (Walker et al, 1994) offers a complete curriculum for teaching effective social skills to pupils at middle- and high-school levels. The program teaches peer- to-peer skills, skills for relating to adults, and self-management skills. ACCEPTS ( A Curriculum for Children's Effective Peer and Teacher Skills ) is a complete curriculum for teaching classroom and peer-to-peer social skills to children with or without disabilities in Grades K through 6. The curriculum, designed for use by regular and special education teachers, cognitively teaches social skills as subject matter content. The program can be taught in one- to-one, small-group, or large-group instructional formats. ACCEPTS includes a nine-step instructional procedure based on the principles of direct instruction; scripts that teach critically important teacher-child behavioural competencies and peer-to-peer social skills; and behavioural management procedures.

Available at: http://www.proedinc.com/customer/productView.aspx?ID=625

Note: not all instruments and projects are available in all cultural contexts.

Scheduling Events

2. Involve the pupils in your decisions. This will help them nurture their social skills. For instance, in collaboration with the pupils you can decide that a specific week (eg. A week in November) will be intellectual disabilities/social development awareness week and ask from the pupils to create theatre shows, presentations and other collaborative tasks.

School Celebrations / Events / Activities

Include the pupils into school events by differentiating their role and contribution, for example, instead of memorising a poem, bring out other talents such as drawing or dancing. Encourage all pupils to feel they are part of a group.

School Purchases

1. Εquip the school with tablets and computers so as teachers and pupils can use technology for teaching/learning social skills. Most pupils are confident in using everyday technology (mobiles, tablets) so this approach will enhance their motivation and self-efficacy beliefs. Note: Remember to use technology with all the pupils and not only with the pupils that experience social difficulties.

www.idecide-project.eu

2. Provide ICT training to teachers, to empower them to be able to use the technology with their pupils. Consider appropriate organisations who can host such training, and where and when it would be suitable to schedule the sessions. (Jung, 2005). Focus the training on specific areas, such as software and applications that can assist in helping pupils with their social skills. Some examples of applications can be found here: https://www.edutopia.org/blog/social- emotional-apps-special-ed-jayne-clare https://glenwood.org/wp-content/uploads/2013/04/Social-Skills-and-Autism-Spectrum- Disorders-Application-List.pdf

Pupil Support

2. Avoid ‘a one size fits all approach’. Adapt the intervention to meet the individual’s or particular group’s needs. Pupils who speak English as a Second Language might need intensive social skill instruction to promote acculturation and peer acceptance. Pupils with disabilities might need adaptive curriculum and learning strategies. Most pupils will need a combination of different strategies that are matched to their particular deficits and backgrounds.

3. Ensure that further provision is provided for those pupils such as additional support in the class, for example with the presence of a teaching assistant, to keep them on track.

Teacher Professional Development

3. Provide information about social skills by arranging onsite trainings or by using resources and materials related to the following evidence-based social skills programs:

www.idecide-project.eu

a) "Stop and Think" Social Skills Program: Part of Project ACHIEVE (Knoff and Batsche, 1995). Project ACHIEVE is an innovative, evidence-based school effectiveness and improvement program focusing on all pupils' academic and social, emotional, and behavioural progress and success. The program uses strategic planning, professional development, and on-site consultation and technical assistance to address pupil achievement, positive school and classroom climates, effective teaching and instruction, and parent and community outreach and involvement. This program has demonstrated success in reducing pupil discipline referrals to the principal's office, school suspensions, and expulsions; fostering positive school climates and pro-social interactions; increasing pupils' on-task behavior; and improving academic performance. [Reference: http://www.projectachieve.info]

b) The EQUIP Program (Gibbs, Potter, & Goldstein, 1995) skills. Available at: http://www.researchpress.com/scripts/product.asp?item=4848#5134 EQUIP is a three- part intervention method for working with antisocial or behaviour-disordered adolescents. The approach includes training in moral judgment, anger management/correction of thinking errors, and pro-social skills. Youth involved in the EQUIP training program participate in two types of group sessions - Equipment Meetings (in which the leader teaches specific skills) and Mutual Help Meetings (in which the leader coaches pupils as they use the skills they have learned to help each other). The EQUIP program received the 1998 Reclaiming Children and Youth Spotlight on Excellence Award. EQUIP has been adapted for use in Canada, the Netherlands, and several other countries.

c) The ACCEPTS Program (Walker et al, 1994) offers a complete curriculum for teaching effective social skills to pupils at middle- and high-school levels. The program teaches peer-to-peer skills, skills for relating to adults, and self-management skills. ACCEPTS ( A Curriculum for Children's Effective Peer and Teacher Skills ) is a complete curriculum for teaching classroom and peer-to-peer social skills to children with or without disabilities in Grades K through 6. The curriculum, designed for use by regular and special education teachers, cognitively teaches social skills as subject matter content. The program can be taught in one-to-one, small-group, or large-group instructional formats. ACCEPTS includes a nine-step instructional procedure based on the principles of direct instruction; scripts that teach critically important teacher-child behavioural competencies and peer-to-peer social skills; and behavioural management procedures.

Available at: http://www.proedinc.com/customer/productView.aspx?ID=625

Note: not all instruments and projects are available in all cultural contexts.

4. Provide ICT training to teachers, to empower them to be able to use the technology with their pupils. Consider appropriate organisations who can host such training, and where and when it would be suitable to schedule the sessions. (Jung, 2005). Focus the training on specific areas, such as software and applications that can assist in helping pupils with their social skills. Some examples of applications can be found here: https://www.edutopia.org/blog/social- emotional-apps-special-ed-jayne-clare https://glenwood.org/wp-content/uploads/2013/04/Social-Skills-and-Autism-Spectrum- Disorders-Application-List.pdf

www.idecide-project.eu

Technology

Εquip the school with tablets and computers so as teachers and pupils can use technology for teaching/learning social skills. Most pupils are confident in using everyday technology (mobiles, tablets) so this approach will enhance their motivation and self-efficacy beliefs. Note: Remember to use technology with all the pupils and not only with the pupils that experience social difficulties.

Supportive Literature

Definition: Making and sustaining friendships and personal relationships present significant challenges for many children with intellectual disabilities (Guralnick, Connor, Neville, & Hammond, 2006). Poor communication skills, inability to recognise the emotional state of others, and unusual or inappropriate behaviours when interacting with others can lead to social isolation (Matheson, Olsen, & Weisner, 2007; Williams, Wishart, Pitcarin, & Willis, 2005). It is difficult at best for someone who is not a professional educator or paid caretaker to want to spend the time necessary to get to know a person who stands too close, interrupts frequently, does not maintain eye contact, and strays from the conversational topic.

Characteristics: Social situations that present difficulties for pupils with disabilities can range from the fairly simple (engaging in a conversation with a peer) to the extremely complex: determining whether someone who seems friendly is actually harming you (De Bildt et al., 2005).

[Reference: Heward, W. L. (2013). Exceptional children: An introduction to special education. Pearson College Div.]

Because of this, social skills are often broken down into categories, or types of skill, according to the level of complexity and interaction. One way of categorising social skills is as follows:

Skill Set Used for Examples

Foundation Basic social Ability to maintain eye Skills interaction contact, maintain appropriate personal space, understand gestures and facial expressions

Interaction Skills needed to Resolving conflicts, taking Skills interact with others turns, learning how to begin and end conversations, determining appropriate topics for conversation, interacting with authority figures

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Affective Skills Skills needed for Identifying one's feelings, understanding recognising the feelings of oneself and others others, demonstrating empathy, decoding body language and facial expressions, determining whether someone is trustworthy

Cognitive Skills Skills needed to Social perception, making maintain more choices, self-monitoring, complex social understanding community interactions norms, determining appropriate behaviour for different social situations.

(Canney and Byrne, 2006; Waltz, 1999)

Note: School leaders do need to remember to use the social development tips as they relate to the categories included in the table above.

Websites and EU Reports http://www.euro.who.int/en/health-topics/noncommunicable-diseases/mental-health/priority- areas/intellectual-disabilities http://www.enil.eu/wp-content/uploads/2012/07/Intellectual-Disability-in-Europe.pdf http://www.unicef.org/protection/World_report_on_disability_eng.pdf http://inclusion-europe.eu/wp-content/uploads/2015/03/SocInc_EUPovertyRreport.pdf http://www.disability-europe.net/content/aned/media/FI%20social%20inclusion%20report.pdf

References

Ayres, K. M., Mechling, L., & Sansosti, F. J. (2013). The use of mobile technologies to assist with life skills/independence of students with moderate/severe intellectual disability and/or autism spectrum disorders: Considerations for the future of school psychology. Psychology in the Schools, 50(3), 259-271.

Cannella-Malone, H. I., Brooks, D. G., & Tullis, C. A. (2013). Using self-directed video prompting to teach students with intellectual disabilities. Journal of Behavioral Education, 22(3), 169-189.

Canney, C., & Byrne, A. (2006). Evaluating Circle Time as a support to social skills development–reflections on a journey in school‐based research. British Journal of Special Education, 33(1), 19-24.

Carter, E. W., Sisco, L. G., Chung, Y. C., & Stanton-Chapman, T. L. (2010). Peer interactions of students with intellectual disabilities and/or autism: A map of the intervention literature. Research and Practice for Persons with Severe Disabilities, 35(3-4), 63-79.

Gibbs, J. C., Potter, G. B., & Goldstein, A. P. (1995). The EQUIP program: Teaching youth to think and act responsibly through a peer-helping approach. Research Press.

Goldstein, A. P. (1999). The prepare curriculum: Teaching prosocial competencies. Research Press. Hoppey, D., & McLeskey, J. (2013). A case study of principal leadership in an effective inclusive school. The Journal of Special Education, 46(4), 245-256.

www.idecide-project.eu

Knoff, H. M., & Batsche, G. M. (1995). Project ACHIEVE: Analyzing a school reform process for at-risk and underachieving students. School Psychology Review.

McDonnell, J., Mathot-Buckner, C., Thorson, N., & Fister, S. (2001). Supporting the inclusion of students with moderate and severe disabilities in junior high school general education classes: The effects of classwide peer tutoring, multi-element curriculum, and accommodations. Education and Treatment of Children, 24, 141-160.

Rohrbeck, C. A., Ginsburg-Block, M. D., Fantuzzo, J. W., & Miller, T. R. (2003). Peer-assisted learning interventions with elementary school students: A meta-analytic review. Journal of Educational Psychology, 95, 240-257.

Shepherd, C. K., McCunnis, M., Brown, L., & Hair, M. (2010). Investigating the use of simulation as a teaching strategy. Nursing Standard, 24(35), 42-48.

Stephens, D., Sachin Jain, P. H. D., & Kim, K. (2010). Group counseling: Techniques for teaching social skills to students with special needs. Education, 130(3), 509.

Carter, E. W., Cushing, L. S., Clark, N. M., & Kennedy, C. H. (2005). Effects of peer support interventions on students' access to the general curriculum and social interactions. Research and practice for persons with severe disabilities, 30, 15-25.

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Behavioural Excesses & Challenging Behaviour

Classroom-based tips (focus on instructional methods)

1. Use circle time to ask pupils to tell you how they spend their day and the others will have to listen carefully. This will encourage active listening.

2. Encourage empathic thinking with questions such as, “Why do you think he is crying?” This will help pupils to reflect on their own and others’ behaviour.

3. Promote the pupil’s confidence and development of new skills by engaging her/him in problem-solving activities, for example by asking questions like: “Can you think of a way to help you remember to wait for your turn?”

4. Use natural interaction among a pupil and an adult to practice a skill (Elksnin and Elksnin, 2000). Naturalistic interventions refer to the creation of numerous opportunities for desired child responses. Kaiser and Grim (2006: 455-456) make the following recommendations about naturalistic interventions: - Teach pupils based on their interests. - Teach what is functional for the pupil at the moment. - Stop while both the pupil and the teacher are still enjoying the interaction.

5. Read and discuss literature on social skills, which involve topics such as dealing with new situations, dealing with bullying, making new friends (DeGeorge, 1998)

6. Note: Take into consideration the pupil’s cultural or language barriers to good behaviour when discussing or creating stories.

7. Discuss what the pupil did after a social interaction: what happened, whether the outcome was positive or negative, and what the pupil will do in the same situation in the future (Elksnin and Elksnin, 2000; Lavoie, 2005)

8. Note: Take into consideration the pupil’s cultural or language barriers to good behaviour when discussing or creating stories.

9. Use multimedia to teach social skills. A lot of pupils with learning disabilities tend to be visual learners; thus videos, simulations, virtual environments and other multimedia can be effective teaching tools (Parsons, 2006; Parsons, Leonard and Mitchell, 2006). You can also implement 4-6 (above) i.e., role playing, social stories, observing others’ behaviour by utilising multimedia.

10. Create your own social skills tools and adapt them to your pupils’ needs. For instance, you can audio/video-record your pupils in class (ensuring necessary and appropriate permissions are given) and then use the video to initiate a discussion of your pupils’ social interactions. (NCTI, CITed – Centre for Integrating Technology in Education)

www.idecide-project.eu

Note: Take into consideration the pupil’s cultural or language barriers to good behaviour when discussing or creating the stories.

11. Use photographs or still images from videos as ‘reminders of social behaviour’.

12. Use peer-tutoring, which involves having pupils interact with another For example you can pair up a more able pupil with a disabled pupil in order to share knowledge about social skills. Peer-tutoring can be also expanded to include other peer arrangements such as pupils interacting with disabled pupils during lunch breaks, extra-curricular activities (e.g. social clubs and sports) and during school events in order to include them and teach them social skills (Carter et al., 2005)

13. Use simulations and other visual prompts to teach your pupils daily life skills. For example, you can use technological means to teach about going to the grocery store, and how to interact with others in public places.

13. Plan ahead for your pupil’s behaviour excesses. Ensure that you will gather information on possible causes for the behaviour beforehand. Use the causes to decide which actions to take.

References / Multimedia resources

- Choices, Choices (K-5) Choices, Choices uses real-world scenarios to help pupils learn problem-solving and decision- making skills. - Right Choices: A Multimedia Social Skills Training Program for Adolescents (6-12) Right Choices is a 34-week program that uses video to help pupils learn problem-solving and decision-making skills; modules focus on topics such as conflict resolution, negotiating, and dealing with peer pressure.]

School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

1. Involve parents and other caregivers, as well as other adults that have an important role in the pupil’s life. Arranging meetings between parents/caregivers and staff helps to build a rapport which in turn helps the pupil feel supported and improve her/his social skills further.

2. Ensure that further provision is provided for those pupils such as additional support in the class, for example with the presence of a teaching assistant, to keep them on track.

www.idecide-project.eu

Community

Avoid ‘a one size fits all approach’. Adapt the intervention to meet the individual’s or particular group’s needs. Pupils who speak English as a Second Language might need intensive social skill instruction to promote acculturation and peer acceptance. Pupils with disabilities might need adaptive curriculum and learning strategies. Most pupils will need a combination of different strategies that are matched to their particular deficits and backgrounds.

Other (School Signage)

Have visual prompts within the school area, which demonstrate appropriate social skills, for example, how to queue in the school canteen and interact with their fellow peers during lunch breaks.

Parents / Parents’ Associations

Provide to the teachers/assistants a communication form with parents’/caregivers’ phone numbers in case something happens during an excursion. This will be achieved through collaboration with parents.

Safety 1. Organise events at your school related to social skills. For instance, through collaboration with teachers, parents and pupils, you can ask from the pupils to be part of groups and work together to achieve specific tasks (eg. To plant the garden, or mend things at school).

2. Involve the pupils in your decisions about events. This will help them to cultivate their social skills. For instance, in collaboration with the pupils prepare an agenda in which there will be an event related to intellectual disabilities/social development awareness week and ask from the pupils to participate in theatre and/or do relevant presentations.

3. Provide to the teachers/assistants a communication form with parents’/caregivers’ phone numbers in case something happens during an excursion. This will be achieved through collaboration with parents.

School Breaks

1. Organise events at your school related to social skills. For instance, through collaboration with teachers, parents and pupils, you can ask from the pupils to be part of groups and work together to achieve specific tasks (eg. To plant the garden, or mend things at school).

www.idecide-project.eu

Pupil Support

1. Establish an inclusive culture within your school: organise workshops and seminars with academics. This will help teachers to understand aspects of inclusion and apply inclusive practices, which will contribute in teaching social skills to the pupils.

2. Organise seminars/workshops at your school to raise awareness about intellectual disabilities and social skills: - Arrange one-day workshops for teachers in which you can invite external agencies (including drama therapists) to model teachers how to implement experiential learning into their teaching for those pupils. This can help the pupils to feel part of a team, practice their group work skills, to interact productively with their peers, and to socialise. - Invest in ongoing training for teachers in the form of on-site workshops and seminars provided by educational professionals or educational psychologists on aspects of social skills/social behaviour difficulties to raise awareness the difficulties these pupils experience. - Provide on-site training on drama therapy/experiential learning by inviting practitioners and professionals on the use role-playing for the development of social skills. - Εquip the school with tablets and computers so as teachers and pupils can use technology for teaching/learning social skills.

3. Involve parents and other caregivers, as well as other adults that have an important role in the pupil’s life. Arranging meetings between parents/caregivers and staff helps to build a rapport which in turn helps the pupil feel supported and improve her/his social skills further.

4. Ensure that further provision is provided for those pupils such as additional support in the class, for example with the presence of a teaching assistant, to keep them on track.

5. Provide to the teachers/assistants a communication form with parents’/caregivers’ phone numbers in case something happens during an excursion. This will be achieved through collaboration with parents.

6. Provide information about social skills by arranging onsite trainings or by using the website of the school which could be related to the following evidence-based social skills programs:

a) "Stop and Think" Social Skills Program: Part of Project ACHIEVE (Knoff and Batsche, 1995). This program has demonstrated success in reducing pupil discipline referrals to the principal's office, school suspensions, and expulsions; fostering positive school climates and pro-social interactions; increasing pupils' on-task behaviour; and improving academic performance. [Reference: http://www.projectachieve.info] Project ACHIEVE: is an innovative, evidence- based school effectiveness and improvement program focusing on all pupils' academic and social, emotional, and behavioural progress and success. The program uses strategic planning, professional development, and on-site consultation and technical assistance to address pupil achievement, positive school and classroom climates, effective teaching and instruction, and parent and community outreach and involvement.

b) The EQUIP Program (Gibbs, Potter, & Goldstein, 1995) skills. Available at: http://www.researchpress.com/scripts/product.asp?item=4848#5134

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EQUIP is a three-part intervention method for working with antisocial or behaviour- disordered adolescents. The approach includes training in moral judgment, anger management/correction of thinking errors, and pro-social skills. Youth involved in the EQUIP training program participate in two types of group sessions - Equipment Meetings (in which the leader teaches specific skills) and Mutual Help Meetings (in which the leader coaches pupils as they use the skills they've learned to help each other). The EQUIP program received the 1998 Reclaiming Children and Youth Spotlight on Excellence Award. EQUIP has been adapted for use in Canada, the Netherlands, and several other countries.

c) The ACCEPTS Program (Walker et al,1994) Offers a complete curriculum for teaching effective social skills to pupils at middle and high school levels. The program teaches peer-to- peer skills, skills for relating to adults, and self-management skills. ACCEPTS ( A Curriculum for Children's Effective Peer and Teacher Skills ) is a complete curriculum for teaching classroom and peer-to-peer social skills to children with or without disabilities in Grades K through 6. The curriculum, designed for use by regular and special education teachers, cognitively teaches social skills as subject matter content. The program can be taught in one-to-one, small-group, or large-group instructional formats. ACCEPTS includes a nine-step instructional procedure based on the principles of direct instruction; scripts that teach critically important teacher-child behavioral competencies and peer-to-peer social skills; and behavioural management procedures.

d) The School Wide- Positive Behavioural Intervention Support Programme (SW-PBIS). SW-PBIS refers to a systems change process for an entire school or district. The underlying theme is teaching behavioural expectations in the same manner as any core curriculum subject. Typically, a team of approximately ten representative members of the school will attend a two- or three- day training provided by skilled trainers. This team will be comprised of administrators, classified, and regular and special education teachers. The school will focus on three- to five- behavioural expectations that are positively stated and easy to remember. In other words, rather than telling pupils what not to do, the school will focus on the preferred behaviours. Here are some examples: o Respect Yourself, Respect Others, and Respect Property o Be Safe, Be Responsible, Be Respectful o Respect Relationships and Respect Responsibilities

Available at: https://www.pbis.org/school/swpbis-for-beginners Please note: not all instruments and projects are available in all cultural contexts. With regards to excursions, assign an assistant for the pupil for safety issues in case an episode happens.

Supportive Literature

Definition: Pupils with intellectual disabilities are more likely to exhibit behaviour problems than are children without disabilities (Dekker, Koot, van der Ende, & Verhulst, 2002). While youth with mild or borderline intellectual disabilities exhibit more antisocial behaviour than do adolescents without disabilities (Douma, Dekker, de Ruiter, Tick, & Koot, 2007), in general, the more severe the intellectual impairment, the higher the incidence and severity of problem behaviour.

Characteristics: Difficulty accepting criticism, limited self-control, and bizarre and inappropriate behaviours such as aggression or self-injury are observed more often in children with intellectual

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disabilities than in children without disabilities. Some genetic syndromes associated with intellectual disabilities tend to include atypical and maladaptive behaviour. For example, children with Prader-Willi syndrome often engage in self- injurious, obsessive-compulsive behavior and pica causes children to be eating non-nutritive substances such as string, hair or dirt (Ali, 2001; Dimitropoulos, Feurer, Butler, & Thompson, 2001; Symons, Butler, Sanders, Feurer, & Thompson, 1999).

Adapted from: Heward, W. L. (2013). Exceptional children: An introduction to special education. Pearson College Div.

Websites and EU Reports http://www.bacdis.org.uk/publications/documents/EIPBriefingPaper.pdf http://www.bps.org.uk/sites/default/files/documents/challenging_behaviour__a_unified_approach. pdf

References:

Gibbs, J. C., Potter, G. B., & Goldstein, A. P. (1995). The EQUIP program: Teaching youth to think and act responsibly through a peer-helping approach. Research Press.

Goldstein, A. P. (1999). The prepare curriculum: Teaching prosocial competencies. Research Press.

Hoppey, D., & McLeskey, J. (2013). A case study of principal leadership in an effective inclusive school. The Journal of Special Education, 46(4), 245-256.

Knoff, H. M., & Batsche, G. M. (1995). Project ACHIEVE: Analyzing a school reform process for at-risk and underachieving pupils. School Psychology Review.

Lane, K. L., Menzies, H. M., Oakes, W. P., Zorigian, K., & Germer, K. A. (2014). Professional development in EBD: What is most effective in supporting teachers. The SAGE handbook of emotional and behavioral difficulties, 415-425.

Menzies, H. M., & Bruhn, A. L. (2010). Managing challenging behaviors in schools: Research-based strategies that work. Guilford Press.

Menzies, H. M., & Lane, K. L. (2011). Using self-regulation strategies and functional assessment-based interventions to provide academic and behavioural support to pupils at risk within three-tiered models of prevention. Preventing School Failure: Alternative Education for Children and Youth, 55(4), 181-191.

Poon, K. K. (2012). Challenging behaviors among children with autism spectrum disorders and multiple disabilities attending special schools in Singapore. Research in Developmental disabilities, 33(2), 578-582.

Carter, E. W., Cushing, L. S., Clark, N. M., & Kennedy, C. H. (2005). Effects of peer support interventions on pupils' access to the general curriculum and social interactions. Research and practice for persons with severe disabilities, 30, 15-25.)

Walton, K. M., & Ingersoll, B. R. (2013). Improving social skills in adolescents and adults with autism and severe to profound intellectual disability: A review of the literature. Journal of Autism and Developmental Disorders, 43(3), 594-615.

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Pupils with Learning Difficulties

Generic Tips for Learning Difficulties

Classroom-based tips (focus on instructional methods)

1. Use ICT technology in your class and visual means of presentation of information where possible. These could include PowerPoint presentations, UDL, videos and interactive whiteboards (IWB).

2. Plan experiential learning sessions for your pupils. This will assist them to feel part of a team, practice their group work skills, and interact and socialise with their peers.

3. Avoid ‘a one size fits all approach’. Adapt the intervention to meet the individual or particular group needs. Pupils who speak English as a Second Language might need intensive social skill instruction to promote acculturation and peer acceptance. Children with disabilities might need adaptive curriculum and learning strategies. Most children will need a combination of different strategies that are matched to their particular strengths, needs and backgrounds.

4. Monitor your pupils’ behaviour during the lesson and during school breaks in order to determine if there are signs of bullying. Types of bullying could be either verbal or physical. If any of these signs are brought to your attention, inform the head teacher immediately and take action.

5. Encourage teamwork in the class and pair up these pupils with more able peers. This will help pupils feel valued and included and enhance their participation in the class.

6. Use differentiation techniques in your class. For example, differentiate the tasks for the pupils who are struggling to acquire the literacy skills. Provide single worksheets which gets progressively more difficult so as to respond to the various learning needs of your pupils.

7. Monitor the progress of pupils not only academically but also socially in terms of marginalisation, social interactions with peers, behavior at home and self-esteem (McCaleb, 2013).

8. Make sure that you accurately identify the pupils’ talents and strengths, so that you can utilise them appropriately during your lesson. For example, if a pupil is talented in theatre, introduce more role-playing activities into the lesson.

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School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Equip the school with visual prompts and signs which are related to school life, events, daily schedule and national days (Hall, Meyer and Rose, 2012; BBC active, 2010)

Community

1. Create an inclusive culture within your school, for example by organising workshops and seminars with academics. Such efforts will raise awareness on cognitive functioning and will provide teachers with the necessary teaching tools and inclusive practices, which will in turn contribute in enhancing pupils’ cognitive skills (Hoppey, & McLeskey, 2013).

2. Organise awareness days and education events in which parents and teachers are invited to get information about the diversity of educational needs and abilities of pupils.

Curricular Adaptations

2. Provide additional class support, such as teaching assistants.

3. Εquip the school with tablets and personal computers for teachers and pupils.

4. Make necessary curricular adaptations: differentiate the resources, allow extra time for those pupils with learning differences to complete their work, make appropriate adjustments to their homework and workload, and invest in on-going assessment rather than summative.

Discipline

Make sure that before you make any decisions about pupils’ behaviour, you gain more information about their history from appropriate persons in the school.

Other (Planning and Timetabling)

Schedule special education collaboration meetings, “vertical” planning across primary, secondary, and post-secondary, and school-wide goal planning with all school stakeholders. These highlight the various levels of planning involved to support inclusive teaching efforts for pupils with disabilities.

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Scheduling Events

Organise awareness days and education events in which parents and teachers are invited to get information about the diversity of educational needs and abilities of pupils.

School Celebrations / Events / Activities

Organise awareness days and education events in which parents and teachers are invited to get information about the diversity of educational needs and abilities of pupils.

School Purchases

1. Εquip the school with tablets and personal computers for teachers and pupils.

2. Make necessary curricular adaptations: differentiate the resources, allow extra time for those pupils with learning differences to complete their work, make appropriate adjustments to their homework and workload, and invest in on-going assessment rather than summative.

Student Council

Organise extra-curricular activities such as sport clubs and activities in order to include all pupils during this time.

Pupil Support

1. Provide additional class support, such as teaching assistants.

2. Ensure that pupils who appear to be anxious, depressed or may present with low self- esteem are referred to a counselor or school psychologist based on your country’s educational system and available resources.

Teacher Professional Development

2. Provide training on Universal Design for Learning (UDL), which can help teachers to adapt their materials and practices to the needs of all pupils to develop cognitive skills (Hall, Meyer and Rose, 2012).

For instance: workshop on UDL’s three principles (see below):

Principle 1: Provide multiple means of representation (recognition network).

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For example, this workshop will include how to use different means for interdisciplinary lessons. E.g. the use of videos for representation of historical events in history, digital storytelling movies

 Principle 2: Provide multiple means of action and expression (strategic network).

 For example, you can use different means of communication such as tablets, mobile devices, forums, and social media so as pupils to feel more comfortable to express themselves.  Principle 3: Provide multiple means of engagement (affective network).  For example, the workshop will consider on how to take pupils’ interests in technology into account in order to engage them in the learning process. This might be on how to make use of social media effectively, the use of mobile devices and tablets or software applications based on the purpose of the lesson. Useful resource: http://www.udlcenter.org/print/371 Guidelines: UDL Guidelines – Educator Worksheet available at http://www.udlcenter.org/aboutudl/udlguidelines/downloads

3. Provide ICT training to teachers, so they can use the technology with their pupils. Teachers must be in a position to use ICT before using it to teach their pupils. (Jung, 2005).

4. Arrange one-day workshops for teachers to which you can invite external agencies such as drama therapists and educational psychologists to demonstrate how to create experiential learning and support the pupils.

Technology

1. Εquip the school with tablets and personal computers for teachers and pupils.

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Dyslexia

Classroom-based tips (focus on instructional methods)

1. Keep the pace of instruction slow and deliberate, so as to allow time for the pupils to absorb the meaning of the lesson and language being used. Ask pupils to explain learning points back to you to make sure that they have understood the lesson well.

2. Take advantage of dyslexic pupils’ talents and strengths. For example, if a pupil is talented in theatre, introduce more role-playing activities into the lesson.

3. Give guidance about how to deal with everyday tasks in a systematic way. Dyslexic children often need adult support with tasks, such as how to tidy a drawer or put their toys away; how to get dressed; how to look for something they have lost; how to pack their school bag; how to tie a tie or tie shoelaces.

4. Use two different colours when marking pupil work, in the case you need to mark a piece of work while the child is away, for example: one for content and another one for spelling and presentation). Correct only those spellings you have taught in that lesson.

5. Use different colours to divide the board into sections; this will make it easier for the child to find words and copy them.

6. Read each word or sentence twice; explain the meaning of the words or use pictures of the text in which there are full stops and commas. This helps dyslexic children understand the text they are reading. Dyslexic children may experience difficulties in comprehension tasks so it is important to explain the meaning of a given text or passage to them.

7. Give dyslexic children the books or the text they need to use in shared reading in advance, giving them more time to practice it. This will help them to keep themselves on track and not to sit passively during the lesson.

8. Use the board or whiteboard for reminders, but not for large pieces of work. 9. Allow plenty of time for pupils to read from the board.

10. Use a plain, evenly spaced sans serif font such as Arial or Comic Sans; use cream or soft pastel colored paper instead of white for printouts and worksheets for dyslexic pupils.

11. Provide single worksheets, which get progressively more difficult so as to respond to the various learning needs of your dyslexic pupils.

[Reference: Dyslexia Friendly Pack (BDA, no date)]

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School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Equip school spaces with visual signs identifying the different areas of the school, such as dining area, toilets, canteen, principal’s office, school yard, teachers’ office, emergency exit doors, and gym.

Class Divisions / Arrangements

Pair dyslexic pupils with other pupils in the class during reading and writing activities. Accommodate the class so as the dyslexic learner is seated close to the teacher for regular eye contact.

Curricular Adaptations

Inform teachers to make necessary adaptations to the curriculum tasks. For example, based on one learning objective, provide a single worksheet, which gets progressively more difficult (BBC active, 2010).

Discipline

Be aware of the underpinning factors of the behaviour of dyslexic pupils when you are following the behavioural code in your school. Make sure that before you make a decision about their behaviour, you gain more information about their history from the responsible person in the school. For example, some pupils with dyslexia, experience frustration at school and they have low self-esteem. This may influence their behavior such as acting as the clown of the class in order to mask their difficulties.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Assign responsible persons for dyslexic pupils and make sure they are available to direct pupils when extra help is needed such as crossing the road safely during a school trip. Pupils with dyslexia tend to have difficulties in directionality and orientation and this may cause confusion between the left and right side of the street.

Homework

Reduce the amount of writing activities such as spelling. For example, instead of three sentences of spelling, you might assign a dyslexic pupil one or two. Allow dyslexic pupils to

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practice their reading skills aloud only if they feel comfortable doing so. Alternatively, ask them to read quietly at their own pace.

Parents / Parents’ Associations

Arrange regular meetings between parents and staff to discuss pupils’ progress and to enhance the home-school collaboration. This will help to monitor progress and to discuss issues that might be related to the social life of the pupil, such as marginalisation, social interactions with peers, behaviour at home, and self-esteem.

Safety

School Celebrations / Events / Activities

Include dyslexic pupils in events by differentiating their role and contribution. For example, instead of memorising a poem, take advantage of pupils’ talents in acting, theatre and role- playing.

School Purchases

Equip the classrooms in which there are dyslexic learners with different materials and advanced technology, such as tablets and projectors, so as to attain a single learning outcome (BDA, no date).

Pupil Support

Provide additional support in the classroom, such as teaching assistants to support dyslexic pupils’ learning. (BDA, 2012).

Teacher Professional Development

1. Provide training for teachers, such as with educational psychologist services, or dyslexia organisations. This will help teachers be more familiar with the main difficulties faced by dyslexic pupils, the signs for early identification and assessment, and practical tips to better support dyslexic pupils in the class. (Armstrong and Squires, 2014).

2. Arrange co-teaching sessions for your teachers to get feedback, which can include suggestions on support strategies for dyslexic pupils, and allow teachers time to reflect. (Villa, Thousand and Nevin, 2008).

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Technology

Equip the classrooms in which there are dyslexic learners with different materials and advanced technology, such as tablets and projectors, so as to attain a single learning outcome (BDA, no date).

Supportive Literature

Definition: “Dyslexia is a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling. Characteristic features of dyslexia are difficulties in phonological awareness, verbal memory and verbal processing speed. Dyslexia occurs across the range of intellectual abilities. It is best thought of as a continuum, not a distinct category, and there are no clear cut-off points. Co-occurring difficulties may be seen in aspects of language, motor co-ordination, mental calculation, concentration and personal organisation, but these are not, by themselves, markers of dyslexia. A good indication of the severity and persistence of dyslexic difficulties can be gained by examining how the individual responds or has responded to well founded intervention” (Rose review, 2009, p.30).

[Reference: General signs: Dyslexia Friendly Pack, BDA (2012, pp.4-5)]

Throughout their school careers a dyslexic child may:  Appear bright, highly intelligent and articulate but be unable to read, write or spell at grade level and get their thoughts down on paper;  Be labeled lazy, dumb, careless, immature, “not trying hard enough” or having a “behaviour problem;”  Have areas in which they excel, particularly in drama, art, music, sports business, designing, engineering and debating;  Be clumsy;  Act as the ‘class clown’ to mask what they see as their academic failure;  Become withdrawn and isolated, sitting at the back and not participating;  Be able to do one thing at a time very well but have difficulty remembering an entire list;  Have a ‘glazed over’ look when language is spoken too quickly;  Go home exhausted at the end of a normal day because they have had to put so much effort into learning;  Be bullied;  Have difficulty sustaining attention; seem to be “hyper” or a “daydreamer”  Learn best through hands-on experience, demonstrations, experimentation, observation and visual aids (multi-sensory teaching).

Signs in Written Work  Poor standard of written work compared with oral ability  Produces messy work, often crossing out words  Persistently confused by letters/numbers which look similar e.g. (θ/9, ε/3)  Spells a word several different ways in one piece of writing

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 Has difficulty with punctuation and/or grammar  Produces phonetic and bizarre spelling: not age/ability appropriate

Signs in Reading • Makes poor reading progress • Finds it difficult to blend letters together • Fails to recognise familiar words • Is hesitant in reading, especially when reading aloud • Misses out words/lines when reading, or adds extra words • Has difficulty picking out the most important points from a passage (comprehension difficulties)

Signs in Organisation and Behaviour • Difficulty in learning to tell the time • Shows poor time-keeping • Disorganised and forgetful e.g. over sport equipment and homework • Confuses direction, has trouble between left and right • Poor concentration • Difficulty following instructions • Class clown or disruptive to avoid or mask difficulties

Strengths of Dyslexia  Innovative thinking  Big picture thinking  Strong visual skills  Creative talent

The pupil that faces reading difficulties may exhibit the following characteristics: • Makes poor reading progress • Finds it difficult to blend letters together into words • Is hesitant in reading, especially when reading aloud • Misses out words/lines when reading, or adds extra words • Has difficulty picking out the most important points from a passage (comprehension difficulties)

Websites and EU Reports Dyslexia Action: www.dyslexiaaction.org.uk BeatingDyslexia.com: http://www.beatingdyslexia.com/ International Dyslexia Association: http://www.interdys.org/ British Dyslexia Association: http://www.bdadyslexia.org.uk/ Multisensory instruction: https://www.understood.org/en/school-learning/partnering-with-childs- school/instructional-strategies/multisensory-instruction-what-you-need-to-know Dyslexia friendly pack (DFA), British Dyslexia Association (2012): http://www.bdadyslexia.org.uk/common/ckeditor/filemanager/userfiles/Educator/Resources/dfs- gpg-abridged.pdf Methods of Differentiation in classrooms: http://www.bbcactive.com/BBCActiveIdeasandResources/MethodsofDifferentiationintheClassroom.

