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Project  Head  Start 


HV1631 

L335 

M435 


Mainstreaming  Preschoolers: 

Children  with 

Emotional 
Disturbance 


DHEW  Publication  No.  (OHDS)  78-31115 

U.S.  Department  of  Health,  Education,  and  Welfare 

Office  of  Human  Development  Services 
Administration  for  Children,  Youth  and  Families 
Head  Start  Bureau 


Special  Message  to  Parents 

This  book  is  meant  to  help  parents  as 
well  as  teachers  understand  main- 
streaming  and  emotional  disturbance. 
Chapter  3  describes  specific  ways  in 
which  parents  can  help  their  emotion- 
ally disturbed  child.  But  parents  will 
find  the  other  chapters  useful  in  learn- 
ing more  about  development  in  emo- 
tionally disturbed  youngsters,  tech- 
niques and  activities  to  promote  learn- 
ing, how  Head  Start  functions  in  serv- 
ing handicapped  children,  and  what 
resources  outside  of  Head  Start  are 
available  to  help  fill  their  child's  spe- 
cial needs. 


This  series  on  Mainstreaming  Preschoolers  was  developed  by  the  staff  of  CRC  Education  and  Human  Development, 
Inc.,  a  subsidiary  of  Contract  Research  Corporation,  25  Flanders  Road,  Belmont.  Massachusetts  02178.  under  Con- 
tract No.  HEW  10.5-76-1139  for  the  Administration  for  Children,  Youth  and  Families. 


For  sale  by  the  Superintendent  of  Documents,  U.S.  Government  Printing  Oflice 
Washington,  D.C.  20402 

Stock  Number  017-092-00036-7 


Mainstreaming  Preschoolers: 

Children  with 

Emotional 

Disturbance 


A  Guide  for  Teachers,  Parents, 
and  Others  Who  Work  with 
Emotionally  Disturbed  Preschoolers 


by 


Miriam  G.  Lasher 

Instructor,  Department  of  Child  Study,  Tufts  University,  and  Education  Director 
of  Preschool  Unit,  Cambridge-Somerville  Mental  Health  and  Retardation  Center, 
Cambridge,  Massachusetts 

Use  Mattick 

Associate  Professor,  Early  Childhood  Education  Coordinator,  Therapeutic  Tutoring 
Program,  Children  with  Special  Needs  in  the  Family  and  Clinic,  Wheelock  College 

Frances  J.  Perkins 

Associate  Professor  in  Psychology,  Wheelock  College 

AMERiCAN  royf(5W19»if  OR  THE  BLIND,  li^C. 

and  Irr -mf^  Y  loea- ' 

Caren  Saaz  von  Hippel,  Ph.D. 

Director  of  Research  and  Evaluation,  CRC  Education  and  Human  Development, 
Inc.,  Contract  Research  Corporation 

Linda  Gaines  Hailey,  M.Ed. 

Research  Associate,  CRC  Education  and  Human  Development,  Inc.,  Contract 
Research  Corporation 


The  authors  were  fortunate  in  being  able  to  draw  on  the  advice  and  contribu- 
tions of  many  knowledgeable  and  talented  people  during  the  preparation  of  this 
book.  Chief  among  them  were  the  following  experts  on  emotional  disturbance  and 
early  childhood  education,  who  reviewed  the  text  in  its  successive  versions  and 
gave  us  many  excellent  suggestions  for  improving  it: 

Reviewers 

Albert  H.  Fink,  Ph.D.,  Associate  Professor,  Coordinator  of  Programs  of  Behavior 

Disorders,  Indiana  University 
Morris  Stambler,  M.D.,  Director,  Baycove  Day  Center  for  Children,  Tufts-New 

England  Medical  Center,  Boston,  Massachusetts 
Gloria  S.  Wrenn,  M.A.,  Coordinator  of  Handicap  Services,  WAGES  Head  Start, 

Golds  boro.  North  Carolina 

A  number  of  people  assisted  us  in  different  ways  with  certain  sections  of  this 
book.  We  thank  them  for  their  valuable  help. 

Joyce  Evans,  Ph.D.,  Director,  Division  of  Special  Projects,  Southwest  Education 
Development  Laboratory,  Austin,  Tbxas 

Alice  H.  Hayden,  Ph.D.,  Director,  Model  Preschool  Center  for  Handicapped  Chil- 
dren, Child  Development  and  Mental  Fletardation  Center,  University  of  Washing- 
ton 

Shari  Kieran,  Ed.D.,  Lecturer,  Eliot-Pearson  Department  of  Child  Study,  Tufts 
University 

Jacqueline  Liebergott,  Ph.D.,  Associate  Professor,  Department  of  Communication 
Disorders,  Emerson  College 

Sheldon  Maron,  Ph.D.,  Assistant  Professor  of  Special  Education,  Department  of 
Special  Education,  Florida  State  University 

Ra3anond  Schimmer,  M.A.T.,  Assistant  Director  of  Baycove  Day  Center  for  Chil- 
dren, Tufts-New  England  Medical  Center,  Boston,  Massachusetts 

Judith  Siegel,  M.S.,  Coordinator,  Rhode  Island  Child  Find/Placement/Service  Pro- 
gram 

Janet  Zeller,  M.S.,  Supervisor  and  Instructor,  Graduate  Special  Needs  Program, 
Wheelock  College. 


Much  of  the  credit  for  the  success  of  this  book  is  due  to  the  team  responsible 
for  the  visual  and  stylistic  aspects.  Their  creative  efforts  were  essential,  and  we 
are  very  grateful.  The  skill  and  enthusiasm  of  the  production  staff,  on  which  we 
have  relied  so  frequently  in  the  past,  were  demonstrated  even  more  impressively 
in  this  difficult  and  complex  effort. 

CRC  Education  and  Human  Development,  Inc. 

Editor:  Nancy  Witting 

Graphic  Design  Unit:  Kristina  Engstrom,  Sandra  Baer,  Linda  HaUey 

Designer:  Alison  Wampler 

Photographer:  Harriet  Klebanoff 

Illustrator:  Stephanie  Fleischer 

Contract  Research  Corporation 

Production  Staff:  Barbara  Boris,  Mary  Tfess  Crotty,  Kelly  Gerry,  Barbara 
Rittenberg 

In  addition,  we  wish  to  thank  the  associations  of  the  National  Advisory  Board 
to  this  project  who  reviewed  our  book  during  its  development.  They  made  many 
valuable  suggestions. 

American  Association  of  Psychiatric  Services  for  Children;  American  Physical 
Therapy  Association;  American  Psychological  Association;  National  Society 
for  Autistic  Children. 

We  are  grateful  to  the  Resource  Access  Projects  and  the  Regional  Office 
staff  of  the  Administration  for  Children,  Youth  and  Famihes  for  their  review  of 
this  book  and  their  help  in  organizing  the  national  field  test.  We  also  thank  the 
teachers,  aides,  parents,  trainers,  directors,  and  others  in  the  40  Head  Start 
programs  across  the  country  who  field  tested  this  book  and  provided  invalu- 
able feedback.  We  thank  as  well  the  Head  Start  and  other  preschool  programs 
who  permitted  us  to  take  photographs  at  their  centers. 

Finally,  we  have  special  thanks  to  Mrs.  Rossie  Kelly,  the  Project  Officer, 
and  Raymond  C.  Collins,  Chief  of  the  Program  Development  and  Innovation 
Division,  Head  Start  Bureau,  for  their  continued  commitment  and  support  dur- 
ing this  project.  Rossie  Kelly's  involvement  throughout  the  project,  in  discus- 
sions, coordination  of  reviews  of  this  book  among  Program  Development  and 
Innovation  staff,  and  continued  receptiveness  and  helpfulness  required  to  com- 
plete a  project  of  this  scope  were  essential.  In  addition,  we  thank  the  following 
persons  for  their  interest,  involvement,  and  review  of  this  book  during  its  vari- 
ous developmental  stages:  Pamela  Coughhn,  Ph.D.;  Laura  Dittman,  Ph.D.; 
Jenni  Klein,  Ed.D.;  Jerry  Lapides,  Ed.S.;  Ann  O'Keefe,  Ed.D.;  Margaret  G. 
Phillips,  Ed.D.;  and  Linda  Randolph,  M.D. 

Caren  von  Hippel 
Linda  Hailey 
Miriam  Lasher 
Use  Mattick 
Frances  Perkins 


Preface 


Project  Head  Start  was  initially  conceived  and  launched  as  a  national  program 
of  comprehensive  developmental  services  for  preschool  children  from  low-income 
families.  The  early  design  also  indicated  that  the  comprehensive  program  should  be 
tailored  to  the  needs  of  the  individual  community  and  of  the  individual  child. 

The  Head  Start  Program  Performance  Standards  require  local  programs  to 
develop  an  educational  plan  that  provides  procedures  for  ongoing  observation, 
recordmg,  and  evaluation  of  each  child's  growth  and  development  for  the  purpose 
of  planning  activities  to  suit  individual  needs.  The  Performance  Standards  also 
require  that  classroom  materials  and  activities  reflect  the  cultural  backgroimd  of 
the  children.  Thus,  individualization  has  always  been  a  major  thrust  of  the  Head 
Start  program. 

The  Congressional  mandate  to  assure  that  not  less  than  10  percent  of  enroll- 
ment opportunities  in  Head  Start  be  available  for  handicapped  children  presented 
special  opportunities  and  challenges  to  Head  Start  programs  to  further  their 
efforts  in  the  individualization  of  services.  Head  Start  classes  are  small,  rnaking  it 
possible  for  teachers,  worldng  with  a  professional  diagnostic  team,  to  design  a  pro- 
gram to  meet  the  special  needs  and  capabilities  of  each  child. 

Mainstreaming  handicapped  children  into  classrooms  with  non-handicapped 
children  has  become  a  major  activity  for  Head  Start.  However,  teachers  and 
other  staff  are  continually  asking  for  assistance  in  mainstreaming  a  child  with  a 
specific  handicapping  condition.  This  series  of  eight  manuals,  Mainstreaming  Pre- 
schoolers, was  prepared  by  ACYF  to  help  meet  this  need. 

The  series  was  developed  through  extensive  collaboration  with  many  persons 
and  organizations.  Under  contract  with  Contract  Research  Corporation,  teams  of 
national  experts  and  Head  Start  teachers  came  together  to  develop  each  of  the 
manuals.  At  the  same  time,  the  major  national  professional  and  voluntary  associa- 
tions concerned  with  handicapped  children  were  asked  to  critique  the  materials 
during  their  various  stages  of  development.  Their  response  was  enthusiastic.  Vari- 
ous f^eral  agencies  concerned  with  handicapped  persons  —  the  Bureau  of  Educa- 
tion for  the  Handicapped,  the  President's  Committee  on  Mental  Retardation,  the 
Office  of  Developmental  Disabilities,  the  National  Institute  of  Mental  Health,  the 
Office  of  Handicapped  Individuals,  National  Institute  of  Child  Health  and  Human 
Development/National  Institute  of  Health,  and  Medicaid/Early  and  Periodic 
Screening,  Diagnosis,  and  Treatment  —  also  enthusiastically  reviewed  the  mate- 
rials as  they  were  being  developed.  Finally,  drafts  of  each  of  the  manuals  were 
reviewed  by  teachers,  paraprofessionals,  parents,  social  service  and  health  person- 
nel, and  various  other  specialists  in  Heaa  Start  programs  across  the  country. 

It  is  hoped  that  this  series  will  be  helpful  to  the  variety  of  people  beyond  the 
Head  Start  community  —  in  public  schools,  day  care  centers,  nursery  schools,  and 
other  child  care  programs  —  who  are  involved  in  providing  educational  opportuni- 
ties and  learning  experiences  to  handicapped  children  during  the  preschool  years. 


Blandina  Cardenas,  EdD. 
Commissioner 
Administration  for 
Children,  Youth  and  Families 


Contents 


Introduction 2 

Chapter  1:  What  Is  Mainstreaming? 3 

What  Does  Mainstreaming  Mean? 4 

How  Is  Mainstreaming  Carried  Out? 6 

What  Is  Your  Role  in  Mainstreaming? 7 

Chapter  2:  Where  to  Find  Help  in  Your  Area 9 

Finding  Out  About  Resources 10 

Who  Are  the  Specialists?  What  Do  They  Do? 18 

Chapter  3:  Parents  and  Tkachers  as  Partners 21 

What  Parents  Can  Do  23 

What  Teachers  CanDo 27 

Chapter  4:  What  Is  Emotional  Disturbance? 31 

How  Is  Emotional  Disturbance  Defined?  33 

Recognizing  Problems  for  Referral 41 

Chapter  5:  How  Emotional  Disturbance  Affects  Learning  in 

Three-  to  Five-Year-Olds 45 

Children  Whose  Behavior  Is  Withdrawn 46 

Children  Who  Behave  Anxiously 50 

Children  Who  Behave  Aggressively 53 

Children  Who  Behave  Hyperactively 57 

Children  Whose  Behavior  Is  Psychotic 59 

Medication 64 

Chapter  6:  Mainstreaming  Children  with  Emotional  Disturbance 69 

Planning 70 

The  Physical  Setting  and  Classroom  Facilities 80 

General  Teaching  Guidelines 82 

Techniques  and  Activities 90 

Chapter  7:  Other  Sources  of  Help 125 

Professional  and  Parent  Associations,  and  Other  Organizations 126 

Bibliography 133 

Appendix 137 

Screening  and  Diagnosis 138 

Chart  of  Normal  Development:  Infancy  to  Six  Years  of  Age  141 


Introduction 


The  Purpose  of  This  Book 

This  book  was  written  for  teachers, 
parents,  and  others  who  live  with  or 
work  directly  with  emotionally  dis- 
turbed preschoolers.  It  provides  useful 
ideas  for  helping  emotionally  disturbed 
children  learn  and  feel  good  about 
themselves,  and  answers  many  ques- 
tions, including: 

What  is  mainstreaming? 

What  is  emotional  disturbance? 

How  does  emotional  disturbance  eiffect 
learning  in  three-  to  five-year-olds? 

How  can  you  design  an  individualized 
program  for  a  disturbed  child? 

What  activities  are  especially  useful  for 
disturbed  children? 

How  can  parents  help  their  disturbed 
child? 

Where  can  you  go  to  seek  help  —  peo- 
ple, places,  and  information? 


The  Organization  of  This  Book 

This  is  one  of  a  series  of  eight  books 
on  children  with  handicaps,  written  for 
Head  Start,  day  care,  nursery  school 
and  other  preschool  staff,  and  parents 
of  children  with  special  needs.  Each 
book  is  concemea  with  one  handicap- 
ping condition.  The  other  seven  books 
address: 

•  health  impairments 

•  hearing  impairment 

•  learning  disabilities 

•  mental  retardation 

•  orthopedic  (physical)  handicaps 

•  speech  and  language  impairments 
(communication  disorders) 

•  visufd  handicaps. 

There  are  certain  guidelines  that  are 
similar  in  working  with  all  handicapped 

Preschoolers.  These  guidelines  should 
e  useful  to  teachers  and  parents  who 
are  directly  involved  with  children  with 
special  needs.  They  are  described  in  the 
chapters  "What  Is  Mainstreaming?" 
"Parents  and  Tbachers  as  Partners," 
"Where  to  Find  Help  in  Yoiir  Area," 
and  the  sections  on  planning,  the  physi- 
cal setting,  and  general  teaching  guide- 
lines in  the  chapter  "Mainstreaming 
Children  with  Emotional  Disturbance." 
While  these  chapters  (or  sections  of 
chapters)  are  largely  the  same  in  most 
of  tne  books  in  this  series,  the  examples 
and  suggestions  provided  in  each  book 
are  specific,  and  will  help  you  apply  the 
general  information  to  a  child  with  a 
particular  handicap. 


A  Word  on  Words 

In  this  book  the  terms  handicapped 
children  and  children  with  special  needs 

mean  the  same  thing. 


Chapter  1: 


What 

Is 

Mainstreamin^ 


Definite  steps  must  be 
taken  to  ensure  that 
handicapped  children  par- 
ticipate actively  and  fully 
in  classroom  activities. 


What  Does 

Mainstreaming 

Mean? 


"Mainstreaming"  means  helping 
people  with  handicaps  live,  learn,  and 
work  in  typical  settings  where  they  will 
have  the  greatest  opportunity  to 
become  as  independent  as  possible.  In 
Head  Start  programs,  mainstreaming  is 
defined  as  the  integration  of  handi- 
capped children  and  non-handicapped 
children  in  the  same  classroom.  It  gives 
handicapped  children  the  chance  to  join 
in  the  "mainstream  of  life"  by  including 
them  in  a  regular  preschool  experience, 
and  gives  non-handicapped  children  the 
opportunity  to  learn  and  grow  by  expe- 
riencing the  strengths  and  weaknesses 
of  their  handicapped  friends. 

However,  mainstreaming  does  not 
simply  involve  enrolling  handicapped 
children  in  a  program  with  non- 
handicapped  children.  Definite  steps 
must  be  taken  to  ensure  that  handi- 
capped children  participate  actively  and 
fully  in  classroom  activities.  As  a  Head 
Start  teacher,  it  is  your  role  to  take 
these  steps. 

Mainstreaming  is  not  new  to  Head 
Start.  Since  its  beginning.  Head  Start 
programs  have  included  handicapped 
children  in  classrooms  with  non- 
handicapped  children.  The  Economic 
Opportunity  Amendments  of  1972 
(PubUc  Law  92-424)  required  that  ten 
percent  of  the  Head  Start  enrollment  in 
the  nation  be  handicapped  children. 
Two  years  later,  the  Headstart,  Eco- 
nomic Opportunity,  and  Community 
Partnership  Act  of  1974  required  that, 
by  fiscal  year  1976,  not  less  than  ten 
percent  of  the  total  number  of  enroll- 
ment opportunities  in  Head  Start  pro- 
grams in  each  state  be  available  to 
handicapped  children.  And  most 
recently,  Public  Law  94-142,  the  Educa- 
tion for  All  Handicapped  Children  Act, 
has  mandated  that  the  public  schools 


provide  "free,  appropriate  education"  in 
the  "least  restrictive  setting"  for  handi- 
capped children  from  3  to  21  years  of 
age.  Thus,  mainstreaming  has  become 
an  important  and  well-accepted 
approach  in  the  education  of  young 
handicapped  children. 

It  is  the  function  of  Head  Start  pro- 
grams to: 

serve  hfindicapped  children  in  an 
integrated  setting  or  mainstream 
environment  with  other  children; 
provide  for  the  spedal  needs  of  the 
handicapped  child;  and  work  closely 
with  other  agencies  and  organiza- 
tions serving  handicapped  children 
in  order  to  identify  handicapped 
children,  £ind  provide  the  full  range 
of  services  necessary  to  meet  the 
child's  developmental  needs. 

(Head  Start  Transmittal  Notice  75.11  -  9/11/75.) 

Research  has  shown  over  and  over 
that  the  early  years  of  hfe  are  critical 
for  learning  and  growth.  It  is  during 
this  time  that  children's  cognitive, 
communicative,  social,  and  emotional 
development  can  be  most  influenced. 
If  special  needs  are  recognized  and 
met  during  these  years,  handicapped 
children  will  have  a  much  better 
chance  of  becoming  competent  and 
independent  adults.  Handicapped 
youngsters  who  are  given  the  oppor- 
tunity to  play  with  other  children  in 
the  Head  Start  classroom  learn  more 
about  themselves  and  about  how  to 
cope  with  the  give-and-take  of  every- 
day Ufe.  This  is  one  of  the  first  steps 
toward  developing  independence.  By 
participating  in  regular  preschool  set- 
tings tnat  are  able  to  provide  for  spe- 
cial needs,  with  teachers  who  know 
how  to  adapt  teaching  techniques  and 
activities,  children  with  special  needs 
will  truly  have  a  "head  start"  in 
achieving  their  fullest  potential. 


Benefits  of 
Mainstreaming 

There  are  many  benefits  to  main- 
streaming  —  benefits  that  affect  both 
handicapped  and  non-handicapped 
children,  as  well  as  their  parents  and 
teachers. 

Mainstreaming  Helps 
Handicapped  Children 

Participating  in  a  mainstream  class- 
room as  a  welcome  member  of  the  class 
teaches  children  with  special  needs  self- 
reliance  and  helps  them  master  new 
skills.  For  some,  it  may  be  the  first 
time  in  their  lives  that  they  are 
expected  to  do  for  themselves  the 
things  they  are  capable  of  doing.  Work- 
ing and  playing  with  other  children 
encourages  handicapped  children  to 
strive  for  greater  achievements.  Work- 
ing toward  greater  achievements  helps 
them  develop  a  healthy  and  positive 
self -concept. 

Attendance  in  a  preschool  program 
provides  a  way  for  oiscovering 
undiagnosed  handicaps.  Some  handi- 
caps don't  become  evident  until  after  a 
child  enters  elementary  school,  and  by 
then  much  important  learning  time  has 
been  lost.  A  preschool  teacher  is  able  to 
observe  and  compare  many  children  of 
the  same  age,  which  makes  it  easier  to 
spot  problems  that  may  signal  a  handi- 
cap. Preschool  may  therefore  be  the 
first  chance  some  children  get  to 
receive  the  services  they  need. 


Mainstreaming  Helps 

Non-Handicapped 

Children 

Mainstreaming  can  help  non- 
handicapped  children,  too.  They  learn 
to  accept  and  be  comfortable  with  indi- 
vidual differences  among  people.  Stud- 
ies have  shown  that  children  s  attitudes 
toward  handicapped  children  can 
become  more  positive  when  they  have 
the  opportunity  to  play  together  regu- 
larly. They  learn  that  handicapped  chil- 
dren, just  like  themselves,  can  do  some 
things  better  than  others.  In  a  main- 
stream classroom,  they  have  the  oppor- 
tunity to  make  friends  with  many  (Af- 
ferent individuals. 


How  Is 

Mainstreaming 
Carried  Out? 


Mainstreaming  can  be  carried  out  in 
a  variety  of  ways.  How  you  decide  to 
mainstream  a  particular  handicapped 
child  will  depend  upon  the  child's 
strengths,  weaknesses,  and  needs,  and 
wiQ  also  depend  upon  the  parents,  the 
staff  and  resources  within  your  pro- 
gram, and  the  resources  within  your 
community.  As  you  know,  every  child 
is  an  individual  with  different  needs 
and  abilities.  This  is  just  as  true  for 
handicapped  children:  they  display  a 
broad  range  of  behavior  and  a  Dili  ties. 

Some  handicapped  children  may 
thrive  in  a  full-day  program  with  non- 
handicapped  children.  Others  will  do 
best  in  a  mainstream  environment  for 
only  part  of  the  time,  attending  special 
classes  or  staying  at  home  for  the  rest 
of  the  day.  For  still  others,  mainstream- 
ing may  not  be  the  most  helpful 
approach.  The  principle  to  follow  is  that 
handicapped  children  should  be  placed 
in  the  least  restrictive  environment. 
This  means  that  the  preschool  experi- 
ences of  handicapped  children  should  be 
as  close  as  possible  to  those  of  non- 
handicapped  children,  while  still  meet- 
ing the  special  needs  created  by  their 
handicaps. 

As  you  and  your  program  staff  get 
to  know  each  child,  and  as  you  work 
with  the  child's  parents  and  specialists 
in  your  community's  agencies  and  pub- 
lic schools,  you  will  be  able  to  decide 
what  is  best  for  each  child.  This  book 
describes  how  mainstreaming  can  be 
carried  out  by  the  parent/Head  Start/ 
specialist  team  in  order  to  provide  the 
best  program  for  both  handicapped  and 
non-handicapped  children. 


This  book  also  discusses  different 
kinds  of  handicapping  conditions 
broadly  known  as  emotional  distur- 
bance, and  describes  the  functioning  of 
emotionally  disturbed  children  in  the 
major  skill  areas. 

Finally,  the  book  describes  how  you 
can  provide  mainstreaming  experiences 
for  emotionally  disturbed  clularen. 
Mainstreaming  children  who  are  dis- 
turbed can  be  a  challenging  yet  reward- 
ing experience  for  you,  and  extremely 
beneficial  to  the  disturbed  children. 
Even  children  with  severe  emotional 
problems  can  profit  from: 

•  the  warm  and  caring  atmosphere 
of  your  classroom 

•  the  structure  of  a  routine  super- 
vised by  concerned  adults 

•  the  interaction  with  non- 
handicapped  children  of  the  same 
age. 

Mainstream  experiences  can  help  dis- 
turbed children  to  learn  about  and  bet- 
ter understand  themselves  and  the 
world  around  them. 


What  Is 
Your  Role  in 
Mainstreaming? 


This  book  approaches  mainstream- 
ing from  the  standpoint  of  child  devel- 
opment. It  emphasizes  the  importance 
of  seeing  handicapped  children  first  and 
foremost  as  children,  with  the  same 
needs  all  children  have  for  love,  accep- 
tance, exploration,  and  a  sense  of  com- 
petence. By  understanding  how  all  chil- 
dren develop  and  learn  you  can  better 
understand  the  effects  of  a  particular 
handicapping  condition.  For  example, 
knowing  the  importance  of  feeling  trust 
and  self-confidence  will  help  you  under- 
stand the  effects  of  emotional  distui-- 
bance  on  a  child's  development.  You 
can  then  use  this  knowledge  to  plan 
appropriate  activities  for  building  on 
the  child's  strengths  and  working  on 
his  or  her  weaknesses. 


The  teaching  techniques  and  activi- 
ties provided  in  this  book  are  designed 
to  help  develop  skills  in  particular  areas 
of  development  —  motor,  social,  cogni- 
tive, language  and  speech,  and  self- 
help   —  and  can  be  used  with  any  child 
or  group  of  children  in  your  classroom, 
whether  they  are  handicapped  or  non- 
handicapped. 

As  a  teacher,  your  role  in  main- 
streaming  includes: 

•  developing  and  putting  into  effect 
an  individualized  program  that 
meets  the  needs  of  each  child  in 
the  classroom,  including  the  special 
needs  of  a  child  with  a  handicaph 
ping  condition 

•  working  together  with  the  parents 
of  a  handicapped  child  so  that 
learning  situations  that  occur  in 
your  classroom  are  reinforced  by 
the  pEirents  at  home 

•  finding  out,  through  your  handicap 
coordinator  or  social  services  coor- 
dinator, what  special  services  a 
handicapped  child  is  receiving  and 
how  you  can  get  a  specialist  to  pro- 
vide information  that  can  enhance 
yovu"  classroom  teaching 

•  arranging  referrals  through  yoiu- 
handicap  coordinator  or  social  serv- 
ices coordinator  for  diagnostic  eval- 
uation, if  you  feel  a  child  has  a 
problem  that  has  not  been  clearly 
identified. 

In  carrying  out  this  role,  there  are 
many  resources  that  can  be  tapped  to 
assist  you.  Later  in  the  book  they  wiU 
be  described  in  more  detail,  but  they 
are  summarized  on  the  following  chart. 


8 


Where  to  Go 
for  Help 


There  are  many  resources  you  can 
tap  for  help  with  a  handicapped  child. 
T^e  advantage  of  these  resources  by 
actively  seeking  them  out.  For  detailed 
information  on  Head  Start  and  other 
resources  in  your  area,  see  Chapter  2. 
For  detailed  information  on  national 
professional  and  parent  associations 
and  other  organizations,  and  a  list  of 
helpful  materials,  see  Chapter  7. 


'^^,'- 


Places 


People 


Public  schools 

Head  Start  staff 

Community  agencies 
Colleges  and  universities 
Hospitals  and  clinics 
State  Department  of 
Education 

rw^          1 

Child's  parents 

Specialists 

Public  school  teachers 

of  handicapped  children 

Resource  Access  Projects 

Teacher 

and 

Child 

with  emotional 
disturbance 

Information 


Libraries 

State  and  federal  agencies 
for  the  handicapped 
Professional  associations 
Parent  organizations 


Chapter  2: 


Where  to 

Find 

Help  in 

'Your  Area 


Provision  of  services  to 
handicapped  children  is 
not  a  solo  effort. 


10         Head  Start  is  a  comprehensive  child 
development  program  for  all  eligible 
children  —  handicapped  and  non- 
handicapped.  It  includes  mainstream- 
ing  experiences  in  the  classroom;  medi- 
cal, dental,  mental  health,  and  nutri- 
tion services;  parent  involvement;  and 
social  services.  Ih  strengthen  services 
to  handicapped  children,  Head  Start 
programs  are  required  to  make  everg 
effort  to  work  with  other  programs  and 
agencies  that  serve  these  children.  This 
cooperation  is  essential. 

Provision  of  services  to  handi- 
capped children  is  not  a  solo  effort.  As 
you  have  already  found  out  (or  soon 
will),  it  requires  the  involvement  and 
cooperation  of  many  people  with  differ- 
ent kinds  of  skills  and  knowledge.  You 
are  the  primary  planner  of  the  child's 
daily  educational  program  and  the  per- 
son who  is  central  in  carrying  it  out. 
But  it  will  help  you  and  the  child  if 
you  can  identify  and  work  with  special- 
ists in  your  program  and  in  your  com- 
munity. You  and  the  specialists  can 
achieve  more  working  as  a  team  than 
as  individuals.  This  chapter  discusses 
how  to  find  out  about  local  or  regional 
resources,  what  they  provide,  how  you 
can  make  the  most  of  what  is  avail- 
able, and  the  kinds  of  specialists  you 
may  meet  as  you  work  with  handi- 
capped children. 


Finding 
Out  About 
Resources 


Tb  find  out  about  resources,  start  by 
asking  questions.  Ask  other  teachers, 
your  center  director,  and  other  program 
staff  to  recommend  people  who  can 
answer  your  questions.  You  need  some 
basic  information  about  the  kinds  of 
support  personnel  available  in  your  pro- 
gram. For  example: 

•  Is  there  a  handicap  coordinator,  a 
mental  health  professional,  or  a 
health  coordinator  who  is  familar 
with  emotional  disturbance  and 
disturbed  children,  and  who  can 
suggest  materials,  methods,  and 
additional  resources? 

•  Is  there  an  educational  coordinator, 
a  director  of  educational  services, 
or  another  classroom  teacher  who 
can  help  you  to  make  any  changes 
in  your  program  as  needed  by  a 
disturb^  child? 

•  Does  the  program  have  a  social 
worker,  a  social  services  director, 
or  a  parent-involvement  staff  mem- 
ber who  can  help  arrange  contacts 
with  the  child's  family  and  with 
resources  outside  the  program? 

•  Does  your  program  have  consul- 
tants, whether  from  public  schools, 
nearby  colleges  or  universities, 
community  health  or  social  serv- 
ices agencies,  a  state  department 
of  education,  the  State  Develop- 
mental Disaljilities  Council,  or  local 
chapters  of  national  associations 
serving  emotionally  disturbed  chil- 
dren? (For  more  information  on 
national  associations,  see  the  sec- 
tion in  Chapter  7  on  professional 
and  parent  associations.) 


Head  Start 

Program 

Resources 


Certain  components  —  social  serv- 
ices, health  services,  educational  serv- 
ices, handicap  services,  and  parent 
involvement  —  are  found  in  Head  Start 
programs.  Programs  vary  greatly,  how- 
ever, in  the  number  of  staff  members 
providing  these  services. 

In  a  given  program,  one  person  may 
be  both  the  social  services  director  and 
the  parent  involvement  coordinator.  In 
another  program,  several  people  may 
work  in  each  component.  These  staff 
members  may  work  part-time  or  full- 
time.  They  may  be  a  part  of  your  pro- 
gram or  outside  consultants  to  your 
program.  Their  job  titles  may  vary.  It 
often  happens  that  people  with  the 
same  title  do  different  jobs,  or  that  peo- 
ple with  different  titles  do  the  same 
job.  A  job  title  only  gives  you  a  small 
clue.  You  will  need  to  find  out  who  does 
what,  when,  and  where,  and  how  you 
can  get  things  going. 

Social  Services 

Social  services  staff  (whether  a  full- 
time  director,  a  part-time  social  case- 
worker, or  a  community  aide)  usually 
coordinate  contacts  among  a  child's 
family,  the  Head  Start  program,  and 
outside  community  resources.  This  per- 
son (or  people)  can  help  you  put 
together  a  team  of  specialists  to  work 
with  you  and  a  disturbed  child  in  your 
class.  When  needed,  the  teacher  and 
the  social  services  person  work  together 
to  arrange  referrals  for  children  and 
families  who  need  diagnosis  and  treat- 
ment. Social  services  staff  oversee  the 
foUow-up,  too,  making  sure  appoint- 
ments are  made  and  coordinating  serv- 
ices if  several  agencies  are  involved.  It 
is  important  that  you  get  information 
from  the  social  services  person  about 
the  kinds  of  services  a  child  is  receiv- 
ing. 


The  social  services  component  is  an 
extremely  valuable  resource  to  you  in 
your  efforts  to  provide  handicapped 
children  with  a  good  education  in  a 
mainstream  setting. 

Health  Services 

The  health  services  component  of 
the  Head  Start  program  must  include 
medical,  dental,  mental  health,  and 
nutritional  services.  The  specialists  who 
carry  out  these  services  may  work  on  a 
full-time,  part-time,  or  consultant  basis. 
The  person  responsible  for  coordinating 
all  these  health  services  can  draw  upon 
a  number  of  services  outside  of  the  pro- 
gram for  diagnosis  and  treatment.  This 
means  they^can  help  you  get  health 
information  or  the  services  of  special- 
ists for  a  child.  For  example,  a  speech- 
language  pathologist  may  be  called 
upon  to  assess  a  child's  communication 
skills.  An  audiologist  (hearing  special- 
ist) may  be  recruited  to  assess  a  child's 
hearing.  A  mental  health  professional 
such  as  a  psychologist  can  diagnose 
emotional  disturbance.  Other  specialists 
such  as  a  neurologist  (nervous  system 
specialist),  an  occupational  therapist 
(activities  specialist),  a  physical  thera- 
pist (movement  specialist),  or  an  oto- 
laryngologist (ear,  nose,  and  throat  spe- 
cialist) may  be  consulted  when  neces- 
sary. 

You  will  want  to  know  who  in  your 
program  is  responsible  for  contacting 
and  coordinating  health  service  agen- 
cies, and  what  your  relationship  is  with 
the  agencies.  What  kinds  of  assistance 
can  you  expect  from  them?  What  con- 
ference arrangements  are  being  made 
among  team  members?  While  some 
agencies  are  more  accessible  than 
others,  all  Head  Start  programs  (no 
matter  how  large  or  small)  havfe  or  will 
have  access  to  these  resources,  either 
within  the  program  or  through  outside 
referrals. 

Be  sure  that  the  parents  are  com- 
pletely informed  of  any  plan  for  ser- 
vices for  their  child,  and  that  they  give 
their  consent. 


11 


12  Educational  Services 

This  component  comprises  all 
aspects  of  the  educational  program.  All 
Head  Start  programs,  however,  should 
use  the  resources  of  local  institutions  of 
higher  learning  (junior  colleges,  colleges, 
universities,  and  University  Affiliated 
Facilities)  that  are  available  to  them. 

In  many  programs,  the  people  who 
are  responsible  for  educational  services 
(including  outside  educational  consul- 
tants) can  provide  guidance  and  advice 
to  teachers  in  the  classroom.  This 
advice  would  include  helping  you  to 
observe  a  child  systematically,  to 
assess  a  child's  skills,  and  to  develop 
and  carry  out  an  individualized  educa- 
tion plan  for  a  disturbed  child.  Your 
center's  educational  director  should  be 
able  to  help  you  tailor  classroom  activi- 
ties to  meet  each  child's  needs. 


Parent  Involvement 

Parent  involvement,  a  cornerstone 
of  Head  Start,  encourages  family  par- 
ticipation in  ail  aspects  of  the  program. 
Head  Start  believes  that  the  gains 
made  by  a  child  in  Head  Start  must  be 
understood  and  built  upon  by  the 
child's  family  and  by  the  community, 
lb  achieve  parent  involvement  in  a 
child's  Head  Start  experiences,  each 
program  works  toward  increasing  par- 
ents' understanding  of  their  young 
child's  needs  and  how  to  satisfy  them. 
Project  Head  Start  is  based  on  the 
premise  that  successful  parent  involve- 
ment requires  parents  to  participate  in 
making  decisions  about  the  program 
and  about  the  kinds  of  activities  that 
are  most  helpful  and  important  for 
their  child. 

In  some  Head  Start  programs,  the 
parent  involvement  component  may  be 
combined  with  social  services.  In 
others,  it  is  a  separate  service.  Regard- 
less of  its  place  m  the  organization  of 
your  program,  the  people  in  this  compo- 
nent are  responsible  for  the  coordina- 
tion of  all  activities  that  involve  the 
child's  family. 

You  probably  realize  that  the  parent 
involvement  component  is  especially 
important  for  families  of  handicapped 
children.  Since  they  have  lived  witn  the 
child  you  are  trying  to  help,  they  know 
a  great  deal  about  their  child's  needs 
and  strengths.  The  more  the  home  and 
Head  Start  can  exchange  information 
and  work  together,  the  oetter  the  child 
will  do  in  your  class. 


Handicap  Services 

A  handicap  coordinator  is  responsi- 
ble for  supervising  the  mainstreaming 
of  all  handicapped  children  in  the  pro- 
gram. This  person  is  usually  famihar 
with  special  education  methods  and 
materials,  and  should  be  able  to  teach 
you  how  to  use  them  in  your  classroom 
if  you  need  help. 

Many  Head  Start  programs  have  a 
close  working  relationship  with  the 
local  school  system.  The  local  school 
system  may  pay  for  specialists  to  work 
with  handicapped  children.  Under  1975 
federal  legislation,  Education  for  All 
Handicapped  Children  Act  (Public  Law 
94-142),  local  school  districts  must  pro- 
vide a  free  public  education  to  all  handi- 
capped children  from  3  to  21  years  of 
age.  Some  states  have  their  own  special 
education  laws,  which  require  services 
for  children  from  infancy  to  age  five. 
You  will  want  to  learn  as  much  as  you 
can  about  these  laws  in  your  own  state 
so  that  you  can  take  advantage  of  the 
services.  Your  local  public  school  direc- 
tor of  special  education  is  a  good 
resource  for  such  information. 


It  is  important  for 
teachers  and  parents 
to  exchange  informa- 
tion on  the  child's 
needs  and  progress  on 
a  regular  basis. 


One  aspect  of  the  Education  for  All 
Handicapped  Children  Act  that  con- 
cerns Head  Start  teachers  and  parents 
is  its  outreach  component.  Under  the 
law,  public  school  systems  are  required 
to  demonstrate  a  practical  methoa  for 
identifjdng  unserved  and  underserved 
handicapped  children,  so  that  they  can 
receive  the  special  services  they  need. 
Called  Child  Find,  Child  Search,  or 
Child  Identification  in  different  states, 
the  method  varies  from  state  to  state. 
In  some,  it  consists  of  an  advertising 
campaign  to  let  parents,  teachers,  and 
others  know  whom  thev  should  contact 
if  they  suspect  a  child  has  a  handicap 
that  has  not  been  recognized.  In  other 
states,  there  is  a  formal  program  of 
screening  and  diagnosis  m  addition  to  a 
public  awareness  campaign,  lb  take 
advantage  of  this  service,  which  is  your 
right  under  the  law,  call  the  director  of 
sjiecial  education  in  your  local  school 
system,  the  sujierintendent  of  schools 
in  your  town,  or  the  special  education 
section  of  your  state's  department  of 
education. 

Since  the  Head  Start  program  in 
many  states  enrolls  children  for  whom 
the  public  school  system  is  also  respon- 
sible, the  school  district  mav  be  able  to 
provide  many  services  for  these  chil- 
dren in  your  classroom,  such  as  free 
diagnoses  and  specialists'  services.  The 
handicap  coordinator  should  be  in  close 
contact  with  the  public  schools  in  your 
community,  and  should  know  all  of  the 
resources  available  and  how  to  link  up 
with  them. 


13 


1^  Who  Knows  About 
Resources  and 
Services? 


The  staff  person  in  your  program 
who  is  responsible  for  handicap  services 
may  be  the  best  person  to  contact  to 
find  out  about  resources  and  services. 
In  your  community,  there  are  other 
people  who  can  tell  you  what  agencies 
or  people  provide  the  services  you  need 
for  a  handicapped  child. 

The  special  education  supervisor  in 
your  public  school  system  is  one  person 
to  contact  for  information  about  local 
resources.  It  is  also  a  good  idea  to  con- 
tact this  person  to  alert  the  school  sys- 
tem to  the  special  needs  of  a  child. 
After  all,  the  child  will  probably  be 
starting  public  school  after  leaving 
Head  Start. 

Your  local  hospital  may  have  a 
department  called  a  child  development 
unit,  which  deals  with  all  sorts  of  devel- 
opmental problems  in  children.  Some- 
times the  hospitals  have  specialty 
clinics  for  children  with  particular 
health  and  developmental  problems, 
including  emotional  disturbance.  The 
services  the  clinics  can  offer  will  vary, 
depending  on  the  staff  and  funds  they 
have.  But  the  hospital  will  often  be  able 
to  suggest  other  resources  for  you  to 
contact. 

Some  states  have  a  University  Affil- 
iated Facility,  which  provides  direct 
services  to  handicapped  children  and 
their  families.  The  address  for  this 
resource  is  given  in  Chapter  7,  page 
127. 


The  Resource  Access  Project  (RAP) 
in  your  region  should  be  contacted. 
RAPs  are  designed  to  link  local  Head 
Start  staff  with  a  variety  of  resources 
to  meet  the  special  needs  of  handi- 
capped children.  They  identify  all  possi- 
ble sources  of  training  and  technical 
assistance  and  enlist  their  support  in 
helping  Head  Start  programs  find  and 
serve  handicapped  chilc&en.  The 
addresses  of  tne  RAPs  are  given  in 
Chapter  7,  page  131. 

Parents  of  school-aged  disturbed 
children  are  often  very  knowledgeable 
about  the  resources  that  can  be  tapped. 
Find  out  if  your  community  has  an 
organization  for  parents  of  disturbed 
children. 


How  to  Make  the  Most 
of  Available  Resources 

You  can  make  the  most  of  available 
resources  by  taking  the  following  steps: 


1.    Be  Precise  ' 

Be  precise  about  the  help  you  need. 
For  people  to  be  helpful,  they  have  to 
understand  exactly  what  you  need.  You 
may  want  to  discuss  your  problem  first 
with  other  Head  Start  teacners  and 
specialists,  so  that  you  end  up  with  a 
clear  idea  of  what  you  need  to  know. 


2.    Develop  Objectives 

With  your  team  of  specialists, 
develop  objectives  about  what  each  of 
you  wants  to  achieve  in  working  with  a 
particular  handicapped  child.  That  is, 
know  what  you  are  aiming  for  so  you     . 
can  plan  activities  to  meet  that  aim,       ' 
and  so  you  will  know  when  you  have 
reached  it. 


3.    Agree  on  Responsibilities 

You  and  the  specialists  should  work 
together  to  determine  what  you  expect 
from  one  another.  People  sometimes 
start  out  with  different  expectations  — 
such  as  who  is  responsible  for  working 
with  the  child  (the  specialist  or  the 
teacher),  or  who  is  responsible  for 
checking  on  whether  tne  plan  has 
worked.  Responsibilities  need  to  be 
spelled  out  so  that  an  agreement  can  be 
reached. 


4.    Be  Sure  You  Understand 

Advice  and  explanations  that  don't 
tell  you  specifically  what  you  can  do  for 
the  child  in  your  classroom  leave  you 
as  stranded  as  you  were  before.  If  you 
don't  vmderstand,  ask.  Some  specialists 
are  used  to  saying  things  in  compli- 
cated ways,  and  they  need  to  be 
reminded  to  say  them  in  plain  English. 
Once  you  get  the  general  idea,  you  will 
be  able  to  develop  activities  on  your 
own. 


5.    Keep  in  Touch 

Feedback  on  both  sides  is  very 
important.  You  need  to  know  what  the 
specialists  are  doing  for  the  child  and 
how  the  child  is  progressing.  The  spe- 
cialists need  to  Imow  what  the  child  is 
doing  in  your  classroom  and  how  the 
child  is  progressing.  And  everyone  — 
the  parents,  the  specialists,  and  you  — 
needs  to  know  what  everyone  else  is 
doing,  so  that  the  services  can  be  coor- 
dinated. Otherwise,  two  specialists 
could  be  providing  the  same  services 
for  a  child  —  or  even  worse,  no  one 
could  be  providing  them. 

Feedback  won't  happen  by  itself. 
Plan  a  schedule  of  contacts  —  meetings 
and  phone  calls  are  fine  —  and  hold 
yourself  and  the  specialists  responsible 
for  sticking  to  it. 


6.     Consider  Parents  Specialists 

Try  to  work  with  parents  in  the 
same  way  that  you  work  with  special- 
ists. Some  parents  are  sp)ecialists  on 
their  own  cnild's  needs,  strengths,  prob- 
lems, Hkes,  and  dislikes.  Furthermore, 
like  working  with  specialists,  working 
with  parents  involves  agreed-upon 
goals,  knowing  what  each  of  you  is 
doing,  sharing  information  on  how  the 
child  is  progressing,  and  maintaining 
regular  contact. 


7.    Expect  a  Lot 

You  will  be  working  with  a  child 
who  has  problems  that  may  be  unfamil- 
iar to  you,  and  for  which  there  are  no 
easy  solutions.  This  means  you  need  to 
expect  a  lot,  both  from  yourself  and 
from  others  hired  to  help  a  child  with 
special  needs. 

If  you  are  going  to  get  the  most 
from  resource  persons  both  inside  and 
outside  your  program,  you  need  to  be 
doing  a  great  deal  yourself.  You  need  to 
identify  what  the  child  can  currently  do 
and  what  he  or  she  is  developmentaUy 
prepared  to  learn.  At  the  same  time, 
you  win  have  to  maintain  a  program 
that  is  good  for  all  the  children  in  the 
classroom. 

