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Motor Skills Education Program & Clinic Bethune-Cookman University MOTOR SKILLS EDUCATION PROGRAM & CLINIC PROCEDURES HANDBOOK Bethune-Cookman University School of Education Timothy A. Mirtz DC, PhD, CAPE CONTACT INFORMATION 640 Dr. Mary McLeod Bethune Blvd. Daytona Beach, Florida 32114 [email protected] Kottle 221 (386) 481-2395 *Revised January 2017 TABLE OF CONTENTS College of Education Conceptual Framework 3 MOTOR SKILLS EDUCATION PROGRAM & CLINIC CLIENT SECTION 4 Program philosophy 4 Program mission 4 Program objectives 4 Opportunities 5 Movement exploration 5 Motor Skills Education Program & Clinic Application 6 Medical & Developmental History Quick Reference Form 6 Release Form 9 Fee for Services Notification 9 Picture Release Form 9 Release of Information 9 Policy on Release of Child 9 Initial Screening 10 Proprioception Tests 11 Coordination Tests 11 Cranial Nerve Assessment 12 Results of Assessment and ABCD Goals 13 Progress Notes 14 MOTOR SKILLS EDUCATION PROGRAM & CLINIC STUDENT SECTION 15 Policies and Procedures 16 Internship Activities Form (see also page 32) 17 Lesson Planning 18 Lesson Planning Rubric 19 Attitudes and Belief Survey Pre-test 21 Journal Reflection Questions 22 Rubric for IEP 23 Danielson’s Contextual Factors 24 TOOLBOX OF ABILITIES 25 Glossary to Terms 26 NASPE Standards 29 Core Principles 30 Addendum: Quick Disposition Form 30 Addendum: Additional Log Hours 31 2 3 MOTOR SKILLS EDUCATION PROGRAM & CLINIC CLIENT SECTION § Program Philosophy: The belief that all people can learn through play. § Program Mission: The mission of the Motor Skills Education Program & Clinic is to offer a curriculum of developmental motor skill activities to children and special needs children and adults in the community and surrounding area and to provide an avenue of an embedded practicum training experience for students majoring in health, physical education, exercise science and therapeutic recreation. An ancillary mission of the program is to offer individualized motor instruction through the program’s clinic. § Program Objectives: The Motor Skills Education Program & Clinic seeks to improve the motor fitness of children and adults with special needs by concentrating on fine and gross motor skills and patterns. In addition, the program concentrates on the improvement of self-esteem by strengthening the psychomotor, cognitive and affective domains through success at play. The Motor Skills Education Program & Clinic offers children and adults with special needs a unique opportunity to enhance their psychomotor, affective and cognitive skills and gain success at a variety of activities. Though this program, the person with a special need can gain participation in school and social events; and as a result, the goal of overall development of the learning potential of children and adults can be enhanced. 4 OPPORTUNITIES As a client enrolled in the program you will be given the opportunity to enhance your motor skills. Areas that clients work with are in the psychomotor, affective and cognitive learning domains. Motor skill areas include the following perceptual motor skills: Static and Dynamic balance Laterality and directionality Gross motor skills Fine motor skills Hand-eye and/or eye/hand coordination Overall motor control We teach the above skills through the following activities: Bean bag games Bowling games Batting games Throwing games Catching games Kicking games Fun with balloons and balance tubes And many other fun activities!!! MOVEMENT EXPLORATION At the MSEP&C we utilize a technique known as “movement exploration.” This technique concentrates on the improvement of self-esteem by strengthening the creative aspects of a person’s psychomotor, cognitive and affective domains through success at play. As a result, the goal of improved learning potential can be enhanced. 5 MOTOR SKILLS EDUCATION PROGRAM & CLINIC APPLICATION Overview of the Program—The Motor Skills Education Program & Clinic is a unique community service offered by Timothy Mirtz who is employed as a faculty member at the Bethune-Cookman University. The mission of the Motor Skills Education Program is to offer a curriculum of developmental motor skill activities to children and special needs children and adults in the greater Daytona Beach, Florida area and to provide an avenue of clinical training for Indiana Tech health, physical education & recreation students. The Motor Skills Education Program & Clinic seeks to improve the motor fitness of children and adults with special needs by concentrating on fine and gross motor skills and patterns. In addition, the program concentrates on the improvement of self-esteem by