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aspx School leadership: collaboration, communication, shared vision and commitment: http://www.advanced-training.org.uk/module4/M04U01C.html#

Useful Journals Annals of Dyslexia. Available at: (http://www.springer.com/linguistics/languages+&+literature/journal/11881) London Library.

British Journal of Educational Psychology and British Psychology Journal, Cognition. Available at: British Psychological Society (http://www.bps.org.uk).

Dyslexia Journal. Available at: http://eu.wiley.com/

References

Armstrong, D. and Squires, G., (2014). Key Perspectives on Dyslexia: An essential text for educators. Routledge.

Hoppey, D., & McLeskey, J. (2013). A case study of principal leadership in an effective inclusive school. The Journal of Special Education, 46(4), 245-256

Reid, G., (2012). Dyslexia and inclusion: classroom approaches for assessment, teaching and learning. Routledge.

Rose, J., (2009). Identifying and teaching children and young people with dyslexia and literacy difficulties: An independent report.

Siegel, L.S., (2006). Perspectives on dyslexia. Paediatrics & child health,11(9), p.581.

Squires, G. and McKeown, S., 2006. Supporting Children with Dyslexia 2nd Edition. Bloomsbury Publishing.

Villa, R. Thousand, J., & Nevin, A. (2008). A Guide to Co-Teaching: Practical Tips for Facilitating Student Learning (2nd. Ed.). Thousand Oaks, California: Corwin Pres. (800) 818- 7243

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Reading Problems (Misspelling Sounds)

Classroom-based tips (focus on instructional methods)

1. Develop the phonemic awareness of the pupils. Use phoneme deletion, which refers to what word would be left if a sound were removed, e.g. if the /k/ sound were taken away from cat. Another way is word-to-word matching: Do the words “pen” and “pipe” begin with the same sound? A Greek language example is: Do the words “μάτι” and “μαχαίρι” begin with the same sound? This could be done as a game in which you can use printed images and ask pupils to categorise the images according to the first sound of the word. Phoneme counting also develops phonemic awareness, e.g.: How many sounds do you hear in the word cake? (Greek word example: λεμόνι, γάτα). Ask pupils to identify the Odd word out, e.g., which word starts with a different sound: bag, nine, beach, bike? (Greek word example: βροχή, βόλτα, δράκος, βγαίνω).

2. Teach each letter-phoneme relationship explicitly. For example, demonstrate to the pupils the letter m and say “this letter says /mmm/”. Practice the new phoneme and other phonemes that they have already been taught for five minutes each day.

3. Teach frequent, highly regular letter-sound relationships systematically. For example if the first three letter-phoneme relationships the pupils learn are /a/, /b/, /c/ the only real word the pupils can read is cab. But if the first three letter-phoneme relationships are /m/, /a/, /s/, the pupils can read am, Sam, mass. (Greek word example: α/π/ι/τ the pupils can read παπί/ πίτα/πατάτα).

4. Use interesting stories to develop language comprehension. You should teach comprehension strategies and new vocabulary using orally presented stories. Read these stories to the pupils and discuss their meaning with them.

5. Show pupils exactly how to sound out words. Teach the pupils how to blend the sounds into words. Show them how to move from left to right through spellings as they sound out each word. Remember to practice blending words composed of only the letter- phoneme relationships the pupils have learned.

6. Practice reading aloud. Ask pupils to read aloud on a 1:1 (individual) setting first, if this is feasible, so as to provide verbal reinforcement and make the pupil feel more at ease to read aloud in the presence of others. In the event that the pupil appears to be uncomfortable to read in front of his/her classmates, try to gradually introduce them to this concept (i.e. by initially grouping the pupil with a classmate with whom he/she feels comfortable working with, then into smaller groups and eventually in front of the entire class). Do not ask pupils to read aloud unless they are comfortable doing so. Allow adequate time for pupils to read the words/information presented on the board. Avoid making sudden timetable or reading task changes. Do not expect them to learn strings of facts by heart, e.g. multiplication tables just from reading it aloud many times.

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Source: Heward, W. L. (2013). Exceptional children: An introduction to special education. Pearson College Div.

School-based practical tips (focus on instructional methods)

Curricular Adaptations

1. Arrange co-teaching activities among colleagues that may be able to assist individual teachers in implementing additional activities/methods to further support their teaching. Invite researchers or educational psychologists to conduct clinical observations and provide feedback, including suggestions on support strategies.

2. Make specific adaptations to the material given to these pupils. For example:  Use a plain, evenly spaced sans serif font such as Arial and Comic Sans  Use cream or soft- pastel- coloured paper instead of white paper to print the activities given to the pupils). (Hall, Meyer and Rose, 2012).

3. Make curricular adaptations in terms of differentiating to the task. Ensure that you inform teachers to make necessary adaptations to the tasks based on individual learning objectives in the curriculum and in response to the various learning needs of the pupils and the severity of the case (Hall, Meyer and Rose, 2012).

4. Make curricular adaptations in terms of resources. If feasible, equip the classrooms in which there are pupils exhibiting specific learning difficulties with different and adapted materials and advanced technology, such as tablets or projectors, so as to attain a single learning outcome. (BDA, 2012)

Other (External Expertise)

Provide training for teachers and SEN teachers from external agencies like educational psychologist services and dyslexia organisations, related to pupils’ main areas of difficulty. They can also advise on the signs for early identification and assessment, and practical tips for the teachers in order to support those pupils in the class (Armstrong & Squires, 2014).

Parents / Parents’ Associations

Arrange regular meetings between the parents and the staff to discuss pupils’ progress and to enhance the home-school collaboration. This will help to monitor progress and to discuss other issues related to the social-emotional needs of the pupil, such as, social skills, social interactions with peers and adults within the school setting, marginalisation, behaviour at home, special areas of interest, and self-esteem.

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School Purchases Make curricular adaptations in terms of resources. If feasible, equip the classrooms in which there are pupils exhibiting specific learning difficulties with different and adapted materials and advanced technology, such as tablets or projectors, so as to attain a single learning outcome. (BDA, 2012)

Pupil Support

1. Where possible, provide additional class support, such as the presence of a teaching assistant, for pupils presenting with reading problems to keep them on track (BDA, 2012).

2. Arrange regular meetings between the parents and the staff to discuss pupils’ progress and to enhance the home-school collaboration. This will help to monitor progress and to discuss other issues related to the social-emotional needs of the pupil, such as, social skills, social interactions with peers and adults within the school setting, marginalisation, behaviour at home, special areas of interest, and self-esteem.

Teacher Professional Development

1. Provide training for teachers and SEN teachers from external agencies like educational psychologist services and dyslexia organisations, related to pupils’ main areas of difficulty. They can also advise on the signs for early identification and assessment, and practical tips for the teachers in order to support those pupils in the class (Armstrong & Squires, 2014).

2. Arrange co-teaching activities among colleagues that may be able to assist individual teachers in implementing additional activities/methods to further support their teaching. Invite researchers or educational psychologists to conduct clinical observations and provide feedback, including suggestions on support strategies.

3. Invest in ongoing training in the form of workshops and seminars provided by educational professionals or educational psychologists on aspects of differentiated teaching and strategies that may better assist the needs of pupils presenting with specific learning difficulties. (Rose review, 2009)

Technology

Make curricular adaptations in terms of resources. If feasible, equip the classrooms in which there are pupils exhibiting specific learning difficulties with different and adapted materials and advanced technology, such as tablets or projectors, so as to attain a single learning outcome. (BDA, 2012)

Supportive Literature

Definition: Difficulty with reading is by far the most common characteristic of pupils with learning disabilities. Reading problems of pupils with learning disabilities include difficulty at the word level of

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processing, for example, inability to accurately and fluently decode single words. Additionally, these pupils present with deficits in the area of phonological awareness of spoken words (Torgesen and Wagner, 1998). Phonological awareness refers to the “conscious understanding and knowledge that language is made up of sounds” (Simmons, Kame’nui, Coyne, Chard & Hairrell, 2011, p. 54).

The pupil that faces reading difficulties may exhibit the following characteristics:

• Makes poor reading progress • Finds it difficult to blend letters together into words • Is hesitant in reading, especially when reading aloud • Misses out words/lines when reading, or adds extra words • Has difficulty picking out the most important points from a passage (comprehension difficulties)

A great majority of pupils who experience difficulties representative of a specific learning disability also experience difficulties related to reading and literacy skills.

Websites and EU Reports

Phonological Awareness Organisation, Available at: http://www.phonologicalawareness.org/ Multisensory instruction: https://www.understood.org/en/school-learning/partnering-with-childs- school/instructional-strategies/multisensory-instruction-what-you-need-to-know Dyslexia friendly pack (DFA), British Dyslexia Association (2012): http://www.bdadyslexia.org.uk/common/ckeditor/filemanager/userfiles/Educator/Resources/dfs- gpg-abridged.pdf Methods of Differentiation in classrooms http://www.bbcactive.com/BBCActiveIdeasandResources/MethodsofDifferentiationintheClassroom. aspx

References

Armstrong, D. and Squires, G., (2014). Key Perspectives on Dyslexia: An essential text for educators. Routledge.

Foorman, B. R., Francis, D. J., Fletcher, J. M., Schatschneider, C., & Mehta, P. (1998). The role of instruction in learning to read: Preventing reading failure in at-risk children. Journal of Educational Psychology, 90(1), 37.

Fuchs, D., & Fuchs, L. S. (2006). Introduction to response to intervention: What, why, and how valid is it?. Reading research quarterly, 41(1), 93-99.

Hall, T. E., Meyer, A., & Rose, D. H. (Eds.). (2012). Universal design for learning in the classroom: Practical applications. Guilford Press. Heward, W. L. (2013). Exceptional children: An introduction to special education. Pearson College Div.

McCaleb, S. P. (2013). Building communities of learners: A collaboration among teachers, students, families, and community. Routledge.

Rose, J., (2009). Identifying and teaching children and young people with dyslexia and literacy difficulties: An independent report.

Simmons, D.C, Kame’enui, E.J, Coyne, M.D., Chard, D.J & Hairrell, A. (2011) Effective strategies for teaching beginning reading. In M.D. Coyne, E.J. Kame’enui, D.W Carnine (Eds.), Effective teaching strategies that accommodate diverse learners (4th ed., pp. 51-84). Upper Saddle River, NJ: Pearson

Torgesen, J. K., & Wagner, R. K. (1998). Alternative diagnostic approaches for specific developmental reading disabilities. Learning Disabilities Research & Practice.

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Villa, R. Thousand, J., & Nevin, A. (2008). A Guide to Co-Teaching: Practical Tips for Facilitating Student Learning (2nd. Ed.). Thousand Oaks, California: Corwin Pres. (800) 818- 7243

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Written Language Deficits

Classroom-based tips (focus on instructional methods)

To help pupils develop their writing skills you can use the following techniques:

1. Use ICT with individuals or groups (e.g. the pupils read a text as a group, and then each pupil individually prepares a short story based on this text using digital storytelling.

2. Use visual prompts like flash cards/multimedia and other applications to enhance pupils’ spelling skills and vocabulary (Chera & Wood, 2003)

3. Let your pupils be creative and use their imagination during the writing process. Show them that writing constitutes an important part of our lives (Troia, 2006). Some examples that could be adapted based on your class’s needs may include assisting pupils to write different kinds of letters, or even shopping lists.

4. Create activities that are relevant to your pupils’ experiences and interests (González, Moll, & Amanti, 2006) and ask them to prepare stories in different formats, for example drawings, or photos taken on their phones that they can use in their writing assignments.

5. Build on your pupils’ interests and provide them with material that motivates them to learn new vocabulary and engage in the writing process, such as comics and super-heroes with related vocabulary development (González, Moll, & Amanti, 2006)

6. Provide your pupils with feedback; for example, you may ask your pupils what they consider important and produce a feedback document form together (Genlott, & Grönlund, 2013; Lieneman, Graham, Leader- Janssen & Reid, 2006).

7. Check that pupils are attentive and not just sitting passively during shared reading and writing times.

8. Give pupils the books or text to be used in shared reading the week before, so that they can practice.

School-based practical tips (focus on instructional methods)

Community

1. Arrange regular meetings between the parents and the staff to discuss pupils’ progress and to enhance the home-school collaboration. This will help to monitor progress and to discuss other issues related to the social-emotional needs of the pupil, such as, social skills, social

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interactions with peers and adults within the school setting, marginalisation, behaviour at home, special areas of interest, and self-esteem. (McCaleb, 2013).

2. Promote the notion that writing constitutes an important part of our lives in conjunction with other modes of communication. Organise exhibitions and other events which could be attended by famous authors who can engage pupils in different activities.

Curricular Adaptations

2. Invest in ongoing training in the form of workshops and seminars provided by educational professionals or educational psychologists on aspects of differentiated teaching and strategies that may better assist the needs of pupils presenting with specific learning difficulties. (Rose review, 2009)

3. Make specific adaptations to the material given to these pupils. For example:  Use a plain, evenly spaced sans serif font such as Arial and Comic Sans  Use cream or soft- pastel- coloured paper instead of white paper to print the activities given to the pupils. (Hall, Meyer and Rose, 2012)

4. Make curricular adaptations in terms of differentiating to the task. Ensure you inform the teachers to make necessary adaptations to the tasks based on individual learning objectives in the curriculum and in response to the various learning needs of the pupils and the severity of the case (Hall, Meyer and Rose, 2012).

5. Make curricular adaptations in terms of resources. If feasible, equip the classrooms in which there are pupils exhibiting specific learning difficulties with different and adapted materials such as sand, magnetic letters and board games, and advanced technology, such as tablets and projectors, so as to attain a single learning outcome. (BDA, 2012)

Other (External Expertise)

Parents / Parents’ Associations

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School Purchases

Make curricular adaptations in terms of resources. If feasible, equip the classrooms in which there are pupils exhibiting specific learning difficulties with different and adapted materials such as sand, magnetic letters and board games, and advanced technology, such as tablets and projectors, so as to attain a single learning outcome. (BDA, 2012)

Pupil Support

Where possible, provide additional class support, such as the presence of a teaching assistant, for pupils presenting with writing difficulties (BDA, 2012).

Teacher Professional Development

Technology

Make curricular adaptations in terms of resources. If feasible, equip the classrooms in which there are pupils exhibiting specific learning difficulties with different and adapted materials such as sand, magnetic letters and board games, and advanced technology, such as tablets and projectors, so as to attain a single learning outcome. (BDA, 2012)

Supportive Literature

Definition: Pupils with learning disabilities perform significantly lower than their age-matched peers without disabilities on all written expression tasks, including the transcription of handwriting, spelling, punctuation, vocabulary, grammar, and expository writing (De La Paz and Graham 1997; Englert, Wu and Zhao, 2005).

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Characteristics:

 Pupils with written language deficits tend to demonstrate minimal planning, effort and meta- cognitive control in terms of writing.  Pupils with writing deficits also experience difficulties with spelling, grammar and punctuation  Pupils with written language deficits produce poorly organised compositions containing a poorly developed ideas. (Heward, 2013)

Websites and EU Reports http://eacea.ec.europa.eu/education/eurydice/documents/key_data_series/129en.pdf

Balanskat, A., Blamire, R., & Kefala, S. (2006). The ICT impact report. European Schoolnet. https://www.european-agency.org/sites/default/files/Lithuania.pdf

References

Alber-Morgan, S. R. (2006). Ten ways to enhance the effectiveness of repeated readings. Journal of Early and Intensive Behavior Intervention, 3(3), 273.

Armstrong, D. and Squires, G., (2014). Key Perspectives on Dyslexia: An essential text for educators. Routledge. Chera, P., & Wood, C. (2003). Animated multimedia ‘talking books’ can promote phonological awareness in children beginning to read. Learning and instruction, 13(1), 33-52.

De La Paz, S., & Graham, S. (1997). Strategy instruction in planning: Effects on the writing performance and behavior of students with learning difficulties. Exceptional Children, 63(2), 167-181.

Englert, C. S., Wu, X., & Zhao, Y. (2005). Cognitive tools for writing: Scaffolding the performance of students through technology. Learning Disabilities Research & Practice, 20(3), 184-198.

Genlott, A. A., & Grönlund, Å. (2013). Improving literacy skills through learning reading by writing: The iWTR method presented and tested. Computers & Education, 67, 98-104.

González, N., Moll, L. C., & Amanti, C. (Eds.). (2006). Funds of knowledge: Theorizing practices in households, communities, and classrooms. Routledge. Graham, S., & Harris, K. R. (2003). Students with learning disabilities and the process of writing: A meta-analysis of SRSD studies.

Hall, T. E., Meyer, A., & Rose, D. H. (Eds.). (2012). Universal design for learning in the classroom: Practical applications. Guilford Press.

Hessler, T., & Konrad, M. (2008). Using curriculum-based measurement to drive IEPs and instruction in written expression. Teaching Exceptional Children, 41(2), 28-37.

Heward, W. L. (2013). Exceptional children: An introduction to special education. Pearson College Div.

Lienemann, T. O., Graham, S., Leader-Janssen, B., & Reid, R. (2006). Improving the writing performance of struggling writers in second grade. The Journal of Special Education, 40(2), 66-78.

McCaleb, S. P. (2013). Building communities of learners: A collaboration among teachers, students, families, and community. Routledge.

Rathvon, N. (1999). Effective School Interventions. New York: Guilford Press.

Rose, J., (2009). Identifying and teaching children and young people with dyslexia and literacy difficulties: An independent report.

Troia, G. A. (2006). Writing instruction for students with learning disabilities. Handbook of writing research, 324-336.

Villa, R. Thousand, J., & Nevin, A. (2008). A Guide to Co-Teaching: Practical Tips for Facilitating Student Learning (2nd. Ed.). Thousand Oaks, California: Corwin Pres. (800) 818- 7243

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Math Underachievement

Classroom-based tips (focus on instructional methods)

To support and assist the learning of pupils who are facing this learning difference, consider the following ways to diversify teaching techniques and materials:

1. Make use of mathematics resources, plastic letters, magnetic rainbow alphabets, word cards and word mats (BDA, 2012; Dowker, 2009).

2. Use a multisensory approach (Dowker, 2009; Witzel, 2005; Scott, 1993). For instance, if you want to teach about squares you can ask pupils to bring square objects from home or ask them to search the classroom for square objects.

3. Use visual displays in your classroom, flash cards and math games with your pupils asking them to revise addition and subtraction. (BDA, 2012)

4. For revising or teaching new concepts use cubes and other items, such as counting cubes to teach addition, subtraction, multiplication, division.

5. ICT can play an important role in enhancing pupils’ mathematical skills. Ask your pupils to use applications on their tablets such as SushiMonster, MathMonsters, MotionMath and other free available applications available online. (Meletiou-Mavrotheris & Mavrotheris, 2012; Oliv et al. 2009)

6. Provide your pupils feedback about the task: use a rubric for explicit feedback or writing comments for implicit feedback; ask your pupil to give more information. (Brophy, 2010)

7. Make your lessons and activities interesting and engaging for your pupils. (Brophy, 2010)

School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Provide visual displays in school common areas to assist pupils in revising mathematical concepts in their daily lives.

Class Divisions / Arrangements

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math skills (Hoppey, & McLeskey, 2013). Provide to all pupils the option to learn maths through playing with interactive games on their tablets (Kyriakides, Mavrotheris & Prodromou, 2016).

2. Ask teachers to keep a progress log regarding specific pupils with learning differences, either for a specific lesson, topic or learning objective, or for an academic term. At the pre- intervention level, arrange a meeting with the pupil’s parents in order to determine the pupil’s study habits. The maths teacher can offer recommendations in order for the parents to be able to assist in the learning process, if this is feasible. Teachers and parents can work together to set realistic goals. With regular follow-up meetings, a pupil’s progress and learning goals can be monitored and reevaluated. If expected progress is not made, then contact the multi-disciplinary team / educational psychologist to determine more appropriate suggestions according to the pupil’s needs and how best to address them. Based on this data, re-organise the school schedule (if needed) to allow more time for co-teaching activities (Hoppey, & McLeskey, 2013).

Community

1. Arrange teacher training workshops and seminars that raise awareness of how to create an inclusive ethos in your school. This will help teachers to understand concepts like inclusion, diversity, and diverse abilities and needs, Apply inclusive practices which will enhance pupils’ math skills (Hoppey, & McLeskey, 2013). Provide to all pupils the option to learn maths through playing with interactive games on their tablets (Kyriakides, Mavrotheris & Prodromou, 2016).

2. Arrange regular meetings between the parents and the staff to discuss pupil progress and to enhance home-school collaboration. This will help to monitor progress and to discuss other areas such as social skills, interactions with peers and adults within the school setting, marginalisation, behaviour at home and self-esteem. (McCaleb, 2013).

3. Demonstrate to your pupils that maths is an essential part of our lives, by organising school events where pupils are responsible for collecting money as well as other tasks that involve maths skills at work in daily life.

Curricular Adaptations

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together to set realistic goals. With regular follow-up meetings, a pupil’s progress and learning goals can be monitored and reevaluated. If expected progress is not made, then contact the multi-disciplinary team / educational psychologist to determine more appropriate suggestions according to the pupil’s needs and how best to address them. Based on this data, re-organise the school schedule (if needed) to allow more time for co-teaching activities (Hoppey, & McLeskey, 2013).

3. Enforce curricular adaptations in terms of differentiating to the task. Inform teachers to make necessary adaptations to tasks so as to responds to the various learning needs of the pupils, and the severity of each case (Hall, Meyer and Rose, 2012; BBC active, 2010).

4. Make curricular adaptations in terms of resources – where possible equip the classrooms in which there are pupils struggling in maths with different materials and advanced technology, such as tablets or projectors, so as to attain a single learning outcome.

Discipline

Be aware of the underpinning factors of these pupils’ behaviour when you are following the behavioural code at your school. Make sure that before you reach a decision about their behaviour you have consulted the child’s parent/guardian/teacher and gain more information about the pupil’s history.

Where needed and possible, involve an educational psychologist and/or multi-disciplinary team (based on your country’s educational system and available provisions). Remember that sometimes pupils that exhibit significant learning difficulties, including in the area of maths, may present as being withdrawn and indifferent about the lesson presented, whereas others may act out and may assume the role of the class’ ‘clown’. There may be a number of reasons as to why the pupil exhibits the aforementioned behaviors; there is always a reason/purpose behind a pupil’s behavior. Some of the reasons may include: communicating frustration about the specific lesson or about difficulties in a nonverbal manner; acting out to gain some form of attention/negative reinforcement. Make an effort to talk to the pupil on an individual basis in an attempt to firstly show them that someone genuinely cares and so that a trusting relationship can be built. Discuss the purpose of the pupil’s behaviour and alternative ways in which s/he can express his/her thoughts and feelings.

Other (Pupils’ Involvement)

Collaborate with universities (Ainscow, Booth & Dyson, 2004) and organise collaborative events/trainings for teachers. This will provide teachers the opportunity to become familiar with material and best practices that can be applied when working with pupils who present underachievement in the area of maths, e.g. on the use of mobile technologies for learning maths (Kyriakides, Mavrotheris & Prodromou, 2016).

Other (Assessment)

Ask teachers to keep a progress logs regarding specific pupils with learning differences, either for a specific lesson, topic or learning objective, or for an academic term.

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At the pre-intervention level, arrange a meeting with the pupil’s parents in order to determine the pupil’s study habits. The maths teacher can offer recommendations in order for the parents to be able to assist in the learning process, if this is feasible. Teachers and parents can work together to set realistic goals. With regular follow-up meetings, a pupil’s progress and learning goals can be monitored and reevaluated. If expected progress is not made, then contact the multi-disciplinary team / educational psychologist to determine more appropriate suggestions according to the pupil’s needs and how best to address them. Based on this data, re-organise the school schedule (if needed) to allow more time for co-teaching activities (Hoppey, & McLeskey, 2013).

Other (Pupils’ Involvement in Decisions that Concern Them)

Parents / Parents’ Associations

2. Be aware of the underpinning factors of these pupils’ behaviour when you are following the behavioural code at your school. Make sure that before you reach a decision about their behaviour you have consulted the child’s parent/guardian/teacher and gain more information about the pupil’s history. Where needed and possible, involve an educational psychologist and/or multi-disciplinary team (based on your country’s educational system and available provisions). Remember that sometimes pupils that exhibit significant learning difficulties, including in the area of maths, may present as being withdrawn and indifferent about the lesson presented, whereas others may act out and may assume the role of the class’ ‘clown’. There may be a number of reasons as to why the pupil exhibits the aforementioned behaviors; there is always a reason/purpose behind a pupil’s behavior. Some of the reasons may include: communicating frustration

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about the specific lesson or about difficulties in a nonverbal manner; acting out to gain some form of attention/negative reinforcement. Make an effort to talk to the pupil on an individual basis in an attempt to firstly show them that someone genuinely cares and so that a trusting relationship can be built. Discuss the purpose of the pupil’s behaviour and alternative ways in which s/he can express his/her thoughts and feelings.

School Celebrations / Events / Activities

Demonstrate to your pupils that maths is an essential part of our lives, by organising school events where pupils are responsible for collecting money as well as other tasks that involve maths skills at work in daily life.

School Purchases

2. Εquip the school with tablets and personal computers to promote the use of technology to motivate underachieving pupils in maths (Brophy, 2010). Build on pupils’ confidence in using everyday technology such as mobiles and tablets to enhance their motivation and self-efficacy beliefs.

3. Make curricular adaptations in terms of resources – where possible equip the classrooms in which there are pupils struggling in maths with different materials and advanced technology, such as tablets or projectors, so as to attain a single learning outcome.

Pupil Support

1. Where possible, provide additional classroom support, such as a teaching assistant.

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basis in an attempt to firstly show them that someone genuinely cares and so that a trusting relationship can be built. Discuss the purpose of the pupil’s behaviour and alternative ways in which s/he can express his/her thoughts and feelings.

Teacher Professional Development

2. Collaborate with universities (Ainscow, Booth & Dyson, 2004) and organise collaborative events/trainings for teachers. This will provide teachers the opportunity to become familiar with material and best practices that can be applied when working with pupils who present underachievement in the area of maths, e.g. on the use of mobile technologies for learning maths. (Kyriakides, Mavrotheris & Prodromou, 2016).

Technology

1. Εquip the school with tablets and personal computers to promote the use of technology to motivate underachieving pupils in maths (Brophy, 2010). Build on pupils’ confidence in using everyday technology such as mobiles and tablets to enhance their motivation and self-efficacy beliefs.

2. Make curricular adaptations in terms of resources – where possible equip the classrooms in which there are pupils struggling in maths with different materials and advanced technology, such as tablets or projectors, so as to attain a single learning outcome.

Timetabling

Ask teachers to keep a progress log regarding specific pupils with learning differences, either for a specific lesson, topic or learning objective, or for an academic term. At the pre- intervention level, arrange a meeting with the pupil’s parents in order to determine the pupil’s study habits. The maths teacher can offer recommendations in order for the parents to be able to assist in the learning process, if this is feasible. Teachers and parents can work together to set realistic goals. With regular follow-up meetings, a pupil’s progress and learning goals can be monitored and reevaluated. If expected progress is not made, then contact the multi-disciplinary team / educational psychologist to determine more appropriate suggestions according to the pupil’s needs and how best to address them. Based on this data, re-organise the school schedule (if needed) to allow more time for co-teaching activities (Hoppey, & McLeskey, 2013).

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Supportive Literature

Definition: Numerical reasoning and calculation pose major problems for many pupils with learning disabilities. Pupils with learning disabilities perform lower than typically achieving children on every type of arithmetic problem at every grade level (Cawley, Parmar, Foley, Salmon, & Roy, 2001). Deficits in retrieving number facts and solving story problems are particularly evident (L. S. Fuchs et al., 2010; Geary, 2004).

Source: Heward, W. L. (2013). Exceptional children: An introduction to special education. Pearson College Div.

Characteristically, pupils with Mathematics Underachievement:

• show confusion with number order, e.g. units, tens, hundreds • are confused by mathematical symbols • have difficulty remembering anything in a sequential order, e.g. tables, days of the week, the alphabet • have difficulty learning and remembering multiplication tables • may reverse numbers such as 2 and 5

Websites and EU Reports http://www.dyscalculia.org/ http://www.bdadyslexia.org.uk/dyslexic/dyscalculia http://www.catchup.org/resources/610/what_works_for_children_with_mathematical_difficulties. pdf https://www.european-agency.org/publications/ereports/ict-for-inclusion-developments-and- opportunities-for-european-countries https://www.european-agency.org/publications/ereports/ra4al-synthesis-report/ra4al-synthesis- report Multisensory instruction: https://www.understood.org/en/school-learning/partnering-with-childs- school/instructional-strategies/multisensory-instruction-what-you-need-to-know Dyslexia friendly pack (DFA), British Dyslexia Association (2012): http://www.bdadyslexia.org.uk/common/ckeditor/filemanager/userfiles/Educator/Resources/dfs- gpg-abridged.pdf Methods of Differentiation in classrooms http://www.bbcactive.com/BBCActiveIdeasandResources/MethodsofDifferentiationintheClassroom. aspx

References

Brophy, J. (2010). Motivating students to learn. New York, NY: Routledge.

Cawley, J. F., Parmar, R. S., Foley, T. E., Salmon S., & Roy, S. (2001). Arithmetic performance of students: Implications for standards and programming. Exceptional Children, 67, 311–328.

Dowker, A. (2009). What works for children with mathematical difficulties?. DfES Publications.

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Hoppey, D., & McLeskey, J. (2013). A case study of principal leadership in an effective inclusive school. The Journal of Special Education, 46(4), 245-256.

Jung, I. (2005). ICT-Pedagogy Integration in Teacher Training: Application Cases Worldwide. Educational Technology & Society, 8(2), 94-101. Konstantinou-Katzi, P., Tsolaki E., Meletiou-Mavrotheris M., & Koutselini, M.(2013) "Differentiation of teaching and learning mathematics: an action research study in tertiary education." International Journal of Mathematical Education in Science and Technology 44, 3, 332-349.

Kyriakides, A. O., Meletiou-Mavrotheris, M., & Prodromou, T. (2016). Mobile technologies in the service of students’ learning of mathematics: the example of game application ALEX in the context of a primary school in Cyprus. Mathematics Education Research Journal, 28(1), 53-78.

Meletiou-Mavrotheris, M., & Mavrotheris, E. (2012). Game-enhanced mathematics learning for pre-service primary school teachers. In International Conference on Information Communication Techonologies in Education.

Niess, M. L. (2005). Preparing teachers to teach science and mathematics with technology: Developing a technology pedagogical content knowledge. Teaching and teacher education, 21(5), 509-523.

Olive, J., Makar, K., Hoyos, V., Kor, L. K., Kosheleva, O., & STRäSSER, R. (2009). Mathematical knowledge and practices resulting from access to digital technologies. In Mathematics education and technology-rethinking the terrain (pp. 133-177). Springer US.

Scott, K. S. (1993). Multisensory mathematics for children with mild disabilities. Exceptionality, 4(2), 97-111.

Witzel, B. S. (2005). Using CRA to teach algebra to students with math difficulties in inclusive settings. Learning Disabilities—A Contemporary Journal, 3(2), 49-60.

Zaranis, N., Kalogiannakis, M., & Papadakis, S. (2013). Using mobile devices for teaching realistic mathematics in kindergarten education. Creative Education, 4(07), 1. https://www.touchmath.com/pdf/UsingTouchMathwithStudentswithLearningDisabilities.pdf

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Social Skills Deficits

Classroom-based tips (focus on instructional methods)

1. Use a natural interaction with pupils to practice a certain skill (Elksnin and Elksnin, 2000). Naturalistic interventions involve structuring the environment to create numerous opportunities for desired pupil responses (e.g., holding up a toy and asking, “What do you want?”) and structuring adult responses to a pupil’s communication (e.g., the pupil points outside and says, “Go with me,” and the teacher says, “Okay, I’ll go with you”). Kaiser and Grim (2006: 455-456) make the following recommendations about naturalistic interventions:  Teach when the pupil is interested  Teach what is functional for the pupil at the moment.  Stop while both the pupil and the teacher are still enjoying the interaction.

2. Read and discuss literature related to stories on social skills which involve topics such as dealing with new situations, dealing with bullying and making new friends (DeGeorge, 1998)

3. Discuss what the pupil did after a social interaction: what happened, whether the outcome was positive or negative and what the pupil will do in the same situation in the future (Elksnin and Elksnin, 2000; Lavoie, 2005)

4. Use multimedia resources to teach social skills. A lot of pupils with learning disabilities tend to be visual learners; thus videos, simulations, virtual environments and other multimedia can be effective teaching tools (Mitchell et al, 2007; Parsons, Leonard and Mitchell, 2006). Additionally, 1-3 (above) can also be taught by utilising multimedia resources, as well as inclusion of auditory learners.

5. Create your own social skills tools and adapt them to your pupils’ needs. For instance, you can audio/video-record your pupils in class (with parental permission in advance) and then use the video to initiate a discussion of your pupils’ social interactions. For example, record an event that takes place in the classroom – the event could be less positive and it might be related to pupils’ behaviour in the class. By recording it, the pupils will be able to reflect on their behaviour.

Set your expectations appropriately according to pupils’ developmental levels. Consider your pupils’ understanding in terms of social skills; ome pupils might not be able to process and may not have developed their social skills to the same degree as their peers.

(NCTI, CITed – Centre for Integrating Technology in Education)

6. Ask pupils to create their own stories about social behaviour and discuss and provide immediate feedback about these stories (NCTI, CITEd)

7. Use still images from the video as ‘reminders of social behaviour’ for your pupils. Photographs can be used as well for this purpose. (NCTI, CITEd)

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Multimedia resources  Choices, Choices (K-5) http://www.tomsnyder.com/products/product.asp?SKU=CHOCHO Choices, Choices uses real-world scenarios to help pupils learn problem-solving and decision- making skills.

 Right Choices: A Multimedia Social Skills Training Program for Adolescents (6-12) http://store.cambiumlearning.com/ProductPage.aspx?parentId=019000986&functionID=00 9000008&site=sw Right Choices is a 34-week program that uses video to help pupils learn problem-solving and decision-making skills; modules focus on topics such as conflict resolution, negotiating, and dealing with peer pressure.

School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Εquip the school with posters that demonstrate appropriate social skills.

Community

1. Involve parents and other caregivers, as well as other adults that have an important role in pupils’ lives. Arranging meetings between parents/caregivers and staff can build a rapport on how to support the pupils at school in order to develop their social skills further.

3. Organise events at your school related to social skills. For instance, involve teachers, parents and pupils to form collaborative groups including the pupils with social skills’ deficits and prepare an agenda to work in groups.

Develop pre-teaching and/or modeling of certain skills within the school setting prior to implementing them at a school event.

4. Establish an inclusive culture within your school. Arrange workshops and seminars that raise awareness of how to create an inclusive ethos in your school and help teachers to understand aspects of inclusion, diversity, diverse abilities and needs and finally to apply inclusive practices which will contribute in enhancing pupils’ social skills. Help teachers to apply inclusive practices and differentiation strategies, which will contribute in enhancing all pupils’ social and academic skills (Hoppey, & McLeskey, 2013).

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Curricular Adaptations

1. Establish an inclusive culture within your school. Arrange workshops and seminars that raise awareness of how to create an inclusive ethos in your school and help teachers to understand aspects of inclusion, diversity, diverse abilities and needs and finally to apply inclusive practices which will contribute in enhancing pupils’ social skills. Help teachers to apply inclusive practices and differentiation strategies, which will contribute in enhancing all pupils’ social and academic skills (Hoppey, & McLeskey, 2013).

2. Include the pupils in school events by differentiating their role and contribution. For example if they do not want to dance or recite a poem, provide them with an alternative such as helping with the costumes. Make sure they feel that they are part of a group and that their contribution is important. If they feel that they are being marginalised they may exhibit problem behavior such as throwing tantrums, becoming uncooperative, or being oppositional and defiant.