Expect  a  lot  from  the  people  your 
program  has  hired  on  a  full-time,  part- 
time,  or  consultant  basis.  Don't  be 
impressed  by  their  titles,  backgrounds, 
or  anything  else  except  how  helpful 
they  really  are  to  you,  the  handicapped 
child,  and  the  child's  family. 


15 


16 


Using  Local 
Resources  for 
Mainstreaming 
Handicapped 
Children 


Classroom 
Teacher 

•  observes  child 

•  records  information 

•  develops  questions 

•  identifies  where  help 
is  needed. 


Paren 


ent 


( 

^ 


Head  Start 
Person 
Responsible 
for  Referral 

•  receives  results 

•  coordinates  program 
review 

•  coordinates  follow- 
through. 


Team 

Within 

Program 


Educational  Services 
Handicap  Services 
Health  Services 
Parent  Involvement 
'ocial  Services 


•  determines  additional 
information  needed 

•  plans  strategy  for 
gathering  information 

•  provides,  seeks,  and 
coordinates  services 

•  makes  referral  to  out- 
side agency. 


•  observes  child 

•  notes  information 

•  develops  questions 

•  identifies  where  help 
is  needed. 


17 


Resources 

Outside 

Program 

Neurologist 
Pediatrician 
Psychiatrist 
k  Psychologist 

Audiologist 

Dentist 

Nutritionist 

Occupational  therapist 

Ophthalmologist 

Optician 

Optometrist 

Orthopedist 

Otolaryngologist 

Physical  therapist 

Social  worker 

Speech-language 

pathologist 


Colleges  and  universities 

Hospitals 

National  associations 

Public  school  personnel 

Resource  Access  Projects 

Social  service  agencies 

State  department  of 
education 

University  Affiliated 
Facilities 

•  provide  additional 
information  and/or 
service 

•  recommend  steps  to 
take. 


Head  Start 
Person 
Responsible 
for  Referral 


Classroom 
Teacher 


▼  ▼     frc 


•  processes  referral 
reviews  questions 

aws  together  infor- 
mation and  resources 
from  within  program 


4¥ 


•  translates  information 
into  educational  activi- 
ties 

•  carries  out  educational 
plan 

ssesses  progress. 


Parent^ 


translates  information 

into  home  activities 

discusses  educational 

plan  with  Head  Start 

staff 

assesses  progress. 


''  Who  Are 
the  Specialists? 

What  Do 
They  Do? 


This  section  describes  the  specialists 
emotionally  disturbed  children  are  most 
likely  to  need  help  from.  Other  special- 
ists who  work  with  handicapped  chil- 
dren are  described  in  the  section  begin- 
ning on  page  20. 

In  addition  to  being  skilled  in  the 
area  of  a  specific  handicap,  specialists 
should  be  familiar  with  the  needs  of 
children  from  low-income  and  minority 
families.  This  familiarity  may  be  an 
asset  in: 

•  providing  a  more  complete  and 
accurate  diagnosis 

•  identifying  underlying  environmen- 
tal factors  that  may  contribute  to 
the  disturbance 

•  helping  you  develop  an  appropriate 
and  realistic  individualized  plan  for 
the  child. 


Psychologist 


A  psychologist  conducts  screen- 
ing, diagnosis,  and  treatment  of 
people  with  social,  emotional, 
psychological,  behavioral,  or 
developmental  problems.  There 
are  many  different  kinds  of  psy- 
chologists. 

What  Is  Done 

Psychologists  may  ask  chil- 
dren questions,  observe  them  at 
play,  ask  the  parents  questions, 
and  observe  the  children 
interacting  with  the  parents. 
They  may  choose  to  administer 
standardized  tests  to  assess 
children's  problem-solving  abili- 
ties and  adaptive  behavior  (such 
as  ability  to  use  language,  to 
play  with  others,  and  to  do 
things  independently).  Psycholo- 
gists sometimes  use  play  activi- 
ties to  understand  and  treat  chil- 
dren. At  times  they  may  want  to 
talk  with  the  whole  farmly  to 
help  with  problems  they  might 
have  concerning  a  particular 
child.  Psychologists  can  also  help 
to  decide  what  kinds  of  educa- 
tional programs  and  activities 
would  oe  best  to  improve 
children's  problem-solving  abili- 
ties and  adaptive  behavior. 


Psychologists  are 
often  called  upon 
to  observe  and 
test  young  chil- 
dren with  sus- 
pected emotional 
problems. 


Pediatrician 


Neurologist 


19 


A  pediatrician  is  a  medical  doc- 
tor who  specializes  in  childhood 
diseases  and  problems,  and  in 
the  health  care  of  children. 

What  Is  Done 

A  pediatrician  can  examine 
general  health  conditions  to 
determine  whether  a  child  should 
spend  a  full  day  in  your  class- 
room and  what  activities  are 
within  the  child's  capabilities. 
Nutritional  problems  may  be 
identified.  Ii  there  are  specific 
health  problems,  the  pediatrician 
may  prescribe  medication,  or 
may  suggest  another  specialist. 


Psychiatrist 


A  psychiatrist  is  a  medical  doc- 
tor who  conducts  screening, 
diagnosis,  and  treatment  of  psy- 
chological, emotional,  behav- 
ioral, and  developmental  or 
organic  problems.  Psychiatrists 
can  prescribe  medication.  They 
generally  do  not  administer 
tests.  There  are  different  kinds 
of  psychiatrists.  A  child  psychia- 
trist is  a  medical  doctor  who 
specializes  in  psychological/ 
behavioral  and  developmental 
problems  of  childhood. 

What  Is  Done 

A  psychiatrist  spends  time 
talking  or  playing  with  a  child. 
He  or  she  may  or  may  not 
interview  the  child's  parents. 
While  observing  how  the  child 
relates  to  others,  communicates, 
and  plays,  the  psychiatrist  is 
also  alert  for  signs  of  some 
physical  problem  that  might 
indicate  a  nervous  system  disor- 
der. 


A  neurologist  is  a  medical  doc- 
tor who  conducts  screening, 
diagnosis,  and  treatment  of 
brain  and  nervous  system  disor- 
ders. 

What  Is  Done 

A  neurologist  performs  a 
physical  examination  to  deter- 
mine how  the  body  gains  infor- 
mation from  the  sense  organs, 
and  how  it  uses  the  muscular 
system  to  perform  motor  acts. 
He  or  she  may  do  special  tests 
such  as  lumbar  punctures  or 
electroencephalograms  (EEGs). 
The  EEG  is  used  to  determine 
abnormal  patterns  of  activity  in 
the  brain.  This  test  can  help  the 
neurologist  decide  whether  the 
child's  abnormal  behavior  is 
related  to  some  underlying  cen- 
tral nervous  system  condition. 


20 


Other  Specialists 

Below  is  a  Kst  of  other  spe- 
cialists who  may  work  with 
handicapped  and  non- 
handicapped  preschoolers. 

An  Audiologist  conducts 
screening  and  diagnosis  of  hear- 
ing problems  and  may  recom- 
mend a  hearing  aid  or  suggest 
training  approaches  for  people 
with  hearing  handicaps. 

A  Dentist  conducts  screen- 
ing, diagnosis,  and  treatment  of 
the  teeth  and  gums. 

A  Nutritionist  evaluates  a 
person's  food  habits  and  nutri- 
tional status.  This  specialist  can 
provide  advice  about  normal  and 
therapeutic  nutrition,  and  infor- 
mation about  special  feeding 
eqmpment  and  techniques  to 
increase  a  person's  self-feeding 
skills. 

An  Occupational  Therapist 

evaluates  and  treats  children 
who  may  have  difficulty  perform- 
ing self-care,  play,  or  preschool- 
related  activities.  The  aim  is  to 
promote  self-sufficiency  and  inde- 
pendence in  these  areas. 

An  Ophthalmologist  is  a 
medical  doctor  who  diagnoses 
and  treats  diseases,  injuries,  or 
birth  defects  that  affect  vision. 
He  or  she  may  also  conduct  or 
supervise  vision  screening. 

An  Optician  assembles  cor- 
rective lenses  and  frames.  He  or 
she  will  advise  in  the  selection  of 
frames  and  fit  the  lenses  pre- 
scribed by  the  optometrist  or 
ophthalmologist  to  the  frames. 
An  optician  also  fits  contact 
lenses. 


An  Optometrist  examines  the 
eyes  and  related  structures  to 
determine  the  presence  of  visual 
problems  and/or  eye  diseases, 
and  to  evaluate  a  child's  visual 
development. 

An  Orthopedist  is  a  medical 
doctor  who  conducts  screening, 
diagnosis,  and  treatment  of  dis- 
eases and  injuries  to  muscles, 
joints,  and  bones. 

An  Otolaryngologist  is  a 
medical  doctor  who  conducts 
screening,  diagnosis,  and  treat- 
ment of  ear,  nose,  and  throat  dis- 
orders. This  specialist  may  also 
be  known  as  an  E.N.T.  (ear,  nose, 
and  throat)  doctor. 

A  Physical  Therapist  evalu- 
ates and  plans  physical  therapy 
programs.  He  or  she  directs 
activities  for  promoting  self- 
sufficiency  primarily  related  to 
gross  motor  skills  such  as  walk- 
ing, sitting,  and  shifting  position. 
He  or  she  also  helps  people  with 
special  equipment  used  for  mov- 
ing, such  as  wheelchairs,  braces, 
and  crutches. 

A  Social  Worker  provides 
services  for  individuals  and  fami- 
lies experiencing  a  variety  of 
emotional  or  social  problems. 
This  may  include  du^ect  coimsel- 
ing  of  an  individual,  family,  or 
group;  advocacy;  and  consulta- 
tion with  preschool  programs, 
schools,  clinics,  or  other  social 
agencies. 

A  Speech-Language  Patholo- 
gist conducts  screening,  diagno- 
sis, and  treatment  of  children 
and  adults  with  communication 
disorders.  This  person  may  also 
be  called  a  speech  clinician  or 
speech  therapist. 


Chapter  3: 


Parents 

and 

Teachers  as 

Partners 


I  ^IVi 


A  joint  family/teacher 
effort  is  essential  for 
developing  the  best 
program  for  a  child. 


22  One  of  Head  Start's  unique  achieve- 

ments has  been  the  involvement  of  par- 
ents in  the  education  of  their  children. 
Parents  are  the  primary  educators  of 
their  children,  and  their  involvement  is 
the  cornerstone  of  a  successful  Head 
Start  program.  This  partnership  is 
even  more  important  in  the  education 
of  a  child  who  is  handicapped,  for  the 
following  reasons: 

•  Parents  know  their  children 's 
strengths  and  limitations  better 
than  anyone  else.  They  can  help  a 
teacher  understand  and  plan  for 
their  child. 

•  A  joint  family/teacher  effort  is 
essential  for  developing  the  best 
program  for  a  child  and  for 
ensuring  that  the  child  will  benefit 
as  much  as  possible  from  the  Head 
Start  experience. 

•  Head  Start  may  be  the  first  pre- 
school experience  the  child  and 
parents  will  participate  in.  Making 
it  a  successful  experience  will  have 
positive  effects  on  the  child's 
school  years  to  come. 


Parents  as  Decision-Makers 

Head  Start  has  always  considered 
parents  important  decision-makers  for 
their  child,  because  they  are  the  main 
influence  on  the  child's  development. 
They  are  affected  by  the  changes  in 
their  child  that  come  about  through 
your  efforts,  the  efforts  of  specialists 
who  provide  services,  and  the  experi- 
ence of  mainstreaming.  They  should  be 
called  upon  to  reinforce  what  you  are 
teaching  in  preschool  if  maximum 
progress  is  to  be  made.  For  all  these 
reasons,  it  is  important  that  the  par- 
ents participate  directly  in  what  you 
are  trying  to  accomplish  with  the  child 
in  the  program. 

The  direct  involvement  of  parents  in 
decisions  affecting  their  child  is  essen- 
tial. They  should  decide  with  you  what 
and  how  you  teach  their  child,  and 
what  efforts  they  will  make  at  home. 
They  should  participate  in  decisions 
involving  formal  assessment  and  diag- 
nosis of  their  child,  and  selection  and 
arrangements  for  any  special  services 
that  are  needed.  They  snould  be  a  part 
of  any  decisions  that  are  made  as  a        | 
result  of  evaluations  of  their  child's         j 
progress.  ' 

One  of  the  major  areas  in  which  par- 
ents are  needed  as  decision-makers  is  in 
the  development  of  an  individualized 
education  plan  for  their  child.  This  plan 
is  a  written  statement  developed  in 
meetings  of  the  diagnostic  team,  the      i 
parents,  and  the  teacher.  It  spells  out     | 
the  educational  goals  for  the  child,  the    i 
activities  that  take  place  in  the  class- 
room, the  involvement  of  parents,  the 
special  services  provided  by  other  agen- 
cies, and  details  of  the  evaluation  proce- 
dure. Parental  consent  is  reqiiired  oy 
law  at  two  points:  to  give  permission 
for  the  diagnostic  process  to  take  place, 
and  to  give  permission  to  put  into 
effect  the  individualized  education  plan 
that  has  been  developed  for  the  child. 
This  requirement  is  intended  to  guaran- 
tee that  parents  have  their  rightful  say 
in  the  education  of  their  child. 


The  rest  of  this  chapter  discusses 
specific  ways  in  which  parents  can  help 
in  the  education  of  their  child,  and  pro- 
vides guidelines  for  teachers  in  working 
with  the  parents  of  handicapped  chil- 
dren. 


What 
Parents 
Can  Do 

Helping 

Your 

Child 


As  parents,  you  are  the  first  and 
most  important  educators  of  your  child. 
You  can  help  in  your  child's  education 
in  a  number  of  ways,  both  at  home  and 
in  the  classroom.  You  can  begin  by  tak- 
ing the  following  steps: 

1.    Get  to  know  your  child's  teacher. 
Share  with  the  teacher  information 
about  the  family  and  daily  routines. 
This  will  help  to  give  the  teacher  a  bet- 
ter idea  of  how  to  help  your  child  in 
daily  tasks  and  in  learning  new  skills 
and  behaviors. 


^.    Recognize  that  you  have  a  tremen- 
dous influence  on  the  growth  and  devel- 
opment of  your  child.  What  you  do 
does  make  a  difference.  You  can  partici- 
pate in  your  child's  learning  in  many 
ways:  showing  interest  and  pride  in  his 
or  her  accomplishments,  selecting  and 
demonstrating  skills  he  or  she  needs  to 
learn,  offering  encouragement  and  guid- 
ance when  he  or  she  meets  with  a  diffi- 
cult task. 

O.    Seek  guidance  from  your  child's 
teacher  if  you  are  not  certain  how  to 
use  everyday  events  at  home  as  learn- 
ing experiences  for  your  child.  The 
teacher  may  be  able  to  suggest  specific 
activities  you  can  do  with  your  child  to 
help  him  or  her  build  necessary  skills  or 
behaviors. 

4.    Build  on  Head  Start's  firm  com- 
mitment to  a  partnership  between 
teachers  and  parents.  You  aren't  alone 
in  your  efforts  to  help  your  child.  You 
now  have  others  who  can  help  promote 
the  well-being  and  development  of  your 
child:  the  teacher,  other  staff  members 
in  the  program,  agencies  and  public 
school  resources  in  the  community,  and 
other  parents. 


23 


Help  your  child  feel  more  comfortable  in  preschool  by  taking  time  to  explain  what  the 
new  situation  will  be  like,  and  by  accompanying  him  or  her  for  a  short  time. 


24  The  next  section  discusses  how  to 
prepare  your  child  for  the  Head  Start 
program,  what  to  discuss  with  the 
child's  teacher,  and  how  to  use  every- 
day events  in  the  home  to  foster  your 
child's  development. 

Preparing  Your  Child 

You  can  help  both  your  child  and 
the  program  staff  by  preparing  the 
child  for  the  Head  Start  program.  Just 
before  the  start  of  class,  Ibring  your 
child  to  the  Head  Start  center.  Intro- 
duce yourself  and  the  child  to  the 
teacher  and  other  staff  members. 
Encourage  your  child  to  explore  the 
classroom  and  to  plav  with  some  of  the 
materials.  Try  to  make  sure  that  the 
child  has  a  good  time  during  this  visit. 

Some  disturbed  children  will  be  fear- 
ful of  leaving  home,  while  others  wiU  be 
excited  about  meeting  other  children 
and  learning  new  things.  Sometimes  a 
child  will  have  both  of  these  feelings  at 
the  same  time.  You  and  the  teacher 
mav  want  to  discuss  whether  it  would 
be  helpful  to  your  child  if  you  remain  in 
the  classroom  during  the  first  few  days. 
At  some  point  your  child  will  feel  com- 
fortable in  the  classroom  without  your 
being  there.  This  takes  more  time  for 
some  children  than  for  others. 

A  little  bit  of  home  at  preschool  and 
a  little  bit  of  preschool  at  home  go  a 
long  way  toward  helping  children  feel 
comfortable  and  secure.  Perhaps  at 
home  you  can  hang  some  pictures  of 
the  classroom  or  the  teacher.  Or  your 
youngster  could  be  sent  to  class  with  a 
favorite  toy  or  familiar  object  from 
home,  to  increase  his  or  her  feelings  of 
security. 

Try  to  have  your  child  arrive  in 
class  on  time.  Let  the  teacher  know  of 
important  events  at  home  that  might 
influence  the  child's  behavior  in  class. 
These  special  events  may  be  happy 
times  (such  as  birthdays,  a  family  visi- 
tor, or  a  trip),  or  unhappy  times  (such 
as  disruption  in  the  family  routine,  ill- 
ness, or  death). 


Understanding  What 
Your  Child 
Needs  to  Learn 

You  may  feel  that  you  need  help 
from  the  teacher  in  understanding  the 
skill  areas  —  such  as  language  skills, 
motor  skills,  social  skills,  self-help  skills 
—  that  your  child  has  serious 
weaknesses  in.  Don't  hesitate  to 
approach  the  teacher  for  this  help,  or 
for  help  in  figuring  out  wavs  to  use 
daily  home  activities  to  help  build  on 
the  child's  strengths  and  work  on  the 
child's  problems.  Try  to  talk  frequently 
with  the  teacher  in  terms  of  specific 
skills  or  behaviors.  Exchange  sugges- 
tions. 

Ask  to  see  for  yourself  what  the 
teacher  does  and  how  he  or  she  does  it 
in  the  classroom.  You  might  even  want 
to  try  practicing  skills  with  your  child 
in  the  classroom.  Sometimes  it  is  better 
for  you  to  work  with  a  child  other  than 
your  own.  But  in  either  case  it  will  give 
you  practice  and  an  opportimity  to 
exchange  ideas  with  tne  teacher. 

Describe  to  the  teacher  an  average 
day  at  home,  in  order  to  leam  how  you 
can  use  these  ordinary  events  to  work 
on  the  skills  or  behaviors  the  child  is 
having  problems  with. 


As  a  parent,  you  can  help  your  child  become 
more  patient,  concentrate  better  on  tasks, 
and  develop  self-confidence. 


Additional  Effort 

All  young  children  learn  by  having 
different  experiences  and  by  trying 
things  out.  This  means  that  your  child 
needs  to  be  involved  as  much  as  possi- 
ble in  daily  activities  at  home,  just  like 
other  children.  If  it's  good  for  a  non- 
handicapped  child  to  help  clean  up  after 
a  meal,  rather  than  rushing  away  from 
the  table,  then  it's  good  for  a  disturbed 
child.  Any  task  the  child  can  perform 
can  go  a  long  way  toward  helping  him 
or  her  build  up  self-confidence. 

You  will  wish  to  make  some  addi- 
tional efforts  to  help  your  child  become 
appropriately  involv^  in  daily  events. 
Children  cannot  be  expected  to  learn 
new  and  better  ways  of  acting  by  them- 
selves. Some  children  will  need  extra 
help  to  become  actively  involved  in 
daily  routines,  while  others  may  need 
extra  help  to  calm  down  and  become 
more  purposeful  in  using  their  energy. 
Some  children  may  need  extra  help  in 
daily  events  that  seem  routine  and  sim- 
ple to  others.  For  example,  a  bossy, 
threatening  child  may  need  extra  help 
in  forming  and  maintaining  friendships 
with  neighborhood  children.  Work  out 
with  the  teacher  what  you  can  realisti- 
cally do,  but  recognize  that  extra  effort 
is  necessary. 


Home  Activities 

Activities  at  home  should  be  as 
enjoyable  as  possible  for  the  child  and 
for  the  family.  Don't  overburden  your- 
self or  your  child.  Ask  the  teacher  to 
suggest  things  that  can  easily  be  built 
into  the  daily  routine.  If  the  sugges- 
tions are  too  hard  to  carry  out,  they 
may  not  get  done. 

On  the  other  hand,  if  you  are  willing 
to  take  a  more  active  teaching  role  at 
home,  ask  for  suggestions  for  extra 
things  you  can  do.  Talk  with  the 
teacher  about  what  you  Uke  to  do  with 
your  child  and  about  what  the  child 
likes  to  do  at  home.  Those  activities 
can  aU  be  learning  opiwrtunities. 

If  you  would  like  some  specific 
activities  to  do  at  home  with  your 
child,  look  over  the  activities  in  Chapter 
6.  Remember,  however,  that  you  need 
not  be  a  formal  teacher  for  your  child. 
Often  the  best  way  to  help  your  child  is 
to  be  loving  and  helpful,  and  to  use  the 
dailv  routine  as  a  way  to  teach  the 
child. 


1.    Using  the  Daily  Routine 

Most  of  the  things  that  you  do  at 
home  can  be  used  to  help  a  child  with 
special  needs  learn  more  about  the 
world.  For  example,  you  can  describe 
what  you're  doing  when  you  prepare 
meals,  set  the  table,  or  do  the  laundry. 
You  can  use  bedtime  to  tell  a  happy 
story  or  recall  a  pleasant  experience. 
You  can  use  bath  time  to  talk  about 
feeling  wet.  You  can  give  the  child  sim- 
ple chores,  like  putting  the  napkins  by 
each  plate,  passing  the  cookies,  putting 
clothes  in  the  laundry  basket.  Don't 
expect  the  job  to  be  done  perfectly  the 
first  time,  or  even  the  second.  With 
patience  and  affection  you  can  help  the 
child  improve. 

Be  reasonably  consistent  in  what 
you  ask  your  child  to  do.  If  you  expect 
your  child  to  sit  at  the  table  during 
mealtimes,  then  you  should  expect  that 
at  every  meal  (except,  of  course,  during 
times  of  illness  or  other  stress). 


25 


26         Expensive  toys  or  materials  are  not 
needed  to  help  children  learn.  The  kinds 
of  things  that  are  in  all  homes  —  pots 
and  pans,  socks,  spoons,  and  magazine 
pictures  —  are  all  good  teaching  aids. 
Pots  and  pans  can  be  used  as  rhythm 
instruments,  can  be  stacked  or  nested, 
or  can  be  sorted.  Socks  can  be  matched 
by  color,  counted,  and  folded  together. 
Pictures  can  be  named,  or  used  to  tell 
stories. 

Most  handicapped  children  need 
more,  not  less,  stunulation  from  people 
around  them.  A  good  and  simple  way 
to  achieve  this  is  for  you  and  other 
members  of  the  familv  to  talk  to  the 
child  about  what  you  re  doing  as  you 
do  it,  and  to  listen  to  and  encourage 
your  child  to  talk.  It  is  very  important 
to  talk  and  listen  to  all  children,  partic- 
ularly disturbed  children.  However, 
some  disturbed  children  easily  become 
over-stimulated.  These  children  need 
help  in  focusing  their  attention. 

Confusion  and  failure  can  result  if 
you  shower  the  child  with  too  many 
activities.  As  you  work  with  your  child, 
you  will  recognize  when  the  child  has 
had  enough.  You  can  help  the  teachers 
recognize  this  limit,  too. 

2.    Fostering  Independence 

Help  your  child  become  as  independ- 
ent as  possible.  It's  tempting  for  aU  of 
us  to  do  things  for  children  that  they 
could  do  on  their  own,  since  we  can  do 
them  faster  and  better.  But  it  is  very 
important  for  handicapped  children  to 
learn  to  do  as  much  as  they  can  by 
themselves.  Independence  helps  chil- 
dren feel  good  about  themselves  and 
improves  their  ability  to  get  along  with 
others. 

If  your  child  is  fearful  about  toilet- 
ing, for  example,  you  may  worry  that 
he  or  she  may  have  frequent  "acci- 
dents" at  preschool.  You  may  even  feel 
that  you  should  put  the  child  back  into 
diapers.  Doing  so,  however,  is  a  disserv- 
ice to  your  cMld,  who  learns  best  about 
the  world  and  daily  routines  by  partici- 
pating firsthand.  You  might  ask  the 


teacher  to  suggest  ways  in  which  you 
can  make  toileting  less  fearful  for  your 
child  so  that  eventually  he  or  she  can 
perform  this  routine  without  your  assis- 
tance. 


3.    Praise  and  Encouragement 

We  all  benefit  from  honest  praise  — 
children  as  well  as  adults.  Praise  pro- 
gram staff  honestly  for  their  efforts 
with  your  child,  and  ask  them  for  feed- 
back on  your  work  with  the  child. 
Remember  also  to  praise  your  child's 
achievements.  For  some  children,  even 
small  tasks  can  take  a  lot  of  time  to 
master.  Every  achievement  —  from 
learning  to  handle  foods  appropriately 
at  mealtime  to  managing  to  spend  an 
evening  with  a  baby  sitter  without  con- 
tinually crying  or  acting  destructively 
—  represents  real  progress  and 
deserves  real  praise. 

Also,  praise  the  child  for  trying, 
even  if  failure  or  mistakes  result.  Con- 
tinued effort  is  essential  for  children 
with  special  needs,  who  have  many 
obstacles  to  overcome.  Repeated, 
steady  praise  will  help  the  child  to  keep 
on  trying. 

It  is  important,  however,  that  your 

E raise  be  honest,  and  that  your  child 
as  done  something  to  earn  it.  Dis- 
turbed children,  just  like  other  children, 
are  very  good  at  recognizing  insincer- 
ity. If  you  praise  your  child  at  times 
when  he  or  she  has  not  been  trying  or 
has  not  mastered  something,  the 
yoimgster  will  be  confused  and  wiU  not 
understand  what  your  expectations  are. 

Ask  the  teacher  to  share  assessment 
results  with  you.  Everyone  involved 
should  understand  how  the  child  is 
functioning  and  share  pleasure  at  the 
child's  progress. 


What 
Teachers 
Can  Do 

Guidelines 
for  a 

Partnership 
with 
Parents 


Parents  of  children  with  special 
needs  are  as  concerned  about  their  chil- 
dren as  any  other  parents,  if  not  more 
so.  One  difference  for  parents  of  a  dis- 
turbed child  is  that  their  child  may  not 
be  as  predictable  as  other  children.  This 
lack  of  predictability  makes  the  child 
more  difficult  to  plan  for,  to  teach,  and 
to  live  with.  You  may  want  to  keep  in 
mind  the  suggestions  below  as  you  talk 
with  parents. 


Maintain  regular  contact  with  parents  and 
provide  them  with  helpful  information. 


1.    Establish  and  Maintain  Contact 

Describe  the  Head  Start  program  in 
detail,  and  invite  the  parents  to  observe 
and  participate  in  the  classroom.  Work 
out  the  child's  educational  goals  in  con- 
ference with  them.  Review  the  child's 
short-  and  long-term  goals  with  the  par- 
ents at  least  every  three  months,  or 
whenever  needed. 

Although  at  least  two  home  visits  a 
year  are  required  in  Head  Start  pro- 
grams for  all  children,  you  may  need  to 
make  more  visits  if  a  chUd  is  handi- 
capped. Maintain  contact  with  the  par- 
ents as  often  as  you  can.  Visits,  phone 
calls,  notes,  and  sending  children's  proj- 
ects home  with  them  can  help  parents 
see  the  skills  their  child  is  learning.  As 
with  any  child,  don't  contact  parents 
only  when  there  is  a  problem.  Ask 
yourself,  as  often  as  you  have  time, 
"What  did  the  child  do  today  or  this 
week  that  shows  some  progress  or 
enjoyment?  How  can  I  find  time  to  tell 
the  parents,  along  with  everything  else 
I  have  to  do?" 

Some  teachers  and  parents  send  a 
notebook  back  and  forth  each  day  or 
so.  Tfeachers  write  a  short  note  and 
send  it  home.  Parents  write  one  back 
for  the  chUd  to  take  to  preschool  the 
next  day.  Other  teachers  and  parents 
prefer  to  check  with  each  other  over  the 
phone.  The  most  useful  way  is  usually 
the  one  that  is  most  comfortable  for 
the  parents. 


2.    Know  the  Family's  Limits 

Everyone  has  a  personal  limit  on 
how  much  he  or  she  can  do  for  a  child 
in  the  classroom  and  at  home.  Get  to 
know  families  well  enough  to  under- 
stand these  limits.  Make  sure  that  the 
suggestions  you  give  them  for  working 
with  their  child  can  easily  be  included 
in  their  daily  routine.  For  example,  in 
families  with  several  children,  it  may  be 
difficult  to  spend  a  large  amount  of 
time  alone  with  one  child.  Try  to  help 

Earents  plan  family  activities  that  are 
enefici^  to  both  the  disturbed  child 
and  other  members  of  the  family. 


27 


28    3.    Focus  on  the  Child's  Education 

Families  of  handicapped  children 
may  have  all  kinds  of  feelings  about 
having  a  handicapped  child.  Some  may 
feel  angry,  some  guilty,  and  some 
embarrassed.  Some  may  feel  that  they 
have  a  special  responsibility  to  protect 
their  child  from  all  problems  and  frus- 
trations, and  they  may  expect  much 
less  from  the  child  than  he  or  she  is 
really  capable  of.  They  may  need  the 
help  of  a  psychologist,  a  social  worker, 
or  a  counselor  in  learning  to  accept  and 
deal  with  these  feelings. 

While  you  can  be  supportive  and 
sympathetic,  you  haven  t  been  trained 
to  be  a  social  worker  and  should  not 
try  to  take  that  role.  Suggest  to  these 
parents  that  they  talk  to  people  who 
can  help  them  work  through  their  feel- 
ings, if  you  feel  they  need  it.  You 
should  concentrate  on  the  child's  educa- 
tional program. 


4.    Be  Reassuring,  but  Be  Honest 

Parents  may  be  worried  and  upset 
when  their  child  is  about  to  be  eva- 
luated or  re-evaluated.  At  such  a  time, 
it  might  be  tempting  for  you  to  tell 
them  not  to  worry,  that  everything  will 
be  fine.  It  is  natural  for  you  to  want  to 
soothe  their  anxiety.  However,  you 
shouldn't  tell  them  these  things 
because  in  fact  you  don't  know  if 
things  really  will  be  fine.  A  false  sense 
of  confidence  can  be  hurtful.  Be  reas- 
suring, be  calm,  be  understanding  — 
but  be  truthful. 

Parents  may  ask  you  questions 
about  the  child's  problems  that  you 
can't  answer:  "What's  wrong  with  my 
child?"  "Will  my  child  learn  to  behave 
like  other  children  by  the  end  of  the 
year?"  Don't  be  afraid  to  say  that  you 
don't  know  the  answers,  but  help  par- 
ents find  someone  with  whom  they  can 
discuss  their  concerns.  Your  social  serv- 
ice personnel  should  be  able  to  help  you 
find  people  who  can  provide  some 
answers.  The  answers  to  other  ques- 
tions, such  as  "What  will  my  child  be 
like  when  he  grows  up?"  are  often 
uncertain  and  complicated.  Beware  of 
people  who  have  easy  answers. 


Some  parents  need  reassurance  and 
evidence  that  they  can  help  their  cMld. 
Help  them  see  the  many  things  that 
they  already  teach  their  children. 


5.    Recognize  £ind  Deal  with  Yoiu* 
Feelings 

Be  aware  and  honest  with  yourself 
about  your  own  feelings  toward  a  hand- 
icapped child  and  his  or  her  family. 
Negative  feelings  (such  as  blame,  anger, 
sorrow,  nervousness,  and  fear)  are 
understandable.  Getting  to  know  the 
child  and  the  family  helps  to  reduce 
some  of  these  negative  feelings. 

Think  positively  about  children  with 
special  needs.  Focus  on  their  strengths 
and  be  optimistic  about  helping  them. 
Work  on  improving  skills  or  eliminating 
behaviors  that  are  making  it  difficult 
for  such  children  to  understand  them- 
selves and  play  with  others.  Help  the 
parents  see  their  child  as  someone  who 
can  grow,  learn,  and  improve,  no  mat- 
ter how  severely  handicapped.  Most  of 
us  feel  better  about  ourselves  when  peo- 
ple look  at  our  strengths  rather  than 
our  weaknesses. 


6.    Working  with  Parents 

You  and  parents  may  not  always 
agree  on  what  children  can  and  should 
be  allowed  to  do,  both  at  preschool  and 
at  home.  In  such  cases,  it  may  be  best 
to  talk  with  the  parents  to  reach  a  com- 
promise that  works  for  you,  the  par- 
ents, and  the  child. 

At  times  parents  may  be  hard  to 
reach.  Single  parents  and  parents  with 
long  working  hours  may  have  Httle  or 
no  free  time.  Try  to  accommodate  par- 
ents' schedules  in  arranging  home 
visits  and  conferences.  Their  Hmited       j 
participation  in  program  activities  does 
not  necessarily  indicate  that  they  are 
not  interested  in  their  child  or  their        | 
chUd's  performance  in  your  classroom.   ■ 
Rather,  they  may  be  overwhelmed  with 
other  family  responsibilities  or  prob- 
lems. 


Concerns 
of  Parents 

Parents  of  Children 
with  Special  Needs 

Parents  of  handicapped  youngsters 
often  have  special  concerns.  In  general, 
it  is  wise  for  you  to  wait  until  they 
bring  up  these  problems,  rather  than  to 
suggest  what  the  problems  might  be. 
Otherwise,  you  could  be  creating  a 
problem  that  they  have  never  felt. 

Reading  about  some  of  the  concerns 
that  parents  of  children  with  handicaps 
often  have  should  help  you  understand 
what  some  parents  mean  when  they 
hint  at  a  concern  without  actually  say- 
ing it. 

Enrollment  in  a  Meiinstream  Classroom 

Parents  may  worry  that  their  child 
will  not  fit  into  the  Head  Start  pro- 
gram. You  may  need  to  reassure  the 
family  that  you  want  the  child  in  your 
classroom,  and  that  you  believe  the 
child  will  enjoy  and  learn  from  your 
classroom.  Invite  the  parents  to  watch 
and  listen  to  what  is  going  on  —  let 
them  see  for  themselves  how  their  child 
plays  and  works  with  the  other  children 
and  with  you.  Seeing  is  believing. 

Acceptance  by  Other  Children 

Parents  are  sometimes  concerned 
that  their  child  will  not  be  liked  and 
accepted,  and  that  other  children  may 
be  cruel  and  teasing. 

You  can  reassure  them  that 
preschool-aged  children  are  usually  too 
young  to  notice  handicapped  children 
as  different  unless  the  handicap  is  very 
obvious  or  their  behavior  is  very  differ- 
ent. You  can  also  tell  them  that  you  do 
not  allow  teasing  or  bullying  of  any 
child  in  your  classroom,  and  that  you 
will  deal  with  it  firmly  if  it  should 
happen. 


Of  course,  some  children  just  don't 
get  along  well  with  others,  but  this  is 
not  a  problem  that  is  limited  to  chil- 
dren with  special  needs.  It  is  not  a  rea- 
son to  avoia  the  classroom,  any  more 
than  it  is  a  reason  to  avoid  the  rest  of 
the  world.  You  can  tell  parents  that 
managing  these  situations,  when  and  if 
they  arise,  is  a  normal  part  of  your  job. 

Throughout  the  year,  keep  the  par- 
ents as  informed  as  you  can  about  how 
their  child  is  getting  along  with  the 
other  children.  If  problems  do  arise, 
you  may  want  to  ask  the  parents  how 
they  handle  similar  situations  at  home. 

You  have  developed  a  number  of 
techniques  for  helping  children  cooper- 
ate and  get  along  in  your  classroom. 
You  will  probably  find  that  these  tech- 
niques are  just  as  useful  for  a  child 
with  special  needs. 


Teacher's  Time 

Assure  the  parents  of  a  handicapped 
child  that  you  will  have  time  for  their 
youngster.  Describe  to  them  what  you 
will  be  doing  with  their  child  and 
explain  that  you  wiU  have  your  aide, 
volunteers,  and  other  staff  members  to 
help  you.  Discuss  also  any  outside 
assistance  the  child  will  be  getting. 


29 


30    The  Future 

Parents  may  worry  that  their  child 
will  not  make  progress  in  your  pro- 
gram. You  can  assure  them  that  there 
are  many  things  that  you  can  teach 
their  clmd,  and  that  their  child  will 
learn  a  lot  from  the  other  children  in 
the  class,  too.  But  be  careful  not  to 
offer  the  parents  false  hopes.  Make  it 
clear  that  you  can't  make  long-range 
predictions  about  how  far  the  child  will 

Erogress  in  the  future,  but  that  you  will 
elp  the  child  learn  as  much  as  he  or 
she  can  in  Head  Start.  Be  honest  when 
you  describe  the  skill  areas  you  are 
working  on  with  their  child,  and  keep 
them  well  informed  of  their  child's 
progress.  Ask  the  family,  in  turn,  to  tell 
you  how  they  see  the  child  progressing 
at  home. 

As  with  non-handicapped  children,  if 
you  genuinely  like  a  child,  and  if  you 
and  other  staff  members  in  your  pro- 
gram have  worked  out  a  sensible  plan 
to  meet  the  child's  needs  and  stimulate 
his  or  her  development,  you  have  a 
solid  basis  for  working  out  a  real  part- 
nership with  the  parents.  While  parents 
of  handicapped  youngsters  have  some 
concerns  that  are  different  from  the 
concerns  of  other  parents,  you  can  use 
the  same  ways  of  working  with  them 
that  you  have  already  developed  in 
your  conversations  and  personal  con- 
tacts with  other  parents. 

Parents  of 

Non-Handicapped 

Children 

Many  Head  Start  programs  have 
children  with  handicaps  in  their  classes. 
It  is  not  unusual  for  parents  of  non- 
handicapped  children  to  be  concerned 
about  the  presence  of  an  emotionally 
disturbed  child  in  the  class.  This  con- 
cern may  be  greatest  if  parents  suspect 
that  the  emotionally  disturbed  chila  is 
potentially  hurtful  or  aggressive  (for 
example,  if  they  think  that  the  child 
may  hit  other  children  for  no  apparent 
reason)  or  is  otherwise  abusive  (for 
example,  if  they  think  that  the  child 
may  scream  at  other  children  or 
destroy  other  children's  work).  Try  to 


explain  to  apprehensive  parents  that 
you  have  adequate  staff  in  your  class- 
room to  manage  an  emotionally  dis- 
turbed child.  Because  some  disturbed 
children  can  be  more  impulsive  and 
impredictable  than  others,  you  cannot 
guarantee  the  parents  that  their  child 
will  never  have  an  impleasant  experi- 
ence in  your  classroom.  Explain  to  par- 
ents that  no  child  would  ever  be 
enrolled  in  your  class  if  it  were  thought 
that  the  child  could  seriously  hurt 
someone.  Also  explain  that  the  dis- 
turbed child  has  been  enrolled  because 
you  and  other  professionals  believe  that 
the  child's  behavior  can  improve,  and 
because  the  child  has  strengths  and 
abilities  to  contribute  to  group  learning 
experiences.  It  is  good  for  all  the  chil- 
dren to  see  that  a  child's  behavior  can 
change,  and  to  recognize  that  they  have 
the  ability  to  cope  with  a  range  of 
behaviors,  with  the  teacher's  help. 
Assure  parents  that  every  effort  wiU  be 
made  to  provide  a  safe  and  happy 
learning  experience  for  all  children. 

Some  parents  may  also  be  con- 
cerned that  their  child  wiU  pick  up 
undesirable  behavior  from  disturbed 
children  (for  example,  giving  up  when  a 
task  becomes  too  hard,  shouting  and 
grabbing  food  at  mealtimes,  or  break- 
ing toys).  You  can  explain  to  parents 
that  it  is  normal  for  children  to  imitate 
other  children.  This  is  one  of  the  ways 
they  learn.  However,  undesirable  benav- 
ior  tends  to  be  dropped  quickly,  once  it 
has  been  tested  and  met  with  disap- 
proval and/or  fovmd  unsatisfying.  ' 

If  the  parents  of  a  non-handicapped 
child  have  these  concerns,  invite  them 
to  your  classroom.  This  may  help  to 
show  them  that  an  emotionally  ois-        ' 
turbed  child  is  first  and  foremost  a 
child  and  an  individual,  like  their  own 
child.  Visiting  a  mainstream  classroom 
may  help  dispel  unfounded  fears  par- 
ents may  have  about  a  child  whom 
they  have  never  met.  On  the  other 
hand,  visiting  your  classroom  may 
sometimes  reinforce  parents'  concerns. 
Be  prepared  to  explain  what  your  pro- 
gram can  offer  their  child. 


Chapter  4: 


What 

Is 

Emotional 

Disturbance? 


Learning  about  emotional 
disturbance  can  help  you 
realize  the  special  needs 
of  disturbed  children. 


32         Like  all  children,  emotionally  dis- 
turbed children  need  a  warm  and 
caring  atmosphere  in  which  to  grow 
and  learn.  And  like  other  children, 
they  have  good  days  and  bad  days, 
mth  disturbed  children,  however,  their 
bad  days  may  be  especially  bad,  and 
may  continue  for  long  periods  of  time. 
For  this  reason,  they  may  need  an 
extra  measure  of  warmth,  understand- 
ing, and  tolerance  from  you.  As  you 
will  learn,  working  with  these  children 
is  not  an  easy  job.  They  will  often  try 
your  patience,  your  trust,  and  your 
teaching  skills.  However,  as  you  work 
with  them  and  learn  more  about  them, 
you  will  find  that  meeting  the  chal- 
lenge they  present  can  be  personally 
and  professionally  rewarding  to  you 
and  of  tremendous  value  to  the  chil- 
dren. 

At  one  time  or  another  you  may 
have  an  emotionally  disturbed  child  in 
your  classroom.  You  may  receive  a 
"diagnostic  evaluation  "  for  this  child 
from  a  psychologist  or  psychiatrist. 
This  evaluation  will  outline  the  child's 
development  —  both  strengths  and 
needs  —  and  will  explain  what  special 
services  the  child  should  receive  from 
you  and  other  specialists.  On  the  other 
hand,  you  may  only  receive  a  report 
that  says  the  child  is  "emotionally  dis- 
turbed. "  This  report  may  identify  the 
specific  kind  of  disturbance  by  name 
only.  The  advantage  of  using  these 
names  or  categories  is  that  a  single 
word  can  stand  for  a  whole  range  of 
related  behaviors.  However,  classifying 
a  child  usually  limits  rather  than 
extends  our  understanding,  and  often 
produces  negative  and  inaccurate 
expectations  for  that  child.  The  use  of 
these  names  doesn  't  allow  us  to  think 
of  the  range  of  skills  and  behaviors  a 
child  may  demonstrate.  It  doesn 't 
describe  the  severity  of  the  child's 
problem  with  a  particular  skill  or  set 
of  skills.  For  example,  the  term  "dis- 
turbed" cannot  possibly  tell  you 
whether  a  child  has  problems  with 
sharing.  One  disturbed  child  may  have 
problems  sharing  a  certain  toy  with 
certain  people,  while  another  disturbed 
child  may  have  trouble  sharing  any- 
thing with  anyone.  Still  another  dis- 


turbed child  may  have  no  special  diffi- 
culty sharing.  A  word  or  phrase  cannot 
possibly  describe  all  of  the  possibilities 
to  you.  Describing  children  in  terms  of 
strengths  and  weaknesses  is  much 
more  valuable  to  you  than  being  able 
to  fit  them  into  a  category. 

Another  real  disadvantage  of  class- 
ifying is  that  the  terms  tend  to  stick 
with  a  child  for  a  long  time,  regardless 
of  whether  the  handicapping  condition 
is  still  present.  This  can  lead  to  social 
isolation  and  incorrect  assumptions 
about  a  child's  ability.  Young  children 
change  and  grow  so  rapidly  that  some 
children  with  handicaps  may  overcome 
their  disabilities  before  entering  public 
school  Names  acquired  in  preschool 
are  likely  to  follow  children  into  public 
schools,  and  may  be  used  as  a  basis  for 
excluding  them  from  the  regular  school 
program.  It  is  hard  to  outlive  or  live 
down  how  you  have  been  classified  Do 
your  best  to  get  to  know  the  whole 
child  and  add  important  information  to 
the  diagnosis. 

This  chapter  looks  at  how  emo- 
tional disturbance  is  defined  by  Project 
Head  Start  and  by  other  professionals 
in  the  field.  It  also  considers  what  emo- 
tional disturbance  means  for  those  who 
teach  and  work  with  disturbed  chil- 
dren. Learning  about  emotional  distur- 
bance can  help  you  to  realize  the  spe- 
cial needs  of  disturbed  children,  and  to 
recognize  when  to  refer  a  child  for 
diagnostic  evaluation.  However,  only 
by  working  with  a  disturbed  child  will 
you  recognize  his  or  her  uniqueness, 
capabilities,  and  problems.  ' 


How  Is 
Emotional 
Disturbance 
Defined? 

The  "Head  Starr 
Definition 


In  defining  handicapping  condi- 
tions, Project  Head  Start  distin- 
guishes between  categorical  defini- 
tions, which  are  used  for  reporting 
purposes,  and  functional  definitions, 
which  describe  the  child's  areas  of 
strength  and  weakness.  The  categori- 
cal definition  uses  Project  Head 
Start's  legislated  diagnostic  criteria. 
An  interdisciplinary  diagnostic  team 
(or  a  professional  who  is  qualified  to 
diagnose  the  specific  handicap)  must 
use  this  definition  to  make  a  categori- 
cal diagnosis  of  a  child.  This  diagno- 
sis is  used  only  for  reporting  pur- 
poses. A  functional  definition  or  diag- 
nosis, on  the  other  hand,  assesses 
what  a  child  can  and  cannot  do,  and 
identifies  areas  that  call  for  special 
education  and  related  services.  The 


functional  assessment  should  be 
developed  by  a  diagnostic  team,  with 
the  child's  parents  and  teacher  as 
active  participants.  Another  term  for 
functional  assessment  or  functional 
diagnosis  is  developmental  profile. 