strengthening the psychomotor, cognitive and affective domains through success at play. The Motor Skills Education Program & Clinic offers children and adults with special needs a unique opportunity to enhance their psychomotor, affective and cognitive skills and gain success at a variety of activities. Through this program, the person with a special need can gain participation in school and social events; and as a result, the goal of overall development of the learning potential of children can be enhanced. MEDICAL & DEVELOPMENTAL HISTORY QUICK REFERENCE FORM Please PRINT and Write Legibly Child’s Full Name___________________________________ Current Date________ Full Address_______________________________________________________________________________ Phone:___________________ Child’s DOB_______ Age_______ (yr & month) Reason for Referral to Program (Diagnosis)____________________________________________________________________________ What do you hope to see your child accomplish with the Motor Skills Education Program & Clinic? _______________________________________________________________________________________ Does Your Child Have Any Allergies? If Yes, Explain:________________________________________________________________________ List All Medications Your Child Is Taking? ____________________________________________________________________________________________________________ ________________________________________________________________ Referred to Program By:________________________________________________________________ (Name & Title) _____________________________________________________________________________________ (Physician Address) (Phone) Name of Current School_______________________________________________ Grade___________ Father’s Name________________________________________________ Age_____________ Father’s Occupation_______________________________________ Education_______________ 6 Mother’s Name________________________________________________ Age_____________ Mother’s Occupation_______________________________________ Education_______________ Siblings Names & Ages:_____________________________________________________________ Used Only by the Bethune-Cookman University Motor Skills Education Program & Clinic for Educational Purposes CHILD’S MEDICAL HISTORY Birth YES NO UNKNOWN Was your child premature? Baby’s Birth Weight: ___lbs. ____oz APGAR Score If Known:__________ Normal Birth In Every Respect? Child’s Height At Birth: __________inches Child’s Health: The Following Questions Pertain to Your Child At Any Time Since Birth GENERAL HEALTH QUESTIONS Yes No UNKNOWN CONCERNED? Has Your Child Ever Had Any Trouble Seeing? Has Your Child’s Eyes Ever Looked Crossed? Has Your Child Ever Had Frequent Ear Infections? Has Your Child Ever Had Any Trouble Hearing? List All Illnesses: Does Your Child Have Any Allergies? Has Your Child Ever Had Fainting Spells? Has Your Child Ever Had Frequent Headaches? Has Your Child Ever Had Dizzy Spells? Has Your Child Ever Had Convulsions? Has Your Child Ever Had Any Orthopedic Problems? Has Your Child Ever Worn Braces? Has Your Child Ever Worn Corrective Shoes? Has Your Child been In A Cast? Has Your Child Had Problems With Limbs? Is Your Child Active? When Tired, Does your Child Say So? Has Your Child Had Difficulty In Sleeping? Does Your Child Get Along Well With Other Children? Has Your Child Ever Been Given a Psychological Evaluation? Does Your Child Revert To Bad Habits When Under Stress Or Pressure? Is Your Child A Happy Person? Does Your Child Have Abnormal Fears? QUESTIONS YES NO UNKNOWN CONCERNED? Can Your Child Throw And Catch A Ball? Can Your Child Ride A Tricycle? Has Your Child Confidence In His/Her Movement? Does Your Child Have Good Self-Help Skills? Is Your Child Under The Care Of A Physician? Did Your Child Attend A Preschool Program? Age At Entrance To Kindergarten: Years_____ Months_________ aaaaa aaaa aaaaaaaaaa aaaaaaaaaaaaa Does Your Child Like School? Has Your Child Ever Repeated a Grade? Does Your Child Have Any Difficulties In School? 7 What Is Your Child’s Weakest Subject In School? Subject(s): ADDITIONAL COMMENTS ABOUT YOUR CHILD OR FAMILY: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ________________________________________________________________________ Motor Skills Education Program & Clinic Release Form My child:_____________________________________________________________ will be a participant in the Motor Skills Education Program & Clinic at Bethune-Cookman University. The Motor Skills Education Program & Clinic program will involve activities in the gymnasium. The program director will supervise each session.
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