Discipline

1. Introduce evidence-based social skills programs, such as:

 "Stop and Think" Social Skills Program: Part of Project ACHIEVE (Knoff and Batsche, 1995). Has demonstrated success in reducing pupil discipline referrals to the principal's office, school suspensions, and expulsions; fostering positive school climates and prosocial interactions; increasing pupils' on-task behavior; and improving academic performance.

http://www.projectachieve.info

 Primary Mental Health Project (Cowen et al, 1996.) Targets children K-3 and addresses social and emotional problems that interfere with effective learning. It has been shown to improve learning and social skills, reduce acting, shyness and anxious behaviors, and increase frustration tolerance.

http://www.sharingsuccess.org/code/eptw/profiles/48.html

 The EQUIP Program (Gibbs, Potter, & Goldstein, 1995) Offers a three-part intervention method for working with antisocial or behavior disordered adolescents. The approach includes training in moral judgment, anger management/correction of thinking errors, and prosocial skills.

http://www.researchpress.com/scripts/product.asp?item=4848#5134

 The PREPARE Curriculum (Goldstein, 1999) Presents a series of 10 course-length interventions grouped into three areas: reducing aggression, reducing stress, and reducing prejudice. It is designed for use with middle school and high school pupils but can be adapted for use with younger pupils.

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http://www.researchpress.com/scripts/product.asp?item=5063

 The ACCEPTS Program (Walker et al, 1994) Offers a complete curriculum for teaching effective social skills to pupils at middle and high school levels. The program teaches peer-to-peer skills, skills for relating to adults, and self-management skills.

3. Conduct multidisciplinary team meetings in order to: (i) Gain a better understanding of pupils’ behaviours and needs and (ii) Determine the potential need for referral to the appropriate professionals. Remember that some pupils with social skills deficits might be overreacting in some situations or be extremely shy and not want to speak in others situations. Allow them space to relax and take the time to discuss issues with them and actively listen to what they have to say.

 Approach the pupil in a non-confrontational manner, being aware both of the nonverbal and verbal language that you will use.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Ensure that you take the necessary measures both within the school setting and on school excursions if you have pupils who have exhibited behaviors that put them or others in danger. First decide based on the individual needs of the pupil, whether it would be safe for him/her to engage in the specific activity. Assign an assistant to accompany the pupil, and ensure his/her and others’ safety and well-being. Work with the assistant or special education teacher to prepare the pupil in advance. This is especially important when dealing with adolescents in secondary schools; some pupils at this age would rather not to be ‘accompanied’ by an assistant. Give specific instructions to the assistant to ensure potential interventions will be positive.

Other (External Expertise)

Provide training on drama therapy/experiential learning so teachers can use role playing with their pupils to teach social skills (Jennings, 2013; Freeman, Sullivan & Fulton, 2003; De la Cruz, Lian & Morreau, 1998). Through theatre, for example, pupils with social skills deficits can be taught how to react in certain real life situations. Involve the speech therapist, special education teacher and educational psychologist, depending on your country’s educational system and the involvement that the have within the school setting. Work with them to set specific lesson plans with the classroom teacher to address social skills needs.

Other (Pupils’ Involvement)

Organise events at your school related to social skills. For instance, involve teachers, parents and pupils to form collaborative groups including the pupils with social skills’ deficits and prepare an agenda to work in groups. Develop pre-teaching and/or modeling of certain skills within the school setting prior to implementing them at a school event.

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Parents / Parents’ Associations

Safety

Scheduling Events

School Celebrations

Include the pupils in school events by differentiating their role and contribution. For example if they do not want to dance or recite a poem, provide them with an alternative such as helping with the costumes. Make sure they feel that they are part of a group and that their contribution is important. If they feel that they are being marginalised they may exhibit problem behavior such as throwing tantrums, becoming uncooperative, or being oppositional and defiant.

School Purchases

Εquip the school with tablets and personal computers so as teachers and pupils can use technology for teaching/learning social skills (Mitchell et al, 2007; Parsons, Leonard and Mitchell, 2006). Useful applications that can be used on pupils’ and teachers’ tablets include:

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https://www.edutopia.org/blog/social-emotional-apps-special-ed-jayne-clare https://glenwood.org/wp-content/uploads/2013/04/Social-Skills-and-Autism-Spectrum- Disorders-Application-List.pdf

Pupil Support

1. Provide training on drama therapy/experiential learning so teachers can use role playing with their pupils to teach social skills (Jennings, 2013; Freeman, Sullivan & Fulton, 2003; De la Cruz, Lian & Morreau, 1998). Through theatre, for example, pupils with social skills deficits can be taught how to react in certain real life situations. Involve the speech therapist, special education teacher and educational psychologist, depending on your country’s educational system and the involvement that the have within the school setting. Work with them to set specific lesson plans with the classroom teacher to address social skills needs.

2. Where possible, ensure that further provision is provided for those pupils such as additional support in the class through the presence of a teaching assistant, or even appropriate peers who could assist without feeling burdened.

4. Approach the pupil in a non-confrontational manner, being aware both of the nonverbal and verbal language that you will use.

Teacher Professional Development

2. Introduce evidence-based social skills programs, such as:

[Reference: http://www.projectachieve.info]

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[Reference: http://www.sharingsuccess.org/code/eptw/profiles/48.html]

[Reference: http://www.researchpress.com/scripts/product.asp?item=4848#5134]

3. Establish an inclusive culture within your school. Arrange workshops and seminars that raise awareness of how to create an inclusive ethos in your school and help teachers to understand aspects of inclusion, diversity, diverse abilities and needs and finally to apply inclusive practices which will contribute in enhancing pupils’ social skills. Help teachers to apply inclusive practices and differentiation strategies, which will contribute in enhancing all pupils’ social and academic skills (Hoppey, & McLeskey, 2013).

Technology

1. Εquip the school with tablets and personal computers so as teachers and pupils can use technology for teaching/learning social skills (Mitchell et al, 2007; Parsons, Leonard and Mitchell, 2006). Useful applications that can be used on pupils’ and teachers’ tablets include:

https://www.edutopia.org/blog/social-emotional-apps-special-ed-jayne-clare https://glenwood.org/wp-content/uploads/2013/04/Social-Skills-and-Autism-Spectrum- Disorders-Application-List.pdf

Supportive Literature

Definition: Pupils with learning disabilities are also more prone to social problems. The poor social skills of pupils with learning disabilities may be due to the ways they interpret social situations relative

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to their own experiences and their inability to perceive the nonverbal affective expressions of others (Meadan & Halle, 2004; Most & Greenbank, 2000).

Teachers should be very observant of behaviours related to difficulties with social skills and bring them to the attention of the school multi-disciplinary team. This will determine whether further assessment is necessary for the child so as to provide a clearer understanding of their needs and diagnosis.

Social situations that present difficulties for disabled pupils can be simple or more complex (De Bildt et al,.2005): - engaging in a conversation with a peer - deciding if someone who appears friendly wants to harm you

According to Kavale and Forness (1996) 75% of pupils with learning disabilities demonstrate deficits in social skills. In addition, as Estell, Jones, Pearl & Van Acker (2009) and Wiener (2004) have pointed out social skills deficits result in negative consequences such as:

- low social status - scarcer interactions with teachers - struggling in making friendships - loneliness

Social skills are often broken down into categories, or types of skill according to the level of complexity and interaction, for example:

Skill Set Used for Examples Foundation Basic social Ability to maintain eye Skills interaction contact and appropriate personal space, understand gestures and facial expressions Interaction Skills needed to Resolving conflicts, taking Skills interact with turns, learning how to begin others and end conversations, determining appropriate topics for conversation, interacting with authority figures Affective Skills needed for Identifying one's feelings, Skills understanding recognising the feelings of oneself and others others, demonstrating empathy, decoding body language and facial expressions, determining whether someone is trustworthy

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Cognitive Skills needed to Social perception, making Skills maintain more choices, self-monitoring, complex social understanding community interactions norms, determining appropriate behavior for different social situations. (Canney and Byrne, 2006; Waltz, 1999)

Source: Heward, W. L. (2013). Exceptional children: An introduction to special education. Pearson College Div

Websites and EU Reports

British Dyslexia Association http://www.bdadyslexia.org.uk/ http://www.disabilityeurope.net/content/aned/media/ANED%202010%20Task%205%20Education% 20final%20report%20-%20FINAL%20(2)_0.pdf http://www.disability-europe.net/content/aned/media/EE%20social%20inclusion%20report.pdf

References

A "Tech Works" brief from the National Center for Technology Innovation(NCTI) and the Center for Implementing Technology in Education (CITEd)

Agaliotis, I., & Kalyva, E. (2008). Nonverbal social interaction skills of children with learning disabilities. Research in developmental disabilities, 29(1), 1-10.

Chen, K. (2006). Social skills intervention for students with emotional/behavioral disorders: A literature review from the American Perspective. Educational Research and Reviews, 1(4), 143.

Clement-Heist, K., Siegel, S., & Gaylord-Ross, R. (1992). Simulated and in situ vocational social skills training for youths with learning disabilities. Exceptional children, 58(4), 336-345.

Cowen, E. L., Hightower, A. D., Pedro-Carroll, J. L., Work, W. C., Wyman, P. A., & Haffey, W. G. (1996). School-based prevention for children at risk: The Primary Mental Health Project. American Psychological Association.

De la Cruz, R. E., Lian, M. C. J., & Morreau, L. E. (1998). The effects of creative drama on social and oral language skills of children with learning disabilities. Youth Theatre Journal, 12(1), 89-95.

DeGeorge, K. L. (1998). Friendship and Stories Using Children's Literature to Teach Friendship Skills to Children with Learning Disabilities. Intervention in School and Clinic, 33(3), 157-162.

Elksnin, L. K., & Elksnin, N. (2000). Teaching parents to teach their children to be prosocial. Intervention in School and Clinic, 36(1), 27-35.

Elksnin, N., & Elksnin, L. K. (2001). Adolescents with disabilities: The need for occupational social skills training. Exceptionality, 9(1-2), 91- 105.

Estell, D. B., Jones, Pearl, M. H., Pearl, R., & Van Acker, R. (2009). Best friendships of students with and without learning disabilities across late elementary school. Exceptional Children, 76, 110–124.

Freeman, G. D., Sullivan, K., & Fulton, C. R. (2003). Effects of creative drama on self-concept, social skills, and problem behavior. The Journal of Educational Research, 96(3), 131-138.

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Gibbs, J. C., Potter, G. B., & Goldstein, A. P. (1995). The EQUIP program: Teaching youth to think and act responsibly through a peer-helping approach. Research Press.

Goldstein, A. P. (1999). The prepare curriculum: Teaching prosocial competencies. Research Press. Jennings, S. (2013). Dramatherapy: Theory and practice (Vol. 3). Routledge.

Kavale, K. A., & Forness, S. R. (1996). Social skills deficits and learning disabilities: A metaanalysis. Journal of Learning Disabilities, 29,226– 237.

Knoff, H. M., & Batsche, G. M. (1995). Project ACHIEVE: Analysing a school reform process for at-risk and underachieving students. School Psychology Review.

Lewis, T. J., Sugai, G., & Colvin, G. (1998). Reducing problem behavior through a school-wide system of effective behavioral support: Investigation of a school-wide social skills training program and contextual interventions. School Psychology Review, 27(3), 446.

McCaleb, S. P. (2013). Building communities of learners: A collaboration among teachers, students, families, and community. Routledge.

Meadan, H., & Halle, J. W. (2004). Social perceptions of students with learning disabilities who differ in social status. Learning Disabilities Research and Practice, 19 , 71–82.

Mitchell, P., Parsons, S., & Leonard, A. (2007). Using virtual environments for teaching social understanding to 6 adolescents with autistic spectrum disorders. Journal of autism and developmental disorders, 37(3), 589-600.

Morris, S. (2002). Promoting social skills among students with nonverbal learning disabilities. Teaching Exceptional Children, 34(3), 66.

Most, T., & Greenbank, A. (2000). Auditory, visual, and auditory-visual perception of emotions by adolescents with and without learning disabilities, and their relationship to social skills. Learning Disabilities Research & Practice, 15(4), 171-178.

Parsons, S., Leonard, A., & Mitchell, P. (2006). Virtual environments for social skills training: comments from two adolescents with autistic spectrum disorder. Computers & Education, 47(2), 186-206.

Peterson, L. D., Young, K. R., Salzberg, C. L., West, R. P., & Hill, M. (2006). Using self-management procedures to improve classroom social skills in multiple general education settings. Education and treatment of children, 1-21.

Raskind, M. H., Margalit, M., & Higgins, E. L. (2006). “My LD”: Children’s voices on the Internet. Learning Disability Quarterly, 29, 253–268.

Rose, J., (2009). Identifying and teaching children and young people with dyslexia and literacy difficulties: An independent report.

Walker, H. M., Schwarz, I. E., Nippold, M. A., Irvin, L. K., & Noell, J. W. (1994). Social skills in school-age children and youth: Issues and best practices in assessment and intervention. Topics in Language Disorders, 14(3), 70-82.

Wiener, J. (2004). Do peer relationships foster behavioral adjustment in children with learning disabilities? Learning Disability Quarterly, 27,21–30.

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Attention Deficit Hyperactivity Disorder (generic tips)

When addressing Attention Deficit and Hyperactivity in school, it is important to consider the following:

1. A formal ADHD (Inattentive, Hyperactive, Mixed type ) diagnosis cannot be made by teachers but by the appropriate professionals; therefore teachers should not try to place students into specific diagnostic categories based on their observations of their behaviors

2. The following suggestions may be implemented to students who exhibit behaviors that are withinin the ADHD diagnostic criteria; however, the student’s individual needs should also be taken into consideration.

3. Not all students who meet the criteria to be eligible for an ADHD diagnosis present the same symptomatology and needs. Therefore, the school should involve the appropriate professionals (educational psychologists, multi-disciplinary support team – based on your country’s educational system and available supports) in the event that assessment/counseling or other services may be of need.

Attention Deficit Hyperactivity Disorder

Classroom-based tips (focus on instructional methods)

1. Restructure the environment and seat the pupil near you so you can monitor his/her performance and behaviour (Garrick Duhaney, 2003; Harlacher, Roberts, & Merrell, 2006; Salend, Elhoweris, & van Garderen, 2003).

2. Break assignments into small manageable chunks. Be as clear as possible as pupils with ADHD tend to get overwhelmed when presented with lots of information. (Garrick Duhaney, 2003; Harlacher, Roberts, & Merrell, 2006; Salend, Elhoweris, & van Garderen, 2003).

3. Use a timer to assist the pupil in learning to monitor his/her own work. For example, you can say ‘you have 10 minutes to complete that task’ and set the timer at 10 minutes. Be careful in selecting a task that the pupil can actually finish in 10 minutes and provide him/her with positive feedback.

4. Provide frequent opportunities to actively respond with ongoing instruction and provide differential consequences for pupils’ behaviour (e.g., positive reinforcement such as praise and tokens for appropriate behaviour, ignoring inappropriate behaviour, and time out or response cost for inappropriate behaviour) (Garrick

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Duhaney, 2003; Harlacher, Roberts, & Merrell, 2006; Salend, Elhoweris, & van Garderen, 2003).

5. Teach self-control to your pupils (Pelham & Fabiano, 2008). There are several ways to do this, for example, taking into account activity 3, your pupil must finish his/her task in the specific time and then be allowed to do something else.

6. Ask from your pupils to describe their own behaviour and provide clear instructions and consistent reinforcement (Bicard & Neef, 2002; Reid et al, 2005). This can be done by asking them to write a story, or audio/video recording them during an assignment and then using this for discussion. (Be sure to respect the ethics code and get necessary permissions for audio-visual recordings.)

7. Use correspondence training. Correspondence training is a procedure in which children are reinforced for “do–say” verbal statements about what they had done previously and “say–do” statements describing what they plan to do (Shapiro, DuPaul, & Bradley-King, 1998).

School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

If it is possible, arrange the classroom or another space in school to be a relaxing environment that pupils can use during breaks and lunch-time.

Community

1. Arrange weekly or fortnightly meetings between the parents and the staff to discuss the pupils’ progress and to enhance the home-school collaboration. This will help to monitor progress and provide opportunities to discuss issues that might be related to the social life of the pupil, marginalisation, social interactions with peers, behaviour at home, and self-esteem (McCaleb, 2013).

2. Collaborate with the parents and pupil to consider if and how they would like to share specific information on ADHD with peers. If they wish to do this, consultation with health care providers, such as school or community health nurses, may be helpful.

Curricular Adaptations

1. Make curricular adaptations in terms of differentiating to the task – make sure you inform the teachers to make the necessary adaptations to the tasks and responds to the various learning needs of the pupils and on the severity of each individual case. For example, based

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on a particular learning objective in the curriculum, a teacher might provide a single worksheet, which gets progressively harder (Hall, Meyer and Rose, 2012; BBC active, 2010).

2. Make curricular adaptations in terms of resources so that where possible you equip the classrooms in which there are pupils with ADHD with different materials and advanced technology, such as, tablets and projectors, so as to attain a single learning outcome (BDA, 2012)

Discipline

1. If the pupil is taking medication during the school day, discuss with the parents the possible side effects of these. Follow school and/or jurisdictional policies and protocols in storing and administering medication. Reference: http://www.learnalberta.ca/content/inmdict/html/adhd.html]

2. Be aware of the fact that often pupils with ADHD are highly sensitive and impulsive. If a situation appears unfair to them they might become angry. Give them time to calm down, and then talks things through with them.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

During an excursion assign an assistant – especially if the pupil is taking medication. Provide clear guidance and information.

Other (Awareness Raising)

Arrange meetings with adults with ADHD to talk to teachers and pupils to raise awareness regarding ADHD [Reference: Forlin, Sharma & Loreman, 2007]

Parents / Parents’ Associations

2. If the pupil is taking medication during the school day, discuss with the parents the possible side effects of these. Follow school and/or jurisdictional policies and protocols in storing and administering medication. Reference: http://www.learnalberta.ca/content/inmdict/html/adhd.html]

3. Be aware that some pupils may be uncomfortable discussing or taking medications in the presence of peers. Collaborate with the pupil and family to determine how to best support the pupil.

4. Collaborate with the parents and pupil to consider if and how they would like to share

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specific information on ADHD with peers. If they wish to do this, consultation with health care providers, such as school or community health nurses, may be helpful.

Safety

2. During an excursion assign an assistant – especially if the pupil is taking medication. Provide clear guidance and information.

School Celebrations / Events / Activities

Pupils with ADHD tend to be creative. Include the pupils into school events by differentiating their role and contribution. For instance, instead of memorising a poem, or dancing (if they have difficulties in coordination) take advantage of other talents such as drawing or constructing something for a school play.

School Purchases

1. Εquip the school with tablets and personal computers so that technology can be used in teaching/learning social skills, and following rules (Jung, 2005).

2. Make curricular adaptations by differentiating the resources available for pupils with ADHD, for example, visual prompts/ posters in school showing the daily schedule and school-wide events (Hall, Meyer and Rose, 2012; BBC active, 2010).

3. Make curricular adaptations in terms of resources so that where possible you equip the classrooms in which there are pupils with ADHD with different materials and advanced technology, such as, tablets and projectors, so as to attain a single learning outcome (BDA, 2012)

Pupil Support

1. Where possible, ensure the provision of additional classroom support such as the presence of teaching assistant to help pupils with ADHD to stay on track (BDA, 2012).

2. Be aware that some pupils may be uncomfortable discussing or taking medications in the presence of peers. Collaborate with the pupil and family to determine how to best support the pupil.

Teacher Professional Development

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1. Provide training for teachers and SEN teachers from external agencies (e.g., educational psychologist services and ADHD organisations.) related to the main difficulties of ADHD pupils in classes, the signs for early identification and assessment and practical tips for the teachers in order to support those pupils in the class (Rose, 2009). Focus the training on specific areas, such as, training on the design of learning activities that require a high response rate such as providing pupils with individual white boards, chalkboards, response cards or electronic tools so they can respond while working in large groups [Reference: http://www.learnalberta.ca/content/inmdict/html/adhd.html]

2. Arrange meetings with adults with ADHD to talk to teachers and pupils to raise awareness regarding ADHD [Reference: Forlin, Sharma & Loreman, 2007]

3. Provide training on drama therapy/experiential learning so teachers can use role playing with their pupils to teach them social skills and how to follow rules [Reference Jennings, 2013; Freeman, Sullivan & Fulton, 2003; De la Cruz, Lian & Morreau, 1998]

Technology

1. Εquip the school with tablets and personal computers so that technology can be used in teaching/learning social skills, and following rules (Jung, 2005).

Supportive Literature

Definition: “The essential feature of attention-deficit/hyperactivity disorder is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development” (American Psychiatric Association, 2000a, p. 85).

Some pupils with learning disabilities have difficulty attending to a task and/or display high rates of hyperactivity. Children who consistently exhibit these problems may be diagnosed with attention- deficit/hyperactivity disorder (ADHD). A high degree of comorbidity (two conditions occurring in the same individual) between learning disabilities has frequently been reported (Smith & Adams, 2006)

Characteristics of pupils with ADHD: Inattention - not attending to details - difficulty sustaining attention to tasks or activities - does not seem to listen

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- does not follow through on instructions (e.g., starts a task but soon gets sidetracked) - difficulty organising tasks and activities (e.g., work is messy and disorganised) - dislikes tasks that require sustained mental effort - frequently loses things - easily distracted - Often forgetful.

Hyperactivity and impulsivity - Fidgeting - Restlessness - runs about or climbs on furniture, often excessively loud or noisy - often “on the go” as if “driven by a motor” - talks excessively, blurts out answers, difficulty waiting to take his or her turn, interrupts others - acts without thinking (e.g., starts a task without reading or listening to the instructions) - Impatient, rushes through activities or tasks, has difficulty resisting temptations.

(adapted from American Psychiatric Association, 2011c)

Websites and EU Reports http://www.apa.org/topics/adhd/ https://www.psychiatry.org/patients-families/ADHD/what-is-ADHD https://www.adhsdeutschland.de/Portaldata/1/Resources/PDF/4_8_4_Politik/Anlage_4a_Mapping_ (Englisch).pdf

References

Bicard, D. F., & Neef, N. A. (2002). Effects of strategic versus tactical instructions on adaptation to changing contingencies in children with ADHD. Journal of Applied Behavior Analysis, 35, 375–389.

DuPaul, G. J., & Stoner, G. (2014). ADHD in the schools: Assessment and intervention strategies. Guilford Publications.

Forlin, C., Sharma, U., & Loreman, T. (2007). An international comparison of pre-service teacher attitudes towards inclusive education. Disability studies quarterly, 27(4). Freeman, G. D., Sullivan, K., & Fulton, C. R. (2003). Effects of creative drama on self-concept, social skills, and problem behavior. The Journal of Educational Research, 96(3), 131-138.

Garrick Duhaney, L. M. (2003). A practical approach to managing the behaviors of students with ADD. Intervention in School and Clinic, 38 , 267–279.

Harlacher, J. E., Roberts, N. E., & Merrell, K. W. (2006). Classwide interventions for students with ADHD. Teaching Exceptional Children, 39 (2), 6–12.

Hughes, L., & Cooper, P. (2007). Understanding and supporting children with ADHD: Strategies for teachers, parents and other professionals. London: Paul Chapman.

Jennings, S. (2013). Dramatherapy: Theory and practice (Vol. 3). Routledge.

McCaleb, S. P. (2013). Building communities of learners: A collaboration among teachers, students, families, and community. Routledge.

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Pelham, W., & Fabiano, G. A. (2008). Evidence based psychosocial treatments for attention deficit/hyperactivity disorder. Journal of Clinical Child Psychology, 37, 184–214.

Reid, R., Trout, A. L., & Schartz, M. (2005). Self-regulation interventions for children with attention defi cit/hyperactivity disorder. Exceptional Children, 71, 361–377.

Rose, J., (2009). Identifying and teaching children and young people with dyslexia and literacy difficulties: An independent report.

Salend, S. J., Elhoweris, H., & van Garderen, D. (2003). Educational interventions for students with ADD. Intervention in School and Clinic, 38, 280–288.

Sava, F. A. (2000). Is Attention Deficit Hyperactivity Disorder an exonerating construct? Strategies for school inclusion. European Journal of Special Needs Education, 15(2), 149-157.

Shapiro, E. S., DuPaul, G. J., & Bradley-King, K. L. (1998). Self-management as a strategy to improve the classroom behavior of adolescents with ADHD. Journal of Learning Disabilities, 31, 545–555.

Shapiro, E. S., DuPaul, G. J., & Bradley-Klug, K. L. (1998). Self-management as a strategy to improve the classroom behavior of adolescents with ADHD. Journal of Learning Disabilities, 31(6), 545-555.

Sherman, J., Rasmussen, C., & Baydala, L. (2008). The impact of teacher factors on achievement and behavioural outcomes of children with Attention Deficit/Hyperactivity Disorder (ADHD): A review of the literature. Educational research, 50(4), 347-360.

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Low Ratings of Self-Efficacy

Classroom-based tips (focus on instructional methods)

1. Provide feedback to your pupils about the task using a rubric for explicit feedback or writing comments for implicit feedback (Brophy, 2010). The feedback teachers give to pupils and the way it is presented is important for the self-efficacy of pupils. In studies, pupils have commented that when a teacher gives praise or encouragement, “you don’t really think it helps at the time, but when it comes down to it, it does” (Klassen & Lynch, 2007 in https://www.rivier.edu/journal/ROAJ-Fall-2013/J783-Bergen.pdf).

2. Be aware of the support you offer in the classroom, and the way you offer help which can make a difference. Encourage pupils to come to you and ask for help with new projects and assignments. (Klassen & Lynch, 2007). (https://www.rivier.edu/journal/ROAJ-Fall-2013/J783- Bergen.pdf)

3. Use the RAFT approach (Santa, 1998) to enhance pupils’ understanding of narrative and expository text, and help your pupils build self-efficacy by enhancing their motivation. Use RAFT to differentiate the content and product for pupils with varying academic skills and knowledge levels. RAFT is defined as follows:

4. Establish meaningful, purposeful and realistic content learning goals for pupils. For instance, show them that reading and writing constitute an important part of our lives. Make adaptations based on your class’s needs; for example assist pupils to write different kinds of letters.

5. Praise your pupils for their effort regardless of the results produced. This will help to create a positive learning environment in which pupils will feel it is safe to make mistakes (Weiser, 2014).

6. Create activities that are relevant to pupils’ experiences and interests (González, Moll, & Amanti, 2006). For example if your pupils like super-heroes you can use comics and ask them to prepare their own comic strips, and enhance their vocabulary. With older pupils you can use blogs to enhance their writing and vocabulary skills.

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School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Put visual/written signs around school with motivational quotes. Encourage pupils to work with a mentor or teacher and assist in finding inspirational and motivational quotes that they like and participate in creating signs for the school.

Community

Arrange regular meetings between the parents and the staff to discuss pupils’ progress and to enhance the home-school collaboration. This will help to monitor progress and to discuss other issues related to the social life of the pupil, such as marginalisation, social interactions with peers, behavior at home and self-esteem. (McCaleb, 2013)

Curricular Adaptations

1. Ask that your teachers keep data about their pupils, such as records on which pupils show low self-efficacy beliefs and why. Design interventions based on this data in collaboration with the teachers (Hoppey & McLeskey, 2013).

2. Make curricular adaptations in terms of differentiating to the task and inform teachers to make necessary adaptations to the tasks so that they respond to the various learning needs of the particular pupils and the severity of each case. (Hall, Meyer and Rose, 2012; BBC active, 2010).

3. Make curricular adaptations in terms of resources; where possible equip the classrooms in which there are pupils with low self-efficacy beliefs with different materials and advanced technology, such as tablets and projectors, so as to attain a single learning outcome. (BDA, 2012).

4. Provide staff training on drama therapy and experiential learning so teachers can use role- playing with their pupils to build their confidence (Jennings, 2013; Freeman, Sullivan & Fulton, 2003; De la Cruz, Lian & Morreau, 1998)

Discipline

Ensure that before you reach a decision about pupils’ behaviour you have contacted the parents/guardians and teacher and gained more information about the pupil’s history. Involve the appropriate professionals in this process, such as an educational psychologist, or a multi-disciplinary team, depending on your country’s educational system and available supports.

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Other (Assessment)

Ask that your teachers keep data about their pupils, such as records on which pupils show low self-efficacy beliefs and why. Design interventions based on this data in collaboration with the teachers (Hoppey & McLeskey, 2013).

Other (Pupils’ Involvement – Important for Inclusion)

Encourage teachers to ask for their pupils’ opinions for issues that concern them, in relation for example to how they are taught specific subjects and the materials used.

Parents / Parents’ Associations

1. Arrange regular meetings between the parents and the staff to discuss pupils’ progress and to enhance the home-school collaboration. This will help to monitor progress and to discuss other issues related to the social life of the pupil, such as marginalisation, social interactions with peers, behavior at home and self-esteem. (McCaleb, 2013).

2. Ensure that before you reach a decision about pupils’ behaviour you have contacted the parents/guardians and teacher and gained more information about the pupil’s history. Involve the appropriate professionals in this process, such as an educational psychologist, or a multi-disciplinary team, depending on your country’s educational system and available supports.

School Celebrations / Events / Activities

Organise events at your school like theatre performances, bazaars and sports days where pupils are assigned different roles and responsibilities. This will help them build their self- confidence and transfer skills from that context to the classroom context.

School Purchases

1. Εquip the school with tablets and comptuers so teachers and pupils can use technology to motivate pupils with low self-efficacy beliefs and help them feel more confident (Brophy, 2010). Most pupils are confident in using everyday technology such as mobiles and tablets, so this approach will enhance their motivation and self-efficacy beliefs further.

2. Make curricular adaptations in terms of resources; where possible equip the classrooms in which there are pupils with low self-efficacy beliefs with different materials and advanced technology, such as tablets and projectors, so as to attain a single learning outcome. (BDA, 2012).

Pupil Support

1. Where possible, ensure the provision of additional class support, such as the presence of a teaching assistant to keep pupils with low self-efficacy on track (BDA, 2012).

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2. Provide staff training on drama therapy and experiential learning so teachers can use role- playing with their pupils to build their confidence (Jennings, 2013; Freeman, Sullivan & Fulton, 2003; De la Cruz, Lian & Morreau, 1998).

3. Ensure that before you reach a decision about pupils’ behaviour you have contacted the parents/guardians and teacher and gained more information about the pupil’s history. Involve the appropriate professionals in this process, such as an educational psychologist, or a multi-disciplinary team, depending on your country’s educational system and available supports.

Teacher Professional Development

1. Establish an inclusive culture within your school – This can be achieved through workshops and seminars with academics. These will help teachers to understand aspects of inclusion and apply inclusive practices, which will contribute to enhancing pupils’ self-efficacy beliefs (Hoppey & McLeskey, 2013).

2. Provide training for teachers and SEN teachers from external agencies such as educational psychologist services and academics on ways that teachers can enhance their own self- efficacy beliefs. This will in turn help teachers to support pupils to enhance their own self- efficacy beliefs (https://www.european-agency.org/sites/default/files/TE4I-Literature- Review.pdf)

3. Provide staff training on drama therapy and experiential learning so teachers can use role- playing with their pupils to build their confidence (Jennings, 2013; Freeman, Sullivan & Fulton, 2003; De la Cruz, Lian & Morreau, 1998)

Technology

Supportive Literature

Definition: Self-efficacy refers to an individual's belief in his or her capacity to execute behaviours necessary to produce specific performance attainments (Bandura, 1977, 1986, 1997). Self-efficacy reflects confidence in the ability to exert control over one's own motivation, behaviour, and social environment. These cognitive self-evaluations influence all manner of human experience, including the goals for which people strive, the amount of energy expended toward goal achievement, and likelihood of attaining particular levels of behavioral performance. Unlike traditional psychological

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constructs, self-efficacy beliefs are hypothesised to vary depending on the domain of functioning and circumstances surrounding the occurrence of behaviour (http://www.apa.org).

Pupils with learning disabilities are more likely to report lower levels of self-efficacy, mood, effort, and hope than are their peers without learning disabilities. It is not known whether a tendency for negative self-perceptions is an inherent characteristic of learning disabilities or the result of a painful history of frustration and disappointment with academic and social situations (Cosden, Brown, & Elliott, 2002 and Lackaye, Margalit, Ziv, & Ziman, 2007, p. 111).

Pupils with learning disabilities are an extremely heterogeneous group. It is important to remember that the fundamental, defining characteristic of pupils with learning disabilities is the presence of specific and significant achievement deficits seemingly in spite of adequate overall intelligence. The difference between what pupils with learning disabilities “are expected to do and what they can do…grows larger and larger” over time (Deshler et al., 2001, p. 97). The performance gap becomes especially noticeable and handicapping in the middle and secondary grades, when the academic growth of many pupils with disabilities plateaus. By the time they reach high school, pupils with learning disabilities are the lowest of the low achievers, performing below the 10th percentile in reading, written language, and math (Hock, Schumaker, & Deshler, 1999).

[Reference: Heward, W. L. (2013). Exceptional children: An introduction to special education. Pearson College Div.]

Websites and EU Reports http://www.council-for-learning-disabilities.org/wp- content/uploads/2014/07/Weiser_Motivation.pdf https://www.european-agency.org/sites/default/files/TE4I-Literature-Review.pdf Note: this is mainly about teachers’ efficacy (however it is suggested that teachers’ self-efficacy beliefs have a direct impact on their pupils’ efficacy). British Dyslexia Association. http://www.bdadyslexia.org.uk/http://www.bdadyslexia.org.uk/ http://www.bdadyslexia.org.uk/ http://www.council-for-learning-disabilities.org/wp content/uploads/2014/07/Weiser_Motivation.pdfhttp://www.council-for-learning- disabilities.org/wp content/uploads/2014/07/Weiser_Motivation.pdf http://www.council-for-learning-disabilities.org/wp content/uploads/2014/07/Weiser_Motivation.pdf http://serc.carleton.edu/NAGTWorkshops/affective/efficacy.html

References

Klassen, R. M., & Lynch, S. L. (2007). Self-efficacy from the perspective of adolescents with LD and their specialist teachers. Journal of Learning Disabilities, 40(6), 494-507.

Hoppey, D., & McLeskey, J. (2013). A case study of principal leadership in an effective inclusive school. The Journal of Special Education, 46(4), 245-256.

Schunk, D. H. (2003). Self-efficacy for reading and writing: Influence of modeling, goal setting, and self-evaluation. Reading &Writing Quarterly, 19(2), 159-172.

Brophy, J. (2010). Motivating students to learn. New York, NY: Routledge

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Santa, C. (1988). Content reading including study systems. Dubuque, IA: Kendall/Hunt Publishing.

Filippatou, D., & Kaldi, S. (2010). The Effectiveness of Project-Based Learning on Pupils with Learning Difficulties Regarding Academic Performance, Group Work and Motivation. International journal of special education, 25(1), 17-26.

Zimmerman, B. J., & Schunk, D. H. (2011). Motivational sources and outcomes of self-regulated learning and performance. Handbook of self- regulation of learning and performance, 49-64.

Vaughn, S., Klingner, J. K., Swanson, E. A., Boardman, A. G., Roberts, G., Mohammed, S. S., & Stillman-Spisak, S. J. (2011). Efficacy of collaborative strategic reading with middle school students. American Educational Research Journal, 48(4), 938-964.

Bergen, A. (2013). Self-efficacy, special education students, and achievement: shifting the lens. InSight: Rivier Academic Journal, 9(2).

Heacox, D. (2011). Making differentiation a habit: How to ensure success in academically diverse classrooms. Minneapolis, MN: Free Spirit Publishing.

Tomlinson, C. A. (2003). Fulfilling the promise of the differentiated classroom. Alexandria, VA: Association for Supervision and Curriculum Development (ASCD). Note. More information on this book with selected samples from the chapters can be found at http://www.ascd.org/publications/books/103107.aspx

Freeman, G. D., Sullivan, K., & Fulton, C. R. (2003). Effects of creative drama on self-concept, social skills, and problem behavior. The Journal of Educational Research, 96(3), 131-138.

Jennings, S. (2013). Dramatherapy: Theory and practice (Vol. 3). Routledge.

McCaleb, S. P. (2013). Building communities of learners: A collaboration among teachers, students, families, and community. Routledge. Rose, J., (2009). Identifying and teaching children and young people with dyslexia and literacy difficulties: An independent report.

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Autism Spectrum

Autistic Disorder (Autism)

Classroom-based tips (focus on instructional methods)

1. Use pictorial self-instruction (Mithaug & Mithaug, 2003). Pupils can learn to complete academic assignments using a picture-based graphic organiser. Pupils plan, complete, and evaluate their work by circling pictures according to the following categories: (a) Subjects to Work, (b) What I Will Do, and (c) What I Did. Use this strategy to teach self-management skills.

2. Use multimedia to teach social skills. A lot of pupils with autism tend to be visual learners thus videos, simulations, virtual environments and other multimedia can be effective teaching tools (Parsons, 2006; Parsons, Leonard and Mitchell, 2006). You can also implement role- playing, social stories, and observing others’ behaviour by utilising multimedia.