According  to  Project  Head  Start, 
the  following  categorical  definition  of 
emotional  disturbance  is  to  be  used  for 
reporting  purposes  in  Head  Start  pro- 
grams: 

A  child  shall  be  considered  seriously 
emotionally  disturbed  who  is  identi- 
fied by  professionally  qualified  per- 
sonnel (psychologist  or  psychiatrist) 
as  requiring  specied  services.  This 
definition  would  include  but  not  be 
limited  to  the  following  conditions: 
dangerously  aggressive  towards 
others,  self-destructive,  severely 
withdrawn  and  non-communicative, 
hyperactive  to  the  extent  that  it 
affects  adaptive  behavior,  severely 
anxious,  depressed  or  phobic,  psy- 
chotic or  autistic. 

("Transmittal  Notice  Announcement  of  Diagnostic 
Criteria  for  Reporting  Handicapped  Children  in 
Head  Start,"  OCD-HS,  September  11,  1975.) 

As  the  Head  Start  definition  indi- 
cates, there  are  many  "conditions"  that 
fall  within  the  broad  scope  of  emotional 
disturbance.  Professionals  in  the  field  of 
emotional  disturbance  (such  as  psychol- 
ogists and  psychiatrists)  usually  refer 
to  these  conditions  as  "diagnostic  cate- 
gories." They  are  discussed  in  Chapter 
5.  This  chapter  focuses  on  a  more  gen- 
eral definition  of  emotional  disturbance. 


33 


^^  A  Functional 
Definition 

Emotional  disturbance  can  be  gener- 
ally defined  as  an  abrupt  break,  slowing 
down,  or  postponement  in  developing 
and  maintaining  meaningful  relation- 
ships with  other  persons,  and/or  in 
developing  a  positive  and  accurate 
sense  of  self.  Generally,  children  who 
are  emotionally  disturbed  may  have  dif- 
ficulty in: 

•      developing  the  capacity  to  give  and 
take  in  relationships  with  other 

Eeople.  For  example,  Tina  may  not 
e  able  to  treat  other  persons  as 
they  treat  her. 


identifying  and  appropriately 
expressing  feeKngs  and  motives. 
For  example,  Masao  may  not  know 
that  he  is  happy  when  something 
good  happens.  He  may  express 
himself  by  throwing  a  toy  or  hit- 
ting another  child,  rather  than  by 
smiling. 

learning  skills  and  gaining  self- 
confidence.  For  example,  Patrick 
may  have  difficulty  learning  skills, 
may  not  have  confidence  in  his 
ability  to  perform  a  task,  and  may 
not  be  able  to  demonstrate  that 
ability. 

asking  for  and  accepting  help.  For 
example,  Virginia  may  not  be  able 
to  ask  for  help  when  a  task  gets 
too  hard  or  to  allow  another  child 
who  has  offered  help  to  be  her 
partner  in  a  game.  Some  disturbed 
children  have  trouble  accepting 
their  dependency  on  others. 


Within  each  of  these  developmental 
areas,  emotionally  disturbed  children 
may  show  widely  different  behaviors.  A 
child's  behavior  is  influenced  by  many 
factors,  including: 

•  the  environment  of  a  child  (for 
example,  whether  it  is  permissive 
or  strict,  unresponsive  or  attentive) 

•  individual  coping  styles  (that  is, 
the  ways  a  child  has  learned  to 
handle  problems) 

•  the  range  of  behavior  sldlls  known 
to  a  child  (for  example,  whether  the 
child  has  learned  a  number  of  ways 
to  handle  a  problem  and  under- 
stands the  appropriateness  of  these 
ways  in  a  given  situation.  Clare 
may  have  learned  that  she  can  go 
outside  to  play  if  she  asks  nicely,  if 
she  cries  long  enough  to  become 
disruptive,  or  if  she  follows  her 
mother  around  the  house  begging 
to  go  outside.  Of  these  various 
ways,  Clare  has  learned  that  ask- 
ing nicely  is  most  effective  and 
causes  fewer  conflicts  with  her 

I       mother.  Albert,  on  the  other  hand, 
'       has  learned  that  he  always  gets 
what  he  wants  by  crying.  So  cry- 
ing is  the  approach  he  takes.) 

Obviously  a  variety  of  factors  contrib- 
ute to  how  children  learn  to  behave. 
These  factors  can  be  altered  or  changed 
to  encourage  more  appropriate  behavior 
and  a  better  understanding  of  self  and 
of  the  world. 


Levels  of 

Emotional 

Disturbance 


Tb  distinguish  between  disturbed 
children  and  children  who  have  behav- 
ioral problems  that  do  not  require  spe- 
cial services,  Head  Start  refers  to 
"seriously"  disturbed  children  in  its 
definition.  Head  Start  does  not  use  the 
word  "seriously"  to  distinguish  differ- 
ent levels  of  disturbance,  but  rather 
to  distinguish  "disturbed"  from 
"non-disturbed"  children.  In  fact,  all 
disturbed  children  who  require  special 
services  fall  within  the  Head  Start  defi- 
nition, even  though  behavior  may  vary 
drastically  from  child  to  child. 

Specialists  in  emotional  disturbance 
do  not  aU  agree  that  levels  of  emotional 
disturbance  can  be  determined  accu- 
rately. Some  believe  that  three  levels 
can  be  clearly  distinguished  from  one 
another:  mild,  moderate,  and  severe. 
They  use  these  classifications  to  indi- 
cate the  severity  of  the  disturbance. 
Other  specialists  believe  that  levels  are 
difficult  to  establish  because  of  the  dif- 
ficulty in  evaluating  young  children  and 
because  of  problems  with  the  tests 
themselves.  A  further  consideration  is 
that  disturbances  show  themselves 
with  different  intensities  under  various 
conditions.  Chapter  5,  which  describes 
the  diagnostic  categories  of  emotional 
disturbance,  does  not  distinguish  levels 
of  disturbance. 


35 


Masao  doesn  Y  always 
know  how  to  express 
pleasure. 


^^  Commonly 
Associated 
Handicaps 

Many  emotionally  disturbed  chil- 
dren do  not  have  other  handicaps,  but 
some  do  —  particularly  those  who  are 
seriously  disturbed.  These  children 
require  a  very  special  kind  of  help.  You 
wiu  need  to  worK  closely  with  the 
diagnostic  team  to  determine  how  best 
to  help  such  children,  and  to  seek  out 
other  resources  as  necessary. 

Some  experts  have  found  that  learn- 
ing disabilities  and  communication  dis- 
orders are  likely  to  be  associated  with 
emotional  disturbance.  Learning  disa- 
bilities, as  defined  by  Project  Head 
Start's  legislative  diagnostic  criteria, 
mean  a  disorder  in  one  or  more  of  the 
basic  psychological  processes  involved 
in  understanding  or  in  using  language. 
This  disorder  may  result  in  an  imper- 
fect ability  to  listen,  think,  speak,  and 
to  learn  pre-reading  skills. 

A  small  percentage  of  disturbed 
children,  most  of  whom  are  severely 
disturbed,  have  still  other  handicaps. 
These  may  include  visual  handicaps, 
hearing  impairment,  physical  handi- 
caps, and  mental  retardation. 

Emotional  disturbances  interfere 
with  or  exaggerate  the  range  of  behav- 
iors usually  shown  by  young  children. 
Additional  handicaps  simply  compound 
the  child's  problems.  If  an  emotionally 
disturbed  cnild  has  been  diagnosed  as 
having  other  handicaps,  you  wQl  want 
to  take  the  following  steps: 

•      Get  some  background  information. 
Set  up  a  conference  with  parents 
and  ask  such  questions  as:  How 
have  the  child's  handicaps  been 
dealt  with  by  the  family  and  physi- 
cians in  the  past?  What  are  the 
child's  strengths,  weaknesses,  and 
interests? 


Read  other  relevant  books,  such  as 
those  in  this  series.  They  can  pro- 
vide useful  information  and  sugges- 
tions on  how  to  help  children  with 
other  handicaps. 

If  at  all  possible,  discuss  the  child 
with  those  specialists  who  diag-       . 
nosed  the  cMld's  handicaps.  Feel 
free  to  ask  lots  of  questions  about 
the  specialists'  impressions  of  the 
child  and  about  the  handicap  itself. 
Encourage  specialists  to  give  you 
information  that  is  useful  to  you  in 
your  individual  classroom.  You 
may  need  to  familiarize  the  special- 
ists with  your  classroom  faciGty, 
the  daily  routine,  resources  that 
are  available  to  you,  and  other 
aspects  of  your  program. 


Ask  more  experienced  teachers  to 
help  you  plan  for  this  child. 

Try  to  find  ways  to  provide  experi- 
ences that  seem  to  fit  the  chila  s 
individual  needs  (for  example,  a 
place  to  retreat  or  a  substitute 
task  when  a  child  cannot  seem  to 
handle  a  group  activity).  At  the 
same  time,  make  sure  that  a  handi- 
capped child  has  as  many  of  the 
usual  preschool  experiences  as  pos- 
sible. Most  handicapped  children 
do  best  if  the  teacher  adjusts  their 
program  to  their  abilities  and  spe- 
cial needs  without  making  them 
feel  isolated  from  the  rest  of  the 
group. 


Problems 
Related  to 
Diagnosis 

Accurate  diagnosis  will  enable  you 
and  others  to  give  the  kind  of  help  that 
a  child  needs.  This  means,  first  of  all, 
that  someone  has  to  recognize  that  a 
diagnosis  is  called  for.  If  tests  are 
given,  they  have  to  be  appropriate,  and 
administered  by  trained  people.  Fur- 
ther, the  test  results  have  to  be  prop- 
erly interpreted.  Accurate  diagnosis, 
therefore,  can  sometimes  be  tricky. 

Some  problems  related  to  diagnosis 


37 


are: 


difficulty  in  identifying  the  type  of 
emotional  disturbance  (the  diagnos- 
tic category) 

difficulty  in  determining  what  the 
handicap  is  when  the  child's  behav- 
ior can  have  a  variety  of  causes 
(for  example,  a  non-verbal  child's 
problem  may  stem  from  physical 
or  psychological  factors) 

mistaking  cultural  and  lifestyle  dif- 
ferences for  handicaps 

problems  with  the  testing  situation 

lack  of  regularly  scheduled 
reassessment. 


Some  emotionally  dis- 
turbed children  have 
additional  handicaps. 


3^  Identifying  the 
Disturbance 

Because  children  are  unique  individ- 
uals, they  respond  to  situations  in  dif- 
ferent ways.  This  means  that,  for  exam- 
ple, aggressive  children  may  each  dem- 
onstrate their  disturbance  differently, 
making  it  difficult  to  diagnose  their 
problem  accurately.  If  an  aggressive 
boy  bottles  up  his  hostility,  he  could  be 
mistakenly  diagnosed  as  withdrawn 
and  given  inappropriate  and  inadequate 
help.  This  fact  underscores  the  impor- 
tance of  having  a  trained  individual 
conduct  the  diagnostic  evaluation. 


Determining  the 
Handicap 

Diagnosis  can  be  especially  difficult 
when  a  single  behavior  can  have  a  vari- 
ety of  causes.  It  is  important,  therefore 
that  each  child  be  adequately  screened 
for  all  possible  problems.  A  non-verbal 
child,  for  example,  may  have  a  serious 
hearing  loss  that  has  never  been  recog- 
nized. It  may  be  that  the  child  truly 
wants  to  enjoy  conversations  with  you 
and  other  children.  But  since  the  child 
cannot  adequately  hear  what  is  being 
said,  it  is  difficult  for  him  or  her  to 
respond  verbally.  This  experience  can 
be  very  frustrating,  and  sometimes  the 
child  will  act  nervous,  fearful,  or  timid. 
However,  if  the  hearing  loss  is  detected 
and  treated,  the  child  will  learn  to  com- 
municate with  others. 


''Street-wise''  children  have  learned  to  be  assertive.  They  are  not  necessarily 
disturbed. 


Mistaking 
Cultural  and 
Lifestyle 
Differences  for 
Handicaps 

Many  tests  commonly  given  to  chil- 
dren are  standardized  to  fit  children 
[from  a  middle-class,  white  American 
'background.  Some  children  from  low- 
income  and/or  minority  families  may 
not  have  learned  the  social  behavior 
■and  school-related  skills  that  children 
from  white,  middle-class  families  have 
learned.  This  means  that  when  they  are 
tested  they  do  not  perform  according  to 
test  standards. 

1      If  they  speak,  for  example,  Spanish, 
Chinese,  or  a  non-standard  EngUsh  dia- 
lect at  home,  they  may  not  understand 
or  may  misunderstand  what  is  being 
said  to  them.  This  means  they  can't 
answer  the  test  questions  correctly  and 
may  appear  to  be  emotionally  dis- 
turbed. 

Children  from  low-income  and 
minority  families  may  also  display 
behavior  that  makes  perfectly  good 
sense  for  the  child  in  his  or  her  environ- 
ment, but  not  in  the  eyes  of  someone 
who  is  unfamiliar  with  the  child's  life- 
style. For  example,  some  children  are 
"street  wise"  at  an  early  age:  they 
know  how  to  fight  for  their  rights  and 
take  care  of  themselves.  This  behavior 
might  include  using  physical  force  and 
yellmg  to  settle  problems,  rather  than 
talking  things  out.  These  children  may 
JDe  very  assertive  in  this  way  because  it 
is  how  they  have  learned  to  respond 
and,  perhaps,  because  this  way  is 
acceptable  to  other  people  around  them. 
They  may  in  fact  not  be  disturbed  at 
all. 


Circumstances  like  these  can  mean 
that  children  from  minority  and  low- 
income  families  may  appear  disturbed 
when  compared  with  children  from 
white,  middle-class  families.  The  prob- 
lem is  often  not  with  the  children  but 
with  the  tests  or  with  the  value  system 
of  the  diagnostician.  Diagnosticians, 
then,  should  be  familiar  with  a  child's 
background  and  should  also  have  a 
good  deal  of  insight  into  how  different 
lifestyles  promote  or  affect  a  child's 
behavior  or  skill  level. 

Emotional  disturbance  occurs  at  all 
income  levels  and  in  all  ethnic  groups. 
But  you  should  be  especially  careful 
about  drawing  any  conclusions  from 
intelligence  or  psychological  develop- 
ment tests  given  to  children  from  low- 
income  or  minority  families.  You  may 
be  told  that  a  particular  child  has  been 
tested  and  found  to  be  disturbed.  But  if 
your  experience  with  the  child  makes 
you  think  the  child  is  functioning  well, 
teU  the  responsible  person  in  your  pro- 
gram that  the  child  should  be  looked  at 
more  carefully. 


39 


40   Problems  with  the 
Testing  Situation 

The  testing  situation  itself  may 
interfere  with  accurate  assessment  of 
both  handicapped  and  non-handicapped 
children.  For  example,  a  disturbed  Doy 
who  is  overly  concerned  about  making 
mistakes,  as  is  typical  for  some  dis- 
turbed children,  may  say  that  he  can't 
do  a  task  that  he  really  can.  In  another 
case,  testing  may  make  a  non-handi- 
capped girl  so  "nervous"  that  her 
behavior  may  be  at3^ical  for  her.  While 
her  usual  behavior  might  be  friendly 
and  outgoing,  a  testing  situation  might 
make  her  tense  and  guarded.  Or,  for 
example,  a  non-handicapped  child  who 
is  shy  and  not  used  to  answering  ques- 
tions may  act  disturbed  in  a  diagnostic 
situation,  but  perfectly  normal  in  a 
more  familiar  situation. 

Sometimes  it  is  helpful  to  have  a 
child's  parent  or  parents  present  during 
testing.  Their  presence  may  help  the 
child  feel  comfortable.  In  addition,  the 
parents  will  be  able  to  say  whether 
their  child  is  behaving  typically. 


Lack  of  Regularly 
Scheduled  Reassessment 

Children  at  the  preschool  age  are 
growing  and  changing  rapidly.  If 
assessment  is  not  conducted  on  a  regu- 
lar and  routine  basis,  it  is  difficult  to 
know  for  certain  the  kind  and  amount 
of  development  that  has  taken  place  in 
a  child.  Lack  of  reassessment  can  be 
disastrous  for  a  child.  It  can  mean  that 
a  child  whose  behavior  has  changed  or 
whose  source  of  disturbance  has 
changed  is  no  longer  receiving  appropri- 
ate services.  It  can  mean  that  a  cnild 
who  is  no  longer  disturbed  remains 
classified  as  disturbed.  Tb  provide  a 
child  with  the  best  possible  services 
and  to  keep  track  of  his  or  her  develop- 
ment, it  is  important  that  regular 
assessment  be  an  integral  part  of  that 
child's  program. 

With  help,  most  disturbed  children 
wiU  gradually  show  some  improvement. 
Some  children  may  improve  as  they 
mature,  only  to  show  more  disturbance 
again  when  they  are  under  stress,  that 
is,  when  something  special  happens  to 
them  (an  upcoming  vacation,  the  birth 
of  a  sibling,  or  illness  or  death  in  the 
family). 


A  very  shy  child  may 
seem  disturbed  during 
testing. 


Recognizing 
Problems 
for  Referral 


An  accurate  diagnosis  can  help  you 
understand  a  disturbed  child's  behavior. 
But  children  grow  and  change.  You  are 
in  an  excellent  position  to  observe  the 
child  for  behavior  that  is  consistent 
with  the  diagnosis  and  behavior  that 
isn't.  It  is  critical  to  note  inconsistent 
behavior  and  alert  the  child's  parents  of 
the  need  for  re-evaluation. 

You  are  also  in  an  excellent  position 
to  recognize  behavior  that  may  indicate 
undiagnosed  distiirbance.  Some  dis- 
turbed children  may  not  be  diagnosed 
before  they  are  enrolled  in  Head  Start. 
Children  who  are  only  mildly  or  moder- 
ately disturbed,  for  example,  may  be 
enrolled  in  your  program  without  ever 
having  been  recognized  as  handicapped. 
You  may  be  the  first  person  in  the  life 
of  the  child  who  can  alert  other  profes- 
sionals to  the  problem,  so  that  services 
for  that  child's  special  needs  can  finally 
begin.  Sometimes  parents  need  advice 
and  encouragement  from  teachers  to 
recognize  and  face  problems  that  may 
have  troubled  them  in  their  child's 
behavior.  Diagnosis,  first  and  foremost, 
is  needed  to  point  out  the  extra  help 
and  services  these  children  need. 


General 
Guidelines 

Learn  to  Observe 
Carefully 

Your  own  classroom  observation, 
plus  conversations  with  parents  about 
their  children,  can  be  the  best  founda- 
tion for  deciding  whether  to  refer  a  par- 
ticular child  to  a  professional  diagnosti- 
cian. As  a  classroom  teacher,  you 
observe  children  and  draw  conclusions 
every  day. 

Do  you  have  a  child  in  your  class 
who  strikes  you  as  difficult  to  handle, 
hard  to  get  along  with,  or  slow  in  learn- 
ing new  skills?  If  you  observe  the  child, 
figure  out  what  might  improve  the 
behavior,  and  try  several  approaches, 
you  may  find  that  the  child  s  problems 
are  not  as  serious  as  you  first  thought. 
And  if  they  still  seem  serious,  you  can 
conclude  tnat  a  professional  evaluation 
is  in  order. 

This  process  of  carefully  observing 
and  drawing  conclusions  helps  you  plan 
activities  to  meet  the  individual  needs 
of  all  children.  Even  though  you  aren't 
a  professional  diagnostician,  don't  un- 
derestimate your  ability  to  spot  pos- 
sibly serious  problems  that  may  signal 
a  handicapping  condition  in  a  cMld. 


41 


42 


Ask  Questions 


Ask  yoiirself  some  good,  basic  ques- 
tions to  determine  whether  a  child 
should  be  referred  for  professional  eval- 
uation: 


Is  the  child's  social  and  personal  behav- 
ior (ability  to  share,  cooperate,  and 
interact  with  other  children,  and  to  be 
reasonably  independent)  so  limited  that 
it  keeps  Mm  or  her  from  participating 
fully  with  the  other  children? 

Does  the  child's  learning  style  or  rate 
of  learning  prevent  him  or  her  from 
participating  fully  with  other  children? 
For  example,  a  child  who  has  a  short 
attention  span  and  who  is  constantly 
on  the  move  may  have  difficulty  learn- 
ing a  group  activity.  Or  a  child  who 
learns  very  quickly  may  retreat  from 
the  group  to  practice  skills  that  other 
children  are  not  yet  ready  to  learn. 

If  your  answer  to  either  or  both  of 
these  questions  is  yes,  and  if  the  par- 
ents agree,  referral  is  in  order.  If  it 
turns  out  that  the  child  is  not  handi- 
capped, you  and  the  parents  will  be 
reassured  and  wiU  gain  a  better  under- 
standing of  the  child.  If  a  problem  does 
exist,  the  child  will  then  be  able  to 
obtain  the  needed  help. 


Recognize  Individual 
Differences 

Distinguish  between  those  children 
whose  temperaments  and  individual 
learning  styles  you  find  difficult  and 
those  cmldren  who  may  be  handi- 
capped. Children,  like  adults,  can  be 
qmet  and  thoughtful  or  very  energetic 
and  into  everything.  Some  get  frus- 
trated more  easily  than  others,  some 
get  distressed  and  upset  more  easily 
than  others,  and  some  demand  more 
attention  than  others.  It  is  helpful  to 
ask  yourself:  "Do  I  find  this  child  diffi- 
cult because  of  individual  style  differ- 
ences between  the  two  of  us?  Or  is  the 
behavior  of  the  child  genuinely  different 
from  the  behavior  of  other  children  the 
same  age?"  Children  who  appear  differ- 
ent are  not  necessarily  distiu*bed.  You 
should  try  to  discover  why  they  behave 
differently.  If  you  can't  come  up  with 
any  logical  answers,  you  may  need  to 
seek  help. 

Get  Professional  Help        < 

Tb  find  out  why  (and  sometimes        1 
how)  a  child's  behavior  appears  differ-    ' 
ent  from  what  is  considered  normal,  it 
may  be  necessary  for  you  to  seek  refer- 
ral and  assessment  for  the  child.  From 
the  child's  point  of  view,  referral  is  bet- 
ter than  non-referral.  This  means  that  if 
you  think  a  handicap  might  accoimt  for 
the  behavior  you  have  observed,  it  is 
best  to  have  the  child  professionally 
evaluated.  If  you  find  out  that  the  child 
does  not  have  a  handicap,  no  harm  has 
been  done.  If,  on  the  other  hand,  a 
handicapped  child  is  not  diagnosed,  the 
child's  special  needs  will  not  be  met.       , 
Regularly  scheduled  re-evaluation  is 
preferreci  over  non-referral  for  children 
who  have  already  been  diagnosed:  as      i 
vou  have  read,  children  can  sometimes 
be  incorrectly  diagnosed.  If  a  child 
enters  your  class  already  diagnosed  as 
emotionally  disturbed,  take  an  espe- 
cially close  look.  Have  the  child  re- 
evaluated if  you  have  doubts  about  the 
diagnosis. 


Behaviors 

that  Do  Not 

Necessarily 

Indicate 

Emotional 

Disturbance 


Children  who  are  emotionally  dis- 
turbed show  unusual  behaviors  often 
and  for  long  periods  of  time.  However, 
children  who  are  not  emotionally  dis- 
turbed may  sometimes  show  these 
same,  unusual  behaviors  from  time  to 
time.  With  non-disturbed  children,  these 
behaviors  are  almost  always  short-lived 
and  caused  by  a  situation  that  you  can 
identify. 

For  example,  Victor  was  an  out- 
going, sociable  four-yeai^old  until  his 
parents  separated.  Victor's  mother,  Mrs. 
Williams,  was  forced  to  go  on  welfare 
because  she  couldn  Y  find  a  job  to  help 
support  the  family.  Being  on  welfare 
upset  Mrs.  Williams,  and  her  usual 
cheerful  and  caring  behavior  began  to 
change.  It  seemed  that  now  she  was 
impatient,  screaming  at  Victor  about  lit- 
tle things.  At  other  times,  she  neglected 
Victor  and  his  sisters  altogether 
Victor's  behavior  began  to  change,  too. 
He  no  longer  wanted  to  be  with  the 
other  children  at  preschool  He  was 
very  quiet  and,  every  now  and  then, 
would  go  silently  into  a  comer  and  cry. 
Ms.  Jones,  Victor's  teacher,  was  very 
concerned  about  Victors  new  behavior 
She  contacted  the  social  services  coordi- 
nator, who  met  with  Victor's  mother  to 
discuss  the  problem. 

Several  months  later,  Mrs.  Williams 
was  able  to  find  a  job.  As  she  began  to 
feel  more  confident  in  herself  and  in  her 
ability  to  take  care  of  her  family,  her 
attitude  toward  Victor  and  his  sisters 
began  to  return  to  normal  By  the  end 
of  the  year,  Victor  was  beginning  to 
seem  more  like  his  old  self. 


Of  course,  it  is  not  always  easy  to 
determine  which  behaviors  signal  real 
problems  in  a  child,  particularly  if  the 
child  is  new  to  your  class.  You  will 
want  to  observe  the  children  in  your 
class  carefully  and  work  closely  with 
parents.  Additionally,  you  may  want  to 
discuss  some  of  the  problem  behaviors 
with  other  staff  (for  example,  with  the 
program's  director  or  handicap  coordi- 
nator, or  with  your  aide). 

Unfortunately,  there  are  no  hard 
and  fast  rules  that  certain  behaviors, 
continuing  over  a  certain  length  of 
time,  definitely  indicate  emotional  dis- 
turbance. Be  careful  not  to  jump  to 
conclusions.  Learn  the  facts  ancf  give 
the  behavior  reasonable  time  to 
improve.  You  will  often  have  to  rely  on 
your  careful  observations  to  know  when 
to  refer  a  child. 


43 


**  Steps 
to 
Take 

If  you  have  reason  to  suspect  that 
you  have  an  undiagnosed  emotionally 
disturbed  child  in  yoiir  class,  take  the 
following  steps: 

1.         Find  out  if  the  standard  screen- 
ing tests  have  been  given.  Talk  to  the 
handicap  coordinator,  the  person 
responsible  for  coordinating  health  serv- 
ices, or  someone  else  in  your  program 
who  you  think  could  be  helpful. 

^,        If  the  child  has  been  screened, 
no  problems  have  been  found,  and  you 
are  still  concerned  about  the  child, 
speak  to  the  handicap  coordinator.  The 
parents  will  have  to  give  their  permis- 
sion for  further  testing.  Explain  the 
professional  diagnostic  process  and  the 
reasons  for  it  to  the  parents. 


O.        While  waiting  for  a  professional 
diagnosis: 

•  Talk  with  the  parents  about  what 
they  notice  to  help  you  work  more 
effectively  with  the  child.  Reassure 
them  that  you  care  and  you  want 
to  be  helpful. 

•  Continue  to  observe  and  keep 
notes  to  help  you  plan  suitable 
activities. 

•  Chapter  6  discusses  guidelines  and 
ways  of  conducting  activities  for 
children.  Use  them  if  they  seem 
appropriate  and  if  you  find  they 
work. 

•  Find  out  the  resiilts  of  additional 
tests  so  that  you  can  determine 
whether  your  individualized  plan 
for  the  child  needs  to  be  changed. 
Discuss  with  the  parents  the 
results  of  the  tests  and  any  sug- 
gested changes  in  the  services  the 
child  is  receiving. 


Chapter  5: 


How 

Emotional 

Disturbance 

Affects 
Learning  in 

3-to  5-Year-Olds 


You  can  learn  a  great 
deal  about  a  child's  func- 
tioning by  observing  a 
child  on  a  daily  basis. 


46         Good  teaching  involves  finding  out 
what  each  child  can  currentlg  do  and 
what  each  needs  to  learn.  You  are  in  a 
position  to  learn  a  great  deal  about  a 
child's  functioning,  because  gou  have 
the  opportunitg  to  observe  the  child  on 
a  dailg  basis  and  to  talk  with  the 
child's  parents.  Th  help  gou,  this  chap- 
ter contains  detailed  information  on 
how  emotional  disturbance  mag  affect 
learning  in  three-  to  five-gear-olds. 

The  previous  chapter  defined  emo- 
tional disturbance  and  discussed  how 
to  recognize  problems  for  referraL  The 
Head  Start  definition  that  was  given  in 
Chapter  4  listed  different  diagnostic 
categories  of  disturbance.  This  chapter 
describes  the  five  categories  that  are 
most  common  in  preschool-aged  chil- 
dren: withdrawn  (including  depressed), 
anxious,  aggressive,  hgperactive,  and 
psgchotic. 

The  major  characteristics  of  chil- 
dren with  each  of  the  five  tgpes  of  dis- 
turbance are  described  in  this  chapter. 
Also  described  are  how  theg  function 
in  the  major  areas  of  self-concept, 
social,  speech  and  language,  motor, 
and  cognitive  development.  For  each 
diagnostic  categorg  the  developmental 
areas  are  listed  in  their  order  of  diffi- 
cultg  for  the  child,  from  easiest  to  most 
difficult. 

Each  description  that  follows  refers 
to  an  "average"  child.  These  descrip- 
tions should  serve  as  guidelines,  not 
rigid  rules.  Since  all  children  are  dif- 
ferent, the  descriptions  won't  necessar- 
ily applg  to  children  in  gour  class. 
Some  children  mag  behave  as 
described  while  others  mag  behave  dif- 
ferentlg.  As  gou  get  to  know  the  chil- 
dren, gou  will  also  get  to  know  how 
each  child  functions.  It  is  gour  exper- 
tise as  a  teacher  that  will  help  children 
learn  and  develop  as  much  as  theg  pos- 
siblg  can. 


Children 

Whose 

Behavior 

Is  Withdrawn 


All  children  enjoy  being  alone  from 
time  to  time.  But  children  who  are 
withdrawn  seem  to  spend  most  of  their 
time  apart  from  a  group.  It  is  not  so 
much  that  they  enjoy  being  alone. 
Rather,  they  seem  to  feel  uncomfort- 
able when  people  and  activities  get  too 
close  to  them.  Consider  Janie,  for  exam 
pie.  Whenever  the  children  gather 
around  the  water  table,  she  moves 
toward  the  edge  of  the  activity  area 
and  silently  watches  the  other  children 
splashing  and  pouring  water  from  bot- 
tles to  cups  and  back  again.  On  the 
other  hand,  if  Janie  is  alone  at  the 
water  table,  she  will  pour  and  splash 
the  water  herself,  though  not  vigor- 
ously. Clearly,  Janie  knows  what  the 
activity  is  all  about.  What  she  doesn't 
seem  to  know  is  how  to  participate  in 
the  activity  with  other  children. 

Children  who  are  withdrawn  also      ' 
seem  unusually  uncomfortable  when 
they  don't  know  what  to  expect  or  how 
to  handle  a  given  situation,  especially  a 
new  experience.  For  example,  Danielle 
began  to  cry  when  her  teacher  said  thai 
the  doctors  would  be  coming  to 
examine  the  children.  The  only  contact 
she  had  ever  had  with  a  doctor  before 
was  at  the  clinic  where  she  was  vac- 
cinated. Because  she  did  not  know 
what  the  examination  at  the  preschool 
would  be  like,  but  rememberai  her  past 
experience  with  the  doctor,  she  was 
fearful. 


Most  withdrawn  children  have  a 
favorite  spot  in  the  classroom,  usually 
away  from  active  areas  and  frequently 
on  the  floor.  They  do  not  interact  with 
other  children  and  adults,  but  react  by 
moving  away  when  someone  gets  too 
close.  Withdrawn  children  appear  disin- 
terested in  and  unaware  of  most  of 
what  goes  on.  They  seem  to  have  few 
interests  and  frequently  need  self- 
comfort  in  the  form  of  thumb-sucking, 
rocking,  masturbating,  or  pulling  on 
their  hair  or  ears. 

Few  preschool  children  are 
diagnosed  as  depressed.  There  are,  how- 
ever, some  young  children  who  seem  to 
be  depressed.  Their  behavior  is  similar 
to  that  of  the  withdrawn  child,  with 
one  difference:  they  seem  unhappy 
about  something.  It  is  not  always  clear 
to  themselves  or  to  others  why  they  are 
so  sad.  Most  depressed  children  seem 
to  do  little  more  than  daydream.  They 
startle  and  cry  easily.  Some  of  them 
can  be  comforted.  Some  can  be  cheered 
up  by  playing  for  a  while.  Most  de- 
pressed children  will  become  sad  and 
quiet  many  times  during  the  day. 

Like  other  children,  withdrawn  or 
depressed  children  are  individuals.  This 
means  that  their  behavior  can  cover  a 
wide  range.  One  child  may  seem  to  be 
overly  shy  and  timid;  another  may 
seem  completely  withdrawn.  With  gen- 
tle guidance,  most  can  be  helped.  Most 
have  the  potential  to  learn  all  the  skills 
other  children  learn,  once  they  have 
gained  some  self-confidence  and  feel 
free  enough  to  let  themselves  go  and 
play  with  others. 

The  following  are  descriptions  of 
skills  and  behavior  typically  exhibited 
by  withdrawn  children. 


Cognitive 
Skills 


47 


Most  withdrawn  children  acquire 
cognitive  skills  at  the  expected  age  and 
learn  to  use  most  manipulative  mate- 
rials. Their  need  to  withdraw,  however, 
usually  makes  it  hard  for  them  to  put 
their  knowledge  and  skQls  to  use.  It  is 
safe  to  assume  that  most  withdrawn 
children  know  and  are  able  to  do  far 
more  than  they  can  express  by  words 
or  actions. 

Most  withdrawn  children  learn  pri- 
marily from  watching  others,  at  a  safe 
distance.  They  generally  will  not  join 
group  activities,  and  are  very  timid 
about  trying  new  activities  and  about 
using  materials.  Their  hesitant  use  of 
materials  is  due  to  anxiety  and  lack  of 
self-confidence,  rather  than  to  inability. 


A  withdrawn  child  may  have  a  favorite  spot 
in  the  classroom. 


48    For  example,  most  withdrawn  children 
in  preschool  know  different  colors,  even 
if  they  take  only  one  crayon  and  make 
a  barely  visible  mark  with  it  on  one 
edge  of  the  paper.  They  often  have  nor- 
mal dexterity  (as,  for  example,  in 
stringing  beads),  but  might  string  the 
same  bead  over  and  over,  rather  than 
ask  the  teacher  to  put  a  knot  at  the 
end  of  the  string. 

\^^th  a  great  deal  of  gentle  support, 
most  withdrawn  children  can  gradually 
develop  the  confidence  to  master  new 
tasks.  While  they  will  stubbornly  refuse 
to  do  any  task  that  makes  them  anx- 
ious, they  do  wish  to  please  and  will  try 
most  activities  with  your  protective 
support.  For  example,  they  may  play 
with  the  pegboard  after  much  reassur- 
ance and  after  having  watched  other 
children  place  the  pegs.  But  they  may 
refuse  to  work  with  finger  paints, 
despite  days  of  watching  others  use 
them.  When  invited  to  join,  they  may 
just  shake  their  heads,  or  turn  away.  If 
you  tell  such  a  child  to  sit  at  the  finger 
painting  table,  the  child  may  obediently 
sit  down,  but  stick  his  or  her  hands 
firmly  under  the  table.  Nonetheless,  the 
child  may  be  silently  learning  the  task 
by  watching. 


Motor  Skills 


Most  withdrawn  children  move  theii 
bodies  as  little  as  possible,  although 
tests  show  that  their  gross  and  fine 
motor  development  is  appropriate  to 
their  age  level.  Some  withdrawn  chil- 
dren sit  motionless  for  long  periods  of 
time,  or  move  only  parts  of  their 
bodies,  holding  the  rest  rigidly  still.  For 
example,  they  might  use  toys  with 
their  hands,  while  sitting  in  the  same 
spot  on  the  floor. 

When  these  children  do  use  their      i 
bodies,  their  movements  tend  to  be 
awkward,  weak,  and  quite  restricted. 
They  may  appear  to  be  poorly  coordi- 
nated. Many  withdrawn  children  have  a 
tendency  to  "fold-up"  easily  and  drop 
on  a  chair  or  to  the  floor  in  a  flabby 
heap,  as  if  their  bones  were  rubber.        ; 
Withdrawn  children  also  use  their 
bodies  to  comfort  themselves.  They  dis- 
play mannerisms  such  as  thumb  suck- 
ing, twisting  their  hair,  and  rocking. 

As  these  children  gain  self- 
confidence  and  are  helped  to  overcome 
their  need  to  withdraw,  their  body 
movements  begin  to  appear  much  more 
normal. 


Speech  and 

Language 

Skills 


Many  withdrawn  children  under- 
stand language  and  are  quite  capable  of 
speech,  but  speak  rarely  or  not  at  all  in 
preschool.  They  may  express  pleasure 
with  a  smile  that  fades  as  quickly  as  it 
appears  and  displeasure  or  discomfort 
by  whimpering  or  crying  softly.  When 
they  do  talk,  it  is  usually  in  a  voice  so 
soft  that  it  can  hardly  be  heard.  When 
these  children  timidly  request  some- 
thing in  the  classroom,  their  attempts 
to  communicate  tend  to  get  lost.  This 
is  particularly  true  since  withdrawn 
children  give  up  quickly  when  they  get 
no  response.  Talking  and  being  talked 
to  seem  to  make  withdrawn  children 
very  uncomfortable.  Often  they  will 
react  by  turning  away  or  sitting  there 
with  a  stony  face.  Since  a  withdrawn 
child  responds  to  others  so  seldom, 
other  children  soon  stop  trying  to  com- 
municate with  him  or  her,  unless  they 
see  your  continuing  efforts  to  talk  with 
the  child. 

By  their  tense,  withdrawn  behavior, 
these  children  express  loneliness,  anx- 
iety, and  a  sense  of  isolation.  But  their 
watchfulness  and  hesitant  imitations  of 
others  communicate  a  desperate  wish 
to  be  like  other  children.  Sometimes 
they  communicate  their  need  for  com- 
panionship and  security  by  pleading 
looks  or  by  clinging  to  an  adult. 


Offer  a  withdrawn 
child  a  great  deal  of 
gentle  support. 


Self-Concept 

and 

Social  Skills 


Most  withdrawn  children  think 
poorly  of  themselves  and  are  uncertain 
of  their  ability  to  do  many  tasks  suc- 
cessfully. For  example,  although  Anita 
has  made  many  necklaces  by  stringing 
beads,  she  always  begins  the  activity 
by  sajdng,  "I'm  just  dumb.  I  don't 
think  I  can  string  these  ol'  beads." 

The  way  withdrawn  children  deal 
with  their  negative  feelings  about  them- 
selves and  what  they  can  do  is  by  mov- 
ing away  from  the  group  and  into  their 
own  personal  "shell."  They  avoid  mak- 
ing a  wrong  move  by  not  moving  at  all, 
or  by  moving  with  such  unsureness 
that  nothing  is  accomplished.  Since 
they  do  not  trust  themselves  to  be  able 
to  do  anything  well,  they  either  avoid 
doing  anything  or  very  carefully 
imitate  others.  Their  discomfort  with 
others  is  evident  in  their  lack  of  respon- 
siveness. For  example,  they  may  turn 
away  when  other  children  attempt  to 
play  with  them,  refuse  to  answer  ques- 
tions, or  ignore  the  activity  around 
them.  But  they  also  have  a  tremendous 
need  for  approval,  which  shows  up  in 
their  constant  attempts  to  please  and 
to  do  (or  at  least  pretend  to  do)  as  they 
are  told.  Feeling  quite  incapable  of  deal- 
ing with  a  problem,  they  avoid  it.  They 
typically  give  up  toys  or  turns  without 
a  struggle,  looking  stunned  or  sobbing 
softly  instead.  Since  withdrawn  children 
seem  uneasy  about  receiving  comfort 
from  others,  they  comfort  themselves 
by  rocking  or  rubbing  themselves.  Not 
daring  to  let  angry  feelings  out  at 
others,  some  of  them  may  turn  on 
themselves,  falling  to  the  floor,  destroy- 
ing their  papers  or  games,  or  even 
depriving  themselves  of  a  treat. 

Feeling  incapable  of  doing  the  right 
thing  at  the  right  time  and  in  the  right 
way,  a  withdrawn  child  does  not  play 
and  relate  like  other  children.  Instead 
the  child  builds  a  protective  shell  of 
passivity  around  him-  or  herself. 


49 


50         Timid  and  apprehensive,  withdrawn 
children  are  nevertheless  aware  of  what 
is  going  on  around  them.  Many  with- 
drawn children  are  careful  observers  of 
other  children  and  adults.  They  watch 
out  of  the  comers  of  their  eyes,  but 
turn  away  quickly  if  looked  at.  In  their 
play  they  often  imitate  the  gestures 
they  have  seen  other  children  use  in 
their  games.  Sometimes  they  will 
imitate  the  entire  activity,  except  for 
vigorous  movements  and  lively  excla- 
mations. 

Most  of  the  time,  withdrawn  chil- 
dren make  no  effort  to  get  along  with 
others.  They  ignore  efforts  by  others  to 
include  them  in  play,  sometimes  turn- 
ing their  backs  to  them.  Other  times 
they  seem  quite  unaware  of  other  chil- 
dren, and  become  annoyed  when  other 
children  try  to  play  with  them,  some- 
times ruiming  away  or  whispering 
unkind  things  to  other  children. 
Because  of  these  behaviors,  it  is  very 
difficult  for  withdrawn  children  to 
develop  friendships  with  other  children. 

Many  withdrawn  children  find  their 
self-imposed  isolation  and  exclusion 
from  the  group  very  frightening.  These 
children  are  likely  to  find  separation 
from  important  adults  (such  as  a  par- 
ent) terrifying.  This  is  particularly  true 
when  a  child  enters  preschool.  The  child 
may  cling  to  his  or  her  parents,  or  just 
sit  and  sob.  In  these  cases,  adjustment 
to  preschool  may  be  a  long  and  difficult 
process.  It  may  take  many  weeks  or 
months  of  your  continued  and  caring 
attention  for  these  children  to  allow 
themselves  to  begin  to  open  up  and 
relate  to  you  and  other  cnildren  in  the 
smallest  of  ways  (for  example,  smiling 
occasionally,  showing  interest  in 
another  child's  activity,  or  asking  for 
help  when  a  task  becomes  too  difficult). 


Children 
Who  Behave 
Anxiously 


All  children  go  through  periods  of 
strong  fears  and  anxieties.  They  learn 
to  deal  with  their  fears  either  by  them- 
selves (often  in  their  play,  by  acting  out 
a  frightening  experience  such  as  a  visit 
to  the  dentist),  or  with  the  help  of  other 
people  (parents,  teachers,  and  other 
children).  But  there  are  some  children 
who  are  so  anxious  for  such  a  long  time 
that  they  can  hardly  think  of  anything 
else.  Perhaps  they  are  always  thinking 
of  the  territjle  things  that  could  happen 
to  them  or  to  others  in  their  family. 
Sometimes  this  fear  becomes  genera-      ' 
lized.  That  is,  they  begin  to  be  afraid  of 
other  things  that  reaUy  wiU  not  harm 
them.  For  example,  if  they  are  afraid  of 
a  particular  dog  in  the  neighborhood, 
they  may  begin  to  fear  all  dogs,  or  all 
animals.  This  fear  can  also  be  carried 
over  to  include  people,  things,  or  situa- 
tions. For  instance,  if  Eva  is  anxious 
about  animals,  she  may  even  begin  to 
fear  animal  crackers.  Or,  if  Anton  is       j 
afraid  of  separation  from  his  mother, 
when  he  goes  to  preschool  he  may 
begin  to  expect  something  to  happen  to 
his  mother  that  wiU  prevent  her  from 
ever  coming  back  to  take  him  home. 
Sometimes  such  extreme  anxiety 
becomes  focused  on  a  single  object, 
place,  or  situation.  When  this  occurs,  it 
can  be  called  a  phobia.  It  is  normal  for 

Ereschool  children  to  have  passing  pho- 
ias  (of  dogs,  insects,  school,  or  trains, 
for  example).  But  when  phobias  persist 
for  a  long  time  (many  months)  or 
become  so  limiting  that  they  prevent 
the  child  from  performing  his  or  her 
daily  routine,  they  go  beyond  the  limits 
of  normal.  Phobic  children  are  one  type 
of  anxious  children.  i 

Anxiety  can  make  some  children        j 
overly  fearful,  or  phobic,  but  other  anx-  ' 
ious  children  may  display  other  behav- 
iors. Anxiety  makes  some  children 
aggressive,  others  hyperactive  (overac- 
tive), and  others  withdrawn.  There  are 


some  anxious  children  who  behave  in 
all  of  these  ways,  in  a  rapid  and  confus- 
ing succession. 

Anxious  children  look  worried,  little 
things  bother  them,  and  they  cry  a  lot. 
Some  will  wet  or  soil  themselves.  Some 
will  get  stomachaches  or  headaches. 
They  might  bite  their  nails,  rub  their 
hands  together  a  lot,  or  blink  their 
eyes.  Some  bang  their  heads  against 
tne  floor  when  they  are  upset. 

Anxious  children  may  be  awkward 
and  overly  cautious.  They  get  upset 
about  falling  or  other  minor  hurts. 
Others  are  impulsive  and  impetuous  in 
an  attempt  to  hide  their  anxieties.  But 
many  of  them  show  their  anxieties  in 
their  play.  For  instance,  when  they  play 
house  or  play  with  puppets,  they  may 
act  out  fearful  situations  (such  as  tak- 
ing a  bath,  going  on  a  trip,  or  being  left 
with  a  baby  sitter  for  the  afternoon). 
They  may  become  confused  or  scared 
by  their  own  make-believe  (believing, 
for  example,  that  the  water  has  terrible 
monsters  in  it,  that  they  will  have  an 
accident  during  the  trip,  or  that  the 
baby  sitter  will  treat  them  unkindly). 
They  have  more  trouble  than  other  chil- 
dren knowing  the  difference  between 
make-believe  and  real  life. 

Most  anxious  children  are  eager  to 
do  well,  to  do  the  right  thing,  and  not 
to  make  mistakes.  They  may  be  skillful 
but  insist  that  they  "can't  do  it." 
Tfeachers  often  call  them  perfectionists 
because  they  want  everything  they  do 
to  be  perfect.  If  they  tear  their  picture, 
for  example,  they  mil  insist  on  making 
a  new  one  rather  than  repairing  the 
torn  one.  They  may  refuse  to  stop  an 
activity  until  it  is  completed  to  their 
satisfaction. 

Meiny  anxious  children  wiU  stay 
away  from  "messy"  activities  such  as 
finger  painting  or  building  with  clay. 
They  may  get  upset  when  there  is  a 
spot  on  their  clothes  or  arms,  and  they 
may  wash  their  hands  a  lot.  They  tend 
to  avoid  playing  with  children  their 
own  age,  preferring  to  play  with 
younger  children  or  grownups. 


Anxious  children  do  best  in  situa- 
tions where  they  understand  everything 
that  is  going  on  and  when  they  know 
exactly  what  to  expect.  They  like  to  do 
familiar  things  in  tne  same  way  each 
time.  They  do  not  like  changes  and  can 
become  really  upset  and  frightened  of  a 
new  experience  such  as  a  field  trip  or 
trjdng  a  new  game.  They  are  very 
troubled  by  unstructured  situations, 
such  as  the  transition  from  one  activity 
to  another.  Many  anxious  children  get 
upset  at  rest  time  because  it  is  unstruc- 
tured. They  may  feel  that  if  they  relax 
too  much  they  will  lose  control  of  the 
situation. 

In  teaching  children  who  are  anx- 
ious, it  is  very  important  to: 

•  reassure  them  about  the  obvious 
("You  will  be  very  safe  on  the  field 
trip.  We  wiU  all  go  and  come  back 
on  the  bus  together.") 

•  explain  clearly  what  is  expected  of 
them 

•  reassure  them  that  you  are  confi- 
dent in  their  abilities  to  do  what 
others  can  do. 


51 


Anxiety  can  lead  to  random,  repetitive 
busy  work. 


^^  Cognitive 
Skills 

Anxious  children  generally  under- 
stand how  to  use  materials  because 
they  spend  a  great  amount  of  time 
silently  and  secretively  watching 
others.  However,  their  tentative,  half- 
hearted efforts  and  their  reluctance  to 
try  new  things  may  delay  their  mastery 
of  skills. 

Anxiety  usually  interferes  with  the 
thinking  of  these  children.  An  anxious 
child  might  suddenly  forget  the  steps 
necessary  to  continue  a  game  or  project 
and  become  confused.  This  leads  to  ran- 
dom, repetitive  "busy  work."  For  exam- 
ple, in  tne  middle  of  a  lotto  game, 
Hisako  was  suddenly  unable  to  match 
any  more  pictures.  She  began  to  wail 
that  somebody  had  taken  the  picture 
she  was  looking  for.  Making  no  further 
effort  to  participate  in  the  game,  she 
resorted  to  counting  the  lotto  cards 
over  and  over  again. 


Speech  and 

Language 

SkiUs 


Many  anxious  children  are  expert 
talkers.  Most  of  their  talk  relates  to 
their  fears  and  concerns.  Though  they 
may  talk  a  lot  and  quite  clearly,  what 
they  say  is  often  confused  and  therefore 
hard  to  understand,  t'or  example, 
Hsiao-Ti  said  to  the  teacher,  "Before 
the  cookies  got  on  the  table,  I  got  aU 
eaten  up."  But  what  she  really  meant 
was,  "I  got  the  cookies  on  the  table 
before  they  were  cdl  eaten  up." 

Other  anxious  children  may  com- 
municate mostly  in  non-verbal  ways. 
They  tend  to  communicate  with  eye 
contact  and  tentative  or  fearful  ges- 
tures. Some  whimper  or  cry  when 
upset,  waiting  for  others  to  figure  out 
what  is  wrong. 


Social  SkiUs 


When  they  are  feeling  less  anxious, 
many  of  these  children  can  play  and 
get  along  well  with  other  cMdren.  Usu- 
ally, though,  they  tend  to  watch  from  a 
safe  distance,  and  become  upset  when 
other  children  are  noisy  or  come  too 
close.  If  they  become  too  uncomfort- 
able, they  may  suddenly  turn  on  other 
children  with  aggression  (for  example, 
grab  a  toy  away  from  another  child,  or 
say  unkind  things).  They  show  their 
interest  in  others  by  watching  and  com- 
menting on  their  activity.  Their  com- 
ments often  describe  possible  disasters 
("It's  going  to  fall,"  "We're  going  to 
get  lost"). 

On  the  other  hand,  anxious  children 
tend  to  be  very  dependent  upon  and 
demanding  of  adults,  constantly  seek- 
ing help  and  reassurance.  For  example, 
on  a  trip  to  the  zoo,  Johnny  insisted  on 
holding  Mrs.  Jay's  hand  and  asked 
repeatedly,  "The  animals  can't  get  out 
of  the  cages,  can  they?"  Anxious  chil- 
dren may  tell  the  teacher  what  other 
children  are  doing  wrong  in  order  to 
have  teachers  stop  the  behavior  that  is 
upsetting  them.  At  other  times, 
though,  they  may  withdraw  entirely 
from  adults  and  show  no  need  to  be 
demanding,  dependent,  or  eager  for 
approval. 

Motor  Skills 

Although  tests  generally  indicate 
that  anxious  children  have  the  potential 
for  normal  gross  and  fine  motor  devel- 
opment, their  body  movements  appear 
restricted,  tense,  and  awkward.  TTieir 
anxiety  makes  them  overly  cautious 
and  often  timid.  They  seem  unable  to 
put  their  "whole  selves"  into  any  activ- 
ity. Because  of  the  tension  in  their 
body  movements,  it  is  often  difficult  toi 
tell  how  weU  coordinated  they  may  be. 
In  manipulating  objects,  they  may  be 
extremely  gentle,  barely  touching  the 
object.  Sometimes  their  hands  and  fin- 
gers may  tremble,  making  assembly  of 
puzzles,  form  boards,  and  other  objects 
difficult. 


Self-Concept 


Anxious  children  tend  to  be  fearful, 
unsure  of  themselves  and  their  abilities. 
They  often  say  that  they  cannot  do 
what  is  asked  of  them.  For  example,  an 
anxious  girl  may  stop  midway  in  mak- 
ing an  Easter  basket,  even  though  she 
is  actually  able  to  complete  the  task.  If 
you  tell  her  that  you  believe  she  can 
finish  the  basket  and  offer  some  direct 
help,  she  may  begin  to  feel  that  she  can 
successfully  complete  the  project. 

Most  anxious  children  like  to  be 
praised  for  their  skills.  They  work  hard 
to  please  the  teacher  and  themselves. 
They  are  overly  sensitive  to  criticism 
and  truly  afraid  of  disapproval  and/or 
punishment.  Many  of  them  worry 
about  what  others  think  of  them  and 
about  what  others  might  do  to  them. 
Often  they  don't  know  themselves  what 
they  want,  but  they  don't  Uke  other 
people  telling  them  what  to  do,  either. 

Anxious  children  are  often  overly 
sober  and  serious.  But  they  may  sud- 
denly get  excited  with  outbursts  of  cry- 
ing or  anger,  or  with  speUs  of  uncon- 
trollable laughter. 


Children 
Who  Behave 
Aggressively 


Assertiveness  is  a  valuable  charac- 
teristic. It  helps  children  be  active  and 
energetic  and  get  to  work  on  their  own. 
But  assertiveness  has  its  negative  side, 
too.  It  can  cause  children  to  have  angry 
outbursts,  to  snatch  away  toys,  to  hurt 
others,  or  to  destroy  things.  Some  chil- 
dren have  learned  that  a  verbal  or 
physical  attack  is  an  effective  way  to 
get  what  they  want:  a  toy,  attention 
from  an  adult,  and  so  on.  In  the  class- 
room, though,  most  children  learn  more 
effective  ways  of  interacting  with 
others,  especially  with  some  help  from 
the  teacher. 

As  you  are  well  aware,  some  chil- 
dren are  more  easily  irritated  or 
angered  than  others.  Some  have  a  hard- 
er time  controlling  themselves  than 
others.  Nevertheless,  their  aggressive 
outbursts  fall  within  the  normal  range 
of  behavior  if  they  are  occasional  occur- 
ences. A  child  is  considered  disturbed 
only  when  his  or  her  typical  ways  of 
reacting  to  others  are  by  forceful  and 
uncontrolled  physical  aggression  (hit- 
ting, biting,  scratching,  kicking)  and/or 
by  verbal  aggression  (shouting,  scream- 
ing, cursing,  name-calling). 

Aggressive  children  tend  to  hurt 
others  with  or  without  provocation. 
Some  of  them  respond  with  anger  only 
to  particular  situations,  as  when  they 
can't  have  a  toy.  Others  will  explode 
more  at  times  of  stress,  such  as  when 
they  are  tired  or  have  been  confined  to 
a  small  space  for  a  long  time.  Still 
others  seem  to  use  aggression  as  their 
major  means  of  communication.  These 
children  appear  to  be  angry  deep  down 
inside  and  very  suspicious  or  hateful 
toward  people  in  general.  Even  after 
hurting  or  upsetting  another  person, 
the  aggressive  child  is  unable  to  calm 


53 


54    down  or  to  refrain  from  the  next  out- 
burst. Many  of  them  are  quite  destruc- 
tive. You  may  see  these  children  ripping 
books,  pulling  dolls  apart,  or  breaking 
crayons  into  oits.  They  may  also  be 
very  demanding  and  impatient.  They 
may  play  with  other  children  for  a 
while  and  then  suddenly  push  them  out 
of  the  way  or  grab  their  toys.  They 
may  disturb  others,  interrupt  or  inter- 
fere with  their  play,  and  refuse  to  coop- 
erate with  the  teacher. 

Though  these  children  may  appear 
to  be  bullies,  their  hard,  aggressive 
behavior  is  the  way  in  which  they  cover 
up  their  inner  sense  of  fear,  vulnerabil- 
ity, and  inferiority.  Aggressive  children 
are  actually  fearful  of  their  own  aggres- 
sion and  of  attack  by  other  people.  For 
example,  in  the  midst  of  an  attack  on 
another  child,  an  aggressive  child  may 
suddenly  appear  to  be  anxious  and  con- 
fused. This  is  because  he  or  she  may 
desperately  want  to  get  away  from  the 
situation  to  hide  his  or  her  lack  of  self- 
control. 

Even  the  most  aggressive  child  does 
not  fight  all  the  time.  He  or  she  can 
become  deeply  involved  in  activities 
and  usually  enjoys  vigorous  play.  How- 
ever, aggressive  children  are  set  off 
more  easily  than  other  children.  At 
times  you  may  be  able  to  identify  those 
situational  or  environmental  factors 
that  provoke  aggressive  behavior.  They 
are  likely  to  include  such  things  as: 

•  over-stimulation 

•  seeing  violence  among  adults 

•  inadequate  space  for  motor 
activity 

•  growing  up  in  an  aggressive 
environment. 

At  other  times  it  wiU  be  difficult  to 
determine  what  provokes  the  aggres- 
sive behavior  because  almost  anything 
appears  to  set  off  the  child.  As  you 
begin  to  learn  about  the  child,  his  or 
her  environmental  needs  (for  example, 
the  noise  or  activity  level  that  pro- 
motes less  aggressive  behavior  and 
encourages  concentration),  and  suitable 
outlets  for  aggressive  behavior  (for 
example,  a  punching  bag)  you  will  be 
able  to  work  more  effectively  with  him 
or  her. 


Cognitive 
SkiUs 


Most  aggressive  children  learn  and   i 
enjoy  all  age-appropriate  cognitive  ' 

tasks.  Some  children,  however,  are  eas- 
ily distracted  by  the  activity  of  other 
children  or  by  their  own  need  to  change 
activities  frequently.  This  lack  of  con- 
centration is  most  often  seen  in  aggres- 
sive children  who  are  also  learning 
disabled. 

Many  aggressive  children  are  a  lot 
more  capable  than  their  poor  self-image 
and  anxious  distrust  permit  them  to  be. 
Their  cleverness  may  be  expressed  in 
fighting  rather  than  in  constructive 
accomplishments.  However,  with  reas- 
surance, structure,  and  redirection  (hit- 
ting a  punching  bag  instead  of  children, 
pounding  nails  instead  of  the  teacher, 
knocking  down  tenpins  instead  of  block 
buildings),  they  often  are  able  to  show 
their  real  constructive  ability. 


Lacking  confidence,  an  aggressive  child  may 
throw  the  play-dough  rather  than  attempt  to 
make  something. 


Speech  and 

Language 

SkiUs 


Many  aggressive  children  have  a 
good  command  of  speech  and  language 
skills,  similar  in  development  to  other 
preschool  children.  They  can  tell  you 
clearly  what  they  want  and  how  they 
feel  ("I'm  gonna  eat  all  dem  cookies. 
They's  all  mine!").  While  the  message 
of  their  communication  tends  to  be 
more  hostile  than  friendly,  many 
aggressive  children  do  convey  an  eager- 
ness for  positive  relationships  ("You  re 
my  friend,  come  play  with  me"). 

Other  aggressive  children  communi- 
cate physicaSy  more  than  verbally. 
They  will,  for  example,  grab  a  toy  from 
another  child  rather  than  ask  for  it. 
You  can  help  these  children  by  gently 
reminding  them  to  use  words  to  com- 
mimicate  what  they  want. 


Motor  Skills 


Most  aggressive  children  show  good 
potential  for  doing  activities  that 
require  gross  and  fine  motor  coordina- 
tion. They  enjoy  vigorous  whole  body 
movements  (running,  climbing,  jump- 
ing, throwing,  pounding,  and  so  on), 
and  may  be  particularly  quick  to  learn 
such  gross  motor  skills.  However,  care- 
lessness about  their  own  safety  may 
lead  to  sudden,  uncoordinated  moves, 
causing  tumbles  or  head-on  collisions. 
When  upset,  they  may  be  particularly 
awkv^'ard  and  use  gross  motor  activity 
as  a  way  of  avoiding  or  getting  away 
from  the  upsetting  situation.  Fine 
motor  tasks  that  require  patience  and 
continued  effort  (such  as  putting  a  puz- 
zle together)  are  more  difficult  for 
aggressive  children.  They  may  need  to 
take  many  breaks  from  a  simple  fine 
motor  task  in  order  to  complete  it. 

You  can  encourage  better  use  of  fine 
and  gross  motor  skills  by  observing  the 
child  to  determine  how  much  space  he 
or  she  needs  to  perform  a  task  comfort- 
ably and  successfully,  and  without 
infringing  upon  the  space  of  other  chil- 
dren. For  example,  if  you  notice  that 
Carl  is  drawing  all  over  the  table 
instead  of  the  paper,  perhaps  he  needs 
a  bigger  piece  of  paper.  If  a  bigger 
piece  of  paper  is  unmanageable  at  the 
table  with  other  children,  you  can  try 
taping  a  larger  piece  to  the  wall  close  to 
where  other  children  are  working. 

Self-Concept 

Many  aggressive  children  appear  to 
think  poorlv  of  themselves.  They  are 
frightened  oy  their  own  uncontrolled 
behavior  and  fear  aggression  in  others. 
They  tend  to  destroy  their  work  and 
declare  that  it  was  "no  good."  Aggres- 
sive children  lack  confidence  and  are 
reluctant  to  learn  nev/  skills.  For  exam- 
ple, they  might  throw  the  play  dough 
at  other  children  rather  than  try  to 
make  an  object  out  of  it.  They  need 
praise  and  reassurance  to  help  them 
feel  better  about  themselves. 


55 


56 


Social  Skills 


Aggressive  children  have  great 
trouble  relating  to  people.  Although 
they  are  often  eager  to  be  friendly,  it  is 
difficult  for  them  to  learn  to  trust 
others.  Their  response  to  other  people 
is  determined  more  by  their  own  feel- 
ings than  by  the  way  other  people  treat 
them.  They  tend  to  be  angry  or  hostile, 
demanding,  and  defiant.  They  often 
defeat  their  friendly  intentions  by  hurt- 
ing others.  For  example,  they  may  say 
something  that  sounds  mean,  or 
squeeze  another  child's  hand  too  hard. 
They  occasionally  play  with  others,  but 
the  unpredictability  of  their  attacks 
makes  friendship  difficult.  Additionally, 
they  have  a  tendency  to  strike  out 
when  they  sense  the  negative  reaction 
they  are  provoking  in  others.  You  may 
hear  an  aggressive  child  say,  for  exam- 

Ele,  "I  hit  him  because  he  was  going  to 
it  me!" 

Frequently,  other  children  will 
exclude  an  aggressive  child  from  their 
play.  This  upsets  the  child  even  more. 
He  or  she  may  react  by  even  more 
aggressive  attacks,  or  by  crying  piti- 
fully. In  such  a  situation,  the  teacher 
can  help  by  suggesting  behavior  that  is 
more  acceptable  to  the  other  children, 
by  encouraging  the  other  children  to 
accept  the  child  and  help  him  or  her 
learn,  and  by  standing  by  protectively 
to  ensure  success. 


Aggressive  children  need  more  pro- 
tection than  people  usually  realize. 
They  need  protection  from  physical  and 
verbal  attack  by  others  as  well  as  from 
their  own  outbursts.  Without  this  pro- 
tection, their  aggression  wiU  only 
increase.  Gaining  control  is  a  difficult 
task  for  aU  young  children,  but  is  a  par- 
ticularly painful  and  slow  process  for 
aggressive  children.  The  teacher  can 
assist  such  children  toward  self-control 
by  letting  them  know  that: 

•  he  or  she  understands  how  hard 
the  process  is 

•  he  or  she  has  confidence  in  their 
ability  to  learn  self-control 

•  he  or  she  will  try  to  protect  them 
from  hurting  or  being  hurt 

•  he  or  she  will  permit  them  to  con- 
trol their  own  behavior  as  they 
demonstrate  increasing  ability  to 
do  so. 


Children 
Who  Behave 
Hyperaetively 


At  one  time  or  other,  most  children 
seem  to  have  an  unlimited  supply  of 
energy.  This  is  particularly  true  when 
they  are  overstimulated  or  excited. 
They  may  rush  around  so  fast  and  for 
so  long  that  it  is  exhausting  just  to 
watch  them!  Such  behavior,  however,  is 
a  normal  part  of  a  child's  development, 
because  it  is  generally  seen  in  combina- 
tion with  less  active  behavior. 

However,  there  are  some  children 
whose  typical  way  of  behaving  is  to  be 
constantly  on  the  move.  These  children 
are  called  hyperactive  or  hyperkinetic. 
When  other  children  might  be  merely 
lively  and  enthusiastic,  these  children 
become  overexcited.  They  cannot  wait 
for  explanations  or  turns,  and  seldom 
pause  long  enough  to  relax,  to  watch, 
or  to  listen  to  what  is  going  on.  They 
tend  to  rush  without  purpose  into  situ- 
ations, endangering  themselves  or 
others.  For  example,  they  may  build  a 
block  structure  so  quickly  that  it  tum- 
bles down,  or  pour  juice  so  fast  that  it 
spills  all  over. 

Hyperactive  children  cannot  tolerate 
not  being  able  to  move  around  freely. 
When  they  do  manage  to  sit  down, 
their  bodies  squirm,  turn,  and  twist.  It 
is  impossible  for  them  to  stay  with  a 
chosen  activity  for  any  reasonable 
period  of  time:  their  ability  to  attend  to 
a  single  task  may  be  as  short  as  ten  to 
twenty  seconds!  They  seem  unable  to 
screen  out  unimportant  noises,  which 
make  them  even  more  restless  and  scat- 
tered. 


Because  hyperactivity  may  have 
either  physical  or  emotional  causes  and 
because  no  two  children  are  the  same, 
hyperactivity  can  be  expressed  in  a 
variety  of  ways.  Some  hyperactive  chil- 
dren may  appear  very  anxious.  Others 
may  be  aggressive  toward  other  chil- 
dren. Frequently  they  get  in  the  way  of 
others,  often  without  meaning  to  or 
even  realizing  that  they  are  causing  a 
disruption.  They  may  also  show  aggres- 
sive behavior  when  they  meet  with  a 
challenge  or  a  restriction,  rushing 
around  needlessly  and/or  having  a  tem- 
per outburst. 

Most  hyperactive  children  do  have 
peaceful,  contented  moments,  when 
they  play  and  relate  happUy.  But  their 
mood  swings  are  more  extreme  than 
those  of  other  young  children  and  their 
behavior  is  more  inconsistent.  Their 
hyperactivity  normally  can  be  seen  in 
their  difficulty  with  relationships  with 
other  children,  their  poor  attention 
span,  and  their  lack  of  control  over 
gross  and  fine  motor  movements. 


57 


Schedule  and  time 
activities  well  to  pre- 
vent a  hyperactive 
child  from  losing 
interest. 


^^  Speech  and 
Language 
SkiUs 


Many  hyperactive  children  under- 
stand and  can  use  language  well.  How- 
ever, because  they  have  difficulty  stay- 
ing with  a  task  or  keeping  their  mind 
on  what  they  want  to  say,  they  may 
alter  or  confuse  the  meaning  of  their 
thoughts,  making  it  difficult  to  get  the 
drift  of  what  they  are  saying.  Their 
speech  gives  you  a  sense  of  urgency 
and  bewilderment  rather  than  a  sharing 
of  information  and  ideas.  In  addition, 
their  speech  is  often  so  fast  that  they 
run  words  and  thoughts  together.  For 
these  reasons,  most  hyperactive  chil- 
dren rely  primarily  on  body  language  to 
express  themselves.  They  need  to  be 
encouraged  to  express  themselves  in 
words. 


Cognitive 
SkiUs 


Hyperactive  children  have  difficulty 
acquiring  cognitive  skills  because  of 
their  inability  to  sit  quietly,  listen  to 
instructions  or  explanations,  and  con- 
centrate on  a  task.  If  they  pursue  the 
task  and  it  becomes  more  oifficult,  they 
quickly  lose  interest  and  move  off  to 
something  else. 

In  their  calm  moments  hyperactive 
children  may  show  far  more  Imowledge 
and  ability  than  their  usual,  scattered 
performance  would  lead  one  to  expect. 
These  calm  moments  are  best  realized 
when  the  noise  level  of  the  classroom  is 
low  and  the  room  isn't  too  crowded. 


Self-Concept 

Many  hyperactive  children  think 
poorly  of  themselves.  They  are  usually 
aware  of  and  troubled  by  their  uncon- 
trolled behavior.  It  is  frustrating  for 
them  to  make  mistakes  (to  knock  over 
the  blocks  or  spill  the  juice),  because 
they  really  want  to  play  and  get  along 
with  others.  All  day  long  they  seem  to 
be  searching  actively  for  something 
they  need  and  can't  find.  As  they  rush 
about  they  may  injure  themselves  fre- 
quently, which  can  make  them  feel 
helpless  and  unprotected.  One  minute 
they  may  be  cheerful,  the  next  crying 
and  miserable. 

Social  SkiUs 

Hyperactive  children  are  generally 
friendly  toward  adults  and  other  chil- 
dren and  want  to  be  liked.  They  fre- 
quently offer  to  help  adults  and  tiy 
tneir  best  to  please.  However,  they 
have  difficulty  playing  with  other  chil- 
dren because  of  their  inability  to  con- 
centrate on  tasks  during  cooperative 
and  interactive  play,  and  their  inability 
to  remain  part  of  a  group  except  for 
brief  periods  of  time.  Peaceful  moments 
of  plajdng  with  other  children  are  often 
interrupted  by  sudden  swings  in  mood 
or  imcontrolled  behavior.  They  may 
become  aggressive,  or  get  in  the  way  of 
others  without  meaning  to.  Their  inabil- 
ity to  wait  for  a  turn  may  make  the 
other  children  angry.  Also,  their  inces- 
sant, confused  talk  may  be  irritating  to  ; 
the  others.  i 

! 
I 

When  the  boundless  energy  of  ' 

hyperactive  children  is  guided  toward     <. 
active  tasks  and  play  (arranging  tables 
and  chairs,  washing  paint  brushes,  help- 
ing to  set  up  playground  equipment), 
these  children  can  function  and  cooper- 
ate well.  But  restriction  can  lead  to 
needless  running  and  to  temper  out- 
bursts. 


Motor  Skills 

The  hardest  task  for  hyperactive 
children  is  making  appropriate  use  of 
gross  and  fine  motor  skills.  They  sim- 
ply can't  help  moving  their  bodies 
nearly  all  the  time,  often  in  an  uncon- 
trolled manner.  This  constant  move- 
ment makes  functioning  in  other  areas 
very  difficult  as  well. 

Although  these  children  seem  to 
enjoy  gross  motor  play  such  as  cUmb- 
ing,  bike  riding,  and  jumping,  their 
motor  development  is  imeven  and  is 
often  influenced  by  how  well  they  have 
learned  to  play  with  other  children. 
They  may  seem  perfectly  able,  for 
example,  to  throw  a  ball  against  a  wall, 
but  have  difficulty  throwing  the  ball  to 
another  child.  In  addition,  a  number  of 
experts  believe  that  many  hyperactive 
children  have  perceptual  and  coordina- 
tion problems.  This  may  account  for 
the  many  accidents  these  children  have: 
bumping  into  walls,  tables,  children,  or 
building  blocks;  stumbling  or  tripping; 
spilling;  and  so  on. 


Children 
Whose  Behavior 
Is  Psychotic 


Professionals  differ  in  their  under- 
standing of  the  severe  disorders  of 
childhood  commonly  referred  to  as 
childhood  psychosis.  No  one  is  really 
sure  what  causes  psychotic  disorder  in 
a  very  young  child,  and  many  persons 
have  spent  their  professional  careers 
trying  to  prove  whatever  theory  they 
believe  about  the  causes  of  psychosis. 
Many  use  other  diagnostic  terms  to  dis- 
tinguish types  of  psychotic  disorders, 
such  as  autism,  atypical  development, 
borderline  states,  and  childhood  schizo- 
phrenia. Some  professionals  feel  these 
diagnostic  terms  refer  to  real  differ- 
ences in  behavior  among  psychotic  chil- 
dren, while  others  do  not  oeUeve  the 
differences  are  sufficiently  clear-cut. 
This  book  describes  psychotic  disorders 
in  general,  making  no  distinction  in 
type. 


59 


A  psychotic  child  will 
need  your  gentle 
encouragement  during 
transition. 


60         In  spite  of  professional  disagree- 
ment over  diagnostic  terms  and  possi- 
ble causes  of  psychosis,  most  profes- 
sionals agree  that  this  group  of  child- 
hood disorders  presents  very  special 
educational  challenges.  Children  whose 
behavior  is  psychotic  need  to  be  worked 
with  by  highly  trained  persons.  They 
are  rarely  mainstreamed  into  a  Head 
Start  or  other  preschool  setting,  except 
when  other  specialized  facilities  are 
unavailable. 

Most  professionals  also  agree  that 
regardless  of  the  diagnostic  term,  there 
are  some  clusters  of  symptoms  that  are 
usually  present  in  most  childhood  dis- 
orders in  this  group.  In  their  book, 
Autism  (New  York:  Halstad  Press, 
1976),  Edward  Orwitz  and  Edward 
Ritvo  list  five  clusters  of  symptoms: 

•  problems  in  the  way  the  child  per- 
ceives the  world  (cognitive  skills) 

•  problems  in  the  sequence  and  rate 
at  which  the  child  achieves  certain 
developmental  milestones  (cogni- 
tive slaUs) 

•  problems  in  speech  and  language 
development  (speech  and  language 
skills) 

•  problems  in  forming  relationships 
with  other  people  (social  skills) 

•  problems  in  the  way  the  child  uses 
his  or  her  body  (motor  skills). 


Cognitive 
SkiUs 


Psychotic  children  have  many  prob- 
lems with  learning.  Often  their  thinking 
is  confused.  For  instance,  they  mix  up 
events  that  happened  long  ago  with 
events  that  are  happening  right  now, 
much  more  often  and  for  a  much  longer 
time  than  is  normal  for  yoimg  children. 
They  also  get  confused  when  objects 
are  moved  to  different  places.  For 
example,  when  the  tables  and  chairs 
were  moved  around,  Maria  suddenly 
did  not  know  where  she  was.  She  began 
to  wail  that  she  was  lost.  Later  on  she 
complained  that  the  tables  and  chairs 
were  "lost."  Psychotic  children  seem 
particularly  confused  when  they  have 
to  adjust  to  changes  in  routine,  such  as 
during  transition  times,  trips,  and  vaca- 
tions. 

Many  psychotic  children  seem  to 
have  problems  learning  through  hearing 
and  seeing.  They  have  an  exaggerated 
response  to  both:  they  either  complete- 
ly ignore  what  can  be  heard  and  seen, 
or  they  get  overexcited  by  soimds  and 
by  things  they  see.  Some  prefer  to 
learn  through  their  sense  of  touch  or 
their  sense  of  smell.  As  with  other  chil- 
dren, it  is  a  good  idea  to  teach  psy- 
chotic children  through  the  channels  to 
which  they  are  most  receptive.  Four- 
year-old  Paul  seemed  "deaf"  to  all  the 
talking  around  him,  but  his  teacher 
knew  that  he  loved  music.  She  was 
delighted  when  he  memorized  an  entire 
song  from  a  record,  and  decided  to  use 
music  as  a  bridge  for  teaching  him.  She 
began  by  making  up  a  song  with  Paul 
about  daUy  routines,  to  help  him  make 
transitions  more  easily. 


Unless  you  intervene, 
a  psychotic  child  may 
repeat  a  task  over  and 
over. 


Psychotic  children  are  quite  uninter- 
ested in  social  games  like  pla)dng 
house,  and  most  will  stay  away  from 
creative  play  like  modeling  clay.  How- 
ever, some  psychotic  chil(&en  can  learn 
to  do  some  tasks  very  well.  Some  of 
them  have  an  easy  time  with  sym- 
bols (such  as  numbers,  letters,  and/or 
words),  which  they  enjoy  manipulating 
(counting,  adding,  or  making  up  little 
stories  or  poems).  Many  of  these  chil- 
dren are  excellent  at  manipulating  toys 
and  doing  puzzles.  Their  aoility  to  put 
together  construction  sets,  puzzles,  and 
other  problem-solving  games  that 
depend  on  manipulation  is  limited  only 
by  their  tendency  to  repeat  endlessly 
the  same  task.  Plepeating  tasks  in  this 
way  helps  them  to  master  some  skills, 
but  it  also  limits  their  opportunity  to 
learn  other  skills. 

Some  psychotic  children  have  a  fan- 
tastic memory.  Some,  in  fact,  don't 
seem  to  be  able  to  forget  anything  that 
has  ever  troubled  them.  For  example, 
Kenny's  favorite  phonograph  record  got 
a  crack  in  it.  Kenny  continued  to  look 
for  that  crack  and  complain  about  it, 
long  after  the  record  had  been  replaced. 
His  concern  about  the  damaged  record 
persisted  for  a  long  time,  and  came  out 
during  activities  that  were  in  any  way 
related  to  record  playing.  Other  psy- 
chotic children  seem  to  remember  ran- 
dom facts,  which  they  string  together 
in  a  way  that  may  have  little  meaning 
to  the  listener. 

Psychotic  children  have  definite  pref- 
erences for  toys  and  will  usually  do  well 
with  those  toys  that  appeal  to  them. 
They  may  become  deeply  involved  with 
their  play,  and  continue  with  a  task  no 
matter  what  is  happening  in  the  room. 
In  fact,  they  are  apt  to  get  upset  when 
they  are  stopped,  unless  they  are 
encouraged  to  move  from  one  activity 
to  another  without  having  to  give  up 
the  first  (for  example,  taking  the  toys 
they  have  been  working  with  to  the 
snack  table).  You  can  facilitate  the 
learning  experiences  of  these  children 
by  having  their  routines  remain  the 


same,  keeping  the  toys  and  materials  in 
a  consistent  location,  and  having  the 
people  who  are  important  to  them 
remain  a  constant  part  of  the  preschool 
staff. 

Perception  of  the  World 

Children  with  psychotic  disorders 
may  seem  too  sensitive  or  not  sensitive 
enough  to  such  stimuli  as  sights, 
sounds,  tastes,  touch,  pain,  and  tem- 
perature. Some  children  may  overre- 
spond  to  the  tactual  feeling  and/or 
temperature  of  objects.  Others  may  not 
respond  at  all. 

Sometimes  there  may  be  rapid 
shifts  in  the  sensitivity  of  one  child.  At 
times  he  or  she  may  be  unresponsive  to 
high  degrees  of  stimulation.  At  other 
times  the  child  may  seem  completely 
overwhelmed  by  even  a  mild  degree  of 
the  same  stimulus. 


Sequence  and  Rate  of 
Development 

The  most  striking  quality  of  psy- 
chotic children  is  that  they  don't  seem 
to  develop  and  act  in  ways  typical  for 
their  age.  Sometimes  they  may  seem  to 
be  generally  delayed  in  everything. 
Most  often,  however,  what  is  striking  is 
the  unevenness  of  their  progress. 

Their  functional  development  is  gen- 
erally very  uneven  in  nearly  all  skill 
and  behavioral  areas.  A  child  who  han- 
dles his  or  her  body  very  well  may  be 
very  late  in  learning  to  talk.  Another 
child  may  learn  to  talk  almost  perfectly 
at  a  very  early  age,  but  have  no  idea  of 
how  to  use  words  to  communicate  with 
other  people  or  to  get  what  he  or  she 
wants.  At  times  a  child  may  use  lan- 
guage with  clarity  of  meaning.  At  other 
times  the  same  child  wiU  seem  unable 
to  use  language  at  all. 

Psychotic  children  rarely  function  in 
a  whole  and  iategrated  manner.  This 
quality  accounts  for  the  colloquial  and 
unkind  terms  that  are  often  used  to 
describe  such  children.  "Crazy," 
"cracked,"  and  "mental"  refer  to  the 
broken  and  fragmented  functioning  of 
these  children's  minds. 


61 


^^  Speech  and 
Language 
SkiUs 


In  general,  a  psychotic  child  seems 
either  to  avoid  communicating  or  to  be 
unable  to  communicate.  Many  psy- 
chotic children  can  be  taught  communi- 
cation skills.  However,  they  wiU  only 
use  these  skills  on  their  own  when  they 
begin  to  relate  to  others.  Other  psy- 
chotic children  may  never  learn  to  talk. 

Some  psychotic  children  may  show 
that  they  do  understand  and  can  use 
language  in  an  imitative  way.  They 
may  echo  the  end  of  whatever  is  said  to 
them,  and  speak  in  an  artificial,  parrot- 
like voice  that  does  not  express  reeling 
or  have  the  normal  rhythm  and  inflec- 
tion of  a  sentence.  Some  may  repeat 
rhymes  and  the  words  to  television 
commercials  as  though  they  made  up  a 
private  language.  Sentences  may  be 
strung  together  that  have  little  mean- 
ing to  the  listener.  For  example,  at 
lunch,  the  teacher  asked  TiUy  if  she 
wanted  more  carrots.  In  a  high-pitched 
voice,  TlUy  repeated  the  teacher  s  words 
exactly:  "Do  you  like  more  carrots, 
inly  honey?"  and  then  shouted  a  com- 
plete advertisement  about  a  supermar- 
ket. While  there  was  no  apparent  con- 
nection between  the  supermarket  adver- 
tisement and  the  children's  lunch,  Tilly 
did  seem  to  be  trjdng  to  respond  and 
commimicate. 

Psychotic  children  tend  to  confuse 
words  that  are  associated  with  each 
other  (pail  and  shovel,  for  example). 
Some  may  use  odd  "code  words  '  to 
refer  to  things.  While  many  children 
may  do  these  things  when  they  are 
first  learning  to  speak,  they  usually  cor- 
rect themselves  as  they  get  older, 
whereas  psychotic  children  do  not.  Psy- 
chotic chll(i-en  also  typically  confuse 
"you"  with  "I." 


The  body  language  of  psychotic  chil- 
dren communicates  their  isolation  from 
and  fear  of  people:  no  social  smile,  no 
eye  contact,  and  turning  or  moving 
away  from  people  who  try  to  approach 
them.  They  communicate  their  confu- 
sion by  getting  upset  when  they  have 
to  deal  with  change,  but  their  concen- 
trated play  also  communicates  their 
real  ability  to  enjoy  manipulating  and 
learning. 


Psychotic  children  often  seem  to  enjoy 
manipulating  and  learning. 


Social  SkiUs 


Psychotic  children  rarely  develop 
meaningful  relationships  with  other 
people.  Most  avoid  contact  with  others. 
They  may  not  smile,  make  direct  eye- 
to-eye  contact,  or  reach  out  to  be 
picked  up.  Some  may  become  overly 
attached  to  one  person  and  frightened 
of  all  others.  Some  may  cling  to  adults 
during  times  of  distress,  but  refuse  to 
relate  at  any  other  time.  Some  may 
seem  unable  to  distinguish  at  all  among 
different  people.  Still  others  may  seem 
completely  unaware  of  the  existence  of 
others,  or  may  prefer  inanimate  objects 
to  people. 

Other  children  can  usually  adjust  to 
a  psychotic  child's  avoidance  of  contact. 
They  can  play  side-by-side  with  no 
problem,  unless  or  until  the  psychotic 
child  becomes  destructive  and  unpre- 
dictable. Such  outbursts  should  be 
explained  as  clearly  as  possible  to  other 
children  when  the  child  enters  the  class. 
Of  course,  you  will  want  to  help  the 
child  to  limit  these  outbursts  as  much 
as  possible. 


Motor  Skills 


Gross  and  fine  motor  coordination 
may  or  may  not  be  well  developed.  In 
either  case,  psychotic  children  tend  to 
use  their  bodies  in  very  strange  ways, 
such  as  walking  in  circles,  rocking  back 
and  forth,  moving  their  arms  up  and 
down  in  flapping  motions,  and  so  on. 
They  may  walk  pigeon-toed  or  glide 
gracefully  about  the  room.  Some  psy- 
chotic children  spend  long  periods  of 
time  in  what  loots  like  an  uncomfort- 
able position.  Others  may  sway  back 
and  forth  a  lot.  StUl  others  may  walk 
around  and  around  the  room  in  exactly 
the  same  order  (from  the  block  shelf  to 
the  piano,  to  a  certain  chair,  to  the 
painting  easel,  to  the  block  shelf,  to  the 
piano,  and  so  on)  unless  someone  stops 
them.  They  seem  to  move  for  the  sake 
of  moving,  rather  than  use  movement 
as  a  way  of  getting  from  one  activity  or 
place  to  another. 

Some  psychotic  children  are  able  to 
use  their  hands  with  very  good  control 
and  can  manipulate  toys  skillfully. 
They  may  repeat  a  body  skQl  endlessly, 
however,  until  they  are  helped  to  move 
on  to  something  else. 

Psychotic  children  often  use  their 
bodies  to  comfort  themselves  (as  in 
rocking  or  rubbing)  and  also  to  express 
strong  feelings.  When  they  are  upset 
they  may  hurt  themselves  until  they 
are  stopped.  For  example,  a  child  may 
rhythmically  bang  his  or  her  head 
against  the  wall  or  floor,  or  bite  or  hit 
him-  or  herself. 


63 


64  Self-Concept 


It  is  difficult  to  get  an  accurate  pic- 
ture of  how  psychotic  children  feel 
about  themselves.  These  children  do 
not  respond  well  to  tests.  Their 
responses  are  so  inconsistent  and 
uneven,  when  they  respond  at  all,  that 
professionals  are  unable  to  get  a  clear 
picture  of  their  functioning. 

From  all  appearances,  however,  psy- 
chotic children  nave  a  poorly  defined 
sense  of  self.  Sense  of  self  can  be 
defined  as  knowing  where  one's  body 
and  thoughts  stop  and  the  external 
environment  begins.  Typically  they 
may,  for  example,  seem  confused  or 
angry  upon  seeing  themselves  in  a 
mirror. 

Besides  having  difficulty  separating 
themselves  from  the  environment,  psy- 
chotic children  seem  to  have  difficulty 
sorting  out  what  is  real  from  what  is 
make-believe.  Unlike  other  children, 
who  may  pretend  to  be  an  animal  or  a 
car,  some  psychotic  children  insist  that 
they  are  a  "kitty"  or  a  "steam  shovel." 

Psychotic  children,  however,  seem 
to  be  aware  of  the  difference  between 
pleasure  and  anger,  caring  and  hostil- 
ity, in  themselves  and  in  others.  For 
example.  Carmen  was  told  firmly  by 
her  teacher  that  she  must  stop  throw- 
ing blocks  in  the  air,  "because  I  do  not 
want  you  to  get  hurt."  Carmen  raised 
her  arm  over  her  head  and  shouted, 
"Be  kind  to  yourself!" 


Medication 


Drugs  are  sometimes  used  to  help 
emotionally  disturbed  children  control 
the  behaviors  that  are  causing  them 
problems.  Within  Head  Start  and  other 
preschool  programs  there  are  generally 
few  emotionally  disturbed  children  who 
require  medication. 

Project  Head  Start's  policy  regard- 
ing the  use  of  medication  is  the  follow- 
ing: 

Whenever  possible,  arrangements 
should  be  made  with  the  family  and 
the  physician  to  schedule  admmis- 
tration  of  medication  during  times 
when  the  child  is  most  Ukely  to  be 
under  parental  supervision.  Other- 
wise it  is  the  responsibility  of  the 
Head  Start  director  or  his/her  desig- 
nee to  supervise  the  administration 
of  medication  in  accordance  with 
state  requirements  as  to  specific 
personnel  who  are  designated  to  dis- 
pense drugs  and  be  accountable  for 
them.  In  addition,  over-the-counter 
drugs  (e.g.,  aspirin,  nose-drops) 
should  be  administered  only  by  per- 
sonnel who  are  knowledgeable  aboui 
their  use  and  side  effects.  Other 
drugs  must  not  be  given  unless  the^ 
have  been  prescribed  by  a  physician 
for  a  particular  child.  AU  medicatioi 
must  be  adequately  labeled.  Drugs 
must  be  stored  out  of  the  reach  of 
children  and  prescription  medica- 
tions must  be  kept  under  lock  and 
key.  Before  any  medications  are 
administered,  recorded  parental  con 
sent  must  be  on  file.  Special  precau 
tions  are  of  particular  importance 
when  treatment  for  a  specific  handi 
capping  condition  requires  adminis- 
tration of  potentially  harmful  drugs 
(e.g.,  anticonvulsants,  ampheta- 
mines). 

(Transmittal  Notice  73.4,  2-28-73,  pages  9  and  10.) 


This  section  discusses  why  and  ho\ 
drugs  are  used  and  how  you  may  help 
a  child  who  is  taking  medication. 


Who 

Prescribes 
a  Drug? 

Before  any  drug  is  prescribed,  a  dis- 
turbed child  should  be  thoroughly  eval- 
uated by  a  medical  doctor,  usually  a 
neurologist.  This  evaluation  generally 
includes  a  physical  examination  as  well 
as  psychological  testing.  Sometimes 
observations  by  a  psycnologist  or  expe- 
rienced educator  wno  works  with  the 
child  provide  useful  supplemental  data 
for  the  doctor. 


How  Is  the 
Proper  Dosage 
Determined? 


The  amoimt  of  a  drug  (dosage)  that 
a  child  takes  is  based  partly  on  age  and 
body  weight.  Most  doctors  start  out  by 
giving  a  child  a  small  dose  to  see  what 
effect  it  has  on  behavior.  The  doctor 
works  closely  with  the  family  to  find 
out  what  dosage  is  suitable  for  chang- 
ing the  behavior  without  producing  side 
effects.  The  dosage  may  have  to  be 
increased  to  bring  about  the  desired 
change.  As  the  child  grows  bigger  and 
heavier,  the  dosage  may  have  to  be 
increased  to  maintain  the  same  effect. 
In  cases  in  which  the  child's  behavior 
and  functioning  improve,  the  dosage 
may  be  decreased  and  eventually 
eliminated. 


65 


Medication  can  help  some  children  perform 
tasks  better  by  allowing  them  to  concentrate 
better. 


66  What  Should 
You  Know  When 
a  Child  Is  on 
Medication? 

1 .    You  should  always  be  informed 
when  a  child  begins  to  take  a  drug,  and 
when  the  dosage  is  changed. 

L.    The  person  who  administers  the 
drug  and  others  who  work  closely  with 
the  child  need  careful  instructions 
about  how,  when,  and  how  much  of  the 
drug  to  give,  the  side  effects  to  watch 
out  for,  and  the  expected  effects  on  the 
child's  behavior. 


O.    You,  the  child's  parents,  and  the 
doctor  must  keep  in  close  touch  with 
each  other  to  compare  notes  about  how 
the  drug  is  working. 

4.  You  should  know  whom  to  call 
with  questions  and  in  case  of  emer- 
gency (usually  the  child's  doctor). 

5.  The  drug  must  be  kept  in  a  safe 
place  at  home  and  the  parent  must  be 
truly  reliable  about  giving  the  recom- 
mended dose  at  a  regular  time.  Nothing 
is  more  confusing  to  a  child  than  to 
take  a  drug  irregularly.  One  day  the 
child  feels  controlled  and  able  to  engage 
in  preschool  activities;  the  next  day  the 
same  child  is  unmanageable  and 
thoroughly  unhappy  with  everj^hing 
and  everybody.  This  is  also  hard  on  the 
teacher  and  the  other  children  in  the 
class. 