3. Read and discuss literature related to stories on social skills, which involve topics such as dealing with new situations, dealing with bullying or making new friends (DeGeorge, 1998)

4. Create your own social skills tools and adapt them to your pupils’ needs. For instance, you can audio/video-record your pupils in class and then use the materila to initiate a discussion of your pupils’ social interactions. Make sure necessary parental consent forms are signed. (NCTI, CITed – Centre for Integrating Technology in Education)

5. Ask pupils to create their own stories about social behaviour and discuss and provide feedback about these stories. (NCTI, CITEd)

6. Use photographs or still images from the videos created, as ‘reminders of social behaviour’ with your pupils. (NCTI, CITEd)

7. Use technology, such as tablets, to teach vocabulary and social skills to pupils with autism. Choose from a wide range of applications freely available online to meet your pupils’ needs.

8. Create and implement a visual schedule on a consistent basis. These provide a sense of predictability and security. Avoid sudden changes to the pupils’ schedules as much as possible. [Reference: http://www.cesa7.org/sped/autism/structure/str11.htm] http://www.cesa7.org/sped/autism/structure/str11.htm

9. Provide repetition, predictable routines and structure. Prepare for changes in routine such as school trips in advance. Ensure that you break down the activities and provide opportunities for discussion and role-playing, such as how to study a restaurant menu, how to order and ask for the bill, and how to organise the correct amount of money to pay for the bill.

10. Teach your pupils life skills including food preparation, laundry, household cleaning. Determine the usefulness of a particular skill by asking questions such as:

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• Is this knowledge/skill going to be helpful for the pupil to be more independent and successful in his home, school, or community? • Will failure to learn this knowledge/skill have any negative consequences to the pupil? The ultimate approach to determining if a given skill qualifies as functional curriculum is to contemplate this question from the pupil’s perspective: “Will I need it when I’m 21?” (Heward, 2013)

11. Use visual cues, simulations and prompts to teach everyday skills to your pupils, such as meal preparation. (Mechling, Gast, & Langone, 2002). For example, there might be images modelling the activity of getting dressed and going to the grocery in a sequential form.

12. In the event that the pupil exhibits self-destructive behaviour, conduct a multi-disciplinary team meeting or contact the educational psychologist in order to develop a Functional Behavioral Analysis and consequently a Behavioural Intervention Plan.

13. For pupils who present echolalia: Present opportunities for use of repetitive language to change the pupil’s echolalia. Also, reinforce the pupil’s responsive speech, which is free of echolalia. Use simple language when communicating with autistic pupils to lower their anxiety or frustration levels.

School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Put visual signs of places within the different school areas to help autistic pupils with orientation in the space for the various daily tasks and activities.

Class Divisions / Arrangements

1. Provide the classrooms with resources that can help autistic pupils tackle their motor, social and academic skills, such as equipment for relaxation including music, radio, and a soft couch, and multisensory equipment such as sand letters, sky writing and rice trays.

2. Equip the school with tablets and computers so as teachers and pupils can use technology for teaching/learning social skills and augmentative alternative communication (AAC) devices. Additionally, teach pupils to communicate by using AAC, for example: ● Observe the interaction between an individual with RTT and a familiar person ● Provide targeted strategies to implement during familiar settings, such as: A) Offer choices B) Increase the time within which you expect responses C) Acknowledge behaviours that can potentially be communicative such as gazing, having an open mouth, vocalisation, hand and body movements Ask questions or make comments that require responses from your pupils. (http://praacticalaac.org/praactical/fresh-look-aac-for-children-who-have-rett-syndrome- with-dr-theresa-bartalotta/

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3. Arrange staff meetings to inform teachers how the class can be adapted in order to best accommodate the autistic pupils, including factors such as where the pupil needs to sit, how to prepare and put up visual signs in the class, and how to create visual timetable.

4. Reduce distracting stimuli such as wall decorations, or the hum of florescent lights.

[Reference: http://www.learnalberta.ca/content/inmdict/html/autism.html]

5. Provide a separate space for breaks or regular physical movement outside of the classroom. [Reference: http://www.learnalberta.ca/content/inmdict/html/autism.html]

Community

Arrange regular meetings between parents and staff to discuss the pupils’ progress, and to enhance home-school collaboration. This will help to monitor progress and to discuss issues that might be related to the social life of the pupil, such as marginalisation, social interactions with peers, behavior at home and self-esteem. (McCaleb, 2013)

Curricular Adaptations

2. Equip the school with tablets and computers so as teachers and pupils can use technology for teaching/learning social skills and augmentative alternative communication (AAC) devices. Additionally, teach pupils to communicate by using AAC, for example: ● Observe the interaction between an individual with RTT and a familiar person ● Provide targeted strategies to implement during familiar settings, such as: A) Offer choices B) Increase the time within which you expect responses C) Acknowledge behaviours that can potentially be communicative such as gazing, having an open mouth, vocalisation, hand and body movements Ask questions or make comments that require responses from your pupils. [Reference: http://praacticalaac.org/praactical/fresh-look-aac-for-children-who-have-rett- syndrome-with-dr-theresa-bartalotta/

Discipline

1. Provide increased supervision during free time.

[Reference: http://www.learnalberta.ca/content/inmdict/html/autism.html]

2. Provide a separate space for breaks or regular physical movement outside of the classroom.

[Reference: http://www.learnalberta.ca/content/inmdict/html/autism.html]

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Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

1. Inform teachers about autistic pupils’ needs for school excursions in advance. Make sure that there won’t be any sudden change to pupils’ schedules to avoid upsetting or unsettling them.

2. Provide teachers and assistants a communication form and telephone numbers of parents/caregivers of autistic pupils in the case of an emergency. Communicate in advance with the parents of autistic pupils to be aware of any particular needs to be considered such as diet, behaviour management, medical care and mood swings.

3. Provide a weekly or monthly calendar of events to parents in order to assist them in preparing their child for upcoming changes.

Other (Pupil Involvement – Important for Inclusion)

Request pupils’ feedback on decision-making that concerns them. This will help them develop their social skills. For instance, in collaboration with the pupils you can decide that a specific week there will be awareness week for autism and ask the pupils to contribute by preparing a presentation and other collaborative tasks.

Other (Raising Awareness)

Encourage and train teachers to help their classes in understanding ASD, and their classmate with autism, so as to be more accepting and supportive. [References: http://www.learnnc.org/lp/editions/every-learner/6692; Shally, C., Since we’re friends: An Autism picture book. (Centeron, AR: Awaken Specialty Press. 2007]

Parents / Parents’ Associations

1. Provide teachers and assistants a communication form and telephone numbers of parents/caregivers of autistic pupils in the case of an emergency. Communicate in advance with the parents of autistic pupils to be aware of any particular needs to be considered such as diet, behaviour management, medical care and mood swings.

2. Provide a weekly or monthly calendar of events to parents in order to assist them in preparing their child for upcoming changes.

3. Ensure autistic pupils are able to communicate their needs effectively. In collaboration with parents and speech-language pathologists, determine if augmentative or alternate communication supports need to be explored.

4. Arrange regular meetings between parents and staff to discuss the pupils’ progress, and to enhance home-school collaboration. This will help to monitor progress and to discuss issues that might be related to the social life of the pupil, such as marginalisation, social interactions with peers, behavior at home and self-esteem. (McCaleb, 2013)

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Safety Provide increased supervision during free time.

[Reference: http://www.learnalberta.ca/content/inmdict/html/autism.html]

Scheduling Events

1. Inform teachers about autistic pupils’ needs for school excursions in advance. Make sure that there won’t be any sudden change to pupils’ schedules to avoid upsetting or unsettling them.

3. Provide a weekly or monthly calendar of events to parents in order to assist them in preparing their child for upcoming changes.

School Breaks

1. Provide increased supervision during free time.

[Reference: http://www.learnalberta.ca/content/inmdict/html/autism.html]

2. Provide a separate space for breaks or regular physical movement outside of the classroom.

[Reference: http://www.learnalberta.ca/content/inmdict/html/autism.html]

School Purchases

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4. Provide training to teachers regarding the use of technology such as AAC devices. Teachers should be in a position to use these devices with their pupils.

Pupil Support

1. Provide Teaching Assistant services in the classroom in order to facilitate autistic pupils’ needs, such as how to keep them on track, ensure they are able to work at their own pace on a given task, provide reminders and reinforcement during tasks, create a schedule of the tasks that need to be completed and support pupils during lesson time.

2. Encourage teachers to keep a record regarding the pupils’ progress in social and academic skills. This will help to design interventions based on their individual needs (Hoppey, & McLeskey, 2013).

Teacher Professional Development

1. Arrange staff meetings to inform teachers how the class can be adapted in order to best accommodate the autistic pupils, including factors such as where the pupil needs to sit, how to prepare and put up visual signs in the class, and how to create visual timetable.

2. Establish an inclusive culture within your school by organising workshops related to the inclusion of children with autism in schools. Contact academics or others with expertise in the area of autism to talk to teachers. This will help teachers understand aspects of inclusion and raise awareness on behavioural excesses and challenging behaviour, and apply inclusive practices, which will in turn contribute to enhancing pupils’ social and academic skills (Hoppey, & McLeskey, 2013).

3. Encourage teachers to keep a record regarding the pupils’ progress in social and academic skills. This will help to design interventions based on their individual needs (Hoppey, & McLeskey, 2013).

4. Provide training to teachers regarding the use of technology such as AAC devices. Teachers should be in a position to use these devices with their pupils.

5. Encourage and train teachers to help their classes in understanding ASD, and their classmate with autism, so as to be more accepting and supportive. [References: http://www.learnnc.org/lp/editions/every-learner/6692; Shally, C., Since we’re friends: An Autism picture book. (Centeron, AR: Awaken Specialty Press. 2007]

Technology

1. Equip the school with tablets and computers so as teachers and pupils can use technology for teaching/learning social skills and augmentative alternative communication (AAC) devices. Additionally, teach pupils to communicate by using AAC, for example:

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● Observe the interaction between an individual with RTT and a familiar person ● Provide targeted strategies to implement during familiar settings, such as: A) Offer choices B) Increase the time within which you expect responses C) Acknowledge behaviours that can potentially be communicative such as gazing, having an open mouth, vocalisation, hand and body movements Ask questions or make comments that require responses from your pupils. (http://praacticalaac.org/praactical/fresh-look-aac-for-children-who-have-rett-syndrome- with-dr-theresa-bartalotta/

2. Ensure autistic pupils are able to communicate their needs effectively. In collaboration with parents and speech-language pathologists, determine if augmentative or alternate communication supports need to be explored.

3. Provide training to teachers regarding the use of technology such as AAC devices. Teachers should be in a position to use these devices with their pupils.

Supportive Literature

Characteristics of Autistic Spectrum Disorders (adapted from DSM-5 Autism Spectrum Disorder 299.00 (F84.0) A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text): 1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions. 2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication. 3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers. Specify current severity: Severity is based on social communication impairments and restricted repetitive patterns of behavior

B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive): 1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases). 2. Insistence on sameness, inflexible adherence to routines, or ritualised patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).

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3. Highly restricted, fixated interests that are abnormal in intensity or focus, such as strong attachment to or preoccupation with unusual objects, with excessively circumscribed or perseverative interest. 4. Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

C. Symptoms must be present in the early developmental period (but may not become fully manifested until social demands exceed limited capacities, or may be masked by learned strategies in later life).

D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

Websites and EU Reports http://www.autism.org.uk/ http://www.autism-society.org/ http://www.autismeurope.org/publications/reports-and-good- practices/ http://www.autismeurope.org/main-fields-of-action/right-to-education/ https://www.kent.ac.uk/tizard/research/eu_decl_conference/EAIS%20Nov%2007.pdf http://www.edu.gov.on.ca/eng/general/elemsec/speced/autismSpecDis.pdf http://www.swaaac.com/files/assessandimp/aacbasicsandimplementationbook.pdf

References

A "Tech Works" brief from the National Center for Technology Innovation(NCTI) and the Center for Implementing Technology in Education (CITEd)

Hoppey, D., & McLeskey, J. (2013). A case study of principal leadership in an effective inclusive school. The Journal of Special Education, 46(4), 245-256

McCaleb, S. P. (2013). Building communities of learners: A collaboration among teachers, students, families, and community. Routledge.

Parsons, S., Leonard, A., & Mitchell, P. (2006). Virtual environments for social skills training: comments from two adolescents with autistic spectrum disorder. Computers & Education, 47(2), 186-206.

Pennington, R. C. (2010). Computer-assisted instruction for teaching academic skills to students with autism spectrum disorders: A review of literature. Focus on Autism and Other Developmental Disabilities, 25(4), 239-248.

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Rayner, C. (2011). Teaching students with autism to tie a shoelace knot using video prompting and backward chaining. Developmental Neurorehabilitation, 14(6), 339-347.

Robinson, S. E. (2011). Teaching paraprofessionals of students with autism to implement pivotal response treatment in inclusive school settings using a brief video feedback training package. Focus on Autism and Other Developmental Disabilities, 26(2), 105-118.

Ryan, J. B., Hughes, E. M., Katsiyannis, A., McDaniel, M., & Sprinkle, C. (2011). Research-based educational practices for students with autism spectrum disorders. Teaching Exceptional Children, 43(3), 56.

Sperry, L., Neitzel, J., & Engelhardt-Wells, K. (2010). Peer-mediated instruction and intervention strategies for students with autism spectrum disorders. Preventing School Failure: Alternative Education for Children and Youth, 54(4), 256-264.

Xin, J. F., & Sutman, F. X. (2011). Using the smart board in teaching social stories to students with autism. Teaching exceptional children, 43(4), 18-24.

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Pervasive Developmental Disorder Not Otherwise Specified (PDD- NOS)

Classroom-based tips (focus on instructional methods)

1. Conduct a disability awareness training at the beginning of the school year

2. Provide activities promoting acceptance and support

3. Assign specific student roles during group collaborative work

4. Ensure that each pupil has a role in class activities

5. Provide pupils with 2-3 short breaks during classroom periods

6. Use task analysis, modelling, guided practice and role playing to maximise pupils’ active participation in class

7. Include all types of activities to favour the PDD-NOS pupils’ participation

8. Implement social stories and peer-mediated learning strategies (e.g., peer-tutoring)

9. Implement a class-wide or individual reinforcement system (e.g., token economy)

10. Implement social skills training

11. Use response cards (pre-printed, write-on) to allow pupil additional practice opportunities

School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

Reduce the level of stress and anxiety in the school environment by developing new learning habits without disturbing the PDD-NOS pupil’s routine. Repeat instructions, and explain concepts by turn-taking, sharing or entering into play situations. Reduce anxiety regarding expectations of tasks, to support routine and to introduce new, or a change in, tasks

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

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Community

1. Campaign for support to increase the level of awareness of the teachers, pupils and parents of what PDD-NOS means. Involve the parents and school community to support inclusion of a PDD-NOS pupil in the class.

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

2. Work with families to use a consistent approach to manage behaviour. For example, if the child finds that every time they are given a direction, the same response is expected, or that every time they react in a certain way, the same consequence follows, they will learn the appropriate behaviour far more quickly.

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

Curricular Adaptations

1. Reduce the level of stress and anxiety in the school environment by developing new learning habits without disturbing the PDD-NOS pupil’s routine. Repeat instructions, and explain concepts by turn-taking, sharing or entering into play situations. Reduce anxiety regarding expectations of tasks, to support routine and to introduce new, or a change in, tasks

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

2. Develop literacy skills in order to cope with completing tests, and taking exams in the academic environment.

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

Discipline

Have a policy and strategies to protect against bullying and aggressive situations that target the PDD-NOS pupil.

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

Homework

www.idecide-project.eu

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

Parents / Parents’ Associations

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

School Projects

Develop literacy skills in order to cope with completing tests, and taking exams in the academic environment.

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

Pupils Support

1. Organise the inclusion of the pupil in your class activities by developing forms of communication such as gestural systems or picture-based systems.

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

2. Develop literacy skills in order to cope with completing tests, and taking exams in the academic environment.

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

Teacher Professional Development

1. Reduce the level of stress and anxiety in the school environment by developing new learning habits without disturbing the PDD-NOS pupil’s routine. Repeat instructions, and explain

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concepts by turn-taking, sharing or entering into play situations. Reduce anxiety regarding expectations of tasks, to support routine and to introduce new, or a change in, tasks

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

2. Help the child to understand and use richer language and to use language more spontaneously, developing conversation skills, and enhancing verbal and non-verbal communication including natural gestures, speech, signs, pictures and written words.

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

Technology

Have a policy and strategies to protect against bullying and aggressive situations that target the PDD-NOS pupil.

[Reference: https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/]

Supportive Literature

Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS) “refers to a group of disorders characterised by impairment in the development of social interaction, verbal and non-verbal communication, imaginative activity and a limited number of interests and activities that tend to be repetitive” (https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified-pdd-nos/). In other and very succinct words, PDD- NOS refers to persons who “show only some autistic characteristics” (Delfos, Atwood, p. 20). “PDD-NOS is often incorrectly referred to as simply ‘PDD’ The term PDD refers to the class of conditions to which autism belongs. PDD is not itself a diagnosis, while PDD-NOS is a diagnosis.” (European Commission, Some elements about the prevalence of Autism Spectrum Disorders (ASD) in the European Union). An individual is diagnosed with PDD-NOS if he/she does not fully meet the criteria for Autism Spectrum Disorder (ASD), Asperger’s Syndrome, Rett Syndrome or Childhood Disintegrative Disorder, but has several of the characteristics. Children are generally 3-4 years old before they exhibit enough symptoms for a diagnosis. There is no set pattern of symptoms or signs in children with PDD-NOS. Children with PDD-NOS may exhibit some of the following features:

Social and emotional  Poor social skills  Reluctance to make eye contact.  Experience difficulties interacting meaningfully.  Appear to lack desire to share activities with others, prefers to be alone.  May be willing to make friends, but do not know how. May be unintentionally aggressive in an attempt to be social.

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 Lack social empathy.  Difficulty in understanding that other people have their own beliefs, desires and intentions which guide their behaviour  Difficulty in taking turns and/or sharing with peers.  Difficulty differentiating between familiar and unfamiliar people.  Limited in their play skills and may become fixated on only playing with specific toys in a particular way.  Have poor imaginative play skills.

Language and communication  Difficulty in understanding or using appropriate forms of communication, such as verbal language, body language, facial expression, tone of voice and gestures.  Difficulty in developing and understanding other forms of communication, such as, picture- based systems.  Limited or no speech and/or lack of typical communicative gestures.  Literal understanding of language; they do not understand when someone is joking, for instance.

Adaptation  Find it very difficult to interpret and process new pieces of information.  Have difficulty coping with change.  May feel stress because of small changes to routine, activity or unfamiliar surroundings.  May avoid strangers or new activities because of fear and anxiety.  Want to do work perfectly and may become unwilling to attempt work that they feel they cannot do perfectly.  May want to be in control of situations and may become very successful at manipulating people in order to maintain control.

Cognitive  May have learning difficulties due to poor memory and attention.  Requires repetition of instructions/directions and may require time to process before responding or acting.  May have difficulty understanding concepts such as turn-taking, sharing or how to enter into play situations [Reference: https://childdevelopment.com.au/areas-of- concern/diagnoses/pervasive- developmental-disorder-not-otherwise-specified- pdd-nos/]

Websites and EU Reports

European Union public health actions in the field of ASD http://ec.europa.eu/health/major_chronic_diseases/diseases/autistic_en#fragment2 European Union research actions in the field of ASD http://ec.europa.eu/health/major_chronic_diseases/diseases/autistic_en#fragment3 The EU's strategic framework for European cooperation in education and training (ET 2020) http://bcsd.com/autism/resources/pdd/ http://childstudycenter.yale.edu/autism/information/pddnos.aspx https://www.brainbalancecenters.com/blog/2012/02/signs-and-symptoms-of-pdd-nos/ https://www.autismspeaks.org/what-autism/pdd-nos

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https://iris.peabody.vanderbilt.edu/module/asd1/#content

References

Delfos, Martine F, Attwood, Tone, 2005, A Strange World: Autism, Asperger's Syndrome, and PDD-NOS: A Guide for Parents, Partners, Professional Carers, and People with ASDs, Jessica Kingsley Publishers https://childdevelopment.com.au/areas-of-concern/diagnoses/pervasive-developmental-disorder-not-otherwise-specified-pdd-nos/

Prevalence and early detection of Autism Spectrum Disorders (ASD) in the EU https://ec.europa.eu/health/sites/health/files/major_chronic_diseases/docs/asds_eu_en.pdf

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Pupils with Sensory Disabilities

Hearing Impairment

Classroom-based tips (focus on instructional methods)

1. Inform the pupils about the presence of a fellow pupil who is deaf/hard-of-hearing, e.g. through projects, discussion, parental participation, storytelling, involvement of the pupil himself/herself, depending on the pupils’ age), taking care not to stigmatise the pupil, or make her/him uncomfortable.

2. Provide activities promoting acceptance and support in order to avoid marginalisation.

3. Make use of natural gesture and facial expression as a clue to meaning.

4. Attract the pupil’s attention before speaking; make sure you are facing him/her.

5. Speak clearly; but avoid speaking artificially slowly, exaggerating your lips, or shouting as this affects the natural rhythm of speech.

6. Make sure that there is adequate light on your face. Do not stand with your back to windows.

7. Position the pupil so that he/she can lip-read you easily and see the projector or board and as much of the class as possible if there is to be a group discussion.

8. Do not cover your face with your hands or objects or walk around while you are speaking.

9. Keep background noise to a minimum.

10. Repeat questions asked from the floor.

11. Make use of visual material, i.e. handouts, key vocabulary, diagrams, written instructions, and virtual learning environments such as use of Blackboard.

12. Indicate when you are changing the subject.

13. Check comprehension; encourage and direct questions.

14. Write important new words on the board to fix their form.

15. Provide copies of teachers’ notes or recorded lectures, as well as digital notes for pupils using technology

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[Reference: http://www2.le.ac.uk/offices/accessability/staff/supporting-students-with- disabilities/information-for-staff-working-with-deaf-or-hearing-impaired-students]

School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Equip school spaces with visual signs clearly marking school areas, such as dining area, toilets, canteen, principal’s office, schoolyard, teachers’ office, emergency exit doors and gym. Provide visual signage and written information for the hearing impaired.

Community

Find and have available contact details of local/national associations for deaf/hard of hearing individuals for further information and support.

Curricular Adaptations

Inform teachers to make necessary adaptations to the curriculum tasks. For example, based on one learning objective, provide a single worksheet which gets progressively harder.

Parents / Parents’ Associations

Facilitate family support and confidence in parenting a child with a hearing loss. Arrange meetings between the parents and the staff to discuss the progress of their children and to enhance the collaboration between home-school. This will help to monitor progress and to discuss issues that might be related to the social life of the pupil, marginalisation, social interactions with peers, behaviour at home, self-esteem etc. In case the parents are signing deaf, a sign interpreter should be present.

School Celebrations / Events / Activities

1. Include the pupils into the events by differentiating their role and contribution. Example: instead of memorising a poem, take advantage of their talents in acting, theatre and role-playing.

2. Involve deaf/hard-of-hearing pupils in lunchtime and after-school activities.

School Purchases

1. Consider extra cost for updating equipment, such as video recorders that record subtitles, text telephones, televisions that have teletext.

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2. Provide and effectively use the appropriate technological equipment for deaf/hard-of- hearing children (e.g. FM system, etc.).

3. Improve the acoustic conditions in the classrooms and in the wider school environment.

Pupil Support

1. Refer to campus services such as the Writing Centre and the Academic Support Centre, if your institution possesses this type of service. If such a service is not available, co-operate with those offering communication support to deaf/hard-of-hearing children (e.g. teacher of the deaf, classroom assistant, communication support worker, learning support assistant, etc.).

2. Find and have available contact details of local/national associations for deaf/hard of hearing individuals for further information and support.

Teacher Professional Development

Provide training for teachers related to the main difficulties of inclusion of deaf/hard-of- hearing pupils in classes, and the signs for early identification and assessment and practical tips for the teachers in order to support those pupils in the class. Formal and informal training should be available for all staff in the school, not just those directly involved with the deaf/hard of hearing pupil. Deaf awareness training for pupils is vital as well.

Technology

1. Consider extra cost for updating equipment, such as video recorders that record subtitles, text telephones, televisions that have teletext.

2. Provide and effectively use the appropriate technological equipment for deaf/hard-of- hearing children (e.g. FM system, etc.).

3. Improve the acoustic conditions in the classrooms and in the wider school environment.

Supportive Literature

A hearing impairment by definition is “an impairment in hearing, whether permanent or fluctuating, that adversely affects a child’s educational performance, but is not included under the definition of ‘deafness’” as defined by the Individuals with Disabilities Education Act (IDEA). [Reference: http://www.specialeducationguide.com/disability-profiles/hearing-impairments/]

Pupils with hearing impairments who receive special education services are a diverse group. The level of hearing loss varies according to family, demographic characteristics, school experiences, and outcomes. Most have medium or high social and mental skills, live in two-parent households, and have household incomes above the poverty level. Some spend their days in special schools, though most spend their school time in regular schools. Some receive small-group or individual instruction on a

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regular basis, but whole-group instruction is most common. Nearly all receive some type of accommodation or modification. Most have better-than-passing grades in school.

Pupils that are deaf/hard-of-hearing face unique challenges inside the classroom. Many common learning modes that people take for granted — lectures, discussion groups and even one-on-one conversations — can be a struggle for those who have any level of hearing difficulty. However, that does not mean a college degree is out of reach. Today’s wide range of tools, devices and systems can help pupils who are deaf or hard of hearing thrive in an educational setting. [Reference: http://www.accreditedschoolsonline.org/resources/students-with-hearing-impairments/]

Research suggests that about 3% of children have hearing loss, ranging from mild to profound. Of those affected, about 10% fall into the "profound" category. [Reference: http://www.educationcorner.com/strategies-for-hearing-impaired-students.html]

Some studies have linked inclusion with higher academic achievement for deaf/hard of hearing pupils (Lynas, 1986; Kluwin & Stinson, 1993). However, the majority of studies have shown that deaf/hard of hearing children attending general schools mostly experience feelings of isolation, rejection and loneliness (Stinson & Antia, 1999), and encounter identity development problems (Leigh, 1999).

Hearing impairment can be a major obstacle to academic success, and “deaf students tend to lag behind their hearing peers across the curriculum. Part of the situation, of course, is a direct result of delays in language acquisition. But the complex of factors associated with learning including language, cognitive development, social and emotional learning, and educational experiences will affect achievement in other domains as well.” (Knoors, & Marschark, 2014: 180).

Useful Websites www.nidcd.nih.gov (quick statistics about hearing) www.actiononhearingloss.org.uk (statistics about the UK people with hearing problems) www.healthyhearing.com (report regarding how the hearing loss affects school performance) www.seels.net/designdocs/SEELS_HearingIImpairmentReport.pdf (A National Profile of Students with Hearing Impairments) http://www.ndcs.org.uk/ (National Deaf Children Society) http://www.batod.org.uk/ (British Association of the Teachers of the Deaf) http://www.earfoundation.org.uk/ (Ear Foundation) http://ansr.org.ro/ (Romanian National Association of Deaf People) http://darulsunetului.ro/ (Romanian Association of the Hearing Impaired)

EU Reports

EU Accessibility Act – http://www.europarl.europa.eu/RegData/etudes/IDAN/2016/571382/IPOL_IDA(2016)571382_EN.p df

References www.accreditedschoolsonline.org

www.idecide-project.eu

www.educationcorner.com http://www.specialeducationguide.com/disability-profiles/hearing-impairments/ http://www2.le.ac.uk/offices/accessability/staff/supporting-students-with-disabilities/information-for-staff-working-with-deaf-or-hearing- impaired-students

Johnson, C.C, Benson, P.V and Seaton, J.B. (1997).Educational Audiology Handbook. Appendix 11-A, p.448. Singular publishing Group, Inc

Kluwin, T.N. and Stinson, M. (1993). Deaf students in local public high schools. Springfield, IL: Charles C. Thomas.

Knoors, H. and Marschark, M. (2014). Teaching deaf learners: Psychological and developmental foundations. New York: Oxford University Press.

Leigh, I. (1999) Inclusive education and personal development. Journal of Deaf Studies and Deaf Education, 3, 236-245.

Lynas, W. (1986). Integrating the handicapped into ordinary schools: a study of hearing-impaired pupils. London: Croom Helm.

Stinson, M.S. and Antia, S.D. (1999). Considerations in educating deaf and hard-of-hearing students in inclusive settings. Journal of Deaf Studies and Deaf Education, 4(3), 163-175.

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Visual Impairment

Classroom-based tips (focus on instructional methods)

1. Read what is being written on the board and/or describe what is pictured in the presentation. Allow the pupil time to handle tactually adapted materials.

2. Face the class when speaking. Speak clearly in a normal voice, not loudly, slowly or with exaggeration. Keep your hands away from your mouth when speaking. If in doubt ask the pupil if the pace is right.

3. Seat or encourage the visually impaired pupil to come to the front of the classroom or presentation area in order to be certain that s/he hears all instruction/explanation correctly.

4. Provide materials to be transcribed in braille, preferably electronically, as some text can be transcribed using computer translation software.

5. Observe the pupil and wait until the pupil asks for help and provide minimal assistance only as needed to build self-confidence and independence.

6. Keep furniture arrangement consistent or inform and/or involve the pupil in case of rearranging. Avoid leaving doors and drawers ajar or chairs out from under desks.

7. Address all pupils by name so that the visually impaired pupil can learn to associate names with voices of classmates. Address the visually impaired pupil by name as well, so s/he knows when s/he is being spoken to.

8. Encourage the pupil’s use of proper posture and the development of social skills. Discourage any inappropriate mannerisms to maximise the pupil’s social, educational and career potential.

9. Give the visually impaired pupil as many opportunities to help others as to be helped by others.

[Reference: http://www.tsbvi.edu/instructional-resources/1911-classroom-strategies-for- regular-education-teachers-who-have-students-with-visual-impairments]

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School-based practical tips (focus on instructional methods)

Announcement / Sign at School

Equip school spaces with electronic devices, which use ultrasound or infrared light to detect when a physical object comes near.

Curricular Adaptations

Inform teachers to make necessary adaptations to the curriculum tasks.

Discipline

Allow for visually impaired pupils to be able to tape record classes and, if necessary, transcribe the class lecture into braille.

[Reference: http://www.accreditedschoolsonline.org/resources/helping-students-with- visual-impairments]

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Make sure that a person is assigned to be responsible for the pupil, and is available to direct the pupil when s/he needs to cross the street during a school trip.

Homework

Allow visually impaired pupils to practice their reading skills aloud only if they feel comfortable in doing so.

Parents / Parents’ Associations

Enhance collaboration with families and other professionals in order to monitor progress and to discuss issues that might be related to the social life of the pupil.

Safety

1. Provide specialised services, which address the unique academic and non-academic curriculum needs of pupils with visual impairments.

2. Equip school spaces with electronic devices, which use ultrasound or infrared light to detect when a physical object comes near.

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3. Make sure that a person is assigned to be responsible for the pupil, and is available to direct the pupil when s/he needs to cross the street during a school trip.

School Celebrations / Events / Activities

Include visually impaired pupils in school and class events by differentiating their role and contribution.

School Purchases

1. Buy specialised books, materials and equipment for learning through alternative modes.

2. Equip school spaces with electronic devices, which use ultrasound or infrared light to detect when a physical object comes near.

Teacher Professional Development

Provide training for teachers related to the main difficulties of pupils in classes, the signs for early identification and assessment and practical tips for the teachers in order to support those pupils in the class. Provide specialised services, which address the unique academic and non-academic curriculum needs of pupils with visual impairments.

Technology

Buy specialised books, materials and equipment for learning through alternative modes.

Supportive Literature

Definition: “Visual impairment, also known as vision impairment or vision loss, is a decreased ability to see to a degree that causes problems not fixable by usual means, such as glasses.” (“Change the Definition of Blindness" (PDF). World Health Organisation. Retrieved 23 May 2015).

The most common vision impairments affect:  The sharpness or clarity of vision (visual acuity)  The normal range of what you can see (visual fields)  Colour

Pupils with visual impairments have unique educational needs, which are most effectively met using a team approach of professionals, parents and pupils. In order to meet their unique needs, pupils must have specialised services, books and materials in appropriate media (including braille), as well as specialised equipment and technology to assure equal access to the core and specialised curricula, and to enable them to most effectively compete with their peers in school and ultimately in society.

All pupils have to manage their workload as effectively as they can, but for visually impaired pupils this can be much more time-consuming and requires good organisational skills.

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Lesson It is a great help if visually impaired pupils can be provided with any lesson’s notes or handouts, preferably in advance, so that they can arrange to have them transcribed into their preferred medium.

If during lessons new terms are written on the board, an oral explanation and spelling should be given. Seemingly minor issues, such as finding a place in a busy classroom, can be a source of great embarrassment. Other pupils do not always offer assistance, mainly through lack of confidence about how they should react. If the teacher can deal with these situations confidently and sensitively, it is helpful for everyone.

Written Work Guidance on writing development is no different for a visually impaired pupil than for any other pupil. However, any formative comments made on written work need to be made accessible to the pupil, for example by writing them in enlarged screen, on a separate page or emailing them to the pupil, rather than writing them by hand.

Students working in small groups If visually impaired pupils express concerns about how other pupils are reacting to their disability discuss with the pupil how s/he would like these situations to be handled. After all, s/he is the expert in knowing her/his own needs, and everyone is different.

Communication It is important to agree a means of communicating which is easily accessible for the pupil: this might be by e-mail, telephone (suitable with older pupils) or by having extra time to follow a specific lesson (with younger students).

[References: http://www.afb.org/info/programs-and-services/professional- development/teachers/inclusive-education/1235 http://www2.le.ac.uk/offices/accessability/staff/supporting-students-with-disabilities/information- for-staff-teaching-blind-and-visually-impaired-students]

Useful Websites

American Foundation for the Blind http://www.afb.org

Teaching Pupils with Visual Impairments http://www.teachingvisuallyimpaired.com/

Care of the Patient with Visual Impairment (Low Vision Rehabilitation) http://www.aoa.org/documents/CPG-14.pdf

Facts About Vision Loss

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https://www.cdc.gov/ncbddd/actearly/pdf/parents_pdfs/VisionLossFactSheet.pdf

Defining visual impairment http://www.specialeducationguide.com/disability-profiles/visual-impairment/

Instructional Strategies for Students who are Blind or Visually Impaired http://www.pathstoliteracy.org/instructional-strategies-students-who-are-blind-or-visually-impaired

References

Brian G.; Taylor H. (2001). "Cataract Blindness – Challenges for the 21st Century". Bulletin of the World Health Organisation. 79 (3) Koenig, A. J., & Holbrook, M. C. (Eds.). (2000). Foundations of education, Vol. 2: Instructional strategies for teaching children and youths with visual impairments, New York: AFB Press.

Virgili G, Acosta R, Grover LL, Bentley SA, Giacomelli G (2013). "Reading aids for adults with low vision". Cochrane Database Syst Rev. 10: CD003303

Waterfield, J. and West, B. (2008) Meeting the specific requirements of Blind and Partially Sighted Students studying in Higher Education in the UK University of Plymouth: Plymouth

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Pupils with Physical Disabilities

Congenital Malformation

Classroom-based tips (focus on instructional methods)

1. Inform the class about the presence of a pupil with congenital malformation through age- appropriate means such as a project, discussion, parental participation, storytelling or the involvement of the child himself/herself. Introduce the pupil to his/her classmates, as you do for any newcomer to the class.

2. Provide activities promoting acceptance and support in order to avoid marginalisation [Reference: http://asociatia-profesorilor.ro/integrarea-copiilor-cu-dizabilitati-in-scoala- publica.html]

3. Use mainly the active-participative teaching methods to increase students’ interest for knowledge, develop cooperative learning and stimulate collaboration and mutual support in accomplishing different tasks. [Reference: http://asociatia-profesorilor.ro/integrarea- copiilor-cu-dizabilitati-in-scoala-publica.html]

4. Use role-play as a way to learn social behavior, and avoid stigmatisation; avoid the use of disability role by non-disabled children [Reference: http://asociatia- profesorilor.ro/integrarea-copiilor-cu-dizabilitati-in-scoala-publica.html]

5. Form “heterogeneous pairs (and sometimes trios) consisting of roles as tutor and student (and sometimes also an observer)”. Let all children take turns for all roles. [Reference: Inclusive Education and Classroom Practice in Secondary Education, Summary Report 2005, European Agency for Development in Special Needs Education, p.18] “Heterogeneous grouping and a more differentiated approach in education are necessary and effective when dealing with a diversity of pupils in the classroom.” (Inclusive Education and Classroom Practice, Summary Report, March 2003, European Agency for Development in Special Needs Education, p.27)

6. Provide a specific set of teaching materials for example in digital form so that pupils with congenital malformation do not have to carry heavy books in and out of school.