What 

Goes  Along 
>vith  the 
Medication 
Routine? 


Drugs  should  always  be  used  in 
combination  with  a  ^ood  educational 
program.  Often  a  child  needs  individual 
tutoring  and  special  work  to  learn  the 
skills  that  he  or  she  was  unable  to  learn 
when  his  or  her  behavior  was  out  of 
control.  Nearly  always,  the  family 
needs  to  talk  with  a  counselor  to  learn 
more  about  the  behavior  and  ways  to 
work  with  it  at  home. 

Used  as  part  of  a  comprehensive 
plan  of  education,  therapy,  and  family 
work,  a  drug  can  make  the  child  more 
pleasant  to  be  with,  so  that  he  or  she 
can  have  more  positive  experiences 
with  people  and  in  learning  situations. 
The  drug  is  a  temporary  crutch  that 
enables  the  child  to  ej^erience  success 
—  sometimes  for  the  first  time.  The 
increased  attention  span  that  a  drug 
can  produce  allows  a  child  to  feel  like  a 
competent  person  who  is  able  to  learn 
and  master  new  skills.  Some  parents 
have  reported  that  the  drug  tnerapy 
enabled  them  to  relax  with  their  cmld 
for  the  first  time,  and  to  redirect  their 
own  energy  toward  other  things  that 
could  help  the  child. 


What  Are  the 
Problems/ 
Side  Effects 
that  May 
Occur? 

1 .    A  drug  may  sometimes  mask 
another  problem  that  needs  attention. 
For  instance,  a  child  who  comes  to  pre- 
school hungry  in  the  morning  may 
appear  very  restless.  Feed  the  child 
breakfast  and  observe  his  or  her  reac- 
tion. Sometimes  a  child  is  given  a  drug 
just  to  keep  him  or  her  quiet  and  out  of 
trouble,  while  no  one  pays  any  atten- 
tion to  the  real  causes  of  the  child's 
problem. 

Li.    When  a  child  first  starts  to  take  a 
drug,  you  may  notice  that  he  or  she 
has  a  loss  of  appetite,  is  restless  or 
cranky,  or  has  difficulty  falling  asleep. 
If  you  notice  that  a  child  appears 
groggy,  drowsy,  poorly  coordinated,  or 
very  irritable,  he  or  she  may  be  react- 
ing adversely  to  the  drug.  Your  obser- 
vations shoiild  be  reported  immediately 
to  the  nurse,  the  child's  parents,  or  the 
child's  doctor. 

o.    Medication  sometimes  causes  a 
child  to  grow  somewhat  more  slowly  in 
height  or  weight. 


67 


68 


Drugs 
and  the 
Hyperactive 
Child 


Children  who  are  hyperactive  are 
administered  drugs  more  frequently 
than  children  with  other  kinas  of  emo- 
tional disturbance.  These  children  can 
generally  be  helped  a  great  deal  by  the 
use  of  drugs  combined  with  a  good 
therapeutic  and  educational  program. 
The  drugs  normally  prescribed  for  these 
children  are  stimulants,  commonly 
called  "speed."  The  effect  of  these 
drugs  on  children,  however,  is  the  oppo- 
site of  speed:  they  appear  to  slow  a 
child  down  so  that  he  or  she  can  con- 
centrate better.  The  child  becomes  more 
able  to  keep  his  or  her  mind,  eyes  and 
ears  on  the  task  at  hand.  Body  move- 
ments and  thoughts  can  be  organized 
more  purposefully.  The  child  does  not 
jump  or  look  around,  wiggle,  bounce,  or 
tap  ringers  as  much  because  the  drug 
helps  shut  out  irrelevant  stimuM. 

The  drugs  that  are  administered  to 
young  children  for  h5T3eractivity  and 
distractibility  are  not  habit  forming 
when  given  properly.  The  amounts 
given  do  not  cause  addiction.  However, 
as  a  child's  body  gets  used  to  a  drug, 
he  or  she  may  buHd  up  some  "toler- 
ance" to  it.  The  dose  may  then  have  to 
be  increased  in  order  to  continue  to 
have  the  same  effect  on  the  child's 
behavior.  Parents  should  be  aware  that 
the  child's  dosage  may  change.  This 
does  not  mean  that  the  child  has 
become  addicted. 


Not  all  h5^eractive  children  are 
helped  through  the  use  of  drugs.  Some- 
times the  drugs  do  not  produce  any 
change  in  their  behavior.  In  these 
cases,  the  doctor  generally  discontinues 
the  drug  and  explores  other  kinds  of 
therapy  more  completely. 

You  may  have  seen  articles  in  news- 
papers and  magazines  about  situations 
in  which  thousands  of  school  children 
were  on  drugs  that  had  been  prescribed 
over  the  telephone  by  doctors  who  had 
never  seen  the  children  in  person. 
Drugs  can  be  improperly  used.  Ask 
questions  if  a  child  in  your  class  is  tak- 
ing a  drug.  If  you  have  misgivings, 
speak  to  the  child's  doctor. 


I 


I 


Chapter  6: 


Mainstreaming 

Children 

\srith 

Emotional 

Disturbance 


Mainstream  experiences 
can  help  disturbed 
children  learn  about 
themselves  and  the 
world  around  them. 


70         This  chapter  provides  suggestions 
on  how  to  mainstream  children  with 
emotional  disturbance  in  your  pro- 
gram. Included  are  techniques  for  plan- 
ning, ideas  for  classroom  arrange- 
ments, general  teaching  guidelines  that 
are  useful  for  all  children,  and  specific 
techniques  and  activities  for  use  with 
emotionally  disturbed  children. 

With  any  disturbed  child  in  your 
class,  there  are  some  important  steps 
to  take. 

1.    Get  to  know  the  child.  Learn  the 
child's  strengths  as  well  as  needs. 

Z.    Get  to  know  the  child's  parents 
and  work  together  with  them.  They  can 
give  you  valuable  suggestions.  You  can 
provide  them,  in  turn,  with  ideas  that 
you  have  found  useful  in  working  with 
the  child. 

3.  Learn  all  you  can  about  emotional 
disturbance.  Read  enough  about  it  so 
that  you  feel  comfortable,  prepared, 
and  confident  Talk  to  other  teachers, 
parents,  and  friends  who  have  worked 
or  lived  with  disturbed  children. 

4.  Avoid  being  overprotective,  but  be 
alert  to  the  child's  needs  for  support  If 
you  do  things  for  children  that  they 
can  do  on  their  own,  the  success  is 
yours,  not  theirs.  And  if  you  ask  them 
to  do  things  they  aren  't  capable  of, 
they  will  fait  The  best  encouragement 
for  learning  and  improvement  is  a 
good,  solid  success.  You  can  create  the 
circumstances  that  make  this  not  only 
possible,  but  likely. 


Planning 


The  planning  process  for  an  emo- 
tionally disturbed  child  has  the  same 
purpose  as  for  other  children:  to  help 
you  map  out  a  course  of  action  for 
working  with  the  child.  This  process 
calls  for  the  involvement  of  several  peo- 
ple: the  teacher,  the  parent  or  parents, 
Head  Start  staff  representing  the  vari- 
ous service  components,  and  service 
providers  from  outside  agencies. 

The  goal  of  the  planning  process  is 
to  produce  an  Individualized  Education 
Program  (I.E. P.)  for  the  child,  which  is 
now  required  by  Public  Law  94-142, 
Education  for  All  Handicapped  Chil- 
dren Act,  and  by  Head  Start  Perform- 
ance Standards.  Based  on  an  evaluation 
of  the  child,  the  Individualized  Educa- 
tion Program  states  the  child's  present 
level  of  ^ucational  performance,  the 
annual  goals  and  short-term  instruc- 
tional objectives  for  the  child,  and  eval- 
uation procedures  for  determining 
whether  instructional  objectives  are 
being  achieved. 

From  the  point  of  view  of  Project 
Head  Start,  tne  planning  process  is  as 
follows: 

1 .    An  interdisciplinary  team  is 
required  to  make  two  lands  of  diag- 
noses: a  categorical  diagnosis  and  a 
functional  diagnosis.  A  categorical  diag- 
nosis is  simply  a  statement  of  the  kind 
and  severity  of  the  child's  handicap. 
This  kind  of  diagnosis  is  useful  to  you 
only  for  reporting  or  record-keeping 
purposes.  A  functional  diagnosis  or 
assessment  is  a  developmental  profile 
that  describes  how  the  child  is  function- 
ing, and  that  identifies  the  services  the 
child  requires  to  meet  his  or  her  special 
needs. 


L.    Based  on  the  functional  assess- 
ment, an  individualized  education  plan 
is  to  be  developed  for  the  child.  This 
plan  describes  the  child's  participation 
in  the  full  range  of  Head  Start  services, 
and  the  additional  outside  services  that 
are  needed  to  respond  to  the  child's 
handicap. 

O.     Periodically,  ongoing  assessments 

of  the  child's  progress  are  to  be  made 
by  the  Head  Start  teacher,  the  child's 
parents,  and  (if  needed)  by  the  full 
diagnostic  team.  If  these  re-evaluations 
show  that  the  child's  individualized  edu- 
cation plan  or  the  services  he  or  she  is 
getting  are  no  longer  appropriate  or 
needed,  they  should  be  changed  to  suit 
the  new  circumstances. 

4.    When  the  child  leaves  the  pro- 
gram. Head  Start  should  make  arrange- 
ments for  the  continuity  of  needed 
services  in  elementary  school.  This  can 
be  done  in  a  variety  of  ways,  but  usu- 
ally involves  holding  a  conference  with 
parents,  the  school,  and  service  pro- 
viders. The  elementary  school  should  be 
given  a  description  of  the  services  the 
child  has  been  receiving,  recommenda- 
tions for  future  services,  and  the  child's 
records  from  preschool. 


As  the  child's  teacher,  you  are 
involved  in  many  of  these  procedures. 
Your  part  in  the  process  is  described  in 
more  detail  in  the  following  six  steps. 
These  steps  are  Just  as  useful  with  non- 
handicapped  children  as  they  are  with 
disturbed  children. 

Step  1:     Observe  each  child  in  a  vari- 
ety of  activities,  identify  strengths  and 
weaknesses,  and  record  your  observa- 
tions. 

Step  2:     Set  objectives  based  on  what 
is  reasonable  for  the  child  to  achieve. 

Step  3:     Select  classroom  activities 
and  teaching  techniques  that  can  best 
help  each  child  reach  the  objectives. 
Sedc  outside  assistance  as  needed. 

Step  4:     Develop  the  plans  with  the 
child's  parents  and  specialists. 

Step  5:     On  a  continuing  basis, 
observe,  evaluate  the  child's  progress, 
and  develop  new  objectives. 

Step  6:     When  the  child  is  ready  to 
leave  Head  Start,  make  plans  to  ensure 
that  there  is  continuity  of  needed  serv- 
ices with  the  public  school. 

Each  of  these  steps  in  the  planning 
process  for  handicapped  children  is  dis- 
cussed in  greater  detail  below.  For  help 
in  individualizing  your  activity  plan- 
ning for  disturbed  children,  see  the 
activities  section,  page  96. 


'»)«|BI 


71 


72    Step  1: 

Observe 

The  process  and  purpose  of  observ- 
ing is  the  same  for  all  children.  The 
purpose  of  observing  a  child  is  to  iden- 
tify the  child's  developmental  level  — 
the  level  at  which  the  child  is  actually 
functioning.  This  can  teU  you  much 
about  the  child  as  an  individual. 
Progress  is  made  by  building  on  the 
child's  strengths  and  working  on  areas 
that  are  weak.  As  you  observe  the  child 
in  a  variety  of  activities,  you  should 
take  careful  notes.  Another  name  for 
this  process  is  assessment,  or  evalua- 
tion. Evaluation  is  particularly  neces- 
sary and  useful  to  the  plaiming  process 
because  it  makes  you  aware  of  the 
basis  for  what  you  do  in  the  classroom. 
The  following  example  describes  a  situ- 
ation that  calls  for  evaluation. 


M 


argo 

At  the  beginning  of  the  year,  you 
meet  five-yearold  Margo.  An  obedient 
little  girl,  Margo  always  does  every- 
thing you  ask  of  her,  silently  and  effi- 
ciently. She  almost  seems  like  what 
some  teachers  would  call  "a  model 
pupil "  There  is,  though,  one  thing  that 
troubles  you  about  Margo's  behavior. 
She  seldom  plays  with  other  children     j 
and  almost  never  stands  up  for  her        I 
rights.  She  allows  other  children  to  take 
away  toys  she  is  playing  with,  without 
even  a  word  or  gesture.  When  snack 
time  comes  and  the  little  boy  sitting 
beside  her  snatches  away  her  crackers, 
she  moves  silently  away  from  the  table 
and  begins  thumbing  through  a  picture 
book.  Margo  is  a  child  you  need  to 
observe  closely.  Although  her  behavior 
isn't  disruptive  to  you  or  other  children 
in  the  class,  her  behavior  does  seem 
unusual 

You  think  that  there  are  several  pos- 
sible explanations  for  Margo  s  behavior. 
Maybe  Margo  is  just  shy  and  has  been 
used  to  playing  alone  at  home.  This 
suspicion  is  confirmed  when  you 
observe  her  in  other  social  activities 
and  when  you  talk  with  her  mother. 
Maybe  Margo  really  isn't  hungry  at 
snack  and  so  gives  up  her  share  easily. 
But  soon  after  snack  she  comes  to  you 
to  ask  for  cookies  and  juice.  Maybe  she 
has  never  been  away  from  her  parents 
before,  and  just  needs  a  little  time  to 
adjust  to  preschool  You  notice  she  says 
goodbye  to  her  mother  fairly  easily  in 
the  morning,  and  doesn  't  seem  very 
upset  after  she  has  left.  But  since  you 
know  that  children  often  hide  separa- 
tion anxieties,  you  want  to  watch  her 
closely. 


Giving  up  too  easily  may  be  one  indication  of 
an  emotional  problem. 


Several  weeks  pass  and  Margo 
seems  to  be  moving  further  and  further 
away  from  playing  with  other  children. 
The  more  assertive  children  seem  to  be 
taking  advantage  of  her.  At  this  point, 
you  begin  to  think  something  is  seri- 
ously wrong  with  Margo,  for  her 
unusual  behavior  is  continuing  and,  in 
fact,  getting  worse. 

You  start  to  keep  notes.  You  write 
down  all  the  behavior  that  seems 
unusual-  what  the  circumstances  are 
and  what  Margo  does.  Your  careful 
observations  and  the  notes  you  keep 
are  the  best  beginning  for  figuring  out 
what  the  problem  could  be. 

Anyone  who  works  with  children 
can  be  an  observer  in  this  way.  If  you 
notice  a  problem  in  a  child,  try  to  fig- 
ure out  possible  explanations  for  it. 
Tfest  eacn  explanation  to  see  if  it 
accounts  for  what  you  have  observed 
and  reject  ones  that  don't  fit  the  facts. 
Gradually,  you  can  narrow  down  the 
possibilities.  You  may  find  yourself 
with  one  or  two  possible  explanations 
of  the  problem  or  you  may  still  not 
know.  At  that  point  you  may  decide  to 
seek  help. 


How  to  Observe 

Observation  is  a  technique  of 
focused  looking  and  listening  to  what 
people  say  and  do.  Using  observation 
as  a  tool  for  learning  about  children 
involves  being  systematic,  watching  for 
patterns,  and  using  the  information. 

Be  Systematic 

Your  first  step  is  to  decide  what  you 
want  to  observe.  Thinking  about  Margo 
again,  for  example,  you  remember  that 
in  the  dress-up  comer  Margo  sat  to  one 
side,  half  watching  the  other  children 
but  making  no  attempts  to  join  them. 
Since  you  know  that  dress-up  requires 
social  skills,  you  want  to  observe  how 
she  handles  other  activities  that  require 
such  skills. 


You  next  think  of  other  activities 
that  require  social  skills.  They  might 
include  oeing  a  character  in  a  play,  tak- 
ing turns  on  the  tricycle,  talking  to 
other  children,  and  participating  in 
"Circle  Time"  or  "Show  and  TfeU."  You 
will  want  to  observe  Margo  when  she  is 
doing  these  things. 

Your  observation  notes  should 
include  several  kinds  of  information: 

•  What  the  activity  is:  snack,  for 
example,  or  sand  table. 

•  What  is  happening  around  the 
child.  ("The  room  was  noisy.  A 
new  child  entered  our  classroom 
today.  The  playground  was 
crowded.") 

•  The  details  of  what  Margo  does 
and  how  she  does  it.  ("Margo 
seemed  to  ignore  Jeff  today  when 
he  asked  her  to  help  him  bmld  a 
castle  with  the  tinker  toys.  She 
turned  away  from  him  and  walked 
to  the  other  comer  of  the  room.") 

•  How  you  think  the  child  is  feeling. 
This  information  is  harder  to  come 
by,  because  you  can  never  reaUy  be 
certain  about  how  someone  feels. 
You  can  only  listen,  observe,  and 
try  to  draw  some  logical  conclu- 
sions. (If  Margo  keeps  saying,  "I 
need  my  Mommy,"  you  might 
write  "Margo  seems  unusually 
lonely  and  worried  today."  If  she 
smiles  when  you  say  that  you  will 
catch  her  at  the  bottom  of  the 
slide,  you  might  write,  "Margo 
seemed  relaxed  about  playing  on 
the  slide  today.") 

You  continue  to  observe  Margo 's 
skills  regularly  enough  and  long  enough 
to  get  a  sense  of  how  she  is  function- 
ing. 


73 


74  Here  are  some  general  tips  to  help 

you  be  systematic  as  you  observe. 


1.    Note  details 

It  is  very  important  to  write  down 
specific,  detailed  observations  that 
focus  exactly  on  what  the  child  does. 
For  example,  if  you  write  down, 
"Margo  sat  in  the  comer  all  day,"  this 
could  mean  that  she  was  tired,  she 
didn't  want  to  join  the  activity  going 
on,  she  didn't  like  the  other  children,  or 
a  number  of  other  possibilities.  How- 
ever, consider  this  version:  "Margo  sat 
in  the  comer  by  herself  during  circle 
time,  cooking,  snack,  and  rest  period. 
She  stared  at  the  other  children  while 
they  played.  Twice  she  started  to  get 
up,  as  if  to  join  them,  but  sat  down 
again."  These  notes  would  be  im- 
mensely helpful  both  to  you  and  to  a 
trained  diagnostician,  who  would  recog- 
nize that  they  could  indicate  a  problem. 

For  information  to  be  useful  to  you 
and  others,  it  must  be  specific. 


2.    Write  down  the  details  as  soon  as 
possible 

Write  down  what  you  see  as  soon 
as  possible,  since  it's  easy  to  forget 
quickly  the  details  of  a  child's  behavior 
in  a  particular  circumstance.  Details  are 
important:  they  describe  a  child's  indi- 
viduality. They  are  also  the  best  indica- 
tors of  a  child's  needs.  When  you  make 
notes,  try  not  to  be  obvious  about  it. 
Write  them  down  away  from  the  child. 


3.    Plan  a  realistic  schedule 

Your  observations  should  be  sched- 
uled, just  as  your  activities  are.  Ob- 
serve and  make  notes  as  often  as  neces- 
sarv  to  get  a  full  picture  of  what  the 
child  does  easily  and  has  problems  with 
in  the  skill  area  you  are  focusing  on. 


4,    Vary  the  settings  in  which  you 
observe 

Children  can  behave  differently  in 
different  activities  and  moods,  so  it's 
important  to  observe  a  child  in  a  vari- 
ety of  situations.  Observe  the  child  on 
the  playgroimd  and  in  the  classroom. 
Observe  the  child  as  he  or  she  plays 
alone,  with  other  children,  and  with  you 
and  other  adults.  Observe  the  child 
when  he  or  she  seems  to  be  feeling 
happy,  sad,  tired,  rested,  friendly,  and 
angry,  because  these  feelings  affect  the 
child's  behavior. 


5.    Vary  your  observer  role 

You  might  also  try  to  vary  your 
role  as  an  observer.  You  can  act  as  a 
spectator-observer,  watching  but  not 
participating.  For  example,  you  can 
observe  from  the  side  oi  the  room  while 
another  adult  manages  the  classroom 
activities.  Or  you  can  be  a  participant- 
observer,  taking  part  in  the  activity 
with  the  child.  It  is  usually  easier  to 
observe  as  a  spectator,  so  you  might 
try  this  method  first.  Again,  be  careful 
not  to  call  attention  to  yourself  as  you 
observe,  otherwise  the  child  might  not 
act  naturally. 


6.    Start  by  observing  one  child  at  a 
time 

As  you  become  more  experienced  in 
observing,  you  will  probably  find  that 
you  can  observe  more  than  one  child  at 
a  time.  It's  best  not  to  try  to  do  this, 
however,  until  you  are  pretty  sure  you 
won't  get  confused,  or  miss  or  forget 
important  information. 


Watch  for  Patterns 

Watching  for  patterns  is  an  impor- 
tant part  of  observation.  You  may 
notice  that  a  child  sometimes  hits 
another  child,  seems  unusually  depen- 
dent on  you,  or  is  particularly  attached 
to  one  toy.  All  preschool  children  act  in 
these  ways  from  time  to  time.  What 
you  want  to  know  is  whether  the  child 
often  or  always  does  these  things. 
Carry  a  piece  of  paper  and  a  pencil 
around  with  you  and  keep  track  for  a 
few  days.  Be  sure  you  are  objective 
(factual)  about  your  observations  —  try 
to  keep  your  own  feelings  and  reactions 
separate.  In  this  way,  you  will  be  able 
to  see  the  patterns  that  point  to  the 
particular  skills  with  which  the  child 
needs  help. 

Going  back  over  all  the  notes  you 
have  made  can  help  you  discover  pat- 
terns you  didn't  see  before.  You  should 
review  your  notes  on  a  regular  basis. 
The  information  in  them  can  help  you 
identify  new  skill  areas  and  behavior 
you  might  want  to  find  out  more  about, 
either  by  observing  or  by  other  assess- 
ment methods. 


Use  the  Information 

Once  you  have  observed  a  child  sys- 
tematically, written  down  your  observa- 
tions, and  reviewed  your  notes,  you  will 
be  able  to  identify  areas  of  strength 
and  weakness  in  the  child's  skills.  This 
information  can  be  used  to  develop 
objectives  for  the  child,  and  to  select 
activities  and  teaching  techniques  that 
meet  the  child's  needs.  This  information 
can  also  become  a  basis  of  discussion 
with  other  teachers,  the  parents,  and 
the  specialists. 

For  example,  when  you  review  the 
observations  you  made  about  Margo,  it 
becomes  clear  that  she  does  have  a 
problem  with  social  skills.  In  particular 
you  notice  that  she  has  a  lot  of  trouble 
in  group  games.  Since  your  objective  is 
to  improve  Margo 's  socialization  during 
group  games,  you  select  activities  that 
involve  this  skill.  However,  it  would  be 
unfair  and  unrealistic  of  you  to  expect 
Margo  to  feel  comfortable  in  a  group 
right  away,  so  you  wiU  have  to  modify 
the  activity.  You  may  first  want  to 
encourage  Margo  to  play  with  one 
other  child,  perhaps  someone  she  espe- 
cially likes  or  who  Ukes  her.  As  she 
learns  to  play  successfully  with  one 
child,  you  might  want  to  introduce 
another  child  into  the  play  activity. 


75 


76    Step  2: 


Set  Objectives 

An  important  part  of  the  planning 
process  is  developing  individual  objec- 
tives that  will  lead  to  the  maximiim 
development  of  each  child.  The  objec- 
tives need  to  be  realistic  in  terms  of  the 
purpose  of  Head  Start  and  the 
program's  staff  and  time  resources. 
Most  important,  the  objectives  should 
be  developmental  objectives.  In  other 
words,  you  can't  expect  to  make  a  dis- 
turbed four-year-old  function  exactly 
like  most  other  four-year-olds,  but  you 
can  help  the  child  progress  to  his  or  her 
next  developmental  level. 

Here  are  some  guidelines  for  setting 
objectives. 

1.    Develop  specific  objectives 

When  you  have  gotten  together 
your  observations,  you  will  find  some 
areas  of  strength  and  some  of  weak- 
ness. This  information  becomes  useful 
when  it  is  translated  into  what  the 
child  needs.  State  objectives  in  terms  of 
observable  skills  and  behaviors  that  the 
child  needs  to  learn  for  effective  func- 
tioning. Start  with  what  the  child  does 
well  and  use  those  abilities  as  a  bridge 
to  new  learning. 

For  example,  your  objective  may  be 
to  increase  Edgar's  vocabulary.  Since 
you  have  observed  that  he  enjoys 
music  and  easily  learns  new  songs,  you 
deliberately  select  songs  that  have  new 
words  for  him  to  learn.  In  addition,  you 
encourage  Edgar  to  make  up  songs 
that  teU  a  story  or  to  add  new  verses  to 
songs  he  already  knows. 

Or  your  objective  might  be  to  help 
Mary  EUen  interact  with  others  with- 
out conflict.  From  observation  you 
know  that  she  is  particularly  skilled  at 
building  with  blocks.  In  the  block  cor- 
ner you  set  up  a  project  that  involves 
Mary  EUen  with  a  small  group  of  other 
children.  You  set  a  task  that  necessi- 
tates cooperation  among  the  children. 


Some  teachers  believe  that  setting  a 
target  date  for  the  achievement  of  each 
objective  helps  them  to  measure  a 
child's  progress.  Others  feel  that  set- 
ting a  target  date  is  unrealistic  and 
serves  little  purpose.  Children,  after  all, 
wiU  only  master  a  skill  when  they  are 
ready  to  do  so.  Pushing  toward  a  tar- 
get date  can  sometimes  put  teachers  in 
the  position  of  expecting  the  child  to 
accomplish  something  he  or  she  is  not 
ready  to  do.  On  the  other  hand,  it  is 
important  to  keep  setting  objectives 
and  to  observe  a  child's  progress 
toward  reaching  them.  Ii  there  is  no 
progress  at  all,  it  may  be  that  you 
should  try  another  approach  or  set  a 
different  goal  for  the  time  being.  You 
can  go  back  to  working  toward  your 
original  objective  when  you  can  see 
greater  readiness  on  the  part  of  the 
child. 


I 


Some  disturbed  children  will  need 
to  be  shown  how  to  play  with  other 
children. 


Develop  both  long-  £ind  short-term 
objectives 

Set  long-term  objectives  first;  then 
work  backward  and  set  short-term 
objectives.  For  example,  developing 
trust  may  be  your  long-term  objective 
for  Tbny,  so  that  he  can  separate  easily 
from  his  mother  at  the  beginning  of  the 
preschool  day,  share  a  favorite  toy  with 
another  child,  or  talk  with  you  about 
something  that  is  troubling  him.  Short- 
term  objectives  include  helping  Tbny  to 
become  comfortable  in  the  school  set- 
ting (trusting  the  new  environment)  by 
helping  him  to  become  involved  in 
pleasurable  activities,  by  offering  praise 
for  his  accomplishments,  by  demon- 
strating care  and  support  when  he 
seems  frustrated,  or  by  assisting  him 
whenever  necessary. 

Keep  in  mind  that  setting  both 
long-  and  short-term  objectives  in  your 
work  with  emotionally  disturbed  chil- 
dren can  be  difficult.  You  need  to  be 
flexible  and  to  stay  alert  to  the  child's 
progress  and  to  new  strengths  and 
needs  as  they  emerge. 


Step  3: 

Select  the  Program, 

Activities, 

and  Techniques 

If  your  Head  Start  program  has 
several  program  options,  you  need  to 
consider  which  one  can  best  meet  the 
objectives  you  have  set  for  each  child. 
For  some  disturbed  children,  a  full-day, 
center-based  program  is  best.  For 
others,  a  part-day  program  combined 
with  a  home-based  program  or  a  special 
class  might  be  best.  The  particular 
combination  of  Head  Start  and  other 
services  that  is  best  and  the  amount  of 
time  spent  in  each  varies  from  child  to 
child.  It  is  a  good  idea,  however,  to 
start  off  by  expecting  the  child  to  par- 
ticipate in  all  Head  Start  activities 
along  with  the  other  children.  The 
child's  program  can  then  be  revised,  if 
and  when  it  becomes  necessary. 

lb  make  it  possible  for  disturbed 
children  to  participate  in  all  your  usual 
classroom  activities,  think  about  ways 
to  adapt  them  and  prepare  them  dif- 
ferently. You  can  use  a  variety  of  teach- 
ing techniques  to  make  sure  the  child 
gets  what  ne  or  she  needs.  For  exam- 
ples, look  at  the  activities  in  this 
chapter. 


77 


78    Step  4: 


Develop  Plans 
with  Parents  and 
Specialists 

Parents 

Sometimes  it  is  hard  for  parents  to 
recognize  changes  in  their  child  from 
day  to  day.  In  the  classroom  you  have 
the  opportimity  to  see  a  child  for  long 
stretches  of  time,  to  observe  the  child 
performing  a  wide  variety  of  activities, 
and  to  compare  each  child  with  many 
other  children.  For  these  reasons,  you 
can  observe  a  child's  daily  progress  and 
set  realistic  objectives  based  on  your 
observations.  On  the  other  hand,  par- 
ents know  a  great  deal  about  their  child 
that  no  one  else  can  learn  simply  by 
being  the  child's  teacher.  Moreover,  for 
education  to  be  effective,  parent  and 
teacher  goals  for  the  child  need  to  be 
consistent  so  that  both  are  working  as 
much  as  possible,  in  their  different 
roles,  toward  the  same  end.  Develop 
your  plans  with  parents.  Share  with 
parents  the  progress  their  child  is  mak- 
ing in  your  classroom  and  ask  them  to 
share  with  you  the  child's  accomplish- 
ments at  home.  As  you  work  together 
with  parents,  you  might  invite  them  to 
observe  the  program  and  to  assist  in 
class  activities. 


Specialists 

Specialists  typically  see  a  child  for 
short  periods  of  time  doing  a  limited 
number  of  tasks,  and  interacting  only 
with  themselves  and  the  parents. 
Sharing  your  observations  with  special- 
ists can  provide  them  with  valuable 
information  on  the  child's  activity  in  a 
more  normal  setting.  In  turn,  the  spe- 
cialists can  help  you  understand  what 
lirnits  the  handicap  imposes  on  the 
child's  activities,  and  may  be  able  to 
help  you  develop  objectives  that  are 
based  on  the  child's  needs  and  abilities. 


Step  5: 

Continue  To 
Observe,  Reassess, 
and  Make 
Adjustments 

While  a  formal  assessment  of  each 
child's  development  and  progress  may 
occur  only  once  a  year,  you  should  aim 
for  more  informal  evaluations  much 
more  often.  (Flemember  how  quickly 
children  change  at  this  age,  especially 
in  a  stimulating  classroom!)  As  you 
observe  and  record  regularly  a  dis- 
turbed child's  responses  in  major  skill 
areas,  your  understanding  of  that  child 
and  the  effects  of  the  emotional  distur- 
bance wiU  grow.  Keep  in  mind  the 
objectives  toward  which  the  child  is 
moving,  and  how  much  progress  has 
been  made. 

Refer  often  to  your  past  observa- 
tions, and  look  for  patterns  in  skill 
areas  and  other  behavior.  If,  for  exam- 
ple, a  child  shows  a  pattern  of  silently 
withdrawing  from  group  activities,  con- 
sider whether  you  have  seen  some 
improvement  in  this  area.  Try  to  figure 
out  which  activities  the  child  has 
enjoyed  most  and  which  ones  seem  to 
have  caused  the  most  improvement. 
Try  to  include  more  of  these  kinds  of 
activities  in  the  future. 


Step  6: 

Continuity 
Between 
Head  Start 
and  the 
Public  Schools 


With  the  Education  for  All  Handi- 
capped Children  Act,  public  schools  will 
increasingly  be  providing  the  benefits 
of  mainstream  classrooms  and  special 
services  to  handicapped  children.  After 
being  in  a  mainstream  preschool  class- 
room and  receiving  special  services, 
emotionally  disturbed  children  will  need 
to  have  these  advantages  continue. 
There  are  several  things  you  and  a 
handicap  or  social  services  coordinator 
can  do  to  contribute  to  the  continuity 
of  the  education  that  a  disturbed  child 
has  been  receiving  in  your  program. 


Some  Head  Start  programs  have 
developed  formtd  relationships 
with  the  public  schools  in  their 
areas,  to  assist  in  the  tremsition 
between  preschool  and  elementary 
school.  If  your  program  has  no  for- 
m£d  relationships  with  the  public 
schools,  you  might  explore  the  pos- 
sibility of  establishing  them.  Your 
program  director  or  handicap  coor- 
dinator will  know  where  to  go  for 
suggestions  on  how  to  achieve  this. 

Elducational  continuity  is  made 
easier  if  community  providers  of 
special  services  to  Head  Start  chil- 
dren continue  to  provide  them  to 
these  children  when  they  go  on  to 
public  school.  Before  a  child  leaves 
Head  Start,  you  can  discuss  the 
child's  future  plans  with  the  spe- 
cialists who  have  been  working 
with  him  or  her. 

The  participation  of  parents  in  the 
education  their  child  has  been  get- 
ting in  Head  Start  is  a  valuable 
foimdation  to  build  on.  Encoiu-age 
parents  to  continue  their  involve- 
ment and  to  make  sure  that  the 
child  receives  needed  services  in 
elementary  school. 

Finally,  you  can  keep  in  touch  with 
the  cfuld  and  his  or  her  family 
after  the  child  leaves  your  class- 
room. A  telephone  call  or  a  visit  to 
find  out  how  things  are  going  will 
be  appreciated  by  the  parents.  If 
the  child  is  having  problems,  your 
suggestions  on  how  to  deal  with 
them  would  be  welcomed. 


79 


Observe  carefully  and 
record  information. 


80 


The 

Physical 
Setting  and 
Classroom 
Facilities 


No  two  Head  Start  programs  have 
the  same  classroom  facilities,  and  few 
of  them  have  ideal  physical  settings. 
But  wonderful  learning  environments 
often  exist  without  modem  buildings, 
fancy  furniture,  or  expensive  materials. 
The  children  and  the  staff  really  make 
any  preschool  program. 

By  and  large,  most  handicapped 
children  don  Y  require  special  classroom 
arrangements  or  extra  materials.  You 
can  adapt  and  reorganize  the  materials 
you  already  have  to  meet  the  needs  of 
disturbed  children.  Basically,  the  class- 
room should  be  arranged  to  suit  the 
ways  you  use  it  every  day,  with  modifi- 
cations to  suit  the  special  needs  of  a 
disturbed  child.  These  modifications 
should  not  be  necessary  very  often,  and 
they  are  sure  to  be  minor. 

There  are  moments  when  handi- 
capped children  need  special  help  in 
dealing  with  the  physical  setting  of  the 
classroom.  Such  help  should  be  given 
freely.  In  general,  arrange  your  room  so 
that  the  child  can  explore  the  space  and 
use  the  materials  with  as  little  assis- 
tance as  possible.  Here  are  some  sug- 
gestions that  are  useful  with  all  chil- 
dren. They  are  particularly  helpful  for 
children  with  handicaps,  including  emo- 
tional disturbance. 


Clear 

Traffic 

Patterns 


If  you  have  a  child  in  your  program 
who  is  overly  active,  who  rushes 
around  with  apparently  little  fore- 
thought, or  wno  gets  confused  easUy, 
clearfy  defined  traffic  patterns  are 
essential.  Making  a  floor  plan  before 
the  beginning  of  the  program  year  may 
help  you  to  recognize  and  correct  traffic 
problems  before  they  happen.  Don't 
overlap  traffic  routes  and  activity  areas 
—  this  will  disrupt  the  children  who  are 
involved  in  the  activities.  Make  sure 
there  is  enough  space  between  furniture 
groupings  to  keep  "collisions"  to  a 
minimum. 


Start 
Simple 


Keep  your  room  arrangement  as 
simple  and  uncluttered  as  possible, 
especially  at  the  beginning  of  the  year. 
As  the  children  get  used  to  it  and  learn 
to  handle  a  more  complex  environment, 
you  can  gradually  increase  the  amount 
of  materials  and  nvunber  of  activity 
areas.  The  use  of  well-defined  and  con- 
sistent space  patterns  wiU  avoid  confu- 
sion and  help  the  children  become 
familiar  with  the  classroom  organiza- 
tion. The  space  in  which  each  activity 
occurs  should  be  clearly  marked. 

For  example,  you  might  want  to  put 
masking  tape  on  the  floor  to  indicate 
the  big  olock  area,  the  housekeeping 
comer,  and  other  areas.  Other  space 
cues,  such  as  cabinets  and  movable  par 
titions,  can  be  moved  around  as  needed 
Mark  storage  areas  clearly.  Make  sure 
children  know  where  they  are  and  what 
belongs  in  them,  and  can  get  at  them 
easily.  Be  consistent  about  where  mate- 
rials are  kept  and  where  activities  take 
place. 


Noise  Level 


Avoid  placing  noisy  activities  next 
to  quiet  activities.  Noise  and  movement 
distract  some  children  from  quieter 
tasks.  Noise  interrupts  the  rest  breaks 
that  some  handicapped  children  need. 
You  will  need  to  determine  what  noise 
levels  are  most  comfortable  for  dis- 
turbed children.  Some  children  may  feel 
imcomfortable  in  a  quiet  room.  For 
others,  a  noisy  room  is  hard  to  tolerate. 
Try  to  provide  quiet  places  in  the  room, 
perhaps  sectioned  off,  for  the  child  with 
a  low  tolerance  for  noise. 


Individual 
Space  Cues 


81 


Some  children  aren't  used  to  sharing 
(or  don't  seem  to  want  to  share)  a  room 
with  a  lot  of  other  children.  They  may 
use  more  than  their  share  of  the  space. 
You  can  use  physical  signals  to  limit 
their  movement.  For  example,  when 
Sean  sits  in  a  circle,  he  might  extend 
his  legs  and  kick  the  child  next  to  him. 
lb  avoid  this,  try  a  masking-tape  "x" 
or  a  rug  square  on  the  floor  where  Sean 
is  to  sit.  A  file  cabinet  or  a  bookcase 
can  be  strategically  placed  to  define  the 
space  you  want  a  child  to  occupy.  More 
subtle  cues,  such  as  a  friendly  touch  or 
placing  a  disruptive  child  directly  in 
front  of  you,  wdl  also  help  Umit 
children's  movement. 

In  general,  the  more  obvious  the 
space  cue,  the  easier  it  is  for  the  child 
to  understand.  As  the  children  learn  to 
use  space  properly,  you  can  gradually 
eliminate  the  more  obvious  cues  (rugs, 
tape),  and  substitute  a  less  obvious  one 
(a  spoken  reminder). 

Even  the  spoken  reminder  will  no 
longer  be  needed  when  the  child  learns 
and  accepts  the  Umits  of  his  or  her  own 
space. 


Personal 
Places 


There  should  be  a  quiet  place  avail- 
able where  children  can  go  on  their 
own.  Some  classrooms  have  cubbies 
where  children  keep  their  personal 
belongings.  These  are  sometimes  large 
enough  to  be  used  as  nice  "escape 
hatches."  You  can  even  rig  up  a  curtain 
that  can  be  drawn  across  the  cubby,  if 
the  child  would  like  this.  Try  to  arrange 
your  book  area  so  that  it  is  soft  and 
comfortable,  and  has  private  nooks  and 
crannies. 

Everyone  needs  to  get  away  from  it 
all  every  once  in  a  whQe. 


82 


General 

Teaching 

Guidelines 


There  are  many  good  ways  to  teach. 
Because  of  your  personality,  tempera- 
ment, and  values,  you  have  developed 
your  own  individual  teaching  style, 
which  is  reflected  in  the  activities  you 
choose,  and  in  the  ways  you  interact 
with  children.  Good  teaching  tech- 
niques are  often  the  same  for  the  educa- 
tion of  any  child,  whether  handicapped 
or  non-handicapped.  So  it  is  best  not  to 
try  to  change  your  natural  teaching 
style  for  a  msturbed  child.  It  will  onlv 
serve  to  make  both  you  and  the  child 
uncomfortable. 

With  disturbed  children,  you  will 
want  to  apply  your  teaching  skills  con- 
sciously, using  those  skills  that  most 
effectively  serve  the  needs  of  the  child. 
You  do  much  the  same  for  every  child. 
But  since  children  who  are  handicapped 
have  problems  that  seriously  interfere 
with  overall  performance,  they  require 
extra  consideration.  Below  are  some 
basic  principles  that  you  may  already 
know  and  use  with  all  children.  They 
are  particularly  useful  in  working  with 
children  who  have  handicaps,  including 
emotional  disturbance. 


1. 

Understand 

Your  Feelings 

and  Keep  Trying      j 

A  couple  of  weeks  before  preschool 
opened  in  the  fall,  Ms.  Lazon  was  asked 
to  take  responsibility  for  Linda,  a  four- 
year-old  disturbed  child  who  was  about 
to  enter  the  program.  For  two  weeks 
Ms.  Lazon  had  thoughts  like  these: 

Me?  I've  never  worked  with  a  dis- 
turbed child  before.  I  won't  know 
what  to  do  with  her.  She'll  just  be  a 
nuisance  and  create  problems  for  aU 
the  other  children.  Her  parents  will 
see  I  don't  know  what  I  am  doing. 
What  should  I  do  if  she  tries  to  hit 
me?  Who  will  help  me  with  her? 
How  will  I  be  able  to  have  enough 
patience  to  tolerate  her  temper  tan- 
trums? Why  wasn't  some  other 
teacher  chosen  for  this?  Everybody 
will  see  I  don't  know  how  to  work 
with  this  child,  and  I'll  be  embar- 
rassed. If  I  try  something  and  it 
doesn't  work,  what  on  earth  wiU  I 
do  then? 

If  Ms.  Lazon  had  spoken  with  other 
staff  members  in  her  program  about 
these  worries,  instead  of  keeping  them 
to  herself,  she  might  have  felt  less 
apprehensive  and  more  confident  of  her 
ability  to  manage  Linda.  Talking  with 
the  director  of  the  program,  she  might 
have  been  able  to  find  out  more  about 
the  specific  behavior  that  Linda  was 
likely  to  show,  and  what  kinds  of  help 
were  available  to  her.  She  could  have 
learned  about  materials  to  obtain,  edu- 
cational sessions  to  attend,  and  organi- 
zations, hospitals,  or  clinics  to  contact 
for  special  help. 


Starting  Out 


Some  adults  are  nervous  and  wor- 
ried about  working  with  a  handicapped 
child  for  the  first  time.  This  is  a  typical 
reaction  when  they  don't  know  the 
child  very  well  yet  (if  at  all).  As  a  result 
they  sometimes  start  out  thinking  of 
the  child  as  a  ''disturbed  child."  As 
they  spend  time  with  the  child,  watch 
the  child,  play  with  the  child,  and  pro- 
vide warm  and  caring  direction,  they 
usually  find  that  they  have  begun  to 
think  of  the  child  as  a  ''child  with  an 
emotional  disturbance,"  and  soon  they 
think  of  him  or  her  as  a  "child, "  plain 
and  simple. 

Your  first  efforts  working  with  the 
child  may  not  all  be  successful  —  this 
is  to  be  expected.  You  may  feel  frus- 
trated and  guilty.  If  something  goes 
wrong  (as  things  do  from  time  to  time), 
figure  out  what  happened,  and  keep  it 
in  mind  for  the  next  time. 

Don't  expect  miracles.  No  one  is 
asking  you  to  solve  all  the  child's  prob- 
lems, or  to  make  the  child  into  the 
friendliest  child  in  the  class,  or  into  the 
most  liked  or  most  successful.  Some- 
times, even  with  the  very  best  help 
from  you,  the  staff,  and  specialists,  a 
child  just  doesn't  make  as  much 
progress  as  hoped.  This  was  true  of 
Sammy,  a  child  with  very  serious  prob- 
lems. 


s 


83 


ammy 


Sammy  is  a  four-year-old  with  emo- 
tional disturbance.  Although  the 
teachers  knew  how  difficult  it  would  be 
to  work  with  him,  they  accepted  him 
into  the  program  because  they  had  been 
able  to  help  other  disturbed  children. 

When  Sammy  started  the  program, 
he  was  hard  to  manage.  He  yelled, 
pushed  children  out  of  his  way,  and 
refused  to  do  what  was  asked  of  him. 
He  couldn  't  sit  still.  He  sometimes  got 
so  angry  he  lost  all  ability  to  speak  and 
would  pound  his  fists  on  the  worktable. 

But  every  now  and  then,  Sammy 
did  seem  to  do  better  He  had  peaceful 
moments,  and  he  kept  still  long  enough 
to  play  at  the  water  table.  He  made 
several  approaches  to  play  with  other 
children.  He  could  listen  to  a  very  short 
story  if  a  teacher  held  him  on  her  lap. 
Sometimes  it  looked  as  though  a  break- 
through was  about  to  happen. 

But  then  the  next  day,  Sammy 
would  go  back  to  his  old  behavior  —  or 
worse.  Although  his  teachers  were  dis- 
couraged they  tried  to  be  even  more 
sensitive  to  his  needs  and  moods.  They 
had  regular  staff  meetings  about 
Sammy.  They  asked  a  number  of  spe- 
cialists for  suggestions  and  advice. 
They  scheduled  regular  sessions  with 
some  specialists.  They  worked  closely 
with  his  parents. 

But  in  spite  of  all  their  efforts,  noth- 
ing worked.  Sammy  s  problems  are  as 
serious  now  as  they  were  on  his  first 
day  in  Head  Start. 

Some  children,  like  Sammy,  seem  to 
progress  very  slowly.  All  you  can  do  is 
your  best  to  try  and  help.  There  will  be 
times  when  you  will  be  disappointed 
and  upset.  However,  there  will  also  be 
many  times  when  you  wiU  succeed  in 
helping  these  children  develop  and 
change. 


Some  children  "s  behav- 
ior problems  improve 
very  slowly. 


84  2. 

Classroom 
Personnel 

Aides  and  volunteers  play  a  key  role 
in  all  Head  Start  programs,  and  their 
assistance  should  oe  included  in  class- 
room planning  for  children  with  special 
needs. 

Aides 

Your  aide  or  assistant  helps  you 
teach  activities  and  work  witn  children 
individually.  This  help  is  especially 
valuable  if  you  have  an  emotionally  dis- 
turbed child  in  your  class  who  needs 
special  attention  and  assistance.  Aides 
should  be  included  in  developing  educa- 
tional objectives  for  the  child  and  in 
ongoing  planning.  Both  you  and  the 
aide  should  agree  on  what  the  aide 
should  do,  and  why,  to  help  the  child 
learn  and  play  with  other  children. 

It  is  not  a  good  idea  to  have  the 
child  work  constantly  with  only  one 
adult.  This  isolates  the  child  from  other 
children,  defeating  the  purpose  of  main- 
streaming.  Some  children,  however,  will 
need  the  security  of  an  attachment  to 
only  one  adult  in  the  classroom  before 
they  are  able  to  work  with  several 
adults.  You  may  want  to  assign  an  aide 
to  work  with  such  a  child  for  a  while. 

On  the  other  hand,  other  problems 
can  be  created  when  a  child  has  too 
many  caregivers  who  come  and  go. 
This  makes  it  hard  for  the  child  to  form 
emotional  attachments.  Children  learn 
better  with  the  reassuring  presence  of  a 
few  people  they  know  and  care  about. 


Care  for  the  child  should  therefore 
be  shared  among  several  adults  and 
individual  attention  should  be  limited 
to  what  the  child  needs  so  that  he  or 
she  is  not  separated  from  the  group  too 
often. 


Volunteers 

Experts  have  varying  opinions 
about  whether  volunteers  snould  work 
directly  with  handicapped  children.  If  a 
volunteer  has  been  trained  in  the  field 
of  emotional  disturbance  or  has  worked 
extensively  with  disturbed  children 
similar  to  those  in  your  program,  and  if 
that  volunteer  is  able  to  make  a  regu- 
lar, long-term  commitment  to  worlong 
with  a  particular  disturbed  child,  his  or 
her  contribution  can  be  very  valuable. 
If  a  volunteer  does  not  meet  these  crite- 
ria, it  may  be  best  for  that  person  to 
work  with  other  children,  freeing  the 
teacher  to  spend  more  time  with  chil- 
dren who  have  special  needs. 


3. 

Breaking 
Down  Skills 


Every  skill  is  really  composed  of 
many  sub-skills  —  there  is  no  such 
thing  as  a  one-step  activity.  Skills  such 
as  role  playing,  sharing  a  toy,  throwing 
a  ball  to  another  child,  or  joining  in 
group  activities  consist  of  many  sub-skills. 

Some  children  can  master  a  new 
skill  very  quickly  with  little  help  from 
vou.  These  are  children  who  already 
know  the  sub-skills  and  can  use  them  in 
performing  the  new  skill.  Handicapped 
children,  however,  don't  have  some  of 
the  sub-skills  necessary,  and  need  to  be 
taught  them  before  they  can  succeed  at 
the  overall  activity.  Children  with  emo- 
tional disturbance  have  this  problem  in 
many  skill  areas. 

For  these  children,  you  can  break 
down  the  activity  into  sub-skills  that 
can  be  learned  at  their  current  sldll 
level.  For  example,  if  you  want  to  teach 
a  child  to  share  a  toy,  you  should  make 
sure  that  the  child  Imows  the  meaning 
of  "my  turn"  and  "your  turn,"  has  the 
abUity  to  wait  and  delay  gratification 
while  another  child  uses  the  toy,  and  is 
willing  to  share  the  toy  with  another 
child.  Or,  if  you  are  trying  to  teach  a 
child  to  throw  a  ball  to  another  cMld, 
the  child  must  understand  the  concept 
of  exchange,  must  be  able  to  get  the 
attention  of  the  child  to  whom  he  or 
she  is  throwing  the  ball,  and  must  pos- 
sess the  fine  and  gross  motor  skills  nec- 
essary to  throw  the  ball. 


4. 

Sequencing 

Activities 


85 


In  addition  to  sequencing  skills 
within  an  activity,  sequence  a  series  of 
activities.  Start  with  simple  activities 
and  gradually  increase  the  level  of  diffi- 
culty as  a  child  learns. 

For  example,  Shana  wanted  to  use  a 
tricycle  that  Amani  was  using.  She 
rushed  over,  began  pulling  the  tricycle, 
and  screamed  at  Amani,  "Get  off!  Get 
off!"  Tb  help  Shana  learn  a  more  appro- 
priate way  of  expressing  her  desire  to 
use  the  tricycle,  the  teacher  might 
sequence  the  activity  as  follows: 

•  Hold  Shana  s  hand  (restraint),  and 
try  to  explain  the  meaning  of  "my 
turn"  and  "your  turn." 

•  Give  Shana  a  concrete  way  of 
knowing  when  it  is  her  turn,  such 
as  "when  Amani  has  finished  rid- 
ing" or  "when  all  the  sand  on  this 
little  timer  is  at  the  bottom." 

•  When  it  is  Shana 's  turn,  demon- 
strate to  her  how  to  go  about  get- 
ting the  tricycle.  For  example,  say 
to  Shana,  "Tbll  Amani  that  his 
time  is  up  and  you  would  like  to 
take  your  turn  now." 

Be  sure  to  demonstrate  to  a  child 
how  the  skills  learned  in  one  activity 
can  be  used  in  others.  A  disturbed  child 
may  need  to  repeat  a  sub-skill,  a  skill, 
or  an  activity  several  times  with  your 
help  and  several  more  times  without  it, 
before  moving  on  to  new  activities  at  a 
more  difficult  level. 


"Tell  Amani  that  his 
time  is  up  and  you 
would  like  to  take 
your  turn  now. " 


86 


5. 
Pacing 

Plan  your  day  so  that  the  activities 
are  varied.  Alternate  between  active 
and  quiet  activities,  between  organized 
projects  and  free  play.  When  you  teach 
new  skills,  present  them  first  in  familiar 
contexts,  along  with  some  skills  the 
child  already  has.  This  lessens  the 
child's  uncertainty  and  frustration. 

A  child  with  emotional  disturbance 
is  especially  sensitive  to  the  pace  of  the 
day.  Some  disturbed  children  tire  eas- 
ily, and  may  need  more  quiet  time  than 
other  children.  This  doesn't  necessarily 
mean  a  nap  —  often  ten  minutes  alone 
in  the  book  comer  may  be  enough. 
Also,  the  child's  attention  span  may 
need  training  and  strengthening  if  he  or 
she  isn't  used  to  preschool.  If  a  child's 
attention  span  is  short,  make  the  activi- 
ties short,  too.  You  can  lengthen  them 
as  the  child  learns  to  pay  attention  for 
longer  stretches  of  time.  Finally,  there 
should  be  extra  time  available  for  the 
child  who  needs  more  than  one  turn  to 
understand  or  to  do  something.  Provid- 
ing time  for  that  extra  turn  or  two  can 
mean  the  difference  between  success 
and  failure. 


6. 
Grouping 


Children  with  special  needs  are 
sometimes  isolated  from  other  children   ] 
outside  of  preschool.  One  of  the  bene- 
fits of  mainstreaming  is  that  it  offers 
these  children  the  opportunity  to  play 
with  other  children  and  to  learn  a  new 
skiU  by  seeing  someone  else  do  it  cor- 
rectly. You  can  plan  and  organize  yovr 
learning  situations  so  that  this  interac- 
tion, called  "peer  modeling,"  can  occur. 
In  areas  where  a  handicapped  child  is 
weak,  another  child  (a  peer)  who  has 
the  skiU  can  act  as  a  model.  Likewise, 
in  areas  where  a  handicapped  child 
excels,  he  or  she  might  be  paired  with  a 
less  skilled  child. 

No  child,  handicapped  or  non- 
handicapped,  is  good  at  everything  or 
bad  at  everything.  All  children  should 
have  the  opportunity  to  give  help  to 
their  classmates  and  to  receive  help 
from  them. 

Try  very  hard  not  to  exclude  a 
handicapped  child  from  any  activity 
that  he  or  she  can  cope  with  and  get 
something  out  of.  Exclusion  means  iso- 
lation, and  isolation  means  feeling  dif- 
ferent and  bad.  lb  include  the  child, 
give  extra  assistance  or  change  the 
expectations  for  the  child.  For  example, 
when  the  hamsters  need  to  be  fed, 
gather  the  children  around  and  allow 
the  disturbed  child  to  hold  open  the 
cage  door,  if  he  or  she  is  willing,  while 
you  put  in  the  food.  In  this  way,  the 
child  is  a  full  participant  in  the  activity, 
is  not  isolated,  is  not  interfering  with 
the  other  children,  is  having  fun,  and  is 
also  practicing  needed  social  skills. 

Individualized  teaching  does  not 
mean  isolating  a  child.  Rather,  it 
involves  modifying  the  activity  so  that 
all  children  can  participate  within  the 
same  learning  situation,  in  ways  most 
helpful  to  each. 


7. 

Children 
Helping 
Children 


We  have  already  mentioned  the 
benefit  of  using  children  as  models  for 
each  other.  This  principle  applies 
directly  to  using  non-handicapped  chil- 
dren to  assist  you  in  mainstreaming 
children  with  special  needs.  Your 
youngsters  will  probably  be  eager  to 
serve  as  helpers.  This  experience  has  a 
bonus:  it  helps  them  develop  positive 
attitudes  about  handicapped  people.  In 
addition,  their  help  will  free  some  of 
your  time  for  other  responsibilities. 


Ways  in  which  non-handicapped 
children  can  help  in  mainstreaming  a 
handicapped  child  include: 

•  alerting  a  child  whose  attention 
wanders  that  the  teacher  is  about 
to  give  a  direction 

•  helping  a  confused  or  distracted 
child  to  organize  his  or  her  mate- 
rials (for  example,  lining  up  the 
paper,  paste,  euid  scissors  for  an 
art  activity) 

•  sitting  close  to  an  easily  frightened 
child  to  provide  comfort  (for  exam- 
ple, when  the  lights  go  out  during 
a  film-strip) 

•  introducing  a  new  child  to  the 
physical  setting  of  the  clfissroom 
(for  example,  having  one  child 
show  the  disturbed  child  where  the 
bathroom  is) 

•  providing  a  child  with  opportuni- 
ties to  practice  a  newly  leeuned 
skill. 

Peer  helpers  should  be  used  often, 
and  this  includes  using  a  handicapped 
child  in  areas  where  he  or  she  excels.  In 
this  way,  all  the  children  will  learn  that 
they  each  have  areas  of  strength  and 
weakness.  They  will  also  learn  that  the 
need  to  receive  help  does  not  mean  that 
they  are  failures,  or  are  less  worthy 
than  those  who  offer  help. 

You  may  find  there  is  a  child  in 
your  class  who  is  unusually  responsible 
and  enjoys  being  a  big  brother  or  big 
sister  to  a  disturbed  child.  This  is  fine, 
but  make  sure  thay  you  are  not  relying 
so  much  on  your  helper  that  he  or  she 
becomes  a  substitute  teacher,  or  does 
more  for  the  disturbed  child  than  is 
needed. 


87 


88  8. 

Avoiding 
Over-Dependence 

It  is  sometimes  hard  to  be  accurate 
and  realistic  about  what  children  are 
capable  of  doing  for  themselves.  In  the 
case  of  many  children  with  special 
needs,  it  is  all  too  easy  to  assume  that 
they  are  more  helpless  than  they  really 
are.  Seeing  that  they  cannot  do  some 
things  may  make  us  think  that  they 
cannot  do  others. 

Furthermore,  some  parents  may 
have  overprotected  their  handicapped 
child  to  rnake  up  for  all  the  extra  prob- 
lems that  their  child  has  to  deal  with. 
This  means  that  some  children  may 
come  to  Head  Start  expecting  that 
everything  will  be  done  for  them,  sim- 
ply because  this  is  what  they  are  used 
to. 


Overprotecting  a  child  hinders  him 
or  her  from  learning  skills  and  behav- 
iors that  are  important  in  gaining  inde- 
pendence. You  have  to  ask  yourself:  "Is 
this  really  impossible  for  the  child? 
Could  the  child  do  it  alone  with  more 
time?  Could  the  child  do  it  with  more 
help  from  me?"  Think  hard,  and  be 
honest.  It  is  tempting  to  do  things  for 
a  clumsy  child  because  you  can  do 
them  faster  and  better.  But  if  you  are 
always  the  one  who  gets  a  desired  toy, 
settles  a  disagreement,  and  turns  the 
book  right-side  up,  the  child  won't  have 
the  chance  to  try  to  learn  to  do  these      ■ 
things.  And  isn't  the  child  in  your 
classroom  so  that  he  or  she  can  learn  to 
do  them? 

Being  extra  patient  and  giving  extra 
encouragement  to  children  who  try  to 
do  things  on  their  own  will  pay  oft 
many  times  in  the  future.  You  can  help 
children  think  of  themselves  as  able, 
not  unable.  When  they  grow  up,  they 
will  be  in  the  habit  of  expecting  as 
much  from  themselves  as  they  are 
really  capable  of. 


9. 
Confidentiality 

Making  sure  that  confidential  infor- 
mation stays  confidential  involves  care- 
ful record-keeping  and  watching  what 
you  say. 

Project  Head  Start  requires  pro- 
grams to  institute  careful  procedures, 
"including  confidentiality  of  program 
records,  to  insure  that  no  individual 
child  or  family  is  mislabeled  or 
stigrnatized  with  reference  to  a  handi- 
capping condition"  (OCD  Transmittal 
Notice  N-30-333-1-30,  "Head  Start 
Services  to  Handicapped  Children," 
February  28,  1973,  page  6).  The  Head 
Start  Performance  Standards  also  spell 
out  procedures  to  guarantee  confiden- 
tiality of  records: 

•  Records  must  be  stored  in  a  locked 
place  where  unauthorized  people 
can't  see  them. 

•  The  Head  Start  director  must 
determine  which  staff  members 
can  see  which  parts  of  the  records 
and  for  which  reasons. 

•  Parents  must  fill  out  written  con- 
sent forms  to  give  anyone  outside 
of  Head  Start  permission  to  see 
the  records. 

These  procedures  are  designed  to 
make  sure  that  all  records  on  a  handi- 
capped child  and  his  or  her  family  are 
seen  only  by  people  who  need  to  see 
them  for  legitimate  educational  or  med- 
ical reasons. 


Avoid  copying  down  confidential 
information  from  the  child's  records. 
Limit  the  confidential  information  you 
do  write  down  to  what  you  need  for 
working  with  the  child. 

You  should  not  repeat  confidential 
information  about  children  or  their  par- 
ents, either  to  other  parents  or  to  staff 
members  who  are  not  working  with  the 
children.  This  is  an  invasion  of  the  pri- 
vacy to  which  all  children  and  their  par- 
ents have  a  right. 

If  you  need  to  share  confidential 
information  with  another  staff  member 
to  help  him  or  her  work  better  with  the 
child,  have  your  discussion  in  a  private 
place  and  limit  it  to  necessary  informa- 
tion only. 

Tfeachers  have  sometimes  been 
embarrassed  to  find  that  their  com- 
ments about  a  handicapped  child's  fam- 
ily have  been  repeated  to  the  family. 
Parents  of  children  with  special  needs 
can  be  sensitive  about  this  issue,  and 
understandably  so.  Be  discreet  about 
what  you  say  —  and  to  whom  you 
say  it. 


89 


90 


Techniques 

and 

Activities 


This  section  is  in  two  parts.  The 
first  suggests  specific  techniques  for 
working  with  emotionally  disturbed 
children.  It  includes  guidelines  for 
improving  self-concept,  tips  to  keep  in 
mind,  how  to  handle  transition  times, 
how  to  set  limits,  and  how  to  use  physi- 
cal contact  as  guidance.  The  second 
part  describes  how  to  modify  a  number 
of  everyday  preschool  activities  for  use 
with  disturbed  children. 


Teaching 
Techniques 


There  are  a  number  of  techniques 
that  you  can  use  to  help  emotionally 
disturbed  children  in  your  classroom 
learn  better.  This  section  discusses 
some  of  the  more  helpful  techniques. 


Improving  Self-Concept 

Self-concept  is  a  term  used  to 
describe  how  a  person  feels  about  him- 
or  herself.  Chilcfren  who  feel  able  and 
valued  by  others  usually  develop  a  posi- 
tive self-concept.  They  see  their  world 
as  a  friendly,  pleasurable,  and  exciting 
place  to  be,  and  they  are  eager  to  try 
out  new  things.  Because  these  children 
feel  good  about  themselves  and  because 
they  want  to  learn,  they  are  often  suc- 
cessful at  what  they  do. 

On  the  other  hand,  children  who 
repeatedly  meet  with  failure  or  with 
disapproval  may  begin  to  think  of 
themselves  as  less  able  or  valued.  These 
children  are  more  likely  to  develop  a 
negative  self-concept.  They  begin  to  see 
the  world  as  an  unpleasant  and 
frightening  place,  where  trying  new 
things  is  scary.  EasUy  discouraged, 
these  children  often  feel  that  they  can't 
possibly  succeed.  They  may  hesitate  to 
try  anything  new  or  may  devalue  both 
their  efforts  and  their  products.  Low 
self-esteem  can  cause  children  to  fail 
over  and  over  again  because  they 
expect  failure  rather  than  success. 


A  child's  self -concept  is  affected  by 
the  people  who  are  important  to  him  or 
her.  For  example,  if  Jackie's  parents 
and  teacher  think  it  is  important  for 
her  to  dress  herself,  she  will  enjoy  their 
approval  and  feel  proud  of  herself  when 
she  struggles  into  her  snowsuit  and 
boots.  On  the  other  hand,  if  Bobby's 
attempts  to  bmld  a  sandcastle  are  met 
with  constant  criticism,  he  is  likely  to 
lose  interest  in  the  activity,  as  weU  as 
feel  incapable,  frustrated,  and  humil- 
iated. 

Although  poor  self-concept  is 
damaging  to  all  children,  it  is  a  special 
problem  for  children  with  emotional  dis- 
turbance, who  may  be  very  weU  aware 
that  in  some  ways  they  don't  measure 
up  to  the  other  children  or  that  they 
don't  fit  in  with  the  group.  An  anxious 
child,  for  example,  may  realize  that  he 
or  she  is  uncornfortable  in  situations 
where  other  children  join  right  in.  Or  a 
hyperactive  child  may  be  aware  that  he 
or  she  is  the  one  who  always  causes 
accidents  at  the  water  table.  These  feel- 
ings can  cause  children  to  feel  less  val- 
ued or  worthy  than  other  children.  This 
is  why  disturbed  children  are  very 
much  in  need  of  successes.  With  suc- 
cessful experiences,  these  children  will 
feel  better  about  themselves. 

The  two  most  essential  supports  a 
teacher  can  provide  to  nurture  a  posi- 
tive self-concept  are: 

•  helping  a  child  to  experience  many 
successes  in  varied  activities 

•  letting  a  child  know  that  he  or  she 
is  valued  for  his  or  her  own  self. 

Below  are  some  guidelines  you  can  fol- 
low to  help  children  develop  a  better 
self -concept. 


Think  Positively  About  the  Child 

As  you  think  about  and  plan  your 
work  with  a  child,  focus  on  the  child's 
strengths.  Believe  that  the  child's 
behavior  can  be  improved  upon  and 
changed  and  recognize  that  your  atti- 
tude toward  the  child  plays  an  impor- 
tant role  in  what  and  how  the  child 
learns,  and  in  how  the  child  feels  about 
him-  or  herself. 


Help  Others  to  Think  Positively  About 
the  Child 

Parents  need  to  feel  that  they  play  a 
significant  role  in  their  child's  learning. 
When  you  communicate  to  parents 
your  appreciation  for  their  child  and  his 
or  her  efforts  and  progress  in  preschool, 
parents  are  more  likely  to  appreciate 
the  child's  efforts  and  accomplishments 
at  home.  Meeting  with  encouragement 
and  praise  from  a  variety  of  sources, 
chilcken  are  more  likely  to  try  new, 
more  challenging  experiences. 

Help  other  children  in  your  class  to 
think  more  positively  about  a  disturbed 
child,  too.  Encourage  them  to  include 
the  child  in  their  play.  Design  activities 
so  that  this  can  be  done.  Tfeach  children 
by  your  example  to  treat  others  fairly 
and  kindly.  Encourage  children  to  help 
a  disturbed  child  learn  necessary  skUls 
or  behavior  by  being  helpers  or  friends. 


Work  Positively  with  the  Child 

All  children  need  to  be  shown  that 
they  are  cared  about  and  that  what  and 
how  they  do  things  does  matter.  Praise 
progress,  no  matter  how  small.  Praise 
the  effort  a  child  puts  forth  even 
though  the  results  may  not  meet  your 
(or  the  child's)  expectations.  Be  posi- 
tive, even  about  failures.  You  can 
encourage  success  by  saying,  for  exam- 
ple, "You  tried  very  hard.  With  such 
good  practice,  I'm  sure  that  you  will 
learn  how  to  do  that  soon."  Be  tender, 
accepting,  loving,  and  patient.  Use 
woras  and  gestures  to  express  your 
supportiveness.  As  children  begin  to 
feel  better  about  themselves  and  more 
self-confident  in  their  abilities,  you  may 
begin  to  see  that  they  can  manage  by 
themselves  more  often.  Just  knowing 
that  they  are  performing  well  helps 
them  feel  good  about  themselves.  How- 
ever, building  a  positive  self-concept  is 
a  slow  process  and  you  will  need  to  be 
patient.  Some  children  wiU  continue  to 
depend  on  praise  while  others  wQl  grad- 
ually internalize  your  esteem  for  them 
and  win  feel  genuinely  self-confident. 


91 


92 


Tips  to  Keep  in  Mind 

1.    Make  It  Simple 

When  you  are  explaining  some- 
thing, keep  your  directions  simple. 
Use  only  a  few  words.  Speak  slowly 
and  clearly.  Some  disturoed  children 
become  confused  when  you  tell  them 
too  many  things  at  one  time.  Others 
will  not  be  able  to  sit  still  for  lengthy 
explanations. 

Show  the  child  how  to  do  the  par- 
ticular task.  Physically  move  the 
child  through  the  task  so  that  he  or 
she  begins  to  "feel"  what  to  do.  For 
example,  if  you  are  teaching  an  anx- 
ious child  how  to  use  the  sand  table, 
gently  guide  his  or  her  hands  through 
the  sand  to  show  the  child  how  the 
sand  feels. 

Stand  or  sit  close  to  the  child  dur- 
ing the  task  so  you  can  help  when 
needed  (but  only  when  needed!). 

Reduce  clutter  and  noise.  Use 
materials  that  are  clear  and  plain, 
with  bold  lines.  Avoid  materials  that 
have  confusing  backgrounds  or 
crowded  pages. 


2.    Make  It  Short 

Some  of  the  disturbed  children 
you  work  with  will  be  very  active. 
Some  may  get  easily  distracted.  It 
will  be  hard  for  them  to  sit  and  Hs- 
ten.  When  a  child  doesn't  pay  atten- 
tion, make  sure  that  the  activity  isn't 
too  hard.  Most  of  us  quit  trying  when 
we  don't  understand  what  to  do. 
Some  children  also  have  problems 
when  the  activity  is  long,  even  when 
it  is  simple.  Know  when  a  child  has 
had  enough. 


3.    Keep  It  Orgemized 

Help  the  children  organize  their 
world  by  providing  structure  for  them. 
Plan  each  day  so  that  it  is  balanced 
between  quiet  times  and  active  times. 
Discuss  the  routine  with  the  children. 
As  you  finish  each  activity,  explain 
what  comes  next.  You  might  even  post 
a  picture  schedule  to  show  the  order 
and  kinds  of  activities.  Follow  the  same 
routine  each  day,  so  the  children  can 
anticipate  the  next  activity. 

Give  clear  directions,  but  only  one 
at  a  time.  Show  the  child  how  to  do 
what  you  are  describing. 

Don't  change  activities  abruptly. 
Let  the  children  know  that  it  will  be 
time  to  stop  "when  the  beU  rings," 
"when  the  lights  go  off  and  on,  '  or 
"when  you  hear  music."  This  allows  the 
children  to  get  ready  for  the  shift,  and 
can  help  prevent  tears  and  tantrums. 


4.    Teach  It 

It  is  t5T3ical  for  children  to  learn  in 
informal  ways.  They  pick  up  on  lots  of 
things  that  they  see  around  them  and 
soon  recognize,  know,  and  can  respond 
to  them.  But  children  who  are  dis- 
turbed often  have  to  be  taught  the 
appropriate  responses  that  other  chil- 
dren learn  on  their  own. 

With  some  disturbed  children,  it 
helps  to  use  more  demonstrations  alongj 
with  words.  Don't  just  tell  them  how  to 
do  something;  show  them  how. 

Give  the  children  lots  of  practice. 
Allow  children  to  repeat  the  same  activi 
ity  in  the  classroom  and  on  the  play- 
groimd.  The  more  they  do  an  activity, 
the  better  they  wiU  remember  it. 

Point  things  out  and  describe  them. 
For  example,  "Look  at  how  that  lady  is 
taking  big,  giant  steps.  Now  she's  tak- 
ing tiny,  baby  steps.  Can  you  take  a 
big  step  and  a  little  step?" 

Tfeach  in  small  steps  and  don't  go 
too  fast.  But  expect  a  little  more  from 
the  children  each  day.  Remind  them  of 
their  successes  and  encourage  them  to 
try  their  best. 


5.    Make  It  Meaningful 

Select  activities  that  give  a  child  a 
reasonable  chance  for  success.  Ingre- 
dients for  success  are  self-confidence, 
notivation,  and  mastery.  When  chil- 
iren  think  they  can  do  a  task,  enjoy 
:he  challenge  it  provides,  and  have  the 
lecessary  skills,  they  are  likely  to 
become  involved  and  gain  a  sense  of 
iccomplishment. 

Show  an  active  interest  in  each 
child's  accomplishments.  Many  children 
jnioy  sharing  their  successes  with  each 
Dther  —  even  showing  off  a  bit.  Others 
ire  more  self-conscious.  They  are 
Dleased  with  their  success  in  a  quiet 
A^ay  and  appreciate  a  friendly  acknowl- 
edgment without  much  fanfare. 

Be  sure  to  show  respect  for  each 
child's  work.  Take  the  time  to  display  a 
painting  attractively.  Put  the  child's 
lame  on  his  or  her  work.  Find  a  safe 
place  to  keep  what  the  children  make. 
Remind  children  to  take  their  things 
lome  and  share  their  accomplishments 
ivith  their  family.  For  disturbed  chil- 
iren,  such  respectful  care  for  their  work 
s  particularly  important. 


Handling  TVansition 
Times 

The  hardest  times  for  many 
teachers  and  children  are  the  transition 
times  —  the  times  between  activities. 
For  children  with  emotional  disturbance 
these  unstructured  times  can  be  disas- 
trous. Without  careful  management,  the 
time  can  become  confusing.  And  misbe- 
havior often  results  from  confusion. 

When  the  children  must  all  move 
from  one  area  of  the  room  to  another,  it 
helps  to  divide  them  into  smaller 
groups.  This  cuts  down  on  the  milling 
around  and  sets  a  smoother  tone  for 
the  next  activity. 

Tb  prepare  children  for  a  change  in 
activity,  teU  them  a  few  minutes  ahead 
of  time  that  they  will  have  to  stop 
when  the  bell  rings,  when  they  hear 
music,  or  when  the  lights  go  off  and  on. 
This  winding-down  time  is  especially 
important  for  many  disturbed  children. 

You  might  also  find  it  helpful  to 
assist  a  disturbed  child  during  these 
times  by  walking  with  him  or  her, 
pairing  the  children  with  partners,  and 
so  forth. 


93 


Take  time  to  explain  appropriate  behavior 
to  children. 


94  Setting  Limits 

Some  limits  must  be  put  on  children 
to  protect  their  physical  safety.  Safety 
limits  are  usually  clear-cut:  for  example, 
"We  walk  in  the  classroom"  and  "Look 
both  ways  before  crossing  the  street." 
State  safety  limits  simply  and  fre- 
quently, and  demonstrate  them  when 
necessary.  Enforce  them  consistently, 
so  that  children  will  learn  that  they 
must  be  followed. 

Children  also  need  limits  to  help 
them  control  their  behavior.  Unlike 
safety  Umits,  behavioral  limits  require 
you  to  make  some  judgments  about 
what  is  appropriate  and  what  is  not. 
Each  of  us  has  a  range  of  child  behav- 
ior that  we  accept  or  can  tolerate  in  our 
classrooms.  (Some  teachers  don't  mind 
a  lot  of  noise  or  a  messy  paint  area, 
while  others  can't  stand  this.) 

Whatever  behavioral  limits  you  set, 
be  consistent  in  enforcing  them.  If  the 
limits  keep  changing,  the  children  will 
never  know  what  you  expect,  and  wiQ 
not  learn  what  you  are  trjdng  to  teach. 
Praise  children  for  their  efforts,  and  try 
to  ignore  borderline  but  tolerable 
behavior.  Let  the  children  know  that 
you  accept  and  respect  them,  whatever 
the  quality  of  their  performance.  As  a 
result,  the  children  will  not  feel  person- 
ally threatened  by  failure.  They  will 
approach  learning  without  fear. 

Before  setting  a  behavioral  limit, 
look  carefully  at  the  behavior  you  are 
concerned  with,  and  ask  yourself  the 
following  questions. 


How  Does  It  Affect  the  Other 
Children? 

Does  the  behavior  disrupt  the  learn- 
ing of  the  other  children?  If  the  behav- 
ior does  not  disturb  the  other  children, 
then  perhaps  you  should  try  to  learn  to 
live  with  it. 

For  example,  if  Andrew's  thumb- 
sucking  seems  much  more  annoying  to 
you  than  to  everyone  else  in  the  class, 
then  perhaps  that  behavior  should  be 
tolerated. 


Can  the  Child  Help  It? 

Does  the  child  have  control  over  the 
behavior?  For  example,  if  Eddy  races 
around  the  classroom  and  can't  seem  to 
slow  down,  then  you  should  try  to 
design  activities  for  Eddy  that  use  and 
direct  this  energy.  Focusing  on  Eddy's 
need  to  expend  energy,  rather  than  on 
his  racing  around,  can  be  helpful  to  you 
both. 


Is  a  Change  Justified? 

Do  you  have  a  good  reason  for 
wanting  to  change  the  child's  behavior? 
What  is  your  educational  reason  for 
wanting  to  alter  the  behavior?  In  other 
words,  make  sure  the  behavior  change 
is  good  for  the  chQd,  not  just  more 
convenient. 

Patty  is  a  child  who  has  a  hard  time 
working  in  a  group.  She  needs  to 
develop  better  social  skills.  While  a 
large  group  activity  may  be  easier  for 
you  to  manage,  it  may  not  be  the  best 
thing  for  Patty  at  this  time.  Encourag- 
ing Patty  to  participate  in  a  small 
group  activity  (such  as  playing  "doUs") 
can  give  Patty  practice  with  the  same 
skills  and  would  probably  aUow  her  to 
feel  more  relaxed. 


Can  You  Think  of  Substitute  Behavior? 

What  behavior  do  you  want  the 
child  to  substitute  for  the  unacceptable 
behavior?  One  good  way  to  help  chil- 
dren change  undesirable  behavior  is  to 
teach  them  a  good  substitute.  A  child 
who  hits  other  children  can  be  taught 
to  be  angry  with  words,  or  to  stalk 
away  from  the  anger-producing  situa- 
tion, or  to  hit  a  punching  bag.  Make 
sure  that  the  new  behavior  competes 
with  the  undesirable  one.  Simon  can't 
hit  Carey  and  stalk  away  from  her  at 
the  same  time,  so  stalking  away  would 
be  a  successful  technique  for  him. 


Physical  Contact 

Physical  contact  can  be  used  with 
emotionally  disturbed  children  just  as  it 
is  with  normal  children: 

•  to  ensure  the  safety  of  the  child 
and  of  those  around  him  or  her 

•  to  provide  support,  guidance,  and 
encouragement. 

Ways  of  ensuring  safety  for  an  emo- 
tionally disturbed  child  range  from 
offering  your  hand  as  support  during  a 
balance  beam  activity  to  rigorously 
holding  (restraining)  a  child  who  is  out 
of  control  and  threatening  to  hurt  him- 
or  herself  or  others. 

Physical  contact  is  a  way  of  ex- 
pressing your  affection  for  a  child.  In 
so  many  ways,  emotionally  disturbed 
children  need  this  kind  of  contact.  A 
gentle  hug  or  pat  often  helps  these  chil- 
dren to  start  believing  that  they  are 
worthwhile  persons  whom  others  can 
enjoy  being  with.  You  may  find  that 
some  disturbed  children  shy  away  from 
physical  contact.  Be  patient.  It  takes 
time  to  build  trust  and  develop  the  abil- 
ity to  accept  affection. 

Physical  contact  is  an  especially 
good  way  of  teaching  many  disturbed 
children,  who  can  often  learn  best  by 
being  "moved  through"  an  activity  one 
or  more  times,  until  independent  parti- 
cipation is  possible.  Put  your  hands  on 
Marilyn's  shoulders  and  walk  her 
around  the  circle.  Put  the  crayon  in 
Peter's  hand  and  put  your  hand  over 
his,  so  that  he  can  feel  the  motions  of 
drawing  a  stencil  pattern. 


95 


96  Using  physical  guidance  as  you 

move  Manlyn  around  a  circle  and  as 
you  help  Peter  with  the  stencil  is  a  tem- 

Eorary  technique  that  allows  them  to 
e  successful  on  their  own.  In  this 
sense,  physical  guidance  (and  stencils, 
too)  are  like  training  wheels  on  a  two- 
wheel  bike.  The  success  children  have 
with  your  help  makes  them  more  will- 
ing to  try  again,  and  the  structured 
practice  helps  them  learn  more  quickly. 
After  a  while,  your  help,  just  like  the 
training  wheels,  will  no  longer  be 
needed. 

Physical  restraint  may  be  helpful 
when  a  child  is  truly  out  of  control  and 
when  scolding  only  seems  to  make  mat- 
ters worse  —  provoking  another  out- 
burst or  making  the  child  feel  abso- 
lutely miserable.  You  should  use 
restraint  as  little  as  possible,  and  only 
as  a  last  resort.  Physical  restraint 
should  be  done  in  a  matter-of-fact  way, 
showing  concern  but  not  anger.  After 
restraining  a  child  you  should  spend 
some  time  with  him  or  her  until  he  or 
she  has  regained  composure.  This  kind 
of  restraint  is  time  consuming  and 
requires  a  firm  understanding  of  the 
child's  underlying  problems,  not  just  of 
the  behavior  you  are  trying  to  control. 


Activities 


The  general  purposes  of  classroom 
activities  are  essentially  the  same  for 
all  children: 

•  to  promote  ment£tl,  physical,  and     , 
social  development  | 

•  to  teach  skills  in  the  major  devel- 
opmental areas  (motor,  cognitive, 
speech  and  language,  self-help,  and 
social) 

•  to  allow  for  the  practice  and  dis- 
play of  these  skills 

•  to  give  each  child  the  sense  that  he 
or  she  is  a  growing,  competent 
individual. 

It  is  the  teacher's  job  to  present  activi- 
ties in  a  way  that  provides  each  child 
with  the  best  opportunity  for  success. 
For  a  child  with  emotional  disturbance, 
certain  activity  modifications  may  be 
necessary  to  ensure  his  or  her  success. 

This  section  describes  a  number  of 
activities  that  take  place  daily  in  many 
preschools.  Each  description  includes 
ways  of  modifying  the  activity  so  that 
children  with  various  emotional  disor- 
ders can  participate  and  learn.  The 
activities  are  presented  in  the  order  in 
which  they  might  take  place  in  a  typi- 
cal full-day  program.  Of  course,  each 
teacher  must  decide  which  activities  are 
best  for  the  particular  group,  and 
arrange  them  in  the  order  that  makes 
the  best  sense  for  the  particular  pro- 
gram. 


Arrivals, 
Departures, 
and  Other 
Transition  Times 

Many  preschool  children  have  not 
yet  mastered  the  concepts  of  time  and 
change.  Without  a  sense  of  continuity 
and  a  sense  of  the  future,  transition 
times  can  be  confusing  to  them.  Dis- 
turbed children,  especially,  may  be  con- 
fused and  fearful  during  transitions. 
They  need  the  help  of  adults  to  get 
through  these  difficult  times  of  the  day. 

Handled  properly,  transition  times 
can  be  used  to  teach  children  to: 

•  deal  with  septiration  from  a  loved 
one 

•  trust  persons  outside  their  immedi- 
ate family 

•  cope  with  changing  structure  (for 
exEunple,  end  one  activity  and  start 
a  new  one) 

•  cope  with  a  great  deal  of  move- 
ment, noise,  emd  visual  stimulation. 


Preparation 

For  arrivals  and  departures,  make 
sure  that  the  adults  follow  a  regular 
routine  for  greeting  or  sending  off  chil- 
dren, and  in  helping  them  dress  or 
undress.  If  the  adults  are  disorganized, 
the  children  wiU  have  to  deal  with  even 
more  confusion. 

Before  changing  an  activity,  make 
certain  that  the  new  area  of  activity  is 
ready  for  use.  Aides  and  volunteers 
should  be  free  to  orient  the  children, 
not  busy  with  last-minute  preparations. 

Alert  children  several  times  that  a 
transition  is  about  to  take  place.  Transi- 
tions should  not  be  surprises.  An- 
nounce the  day's  schedule  early  in  the 
morning,  and  then  give  a  countdown 
before  an  actual  change  ("In  a  few  min- 


utes we  have  to  start  cleaning  up  . . 
We  should  start  to  clean  up  now, 
because  it's  almost  time  for  snack"). 


Conducting  the  Activity 

1.  Before  everyone  starts  moving 
around,  ask  the  children  to  sit  qui- 
etly for  10  to  20  seconds.  This  gives 
everyone  (adults,  too)  time  to  orga- 
nize him-  or  herself. 

2.  Announce  the  movement,  then 
accompany  the  group  to  the  new 
area.  If  someone  else  is  taking 
charge  of  the  new  activity, 
announce  that  to  the  children,  too. 
If  you  are  going  outside,  don't  let 
everyone  race  to  the  door  or  coat 
rack  all  at  once.  Send  them  up  one 
at  a  time.  If  the  children  are  to  form 
lines,  call  out  their  names  one  by 
one,  in  the  same  order  each  time. 

3.  During  arrival  times,  try  to  have 
the  same  familiar  face  greet  the  chil- 
dren and  talk  about  what  they  will 
be  doing  that  day.  The  same  proce- 
dure applies  to  departure  times.  As 
the  adults  help  the  children  put  on 
their  coats,  they  can  remind  them 
about  the  next  day's  activities 
("Remember,  tomorrow  morning 
we're  going  to  bake  chocolate  chip 
cookies"). 


97 


Activities 


98 


Tips 

Adults  often  take  transitions  too 
lightly.  Since  transitions  have  no  "prod- 
uct," some  adults  may  not  consider 
them  a  real  activity.  You  should  make 
sure  that  the  program's  staff  do  not 
underestimate  the  difficulty  and  impor- 
tance of  transitions  for  children. 

Holidays,  weekends,  and  vacations 
are  not  always  understood  or  appre- 
ciated by  youngsters  in  preschool.  They 
need  a  great  deal  of  reassurance  that 
everything  will  resume  as  usual  when  a 
weekend,  holiday,  or  vacation  ends. 

When  the  weather  is  bad,  leave 
plenty  of  time  for  dressing  and  undress- 
ing. Snowsuits  and  rain  gear  can  com- 
plicate transitions. 


Modifications  for  an  Aggressive  Child 

Since  an  aggressive  child  has  diffi- 
culty coping  with  change,  it  is  impor- 
tant to  remind  him  or  her  gently,  and 
well  in  advance,  that  an  activity  is 
going  to  end  and  a  new  one  begin. 
Repeat  the  reminder  several  times 
before  announcing  countdowns  to  the 
group.  Encourage  the  child  to  express 
his  or  her  feelings  in  words  rather  than 
actions. 

Be  especially  aware  of  behavior 
when  the  group  is  in  a  line.  Children 
naturally  push  and  shove  in  lines,  and 
aggressive  children  are  particularly 
hard-pressed. 

As  an  aggressive  child  learns  to 
accept  transitional  routines  and  handle 
them  successfully,  gradually  reduce  the 
extra  supports.  Eventually  the  child 
may  need  only  the  amount  of  warning 
time  you  give  the  rest  of  the  group. 


Modifications  for  a  Hyperactive  Child 

Although  it  is  not  likely  that  you 
can  calm  down  a  hyperactive  child,  you 
can  help  the  child  perform  well  by 
explaining  directions  clearly.  Concen-      I 
trate  on  giving  the  child  directions  that 
are  short,  simple,  and  specific.  Rather 
than  teU  the  child  what  not  to  do 
("Stop  that  running"),  assign  the  child 
a  small,  clearly  defined  task  ("I  want 
you  to  sit  in  that  chair  for  10  sec-  J 

onds").  Help  the  child  to  increase  his  or 
her  self-awareness  by  reminding  the 
child  of  his  or  her  situation  with  a  sim- 
ple phrase  ("You're  getting  too  ex- 
cited"). Try  to  maintain  a  cakn  attitude 
and  tone  of  voice  while  organizing  the 
activity.  Your  calmness  may  have  a        , 
soothing  effect  upon  the  child  and 
reduce  the  amount  of  stimulation  with 
which  he  or  she  has  to  deal. 


Remind  the  children  in  advance  that 
the  activity  will  be  changing. 


99 


When  the  child  appears  to  have 
learned  the  sequence  of  steps  involved 
in  the  activity,  you  can  begin  to  reduce 
the  amount  of  individual  instruction 
you  have  been  giving  the  child.  As  the 
child  becomes  more  self-aware  and 
learns  more  self-control,  you  can  also 
cut  down  on  the  number  of  reminders 
you  give  about  getting  too  excited.  At 
that  point  you  can  begin  to  concentrate 
on  lengthening  the  child's  attention 
span  and  on  increasing  his  or  her  inter- 
est in  performing  tasks.  For  example, 
you  might  begin  to  give  more  than  one 
instruction  at  a  time  to  the  child,  and 
to  explain  what  is  going  to  happen 
next. 


Modifications  for  an  Anxious  Child 

Transition  is  probably  the  most  dif- 
ficult activity  for  anxious  children. 
They  are  being  asked  to  leave  what  has 
become  familiar  and  safe  and  enter  a 
new  situation.  It  is  important  to  pre- 
pare an  anxious  child  for  a  transition 
well  in  advance.  Once  such  a  child 
panics,  it  becomes  difficult  to  communi- 
cate with  him  or  her. 

Whenever  possible,  an  anxious  child 
should  explore  a  new  area  and  activity 
beforehand,  with  a  trusted  adult.  For 
example,  before  a  science  activity  you 
might  allow  the  child  to  inspect  the 
work  area  and  show  him  or  her  how  to 
handle  any  new  equipment.  To  reassure 
the  child  of  his  or  her  return  to  a  famil- 
iar area,  give  the  child  a  favorite  toy  or 
book  from  the  area.  Escort  the  child 
between  areas  when  the  actual  transi- 
tion takes  place,  too. 

Routine  has  a  soothing  effect  on  an 
anxious  child.  As  the  day  and  week 
become  more  predictable,  the  child  will 
feel  in  greater  control.  At  that  point, 
you  may  be  able  to  discuss  the  child's 
feelings  with  him  or  her.  The  child 
should  learn  to  recognize  when  he  or 
she  is  becoming  anxious  and  to  seek 
help  from  adults  at  such  times.  Simply 
discussing  his  or  her  feelings  aloud  can 
help  the  child  cope,  as  do  an  adult's 
reassurances. 


Activities 


100 


Modifications  for  a  Withdrawn  Child 

There  are  many  different  causes  of 
withdrawal  in  children,  and  the  source 
of  the  problem  can  affect  how  you  work 
with  a  withdrawn  child.  Many  pre- 
schoolers are  frightened  and  shy 
because  they  are  away  from  home  for 
the  first  time.  Those  who  have  underde- 
veloped receptive  language  may  be  una- 
ble to  understand  what  a  new  adult  is 
saying.  Those  who  have  never  been  in  a 
group  before  may  not  understand  such 
concepts  as  moving  together  and  begin- 
ning and  ending  activities  on  request. 
By  studying  the  individual  child 
closely,  you  will  be  able  to  determine 
how  best  to  proceed.  Most  shy  children 
will  open  up  with  a  little  individual 
attention  from  you.  Children  with  lan- 
guage problems  will  require  your  doing 
extra  things  to  get  their  attention,  such 
as  a  touch  or  a  gesture,  until  they  are 
familiar  with  the  procedure.  Children 
who  are  unfamiliar  with  working  in  a 
group  require  patient  instruction. 
Learning  is  a  process  that  takes  time. 

You  may  have  in  your  class  a  with- 
drawn child  who  understands  what 
behavior  is  desired  but  refuses  to  par- 
ticipate. This  child  may  be  fearful  of 
attempting  new  activities  and  wiU  need 
extra  encouragement  and  support  from 
you.  Praise  the  child  for  any  efforts. 
After  the  child  has  had  some  success 
with  the  activity,  it  should  become 
easier  for  him  or  her  to  participate. 