7. Provide copies of teachers’ notes or recorded lectures, as well as digital notes for students using technology.

8. Provide options for tutoring or extra time to make up assignments and complete tasks.

9. Allow students to leave classes early to have extra time to get to their next class.

10. Arrange the classroom physical environment in an accessible way.

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Reference: http://www.tribunainvatamantului.ro/optimizarea-comunicarii-dintre- cadrul-didactic-si-elevul-cu-dizabilitati-senzoriale-sisau-fizice-exemple-de-bune- practici-2/

11. Make arrangements in sitting and position in classroom to facilitate moving around and participation in activities, safely. Consult the pupil’s physiotherapist for specific seating needs.

12. Make sure that if the pupil uses a wheelchair that s/he can reach where you ask the student to go.

Reference: http://www.tribunainvatamantului.ro/optimizarea-comunicarii-dintre-cadrul- didactic-si-elevul-cu-dizabilitati-senzoriale-sisau-fizice-exemple-de-bune-practici-2/

13. If students use wheelchairs, where possible place yourself at their eye-level when talking to them.

14. The board in the classroom may have to be lowered if the student is in a wheelchair.

School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

Provide for accessible toilets/bathrooms that also ensure safety for children with congenital malformation.

[Reference: http://www.romanialibera.ro/societate/educatie/in-peste-50--din-scoli--copiii- cu-handicap-locomotor-nu-au-acces--361498]

Community

1. Make the physical education class and sports activities in school accessible by adjustment of playing areas (dimension, surface); equipment modification (lighter balls, balls with sounds), modification of net height. (Cristea, Ștef, Dragoș, Adapted Motrical Activities - Theoretical And Methodical Aspects, Oradea, 2014 [Reference: http://www.fefsoradea.ro/PDF/curs/Dragos/Activitati%20motrice%20adaptate_curs.pdf]

2. Find and have available contact details of local and national associations for congenital malformation for further information and support.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

www.idecide-project.eu

When organising field trips and school events out of the school area (a trip, a visit to a museum, a research activity outside school), make arrangements by considering the need for accessible transportation, such as ramps and lifts in buses, accessibility of locations and entrances. [Reference: http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf]

Parents / Parents’ Associations

1. Arrange meetings between the parents and the staff and other professionals working with the pupils such as the physiotherapist, so as to learn as much as possible about the diagnosis, the pupil’s current level of ability and possible needs during the course of the school year.

2. Facilitate family support and confidence in parenting a child with congenital malformation.

Safety

1. Provide for accessible toilets/bathrooms that also ensure safety for children with congenital malformation.

[Reference: http://www.romanialibera.ro/societate/educatie/in-peste-50--din-scoli--copiii- cu-handicap-locomotor-nu-au-acces--361498]

2. When organising field trips and school events out of the school area (a trip, a visit to a museum, a research activity outside school), make arrangements by considering the need for accessible transportation, such as ramps and lifts in buses, accessibility of locations and entrances. [Reference: http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf]

3. Make sure that, in case of emergency, the evacuation plan allows students with congenital malformation to get out of the building safely. [Reference: http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf]

School Purchases

1. Equip the building of the school institution with accessibility and safety adaptations such as elevator, ramps and special desks.

2. Provide for accessible toilets/bathrooms that also ensure safety for children with congenital malformation. [Reference: http://www.romanialibera.ro/societate/educatie/in-peste-50--din-scoli--copiii- cu-handicap-locomotor-nu-au-acces--361498]

3. All school services should ensure general accessibility for disabled students, including access to such materials as catalogues, books and equipment. [Reference: http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf]

Pupil Support

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2. Facilitate family support and confidence in parenting a child with congenital malformation.

4. Find and have available contact details of local and national associations for congenital malformation for further information and support.

Teacher Professional Development

Provide training for teachers who have students with congenital malformation in their classrooms.

Technology

1. Provide for accessible toilets/bathrooms that also ensure safety for children with congenital malformation. [Reference: http://www.romanialibera.ro/societate/educatie/in-peste-50--din-scoli--copiii- cu-handicap-locomotor-nu-au-acces--361498]

2. Make the physical education class and sports activities in school accessible by adjustment of playing areas (dimension, surface); equipment modification (lighter balls, balls with sounds), modification of net height. (Cristea, Ștef, Dragoș, Adapted Motrical Activities - Theoretical And Methodical Aspects, Oradea, 2014 [Reference: http://www.fefsoradea.ro/PDF/curs/Dragos/Activitati%20motrice%20adaptate_curs.pdf]

3. Make arrangements for assistive technology assessment and provision.

Supportive Literature

Congenital malformations are structural, functional or metabolic anomalies, which can manifest from birth or in early childhood. “Different types of pathogenic processes leading to structural abnormalities are indicated by the terms malformation, disruption and deformation. Anomalies can be placed in one of these categories on the basis of developmental stage during which the alteration took place, the process that caused the change, or the end result. Malformations are assumed to be caused by genetic or environmental influences or by a combination of the two.[…] In general, structural anomalies are viewed negatively by medical practitioners, affected individuals and society. Insensitive terminology can further stigmatise those affected and can separate caretakers from affected individuals, the affected from family, and family from society. Terminology should be as neutral as possible while correctly identifying or defining the structural anomaly. (Roger E.

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Stevenson, Benjamin D. Solomon, David B. Everman, Human Malformations and Related Anomalies, Oxford University Press, 2015)

Types Congenital malformations of bones and joints are: structural bone diseases (eg. achondroplasia); malformations (e.g. total or partial amyelia of one or more members, thoracic or pelvic, syndactyly); rachitic deformities with postural disorders; congenital hip dislocation (unilateral or bilateral) with secondary coxarthrosis and/or modifications of spin: congenital rigidity and ankylosis; pseudo arthrosis (leg, hip, arm). The persons who are assessed with a medium disability are oriented towards professional activities with a reduced physical effort, without travelling long distances or picking up heavy objects. They need orthopedic devices and recovery treatment to prevent deterioration of the joint functions. The persons who are assessed with a severe disability need compensatory means (prosthesis, orthosis etc.), adapted according to their activity and the affected members. They may also need special means of moving (wheelchair, adapted cars etc.), an adapted living/work space, assistance for daily activities (for the persons with severe deficiencies).

Reference: http://www.mmuncii.ro/j33/images/Documente/Proiecte_in_dezbatere/2014/2014-04- 15_Ordin_comun_MMFPSPV_MS.pdf

Useful Websites https://www.european-agency.org/sites/default/files/inclusive-education-and-classroom- practices_iecp-en.pdf https://www.european-agency.org/sites/default/files/inclusive-education-and-classroom-practice- in-secondary-education_iecp_secondary_en.pdf http://www.who.int/mediacentre/factsheets/fs370/en/ Societatea Handicapatilor Locomotor din Romania - http://www.invingatorul.org/ APAHM – Asociatia Pentru Protejarea Handicapatilor Motor Cluj - http://apahm.inadcod.com/despre- noi.html Asociatia Handicapatilor Neuromotor din Romania - http://www.ahnr.ro/ro/Programe/locale/body_locale.html

EU Reports

EU Accessibility Act - http://www.europarl.europa.eu/RegData/etudes/IDAN/2016/571382/IPOL_IDA(2016)571382_EN.p df

References

Stevenson, Roger E., Solomon, Benjamin D., Everman, David B., 2015, Human Malformations and Related Anomalies, Oxford University Press

Inclusive Education and Classroom Practice in Secondary Education, Summary Report 2005, European Agency for Development in Special Needs Education

Inclusive Education and Classroom Practice, Summary Report, March 2003, European Agency for Development in Special Needs Education http://asociatia-profesorilor.ro/integrarea-copiilor-cu-dizabilitati-in-scoala-publica.html http://www.mmuncii.ro/j33/images/Documente/Proiecte_in_dezbatere/2014/2014-04-15_Ordin_comun_MMFPSPV_MS.pdf http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf

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http://www.romanialibera.ro/societate/educatie/in-peste-50--din-scoli--copiii-cu-handicap-locomotor-nu-au-acces--361498 http://asociatia-profesorilor.ro/integrarea-copiilor-cu-dizabilitati-in-scoala-publica.html http://www.tribunainvatamantului.ro/optimizarea-comunicarii-dintre-cadrul-didactic-si-elevul-cu-dizabilitati-senzoriale-sisau-fizice- exemple-de-bune-practici-2/

Scoliosis

Classroom-based tips (focus on instructional methods)

1. Provide activities promoting acceptance and support in order to avoid marginalisation, for instance, discussions on various types of disabilities, and specifically on scoliosis, without making specific references to pupils with scoliosis within the classroom or the school.

2. Plan suitable activities devised to meet the needs of the pupil, in consultation with the healthcare provider.

3. Be aware that school-age children under treatment for scoliosis may need continual positive reinforcement, encouragement and as much independence as can be safely assumed (Huffman, Fontaine, Price, Health Problems in the Classroom PreK-6: An A-Z Reference Guide for Educators, p. 275).

4. Consider activities/exercises which can be realised with less physical effort but maintaining same/similar learning objectives as the other pupils in the class. (http://www.eupd.ro/wp- content/uploads/2011/09/Curriculum.pdf).

5. Provide a specific set of teaching materials for example in digital form so that pupils with scoliosis do not have to carry heavy books in and out of school.

6. Provide copies of teachers’ notes or recorded lectures, as well as digital notes for pupils using technology.

7. Provide options for tutoring or extra time to make up assignments and complete tasks.

8. Provide options for adapted physical activities after consulting with the pupil’s physiotherapist. Appropriate physical activity is important for pupils with scoliosis. Differentiate goals accordingly; focus on recreation, and not competition or strength building, and modify playing rules and number of players in a team, while maintaining some basic rules. All these aspects related to the increase of accessibility of practicing different sports by pupils with scoliosis, fully require the teacher’s creativity, and even that of the players. (Cristea, Ștef, Dragoș, Adapted Motrical Activities - Theoretical and Methodical Aspects , 2014).

9. Ensure ergonomic sitting and positioning in the classroom for pupils with scoliosis and minimise non-ergonomic movements. Consult the pupil’s physiotherapist for specific seating recommendations.

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10. Ensure ergonomic position in computer labs, and make assistive technology adaptations when necessary (http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf).

11. Discreetly correct pupil’s posture when when necessary in class.

12. Be aware of safety concerns such as falls, stairs and loss of balance associated with children who are wearing special braces or who have had surgery for spine realignment (Huffman, Fontaine, Price, Health Problems in the Classroom PreK-6: An A-Z Reference Guide for Educators, p. 275)

13. Arrange for the child’s safe exit procedures from the classroom in case of an emergency. (Huffman, Fontaine, Price, Health Problems in the Classroom PreK-6: An A-Z Reference Guide for Educators, p. 275).

School-based practical tips (focus on instructional methods)

Class Divisions

Ensure appropriate adaptations, accommodations and modifications are made to the instruction given, and other activities, including availability of assistive technology.

Community

1. Provide for special services in or out of school, as appropriate such as school counseling and physiotherapy. [Reference: Cristea, Ștef, Dragoș, Adapted Motrical Activities - Theoretical and Methodical Aspects]

2. Find and have available contact details of local and national associations for scoliosis for further information and support.

Curricular Adaptations

1. Provide opportunities for individualised support and differentiation of the learning process if needed.

2. Ensure appropriate adaptations, accommodations and modifications are made to the instruction given, and other activities, including availability of assistive technology.

3. Make the physical education class and sports activities in school accessible by adjustment of playing areas (dimension, surface); equipment modification (lighter balls, balls with sounds), and modification of net height. [Reference: Dana Cristea, Mirela Ștef, Paul Dragoș, Adapted Motrical Activities - Theoretical and Methodical Aspects , Oradea, 2014]

Discipline

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Monitor the safety of the pupils during their curricular and extra-curricular activities during their classes, breaks and other types of activities.

Parents / Parents’ Associations

2. Facilitate family support and confidence in parenting a child with scoliosis.

Safety

1. Provide access and facilities in order to develop inclusive school projects, events and celebrations for all pupils, providing facilities for those with scoliosis to be able to participate, taking into consideration issues like safety conditions, hall accommodation and traffic in the corridors.

2. Make sure that, in case of emergency, the evacuation plan allows pupils with scoliosis to get out of the building.

3. Make the physical education class and sports activities in school accessible by adjustment of playing areas (dimension, surface); equipment modification (lighter balls, balls with sounds), and modification of net height. (Dana Cristea, Mirela Ștef, Paul Dragoș, Adapted Motrical Activities - Theoretical and Methodical Aspects, Oradea, 2014).

4. Monitor the safety of the pupils during their curricular and extra-curricular activities during their classes, breaks and other types of activities.

School Breaks

Monitor the safety of the pupils during their curricular and extra-curricular activities during their classes, breaks and other types of activities.

School Celebrations

Provide access and facilities in order to develop inclusive school projects, events and celebrations for all pupils, providing facilities for those with scoliosis to be able to participate, taking into consideration issues like safety conditions, hall accommodation and traffic in the corridors.

School Projects

Provide opportunities for individualised support and differentiation of the learning process if needed.

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Pupil Support

1. Provide for special services in or out of school, as appropriate such as school counseling and physiotherapy. (Cristea, Ștef, Dragoș, Adapted Motrical Activities - Theoretical and Methodical Aspects)

2. Arrange meetings between the parents and the staff and other professionals working with the pupils such as the physiotherapist, so as to learn as much as possible about the diagnosis, the pupil’s current level of ability and possible needs during the course of the school year.

3. Facilitate family support and confidence in parenting a child with scoliosis.

4. Provide opportunities for individualised support and differentiation of the learning process if needed.

5. Allow time and space for pupils with scoliosis that may temporarily use splints or other similar devices, to adjust and adapt.

6. Provide individual support for pupils with scoliosis that may have missed school for therapies and or medical operations.

7. Find and have available contact details of local and national associations for scoliosis for further information and support.

Technology

Ensure appropriate adaptations, accommodations and modifications are made to the instruction given, and other activities, including availability of assistive technology.

Supportive Literature

Definition: Scoliosis is a three-dimensional deformity that occurs when the spine becomes abnormally rotated and curved sideways. The term “is derived from the Greek word meaning ‘crooked’ and was used for the first time by Galen (AD 131-201) to describe an ‘S-shaped’ or ‘C-shaped’ spinal deformity. Although defined as a lateral curvature, as visualised by plane radiography, the deformity is actually three-dimensional and involves changes in the frontal, sagittal and transverse planes of the spinal column. Patients treated for scoliosis generally belong to one of the three categories” (Kenro Kusumi, Sally L. Dunwoodie, The Genetics and Development of Scoliosis, Springer Sciense, 2009, p. 167). It “can occur in either the upper back or the lower back and very rarely seen in the neck region. The cause for most curvatures of the spine is unknown (idiopathic scoliosis) ” (Dolores M. Huffman, Karen Lee Fontaine, Bernadette K. Price, Health Problems in the Classroom PreK-6: An A-Z Reference Guide for Educators, p. 275)

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Types: “In so-called congenital scoliosis, the structural curvature of the spine is clearly secondary to radiographically visible vertebral malformations and is typically obvious at an early age. Other patients may have scoliosis as part of their pathological conditions. For example, patients with neurologic and neuromuscular diseases such as Duchenne muscular dystrophy, spinal muscular atrophy, neurofibromatosis, or Charcot-Marie tooth disease may develop from scoliosis possibly due to secondary weakness of the paravertebral muscles. Patients with other syndromes, such as Prader- Willi or CHARGE may develop an adolescent-onset scoliosis for reasons that are not as yet understood. However, the great majority (more than 80%) of scoliosis patients are otherwise healthy, with no obvious coexisting diagnoses or structural alterations of the spinal column. This third class of patients is considered ‘idiopathic’”. (Kenro Kusumi, Sally L. Dunwoodie, The Genetics and Development of Scoliosis, Springer Sciense, 2009, p. 167)

Treatment: About 90% of idiopathic scoliosis cases are mild and only require observation by a doctor every 4 to 6 months until the adolescent has reached full skeletal maturity. If the disease starts to cause a noticeable deformity or is at high risk of doing so, a doctor might prescribe a brace to prevent the advancement of the condition. Bracing is a major time commitment and uncomfortable for adolescents - both physically and emotionally – and is usually not prescribed unless there is a significant risk of the disease progressing. If scoliosis continues to get worse and bracing is either not feasible or not working for the patient, surgery may be considered.

Websites and EU Reports

British Scoliosis Society http://www.britscoliosissoc.org.uk/ National Scoliosis Foundation http://www.scoliosis.org/ Scoliosis Association (UK) - http://www.sauk.org.uk/ National Scoliosis Foundation - http://www.scoliosis.org/ Scoliosis Research Society - www.srs.org Federația Română a Asociațiilor de Fizioterapie – FRAF - http://rofizioterapie.ro/ Societatea de Fizioterapie dr. Nicolae Robănescu - http://societaterobanescu.ro/ Asociația profesională a fizioterapeuților Muntenia - https://www.kinetoterapia.ro/ EU Accessibility Act - http://www.europarl.europa.eu/RegData/etudes/IDAN/2016/571382/IPOL_IDA(2016)571382_EN.p df Stimulais Report - http://cordis.europa.eu/result/rcn/171964_en.html SCOLIO-SEE Report - http://cordis.europa.eu/result/rcn/176720_en.html

References

Cristea, Dana, Ștef, Mirela, Dragoș, Paul, (2014), Adapted Motrical Activities - Theoretical and Methodical Aspects , Oradea - http://www.fefsoradea.ro/PDF/curs/Dragos/Activitati%20motrice%20adaptate_curs.pdf

Huffman, Dolores M., Fontaine, Karen Lee, Price, Bernadette K. (2003), Health Problems in the Classroom PreK-6: An A-Z Reference Guide for Educators, Corwin Press

Kenro Kusumi, Sally L. Dunwoodie (2009), The Genetics and Development of Scoliosis, Springer Sciense

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Kyphosis

Classroom-based tips (focus on instructional methods)

1. Inform the class about the presence of a pupil with kyphosis through age-appropriate means such as a project, discussion, parental participation, storytelling or the involvement of the child himself/herself.

2. Provide activities promoting acceptance and support in order to avoid marginalisation, for instance, discussions on various types of disabilities and specifically on kyphosis.

3. Plan suitable activities devised to meet the needs of the pupil, in consultation with the healthcare provider.

4. Consider activities/exercises which can be realised with less physical effort but maintaining same/similar learning objectives as the other pupils in the class. http://www.eupd.ro/wp- content/uploads/2011/09/Curriculum.pdf

5. Provide a specific set of teaching materials for example in digital form so that pupils with kyphosis do not have to carry heavy books in and out of school.

6. Provide copies of teachers’ notes or recorded lectures, as well as digital notes for pupils using technology.

7. Provide options for tutoring or extra time to make up assignments and complete the tasks.

8. Provide options for adapted physical activities after consulting with the pupil’s physiotherapist. Appropriate physical activity is important for pupils with kyphosis. Differentiate goals accordingly; focus on recreation, and not competition or strength building, and modify playing rules and numbers of players in a team, while maintaining some basic rules. All these aspects related to the increase of accessibility of practicing different sports by pupils with kyphosis, fully require the teacher’s creativity, and even that of the players. [Reference: Cristea, Ștef, Dragoș, Adapted Motrical Activities - Theoretical And Methodical Aspects, Oradea, 2014]

9. Be aware of safety concerns such as falls, stairs and loss of balance associated with kyphosis [Reference: Huffman, Fontaine, Price, Health Problems in the Classroom PreK-6: An A-Z Reference Guide for Educators, p. 275]

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10. Arrange for the child’s safe exit procedures from the classroom in case of an emergency. [Reference: Huffman, Fontaine, Price, Health Problems in the Classroom PreK-6: An A-Z Reference Guide for Educators, p. 275]

11. Ensure ergonomic sitting and positioning in the classroom for pupils with kyphosis and minimise non-ergonomic movements. Consult the pupil’s physiotherapist for specific seating recommendations.

12. Ensure ergonomic position in computer labs, and make assistive technology adaptations when necessary. [Reference: http://www.eupd.ro/wp- content/uploads/2011/09/Curriculum.pdf]

13. Consider activities/exercises which can be realised with less physical effort while maintaining the same or similar learning objectives. [Reference: http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf]

14. Discreetly correct pupil’s posture when necessary in class.

School-based practical tips (focus on instructional methods)

Community

1. Provide for special services in or out of school, as appropriate such as school counseling and physiotherapy. [Reference: Dana Cristea, Mirela Ștef, Paul Dragoș, Adapted Motrical Activities - Theoretical And Methodical Aspects, Oradea, 2014. http://www.fefsoradea.ro/PDF/curs/Dragos/Activitati%20motrice%20adaptate_curs.pdf]

2. Find and have available contact details of local and national associations for kyphosis for further information and support.

3. Monitor the safety of pupils during their curricular and extra-curricular activities during their classes, breaks and other types of activities.

Class Divisions / Arrangements

Ensure appropriate adaptations, accommodations and modifications are made to the instruction given, and other activities, including availability of assistive technology.

Curricular Adaptations

1. Provide opportunities for individualised support and differentiation of the learning process if needed.

www.idecide-project.eu

2. Make the physical education class and sports activities in school accessible by adjustment of playing areas (dimension, surface); equipment modification (lighter balls, balls with sounds), and modification of net height. (Dana Cristea, Mirela Ștef, Paul Dragoș, Adapted Motrical Activities - Theoretical And Methodical Aspects, Oradea, 2014).

3. Ensure appropriate adaptations, accommodations and modifications are made to the instruction given, and other activities, including availability of assistive technology.

Discipline

Monitor the safety of pupils during their curricular and extra-curricular activities during their classes, breaks and other types of activities.

Parents / Parents/ Associations

2. Facilitate family support and confidence in parenting a child with kyphosis.

Safety

1. Provide access and facilities in order to develop inclusive school projects, events and celebrations for all pupils, providing facilities for those with kyphosis to be able to participate, taking into consideration issues like safety conditions, hall accommodation and traffic in the corridors.

2. Make the physical education class and sports activities in school accessible by adjustment of playing areas (dimension, surface); equipment modification (lighter balls, balls with sounds), and modification of net height. [Reference: Dana Cristea, Mirela Ștef, Paul Dragoș, Adapted Motrical Activities - Theoretical And Methodical Aspects, Oradea, 2014]

3. Monitor the safety of pupils during their curricular and extra-curricular activities during their classes, breaks and other types of activities.

School Celebrations / Events / Activities

Provide access and facilities in order to develop inclusive school projects, events and celebrations for all pupils, providing facilities for those with kyphosis to be able to participate, taking into consideration issues like safety conditions, hall accommodation and traffic in the corridors.

School Projects

Provide opportunities for individualised support and differentiation of the learning process if needed.

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Pupil Support

3. Facilitate family support and confidence in parenting a child with kyphosis.

4. Provide opportunities for individualised support and differentiation of the learning process if needed.

5. Allow time and space for pupils with kyphosis that may temporarily use splints or other similar devices, to adjust and adapt.

6. Provide individual support for pupils with kyphosis that may have missed school for therapies or medical operations.

7. Find and have available contact details of local and national associations for kyphosis for further information and support.

Technology

Ensure appropriate adaptations, accommodations and modifications are made to the instruction given, and other activities, including availability of assistive technology.

Supportive Literature

Definition: In general terms, kyphosis is a condition that involves an exaggerated rounding of the back. According to a specialised definition, “structural kyphosis is a posterior convex deformity of the spine that may appear in childhood then worsen with growth, most notably during the pubertal growth spurt. The abnormal curvature may be smooth, defining round kyphosis, or may display a sharp angular pattern. […] Angular kyphosis is the most severe of the two forms. The main causes of round kyphosis are postural kyphosis and Scheuermann’s disease. The spontaneous outcome is favorable, and round kyphosis is well tolerated in adulthood. […] Surgery is reserved for severe rigid kyphosis in older children and for kyphosis responsible for refractory pain or neurological deficits. Many conditions may cause angular kyphosis, whose greater severity is related to a greater potential for

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progression and neurological impairment.” (Kyphosis: New Insights for the Healthcare Professional, Atlanta, Scholarly Editions, 2013)

Degrees of deformity: “There is a high incidence of thoracolumbar scoliosis, kyphosis and kyphoscoliosis in many dysplasias, particularly including spondyloepiphyseal dysplasia congenital, spondylometaphyseal dysplasia, spondyloepimetaphyseal dysplasia, diastrophic dysplasia, Kniest syndrome, Morquio’s disease, metatropic dwarfism, and pseudo-achondroplasia. These deformities in the skeletal dysplasias have a marked tendency to occur much earlier, progress more quickly, and be more rigid than those in idiopathic conditions.” (Frederic Shapiro, Pediatric Orthopedic Deformities, Gulf Professional Publishing, 2002, p.782)

Websites and EU Reports

British Scoliosis Society http://www.britscoliosissoc.org.uk/ National Scoliosis Foundation http://www.scoliosis.org/ Scoliosis Association (UK) - http://www.sauk.org.uk/ Asociatia imbunatatirea vietii - http://www.imparte.ro/Fundatii/Buzau/ASOCIATIA-IMBUNATATIREA- VIETII-429 Federația Română a Asociațiilor de Fizioterapie – FRAF - http://rofizioterapie.ro/ Societatea de Fizioterapie dr. Nicolae Robănescu - http://societaterobanescu.ro/ Asociația profesională a fizioterapeuților Muntenia - https://www.kinetoterapia.ro/ The Scheuermann's Disease Fund, a fund of The Pittsburgh Foundation, https://www.diseasemaps.org/scheuermanns-kyphosis/organization/102

National Report on Children and Young Adults Health in Romania, 2015 http://insp.gov.ro/sites/cnepss/wp-content/uploads/2016/01/Raport-National-de-Sanatate-a- Copiilor-si-Tinerilor-din-Romania-2015.pdf EU Accessibility Act - http://www.europarl.europa.eu/RegData/etudes/IDAN/2016/571382/IPOL_IDA(2016)571382_EN.p df

References http://www.fefsoradea.ro/PDF/curs/Dragos/Activitati%20motrice%20adaptate_curs.pdf

Cristea, Dana, Ștef, Mirela, Dragoș, Paul, 2014, Adapted Motrical Activities - Theorethical and Methodical Aspects, Oradea Shapiro, Frederic, 2002, Pediatric Orthopedic Deformities, Gulf Professional Publishing ***, 2013, Kyphosis: New Insights for the Healthcare Professional, Atlanta, Scholarly Editions

Cristea, Dana, Ștef, Mirela, Dragoș (2014), Paul Adapted Motrical Activities - Theoretical And Methodical Aspects, Oradea Huffman, Dolores M., Fontaine, Karen Lee, Price, Bernadette K. (2003), Health Problems in the Classroom PreK-6: An A-Z Reference Guide for Educators, Corwin Press Shapiro, Frederic (2002), Pediatric Orthopedic Deformities, Gulf Professional Publishing, p.782 Kyphosis: New Insights for the Healthcare Professional, Atlanta, Scholarly Editions, 2013 http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf

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Somatic Dysfunctions

Classroom-based tips (focus on instructional methods)

1. Inform the class about the presence of a pupil with somatic dysfunctions through age- appropriate means such as a project, discussion, parental participation, storytelling, or the involvement of the child himself/herself.

2. Provide activities promoting acceptance and support in order to avoid marginalisation, for instance, discussions on various types of disabilities, and specifically on somatic dysfunctions.

3. Encourage the pupil to participate in all activities, without going beyond his/her limits; be supportive encourage pupils to ask for help when needed.

4. Use appropriate assistive technology in all classroom activities and evaluation.

5. Provide support and encourage pupils’ self-confidence by anticipating difficulties and developing strategies.

6. Provide a specific set of teaching materials for example in digital form so that pupils with somatic dysfunctions do not have to carry heavy books in and out of school.

7. Provide copies of teachers’ notes or recorded lectures, as well as digital notes for pupils using technology.

8. Provide pupils with extra time for written evaluations or for other activities, which may require longer for them to achieve.

9. Differentiate learning processes and materials according to specific somatic dysfunctions of the pupil, such as differentiation by task or by pace.

10. Provide options for adapted physical activities after consulting with the pupil’s physiotherapist. [Reference: http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf]

School-based practical tips (focus on instructional methods)

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Class Divisions / Arrangements

Ensure that school services are generally accessible for disabled pupils, including access to materials, catalogues, books, and equipment. [Reference: http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf] Community

2. Design a school project in order to increase the level of awareness of the teachers, pupils and parents of what somatic dysfunctions are, and how to support pupils with somatic dysfunctions.

3. Ensure that school services are generally accessible for disabled pupils, including access to materials, catalogues, books, and equipment. [Reference: http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf]

4. Find and have available contact details of local and national associations for somatic dysfunctions for further information and support.

5. Find and have available contact details of local and national associations for somatic dysfunctions for further information and support.

Curricular Adaptations

1. Discuss with the parents about the pupil’s programme in school and other kinds of interventions that may be needed together with ways to facilitate development and improvement.

2. Facilitate family support and confidence in parenting a child with somatic dysfunctions.

3. Make the physical education class and sports activities in school accessible for pupils with somatic dysfunctions.

Discipline

Monitor the safety of pupils during their curricular and extra-curricular activities during their classes, breaks and other types of activities.

Parents / Parents’ Associations

1. Discuss with the parents about the pupil’s programme in school and other kinds of interventions that may be needed together with ways to facilitate development and improvement.

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2. Facilitate family support and confidence in parenting a child with somatic dysfunctions.

3. Arrange meetings between the parents and the staff and other professionals working with the pupils such as the physiotherapist, so as to learn as much as possible about the diagnosis, the pupil’s current level of ability and possible needs during the course of the school year.

4. Design a school project in order to increase the level of awareness of the teachers, pupils and parents of what somatic dysfunctions are, and how to support pupils with somatic dysfunctions.

Safety

1. Monitor the safety of pupils during their curricular and extra-curricular activities during their classes, breaks and other types of activities.

2. Make the physical education class and sports activities in school accessible for pupils with somatic dysfunctions.

3. Make sure that, in case of emergency, the evacuation plan allows disabled pupils to get out of the building safely. [Reference: http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf]

School Breaks

Monitor the safety of pupils during their curricular and extra-curricular activities during their classes, breaks and other types of activities.

Student Council

2. Design a school project in order to increase the level of awareness of the teachers, pupils and parents of what somatic dysfunctions are, and how to support pupils with somatic dysfunctions.

School Purchases

Equip the building of the school with accessibility and safety adaptations such as elevator, ramps and special desks.

Pupil Support

1. Make provisions for psychological and emotional support for pupils with somatic dysfunctions.

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2. Find and have available contact details of local and national associations for somatic dysfunctions for further information and support.

Teacher Professional Development

Provide training for teachers that have pupils with somatic dysfunctions in their classrooms. Inform teachers about pupils’ profiles and needs during and after school activities to be aware of issues like needing more time to rest, having involuntary movements, fatigue, and needing greater effort needed for some activities. [Refererence: http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf]

Technology

Make arrangements for assistive technology assessment and provision.

Supportive Literature

Definition: “Somatic dysfunction can be defined as ‘impaired or altered function of related components of the somatic (body framework) system: skeletal, arthrodial and myofascial structures and their related vascular, lymphatic and neural elements’ (Educational Council on Osteopathic Principles, 2009)”. Somatic dysfunction could also be the result of a neurophysiological phenomenon, i.e. peripheral or central sensitisation. (Leon Chaitow, Ruth Jones, Chronic Pelvic Pain and Dysfunction: Practical Physical Medicine, Elsevier Health Sciences, 2012)

“Somatic dysfunction is not tissue damage, which the body must heal. Rather, somatic dysfunction is a disorder of the body’s programming for length, tension, joint surface apposition affecting mobility, tissue fluid flow efficiency, and neurological balance. […] Four criteria are used to diagnose somatic dysfunction: tissue texture abnormalities, static or positional asymmetry, restriction of motion, and tenderness.”(Marc Micozzi, Fundamentals of Complementary and Alternative Medicine, Saunders Elsevier, 2010, p. 244)

Symptoms “Somatic dysfunction modifies normal reflex activities and may produce dysfunctional states whose symptoms must be differentiated as to whether they are functional (somatic dysfunction) or pathological.” (Michael Kuchera, William Kuchera, Osteopathic Considerations in systemic dysfunction, Greyden Press, LLC, Dayton, Ohio, 1994) “In summary, a somatic dysfunction can lead to one of the following two disturbances: 1) joint motion restriction […] 2) disturbance in the neuroreflexive feedback mechanisms. This may manifest itself as a) localised, segmental irritation such as long or short muscles of the back, connective tissues and skin. b) peripheral segmental irritation (peripheral muscles, segmentally related dermatomes.” Hans-Dieter Neumann, Introduction to Manual Medicine, Springer, 2013

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Websites and EU Reports

American Academy of Osteopathy, Somatic Dysfunction and Emotional Well-being: An Osteopathic Approach to Mental Health, 2016 - http://files.academyofosteopathy.org/convo/2016/AAOConvo2016ProgramLO-RES.pdf Asociatia Osteore - http://www.osteore.ro/asociatia-osteore/prezentare/

EU Accessibility Act - http://www.europarl.europa.eu/RegData/etudes/IDAN/2016/571382/IPOL_IDA(2016)571382_EN.p df

References

Chaitow, Leon, Jones, Ruth (2012), Chronic Pelvic Pain and Dysfunction: Practical Physical Medicine, Elsevier Health Sciences

Kuchera, Michael, Kuchera (1994), William Osteopathic Considerations in systemic dysfunction, Greyden Press, LLC, Dayton, Ohio

Micozzi, Marc (2010) Fundamentals of Complementary and Alternative Medicine, Saunders Elsevier

Neumann, Hans-Dieter (2013), Introduction to Manual Medicine, Springer http://www.eupd.ro/wp-content/uploads/2011/09/Curriculum.pdf http://forum.portal.edu.ro/index.php?act=Attach&type=post&id=2166579

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Spinal Cord Injury

Classroom-based tips (focus on instructional methods)

1. Inform the pupils about the presence of a colleague with spinal cord injury (e.g. through project, discussion, parental participation, storytelling, involvement of the child himself/herself, depending on the age of the class), taking care not to stigmatise the pupil or make her/him feel uncomfortable.

2. Provide activities promoting acceptance and support in order to avoid marginalisation.

3. Be aware and watch for changes in symptoms and/or for signs of abnormal fatigue throughout the day.

4. Take notice and address the specific emotional or behavioural problems these pupils may experience as a result of their condition and always encourage them to express their feelings.

5. Take into consideration the pupil’s physical needs when designing the class schedule.

6. Encourage pupils with SCI to participate in all classroom activities at their own pace and comfort level.

7. Provide options for tutoring or extra time to make up assignments and complete tasks.

8. Decrease written demands and homework assignments, and be less demanding when it comes to written work, taking into account extra time needed for therapy sessions.

9. Be understanding with such issues as lateness, absences, shortened school days, fatigue, change in mood, and missed homework due to therapy sessions.

10. Provide a specific set of teaching materials in digital form so that pupils with SCI do not have to carry heavy books in and out of school and the classroom.

11. Provide copies of teachers’ notes or recorded lectures, as well as digital notes for pupils using technology.

12. Differentiate testing and assessment by providing options according to individual needs of a pupil. These could be extra time or untimed tests, one-on-one evaluation, alternate response mode, and use of a laptop and/or other assistive technology.

13. Allow pupils to leave classes early to give them adequate time to get to their next class.

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14. Allow preferential seating of a pupil with SCI near the door, to ensure his/her easy access to and from the classroom, as well as well as near electrical outlets, in case of the need to plug- in and charge various devices including electric wheelchairs.

15. If pupils use wheelchairs, where possible place yourself at their eye level when talking to them.

16. The board in the classroom may have to be lowered if the pupil is in a wheelchair.

17. Make arrangements in sitting and positioning in the classroom to facilitate safely moving around and participating in activities. Consult physiotherapist for specific seating needs.

School-based practical tips (focus on instructional methods)

Community

Find and have available contact details of local/national associations for SCI.

Curricular Adaptations

Devise individualised learning plans for pupils with SCI in collaboration with other professionals and family.

Discipline

Monitor the safety of the pupils during their curricular and extra-curricular activities during their classes, breaks and other types of activities.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

When organising field trips and school events, make arrangements by considering the following, based on individual pupil’s needs: How far will this pupil with SCI have to walk? Is there a wheelchair lift on the bus? Is there enough space in the bus for a wheelchair? Is the field trip destination accessible for wheelchairs? Have the teachers accompanying the group of pupils been informed of this pupil’s needs?