Modifications  for  a  Psychotic  Child 

Psychotic  children  have  great 
trouble  understanding  the  world  around 
them.  Their  ability  to  communicate  ver- 
bally is  Hmited.  They  have  little  sense 
of  time.  They  have  a  hard  time  coping 
with  noise  and  movement.  And  they 
have  great  difficulty  tolerating  changes 
in  activity,  setting,  or  personnel.  For 
these  reasons,  a  transition  may  be  com- 
pletely incomprehensible  and  over- 
whelming to  a  psychotic  chQd.  | 

Initially,  you  should  try  to  limit  the 
number  of  transitions  as  much  as  possi- 
ble. The  same  adult  should  help  the 
child  through  nearly  every  transition. 
When  the  child  begins  to  act  in  a  con- 
fused manner,  the  adult  should  attempt 
to  calm  the  child,  and  try  to  interpret 
his  or  her  feelings  ("What's  the  matter? 
Are  you  afraid  to  go  to  lunch?  Do  you 
want  me  to  take  you?").  The  adult  may 
anticipate  such  confusion  whenever 
there  is  a  large  amount  of  noise  or 
movement  in  the  area.  A  child's 
unusual  behavior  at  these  times  often 
results  from  the  child's  confusion,  fear, 
and  inability  to  communicate  needs  and 
feelings  verbally. 

Depending  upon  the  severity  of  the 
disorder,  you  may  be  able  to  teach  the 
child  appropriate  words  and  phrases  to 
express  nim-  or  herself.  After  gradual 
and  gentle  contact  with  other  adults, 
the  child  may  be  able  to  work  with 
them  as  well.  Start  by  including  one 
other  adult  in  your  instruction  of  the 
child.  Once  the  child  has  learned  to  be 
comfortable  with  the  new  adult,  you 
can  gradually  withdraw  from  the 
situation. 


Circle  Time 


For  five-year-olds  and  most  mature 
four-year-olas,  circle  time  can  be  an 
excellent  way  to  begin  the  daily  activi- 
ties. Done  early  in  the  morning,  circle 
time  can  help  to  encourage  smooth 
transitions  throughout  the  day.  For 
younger  children,  three  or  four  years 
old,  it  may  be  better  to  conduct  circle 
time  later  in  the  day  and  focus  on  what 
the  children  have  done  that  day. 

Circle  time  is  helpful  for  improving 
children's: 


ability  to  socialize 

ability  to  behave  in  a  group 

daily  orientation 

ability  to  listen 

speech  and  leinguage  development. 


Preparation 

Have  the  day's  schedule  worked  out. 
Vlake  up  a  seating  chart  for  circle  time, 
[f  furniture  is  to  be  used,  arrange  it  in 
idvance.  Have  materials  (felt  or  black- 
ooard  and  chalk)  in  order  and  on  hand. 


Conducting  the  Activity 

1.  Get  all  the  children  who  will  partici- 
pate seated  quietly. 

2.  Begin  with  a  few  simple  remarks  to 
orient  the  children  and  ease  them 
into  the  learning  situation  ("Do  you 
see  something  new  in  the  room 
today?"  "Let  s  talk  about  what  hap- 
pened at  the  puppet  show  this 
morning").  You  might  describe  the 
weather  and  mention  upcoming  holi- 
days. 

3.  Give  the  children  a  clear  idea  of  the 
day's  schedule.  Be  sure  to  empha- 
size unusual  or  special  events, 
annoimce  absences,  and  identify 
other  adults  who  are  in  the  class- 
room that  day.  Hemember,  however, 
that  many  children  have  short 
memories  and  may  need  gentle 
reminders  of  these  facts  during  the 
day. 

4.  Begin  a  speaking  activity  such  as 
"Show  and  TfeU." 


101 


Activities 


102 


Tips 

The  success  of  this  activity  depends 
on  establishing  and  maintaining  inter- 
est. Ask  the  children  to  sit  quietly  and 
to  speak  in  turns.  Encourage  them  to 
live  up  to  these  expectations  on  a  regu- 
lar basis. 

Keep  in  touch  with  how  well  the 
group  is  paying  attention.  Try  to 
involve  as  many  children  as  possible  in 
the  discussion.  Be  ready  to  adjust  your 
agenda  according  to  the  mood  of  the 
group. 

Place  children  and  adults  strategi- 
cally. Make  sure  that  an  adult  is 
nearby  in  case  a  child  begins  to  with- 
draw or  feel  restless.  Often  the  close- 
ness of  an  adult  will  be  enough  to  help 
a  child. 

It  is  possible  that  circle  time  will 
simply  be  inappropriate  for  some  chil- 
dren. Try  to  have  other  activities  avail- 
able for  these  children,  and,  if  neces- 
sary, staff  to  supervise  them. 

It  is  important  to  establish  proper 
procedures  as  quickly  as  possible.  The 
child  must  learn  that  he  or  she  can  get 
attention  by  raising  a  hand  and  waiting 
for  a  turn,  and  that  speaking  out  or 
clutching  will  not  work.  Once  the  child 
has  learned  the  rules,  you  can  use  silent 
signals  (finger  to  the  lips,  pointing)  to 
remind  him  or  her  without  interrupting 
the  group. 

Praise  the  child  for  good  group 
behavior  ("Good  sitting,"  or  'Nice  job 
of  paying  attention").  In  this  way  you 
let  the  child  know  that  he  or  she  has 
not  been  forgotten  or  unnoticed. 


Modifications  for  an  Aggressive  Child 

Aggressive  children  are  often  fearful 
of  attack  by  others.  Being  close  to 
others  feels  dangerous  to  them.  They 
become  overly  sensitive  when  they  feel, 
or  imagine,  that  others  are  moving  into 
their  personal  space.  If  possible, 
arrange  the  seating  to  provide  extra 
space  on  either  side  of  an  aggressive 
child's  chair.  Seat  the  child  in  between 
unaggressive,  non-threatening  children. 
Placing  the  child  next  to  an  adult  may 
not  work  well,  because  of  the  child's 
tendency  to  cling  to  adults.  Watch 
closely  for  signs  that  an  assault  may 
take  place:  angry  looks  and  threatening 
words  or  gestures.  When  these  signs 
appear,  you  may  need  to  involve  the 
child  in  a  different  activity. 


Modifications  for  a  Hyperactive  Child 

Circle  time  is  hard  for  hyperactive 
children.  Despite  their  impulsiveness 
and  need  for  Dody  activity,  they  are 
asked  to  sit  quietly  in  a  chair.  Despite 
difficulty  focusing  their  attention,  they 
are  asked  to  follow  closely  a  group  con- 
versation that  may  cover  several  sub- 
jects in  ten  or  fifteen  minutes,  with  lit- 
tle individual  attention  from  the  group 
leader. 

A  good  method  to  use  during  circle 
time  is  to  call  on  the  child  frequently. 
When  the  child's  energy  is  being 
focused  on  the  task  (discussion),  he  or 
she  is  likely  to  show  less  body  move- 
ment. Calling  on  the  child  can  increase 
his  or  her  attention  span  somewhat. 
The  shorter  the  time  oetween  ques- 
tions, the  less  danger  there  is  tnat  the 
child's  attention  will  wander. 

It  is  unreasonable,  however,  to 
expect  long  periods  of  appropriate 
behavior  from  a  hyperactive  child  early 
in  the  year.  Keep  activities  short  and 
give  du-ections  frequently.  As  vou  see 
some  improvement  in  the  chila,  make 


efforts  to  extend  his  or  her  attention 
span.  You  should  always  have  an 
alternative  activity  available  for  the 
child.  Some  hyperactive  children  may 
learn  an  activity  more  easily  by  watch- 
ing other  children  perform  it,  particu- 
larly if  an  adult  sits  nearby  to  share 
their  interest. 


Modifications  for  an  Anxious  Child 

Since  an  anxious  child  tends  to  view 
circle  time  as  a  situation  that  could  be 
threatening,  it  is  wise  to  seat  such  a 
child  between  non-aggressive  children. 
As  the  child  learns  to  perceive  the  situ- 
ation more  realistically,  he  or  she  may 
become  less  sensitive  to  the  closeness 
of  other  people. 

Offer  an  anxious  child  the  opportu- 
nity to  speak  regularly,  but  don't  per- 
sist if  the  child  appears  uncomfortable. 
Self-control  is  fra^e  under  pressure: 
the  child  may  react  badly  if  forced  to 
respond  or  perform  in  front  of  a  group. 
As  the  child  becomes  more  comfortable 
and  self-confident  in  the  situation,  you 
can  gently  encourage  him  or  her  to  par- 
ticipate more. 


Modifications  for  a  Withdrawn  Child 

It  is  not  a  good  idea  to  force  a  with- 
drawn child  to  participate  in  circle  time. 
Although  this  child  may  not  react  as 
explosively  as  an  anxious  child,  a 
slower,  less  demanding  approach  is  usu- 
ally more  effective.  Let  the  child  watch 
and  listen.  Watch  carefully  for  the 
child's  first  attempts  to  communicate. 
Your  response  should  be  prompt,  but 
not  overwhelming.  As  the  child's  self- 
confidence  increases,  he  or  she  will  be 
much  more  willing  to  participate  in  dis- 
cussions. 


Modifications  for  a  Psychotic  Child 

The  theme  of  circle  time  is  com- 
munication, which  is  one  of  psychotic 
children's  weakest  skills.  It  may  be 
impossible  for  these  children  to  follow 
conversations  or  behave  according  to 
the  rules.  You  may  find  it  helpful  to 
assign  an  adult  to  sit  with  the  child 
during  the  activity.  The  adult  may  help 
to  soothe  the  child's  fears  and  enable 
him  or  her  to  sit  with  the  group.  As  the 
year  progresses,  the  child  may  have 
developed  enough  language  to  answer 
simple  questions.  Try  to  include  the 
child  as  much  as  possible. 


Call  on  a  restless  child  frequently  to  hold  his  attention. 


103 


Activities 


104 


Instruction 


Formal  instruction  periods  are  often 
viewed  as  being  most  appropriate  for 
children  who  are  at  least  five  years  old. 
If  formal  instruction  is  part  of  your 
program,  it  should  take  place  fu-st  in 
the  day  and  is  best  followed  by  outdoor 
play,  circle  time,  story  time,  music, 
meals,  and  rest. 

Instruction  activities  usually  concen- 
trate on  pre-reading  skills  (formation  of 
letters  and  numbers)  and  on  simple  con- 
cepts (size,  shape,  color).  These  activi- 
ties help  children  develop: 

•  cognitive  skiUs  (following  direc- 
tions, le£iming  concepts) 

•  fine  motor  skills  (using  a  pencil, 
turning  pages). 


Preparation 

Before  preparing  a  lesson  plan,  you 
should  have  a  clear  understanding  of 
each  child's  level  of  development  and 
specific  abilities.  You  can  gather  this 
information  from  any  reports  you  have 
been  given  about  the  children  as  well  as 
from  your  own  informal  observations 
and  assessments.  Otherwise  it  will  be 
difficult  for  you  to  set  realistic  goals  for 
the  group,  or  for  an  individual  child. 

Your  lesson  plan  should  define  the 
goals  of  the  activity,  sequence  the  steps 
involved,  and  list  any  materials  you 
may  need.  After  you  have  worked  out 
the  lesson  plan,  gather  all  necessary 
materials.  If  any  procedures  are  unfa- 
miliar to  you,  practice  with  them 
beforehand. 


Conducting  the  Activity 

1.  Gather  the  children  in  the  work 
area.  Make  sure  they  are  familiar 
with  the  lesson's  rules  of  order.  (For 
example,  should  they  stay  in  their 
seats  or  sit  on  the  floor?) 

2.  Speak  clearly,  using  simple  sen- 
tences. Do  not  assume  that  the  chil- 
dren are  familiar  with  anything. 
Repeat  important  points  several 
times. 

3.  As  you  talk,  try  to  determine  how    1 
well  the  children  are  understanding 
the  lesson.  Ask  questions  and  try  to 
involve  the  children  as  much  as  pos- 
sible. Watch  for  puzzled  faces  and 
other  signs  of  distress. 

4.  Once  the  children  get  to  work,  stay 
with  them  in  case  they  need  help  or 
reassurance.  Encourage  and  praise 
their  efforts. 

5.  Watch  the  time  and  give  children 
advance  warning  of  when  the  activ- 
ity period  will  be  up. 


Tips 

Remember  that  this  may  be  the 
children's  first  formal  instruction.  Make 
instruction  a  successful  experience  for 
them  by  working  out  lessons  you  know 
they  are  capable  of  doing.  Praise  them 
warmly  for  their  efforts. 

Be  prepared  to  adjust  the  activity 
at  any  time:  to  change  the  rules,  to 
lengthen  or  shorten  the  time,  and  so  on. 
The  children's  reactions  will  tell  you 
when  this  is  necessary.  Take  notes 
afterward  on  changes  that  will  improve 
the  next  lesson. 

Make  sure  that  important  people  in 
the  child's  life  see  the  results  of  these 
lessons.  Send  children's  completed  work 
home  with  them  and  let  parents  know 
how  their  children  are  doing. 


It  is  important  to  establish  vour 
authority  early,  so  that  all  chiloren  real- 
ize you  are  there  to  guide  and  help 
them. 


Modifications  for  an  Aggressive  Child 

Your  first  priority  in  working  with 
an  aggressive  child  is  to  make  sure  that 
he  or  she  has  successful  learning  experi- 
ences. Design  some  simple  tasks  you 
are  sure  the  child  can  master  with  some 
help.  After  several  successes,  the  child 
will  feel  more  competent  and  may  even 
begin  to  look  forward  to  instruction. 

Aggressive  children  are  afraid  of 
their  mipulses,  and  frightened  children 
do  not  learn  well.  TVy  to  make  an 
aggressive  child  aware  that  impulsive 
behavior  interferes  with  everyone's  day. 
Remind  the  child  to  use  words  when 
you  sense  that  physical  aggression  is 
about  to  take  place.  Tbgether  you  and 
the  child  might  decide  upon  quiet  cor- 
ners or  areas  where  he  or  she  can  go  to 
work  out  anger  or  to  take  a  break  from 
the  activity. 


Modifications  for  a  Hyp>eractive  Child 

In  arranging  the  setting  of  the  les- 
son, take  into  account  a  hyperactive 
child's  restlessness.  Do  not  exjject  him 
or  her  to  sit  quietly  for  prolonged 
periods.  Instead,  break  a  task  down 
mto  small  steps  that  can  be  done  in  a 
short  amount  of  time,  or  include  a  sim- 
ple motor  activity  in  the  lesson.  For 
example,  after  doing  a  number  recogni- 
tion activity,  let  the  child  work  with  a 
form  board  puzzle,  counting  the  differ- 
ent pieces  as  he  or  she  goes. 

Directions  to  the  child  must  be 
clear,  precise,  and  short.  You  might 
explain  a  task  one  step  at  a  time,  wait- 
ing until  each  step  is  done  before 
describing  the  next.  For  example,  let 
the  child  attempt  to  mix  paint  follow- 
ing your  instructions,  before  you  begin 
to  show  him  or  her  how  to  paint. 


Children  enjoy  being  praised.  Do  it 
often  and  focus  on  their  attempts  rather 
than  their  products. 


105 


Activities 


106 


Watch  the  child  carefully  for  signs 
of  restlessness.  Point  them  out  to  the 
child  so  that  he  or  she  can  begin  to 
understand  these  feelings  and  monitor 
him-  or  herself  ("When  you  work  this 
hard,  you  seem  to  get  tired").  You 
might  offer  the  child  10  or  20  seconds 
to  leave  the  task  and  compose  him-  or 
herself. 


Modifications  for  an  Anxious  Child 

Anxious  children  tend  to  fear  fail- 
ure, and  to  lack  self-control.  If  you 
Eressure  an  anxious  child  to  participate, 
e  or  she  may  panic  and  lose  control. 
You  must  work  just  to  calm  the  child 
and  to  help  the  child  understand  that  it 
is  more  important  to  t/^  an  activity 
than  to  do  it  perfectly.  Gently  encour- 
age the  child  by  demonstrating  the 
task.  Then  let  the  child  do  one  part, 
and  you  do  another.  Offer  praise  for  the 
fact  of  working,  rather  than  for  the 
quality  of  work.  Permit  the  child  to 
work  at  his  or  her  own  pace. 

You  may  find  that  the  child  is  reluc- 
tant to  put  aside  a  task  that  he  or  she 
is  doing  successfully.  Initially  it  is  best 
to  regard  this  refusal  as  a  first  step 
toward  confidence.  As  the  child  grows 
more  comfortable  and  trusting,  you  can 
encourage  him  or  her  to  move  on  to 
other  tasks.  Once  the  child  has  a  sense 
of  competence  and  greater  confidence, 
you  can  work  with  him  or  her  to 
improve  performance. 


Modifications  for  a  Withdrawn  Child       I 

A  withdrawn  child  may  do  best  in 
instruction  activities  if  he  or  she  is 
given  individual  attention  and  instruc- 
tion. However,  it  may  be  difficult  to        j 
approach  the  child  because  he  or  she        ' 
may  feel  uncomfortable  close  to  others. 
You  should  be  as  non-threatening  and 
soothing  as  possible.  Since  the  child's 
language  skills  may  be  underdeveloped, 
take  care  to  speak  slowly  and  clearly, 
and  act  out  wnat  is  desired  if  you  can. 
The  child  may  avoid  eye  contact  and 
refuse  to  respond.  If  the  child  continues 
to  refuse  to  respond,  it  may  be  best  to 
find  another  activity  that  the  child 
wo\ild  like  to  work  on.  If  this  fails,  let 
the  child  sit  and  watch,  or  place  a  toy 
or  other  materials  nearlay  for  the  child 
to  use  when  he  or  she  wishes.  Constant 
probing  may  only  cause  the  child  to 
withdraw  more. 


Modifications  for  a  Psychotic  Child 

The  program  of  instruction  for  a 
psychotic  child  must  be  highly  individ- 
ualized. Working  consistently  with  one 
or  two  familiar  adults,  the  child  will 
probably  be  less  confused  and  more  in 
touch  with  the  learning  experience. 
Language  development  is  also  more 
likely  to  occur  in  individualized  learn- 
ing. In  some  cases,  a  psychotic  child 
may  be  able  to  tolerate  and  profit  from 
small  group  experiences.  These  should 
be  encouraged. 


Outdoor  Play 


Outdoor  play  provides  children  with 
an  opportunity  to  improve  their: 

•  social  skills  (peer  interaction) 

•  cognitive  skills  (developing  spatial 
concepts  such  as  up/down  and  tem- 
poral concepts  such  as  slow/fast; 
recognizing  cause  and  effect  rela- 
tionships) 

•  gross  motor  skills  (balance,  coordi- 
nation, rhythm). 


Preparation 

Examine  the  playground  area 
closely.  Eliminate  any  potential  dangers 
(holes  in  the  ground,  large  rocks,  bro- 
ken glass).  Make  certain  equipment  is 
in  good  repair. 

Know  which  children  may  become 
uncontrolled  in  open  areas.  Playgrounds 
can  be  dangerous.  (Work  out  play- 
ground rules  in  advance.) 

Learn  a  variety  of  simple  games 
that  children  can  play  at  preschool  and 
at  home.  The  activities  should  have 
varying  degrees  of  structure  and  should 
be  non-competitive.  Work  out  a  system 
for  sharing  playground  equipment  such 
as  swings. 


107 


Activities 


108 


Ups 

Out-of-doors  should  not  mean  out-of- 
control.  Some  children  get  reckless  on 
the  playground.  Do  not  hesitate  to  slow 
down  overexcited  children.  Many  play- 
ground accidents  can  be  prevented  by 
alert  teachers. 

Try  to  adjust  your  participation  to 
the  needs  of  each  child.  Some  children 
do  perfectly  well  on  their  own.  Others 
only  need  help  getting  started.  Still 
others  may  need  almost  constant 
attention. 

Some  children  are  afraid  of  play- 
ground activity.  They  may  need  reas- 
surance that  things  are  in  control. 

Conducting  the  Activity 

1.  AUow  plenty  of  time  for  children  to 
dress  themselves  as  much  as  they 
can  on  their  own. 

2.  Explain  playground  rules  carefully 
to  the  children  before  they  go  out- 
side. 

3.  Observe  the  area  closely.  If  possible, 
have  one  or  two  other  adults  assist 
in  guiding  outdoor  play. 

4.  Adults  should  refrain  from  engaging 
in  lengthy  conversations  with  one 
another,  because  this  can  detract 
from  their  availability  to  the  children. 


Modifications  for  an  Aggressive  Child 

The  playground  may  be  a  frighten- 
ing place  for  aggressive  children.  They 
may  fear  that  other  children  will 
become  aggressive,  and  they  are  with- 
out the  indoor  structure  that  they  rely 
upon  to  control  their  own  aggression. 
Tney  easily  become  overexcited  and 
restless,  which  can  lead  to  unpredict- 
able behavior,  "accidents"  in  which 
other  children  get  knocked  about,  over- 
enthusiasm  in  group  games,  and  fights 
with  others. 

You  can  anticipate  an  aggressive 
child's  distress  concerning  loss  of  struc- 
ture by  assuring  him  or  her  that  every- 
thing is  still  being  managed  and  is 
under  control.  Although  impulsiveness 
is  difficult  to  deal  with,  much  of  it  can 
be  avoided  if  the  child's  level  of  stimu- 
lation is  controlled.  For  example,  put 
away  materials  that  are  not  being  used, 
reduce  the  noise  level  by  introducing  a 
quiet  activity,  and  slow  down  an  activ- 
ity that  is  getting  the  child  too  excited 
(for  example,  roll  the  ball  to  a  child 
instead  of  chasing  him  or  her  with  the 
ball).  Watch  carefully  and  give  verbal 
reminders  to  help  keep  the  child  in 
touch  with  what  he  or  she  is  doing.  For 
example,  say  to  the  child,  "You're  rush- 
ing around  very  fast.  Can  you  show  me 
how  a  turtle  crawls?" 


■^^SBSWP?^     ?S5iP| 


109 


Modifications  for  a  Hyperactive  Child 

'       It  is  appropriate  for  children  to  let 
out  energy  on  the  playground,  but  care 
should  he  taken  to  keep  the  level  of 
excitement  manageable,  lb  help  a 
hyperactive  child,  provide  simple  games 
that  allow  for  a  high  energy  level.  Use 
frequent  verbal  reminders  to  keep  the 
child  focused  on  the  game.  Avoid  nag- 
ging at  the  child.  If  you  feel  the  child's 
behavior  is  out  of  line,  give  the  child  a 
clear,  specific  instruction  to  foUow. 

If  the  child  appears  to  be  losing  con- 
trol, ask  him  or  ner  to  sit  down  with 
you  for  20  or  30  seconds.  Danger  signs 
include  a  flushed  face,  excessively  loud 
yelling,  and  high,  prolonged,  artificial 
laughter. 


Modifications  for  an  Anxious  Child 

Anxious  children  are  often  unsettled 
by  the  noise  and  activity  of  a  play- 
ground, and  may  begin  to  withdraw. 
They  tend  to  fear  unfamiliar  activities, 
and  may  refuse  to  plav  with  other  chil- 
dren. When  they  do  play,  they  may 
complain  about  other  children.  Their 
general  fear  for  their  safety  may  be 
seen  in  their  frequent  complaints  of  real 
or  imagined  injuries.  Sandlbox  activities 
are  often  preferred  by  anxious  as  well 
as  withdrawn  children. 

An  anxious  child  does  best  at  play- 
ground activities  that  are  structured, 
non-competitive,  and  quiet,  and  that 
offer  little  chance  for  injury.  One  exam- 
ple is  walking  with  the  teacher  or  with 
a  small  group.  As  the  child  begins  to 
feel  more  comfortable  on  the  play- 
groimd,  you  might  set  up  games  that 
include  several  children. 


Modifications  for  a  Withdrawn  Child 

A  withdrawn  child  requires  special 
attention  on  the  playground.  You  or 
another  adult  should  try  to  engage  the 
child  gradually  in  a  few  simple,  quiet 
activities.  This  may  take  a  long  period 
of  time.  Once  you  have  had  a  number 
of  successes  with  the  child,  you  can 
expand  the  activities  to  include  practice 
in  other  skills.  Very  gradually  you 
might  attempt  to  introduce  other  chil- 
dren into  the  activity,  adding  one  child 
at  a  time. 


Modifications  for  a  Psychotic  Child 

Psychotic  children  have  much 
trouble  coping  with  great  changes  in 
the  setting.  At  first  they  may  be 
extremely  frightened  on  the  play- 
ground, and  may  lose  some  ability  to 
relate  to  familiar  adults  and  surround- 
ings. You  should  provide  a  psychotic 
child  with  close  supervision  in  an  open 
area.  Once  the  child  is  familiar  with  the 
area,  you  or  one  other  adult  may  be 
able  to  engage  him  or  her  in  simple 
activities  such  as  short  walks,  rolling  a 
ball,  and  so  on.  During  these  sessions 
you  may  be  able  to  help  the  child  prac- 
tice language  skills. 


Activities 


110 


Directed  Play/ 
Special  Projects 


Directed  play  is  a  good  way  to  teach 
general  information  and  improve  lan- 
guage. Directed  play  activities  include 
exercises,  body-image  games,  and  cook- 
ing or  science.  Activities  like  these  help 
cluldren  increase  their  general  knowl- 
edge and  improve  their: 

•  social  skills  (cooperation  and 
sharing) 

•  cognitive  skills  (ability  to  follow 
directions) 

•  body  image  (ability  to  identify 
body  parts) 

•  language  skiUs  (general 
vocabulary). 


Preparation 

Gather  all  necessary  materials  and 
make  sure  you  are  familiar  with  them. 
If  you  are  planning  to  cook  or  to  try  a 
science  activity,  try  out  any  unfamiliar 
recipes  or  experiments  on  your  own 
first. 

Conducting  the  Activity 

1.  Give  a  clear,  simple  explanation  of 
the  activity  to  the  group.  Provide  as 
much  general  information  as  the 
children  can  absorb  along  with  the 
activity.  For  example,  if  you  are 
cooking  carrots,  you  might  describe 
how  they  grow  and  why  they  are 
good  for  you.  Define  any  new  words 
and  use  examples  andVor  pictures 
whenever  possible. 

2.  A  number  of  these  activities  (for 
example,  exercises  and  dress-up 
games)  do  not  require  adult  supervi- 
sion. However,  you  should  play 
along  with  the  children  at  first  to 
make  sure  that  they  understand  the 
procedure  and  any  rules  that  are 
involved. 


Ill 


Tips 

Directed  play  activities  allow  chil- 
dren to  learn  words  while  actually 
using  the  objects  for  which  the  words 
stand.  Talk  to  the  children  throughout 
each  activity.  ("Move  your  arms. ' 
"Give  me  one  egg,  please."  "What 
color  is  Billy's  hat?  ')  Be  sure  to  encour- 
age the  children  to  use  the  words  them- 
selves. Also  try  to  use  the  same  words 
in  other  activities. 

When  toys  or  food  are  involved,  con- 
flict is  likely  to  occur  among  the  chil- 
dren. Make  sure  you  have  a  good 
sharing  system  and  remind  children  of 
the  rules. 

Cooking  can  be  an  exciting  activity 
for  children,  especially  those  who  come 
from  homes  where  food  is  not  plentiful. 
Some  may  be  very  anxious  about  get- 
ting their  fair  share  of  the  food,  which 
can  cause  them  to  disrupt  the  activity. 
Until  the  children  learn  to  trust  the  sit- 
uation, you  should  control  the  activity 
carefully.  Give  children  small,  easy  jobs 
to  do  at  the  start,  while  you  play  a 
larger  role.  Gradually  you  should  be 
able  to  reduce  your  role. 


Modifications  for  an  Aggressive  Child 

Aggressive  children  tend  to  have 
irrational  fears  of  being  deprived  of  an 
equal  share  and  of  provoking  aggres- 
sion in  others.  You  can  ease  these  fears 
by  setting  up  an  orderly  and  obvious 
system  for  using  and  snaring  materials. 
As  the  child  comes  to  trust  the  system, 
he  or  she  will  feel  less  need  to  grab  and 
clutch. 

Whenever  possible,  match  up  an 
aggressive  child  with  non-ag^essive 
children.  This  will  help  the  child  feel 
more  at  ease  and  lessen  the  chance  that 
impulsive  behavior  will  take  place. 


In  any  close  situation,  watch  the 
child  carefully  for  signs  of  anger  and 
loss  of  control.  Help  the  child  become 
more  self-aware  by  pointing  out  when 
you  think  he  or  she  is  becoming  upset. 


Modifications  for  a  Hyperactive  Child 

It  is  important  not  to  overestimate 
a  hyperactive  child's  ability  to  concen- 
trate, lb  prevent  failure,  keep  tasks 
short  and  very  direct.  Proviae  a  lot  of 
verbal  structure  for  the  child  and  do 
not  expect  him  or  her  to  function  suc- 
cessfully without  adult  supervision. 

TVy  to  anticipate  the  child's  loss  of 
attention.  If  you  sense  that  the  child  is 
becoming  restless,  move  him  or  her  to 
another  area  or  begin  a  different  activ- 
ity. Otherwise  the  child  may  disrupt 
the  group  with  extra  body  movement 
or  loud  talking. 

In  time  you  wiU  learn  to  recognize 
periods  of  low  excitement  in  the  child. 
Take  advantage  of  these  by  introducing 
more  complicated,  self-directed  tasks. 
For  example,  during  a  science  activity, 
you  might  make  the  child  responsible 
for  measuring  out  a  cupful  of  water. 


Modifications  for  £in  Anxious  Child 

Before  the  activity  begins,  carefully 
explain  how  toys  or  food  will  be  given 
out,  and  explain  the  system  for  using 
and  sharing  materials.  Over  time,  the 
child  will  come  to  trust  you  and  the 
system. 


Activities 


112 


Modifications  for  a  Withdrawn  Child 

It  is  best  not  to  force  a  withdrawn 
child  to  participate.  Simply  give  the 
child  time  to  watch  and  understand  the 
activity.  When  the  child  begins  to  show 
some  interest,  you  or  another  adult  can 
try  to  engage  the  child  by  providing 
individual  instruction.  Gradually  adult 
participation  can  be  replaced  by  interac- 
tion with  other  children.  Although  you 
should  not  expect  the  child  to  com- 
municate much  verbally  (especially  at 
first),  you  should  speak  to  him  or  her 
regularly,  in  a  non-threatening  manner. 


Modifications  for  a  Psychotic  Child 

A  psychotic  child  will  need  to  have 
an  adult  partner  in  order  to  participate. 
In  cooking,  for  example,  the  child  and 
the  adult  can  do  some  of  the  simpler 
tasks  together. 

Don't  expect  the  child  to  use  imagi- 
nation and  pretend.  It  is  best  to  be  lit- 
eral and  direct  as  you  work  on  the 
child's  language  development  and  con- 
cept formation.  As  the  child's  language 
skills  improve,  his  or  her  partner  can 
encourage  him  or  her  to  name  materials 
and  describe  how  they  are  being  used. 


Free  Play 

Free  play  includes  such  activities  as 
water  table,  sand  table,  puzzles,  peg-        I 
boards,  blocks,  and  picture  cards.  These 
activities  help  children  improve  their: 


social  skills 

ability  to  work  independently 

ability  to  fantasize 

fine  motor  skills  and  coordination. 


Preparation 

Gather  all  necessary  materials  and 
organize  them  according  to  the  type  of 
activity  or  the  level  of  difficulty.  You 
might  consider  labeling  them  with 
words  and/or  pictures.  Anticipate  any 
problems  with  materials  (for  example, 
water  may  be  spilled  and  sand  may  be 
scattered).  Have  aprons  ready  for  par- 
ticularly messy  activities. 

lb  reduce  confusion,  divide  a  single 
area  into  smaller  activity  areas  (such  as 
the  water  play  area  and  the  puzzle 
table)  and  place  materials  in  the  rele- 
vant area.  Have  a  system  for  passing 
out  materials,  for  sharing,  and  for  tak- 
ing turns.  Know  the  relative  level  of 
difficulty  of  each  activity,  so  that 
children  won't  be  mismatched  and 
frustrated. 


113 


Conducting  the  Activity 

1.  Help  children  choose  materials  and 
get  started.  Point  out  rules  for 
using  different  materials  ("Put  puz- 
zles on  the  green  shelf  after  you  use 
them."  "Keep  the  water  in  the 
water  table").  New  materials  should 
be  shown  and  demonstrated  to  the 
entire  group. 

2.  Take  some  time  to  work  with  indi- 
vidual children,  moving  from  one  to 
another.  But  don't  interfere  with 
children  who  are  playing  well  by 
themselves. 

3.  Be  alert  for  signs  of  difficulty. 
Grabbing,  threatening,  loud  voices, 
or  running  may  be  signals  to 
remind  children  of  Umits,  or  to  pro- 
vide help  to  a  particular  child. 

4.  Tbward  the  end  of  the  activity,  give 
the  children  an  advance  warning 
that  it  will  soon  be  time  to  clean  up. 


Tips 

Free  play  is  an  excellent  opportu- 
nity to  watch  and  measure  chuldren's 
progress  in  socializing  and  in  motor 
development.  After  free  play  routines 
have  been  established,  and  when  chil- 
dren are  working  well  on  their  own, 
your  role  might  be  shifted  from  facilitat- 
ing or  participating  in  the  play  to 
observing  the  play. 


Modifications  for  an  Aggressive  Child 

An  aggressive  child  may  require 
extra  help  in  selecting  an  activity  and 
getting  started,  since  he  or  she  can  eas- 
ily be  confused  by  a  less  structured 
environment.  Be  careful  to  provide 
materials  that  you  know  the  child  can 
master.  Aggressive  children  often  act 
out  their  feelings  rather  than  ask  for 
help.  This  means  you  should  watch 
closely  for  signs  of  trouble  in  the  child, 
to  prevent  him  or  her  from  losing 
control. 


Modifications  for  a  Hyperactive  Child 

A  hyperactive  child  has  difficulty 
with  free  play.  The  child  needs  help 
from  the  teacher  to  get  organized  and 
to  keep  his  or  her  attention  focused  on 
the  activity.  It  is  helpful  for  you  or 
another  adult  to  start  an  activity  with 
the  child,  since  adult  interest  often 
helps  the  child  stay  interested,  too. 

As  in  other  settings,  you  should 
remind  the  child  when  he  or  she  is  get- 
ting overexcited,  and  offer  specific 
directions  to  help  the  child  calm  down 
and  get  back  under  control. 


Activities 


114 


Modifications  for  an  Anxious  Child 

Tb  help  cut  down  on  interference 
from  other  children,  provide  an  anxious 
child  with  a  relatively  isolated  area. 
Once  the  child  begins  to  feel  safe,  he  or 
she  will  gradually  move  toward  the 
other  children.  Anticipate  frustration 
and  provide  the  child  with  help  in  diffi- 
cult areas. 

Give  an  anxious  child  plenty  of  time 
to  prepare  for  the  end  of  the  activity. 
Allow  the  child  to  replace  favorite  toys 
by  him-  or  herself.  Remind  him  or  her 
that  the  materials  will  be  available 
again. 


Modifications  for  a  Withdrawn  Child 

Free  play  is  a  valuable  activity  for  a 
withdrawn  child.  It  makes  few  de- 
mands, and  allows  him  or  her  to  watch 
other  children  play  and  communicate. 
Observing  the  child  may  help  you  to 
learn  about  the  child's  interests.  You 
might  then  introduce  several  different 
activities  you  think  the  child  would 
enjoy. 

Don't  try  to  rush  the  child  into  con- 
tact with  his  or  her  peers.  When  the 
child  begins  to  play  at  similar  activities 
next  to  the  other  children  without 
apparent  communication,  you  will  know 
that  the  child  has  taken  a  first  step 
toward  real  interaction. 


Modifications  for  a  Psychotic  Child 

A  psychotic  child  does  best  when 
you  provide  individual  attention  and  do 
activities  with  him  or  her.  Puzzles  and 
books  may  hold  the  child's  attention  for 
some  time.  Your  presence  and  conversa- 
tion will  reassure  the  child  that  the  sit- 
uation is  under  control.  Take  this 
opportunity  to  work  on  language  with 
the  child.  Many  psychotic  children 
develop  language  through  imitation. 


Psychotic  children  require  lots  of  individual  attention. 


115 


Meals 

Many  preschool  programs  provide 
breakfast,  snack,  and/or  lunch.  These 
meals  can  be  a  time  for  children  to: 

•  gain  knowledge  (general  informa- 
tion about  food) 

•  improve  their  social  skills  (sharing 
and  cooperating)  and  speech  and 
language  skills. 


Preparation 

Set  the  table  with  unbreakable  uten- 
sUs  and  napkins.  Have  paper  towels  or 
sponges  on  hand  to  take  care  of  spills. 

Conducting  the  Activity 

1.  Make  sure  all  children  are  seated 
before  beginning  a  meal.  Give  them 
a  few  seconds  to  calm  down  before 
you  start. 

2.  Explain  the  system  for  requesting 
and  passing  food.  Take  some  time 
at  first  to  instruct  children  in  the 
proper  use  of  utensUs  and  in  group 
table  manners. 

3.  Pass  the  food  to  the  disturbed  child 

r  yourself,  or  have  an  aide  do  it.  After 
I  a  period  of  time,  the  child  should  be 
i      able  to  serve  him-  or  herself.  Allow 

adequate  time  for  children  to  eat 

well  and  enjoy  the  meal. 

4.  Allow  adequate  time  for  cleanup.  If 
there  are  pokey  eaters,  give  them 
some  advance  warning  that  another 
activity  is  soon  to  follow. 


Tips 

Use  this  opportunity  to  expand  the 
children's  general  knowledge.  Explain 
the  names  and  origins  of  the  various 
foods  they  are  eating. 

Food  and  eating  can  be  a  source  of 
great  anxiety  to  children  who  come 
from  homes  where  food  is  not  plentiful. 
It  helps  to  reassure  them  that  there  is 
enough  food  for  everyone.  Never  with- 
hold food  to  punish  or  control  a  child. 


Modifications  for  an  Aggressive  Child 

An  aggressive  child  needs  clear  and 
simple  instructions  on  table  manners 
and  use  of  utensils.  Rules  must  be 
established  early,  and  consistently 
applied.  You  may  wish  to  sit  next  to  an 
aggressive  child  during  the  initial 
period,  and  handle  the  passing  and 
serving  of  food.  If  the  child  begins  to 
lose  control,  you  might  send  him  or  her 
to  a  "cooHng-off  spot "  at  the  edge  of 
the  activity  setting. 


Modifications  for  a  Hyperactive  Child 

Give  directions  slowly  to  a  hyperac- 
tive child,  and  in  small  parts.  Insist 
that  the  proper  utensils  be  used.  Do 
avoid  spilling  accidents,  take  care  to 
place  open  containers  of  food  away 
from  the  child.  Make  the  child  aware 
when  he  or  she  is  becoming  overex- 
cited. It  is  a  good  idea  to  set  up  a 
cooling-off  spot  at  the  edge  of  the  activ- 
ity setting,  where  the  child  can  go 
when  feeling  restless  or  out  of  control. 


Activities 


116 


Modifications  for  an  Anxious  Child 

Allow  an  anxious  child  to  eat  at  his 
or  her  own  pace  and  according  to 
needs,  but  insist  upon  the  proper  use  of 
utensils.  You  may  need  to  repeat  rules 
on  passing  food  to  the  child,  to  prevent 
him  or  her  from  grabbing  or  hoarding 
food. 

Do  not  pressure  the  child  to  eat  if 
he  or  she  refuses  to.  This  will  only 
result  in  stronger  opposition. 


Modifications  for  a  Withdrawn  Child 

A  withdrawn  child  may  not  be  com- 
fortable eating  in  a  group  for  some 
time.  He  or  she  may  refuse  to  eat  and 
may  ignore  requests  by  others  to  pass 


food.  You  can  try  offering  the  child  par- 
ticular items,  but  do  not  pressure  hirn 
or  her.  AQow  the  child  to  watch  quietly. 
Offer  him  or  her  a  snack  later  on. 


Modifications  for  a  Psychotic  Child 

It  may  take  a  psychotic  child  some 
time  to  learn  the  rules  for  mealtimes. 
You  may  have  to  repeat  these  rules, 
often  and  calmly,  over  a  long  period  of 
time.  Tfeach  the  child  how  to  use  uten- 
sils by  example.  If  possible,  you  or 
another  adult  should  sit  next  to  the 
child  to  demonstrate  procedure  and  to 
serve  him  or  her.  This  can  also  be  an 
opportunity  to  work  on  the  child's  lan- 
guage development. 


Music  and  Art 


I 

Music  and  art  can  be  relaxing  activi- 
ties for  children.  Music  provides  an 
opportunity  for  children  to  improve 
their: 

•  listening  skills  (auditory  percep- 
tion, sound  discrimination) 

•  sense  of  rhythm 

•  ability  to  follow  directions. 

Art  activities  give  children  a  chance  to 
work  on: 

•  visual  perception 

•  fine  motor  skills 

•  ability  to  follow  directions. 

f 

In  most  preschool  programs  art  is 
an  ongoing  activity  that  is  not  separate 
from  free  play  and/or  teacher-directed 
activity.  In  these  programs,  art  is  often 
viewed  as  an  extension  or  supplement 
to  another  learning  experience.  For 
example,  the  theme  for  a  painting  ses- 
sion might  be  "what  we  saw  at  the  fire 
station.  '  In  some  preschool  programs, 
art  is  viewed  as  a  separate  activity. 


Preparation 

Prepare  a  lesson  plan  that  breaks 
the  music  or  art  period  down  into  short 
parts  with  different  activities.  Collect 
all  materials  and  work  out  how  you  wiU 
introduce  them  to  the  group.  If  an  art 
activity  will  be  messy,  have  aprons 
available  for  the  children. 

I      Arrange  a  smtable  area.  Music  may 
require  chairs  and  a  large,  open  area. 
For  an  art  activity,  you  may  need  to 
provide  protection  for  the  furniture  and 
floors. 


Conducting  the  Activity 

1.  Present  instructions  clearly  and  sim- 
ply. Give  special  attention  to  chil- 
dren who  appear  confused. 

2.  Provide  lots  of  verbal  encourage- 
ment. 

3.  Watch  for  children  who  may  be 
overexcited  by  loud  music.  If  one  or 
more  children  become  too  excited, 
turn  the  volume  down,  or  remove 
the  record  periodically. 

4.  Display  children's  completed  proj- 
ects with  their  names  on  them. 
After  the  display,  send  the  projects 
home  with  children  so  that  parents 
get  a  chance  to  see  the  work,  too. 

5.  Announce  transitions  early  to  allow 
plenty  of  time  for  calming  down  and 
cleaning  up. 


Tips 

Keep  the  first  assignments  simple. 
It  is  easier  to  add  tasks  as  you  go 
along  than  it  is  to  deal  with  a  frus- 
trated group.  Some  children  find  partic- 
ular art  materials  (such  as  clay  and 
fingerpaint)  hard  to  work  with.  It 
might  be  best  to  start  out  with  mate- 
rials that  are  less  messy  (such  as  cray- 
ons or  chalk). 

If  some  children  resist  group  sing- 
ing, don't  force  them  to  participate. 
Give  them  time  to  feel  comfortable 
before  joining  in. 

Record  players  and  other  machines 
may  be  irresistible  to  some  children. 
You  might  place  the  machine  on  a  shelf 
out  of  children's  reach.  When  the 
machines  are  not  in  use,  store  them 
safely. 

Music  time  can  leave  children  over- 
excited. It  helps  to  calm  them  down 
with  quiet  music  before  ending  the 
activity. 


117 


Activities 


118 


Modifications  for  an  Aggressive  Child 

You  niust  make  it  clear  to  an  ag- 
gressive child  that  general  behavioral 
expectations  apply  in  music  and  art 
activities,  just  as  they  do  in  others. 
Music  activities  must  be  carefully 
paced  to  avoid  getting  the  child  too 
excited.  Art  must  be  carefully  intro- 
duced and  supervised  to  avoid  overex- 
citement  and  frustration.  Work  closely 
with  an  aggressive  child,  giving  much 
encouragement.  As  the  child's  self- 
control  increases,  such  support  will  be 
less  important. 


Modifications  for  a  Hyperactive  Child 

Pacing  is  very  important  for  a 
hyperactive  child.  In  music,  do  not  con- 
tinue a  high  level  of  physical  activity 
for  too  long.  Give  children  time  to  com- 
pose themselves,  and  end  the  period 
with  a  series  of  slower,  calming  tasks. 
Art  assignments  should  be  short,  use 
simple  materials,  and  be  accompanied 
by  close  attention. 


119 


Modifications  for  an  Anxious  Child 

Begin  music  activities  slowly.  Dis- 
cuss any  instruments  you  are  using  and 
the  sounds  they  make.  Prepare  the 
child  for  loud  noises,  and  try  to  find  a 
volume  level  that  is  acceptable  to  the 
chUd. 

In  art,  show  interest  in  the  child's 
activity,  but  tiy  not  to  discuss  the 
quality  of  the  finished  product,  or  to 
put  too  much  emphasis  on  the  neces- 
sity of  finishing  it  at  all. 


Modifications  for  a  Withdrawn  Child 

Some  young  children  are  imf amiHar 
with  art  and  music  activities,  but  find 
them  both  extremely  attractive.  After  a 
period  of  watching,  a  withdrawn  child 
will  probably  join  the  activities  of  his 
or  her  own  accord.  You  can  encourage 
the  child  gently  to  participate,  but 
avoid  pressuring  him  or  her. 


Modifications  for  a  Psychotic  Child 

Music  can  be  particularly  enjoyable 
to  a  psychotic  child.  Its  rhythms  are 
comforting,  and  the  child  often 
develops  well-loved  favorites.  During 
group  lessons,  the  child  can  enjoy  the 
music  apart  from  the  group.  During 
free  play,  the  child  may  wish  to  listen 
to  records. 

Art  is  a  more  difficult  activity  for 
the  child.  He  or  she  may  have  trouble 
attending  to  the  task,  or  using  the 
materials  properly.  Good  resmts  may 
be  obtained  initially  by  working  with 
the  child  on  a  one-to-one  basis.  Later 
the  child  may  work  in  a  group  under 
close  supervision. 


Story  Time 


Story  time  can  help  children  im- 
prove their: 

•  social  skills 

•  cognitive  skills  (listening  and 
memory  skills) 

•  speech  and  language  skills. 