Parents / Parents’ Associations

1. Arrange meetings between the parents and the staff, including other professionals working with the pupil, such as the physiotherapist, so as to learn as much as possible about the diagnosis, their observations about the pupil’s current level of ability, and possible needs

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during the course of the school year. Design a school project in order to increase the level of awareness of the teachers, other pupils and parents about SCI.

2. Facilitate family support and confidence in parenting a child suffering from spinal cord injury.

Safety

1. When organising field trips and school events, make arrangements by considering the following, based on individual pupil’s needs: How far will this pupil with SCI have to walk? Is there a wheelchair lift on the bus? Is there enough space in the bus for a wheelchair? Is the field trip destination accessible for wheelchairs? Have the teachers accompanying the group of pupils been informed of this pupil’s needs?

2. Provide access and facilities in order to develop inclusive school projects, events and celebrations for all pupils, providing facilities for pupils with SCI to be able to participate (e.g. safety conditions, hall accommodation, traffic in the corridors).

3. Make sure that, in case of an emergency, the evacuation plan allows pupils with SCI to safely get out of the building.

4. Monitor the safety of the pupils during their curricular and extra-curricular activities during their classes, breaks and other types of activities.

5. Provide for medical attention at school whenever concerns over breathing or heart rate may emerge, or the pupil complains of other symptoms s/he did not have previously, such as eye disease, fatigue, or stiffness.

School Breaks

Monitor the safety of the pupils during their curricular and extra-curricular activities during their classes, breaks and other types of activities.

School Celebrations / Events / Activities

Provide access and facilities in order to develop inclusive school projects, events and celebrations for all pupils, providing facilities for pupils with SCI to be able to participate (e.g. safety conditions, hall accommodation, traffic in the corridors).

School Purchases

1. Make arrangements for assistive technology assessment, and provisions for personal use, for example for completing class activities.

2. Equip the building of the school institution with accessibility and safety adaptations such as elevator, ramps and special desks.

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3. Allow pupils with SCI to use assistive technological devices that help them perform tasks and improve performance. A favourable classroom accommodation and the adaptive equipment mentioned above may improve the pupil’s physical abilities.

Pupil Support

1. Ensure that further provision is provided for pupils who may need support during class, such as the presence of a teaching assistant.

2. Provide pupils extra support where possible, including financial, individual teaching support, such as by scheduling extra instruction time, and providing a supportive relationship.

3. Provide for medical attention at school whenever concerns over breathing or heart rate may emerge, or the pupil complains of other symptoms s/he did not have previously, such as eye disease, fatigue, or stiffness.

4. Allow time for mobility for pupils who need to change rooms for classes in order to move safely and on time to their next class. If needed, a classmate, friend or helper may carry books and other materials between classes.

5. Find and have available contact details of local/national associations for SCI.

Teacher Professional Development

Provide training for teachers who have pupils with spinal cord injuries in their classrooms so as to ensure they possess adequate and meaningful information on the disability, and know how to act in different contexts.

Technology

1. Make arrangements for assistive technology assessment, and provisions for personal use, for example for completing class activities.

2. Equip the building of the school institution with accessibility and safety adaptations such as elevator, ramps and special desks.

Timetabling

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Supportive Literature

Definition: The spinal cord can be generally defined as a group of nerves that runs down the middle of a person’s back and carries signals back and forth between the body and the brain, passing through one’s neck and back. An injury of the spinal cord, usually referred to as a spinal cord injury (SCI), represents damage produced to the spinal cord that causes changes in its function, changes that may be either temporary or permanent. The respective changes generally involve the loss of muscle function, of sensation or of autonomic function in those parts of the human body served by the spinal cord that are below the level of the lesion. As a consequence, patients with SCI commonly experience permanent and often devastating neurologic deficits and disability. Spinal cord injuries can occur at any level of the spinal cord and can be divided into two classes, i.e. complete or incomplete.

 Complete SCIs: absence of sensory and motor functions “below the level of the injury - neither sensation nor movement - and both sides of the body are equally affected. Complete injuries can happen at any level of the spinal cord.” (Spinal Cord Injury, available online)  Incomplete SCIs: preservation of sensory or motor function below the level of injury, including the lowest sacral segments (Lawrence S Chin, Spinal Cord Injuries), or “movement in one limb more than the other, feeling in parts of the body, or more function on one side of the body than the other. Incomplete injuries can happen at any level of the spinal cord” (Spinal Cord Injury, available online).

Types of SCIs There are the three main types of SCIs: • Quadriplegia (quad = “four”) means loss of movement and sensation in all four limbs (arms and legs). • Paraplegia (para = two like parts) means loss of movement and sensation in the lower part of the body, including both legs. • Triplegia (tri = “three”) means the loss of movement and sensation in one arm and both legs and usually results from incomplete SCI.

Causes of SCIs  Bullet or stab wound  Traumatic injury  Diving accident  Electric shock  Extreme twisting of the middle of the body  Landing on the head during a sports injury  Fall from a great height  Non-traumatic causes: infection, insufficient blood flow, and tumours

Symptoms of SCIs Symptoms vary depending on the severity and location of the SCI:  Head that is in an unusual position  Numbness or tingling that spreads down an arm or leg  Weakness  Difficulty walking  Paralysis (loss of movement) of arms or legs  Loss of bladder or bowel control

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 Shock (pale, bluish lips and fingernails; acting dazed or semiconscious)  Lack of alertness or unconsciousness  Stiff neck, headache, or neck pain (Dennis Ogiela, Spinal Injury)  Muscle spasticity  Breathing problems  Problems with heart rate and blood pressure  Digestive problems  Sexual dysfunction (http://www.hopkinsmedicine.org/healthlibrary/conditions/physical_medicine_and_rehabili tation/spinal_cord_injury_85,P01180/)

A spinal cord injury is a medical emergency, whose immediate treatment can reduce long-term effects. Treatments may include medicines, braces or traction to stabilise the spine, and surgery. Later treatment usually includes medicines and rehabilitation therapy.

Websites and EU Reports

Spinal Cord Injury: Signs, Causes & Prevention – Healthline: http://www.healthline.com/health/spinal-injury Spinal cord injury - Reeve Foundation: https://www.christopherreeve.org/living-with- paralysis/health/causes-of-paralysis/spinal-cord-injury Spinal Cord Injury Information Pages: http://www.sci-info-pages.com/ WHO | Spinal cord injury: http://www.who.int/mediacentre/factsheets/fs384/en/ Spinal Cord Injury Resource Center: http://www.spinalcord.org/ AANS - Spinal Cord Injury: http://www.aans.org/patient%20information/conditions%20and%20treatments/spinal%20cord%20i njury.aspx ASCIP - Academy of Spinal Cord Injury Professionals: http://www.academyscipro.org/ Spinal Injuries Association – SIA: https://www.spinal.co.uk/ Fundatia Wings for Life http://www.wingsforlifeworldrun.com/ro/ro/ajuta-nesa-strangem-fonduri- pentru-vindecarea-leziunilor-coloanei-vertebrale/ Fundatia S Trauma: http://www.arcmed.ro/partener/fundatia-s-trauma SPINAL CORD REPAIR Report Summary - http://cordis.europa.eu/result/rcn/55544_en.html EU Accessibility Act - http://www.europarl.europa.eu/RegData/etudes/IDAN/2016/571382/IPOL_IDA(2016)571382_EN.p df

References

A Guide for School Personnel Working with Students with Spinal Cord Injuries https://www.kennedykrieger.org/sites/default/files/community-related- files/guide_for_school_personnel_working_with_students_with_spinal_cord_injuries_1.pdf

Dennis Ogiela, MD, Spinal Injury, http://umm.edu/health/medical/ency/articles/spinal-injury

Lawrence S Chin, MD, Spinal Cord Injuries, http://emedicine.medscape.com/article/793582-overview

Palmer, Sara, Kriegsman, Kay Harris, Palmer, Jeffrey B., 2000, Spinal Cord Injury: A Guide for Living, Johns Hopkins University Press

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Selzer, Michael E., 2010, Spinal Cord Injury, Accessible Publishing Systems PTY LTd.

Spinal Cord Injury, http://www.hopkinsmedicine.org/healthlibrary/conditions/physical_medicine_and_rehabilitation/spinal_cord_injury_85,P01180/

Journals

The Journal of Spinal Cord Medicine, http://www.tandfonline.com/loi/yscm20

Spinal Cord Journal - International Spinal Cord Society, http://www.iscos.org.uk/spinal-cord-journal

Journal of Spinal Cord Medicine, http://www.spinalcord.org/resource-center/askus/index.php?pg=kb.page&id=664

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Muscular Dystrophy

Classroom-based tips (focus on instructional methods)

1. Inform the pupils about the presence of a colleague with muscular dystrophy (e.g. through project, discussion, parental participation, storytelling, involvement of the pupil himself/herself, depending on the age of the class), taking care not to stigmatise the pupil or make her/him feel uncomfortable.

2. Speak clearly and concisely, but avoid speaking artificially slowly, exaggerating your lips, or shouting, as this affects the natural rhythm of speech. Repeat the information, so as to make sure that the respective pupil understands the information as pupils with muscular dystrophy often experience learning problems, mainly connected with the amount of information they can process.

3. Make use of natural gestures and facial expression as a clue to meaning.

4. Be aware and watch for changes in symptoms and/or for signs of abnormal fatigue throughout the day.

5. Take notice and address the specific emotional or behavioural problems these pupils may experience as a result of their condition, and always encourage them to express their feelings.

6. Provide activities promoting acceptance and support in order to avoid marginalisation. Encourage discussions on various types of disabilities, use activities based on visual skills and creativity, which, in the case of pupils with MD, are often excellent.

7. Ensure that each pupil has a role in class activities.

8. Use various teaching methods in order to offer equal chances to those pupils with MD.

9. Make use of visual learning materials and aids, such as handouts, key vocabulary, diagrams, written instructions, and virtual learning environments, such as Blackboard.

10. Divide the information/concepts into smaller chunks to help pupils to understand what is being taught. Give one instruction at a time.

11. Explain the lessons carefully and use dynamic activities that stimulate the creativity of pupils with muscular dystrophy; this encourage them to keep their interest and stay actively involved in the various types of learning activities.

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12. Provide a specific set of teaching materials in digital form, so that pupils with muscular dystrophy do not have to carry heavy books in and out of school and the classroom.

13. Provide copies of teachers’ notes or recorded lectures, as well as digital notes for pupils using technology.

14. Be understanding with such issues as lateness, absences, shortened school days, fatigue, change in mood, and missed homework due to physical therapy sessions.

15. Provide options for tutoring or extra time to make up assignments and complete the tasks.

16. Provide opportunity for frequent bathroom breaks or visits to the school nurse for medication as required.

17. Encourage pupils to participate in all classroom activities at their own pace and comfort level.

18. Take into consideration the pupil’s physical needs when designing class schedule, for example, classrooms should be close to minimise the time spent and distance between classes during the course of the day.

19. Differentiate testing and assessment by providing options according to individual needs of a pupil. These could be extra time or untimed tests, one-on-one evaluation, alternate response mode, and use of a laptop and/or other assistive technology.

20. Provide opportunities for the use of alternative communication means in all classroom activities, if available, for pupils that do not have verbal communication abilities.

21. Make arrangements for sitting and positioning in classroom to facilitate safely moving around and participating in activities. Consult physiotherapist for specific seating needs.

22. If pupils use wheelchairs, where possible place yourself at their eye level when talking to them.

23. The board in the classroom may have to be lowered if the pupil is in a wheelchair.

24. Allow pupils to leave classes early to give them adequate time to get to their next class.

25. Provide options for adapted physical activities (consult physiotherapist). Being physically active is important for pupils with muscular dystrophy. Differentiate goals accordingly, for example by placing emphasis on recreation, and not on competition or strength-building.

School-based practical tips (focus on instructional methods)

Community

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Find and have available contact details of local/national associations for MD.

Curricular Adaptations

1. Devise individualised learning plans for pupils with MD in collaboration with other professionals and family members.

2. Make the physical education class and sports activities in school accessible by adjustment of playing areas (dimension, surface); equipment modification, for example using lighter balls, or balls with sounds, or modification of net height, for playing table tennis. (Cristea, Ștef, Dragoș, Adapted Motrical Activities - Theoretical and Methodical Aspects, http://www.fefsoradea.ro/PDF/curs/Dragos/Activitati%20motrice%20adaptate_curs.pdf

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

When organising field trips and school events, make arrangements by considering the following, based on individual pupil’s needs: How far will this pupil with muscular dystrophy have to walk? Is there a wheelchair lift on the bus? Is there enough space in the bus for a wheelchair? Is the field trip destination accessible for wheelchairs? Have the teachers accompanying the group of pupils been informed of this pupil’s needs?

Parents / Parents’ Associations

1. Arrange meetings between the parents and the staff, including other professionals working with the pupils, such as the physiotherapist, so as to learn as much as possible about the diagnosis, their observations about the pupil’s current level of ability, and possible needs during the course of the school year.

2. Facilitate family support and confidence in parenting a child with MD.

Safety

1. When organising field trips and school events, make arrangements by considering the following, based on individual pupil’s needs: How far will this pupil with muscular dystrophy have to walk? Is there a wheelchair lift on the bus? Is there enough space in the bus for a wheelchair? Is the field trip destination accessible for wheelchairs? Have the teachers accompanying the group of pupils been informed of this pupil’s needs?

2. Make sure that, in case of emergency, the evacuation plan allows disabled pupils to safely get out of the building.

3. Ensure emergency precautions are in place and staff are properly trained if pupils’ breathing or heart rate are affected.

4. Make the physical education class and sports activities in school accessible by adjustment of playing areas (dimension, surface); equipment modification, for example using lighter balls,

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or balls with sounds, or modification of net height, for playing table tennis. (Cristea, Ștef, Dragoș, Adapted Motrical Activities - Theoretical and Methodical Aspects, http://www.fefsoradea.ro/PDF/curs/Dragos/Activitati%20motrice%20adaptate_curs.pdf School Purchases

1. Equip the building of the school institution with accessibility and safety adaptations such as elevator, ramps, and special desks.

2. Allow pupils with muscular dystrophy to use assistive technological devices that help them perform tasks and improve performance, for example a keyboard for writing. A favourable classroom accommodation, such as supportive seating, note-taking by means of recording the lesson, adjusting the height of the bench so as to match the height of the wheelchair, or lowering the blackboard, and the use of the adaptive equipment mentioned above, may improve the pupil’s physical abilities.

Pupil Support

1. Provide pupils extra support where possible, including financial, individual teaching support such as by scheduling extra instruction time, and providing a supportive relationship.

2. Ensure that further provision is provided to pupils who may need support during class, such as the presence of a teaching assistant.

3. Consider that MD is a progressive condition and be prepared for continuous adaptations and changes in all the above.

5. Find and have available contact details of local/national associations for MD.

Teacher Professional Development

Provide training for teachers who have pupils with muscular dystrophy in their classrooms.

Technology

Allow pupils with muscular dystrophy to use assistive technological devices that help them perform tasks and improve performance, for example a keyboard for writing. A favourable classroom accommodation, such as supportive seating, note-taking by means of recording the lesson, adjusting the height of the bench so as to match the height of the wheelchair, or lowering the blackboard, and the use of the adaptive equipment mentioned above, may improve the pupil’s physical abilities.

Timetabling

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Definition: Muscular dystrophy, usually abbreviated as MD, can be defined as a collective group of inherited non-inflammatory but progressive disorders that affect muscle function (Alan E. H. Emery, Muscular Dystrophy, Oxford University Press, 2008, 3). The word comes from two Greek words, i.e. dys, “meaning abnormal or faulty, and trophe, meaning food or nourishment” (Emery, 6), thus suggesting that “the nourishment of the muscle was defective” (Emery, 6).

Affecting the muscles with definite fibre degeneration, but without evidence of morphologic aberrations, the general denomination reunites more than 30 inherited diseases, all of which cause muscle weakness and muscle loss. In point of time, certain forms of MD appear in infancy or childhood, whilst others may not appear until middle age or later.

The different types may vary in whom they affect, which muscles they affect, and what the symptoms are. In this context, one may note that there are nine major forms of muscular dystrophy:

 Myotonic - the most common form of muscular dystrophy in adults, whose name refers to a symptom, myotonia = prolonged spasm or stiffening of muscles after use. In Emery’s opinion, myotonic muscular dystrophy means “the delayed relaxation of muscle that occurs after voluntary contraction” (Emery, 38)  Duchenne - the most common form of muscular dystrophy in children, usually affecting males. The muscles decrease in size and grow weaker over time, yet may appear larger. Disease progression varies, but many people with Duchenne need a wheelchair by the age of 12.  Becker – once considered to be rare (Emery, 31), this form of MD is similar to Duchenne muscular dystrophy, but the disease is much milder: symptoms appear later and progress more slowly.  Limb-girdle – in this type of muscular dystrophy, weakness predominantly affects “the limb girdle muscles, that is, the muscles around the hips and the shoulders” (Emery, 33).  Facioscapulohumeral –“the third most common inherited neuromuscular condition, after Duchenne and myotonic muscular dystrophies” (Cooper, Upadhhyaya, 1). It is characterised by progressive muscle weakness and involves atrophy of the muscles “of the face, upper arm and shoulder girdle” (Cooper, Upadhhyaya, 1).  Congenital – congenital means “present at birth” (Emery, 37). The congenital muscular dystrophies “are a group of dystrophies in which weakness and other problems are evident in the new-born period, or certainly within the first month or so” (Emery, 37)  Oculopharyngeal – a type of muscular dystrophy that affects the eye and throat.  Distal – involves weakness and wasting of the distal muscles (those farthest from the centre) of the forearms, hands, lower legs, and feet.  Emery-Dreifuss - causes muscle weakness and wasting in the shoulders, upper arms, and lower legs. (Understanding Muscular Dystrophy -- the Basics, available online)

All forms of MD grow worse as the person's muscles get weaker, most people with MD eventually losing the ability to walk.

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Muscular dystrophy has no cure, but can be kept under treatment and thus symptoms may be ameliorated and complications may be prevented. The treating possibilities include physical and speech therapy, orthopaedic devices, surgery, and medications.

Websites and EU Reports

EU Accessibility Act - http://www.europarl.europa.eu/RegData/etudes/IDAN/2016/571382/IPOL_IDA(2016)571382_EN.p df Muscular Dystrophy – Kids Health, http://kidshealth.org/en/teens/musculardystrophy.html?WT.ac=ctg Muscular Dystrophy Association https://www.mda.org/disease Muscular Dystrophy UK http://www.musculardystrophyuk.org/ Medical News Today, http://www.medicalnewstoday.com/articles/187618.php Muscular dystrophy - Better Health Channel https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/muscular-dystrophy Muscular Dystrophy - NHS Choices - http://www.nhs.uk/conditions/musculardystrophy/Pages/Introduction.aspx Duchenne and Becker muscular dystrophy - https://ghr.nlm.nih.gov/condition/duchenne-and- becker-muscular-dystrophy Facts | Muscular Dystrophy | NCBDDD | CDC- https://www.cdc.gov/ncbddd/musculardystrophy/facts.html Association of people suffering from muscular dystrophy of Romania - https://asociatiadistroficilormuscular.wordpress.com/

References

Cooper, David Upadhhyaya, Meena (2004). Facioscapulohumeral Muscular Dystrophy (FSHD): Clinical Medicine and Molecular Cell Biology, Garland Science

Emery, Alan E. H. (2008). Muscular Dystrophy, Oxford: Oxford University Press

Emery, Alan E. H., Muntoni, Francesco, Quinlivan, Rosaline C. M. (20150. Duchenne Muscular Dystrophy, Oxford: Oxford University Press

Johanson, Paula (2008). Muscular Dystrophy, The Rosen Publishing Group

Understanding Muscular Dystrophy - the Basics, available online at http://www.webmd.com/children/understanding-muscular-dystrophy- basics#1

Journal of the American Heart Association http://jaha.ahajournals.org/keyword/duchenne-muscular-dystrophy-cardiomyopathy

Journal of Child Neurology, http://jcn.sagepub.com/

Assistive Technology (http://www.resna.org/professional-development/assistive-technology-journal/assistive-technology-journal)

Journal of Enabling Technology (http://www.emeraldinsight.com/journal/jet)

Technology & Disability (http://www.iospress.nl/journal/technology-and-disability/)

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Rheumatoid Polyarthritis

Classroom-based tips (focus on instructional methods)

1. Inform the class about the presence of a pupil with rheumatoid polyarthritis through age appropriate means such as a project, discussion, parental participation, storytelling or the involvement of the child himself/herself.

2. Provide activities promoting acceptance and support in order to avoid marginalisation. “Changes in attitudes are possible, provided that traditional teaching methods and materials are enriched with alternative materials that represent typically underrepresented groups of people, and also that the teaching methods adopted encourage active involvement and critical thinking among students.” (http://www.tandfonline.com/doi/full/10.1080/13603116.2012.717638)

3. Ensure that each pupil has a role in class activities.

4. Use various teaching methods in order to offer equal learning opportunities to those with rheumatoid polyarthritis.

5. Provide a specific set of teaching materials for example in digital form so that pupils with rheumatoid polyarthritis do not have to carry heavy books in and out of school.

6. Provide copies of teachers’ notes or recorded lectures, as well as digital notes for pupils using technology.

7. Be understanding with such issues as lateness, absences, shortened school days, fatigue, change in mood, and missed homework due to physical therapy sessions.

8. Provide options for tutoring or extra time to make up assignments and complete tasks.

9. Differentiate testing and assessment by providing options on a case by case basis, for example extra time or untimed tests, one-on-one evaluation, alternate response mode, use of a laptop and/or other assistive technology.

10. Provide options for adapted physical activities after consulting with the pupil’s physiotherapist.

11. Make arrangements for sitting and positioning in class to facilitate moving around and participation in activities safely. Consult physiotherapist for specific recommendations.

12. Employ accessibility features and/or available assistive technology to facilitate learning.

www.idecide-project.eu

School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

Discuss physical therapy programmes with the parents that can be mediated by the school, monitored and improved to best suit the needs of each pupil. Consult with the family and the pupil’s physiotherapist regarding sitting, position and mobility of the pupil in the school environment. (http://www.webmd.com/pain-management/tc/physical-therapy-topic-overview)

Community

1. Arrange meetings between the parents and the staff (including other professionals working with the pupils such as the physiotherapist) so as to learn as much as possible about the diagnosis, their observations about the pupil’s current level of ability and possible needs during the course of the school year. Design a school project in order to increase the level of awareness of the teachers, pupils and parents of what rheumatoid polyarthritis means.

2. Find and have available contact details of local/national associations for rheumatoid (poly)arthritis for further information and support.

Curricular Adaptations

1. Allow pupils with rheumatoid polyarthritis to use assistive technological devices that help them perform the tasks and improve performance, such as a keyboard for writing. Such interventiones may even improve the pupil’s physical abilities.

2. Make the physical education class and sports activities in school accessible by adjustment of playing areas (dimension, surface); equipment modification (lighter balls, balls with sounds), modification of net height. [Reference: Cristea, Ștef, Dragoș, 2014 http://www.fefsoradea.ro/PDF/curs/Dragos/Activitati%20motrice%20adaptate_curs.pdf]

Discipline

Monitor safety of the pupils during their curricular and extra-curricular activities during their classes, breaks or other types of activities.

Educational Visits / Field Trips / School Exchanges / Trips Abroad

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Adapt or differentiate learning tasks and other extra-curricular activities including homework, educational activities and sports competitions in order to diminish exclusion due to rheumatoid polyarthritis.

Food: Canteen / Visits / Camps / Trips

Contact family and dietary consultants for pupils with rheumatoid polyarthritis; nutrition is important in the evolution of the condition. (http://www.webmd.com/rheumatoid- arthritis/biologics-15/rheumatoid-arthritis-diet. [Reference: http://www.webmd.com/pain-management/ss/slideshow-foods-fight-pain]

Homework

Other (Medical Care)

Provide medical attention at school whenever pains are growing or the pupil complains of other new symptoms such as eye disease, fatigue, and stiffness. [Reference: http://www.webmd.com/rheumatoid-arthritis/tc/juvenile-idiopathic-arthritis-inflammatory- eye-disease-credits]

Parents / Parents’ Associations

2. Facilitate family support and confidence in parenting a child with rheumatoid polyarthritis.

3. Discuss physical therapy programmes with the parents that can be mediated by the school, monitored and improved to best suit the needs of each pupil. Consult with the family and the pupil’s physiotherapist regarding sitting, position and mobility of the pupil in the school environment. [Reference: http://www.webmd.com/pain-management/tc/physical-therapy- topic-overview]

4. Contact family and dietary consultants for pupils with rheumatoid polyarthritis; nutrition is important in the evolution of the condition. (http://www.webmd.com/rheumatoid- arthritis/biologics-15/rheumatoid-arthritis-diet. [Reference: http://www.webmd.com/pain-management/ss/slideshow-foods-fight-pain]

Safety

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1. Discuss physical therapy programmes with the parents that can be mediated by the school, monitored and improved to best suit the needs of each pupil. Consult with the family and the pupil’s physiotherapist regarding sitting, position and mobility of the pupil in the school environment. [Reference: http://www.webmd.com/pain-management/tc/physical-therapy-topic-overview]

2. Provide access and facilities in order to develop inclusive school projects, events and celebrations for all pupils, providing facilities for those with rheumatoid polyarthritis to be able to participate, including safety conditions, hall accommodation and traffic in the corridors.

3. Provide medical attention at school whenever pains are growing or the pupil complains of other new symptoms such as eye disease, fatigue, and stiffness. [Reference: http://www.webmd.com/rheumatoid-arthritis/tc/juvenile-idiopathic-arthritis-inflammatory- eye-disease-credits; http://www.webmd.com/rheumatoid-arthritis/features/growing-pains- or-childhood-arthritis]

4. Monitor safety of the pupils during their curricular and extra-curricular activities during their classes, breaks or other types of activities.

5. Make sure that, in case of emergency, the evacuation plan allows pupils with rheumatoid polyarthritis to safely get out of the building.

6. Make the physical education class and sports activities in school accessible by adjustment of playing areas (dimension, surface); equipment modification (lighter balls, balls with sounds), modification of net height. [Reference: Cristea, Ștef, Dragoș, 2014 http://www.fefsoradea.ro/PDF/curs/Dragos/Activitati%20motrice%20adaptate_curs.pdf]

School Breaks

Monitor safety of the pupils during their curricular and extra-curricular activities during their classes, breaks or other types of activities.

School Celebrations

Provide access and facilities in order to develop inclusive school projects, events and celebrations for all pupils, providing facilities for those with rheumatoid polyarthritis to be able to participate, including safety conditions, hall accommodation and traffic in the corridors.

School Purchases

1. Equip the building of the school institution with accessibility and safety adaptations such as elevator, ramps, and special desks.

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2. Allow pupils with rheumatoid polyarthritis to use assistive technological devices that help them perform the tasks and improve performance, such as a keyboard for writing. Such interventions may even improve the pupil’s physical abilities.

Pupil Support

2. Provide pupils extra support if possible, whether financial or individual teaching support to help in improving their learning ability, scheduling extra instruction time and providing a supportive relationship. Consider that rheumatoid (poly)arthritis may be a progressive condition and be prepared for continuous adaptations and changes.

3. Find and have available contact details of local/national associations for rheumatoid (poly)arthritis for further information and support.

Teacher Professional Development

Provide training for teachers that have pupils with rheumatoid polyarthritis in their classes.

Technology

2. Make arrangements for assistive technology assessment and provision.

3. Provide copies of teachers’ notes or recorded lectures, as well as digital notes for pupils using technology.

Supportive Literature

Definition: Juvenile idiopathic arthritis (JIA), previously known as juvenile chronic arthritis or juvenile rheumatoid arthritis is a chronic disease of childhood with a spectrum of joint involvement and associated systemic involvement. The cause of JIA is poorly understood, and there is currently no cure the disease. (https://www.ncbi.nlm.nih.gov/pubmed/23595241)

Juvenile rheumatoid arthritis is a type of arthritis that causes joint inflammation and stiffness for more than six weeks in a child aged 16 or younger.

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Inflammation causes redness, swelling, warmth, and soreness in the joints, although many children with JRA do not complain of joint pain. Any joint can be affected, and inflammation may limit the mobility of affected joints.

JRA is an autoimmune disorder, which means that the body mistakenly identifies some of its own cells and tissues as foreign. The immune system, which normally helps to fight off harmful, foreign substances such as bacteria or viruses, begins to attack healthy cells and tissues. The result is inflammation -- marked by redness, heat, pain, and swelling.

Types of Juvenile Rheumatoid Arthritis

Pauciarticular: (paw-see-are-tick-you-lar) means that four or fewer joints are involved. This is the most common form of JRA; about half of all children with JRA have this type. It typically affects large joints, such as the knees. Eye disease affects from 20% to 30% of children with pauciarticular. Regular preventive exams by an ophthalmologist are necessary to treat serious eye problems. Many children with pauciarticular disease outgrow arthritis by adulthood.

Polyarticular: About 30% of all children with JRA have polyarticular disease, in which five or more joints are affected. The small joints, such as those in the hands and feet, are most commonly involved, but the disease may also affect large joints. Polyarticular JRA often is symmetrical - it affects the same joints on both sides of the body. Some children with polyarticular disease have a special kind of antibody in their blood called rheumatoid factor. These children often have a more severe form of the disease, which doctors consider to be similar to adult rheumatoid arthritis.

Systemic: Along with joint swelling, the systemic form of JRA is characterised by fever and a light pink rash, and may also affect internal organs such as the heart, liver, spleen, and lymph nodes. The systemic form, sometimes called Still's disease, affects 20% of children with JRA. Almost all children with this type of JRA test negative for both rheumatoid factor and ANA. A small percentage of these children develop arthritis in many joints and can have severe arthritis that continues into adulthood.

Websites and EU Reports

EU Accessibility Act - http://www.europarl.europa.eu/RegData/etudes/IDAN/2016/571382/IPOL_IDA(2016)571382_EN.p df

European Accessibility Act 2015 http://ec.europa.eu/social/main.jsp?catId=1202 https://www.ncbi.nlm.nih.gov/pubmed/23595241

Journal of medical Case Reports http://www.medscape.com/viewarticle/807803_2 https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-7-166 http://www.sciencedirect.com/science/article/pii/S2255502114001369 http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Juvenile-Arthritis

www.idecide-project.eu

Arthritis Statistics 2017 – Trends, Analysis and Statistics http://www.reportlinker.com/report-summary/Chronic-Disease/74545/European-Arthritis- Industry.html Asociatia Pacientilor cu Afectiuni Autoimune (APAA)/ Association of Patients with Autoimmune Related Diseases http://www.apaa.ro/

Pediatric Rheumatology International Trails Organisation PRINTO http://www.printo.it

References

Brewer EJ Jr, Bass J, Baum J, Cassidy JT, Fink C, Jacobs J, Hanson V, Levinson JE, Schaller J, Stillman JS: Current proposed revision of JRA criteria. Arthritis Rheum 1977, 20(Suppl 2):195–199.

Petty RE, Southwood TR, Baum J, Bhettay E, Glass DN, Manners P, Maldonado-Cocco J, Suarez-Almazor M, Orozco-Alcala J, Prieur AM: Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol 1998, 25:1991–1994.

Butbul YA, Tyrrell PN, Schneider R, Dhillon S, Feldman BM, Laxer RM, Saurenmann RK, Spiegel L, Cameron B, Tse SM, Silverman ED: Comparison of patients with juvenile psoriatic arthritis and nonpsoriatic juvenile idiopathic arthritis: how different are they? J Rheumatol 2009, 36:2033–2041.

Dell'Era L, Facchini R, Corona F: Knee synovectomy in children with juvenile idiopathic arthritis. J Pediatr Orthop B 2008, 17:128–130.

Ravelli A, Felici E, Magni-Manzoni S, Pistorio A, Novarini C, Bozzola E, Viola S, Martini A: Patients with antinuclear antibody-positive juvenile idiopathic arthritis constitute a homogeneous subgroup irrespective of the course of joint disease. Arthritis Rheum 2005, 52:826–832.

Wynne-Roberts CR, Cassidy JT: Juvenile rheumatoid arthritis with rice bodies: light and electron microscopic studies. Ann Rheum Dis 1979, 38:8–13.

Chung C, Coley BD, Martin LC: Rice bodies in juvenile rheumatoid arthritis. AJR Am J Roentgenol 1998, 170:698–700.

Adamec O, Dungl P, Kasal T, Chomiak J: Knee joint synovectomy in treatment of juvenile idiopathic arthritis. Acta Chir Orthop Traumatol Cech 2002, 69:350–356.

Toledo MM, Martini G, Gigante C, Da Dalt L, Tregnaghi A, Zulian F: Is there a role for arthroscopic synovectomy in oligoarticular juvenile idiopathic arthritis? J Rheumatol 2006, 33:1868–1872.

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Comorbidity

Classroom-based tips (focus on instructional methods)

1. Conduct a disability awareness training at the beginning of the school year

2. Provide activities promoting acceptance and support

3. Use task analysis, modelling, guided practice, and role-play to maximise pupil active participation in class

4. Ensure that each pupil has a role in class activities

5. Provide the pupil with 2-3 short breaks during a classroom period

6. Include all types of activities to favour disabled or comorbid pupils’ participation

7. Implement social stories and peer-mediated learning strategies (e.g. peer-tutoring)

8. Include specific strategies for acquiring social skills (e.g. peer tutoring, collaborative groups)

9. Adopt specific strategies for academic skills (e.g. fluency-building activities).

School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements Ensure appropriate adaptations, accommodations and modifications made to the instruction and other activities.

[Reference: https://www.christopherreeve.org/living-with-paralysis/for-parents/education- for-children-living-with-paralysis-1]

Community

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Ask for support in dealing with pupils’ invalidity/disabilities on behalf of school community and parents. Campaign for support to increase the level of awareness of the teachers, pupils and parents of what invalidity/ disability means.

Curricular Adaptations Ensure related services: physical and occupational therapy, school health services and rehabilitation counselling.

Discipline

Monitor safety of the pupils during their curricular and extra-curricular activities during their classes, breaks or other types of activities.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Consider adaptation of the learning tasks and other extra-curricular activities such as homework, educational activities, sports competitions) in order to diminish abandonment because of comorbidity.

Homework

Consider adaptation of the learning tasks and other extra-curricular activities such as homework, educational activities, sports competitions) in order to diminish abandonment because of comorbidity.

Parents / Parents’ Associations

1. Ask for support in dealing with pupils’ invalidity/disabilities on behalf of school community and parents. Campaign for support to increase the level of awareness of the teachers, pupils and parents of what invalidity/disability means.

2. Support and include families, who may be in for a long physical and emotional haul; they need to feel involved in the process at every stage and can only do this with enough appropriate information to hand. [Reference: http://patient.info/doctor/disability-in- childhood]

3. Discuss possible therapy programmes for pupils with comorbidity with the parents. Monitor their evolution and improvement.

Safety

1. Consider the inclusive aspect of school projects, events, and celebrations for all pupils, providing facilities for those with comorbidity to be able to participate, such as safety conditions, hall accommodation, and managing traffic in the corridors.

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2. Monitor safety of the pupils during their curricular and extra-curricular activities during their classes, breaks or other types of activities.

School Breaks

Monitor safety of the pupils during their curricular and extra-curricular activities during their classes, breaks or other types of activities.

School Celebrations / Events / Activities

Consider the inclusive aspect of school projects, events, and celebrations for all pupils, providing facilities for those with comorbidity to be able to participate, such as safety conditions, hall accommodation, and managing traffic in the corridors.

School Purchases

Ensure supplementary aids and services might include an aide, a note taker, or other assistive technology. Adaptive equipment, such as powered mobility and the introduction of augmentative communication systems such as sign language and picture boards, can have impressive and widespread impacts on social, language and play skills as well as encouraging independent movement.

[Reference: http://patient.info/doctor/disability-in-childhood]

Student Council

1. Establish what type of disability the pupil in your class has. Discuss it with the other pupils and organise the inclusion of the pupil affected by comorbidity.

2. Ask for support in dealing with pupils’ invalidity/disabilities on behalf of school community and parents. Campaign for support to increase the level of awareness of the teachers, pupils and parents of what invalidity/ disability means.

Pupil Support

1. Establish what type of disability the pupil in your class has. Discuss it with the other pupils and organise the inclusion of the pupil affected by comorbidity.

2. Ensure related services: physical and occupational therapy, school health services and rehabilitation counselling.

Technology

www.idecide-project.eu

impressive and widespread impacts on social, language and play skills as well as encouraging independent movement.

[Reference: http://patient.info/doctor/disability-in-childhood]

Supportive Literature

Definition The concept of comorbidity is characterised by a variety of available definitions in specialised literature (according to Valderas et al.), which, in very brief terms, could be summarised as follows: when at least two disabilities or illnesses occur in the same person, simultaneously or sequentially, they are described as comorbid. Comorbidity also implies interactions between the illnesses that affect the course and prognosis of both. https://www.drugabuse.gov/publications/research-reports/comorbidity-addiction-other-mental- illnesses/what-comorbidity Disability The Disability Discrimination Act (DDA) defined disability as being inclusive of children with a limiting long-standing (12 months' duration or longer) illness, disability or infirmity, experiencing one or more significant difficulties or health problems. It also includes those who would have such difficulties or problems if they did not take medication. (Blackburn CM et al, 2010). Child disability is an emerging global health priority. To address the need for internationally comparable information about the frequency and situation of children with disabilities, UNICEF introduced the Ten Questions screen for disability. Children and young people with disabilities constitute about 4-6.5% of the population in many countries. (Maulik PK, Darmstadt, 2007, Suppl 1: S1-55) It appears that the incidence of disability among children and adolescents has risen over a period of thirty years.

Physical disability There are many physical disabilities that can affect children, such as delayed walking, deafness or visual impairment. Cerebral palsy (CP) is the most common physical disability in childhood. Approximately 2 per 1,000 infants in developed countries are born with the condition. CP provides an umbrella term for a broad group of non-progressive motor impairment conditions secondary to lesions or anomalies of the brain arising in the early stages of development. (Rosenbaum P, 2003, 326) There are other conditions that may not be traditionally seen as disabilities but are chronic in nature and therefore can have an impact on the child's development in more subtle ways (e.g. through days lost at school, inability to partake fully in physical activities, need to take medication regularly). These include asthma or diabetes for example.

Learning disability This may be caused by genetic factors, infection prior to birth, brain injury at birth, brain infection, brain damage after birth or due to an unknown reason. There is a significant list of associated conditions, perhaps the most well-known being Down Syndrome. The effects may be far-reaching, with speech and communication problems which can

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result in, or be associated with, behavioural problems. Associated physical problems are common. The stigma attached to some of these conditions places an extra burden on a family which may have to cope with significant stresses already. (The child with general learning disability: for parents and teachers (Factsheet 10), Royal college of Psychiatrists, 2004)

Useful Websites http://www.globalpartnership.org/focus-areas/children-with-disabilities http://www.lungchicago.org/understanding-copd-comorbidities/ http://www.aihw.gov.au/chronic-diseases/comorbidity/

References

Blackburn CM et al. Prevalence of childhood disability and the characteristics and circumstances of disabled children in the UK: secondary analysis of the Family Resources Survey. BMC Pediatrics. Apr 2010. http://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-10-21

Maulik PK, Darmstadt, GL, Childhood disability in low- and middle-income countries: overview of screening, Pediatrics. 2007 Jul;120 Suppl 1:S1-55.

Rosenbaum P., Childhood disability and social policies. BMJ. 2009 Apr 24;338:b1020. doi: 10.1136/bmj.b1020.

Rosenbaum P, Cerebral palsy: what parents and doctors want to know. BMJ. 2003 May 3;326(7396):970-4.

Pallapies D., Trends in childhood disease. Mutat Res. 2006 Sep 28;608(2):100-11. Epub 2006 Jul 18.

Croot Ej, Grant G, Cooper CL, et al: Perceptions of the causes of childhood disability among Pakistani families living in the UK. Health Soc Care Community. 2008, available online at https://www.ncbi.nlm.nih.gov/pubmed/18384357

Half of the world's disabled children are out of school: report, available online at http://www.reuters.com/article/us-education-aid- government-idUSKBN12H009

Valderas, Jose M., Starfield, Barbara, Sibbald, Bonnie, Salisbury, Chris et al., 2009, Defining Comorbidity: Implications for Understanding Health and Health Services, in Ann. Fam.Med., 2009 Jul; 7(4): 357–363.

The child with general learning disability: for parents and teachers (Factsheet 10), Royal college of Psychiatrists, 2004, available online at http://www.google.ro/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0ahUKEwiZsoCzpKbRAhVDMFAKHUnDBq4QFggcMAA&url=htt p%3A%2F%2Fwww.ccats.org.uk%2Fimages%2Froyalcollegepdf%2Fsheet10.pdf&usg=AFQjCNG3jVYFR1- cxsdOnHfJRTS7vhQhAg&bvm=bv.142059868,d.ZWM&cad=rjt

MCH 13-09: Service support for children with a chronic illness or psysical disability attending nainstream schools, Dept of Health (February 2007), available online at http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Aboutus/Researchanddevelopment/AtoZ/Motherandchildhealth/DH_40 15002?PageOperation=email

The EU's strategic framework for European cooperation in education and training (ET 2020)

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Paralysis

Classroom-based tips (focus on instructional methods)

1. Inform the pupils about the presence of a colleague with paralysis (e.g. through project, discussion, parental participation, storytelling, involvement of the pupil himself/herself, and depending on the age of the class), taking care not to stigmatise the pupil or make her/him feel uncomfortable.

2. Provide activities promoting acceptance, critical thinking, active involvement of all pupils and support in order to avoid marginalisation. [Reference: http://www.tandfonline.com/doi/full/10.1080/13603116.2012.717638]

3. Ensure that each pupil has a role in class activities.

4. Use various teaching methods in order to offer equal chances for participation to those pupils with paralysis.

5. Provide a specific set of teaching materials in digital form, so that pupils with paralysis do not have to carry heavy books in and out of school and the classroom.

6. Provide copies of teachers’ notes or recorded lectures, as well as digital notes for pupils using technology.

7. Be understanding with such issues as lateness, absences, shortened school days, fatigue, change in mood, and missed homework due to physical therapy sessions.

8. Provide options for tutoring or extra time to make up assignments and complete tasks.

9. Differentiate testing and assessment by providing options according to individual needs of a pupil. These could be extra time or untimed tests, one-on-one evaluation, alternate response mode, and use of a laptop and/or other assistive technology.

10. Include all types of activities to favour the participation of pupils with paralysis.

11. Take into consideration the pupil’s physical and communication needs when designing class schedule; classrooms should be close, to minimise distance walked throughout the day or the time spent at school.

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12. If pupils use wheelchairs, where possible place yourself at their eye level when talking to them.

13. The board in the classroom may have to be lowered if the pupil is in a wheelchair.

14. Employ accessibility features and/or available assistive technology for providing (physical) access.

15. Provide opportunities for the use of assistive technology and alternative communication means (if used or necessary) for participation in classroom.

School-based practical tips (focus on instructional methods)

Class Divisions / Arrangements

Ensure appropriate adaptations, accommodations and modifications are made to the instruction and other activities, including availability of assistive technology.

Community

1. Arrange meetings between the parents and the staff, including other professionals working with the pupils, such as the physiotherapist, so as to learn as much as possible about the diagnosis, their observations about the pupil’s current level of ability and possible needs during the course of the school year. Design a school project in order to increase the level of awareness of the teachers, other pupils and parents about paralysis.

2. Find and have available contact details of local/national associations for paralysis, and more specific associations, if existing, for further information and support.

Curricular Adaptations

Adapt or differentiate learning tasks and other extra-curricular activities in order to diminish abandonment, including in homework assignments, educational activities, and sports competitions.

[Reference: https://www.christopherreeve.org/living-with-paralysis/for-parents/education- for-children-living-with-paralysis-1]

Discipline

Monitor the safety of the pupil during curricular and extra-curricular activities, during classes, breaks or other types of activities.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

www.idecide-project.eu

Adapt or differentiate learning tasks and other extra-curricular activities in order to diminish abandonment, including in homework assignments, educational activities, and sports competitions.

[Reference: https://www.christopherreeve.org/living-with-paralysis/for-parents/education- for-children-living-with-paralysis-1]

Homework

Adapt or differentiate learning tasks and other extra-curricular activities in order to diminish abandonment, including in homework assignments, educational activities, and sports competitions.

[Reference: https://www.christopherreeve.org/living-with-paralysis/for- parents/education-for-children-living-with-paralysis-1]

Parents / Parents’ Associations

1. Arrange meetings between the parents and the staff, including other professionals working with the pupils, such as the physiotherapist, so as to learn as much as possible about the diagnosis, their observations about the pupil’s current level of ability and possible needs during the course of the school year. Design a school project in order to increase the level of awareness of the teachers, other pupils and parents about paralysis.

2. Involve families in the process of every stage of decision-making for the pupil’s education and provide them with enough appropriate information [Reference: http://patient.info/doctor/disability-in-childhood]

3. Facilitate family support and confidence in parenting a child with paralysis.

4. For pupils with periodic paralysis, it is extremely important for school staff to be flexible and allow the pupil to adapt his or her behaviour as needed to avoid episodes. [Reference: http://hkpp.org/school-aged-child-periodic-paralysis]

5. Work with the parents in terms of the individual pupil’s diet. These guidelines are meant to give school personnel some understanding of the general needs of persons with periodic paralysis. [Reference: http://hkpp.org/school-aged-child-periodic-paralysis]

Safety

1. Ensure emergency precautions are in place and staff are properly trained if pupil’s breathing or heart rate are affected.

[Reference: http://hkpp.org/school-plan-for-student-periodic-paralysis]

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2. Monitor the pupil for signs of weakness, clumsiness, changes in colour (may become flushed or ashen) and/or shaking; pupils with paralysis may push themselves beyond safe capacity in order to keep up with their peers.

3. Provide space for pupil’s involuntary movements (e.g. in case of athetosis) for his/her own and others’ safety. [Reference: http://hkpp.org/school-plan-for-student-periodic-paralysis]

4. Provide access and facilities in order to develop inclusive school projects, events and celebrations for all pupils, providing facilities for those with paralysis to be able to participate, such as safe conditions, hall accommodation, and monitored traffic in the corridors.

5. Monitor the safety of the pupil during curricular and extra-curricular activities, during classes, breaks or other types of activities.

6. For pupils with periodic paralysis, it is extremely important for school staff to be flexible and allow the pupil to adapt his or her behaviour as needed to avoid episodes. [Reference: http://hkpp.org/school-aged-child-periodic-paralysis]

7. Work with the parents in terms of the individual pupil’s diet. These guidelines are meant to give school personnel some understanding of the general needs of persons with periodic paralysis. [Reference: http://hkpp.org/school-aged-child-periodic-paralysis].

8. Make sure that, in case of emergency, the evacuation plan allows pupils with paralysis to safely get out of the building.

School Breaks

Monitor the safety of the pupil during curricular and extra-curricular activities, during classes, breaks or other types of activities.

School Celebrations / Events / Activities

Provide access and facilities in order to develop inclusive school projects, events and celebrations for all pupils, providing facilities for those with paralysis to be able to participate, such as safe conditions, hall accommodation, and monitored traffic in the corridors.

Pupil Support

1. Allow time for mobility for pupils who need to change rooms for classes in order to move safely and on time to their next class. If needed, a classmate, friend or helper may carry books and other materials between classes; assign roles or create groups in class with the participation of the pupil with paralysis. [Reference: http://hkpp.org/school-plan-for-student-periodic-paralysis]

2. Arrange meetings between the parents and the staff, including other professionals working with the pupils, such as the physiotherapist, so as to learn as much as possible about the diagnosis, their observations about the pupil’s current level of ability and possible needs

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during the course of the school year. Design a school project in order to increase the level of awareness of the teachers, other pupils and parents about paralysis.

3. Find and have available contact details of local/national associations for paralysis, and more specific associations, if existing, for further information and support.

4. Consult with the pupil’s physiotherapist, speech and language therapist and occupational therapist for advice on how to best meet the pupil’s individual seating, positioning in the classroom, eating and communication needs.

Teacher Professional Development

Provide training for teachers who have pupils with paralysis in their classrooms.

Technology

Ensure appropriate adaptations, accommodations and modifications are made to the instruction and other activities, including availability of assistive technology.

Timetabling

[Reference: http://hkpp.org/school-plan-for-student-periodic-paralysis]

2. For pupils with periodic paralysis, it is extremely important for school staff to be flexible and allow the pupil to adapt his or her behaviour as needed to avoid episodes.

[Reference: http://hkpp.org/school-aged-child-periodic-paralysis]

Supportive Literature

Definition: Paralysis is defined as complete loss of strength in an affected limb or muscle group [Reference: http://medical- dictionary.thefreedictionary.com/juvenile+paralysis+agitans+%28of+Hunt%29]. Paralysis is also defined as the loss of muscle function in a part of the body. It can be localised or generalised, partial or complete, temporary or permanent. [Reference: http://www.healthline.com]

Description The chain of nerve cells that runs from the brain through the spinal cord out to the muscles is called the motor pathway. Normal muscle function requires intact connections all along this motor pathway. Damage at any point reduces the brain's ability to control the muscle's movements. This reduced efficiency causes weakness, also called paresis. Complete loss of communication prevents any willed

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movement at all. This lack of control is called paralysis. Certain inherited abnormalities in muscles cause periodic paralysis in which the weakness comes and goes.

The line between weakness and paralysis is not absolute. A condition causing weakness may progress to paralysis. On the other hand, strength may be restored to a paralysed limb. Nerve regeneration or regrowth is one way in which strength can return to a paralysed muscle. Paralysis almost always causes a change in muscle tone. Paralysed muscle may be flacid, flabby, and without appreciable tone, or it may be spastic, tight, and with abnormally high tone that increases when the muscle is moved. Paralysis may affect an individual muscle, but it usually affects an entire are of the body.

The distribution of weakness is an important clue to the location of the nerve damage that is causing the paralysis.

Words describing the distribution of paralysis use the suffix "-plegia," from the Greek word for "stroke." The types of paralysis are classified by area of the body affected:  monoplegia, affecting only one limb  diplegia, affecting the same area of the body on both sides of the body (both arms, for example, or both sides of the face)  hemiplegia, affecting one side of the body  paraplegia, affecting both legs and the trunk  quadriplegia, affecting all four limbs and the trunk

The loss of function caused by long-term paralysis can be treated through a comprehensive rehabilitation http://medical-dictionary.thefreedictionary.com/rehabilitation program.

Rehabilitation includes:  Physical therapy The physical therapist focuses on mobility. Physical therapy helps develop strategies to compensate for paralysis by using those muscles that still have normal function, to maintain and build strength and control in the affected muscles, and to maintain range of motion in the affected limbs

 Occupational therapy The occupational therapist focuses on daily activities such as eating and bathing. Occupational therapy develops special tools and techniques that enable self-care, and suggests ways to modify the home and workplace so that a patient with impairment may lead a normal life.

 Other therapies The nature of the impairment may mean that the patient needs the services of a respiratory therapist, vocational rehabilitation counsellor, social worker, speech-language pathologist, nutritionist, special education teacher, recreation therapist, or clinical psychologist.

Websites and EU Reports

European Accessibility Act 2015 http://ec.europa.eu/social/main.jsp?catId=1202 The EU's strategic framework for European cooperation in education and training (ET 2020) - http://ec.europa.eu/education/policy/strategic-framework_en http://www.atia.org/at-resources/what-is-at

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http://medical-dictionary.thefreedictionary.com/juvenile+paralysis+agitans+%28of+Hunt%29 http://hkpp.org/school-aged-child-periodic-paralysis http://hkpp.org/school-plan-for-student-periodic-paralysis http://patient.info/doctor/disability-in-childhood https://www.christopherreeve.org/living-with-paralysis/for-parents/education-for-children-living- with-paralysis-1 https://www.google.ro/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&ved=0ahUKEwi_jpemrabRA hUWOlAKHdjXDkcQFghNMAQ&url=https%3A%2F%2Fwww.unicef.org%2Fdisabilities%2Ffiles%2FFac tsheet_A5__Web_NEW.pdf&usg=AFQjCNG6AlMybr- vlC1xABuEUUtZT42F5Q&bvm=bv.142059868,d.ZWM&cad=rjt http://isabellelorelai.wordpress..com/tag/asociatia-copii-suflete-sperante Asociatia umanitara Marta Maria, http://www.martamaria.ro/ Asociatia Vreau si eu sa merg, http://www.vreausieusamerg.ro/ Asociația Copii Suflete Speranțe’ http://isabellelorelai.wordpress..com/tag/asociatia-copii-suflete- sperante

References

Engin A, et al, (2006), Tick paralysis with atypical presentation: isolated, reversible involvement of the upper trunk of brachial plexus, Emergency Medical Journal, 23(7): e42.

Batshaw, M.,et al, (2012), Children with disabilities, Paul H. Brookes Pub.

Bouck C. E., (2016), Assistive technology, Sage Publications

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Cerebral Palsy

Classroom-based tips (focus on instructional methods)

1. Inform the pupils about the presence of a pupil with cerebral palsy (e.g. through project, discussion, parental participation, storytelling, involvement of the pupil himself/herself, depending on the age of the class), taking care not to stigmatise the pupil, or make her/him feel uncomfortable.

2. Provide activities promoting acceptance and support in order to avoid marginalisation. These might include for instance, discussions on various types of disabilities, in this case specifically on cerebral palsy, and even on the strengths of people affected by this condition such as having above-average intelligence [Reference: https://www.ninds.nih.gov/Disorders/All-Disorders/Cerebral-Palsy-Information-Page].

3. Explain the lessons carefully and use dynamic activities that stimulate the creativity of pupils with cerebral palsy – this would encourage them to keep their interest and remain actively involved in the various types of learning activities.

4. Ensure that each pupil has an active role in class activities.

5. Use various teaching methods in order to offer equal learning opportunities to pupils with paralysis.

6. Provide a specific set of teaching materials in digital form, so that pupils with cerebral palsy do not have to carry heavy books in and out of school and the classroom.

7. Provide course content in digital form for pupils with cerebral palsy that use (assistive) technology for their learning.

8. Provide copies of teachers’ notes or recorded lectures, as well as digital notes for pupils using technology.

9. Use technology and/or other audio-visual aids in the pupil’s learning and teaching programme.

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10. Be understanding with such issues as lateness, absences, shortened school days, fatigue, change in mood and missed homework due to therapy sessions.

11. Provide options for tutoring or extra time to make up assignments and complete tasks.

12. Encourage pupils to participate in all classroom activities at their own pace and comfort level.

13. Encourage pupils to participate in all classroom activities by using their assistive technology, where applicable.

14. Take into consideration the pupil’s physical and communication needs when designing the class schedule; classrooms should be close, to minimise distance walked throughout the day.

15. Differentiate testing and assessment by providing options according to individual needs of a pupil. These could be extra time or untimed tests, one-on-one evaluation, alternate response mode, and use of a laptop and/or other assistive technology.

16. Provide opportunities for the use of alternative communication means in all classroom activities, if available, for pupils that do not have verbal communication abilities.

17. Make arrangements for sitting and positioning in the classroom to facilitate safely moving around and participating in activities. Consult physiotherapist for specific seating needs. Keep in mind that favourable classroom accommodation (supportive seating, note-taking by means of recording the lesson, height of the bench so as to match the height of the wheelchair, lowering the blackboard) and the adaptive equipment mentioned above may improve the pupil’s physical abilities.

18. Provide for any (additional) assistive technology and other adaptations needed, such as technology devices, and adapted desks.

19. If pupils use wheelchairs, where possible place yourself at their eye level when talking to them.

20. The board in the classroom may have to be lowered if the pupil is in a wheelchair.

21. Allow pupils to leave classes early to give them adequate time to get to their next class.

22. Provide options for adapted physical activities (consult physiotherapist). Being physically active is important for pupils with cerebral palsy; slower-paced activities are better than those requiring a fast response.

School-based practical tips (focus on instructional methods)

Class Divisions

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Ensure appropriate adaptations, accommodations and modifications are made to the instruction and other activities, including availability of assistive technology.

Community

1. Design a school project in order to increase the level of awareness of the teachers, pupils and parents of what cerebral palsy is.

2. Find and have available contact details of local/national associations for cerebral palsy and, more generally, for paralysis.

Curricular Adaptations

1. Allow time for mobility for pupils who need to change rooms for classes in order to move safely and on time to their next class. If needed, a classmate, friend or helper may carry books and other materials between classes; assign roles or create groups in class with the participation of the pupil with cerebral palsy. [Reference: http://hkpp.org/school-plan-for- student-periodic-paralysis]

2. Devise individualised learning plans for pupils with cerebral palsy in collaboration with other professionals and family.

3. Make the physical education class and sports activities in school accessible by adjustment of playing areas (dimension, surface); equipment modification, for example using lighter balls, or balls with sounds.

Discipline

Monitor the safety of the pupils during their curricular and extra-curricular activities during their classes, breaks or other types of activities.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

1. When organising field trips and school events, make arrangements by considering the following, based on individual pupil’s needs: Is there a wheelchair lift on the bus? Is there enough space in the bus for a wheelchair? Is the field trip destination accessible for wheelchairs? Have the teachers accompanying the group of pupils been informed of this pupil’s needs?

2. Adapt or differentiate learning tasks and other extra-curricular activities in order to diminish abandonment including in homework assignments, educational activities, and sports competitions. [Reference: https://www.christopherreeve.org/living-with-paralysis/for-parents/education- for-children-living-with-paralysis-1]

Homework

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Adapt or differentiate learning tasks and other extra-curricular activities in order to diminish abandonment including in homework assignments, educational activities, and sports competitions. [Reference: https://www.christopherreeve.org/living-with-paralysis/for-parents/education- for-children-living-with-paralysis-1]

Parents / Parents’ Associations

2. Facilitate family support and confidence in parenting a child with cerebral palsy.

3. Design a school project in order to increase the level of awareness of the teachers, pupils and parents of what cerebral palsy is.

4. Involve families in the process of every stage of decision-making for the child’s education, and provide them with enough appropriate information [Reference: http://patient.info/doctor/disability-in-childhood]

Safety

1. Ensure emergency precautions are in place and staff are properly trained if pupils’ breathing or heart rate are affected. [Reference: http://hkpp.org/school-plan-for-student-periodic-paralysis]

2. Provide access and facilities in order to develop inclusive school projects, events, and celebrations for all pupils, providing facilities for those with cerebral palsy to be able to participate (e.g. safety conditions, hall accommodation, traffic in the corridors).

3. Equip the building of the school institution with accessibility and safety adaptations such as elevator, ramps, and special desks with room for a wheelchair.

4. Monitor the safety of the pupils during their curricular and extra-curricular activities during their classes, breaks or other types of activities.

5. Make sure that, in case of emergency, the evacuation plan allows pupils with cerebral palsy to safely get out of the building.

6. Make the physical education class and sports activities in school accessible by adjustment of playing areas (dimension, surface); equipment modification, for example using lighter balls, or balls with sounds.

School Breaks

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Monitor the safety of the pupils during their curricular and extra-curricular activities during their classes, breaks or other types of activities.

School Celebrations / Events / Activities

Provide access and facilities in order to develop inclusive school projects, events, and celebrations for all pupils, providing facilities for those with cerebral palsy to be able to participate (e.g. safety conditions, hall accommodation, traffic in the corridors).

School Purchases

1. Equip the building of the school institution with accessibility and safety adaptations such as elevator, ramps, and special desks with room for a wheelchair.

2. Allow pupils with cerebral palsy to use assistive technological devices that help them perform tasks and improve performance, for example a keyboard for writing.

Student Council

Design a school project in order to increase the level of awareness of the teachers, pupils and parents of what cerebral palsy is.

Pupil Support

1. Allow time for mobility for pupils who need to change rooms for classes in order to move safely and on time to their next class. If needed, a classmate, friend or helper may carry books and other materials between classes; assign roles or create groups in class with the participation of the pupil with cerebral palsy. [Reference: http://hkpp.org/school-plan-for- student-periodic-paralysis]

2. Provide pupils extra support if possible, including financial support, and individual teaching support.

3. Ensure that further provision is provided to pupils that may need support during class, for example with the presence of a teaching assistant.

4. Find and have available contact details of local/national associations for cerebral palsy and, more generally, for paralysis.

Teacher Professional Development

Provide training for teachers who have pupils with cerebral palsy in their classrooms.

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Technology

1. Ensure appropriate adaptations, accommodations and modifications are made to the instruction and other activities, including availability of assistive technology.

2. Allow pupils with cerebral palsy to use assistive technological devices that help them perform tasks and improve performance, for example a keyboard for writing.

Timetabling

Allow time for mobility for pupils who need to change rooms for classes in order to move safely and on time to their next class. If needed, a classmate, friend or helper may carry books and other materials between classes; assign roles or create groups in class with the participation of the pupil with cerebral palsy. [Reference: http://hkpp.org/school-plan-for- student-periodic-paralysis]

Supportive Literature

Definition: Cerebral palsy (CP) refers to a group of “disorders of the development of movement and posture, causing activity limitation that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain.” [Reference: https://iate.cdt.europa.eu/iatenew/manipulation/dataentry/EntryDetailview.jsp?lilId=1532733&srcL ang=en&trgLang=ro]. It is a “childhood condition” (Miller, 3) as the neurological disorders appear in infancy or early childhood and permanently affect body movement, muscle coordination, and balance [Reference: https://www.ninds.nih.gov/Disorders/All-Disorders/Cerebral-Palsy-Information-Page]. The majority of children with cerebral palsy are born with it, though the condition may not be detected until months or years later. The early signs of cerebral palsy usually appear before the child reaches the age of 3. The condition itself is “stable and non-progressive” (Miller, 3), but “it persists for life” (Stanton, 11), as there is no cure for this disease (Stanton, 12). The causes are various, ranging from infection passed from mother to child in the womb, to environmental, hereditary or even postnatal factors, such as a head injury sustained during the first five years of life (Stanton, 13). In general terms, cerebral palsy is characterised by involuntary jerking movements, a poor sense of balance, spastic muscles and speech impairment. Doctors classify cerebral palsy according to:

(a) the part of the body affected:  Hemiplegia: affecting one side of the body.  Diplegia: affecting the whole body.  Quadriplegia: affecting both arms and legs. Or (b) the way in which the body is affected:  Spasticity: difficulty moving limbs and problems with posture and general movements.  Athetosis: involuntary movements such as twitches or spasms.  Ataxia: difficultly co-ordinating muscle groups and problems with balance, walking, etc. (Erickson, Angie, 1994)

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A mixture of these conditions may sometimes be present, as well as other associated difficulties, so the term embraces a wide spectrum. The associated difficulties include difficulties with epilepsy, general/specific learning disabilities, sleeping, speech and understanding the spoken word, and visual perception.

It is estimated that 1 in 400 pupils are affected by cerebral palsy and it is important to note that there is a huge variation in the manner in which cerebral palsy affects each individual. Some, but not all, pupils will have communication difficulties (including social mixing difficulties), movement and control difficulties, difficulties in processing and in ordering information, and spatial and perceptual difficulties. (Erickson, Angie, 1994)

Websites and EU Reports

EU Accessibility Act - http://www.europarl.europa.eu/RegData/etudes/IDAN/2016/571382/IPOL_IDA(2016)571382_EN.p df NINDS - https://www.ninds.nih.gov/Disorders/All-Disorders/Cerebral-Palsy-Information-Page Children's Hemiplegia and Stroke Assocn. (CHASA) - http://chasa.org/ United Cerebral Palsy (UCP) (link is external) - http://www.ucp.org National Institute of Child Health and Human Development (NICHD) - http://www.nichd.nih.gov NHS - http://www.nhs.uk/conditions/cerebral-palsy/pages/introduction.aspx Centre for Disease Control and Prevention - https://www.cdc.gov/ncbddd/cp/facts.html Asociatia Umanitara Marta Maria - http://www.martamaria.ro/despre-paralizia-cerebrala-2/ Asociatia umanitara “Sfantul Stefan” - http://asociatiasfantulstefan.ro/index.php

References

Erickson, Angie (1994), It’s OK to be different, Newsweek, http://www.sess.ie/categories/physical-disabilities/cerebral-palsy

Miller, Freeman (2005), Cerebral Palsy, Springer

Stanton, Marion (2012), Understanding Cerebral Palsy: A Guide for Parents and Professionals, Jessica Kingsley Publishers https://www.ninds.nih.gov/Disorders/All-Disorders/Cerebral-Palsy-Information-Page https://iate.cdt.europa.eu/iatenew/manipulation/dataentry/EntryDetailview.jsp?lilId=1532733&srcLang=en&trgLang=ro

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Pupils from Religious Minorities

Classroom-based tips (focus on instructional methods)

1. Develop and implement an antiracist policy, which deals with any incidents of racism towards migrant pupils because any aspect of their identity, such as their background, accent, language skills, appearance, legal status in the country of arrival or religion.

2. Develop co-operative learning in order to allow the personal skills and knowledge of the members of the group to become integration criteria, rather than their ethnic or religious affiliation.

3. Promote understanding, respect, and capacity for dialogue among people with different views; teach controversial issues related to religion and faith and deal with them rather than avoid them (e.g. euthanasia, abortion, blood transfusion, IVF, marriage, status of women, homosexuality, gender of priests).

4. Provide a welcoming atmosphere to explore different views regarding faith and religion in the classroom.

5. Implement rules of dialogue to promote respect for each other.

6. Promote knowledge and understanding and avoid promoting a particular religious or non- religious view.

7. Employ methods such as role-play and drama to try to reconstruct someone else's religious ideas or feelings, without focusing or commenting on individuals in the classroom.

8. Allow pupils who wish to pray during certain hours to do so privately, if the school has a suitable space for that.

9. Organise religious festivals in order to provide opportunities for pupils to recognise the richness and diversity in their group, and to put their own experiences in a wider context. Give pupils opportunities to discover similarities and differences between and within each religious practice.

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School-based practical tips (focus on instructional methods)

Community

1. Promote positive values in the school community, such as knowledge, respect and courtesy, valuing the individual, family and community, non-discrimination, acceptance of various traditions and difference.

2. Develop religious education in co-operation with religious communities.

3. Collaborate with local and faith communities that represent all religions of the pupils and the community.

4. Promote encounters with representatives of the major religions (e.g. visits to the church, the mosque, the synagogue and the Buddhist temple) and support pupils with additional guidance in class.

Curricular Adaptations

1. Include opportunities in the curriculum for staff and pupils to study the issues raised by valuing religious diversity and faith.

2. Develop religious education in co-operation with religious communities.

3. Implement a multi-religious systematic approach, by presenting all religions side by side without preferences of any kind.

Discipline Develop and implement an antiracist policy, which deals with any incidents of racism towards migrant pupils because any aspect of their identity, such as their background, accent, language skills, appearance, legal status in the country of arrival or religion.

Educational Visits / Field Trips / Camps / School Exchanges / Trips Abroad

Promote encounters with representatives of the major religions (e.g. visits to the church, the mosque, the synagogue and the Buddhist temple) and support pupils with additional guidance in class.

Food: Canteen / Visits / Camps / Trips Reflect the diversity of cultures and needs in the food provided in school.

Parents / Parents’ Associations

Develop religious education in co-operation with religious communities.

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Safety

2. Create a safe learning environment where all pupils, their cultures, religions and identities are valued, and where pupils feel they have a common sense of belonging.

Scheduling Events

1. Reflect in the school calendar the religious diversity of the school population and the community.

2. Collaborate with local and faith communities that represent all religions of the pupils and the community.

School Breaks Reflect in the school calendar the religious diversity of the school population and the community.

School Celebrations / Events / Activities

Reflect in the school calendar the religious diversity of the school population and the community.

School Projects Collaborate with local and faith communities that represent all religions of the pupils and the community.

Pupil Support

1. Promote understanding of religious diversity and dialogue since respecting other religions is a common principle found in most faiths.

2. Implement a multi-religious systematic approach, by presenting all religions side by side without preferences of any kind.

3. Create a safe learning environment where all pupils, their cultures, religions and identities are valued, and where pupils feel they have a common sense of belonging.

Teacher Professional Development

1. Include opportunities in the curriculum for staff and pupils to study the issues raised by valuing religious diversity and faith.

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2. Provide teachers with training opportunities on the challenges, the curriculum and the teaching approaches of religious education.

Timetabling

Reflect in the school calendar the religious diversity of the school population and the community.

Supportive literature

Definition: A minority religion is a religion held by a minority of the population of a country, state, or region. Minority religions may be subject to stigma or discrimination. An example of a stigma is using the term cult with its extremely negative connotations for certain new religious movements. People who belong to a minority religion may be subject to discrimination and prejudice, especially when the religious differences correlate with ethnic differences. Laws are made in some countries to protect the rights of religious minorities, such as protecting the minority culture, and to promote harmony with the majority.

Council of Europe definition: “Religion is a collection of cultural systems, belief systems, and worldviews that relate humanity to spirituality and, sometimes, to moral values. Many religions have narratives, symbols, traditions and sacred histories that are intended to give meaning to life or to explain the origin of life or the universe. They tend to derive morality, ethics, religious laws or a preferred lifestyle from their ideas about the cosmos and human nature. […] Many religions have organised behaviours, clergy, a definition of what constitutes adherence or membership, congregations of laity, regular meetings or services for the purposes of veneration of a deity or for prayer, holy places (either natural or architectural), and/or scriptures. The practice of a religion may also include sermons, commemoration of the activities of a deities, sacrifices, festivals, feasts, trance, initiations, funerary services, matrimonial services, meditation, music, art, dance, public service, or other aspects of human culture. However, there are examples of religions for which some or many of these aspects of structure, belief, or practices are absent.”

Characteristics: Pupils belonging to religious minorities have a faith which is different from that held by the majority. Most countries of the world have religious minorities. It is now widely accepted in the west that people should have the freedom to choose their own religion, including not having any religion (atheism and/or agnosticism), and including the right to convert from one religion to another. However, in many countries this freedom is restricted.

Armenians

Definition: The origins of the Armenian Church date back to the 1st century. According to tradition, the Armenian Church was founded by two of the twelve apostles of Christ, St. Jude Thaddeus and St. Bartholomew, who preached Christianity in Armenia between the years 40 and 60 AD. Because of these founding apostles, the official name of the Armenian Church is Armenian Apostolic Church.

Food restrictions / Fasting: Orthodox Christians often fast on a regular basis. Fasting periods include most Wednesdays and Fridays, Lent, Advent / Nativity (five weeks before Christmas), Dormition/Assumption (1-15 August) and a variable period before the Feast of the Holy Apostles.

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There are other fast days as well. Dates can be determined by consulting an Orthodox liturgical calendar. During periods of fasting, Orthodox Christians refrain from eating animal products, including fish, chicken and dairy products. In rare cases, fish is allowed for a short period.

Special days:  Amanor (New Year, January 1): This is one of the most popular and beloved public holidays marking the start of the year and celebrated for a whole week after the holiday.  Christmas (January 6): Christmas is a religious holiday. It represents the birthday of Jesus Christ and is celebrated by Christian people all over the world. The Armenians celebrate this holiday with the Epiphany by attending churches, praying, and lighting candles, and celebrate these two holidays at once.  Sargis Holiday (February): This is a beloved religious holiday and very popular among Armenians, particularly young people. Actually, like many other religious holidays and observations, there is no exact date for observing St. Sargis. It is usually celebrated on a Saturday 63 days before Easter (January 18 – February 23).  Trndez (Purification – February 14): Trndez, literally meaning coming forward to the Lord, is also a religious custom, according to which the holiday is connected with the idea of coming closer to the Lord with fire. The celebration of Trndez has pagan origins and is connected with sun and fire worship in the ancient Armenia of pre-Christian period. Later, the Armenian Apostolic Church preserved this tradition, as it was very popular. Nowadays, Armenians celebrate it on February 14th, 40 days after Jesus’s birth that is believed to be on January, 6th by Armenians.  Easter (April): In the Christian world, Easter is considered to be among the most favorite and anticipated holidays. It is one of the greatest religious holidays of the Armenian Apostolic Church.  Hambardzum (Ascension Day – May): Ascension Day is a religious holiday. It presents love and enjoyment; therefore, it is celebrated outdoors, usually in the blossom of May (40 days after Easter).  Grape Blessing Day (August): This religious holiday is usually celebrated on the Sunday nearest to August 15th. The Catholicos of the Armenian Apostolic Church blesses the grape harvest.  Khachverats (Holy Cross – September): This is an official religious holiday, which is celebrated by the Armenian Church on the Sunday nearest to September 14th. It is devoted to Surb Khach, the Holy Cross. The Khachverats holiday also serves as a memorial to those who have passed away.

Maronites

Definition: A particular Catholic sui iuris Church, of the Eastern rite, in full communion with the Apostolic See, and that recognises the authority of the Pope, the Supreme Pontiff of the Catholic Church. Its origin dates back to the community founded by Maron, a Syro-Syrian monk of the fourth century venerated as a saint. The first Maronite patriarch, St. John Maron, was elected at the end of the seventh century.

Food restrictions / Fasting: Maronites have many rules and restrictions regarding eating and drinking, for sample complete abstinence from tea, coffee and alcohol and an emphasis on wholesome eating.

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Special days: Maronites celebrate the usual Christian holidays, such as Christmas (December 25), Easter (in March or April), the Feast of the Ascension (May 15), and the Feast of the Assumption (August 15). On the Festival of the Cross (September 14) Maronites set fires on high places all over Mount Lebanon and light candles at home and in churches. A special Maronite holy day is St. Maron’s Day (February 9), the feast of the Maronites' patron saint, St. John Maron, who lived in the fifth century AD.

Latins

Definition: Latins originally referred to an Italic tribe in the former center of Italy. As Roman power spread the Latin culture, Latinos came to mean anyone who lives in a Latinised culture and speaks Latin or a Romance language. Food restrictions / Fasting: (Same as Catholic Christians). Special days:  Día de los Reyes Magos, Día de Reyes (Three Kings Day) – January 6  Semana Santa (Holy Week) – The week that precedes Easter  Feast of the Assumption – August 15  The Feast of Saint Michael the Archangel and All the Angels – September 29  Día de Todos los Santos (All Saints’ Day) – November 1  Día de los Difuntos or Day of the Dead (All Souls’ Day) – November 2  Nochebuena (Christmas Eve) – December 24 Navidad (Christmas Day) – December 25

Catholic Christians

Definition: Christianity is a monotheistic religion, based on the life and teachings of Jesus Christ, which serves as the focal point for the religion. It is the largest religion in the world, with more than 2.4 billion followers, or 33% of the global population. Christians believe that Jesus is the Son of God and the saviour of humanity (Sara Diaz, 2012).

Food restrictions / Fasting: For most Christians, eating habits are not affected- though some will be vegetarians, usually for moral reasons, and some will refrain from eating meat on Fridays. During Fridays of Lent, Catholics are expected to abstain from eating meat. On Ash Wednesday and Good Friday, Catholics are asked to abstain from eating meat. The minimum fast is not to eat more than one full meal on a quick day. Two smaller meatless meals, equivalent to less than a full meal, are allowed to sustain physical strength. These standards apply to persons over the age of fourteen and apply only up to sixty years.

Special days: The most important Christian holiday is Easter, a spring holiday that celebrates Christ's resurrection from the dead. Easter is immediately preceded by Holy Week, which includes Palm Sunday, Maundy Thursday, and Good Friday. The 40 days prior to Easter form the Lenten season, a time of fasting and repentance. Another holiday that has become important is Christmas, which commemorates the birth of Jesus on December 25.

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Sunni Muslims and Shiite Muslims

Shiite Muslims definition: The name “Sunni” is derived from the phrase “Ahl al-Sunnah”, or “People of the Tradition”. The tradition in this case refers to practices based on what the Prophet Muhammad said, did, agreed to or condemned. Sunni Muslims agree that the new leader should be elected from among those capable of the job. This is what was done, and the Prophet Muhammad's close friend and adviser, Abu Bakr, became the first Caliph of the Islamic nation. Sunni Muslims contend that leadership of the community is not a birthright, but a trust that is earned and which may be given or taken away by the people themselves. Sunni Muslims make up the majority (85%) of Muslims all over the world.

Islam (Sunni Muslims) definition: The origin of the term "Shiite" comes from the abbreviation of the expression "shīatu Ali," meaning "followers," "faction," or "party" of Ali (Ali was married to Fatima, daughter of Muhammad). Contrary to the Sunni Muslins, the Shiite Muslims believe that leadership should have stay within the Prophet's own family, among those specifically appointed by him, or among Imams appointed by God Himself. So they believe that following the Prophet Muhammad's death, leadership should have passed directly to his cousin/son-in-law, Ali bin Abu Talib. Significant populations of Shiite Muslims can be found in Iran and Iraq, and large minority communities in Yemen, Bahrain, Syria, and Lebanon.

Special attire: Muslim women wear the hijab, which is a veil that covers the head and chest. The hijab is worn starting from the age of puberty in the presence of adult males other than those in the immediate family, as a form of modest attire.

Muslims food restrictions / fasting: The Muslim religion has various food restrictions according to dietary laws, which are Halaal. During the holy month of Ramadan, Muslims are not allowed to eat from dawn to sunset. However young children, pregnant women and the sick are often exempted. As with to other religions, guests should ask about which restrictions apply to them.

 Carnivorous animals are not permitted;  All pork and pork products are totally forbidden;  Sea animals which do not have fins or scales are considered undesirable by some Muslims;  Alcohol in any form is not permitted;  Permissible meat other than pork can be eaten only if it is prepared in the correct way (Halaal);  These products should be avoided by all Muslims: lard, gelatine, rennet, whey, vanilla extract;  Utensils should be separate so that there is no contamination of Halaal and non-Halaal foods.

Special days:  Ramadan - Each year, Muslims spend a month in daytime fasting, during the 9th month of the Islamic calendar called Ramadan.  Laylat al-Qadr - Towards the end of Ramadan, Muslims observe the "Night of Power," which is when the first verses of the Quran were revealed to Muhammad.  Eid al-Fitr - At the end of Ramadan, Muslims celebrate "The Festival of Fast-Breaking."  Hajj - Each year during the 12th month of the Islamic calendar, millions of Muslims make an annual pilgrimage to Mecca in Saudi Arabia called Hajj.  Day of Arafat - During one day of the Hajj, pilgrims gather at the Plain of Arafat to seek God's mercy, and Muslims elsewhere fast for the day.

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 Eid al-Adha - At the end of the annual pilgrimage, Muslims celebrate "The Festival of Sacrifice."

Protestants

Definition / Characteristics: Protestantism is a branch of Christianity. The dividing lines of Christianity have been outlined as follows: Roman Catholicism, Eastern and Orthodox churches, and Protestantism. A. G. Mendonça observes that although the Church of England results from the Religious Reformation, it ended up being halfway between Roman Catholicism and Protestantism. Mendonça proposes the establishment of a fourth category, thus becoming the classification: Roman, Orthodox or Eastern, Protestant and Anglican. The Protestant grouping, includes the the great Reform family: Lutherans, Presbyterians, Methodists, Congregations, and Baptists.The doctrines of protestant denominations vary, but many include justification by grace through faith alone – the bible as the only role in matters of faith and order, a doctrine known as sola scriptura.

Food restrictions/ Fasting: While individuals may choose to exercise self-control in the area of personal food consumption, religious dietary mandates are not part of the teachings of Protestantism.

Special Days:

 Ascension Day - The fortieth day after Easter  All Saints Day (November 1) - Protestants celebrate the Protestant special saints  All Souls Day (November 2) – Protestants remember their deceased  Evangelicalism Day (July 7)  Christian Flag Day (September 26)  National Day of Prayer (The first Thursday of May) - This is an annual day of observance held on the first Thursday of May when people are asked “to turn to God in prayer and meditation”.  Faith Day (The third Sunday in August)  National Day of Repentance (The Thursday prior to Easter) - Easter is when the sins of the World were shed by Jesus

Jews

Definition: The word "Jew" was originally used to refer to the children of Judah, son of Jacob, and later was designated to those born in Judea. After deliverance from the captivity of Babylon, the Hebrews began to be called Jews. Jews, also known as the Jewish people, form an ethno-religious group from the Israelites or Hebrews, from the ancient Near East. Jewish ethnicity, nationality and religion are strongly interrelated, as Judaism is the traditional faith of the Jewish nation. Special Attire: Kippah (Yarmulke) Male pupils should wear a kippah, a round cap worn on the head, that is neat, clean, and contains no inappropriate words or symbols. Each boy should have an extra kippah at school.

Navy or khaki, flat or pleated front, uniform style pants, shorts, or skirts; Navy Blue with Light Navy Crest JDS; OR Navy Blue Crested Polo Light Blue Dress for Girls

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Food restrictions / Fasting: Jewish dietary laws are known as Kashrut, and are among the most complex of all religious food practices. In this religion foods are divided into two categories: kosher (allowed) or trefa (forbidden). Characteristics of kosher foods include animals that have a completely split hoof and chew cud (such as cows, goats and sheep), while kosher fish must have fins and scales. In general all plant foods are kosher. In addition, a specific slaughtering process must be followed for meat to be considered kosher. Meat and dairy products must not be prepared, stored or eaten together and certain fasting days are observed (especially Yom Kippur). Many Jewish people practice some or all of these restrictions in various degrees: • No pork, and shellfish; • Fish is acceptable as long as it has fins and scales; • All animals with split hooves and which chew the cud (including sheep and cows) are acceptable; • Refrain from eating meat and dairy products at the same meal; • No wine, unless its kosher wine; • All meat has to be prepared by a qualified kosher butcher (Shochet); • If meat was eaten in the same day, one must wait six hours before consuming any dairy products.

Special days:  Rosh Hashanah ("beginning of the year") - Is the Jewish New Year. It is the first of the High Holidays (Yamim Noraim - Days of Awe"). This Holiday is celebrated by lots of special prayers that Hashem (God) should grant a happy and healthy new year. On Rosh Hashanah there is a biblical commandment to blow or listen to the blowing of a Shofar, a horn of a ram.  Yom Kippur - It is known as the "day of atonement". In this day, Jews from all walks of life stay in synagogue praying during most of the day. The bible commands all Jews to fast and refrain from wearing shoes, massaging and any sexual activity. Thus, Hashem will forgive for all the sins from the previous year.  Sukkoth - is called "Zman Simchaseinu," the time of joy, in the Bible. The holiday is celebrated by eating and sleeping in a hut covered with branches and grass. The hut resembles the "clouds of glory" that the Jews traveled in, when they were in the desert for forty years before entering the land of Israel.  Shmini Atzeret and Simchat Torah - In the Torah there is one additional day that Hashem (God) added to the holiday of Sukkoth. A special day, where Hashem asks the Jewish people to celebrate with him in a special feast. There is no special commandment for this holiday, only to sing and celebrate with Hashem. Throughout the generations, rabbinic sages added a new twist to this holiday: Simchat Torah. In this day the Jews complete their weekly Torah portion, and start again.  Hanukkah – Hanukkah marks the defeat of Seleucid Empire forces that prevented the Jewish people from observing Judaism. The eight-day festival is marked by the kindling of lights - one on the first night, two on the second, and so on - using a special candle holder called a Chanukkiyah, or a Hanukkah menorah. It is celebrated with great joy and love.  Purim - It is a very special and unique holiday introduced to Jews by Mordechai with Esther and the great sages of that time. Purim is a festival that commemorates the saving of the Jewish people living throughout the ancient Persian Empire from a plot by Haman to kill all men, women and children.  Passover - It commemorates the story of the Jewish people when they were freed from Egyptian slavery. Passover begins on the 15th day of the month of Nisan, and is celebrated for eight days (seven in Israel). This is the time when Jews celebrate the great miracles God has brought upon the Egyptians in the form of ten plagues and later by drowning the Egyptians in the red sea. It is celebrated by not eating any bread or leaven.

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 Shavuot - Shavuot is celebrated on the sixth day of the Hebrew month of Sivaan. It marks the great Sinai revelation when Hashem gave the Torah or the bible for the Jewish people. This holiday lasts two days (only one in Israel), and has no special biblical commandments besides refraining from work.  Tu Bishvat - The fifteenth day of the Hebrew month of Shvat is celebrated by eating fruits. This is day is the start of blossoming of the trees.  Lag Be'Omer - Lag Be'Omer is celebrated on the eighteenth day of the month of Iyar, the thirty third day of the counting of the Omer. On this day the great sage R' Shimon Bar Yochai passed away and it is celebrated by lighting large bonfires, and going to his gravesite in Miron, Israel.

Pomaks

Definition: Pomaks (Bulgarian: Помаци / Pomatsi, Greek: Πομάκοι / Pomákoi, Turkish: Pomaklar) is a term used for Muslim Slavs that inhabit Bulgaria, Northeast Greece and northwestern Turkey, referring mainly to ca. 220,000 strong [9] confessional minority in Bulgaria officially known as Bulgarian Muslims. The term has also been used more broadly to include the Slav Muslim populations of the Republic of Macedonia and Albania. The Bulgarian dialect spoken by the pomaks in Greece and Turkey is known there as the Pomak language.

Buddhists

Definition: From the standpoint of classical Buddhist doctrine, the word "buddha" denotes not only a religious master who lived in a particular time, but a whole category of enlightened beings who have attained such spiritual realisation. Buddhism recognises three types of Buddha, among which the term Buddha is usually reserved for the first type, the Samyaksam-buddha. The realisation of nirvana is exactly the same in all three types of buddha, but one Samyaksam-buddha expresses more qualities and capabilities than the other two types of buddha. Among the world religions (most of which proclaim the existence of a creator God), Buddhism is considered unusual because it is a non-theistic religion. For the Buddha the key to liberation is purity of mind and right understanding, and for this reason he rejected the notion that salvation is won by begging for a distant deity. Buddhism is a philosophical or non-theistic religion that encompasses various traditions, beliefs and practices generally based on the Buddha's teachings. It encompasses schools like Teravada, Zen, Pure Land and Tibetan Buddhism, spread farther into Tibet, China and Japan. Various sources put the

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number of Buddhists in the world between 230 million and 500 million, making it the fifth largest religion in the world. Buddhist schools vary on the exact nature of the path of liberation, the importance and canonicity of various teachings and especially their practices. However, the basis of traditions and practices are the Three Jewels: The Buddha (as his master), Dharma (teachings based on the laws of the universe) and the Sangha (the Buddhist community).

Food restrictions / Fasting: Buddhism considers living beings to be sacred, a belief that has translated into widely practiced vegetarianism and veganism. Violence towards animals is considered to translate into human aggression; hence most Buddhists will keep to the principle of ahimsa (non-violence or harmlessness) and avoid all foods related to processes where harm was done. Some Buddhists avoid meat and dairy products while others avoid only meat. Buddhists also avoid the consumption of alcohol. Monks of this religion fast in the afternoon and rely on ‘alms’ or donations of food as they, along with Buddhist nuns, are not allowed to cultivate, store or cook their own food (Sara Diaz, 2012).

Special days:  Buddhist New Year - The Buddhist New Year is celebrated on different days throughout the world. In Theravadin countries, the new year is celebrated for three days from the first full moon day in April. In Mahayana countries, the new year usually starts on the first full moon day in January, and Tibetan Buddhists generally celebrate it in March.  Vesak (Buddha Day) - Vesak is the birthday of the Buddha and the most important festival in Buddhism. On the first full moon day in May, Buddhists all over the world celebrate the birth, enlightenment and death of the Buddha in a single day. The name "Vesak" comes from the Indian month of that name in which it is held.  Sangha Day (Magha Puja Day or Fourfold Assembly Day) - Sangha Day commemorates the Buddha's visit to Veruvana Monastery in the city of Rajagaha, when 1,250 arhats are said to have spontaneously returned from their wanderings to pay their respects to the Buddha. Sangha Day is celebrated on the full moon day of the third lunar month (March).  Dhamma Day (Asalha Puja Day) - Dhamma Day is observed on the full moon day of the eighth lunar month (July). It commemorates the "turning of the wheel of the Dharma" - the Buddha's first sermon - at the Sarnath Deer Park.  Observance Day (Uposatha) - Observance Day refers to each of the four traditional monthly holy days that continue to be observed in Theravada countries - the new moon, full moon, and quarter moon days.  Kathina Ceremony (Robe Offering Ceremony) - The Kathina Ceremony is held on any convenient date within one month of the conclusion of the three-month rains retreat season (Vassa). On this day, the laity (non-monastics) offer new robes and other necessities to the monks and nuns.  Festival of Floating Bowls (Loy Krathong) - At the end of the Kathin Festival season, when the rivers and canals are full of water, the Loy Krathong Festival takes place in all parts of Thailand on the full moon night of the twelfth lunar month. People bring bowls made of leaves (which contain flowers), candles and incense sticks, and float them in the water. As they go, all bad luck is supposed to disappear. The traditional practice of Loy Krathong was originally meant to pay homage to the holy footprint of the Buddha on the beach of the Namada River in India.  Elephant Festival - The Buddha used the example of a wild elephant that is harnessed to a tame one to teach that a person new to Buddhism should be helped by an older Buddhist. To mark this saying, Thai Buddhists hold an Elephant Festival on the third Saturday in November.  The Festival of the Tooth - On a small hill in Sri Lanka is a great temple that was built to house a relic of the Buddha - his tooth. The tooth can never be seen, as it is kept deep inside many

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caskets. But once a year in August, on the night of the full moon, there is a special procession for it.  Ancestor Day (Ulambana) - In Mahayana countries, it is believed that the gates of hell are opened on the first day of the eighth lunar month and ghosts may visit the world for 15 days. Food offerings are made during this time to relieve the sufferings of the ghosts. On the fifteenth day, Ulambana or Ancestor Day, people visit cemeteries to make offerings to their departed ancestors.

Hindu

Definition: McDaniel (2007) classifies Hinduism into six major types and numerous smaller types in order to understand the expression of emotions among Hindus. The main types, according to McDaniel are, Folk Hinduism, which is based on local traditions and cults of local deities and is the oldest, non-literate system; Vedic Hinduism, which is based on the earliest strata of the Vedas traced to the second millennium BC; Vedantic Hinduism, which is based on the philosophy of the Upanishads, including Advaita Vedanta, emphasising knowledge and wisdom; Yogic Hinduism, following the text of Patanjali's Yoga Sutras emphasising introspective awareness; Dharmic Hinduism or "daily morality," which McDaniel claims to be stereotyped in some books as the "only form of Hindu religion with a belief in karma, cows and caste"; nd Bhakti or devotion to Hinduism, where intense emotions are elaborately embodied in the pursuit of the spiritual.

Food restrictions / Fasting: Hinduism is one of the most ancient religions in the world and, although meat was not originally prohibited, many Hindus today regard vegetarianism as a way to maintain the respect observed for life. Hinduism is characterised by the avoidance of the killing of any animal, the cleansing of those involved in food preparation, which is a reflection on previously existing caste- restricted practices, and the symbolism of certain foods. The cow is held in high regard as a symbol of abundance and so it is not eaten by Hindus, yet products such as milk, butter and yogurt may be eaten. Some Hindus fast on selected days as a mark of respect to certain gods. Most Hindus adopt a lactovegetarian diet without meat, poultry, fish or eggs. Dairy products are allowed (Sara Diaz, 2012).

Special days:  Holi (also called Holaka or Phagwa) - is an annual festival celebrated on the day after the full moon in the Hindu month of Phalguna (early March). It celebrates spring, commemorates various events in Hindu mythology and is a time of disregarding social norms and indulging in general merrymaking.  Diwali, from the Sanskrit word Dīpãvali, meaning "row of lights" is a Hindu festival of lights lasting five days. For many Hindus, Diwali is also New Year's Eve. Diwali is held on the final day of the Vikram calendar, a type of Hindu calendar followed by North Indians.  Mahashivaratri (also called Shiva Ratri) is the Great Festival of Shiva. It is held on the 14th day of the dark half of the lunar month of Phalguna. Mahashivaratri is especially important to Saivites (devotees of Shiva), but it is celebrated by most Hindus.

Neo-paganists

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Definition: Neopaganism is a term used to identify a wide variety of modern religious movements, particularly those influenced by the pre-Christian pagan beliefs of Europe. Neo-pagan religious movements are extremely diverse, with a wide range of beliefs, including polytheism, animism, pantheism, and other paradigms. Many Neopagans practice a spirituality that is completely modern in its origin, while others try to reconstruct precisely or to revive old religions as they are found in historical and folkloric sources. Most neo-pagan religions are attempts at reconstruction, resurgence or - more commonly - adaptation of old pagan religions, especially those of pre-Christian European antiquity, but not restricted to them, without losing sight of the experiences and needs presented by the contemporary world. Neopaganism is mainly present in developed countries, especially in the United States and the United Kingdom, but also in continental Europe (German-speaking Europe, Scandinavia, Slavic Europe, Latin Europe and other European countries) and Canada. The largest neo-pagan religion is Wicca, although there were other Neopagan groups of significant size, such as Neodruidism, Ásatrú (Germanic Neopaganism) and Slavic Neopaganism.

Fasting/ Food restriction: There are no days formally devoted to fasting, but some fast in the preparation of the festival of Ostara (Spring Equinox). At the discretion of the individual - some totally avoid food, others reduce the amount of food. The goal is to purify the person energetically; Ostara fasting is used for personal cleansing of heavy winter foods.

Special days: Wiccans and other Neo-pagans celebrate holidays and festivals based on nature and the changing of seasons. The Neo-pagan seasonal cycle, called the Wheel of the Year, consists of eight major Sabbats. The Sabbats are joyous occasions of celebration and festivity. Like Jewish Shabbats, Neopagan Sabbats begin at sunset the day before the holiday. Four of the Sabbats, known as cross-quarter days, have Celtic origins and are called by their Celtic names. The other four mark important points on the solar calendar. The eight Sabbats are:  Imbolc - February 2  Ostara (Spring Equinox) - March 21  Beltane - May 1  Midsummer (Summer Solstice) - June 22  Lughnasadh - August 2  Mabon (Autumn Equinox) - September 21  Samhain - November 1  Yule (Winter Solstice) - December 21

Irreligion

Definition: Irreligion is the absence, indifference, rejection or hostility towards religion. When characterised as the rejection of religious belief, irreligion encompasses atheism, agnosticism, deism, religious dissent and secular humanism. When characterised as the absence of religious belief, it may also include "spiritual but not religious", pandeism, ignoreism, nontheism, pantheism, panentheism, and free thought. When characterised as indifference to religion, it is known as apatheism. When characterised as hostility against religion, which encompasses antitheism, antireligion and misotheism. Irreligion may include some forms of theism, depending on the religious context it is set against.

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Food restrictions / Fasting No fasting traditions have been identified among irreligious groups.

Special days: No special days have been identified in irreligious groups.

Greek / Christian Orthodox

Definition: The name Greek Orthodox Church, or Greek Orthodoxy, is a term referring to the body of several Churches within the larger communion of Eastern Orthodox Christianity, whose liturgy is or was traditionally conducted in Koine Greek, the original language of the New Testament, and whose history, traditions, and theology are rooted in the early Church Fathers and the culture of the Byzantine Empire. Greek Orthodox Christianity has also traditionally placed heavy emphasis and awarded high prestige to traditions of Christian monasticism and asceticism, with origins in Early Christianity in the Near East and in Byzantine Anatolia. The Orthodox Church throughout the ages has maintained a continuity of faith and love with the apostolic community, which was founded by Christ and sustained by the Holy Spirit. Orthodoxy believes that she has preserved and taught the historic Christian Faith, free from error and distortion, from the time of the Apostles. She also believes that there is nothing in the body of her teachings which is contrary to truth or which inhibits real union with God. The air of antiquity and timelessness which often characterises Eastern Christianity is an expression of her desire to remain loyal to the authentic Christian Faith. Orthodoxy believes that the Christian Faith and the Church are inseparable. It is impossible to know Christ, to share in the life of the Holy Trinity, or to be considered a Christian, apart from the Church. It is in the Church that the Christian Faith is proclaimed.

Food restrictions / Fasting: Fasting periods include most Wednesdays and Fridays, Lent, Advent / Nativity (five weeks before Christmas), Dormition/ Assumption (1-15 August) and a variable period before the Feast of the Holy Apostles. There are other fast days as well. During periods of fasting, Orthodox Christians refrain from eating animal products, including fish, chicken and dairy products. In rare cases, fish is allowed.

Special days:  New Year´s Day “Protochronia” (January 1) – Following a morning church ceremony presents are exchanged, and there is singing, dancing, and feasting. A special cake, called a vassilopita, is baked with a coin inside. The person who eats the piece with the coin will have a year of good luck. The traditional New Year greeting is “Kali Chronia.”  Epiphany “Agia Theofania” (January 6) – Epiphany is the celebration of the baptism of Jesus by John the Baptist. The day is marked by blessing the waters. Rivers, lakes and oceans are blessed and crosses immersed in them. The largest celebration is in Piraeus where a cross is thrown into the sea and young men dive to retrieve it.  Feast of the Annunciation (March 25) – is the Christian celebration of the announcement by the angel Gabriel to the Virgin Mary that she would conceive and become the mother of Jesushttps://en.wikipedia.org/wiki/Jesus, the Son of God, marking his Incarnation. The Feast of the Annunciation is one of the twelve “Great Feasts" of the liturgical year, and is among the eight of them that are counted as "feasts of the Lord".

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 Ash/Shrove/Clean Monday (Koulouma) “Kathari Deftera” (40 days after Easter) – On Ash Monday, it is traditional to go the countryside for picnics, fly kites and begin fasting for Easter by eating Lenten food.  Holy Good Friday “Megali Paraskevi” “Epitaphios” Lamentations - The festivities begin on Good Friday with perifora epitaphios, a candlelit procession of a shrouded funeral bier that is carried through the city streets to the local church. Every major city and tiny town in Greece has their own procession, although the most impressive one takes place in Athens where the procession climbs Lykabettus to the Chapel of Agios Georgios.  Holy Good Saturday The Resurrection ' Megalo Savvato' - On Holy Saturday there is a Resurrection Mass at 11 p.m. followed at midnight by darkness symbolising Jesus passing through the underworld, and finally by fireworks and a candlelight procession through the streets, symbolising Jesus's resurrection. The Lent fast is broken by eating red-dyed eggs and mageiritsa soup.  Holy Easter Sunday ' Kyriaki tou Pascha' – Easter Sunday is spent with the family, singing, dancing, and feasting on roast lamb and dyed red eggs.  Whit Monday 'Agiou Pnevma' - Fifty days after Easter. This religious holiday marks the descent of the Holy Spirit to the disciples. It is celebrated with church services decorated with pennants. Greeks use this holiday to go away for a long weekend, usually to the Greek islands.  Assumption of the Virgin 'Apokimisis tis Panagias' (August 15) - Assumption Day falls within the traditional Greek vacation month when people are normally on the move. So typically crowded ferries and buses become even more packed near the holiday as people travel to be near their families. This is the largest celebration of the Holy Virgin Mary in Greece. The island of Tinos is a major pilgrimage destination where thousands go to be blessed, healed or baptised.  Christmas 'Christougenna' (December 25) - Although less important than Easter in the Greek Orthodox religion, Christmas is celebrated with religious services & feasting.

Rastafarians

Definition: A religion with deep political convictions, Rastafarianism began in the slums of Jamaica in the 1920s and 1930s. African religious tradition strongly influenced the Rastafarian culture and biblical themes heavily influenced the belief system of this religion. The most famous Rastafari is undoubtedly Bob Marley, whose reggae music gained international recognition of the Jamaican movement. There is no formal and organised leadership in Rastafarianism, creating a wide variety of spiritual and moral variations within the religion. Some Rastafarians see it more as a way of life, and others see it more as a religion. Yet to unite diversity within the movement is the belief in the divinity and / or messianism of the Ethiopian emperor Haile Selassie I, the influence of Jamaican culture, the resistance of oppression and pride in African heritage. The Rastafarian lifestyle usually includes the ritual use of marijuana, the avoidance of alcohol, wearing hair in dreadlocks and vegetarianism.

Food restrictions / Fasting: Some Rastafarians eat Ital food. Meat may or may not be a part of the individual's diet. Fish, however, is a staple of Ital food. As a result, many Rastafarians are vegetarians (Sara Diaz, 2012).

Special days:  Ethiopian Christmas Day – Rastafarian people believe in the principals of Christianity. They also find spiritual connection to the land of Ethiopia, and have been intertwined with the

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country’s culture right from 330 A.D. As such they celebrate Christmas, but as per the traditional Ethiopian calendar. On this day people pray and also abstain from eating meat.  Grounation Day – The Rastafarians believe that this is the day when Emperor Haile Selassie I visited the country of Jamaica in the year 1966. They believe Emperor Haile Selassie I to be the manifestation of God on Earth whose mission was to save humankind by bringing amongst them the gospels of peace and unity. As such this is a joyous occasion for Rastafarians and they commemorate it with music, dance and prayers.  Ethiopian New Year's Day – Rastafarians all around the world consider Ethiopia to be their spiritual motherland and view the history and traditions of the country with much reverence. Consequently they celebrate New Year’s day as per Ethiopian tradition.

Sikh

Definition: A Sikh is a follower of Sikhism, a monotheistic religion, which originated during the 15th century in the Punjab region of northern South Asia. The term "Sikh" has its origin in the Sanskrit words (disciple, student) or (instruction). A Sikh, according to Article I of the Sikh Rehat Maryada, is "any human being who faithfully believes in One Immortal Being; ten Gurus, from Guru Nanak to Guru Gobind Singh; Guru Granth Sahib; the teachings of the ten Gurus and the baptism bequeathed by the tenth Guru". "Sikh" refers to adherents of Sikhism as a religion, not an ethnic group. However, because Sikhism has seldom sought converts, most Sikhs share strong ethno-religious ties. Many countries, such as the United Kingdom, therefore recognise Sikh as a designated ethnicity on their censuses.[21] The American non-profit organisation United Sikhs has fought to have Sikh included on the U.S. census as well, arguing that Sikhs "self-identify as an 'ethnic group' " and believe "that they are more than just a religion". Male Sikhs have "Singh" (Lion), and female Sikhs have "Kaur" (princess) as their middle or last name. Sikhs who have undergone the khanḍe-kī-pahul (the Sikh initiation ceremony) may also be recognised by the five Ks: Kesh, uncut hair which is kept covered, usually by a turban; kara, an iron or steel bracelet; a kirpan, a sword tucked into a gatra strap or a kamal kasar belt; kachehra, a cotton undergarment; and kanga, a small wooden comb. Initiated male and female Sikhs must cover their hair with a turban. The greater Punjab region is the historic homeland of the Sikhs, although significant communities exist around the world. Food restrictions / Fasting: In Sikhism, only lacto-vegetarian food is served in the Gurdwara (Sikh temple) but Sikhs are not bound to be meat-free. The general consensus is that Sikhs are free to choose whether to adopt a meat diet or not. Sikhs, once they become Amritdhari (baptised) via the Amrit Sanskar (baptism ceremony), are forbidden from eating Kutha or ritually-slaughtered meat because it transgresses one of the four restrictions in the Sikh Code of Conduct. Alcohol, tobacco and all narcotic or intoxicating drugs are banned substances for Sikhs. Fasting may apply only to older Sikhs or those from rural areas. Although the Gurus did not specifically call for their followers to fast at any particular point, some older Sikhs like to fast during the full moon or during certain holidays. They say that this helps them to concentrate the mind on what is holy.

Special days:  Maghi (January 14) - Maghi commemorates the martyrdom of the "Forty Immortals," forty followers of Guru Gobind Singh who had previously deserted him, fought bravely against overwhelming Mughal army forces and were martyred in Muktsar. Guru Gobind Singh blessed them as having achieved mukti (liberation) and cremated them at Muktsar. On Maghi, Sikhs

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visit gurdwaras and listen to kirtan (hymns). Naturally, the largest gathering is at Muktsar where an annual fair is held.  Hola Maholla (March 26) - Hola (or Holla) Maholla is a mela celebrated in Anandpur on the Indian festival of Holi in memory of Guru Gobind Singh. The Guru instituted this day for military exercises and mock battles, followed by music and poetry contests. The holiday is still celebrated with mock battles and displays of horsemanship and skills with the sword. There are also processions with the Sikh flag and the Guru Granth Sahib.  Vaisakhi (April 14) - Vaisakhi, in April, began as a Hindu festival of thankgiving but for Sikhs, marks the founding of the Khalsa in 1699. Those ready to be initiated into the Khalsa are usually baptised on this day.  Celebration of the Guru Granth Sahib (September) - This festival is celebrated in August or September.  Diwali (Date varies) - Diwali is a Hindu festival of lights that was appropriated by the Sikhs to celebrate the release from prison of Guru Hargobind, the sixth Guru, from prison in 1619. The Golden Temple was illuminated with lights to welcome the Guru home, and Sikhs continue this tradition by lighting lamps on Diwali each year. The Golden Temple is illuminated with thousands of lights.

Useful Websites http://www.coe.int/en/ https://ec.europa.eu/commission/index_en https://freedomhouse.org/ http://collections.banq.qc.ca/ark:/52327/bs64376 http://www.adl.org/assets/pdf/civil-rights/religiousfreedom/rips/ReligPubSchs-PDF.pdf http://tandis.odihr.pl/documents/hre- compendium/rus/CD%20SEC%202%20ENV/PR%20SEC%202/CoE%20Religious%20diversity%20ENG. pdf http://ec.europa.eu/eurostat/documents/1001617/4577877/3-2-OUDHOF-EN.pdf http://www.armeniancatholic.org http://unesdoc.unesco.org/images/0022/002201/220101E.pdfttp://www.youtube.com/watch?v=z3 Y9yzTxCfw www.betterhealth.vic.gov.au www.foodafactoflife.org.uk http://www.faqs.org/nutrition/Pre-Sma/Religion-and-Dietary-Practices.html#ixzz1LsxWnBf6 https://translate.googleusercontent.com/translate_c?depth=1&hl=pt- PT&prev=search&rurl=translate.google.com.ph&sl=en&u=http://www.jrsusa.org/RSG_Day%3FTN%3 DDTN-20110407120729%26L%3DEN&usg=ALkJrhgaUCuph46wgM9HmDDKYsm42wohmQ https://www.ewtn.com/library/CHISTORY/armenia.htm http://maronitemonks.org/wp/story-maronite-catholics/ http://www.religionfacts.com/rastafarianism https://debate.uvm.edu/dreadlibrary/grant02.htm http://www.religionfacts.com/sunni http://www.patheos.com/Library/Sunni-Islam https://en.wikipedia.org/wiki/Christian https://en.wikipedia.org/wiki/Sikhism https://en.wikipedia.org/wiki/Pomaks

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https://tl.wikipedia.org/wiki/Budismo http://www.infoescola.com/religiao/islamismo/ http://www.ancient.eu/Greek_Religion/ https://en.wikipedia.org/wiki/Hindu https://en.wikipedia.org/wiki/Jews https://en.wikipedia.org/wiki/Protestantism https://en.wikipedia.org/wiki/Muslim https://en.wikipedia.org/wiki/Latin_American_culture https://armeniagogo.com/armenian-holidays-list/ http://www.everyculture.com/wc/Japan-to-Mali/Maronites.html http://www.explore-hispanic-culture.com/hispanic-holidays.html http://www.religionfacts.com/christianity/holidays https://www.thoughtco.com/what-holidays-do-muslims-celebrate-2004366 https://thegnostictruth.wordpress.com/protestant-holidays/ http://www.orthodox-jews.com/jewish-religious-holidays.html#axzz4avFYXXtk http://www.religionfacts.com/buddhism/holidays http://www.religionfacts.com/hinduism/holidays http://www.religionfacts.com/neopaganism/holidays https://www.santorini.com/churches/holiday_calendar.htm http://www.123newyear.com/2016/rastafari-holidays-calendar.html http://www.religionfacts.com/sikhism/holidays

Relevant Articles and Reports

Council of Europe, CDED (2006)14. Religious Diversity and Intercultural Education: A Reference Book for Schools.

McAndrew, M. (1997). Accommodating Religious and Cultural Diversity in the School.

Anti-Defamation League (2012). Religion in the Public Schools.

Berry, C. and Little, A.W. (2006). Multigrade and Multi-age Teaching in Classrooms in London, England. Little, A.W. (ed.) Education for All and Multigrade Teaching: Challenges and Opportunities. Amsterdam, Springer.

Blum, N. and Diwan, R. (2007). Small, Multigrade Schools and Increasing Access to Primary Education in India: National Context and NGO Initiatives. London, University of London, Institute of Education and National University of Educational Planning and Administration. (CREATE Pathways to Access, Research Monograph No. 17) http://sro.sussex. ac.uk/1865/1/PTA17.pdf (Accessed 30 November 2012).

Commonwealth Secretariat, Caribbean Community Secretariat and Commonwealth of Learning (1998). Module 2, Unit 4: Classroom Organisation. London, Commonwealth Secretariat.

Commonwealth Secretariat, Caribbean Community Secretariat and Commonwealth of Learning (1998). Multigrade Teaching Programme. Module 4: Teaching Strategies for Multigrade Education . London, Commonwealth Secretariat.

Banks, J. A. (1994). Multiethnic Education: Theory and Practice. Needham Heights, MA: Allyn & Bacon.

Bromley, K. D. (1998). Language art: Exploring connections. Needham Heights, MA: Allyn & Bacon.

Garcia, E. (1994). Understanding and meeting the challenge of student cultural diversity. Boston: Houghton Mifflin.

Gollnick, D. M., & Chinn, P. C. (2001). Multicultural Education in a Pluralistic Society. New York: Prentice Hall.

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