Preparation 

Find  appropriate  stories,  taking  into 
consideration  vocabulary,  plot,  pictures, 
and  length.  Arrange  the  seating  so  that 
each  child's  personal  space  is  clearly 
defined. 


Conducting  the  Activity 

1.  Read  the  story  with  expression  and 
feeling,  but  be  careful  not  to 
frighten  the  children.  Show  them 
the  pictures  as  you  come  to  them. 

2.  Don't  lose  sight  of  the  group.  If  you 
notice  that  a  child's  attention  is 
wandering,  use  eye  contact  or  ges- 
tures to  regain  his  or  her  attention. 

3.  When  the  story  is  over,  ask  the  chil- 
dren specific  questions.  The  story 
might  also  serve  as  the  basis  for  an 
art  or  drama  activity. 


Tips 

Keep  track  of  particularly  successful 
stories.  You  wiU  find  there  are  classics 
that  work  year  after  year. 

Story  time  brings  the  children 
together  in  a  group,  and  has  a  calming 
effect  on  them.  It  is  a  particularly  good 
activity  to  have  before  major  transi- 
tions (outdoor  play  or  departure  time). 


120 


Activities 


Modifications  for  an  Aggressive  Child 

Seat  the  child  near  you  or  another 
adult  during  the  story,  and  arrange 
seating  so  that  the  child's  neighbor  is 
non-aggressive.  Keep  the  child  involved 
in  the  story  with  questions,  glances, 
and  gestures.  Attention  from  another 
adult  can  help  to  avert  impulsive 
behavior. 


Modifications  for  a  Hyperactive  Child 

Expectations  must  be  simple  and 
clearly  defined  for  a  hyperactive  child. 
The  child's  space  may  be  marked  by 
tape,  or  the  child  may  sit  on  a  "story 
rug."  He  or  she  should  be  called  on  fre- 
quently, to  maintain  interest  in  the 
story.  Remind  the  child  when  he  or  she 
is  getting  too  excited.  It  helps  to  place 
the  child  near  an  adult. 


Modification  for  an  Anxious  Child 

Seat  an  anxious  child  somewhat 
away  from  other  children,  but  stiU 
inside  of  the  group  area.  Prepare  the 
child  for  the  story  in  advance.  Make 
sure  he  or  she  knows  that  it  is  make- 
believe.  Offer  the  child  a  chance  to  act 
out  the  story  when  it  is  over,  to  give 
him  or  her  a  sense  of  control,  and  to 
improve  the  child's  ability  to  distin- 
guish between  fantasy  and  reality. 


Modifications  for  a  Withdrawn  Child 

Since  a  withdrawn  chUd  may  not  be 
comfortable  with  language,  it  is  helpful 
to  read  clearly  and  distinctly.  Question 
the  chUd  last,  after  other  children  have 
answered,  and  phrase  your  questions  so 
that  they  require  only  a  yes  or  no 
answer.  You  wiU  know  that  the  child 
was  trjdng  to  pay  attention  to  the 
story  if  he  or  she  responds  to  your 
questions.  If  the  child's  language  is  lim- 
ited, he  or  she  might  be  asked  to  draw 
pictures  of  the  story. 


Modifications  for  a  Psychotic  Child 

Since  a  psychotic  child  will  have 
trouble  with  any  group  setting,  an  indi- 
vidual session  with  a  familiar  adult  will 
probably  be  more  successful.  The  child 
will  be  less  fearful  and  more  relaxed, 
and  can  be  asked  to  repeat  words  and 
point  to  pictures.  Psychotic  children 
often  have  a  good  memory  for  detail, 
so  your  questions  can  be  direct  and 
factual. 


Rest  Time 


Rest  time  gives  everyone  a  chance 
to  relax  in  a  quiet  setting.  For  some 
children,  a  short  nap  is  essential. 
Others  can  benefit  from  simply  resting 
quietly. 


Preparation 

Arrange  cots  or  rugs  so  that  there 
is  ample  space  between  all  children. 
More  active  children  should  be  separa- 
ted from  one  another. 

Take  time  before  rest  period  to  set- 
tle the  group  down  to  a  lower  level  of 
activity.  Tbn  or  twenty  seconds  of  quiet 
sitting  may  be  enough. 


Conducting  the  Activity 

1.  Darken  the  rest  area,  but  leave 
enough  light  to  keep  fearful  children 
calm. 

2.  Speak  in  low  tones  or  whispers. 

3.  Move  as  little  as  possible.  The 
teacher's  motion  is  a  powerful  dis- 
traction. 

4.  Many  children  have  trouble  waking 
without  confusion.  Wake  sleeping 
children  very  gently,  and  allow 
them  plenty  of  time  to  regain  alert- 
ness. 


Tips 

After  lunch  is  a  good  time  for  rest, 
although  the  exact  place  in  the  sched- 
ule depends  on  the  length  of  the  daily 
program. 

Some  hyperactive  and  anxious  chil- 
dren have  great  difficulty  resting.  You 
may  need  to  shorten  their  periods  and 
provide  more  active  (but  quiet)  things 
for  them  to  do.  Children  who  need  to 
nap  should  have  a  separate,  appropriate 
area  where  they  will  not  be  disturbed 
by  other  activity. 


Modifications  for  an  Aggressive  Child 

It  is  impossible  to  force  an  unwilling 
child  to  relax.  An  aggressive  child  may 
feel  unsafe  in  the  rest  time  setting,  and 
be  unable  to  let  down  his  or  her  guard. 
Until  the  child  has  built  up  a  measure 
of  trust,  it  is  probably  wiser  to  have  a 
low-level  activity  (a  puzzle,  or  a  favorite 
book)  available  in  case  rest  proves 
impossible.  Once  the  child  begins  to  feel 
safe,  he  or  she  may  welcome  the  oppor- 
tunity to  rest. 


Modifications  for  a  Hyperactive  Child 

It  is  generally  useless  to  try  to  force 
a  h5^ractive  child  to  rest.  Before  aban- 
doning rest  time  entirely,  however,  you 
might  try  shortening  the  period  for  the 
child.  Explain  your  expectations  to  the 
child  and  set  a  time  limit  that  seems 
realistic. 


Modifications  for  an  Anxious  Child 

Place  the  child's  rest  area  near  a 
supervising  adult.  Try  to  eliminate  dis- 
tractions. It  helps  to  speak  in  whispers 
and  to  remain  seated.  A  favorite  toy  or 
book  may  reassure  the  child  that  the 
program  will  resume  after  the  rest.  If 
the  activity  proves  too  difficult  initially, 
reduce  the  child's  participation  time. 
Increase  it  gradually  as  the  child's  trust 
increases. 


121 


Activities 


122 


Modifications  for  a  Withdrawn  Child 

Rest  time  is  often  a  withdrawn 
child's  favorite  activity:  it  is  quiet  and 
non-interactional  (solitary).  The  biggest 
problem  may  be  that  the  child  is  unwill- 
mg  to  end  rest  and  enter  new  activity. 
Ti^  waking  the  child  before  the  other 
children.  Get  him  or  her  started  in  a 
less  passive,  but  stiU  non-interactional 
activity  (folding  blankets,  going  to  the 
bathroom,  loolong  at  a  picture  book). 
As  the  child  becomes  more  comfortable, 
the  rest  of  the  day  should  seem  more 
attractive  to  him  or  her.  At  this  point 
these  transitional  activities  will  be  less 
necessary. 


Modifications  for  a  Psychotic  Child 

It  is  very  difficult  for  a  psychotic 
child  to  rest  quietly  in  a  group.  The 
great  changes  in  setting  and  level  of 
activity  are  extremely  confusing.  If  the 
rest  period  is  generally  silent,  with 
some  sleeping  or  deep  relaxing,  it  may 
be  best  to  remove  the  child  to  another 
section.  If  a  bit  of  noise  and  movement 
won't  disturb  the  others,  the  child 
should  be  allowed  to  remain  with  an 
adult  and  engage  in  a  quiet  activity 
(singing  softly,  cuddling  a  favorite  toy). 


* 


w 


If  a  bit  of  noise  and  movement  wont  disturb  the  others,  allow  some  children  to 
engage  in  quiet  activities. 


IHps  and  Other 
Special  Events 


Trips  and  other  special  events 
increase  children's  general  knowledge 
and  give  children  practice  with: 

•  social  skills  (sharing  and  cooperat- 
ing) 

•  speech  and  language  skills  (follow- 
ing directions,  listening,  speaking) 

•  coping  with  a  highly  stimulating 
activity. 


Prep£iration 

Visit  the  site  of  a  trip  or  special 
event  in  advance  to  anticipate  problems 
that  might  arise.  Carefully  plan  trans- 
portation so  that  there  is  as  little  wait- 
mg  time  as  possible.  Know  beforehand 
how  you  will  keep  the  group  together 
and  how  you  will  handle  illness  or  mis- 
behavior. Be  prepared  to  cope  with 
highly  excitable  children.  You  may  need 
to  increase  staffing  for  the  event. 

Children  should  be  prepared  well  in 
advance  of  any  trip  or  special  event. 
Give  them  specific  details  concerning 
what  they  will  see  and  do,  then  check 
their  understanding.  For  a  party, 
review  eating  procedure.  Special  treats 
like  cake  and  ice  cream  can  make  some 
children  more  anxious  about  getting 
their  fair  share,  and  may  also  be  mes- 
sier than  other  foods.  Finally,  plan  the 
schedule  to  ensure  plenty  oi  time  for  a 
calm  transition. 


Conducting  the  Activity 

1.  Before  leaving  on  a  trip,  check  to 
see  that  each  child  is  appropriately 
dressed  and  wearing  a  name  tag. 

2.  At  the  site,  don't  neglect  the  chance 
to  add  to  children's  general  informa- 
tion. Ask  children  about  what  they 
see,  and  encourage  them  to  ask  you 
questions. 

3.  Review  the  trip  when  you  return. 
Ask  the  children  to  describe  or  draw 
pictures  of  what  they  saw  and  did. 

4.  At  parties,  make  sure  that  the  dis- 
tribution of  food  is  orderly  and  that 
everyone  gets  his  or  her  fair  share. 
Watch  the  level  of  excitement  and 
listen  for  rising  noise.  The  activity 
should  be  enjoyable,  but  not  uncon- 
trolled. 


Tips 

On  trips,  work  out  a  system  to  keep 
the  group  together.  Some  teachers  have 
a  single  rope  that  each  child  holds  on 
to.  Others  use  a  buddy  system. 

Be  sure  that  your  timetable  is  not 
too  tight.  Allow  plenty  of  extra  time. 

Birthday  parties  for  individual  chil- 
dren may  be  a  strain  for  both  the  birth- 
day child  and  the  other  children.  It  is 
probably  a  better  idea  to  hold  monthly 
parties  for  groups  of  children. 


Modifications  for  an  Aggressive  Child 

The  aggressive  child's  greatest  prob- 
lem here  is  his  or  her  anxiety  in  loosely 
structured  settings.  Without  walls  and 
comfortable  routine,  the  child  may  act 
wildly.  This  problem  can  be  prevented 
by  providing  visible  structure  for  the 
child.  Keep  him  or  her  close  and  main- 
tain verbal  contact.  After  some  success, 
you  can  increase  the  distance  slightly, 
while  closely  watching  for  signs  of  fear 
and  uneasiness. 


123 


Activities 


124 


Modifications  for  a  Hyperactive  Child 

An  adult  should  keep  a  hyperactive 
child  close  and  verbally  engaged.  Close- 
ness assures  that  the  child  will  not  lose 
the  group  or  run  into  the  street.  Verbal 
contact  helps  to  hold  down  the  level  of 
agitation  and  confusion.  During  parties, 
the  child  may  need  frequent  reminders 
to  slow  down. 


Modifications  for  £in  Anxious  Child 

lb  get  an  idea  of  how  frightening 
trips  are  for  an  anxious  child,  start  off 
with  short  trips  —  a  walk  to  the  comer 
or  around  the  block.  An  adult  should 
stay  close  to  the  child  during  initial 
trips.  Try  to  give  the  child  some  sense 
of  control.  Don't  force  him  or  her  to  go. 
It  is  better  to  deal  with  a  reluctant 
child  in  the  preschool  than  with  a  pan- 
icky child  on  the  street. 


Modifications  for  a  Withdrawn  Child 

Do  not  force  a  withdrawn  child  to 
go  on  trips  if  he  or  she  is  obviously 
unwilling  or  if  you  (and  the  parents)  feel 
the  timing  is  inappropriate.  Let  the 
child  remain  behind  with  a  trusted 
adult  with  whom  the  child  seems  to  feel 
comfortable.  If  a  field  trip  seems  appro- 
priate, keep  a  constant  check  on  the 
child;  he  or  she  may  dally  along  the 
way  or  wander  away. 


Modifications  for  a  Psychotic  Child 

If  a  field  trip  seems  appropriate  for 
a  psychotic  child,  include  him  or  her 
but  provide  for  close  supervision.  Some 
psychotic  children  are  overwhelmed  by 
the  rapid  transitions  of  field  trips,  and 
really  are  unable  to  cope  with  the  expe- 
rience. If  this  is  the  case,  leave  the 
child  behind  with  an  adult  who  you  feel 
can  handle  the  child. 


You  can  use  the  buddy  system  to  help  a  field 
trip  go  smoothly. 


Chapter  7: 


Other 
Sources 

of 

Help 


There  are  other  sources  of 
help  you  can  draw  on  to 
assist  you  with  children 
who  are  emotionally 
disturbed. 


126         In  addition  to  the  specialists  in  your 
program,  community,  or  region,  there  are 
other  sources  of  help  you  can  draw  on  to 
assist  you  with  children  who  are  emotion- 
ally disturbed  Around  the  country  are  a 
number  of  associations  concerned  with 
helping  those  who  are  emotionally  dis- 
turbed They  can  send  you  helpful  infor- 
mation about  emotional  disturbance  and 
about  how  you  can  work  with  disturbed 
children  in  the  classroom.  There  are  also 
many  good  books  and  articles  that  you 
may  find  usefuL  These  are  listed  in  the 
bibliography  at  the  end  of  this  chapter. 


Professional 
and  Parent 
Associations, 
and  Other 
Organizations 


For  each  association  given  in  this 
section,  we  have  listed  their  national 
addresses,  whether  they  have  local 
branches,  what  they  do,  and  how  they 
can  help  you. 

American  Academy  of  Child  Psychiatry 

This  is  a  professional  society  of  phy- 
sicians who  are  in  training  or  who  are 
graduates  of  child  psychiatry  residency. 
The  primary  goal  of  this  organization  is 
to  stimulate  and  advance  medical  con- 
tributions to  the  knowledge  and  treat- 
ment of  psychiatric  problems.  In  addi- 
tion to  providing  consultation  services 
to  institutions,  this  organization  has 
established  programs  that  include: 
research,  training,  community  child 
psychiatry,  and  psychiatric  facilities  for 
children.  The  organization  publishes  a 
journal,  newsletters,  and  monographs 
focusing  on  the  needs  and  status  of 
children  with  psychiatric  problems.  For 
more  information  write  to: 

American  Academy  of  Child  Psychiatry 
1800  R  Street,  N.W.,  Suite  904 
Washington,  D.C.  20009 


American  Association  of 
Psychiatric  Services  for  Children 

The  purposes  of  this  organization 
are  to  provide  psychiatric  services  for 
children  and  related  services  for  the 
community  at  large,  and  to  promote  a 
coordinated  effort  of  psychiatrists,  psy- 
chologists, and  psychiatric  social 
workers  in  serving  the  needs  of  chil- 
dren. This  organization  has  branch 
offices  in  many  communities  and 
publishes  a  newsletter.  For  more  infor- 
mation write  to: 

American  Association  of  Psychiatric 
Services  for  Children 
1701  18th  Street,  N.  W. 
Washington,  D.C.  20009 

American  Association  of 
University  Affiliated  Programs 

This  organization  is  most  interested 
in  providing  diagnostic  services  to  indi- 
viduals with  developmental  disabilities 
(which  include  emotional  disturbance) 
and  in  providing  training  for  people 
who  work  with  handicapped  persons. 
University  Affiliated  Facilities  provide 
services  in  areas  such  as  early  child- 
hood and  special  education,  pediatrics, 
child  development,  child  psychology, 
social  work,  child  neurology,  speech 
pathology,  physical  and  occupational 
therapy,  nutrition,  and  nursing.  Nearly 
50  UAFs  have  been  established 
throughout  the  country.  The  associa- 
tion has  an  official  working  relationship 
with  Head  Start.  By  writing  to  the 
address  below  you  can  find  out  if  there 
is  a  program  near  you  that  can  provide 
diagnostic  treatment,  training,  and  con- 
sultation services.  For  more  informa- 
tion write  to: 

American  Association  of  University 
Affiliated  Programs 
2033  M  Street,  Suite  406 
Washington,  D.  C.  20036 


American  Psychological  Association/ 
Division  of  Child  and  Youth  Services 

This  is  a  new  division  of  the  APA 
that  draws  on  many  disciplines  other 
than  psychology  to  study,  develop,  and 
foster  appropriate  services  and  service 
structures  for  children  and  youth.  It  is 
concerned  with  the  prevention  and 
treatment  of  emotional  disturbance  and 
emphasizes  the  necessity  of  high- 
quality  services  for  mainstream  chil- 
oren  and  youth.  The  Division  can  serve 
as  a  source  of  information.  Write  to: 

Director,  Division  of  Child 

and  Youth  Services 

c/o  American  Psychological  Association 

1200  17th  Street,  N.W. 

Washington,  D.C.  20005 


Closer  Look 

Funded  through  the  Bureau  of  Edu- 
cation for  the  Handicapped,  U.S.  Office 
of  Education,  this  special  project 
attempts  to  provide  bridges  between 
parents  and  services  for  handicapped 
children,  and  to  help  parents  become 
advocates  for  comprenensive  services 
for  their  own  handicapped  child  as  well 
as  for  others.  Qoser  Look  publishes  a 
newsletter  about  handicaps  and  new 
programs,  as  well  as  information  of  spe- 
cial interest  to  parents.  The  staff  will 
also  respond  to  questions  that  you  may 
have.  The  newsletters  and  information 
are  free.  Bv  writing  to  themvou  can  be 
added  to  their  mailing  list.  This  organi- 
zation has  regional  branches.  For  more 
information  write  to: 

Closer  Look 

Box  1492 

Washington,  D.  C.  20013 


127 


128    Council  for  E^xceptional  Children: 
Division  for  Children  with 
Behavioral  Disorders 

This  division  is  concerned  with 
teaching  children  with  behavioral  disor- 
ders, with  training  the  teachers  of  these 
children  to  be  more  effective,  with  pro- 
moting research  and  development  into 
more  iimovative  and  responsible  educa- 
tion for  exceptional  children,  and  with 
supporting  legislation  for  services  to 
these  children.  CEC  and  this  division 
publish  low-cost  informational  materials 
of  interest  to  parents  and  professionals. 
CEC  has  local  chapters.  For  more  infor- 
mation, write  to: 

Council  for  Exceptional  Children 

Division  for  Children  with  Behavioral 

Disorders 

1920  Association  Drive 

Reston,  Virginia  22091 


Council  for  Ebtceptional  Children 
Information  Center 

This  information  center  provides 
abstracts  of  current  research  and  bibli- 
ographies of  information  currently 
available  in  publications  and  nonprint 
media.  It  also  provides  annotated  list- 
ings of  agencies  that  serve  exceptional 
children  and  their  families.  Contact: 

Council  for  Exceptional  Children 
Information  Center 
1920  Association  Drive 
Reston,  Virginia  22091 


Instructional  Materials  Centers 

These  centers  have  media  and  mate- 
rials suitable  for  use  with  emotionally 
disturbed  children.  Often  the  director  or 
staff  of  the  center  can  demonstrate 
materials,  suggest  especially  good 
materials,  and  consult  with  you  about 
your  needs. 

Tb  find  out  about  a  center,  contact 
the  Resource  Access  Project  in  your 
region,  directors  of  special  education  in 
your  state  department  of  education,  or 
colleges'  and  imiversities'  special  educa- 
tion departments. 


Mental  Health  Association, 
National  Headquarters 

The  Mental  Health  Association  is  a 
private  organization  with  1,000  local 
affiliate  chapters  whose  aims  are  to 
improve  attitudes  toward  mental  illness 
and  the  mentally  ill,  to  improve  serv- 
ices for  the  mentally  ill,  to  work  for  the 
prevention  of  mental  illness,  and  to  pro- 
mote mental  health. 

The  Mental  Health  Association 
sponsors  broad  programs  of  research, 
social  action,  education,  and  service. 
Special  program  emphasis  is  placed  on 
improved  care  and  treatment  for  men- 
tal hospital  patients;  aftercare  and  reha- 
bilitation; community  mental  health 
services;  and  treatment,  education,  and 
special  services  for  mentally  iU  children. 

A  catalog  of  publications  is  avail- 
able upon  request.  For  more  informa- 
tion write  to: 

Mental  Health  Association,  National 

Headquarters 

1800  North  Kent  Street 

Arlington,  'Virginia  22209 


National  Association  of  School 
Psychologists 

The  purposes  of  this  organization 
are  to  serve  the  mental  health  and  edu- 
cational interests  of  all  children  and 
youth,  to  advance  the  standards  of 
school  psychology,  and  to  enhance  the 
effective  practice  of  school  psychology. 
The  Association  publishes  newsletters 
and  research  reports,  and  maintains  an 
archives  of  professional  material.  NASP 
provides  consultation  to  Head  Start  and 
other  preschoolprograms  through  its 
local  cnapters.  For  more  information, 
write  to: 

National  Association  of  School 
Psychologists 

1140  Connecticut  Avenue,  N.W.,  Suite 

401 

Washington,  D.C.  20036 


National  Center  for  Law 
and  the  Handicapped,  Inc. 

This  organization  was  established  to 
ensure  equal  protection  under  the  law 
for  handicapped  people.  It  participates 
in  selected  court  cases  by  consulting 
with  the  lawyers  of  handicapped  people 
whose  rights  may  have  been  violatea. 
Sometimes  NCLH  provides  a  lawyer 
for  a  handicapped  person.  The  staff  can 
answer  questions  and  provide  informa- 
tion about  legal  issues  affecting  dis- 
turbed children.  For  more  information 
write  to: 

National  Center  for  Law  and  the 
Handicapped,  Inc. 
1235  North  Eddy  Street 
South  Bend,  Indiana  46617 


National  Etister  Seal  Society  for 
Crippled  Children  and  Adults 

The  Society  is  a  major  provider  of 
rehabilitation  services  to  disabled  per- 
sons of  all  ages  with  orthopedic,  neuro- 
logical, or  neuromuscular  disabilities; 
sensory,  communication,  and  learning 
disorders;  or  psychological  and  social 
dysfunction.  Others  served  are  parents 
and  families  of  disabled  persons  and  lay 
and  professional  persons  seeking  infor- 
mation. 

The  Society  conducts  programs  of 
evaluation,  treatment,  education,  voca- 
tional training,  and  advocacy.  Support 
services  such  as  equipment  loan  and 
transportation  are  also  provided. 
Nearly  2,000  programs  and  facilities  are 
organized  on  a  state  and/or  local  basis. 
The  Chicago  headquarters  serves  as  a 
national  spokesman  about  the  Society, 
as  an  advocate  of  the  disabled,  and  in 
support  and  leadership  of  the  programs 
of  its  affiliate  Societies.  As  an  advo- 
cate, response  is  given  to  requests  for 
information,  and  testimony  is  prepared 
on  issues  vital  to  the  disabled. 

The  National  Society  building  in 
Chicago  houses  a  library  collection  of 
books,  periodicals,  and  pamphlets  on 
rehabilitation.  The  Society's  Informa- 
tion Center  produces  and/or  dissemi- 
nates several  publications,  including  a 
professional  journal  entitled  Rehabilita- 
tion Literature.  A  publications  catalog 
is  available.  For  more  information 
write: 

National  Easter  Seal  Society  for 
Crippled  Children  and  Adults 
2023  West  Ogden  Avenue 
Chicago,  Illinois  60612 


129 


130    National  Society  for  Autistic  Children 

Comprised  of  teachers,  parents,  and 
other  professionals  concerned  with 
severe  disorders  of  communication  and 
behavior  in  children,  the  purposes  of 
this  organization  are  to  provide  infor- 
mation to  the  public  about  the  S5TTip- 
toms  and  problems  of  the  autistic  child, 
to  promote  better  understanding  of 
autism,  and  to  aid  physicians  in  mak- 
ing earlier  and  more  accurate  diagnoses 
of  autism. 

This  organization  maintains  a 
National  Information  and  Referral 
Service,  supports  the  Institute  of  Child 
Behavior  Research,  and  maintains  a 
1,300- volume  library  of  information  on 
autism,  emotional  disturbance,  and 
behavior  modification.  Its  publications 
include  the  National  Directory  of  Serv- 
ices and  Programs  for  Autistic  Chil- 
dren and  a  newsletter. 

The  organization  has  local  chapters. 
For  more  information  write: 

National  Society  for  Autistic  Children 
621  Central  Avenue 
Albany,  New  York  12206 


Resource  Access  Projects 

Resource  Access  Projects  (RAPs) 
are  designed  to  link  local  Head  Start 
staff  with  a  variety  of  resources  to 
meet  the  special  needs  of  handicapped 
children.  Tney  function  as  brokers, 
facilitatrng  the  delivery  of  training  and 
technical  assistance  to  meet  local  Head 
Start  program  needs  in  the  area  of 
services  to  handicapped  children.  While 
the  RAPs  wiU  assist  local  grantees  in 
determining  and  meeting  their  n^ds  in 
the  area  of  handicapped  services,  the 
cost  of  any  required  training  or  techni- 
cal assistance  must  be  borne  by  the 
grantee  and/or  the  resource  provider. 

RAPs  have  been  established  to  iden- 
tify all  possible  sources  of  training  and 
technical  assistance,  and  to  enlist  their 
support  in  helping  Head  Start  find  and 
serve  handicapped  children.  Examples 
of  resources  include  public  health 
departments,  community  mental  health 
centers,  speech  and  hearing  clinics, 
developmental  disabilities  councils,  imi- 
versities  and  colleges,  professional  asso- 
ciations, and  private  providers  of  train- 
ing, technical  assistance,  materials,  and 
equipment. 

The  addresses  for  the  RAPs  in  all 
regions  of  the  country,  and  tne  states 
served,  are  as  follows. 


DREW 
Region 

States 
Served 

Resource  Access  Project 
(RAP) 

1 

Maine 

New  Hampshire 

Vermont 

Connecticut 

Massachusetts 

Rhode  Island 

Education  Development  Center,  Inc. 

55  Chapel  Street 

Newton,  Massachusetts  02160 

2 

New  York 
New  Jersey 
Puerto  Rico 
Virgin  Islands 

New  York  University 
School  of  Continuing  Education 
3  Washington  Sq.  Village,  Apt.  IM 
New  York,  New  York  10012 

3 

Pennsylvania 

West  "\^ginia 

Virginia 

Delaware 

Maryland 

District  of  Columbia 

PUSH/RAP 
Mineral  Street  Annex 
Keyser,  West  Virginia  26726 

4 

North  Carolina 
South  Carolina 
Georgia 
Florida 
Mississippi 

Chapel  Hill  Training  Outreach  Project 

T.incoLn  School 

Merritt  Mill  Road 

Chapel  Hill,  North  Carolina  27514 

Kentucky 
Tbnnessee 
Alabama 

The  Urban  Observatory 
1101  17th  Avenue,  South 
Nashville,  Tennessee  37212 

5 

Illinois 

Indiana 

Ohio 

University  of  Illinois 
Colonel  Wolfe  Preschool 
403  East  Healey 
Champaign,  Illinois  61820 

Minnesota 
Wisconsin 
Michigan 

Portage  Project 
Resource  Access  Project 
412  East  Slifer  Street 
P  0.  Box  564 
Portage,  Wisconsin  53901 

131 


132  DREW 
Region 

States 
Served 

Resource  Access  Project 
(RAP) 

6 

Tbxas 
Louisiana 
Oklahoma 
Arkansas 
New  Mexico 

Contract  not  awarded 
at  time  of  printing. 

7 

Missouri 
Kansas 
Iowa 
Nebraska 

University  of  Kansas  City 
Medical  Center 
Children's  Rehabilitation  Unit 
39th  &  Rflinbow  Boulevard 
Kansas  City,  Kansas  66103 

8 

Colorado 
North  Dakota 
South  Dakota 
Montana 
Utah 
Wyoming 

Mile  High  Consortium 
Hampden  East  I-Room  215 
8000  East  Girard  Avenue 
Denver,  Colorado  80231 

9 

California 

Arizona 

Hawaii 

Nevada 

Pacific  Trust  Tferritories 

Los  Angeles  Unified  School  District 
Special  Education  Division 
450  North  Grand  Avenue 
Los  Angeles,  California  90012 

10 

Washington 

Oregon 

Idaho 

University  of  Washington 
Model  Preschool  Center  for 
Handicapped  Children 
Expenmental  Education  Unit  WJ-10 
Seattle,  Washington  98195 

Alaska 


Easter  Seal  Society  for  Alaska 
Crippled  Children  and  Adults 
726  E.  Street 
Anchorage,  Alaska  99501 


Bibliography 


Many  books  have  been  published  on 
children  with  emotional  disturbance.  It 
is  not  possible  to  list  all  of  them  here, 
but  the  ones  mentioned  are  some  of 
those  that  are  especially  good  for 
understanding  what  emotional  distur- 
bance is  and  tor  helping  you  work  with 
disturbed  children  in  your  classroom. 
Several  books  that  can  be  especially 
useful  to  parents  are  also  described. 


Books  About 
Emotional 
Disturbance  and 
Its  Treatment 

Greenfield,  Josh.      A  Child  Called 
Noah.  New  York:  Holt,  Rinehart  and 
Winston,  1970. 

A  novelist/playwright  describes  family 
experiences  with  his  autistic  son.  The 
narrative  takes  the  form  of  journal 
entries  recoimting  the  parents'  strug- 
gles to  understand  what  was  wrong, 
and  their  search  across  the  country  for 
help. 


Hamblin,  Robert;  Buckholdt,  David;  et 
al.      The  Humanization  Processes:  A 
Social  Behavioral  Analysis  of 
Children's  Problems.  New  York:  Wiley- 
Interscience,  1971. 

A  major  recent  work  on  how  to  use 
behavior  modification  to  manage 
acting-out  aggressive  children  and 
autistic  children.  The  approach  is 
humane.  The  reading  is  not  easy. 


Kessler,  Jane.      Psychopathology  of 
Childhood.  Englewood  Cliffs,  N.J.: 
Prentice-Hall,  1966. 

This  is  a  major  and  classic  text  for 
those  who  want  a  more  comprehensive 
coverage  of  the  causes  and  treatment 
of  all  types  of  emotional  disorders  in 
children. 


Klein,  Stanley.      Psychological  lasting 
of  Children  —  A  Consimiers  Guide. 

Available  from:  The  Exceptional  Parent 
Bookstore,  Room  708,  Statler  Office 
Building,  Boston,  Mass.  02116. 

This  book  describes  and  assesses  the 
various  tests  commonly  used  with  chil- 
dren of  all  ages,  focusing  on  intelligence 
and  achievement  tests.  This  guide 
offers  information  about  the  appropri- 
ateness of  tests  for  use  with  handi- 
capped and  other  children  (such  as 
those  from  minority  and  low-income 
backgrounds). 

Kozloff,  Martin.      Reaching  the  Autis- 
tic Child:  A  Parent  Training  Program. 
Champaign,  111.:  Research  Press,  1973. 

The  author  describes  ways  of  training 
jarents  to  use  behavior  modification  to 
lelp  their  own  autistic  children  at 
lome,  under  professional  supervision. 
'.  ncluded  are  four  detailed  case  histories 
of  parents  and  their  autistic  children. 


133 


134    Lasher,  Miriam  G.,  and  Braun,  Samuel 
J.      Are  You  Ready  to  Mainstream: 
Helping  Preschoolers  with  Letiming 
and  Behavior  Problems.  Columbus, 
Ohio:  Charles  E.  Merrill  Publishing  Co., 
1978. 

This  book  describes  practical  ways  to 
apply  child  development  principles  in 
working  with  special  needs  children  in 
classroom  and  home  settings.  The  text 
emphasizes  the  teacher's  role  in  a  com- 
prehensive approach  to  working  with  a 
child. 


Lewis,  Richard;  Strauss,  Alfred;  and 
Lehtinen,  Laura.      The  Other  Child 
2nd  ed.  New  York:  Grune  and  Stratton, 
1960. 

A  handbook  for  parents  on  the  charac- 
teristics of  brain-injured  children,  and 
on  management  techniques  that  have 
been  found  useful  in  working  with  these 
children. 


MacCracken,  Mary.      A  Circle  of 
Children.  New  York:  New  American 
Library,  1973. 

The  author,  a  gifted  volunteer-tumed- 
teacher,  describes  her  beginning  experi- 
ences in  teaching  seriously  disturbed 
children  in  a  special  school. 


MacCracken,  Mary.  Lovey:  A  Very 
Special  Child.  New  York:  J.B.  Lippin- 
cott  Co.,  1976. 

Further  experiences  recounted  by  the 
author  on  helping  to  bring  out  one 
severely  withdrawn  little  girl. 


Park,  Clara  Clairbome.      The  Siege: 
The  First  Eight  Years  of  an  Autistic 
Child.  Boston:  Little,  Brown  and  Co., 
1967. 

A  mother's  account  of  her  family's 
struggle  to  raise  and  get  help  for  their 
severely  autistic/learning  disabled 
daughter.  Several  chapters  describe  in 
detail  the  mother's  work  with  her 
daughter. 


Ross,  Dorothea,  M.,  and  Ross,  Sheila 
A.  Hyperactivity.  New  York:  John 
WUey  &  Sons,  1976. 

This  book  makes  a  substantial  contri- 
bution to  the  literature  on  hyperactiv- 
ity, and  is  heavily  referenced.  It  thor- 
oughly reviews  current  theories  as  to 
the  cause  of  the  disturbance,  and 
methods  of  treating  it.  The  book 
includes  a  44-page  reference  list. 


Shaw,  Charles  R.  When  Your  Child 
Needs  Help.  New  York:  William  Mor- 
row &  Co.,  1972. 

This  book  is  written  for  parents  who 
know  that  they  have  an  emotionally 
disturbed  child  or  who  suspect  that 
they  may  have  one.  There  are  chapters 
on  each  of  the  major  categories  of  emo- 
tional disturbance  and  a  section  on  how 
to  get  appropriate  help. 


Stewart,  Mark  A.,  and  Olds,  Sally 
Wendkos.      Raising  a  Hyperactive 
Child.  New  York:  Harper  &  Row,  1973. 

A  very  readable  guidebook  for  parents 
and  teachers  on  the  problem  of  hyp^J"' 
activity  and  home  management.  The 
explanations  are  simple  and  the  sugges- 
tions are  practical. 


Guides  to 
Teaching  and 
Classroom 
Activities 


Anderson,  Zola.      Getting  a  Head 
Start  on  Social  and  Emotional  Growth 
(1976).  Available  from:  Meyer  Children's 
Rehaljilitation  Institute,  University  of 
Nebraska  Medical  Center,  Omaha, 
Nebr.  68105. 

This  is  a  practical  and  easy-to-read 
guide  for  preschool  teachers  on  develop- 
ing the  social  skills  and  emotional 
growth  of  young  children.  Chapter  1 1 
describes  emotional  problems  and  sug- 
gests methods  for  teachers  in  dealing 
with  them. 


D'Audney,  Weslee,  and  Dollis, 
Dorothy.      Calendar  of  Developmentfil 
Activities  for  Preschoolers  (1975). 
Available  from:  Meyer  Children's  Reha- 
bilitation Institute,  University  of 
Nebraska  Medical  Center,  Omaha, 
Nebr.  68105. 

This  is  a  resource  book  on  preschool 
activities  arranged  in  calendar  format. 
The  simpler  activities  are  presented  in 
the  faU  months  and  the  more  complex 
ones  are  presented  in  the  spring 
months,  allowing  you  to  choose  activi- 
ties appropriate  to  the  child's  develop- 
mental level.  Also  given  are  the  skill 
areas  involved  in  each  activity. 


D'Audney,  Weslee,  ed.      Giving  a 
Head  Start  to  Parents  of  the  Handi- 
capped (1976).  Available  from:  Meyer 
Children's  Rehabilitation  Institute,  Uni- 
versity of  Nebraska  Medical  Center, 
Omaha,  Nebr.  68105. 

This  manual  is  designed  primarily  to 
help  Head  Start  teachers  provide  sup- 
port and  encouragement  to  parents  of 
children  with  handicaps.  It  discusses 
subjects  such  as  the  value  of  main- 
streaming,  legal  rights  of  the  handi- 
capped and  their  families,  and  the  dan- 
gers of  labeling.  It  also  provides  spe- 
cific suggestions  for  working  with  par- 
ents of  special  needs  children,  including 
those  with  emotional  disturbance. 


The  Exceptional  Parent  Magazine. 
Psy-Ed.  Corporation,  20  Providence 
Street,  Room  708,  Statler  Office  Build- 
ing, Boston,  Mass.  02116. 

Addressed  to  the  parents  and  teachers 
of  handicapped  youngsters  and  adults, 
this  magazine  has  many  articles  of 
interest,  including  "what  to  do,"  "how 
to  do  it,"  and  "where  to  get  help."  For 
a  subscription,  write  to:  The  Excep- 
tional Parent,  P.O.  Box  4944,  Manches- 
ter, N.H.  03108. 


135 


I 


136    Findlay,  Jane,  et  al.      A  Planning 
Guide:  The  Preschool  Curriculum  — 
The  Child,  The  Process,  The  Day. 

Chapel  Hill,  N.C.:  Chapel  HiU  Training 
Outreach  R-oject,  n.d. 

This  book  elaborates  on  curriculum 
information  found  in  the  Learning 
Accomplishment  Profile  developol  by 
Anne  Sanford,  and  presents  44  pre- 
school curriculum  units  intended  for 
developmentally  delayed  or  unpaired 
children.  It  has  a  section  on  curriculum 
(who  determines  it,  what  it  is,  and  what 
goes  into  it),  a  section  on  methods  and 
principles  (preparing  instructional  objec- 
tives, task  analysis,  error-free  learning, 
and  positive  reinforcement),  the  44  cur- 
riculum units,  with  objectives  and  skill 
sequences,  and  bibliographies.  It  is 
helpful,  although  not  necessary,  to  use 
the  Planning  Guide  together  with  the 
LAP 

Hansen,  S.  Getting  a  Head  Start  on 
Speech  and  Language  Problems  (1974). 
Available  from:  Meyer  Children's  Reha- 
bilitation Institute,  University  of 
Nebraska  Medical  Center,  Omaha, 
Nebr.  68105. 

This  good,  simple  guide  to  working 
with  preschool  children  who  have 
speecn  and  language  problems  gives 
language  milestones,  screening  proce- 
dures, and  teaching  techniques. 

Hogden,  Laurel,  et  al.        School  Before 
Six:  A  Diagnostic  Approach  (1974). 
Available  from:  Cemrel,  Inc.  3120  59th 
Street,  St.  Louis,  Mo.  63139. 

School  Before  Six  is  printed  in  two 
volumes.  Volume  I  includes  procedures 
for  assessing  young  children  s  learning 
needs  and  strengths  through  testing 
procedures  in  four  developmental  areas: 
large,  small,  and  perceptual  motor 
skjJls;  language;  social-emotional  skills; 
and  conceptual  skills.  General  teaching 
strategies  and  activities  are  suggested 
to  help  children  develop  in  each  of  these 
areas.  Volume  II  includes  a  wealth  of 
activities  in  areas  such  as  science,  art, 
table  games,  food  preparation,  lan- 
guage, social  science,  and  music.  Vol- 


ume I  is  extensively  cross-referenced  to 
Volume  II  to  simplify  the  selection  of 
appropriate  activities  for  specifically 
diagnosed  situations. 

Jordan,  June,  ed.      Not  All  Little 
Wagons  Are  Red:  The  Exceptional 
Child's  Early  Years  (1973).  Available 
from:  Council  for  Exceptional  Children, 
1920  Association  Drive,  Reston,  Va. 
22091. 

This  book  discusses  the  importance  of 
beginning  early  to  develop  programs 
for  children  with  handicaps.  Attention 
is  given  to  helping  children  achieve  a 
positive  self-concept,  good  learning 
motivation,  social  skills,  emotional  sta- 
bility, and  physical  well-being.  Two  sec- 
tions are  particularly  helpful:  the  devel- 
opment or  children  who  need  special 
help,  and  program  models  and  resource 
materials.  The  book  includes  many  fine 
illustrations,  and  describes  a  variety  of 
alternative  ways  to  meet  children's 
needs. 


The  Portage  Guide  to  Early 
Education.       Rev.  ed.  Portage,  Wis.: 
Cooperative  Educational  Service 
Agency  No.  12,  1976. 

This  guide  has  three  parts:  a  checklist 
of  skills  for  determining  an  individual 
child's  progress,  a  card  file  listing 
activities  that  can  be  used  to  teach 
these  skills,  and  a  manual  of  directions 
for  conducting  the  activities.  The  areas 
covered  in  the  program  are  infant  stim- 
ulation, socialization,  language,  self- 
help,  cognitive  skills,  and  motor  skills. 


Reinert,  Henry  R.      Children  in 
Conflict.  St.  Louis:  The  C.V.  Mosby 
Co.,  1976. 

A  short  overview  of  the  field  of  teach- 
ing emotionally  disturbed  children.  It  is 
designed  for  beginning  teachers  or  col- 
lege students. 


Appendix 


Ongoing  assessment, 
balanced  against  overtest- 
ing,  can  help  to  provide 
an  accurate  picture  of  a 
child's  developing  skills 
and  functioning. 


138 


Screening 

and 

Diagnosis 


This  section  describes  the  nature 
and  purpose  of  screening  and  diagnosis, 
and  the  use  of  tests  in  each  of  these 
processes.  The  overall  goal  of  both 
processes  is  to  evaluate  or  assess  a 
child's  functioning  and  to  identify  prob- 
lem areas,  if  any  exist. 


Screening 


Screening  is  a  process  that  identifies 
children  who  need  specific  treatment 

(for  example,  eyeglasses  or  immimiza- 
tion  shots)  or  who  need  to  be  referred 
for  a  diagnostic  evaluation.  Screening  is 
therefore  an  important  tool  in  the  early 
identification  or  handicapped  children. 

Screening  procedures  such  as  check- 
lists and  tests  are  inexpensive,  quick, 
and  easily  administered.  They  give  the 
screener  an  overview  of  a  child  s  per- 
formance. Tbachers,  aides,  and  others 
need  to  be  trained  to  use  a  particular 
screening  procedure  correctly.  For  the 
screening  services  that  must  be  pro- 
vided for  every  child,  see  Project  Head 
Start  Performance  Standards. 

Not  all  children  who  fail  a  screening 
test  are  found  to  have  a  problem  when 
they  are  given  a  full  diagnostic  evalua- 
tion. This  is  because  the  results  of 
screening  tests  are  not  exact,  since  the 
tests  do  not  assess  in  depth  a  child's 
functioning  in  a  given  area.  Also, 
because  screening  is  done  in  a  limited 
amount  of  time,  the  screener  may  not 
realize  if  a  certain  child  is  not  perform- 
ing at  his  or  her  best  at  that  particiilar 
time.  For  these  reasons,  a  child  who  is 
not  handicapped  may  fail  a  screening 
and  be  referred  for  further  evaluation. 

On  the  other  hand,  some  children 
who  pass  a  screening  test  may,  in  fact, 
have  a  problem  that  wasn't  detected  in 
the  screening.  If  you  have  a  child  in 
your  class  who  has  passed  the  standard 
screening  tests  and  you  still  feel  there 
may  be  something  wrong,  do  not  hesi- 
tate to  ask  an  appropriate  professional 
to  look  at  the  child  more  closely. 


Diagnosis 


Diagnosis  is  a  process  of  gathering 
information  from  a  variety  of  sources 
in  order  to  get  a  comprehensive  picture 
of  a  child's  functioning  and  to  identify 
problem  areas.  The  diagnostic  process 
assesses  both  physical  and  psychologi- 
cal functioning. 

A  variety  of  tools  should  be  used  in 
the  diagnostic  process:  interviews  (with 
parents  and  other  adults  who  know  the 
child  well,  with  the  child,  with  social 
agency  personnel  the  child  has  been 
receiving  services  from),  psychological 
tests,  medical  and  other  reports/tests  of 
physical  functioning,  and  other  sources 
of  information  about  the  child.  The 
tests  that  are  used  in  the  diagnostic 
process  take  an  in-depth  look  at  a 
child's  skills  in  particular  developmental 
areas.  In  Project  Head  Start,  diagnosis 
is  to  be  conducted  by  an  interdisci- 
plinary team  of  specialists  (or  a  profes- 
sional who  is  qualified  to  diagnose  the 
specific  handicap).  The  diagnostic  proc- 
ess should  involve: 

1.      A  categorical  diagnosis  of  a  child, 
using  Project  Head  Start  diagnostic  cri- 
teria, to  be  used  solely  for  reporting 
purposes. 

L,      A  functional  assessment  of  a 
child.  This  functional  assessment  is  a 
developmental  profile  that  describes 
what  tne  child  can  and  cannot  currently 
do  and  that  identifies  areas  requiring 
special  education  and  related  services. 


3.  An  individualized  program  plan 
based  upon  the  functional  assessment 
and  developed  jointly  by  the  diagnostic 
team,  the  parents,  and  the  child's 
teacher. 

4.  Ongoing  assessment  of  the  child's 
progress  by  the  teacher,  the  child's  par- 
ents, and  (as  needed)  the  diagnostic 
team. 

The  results  of  the  diagnostic  process 
should  inform  the  teacher  and  parents 
as  to  the  child's  strengths  and 
weaknesses  —  and  hence  the  child's 
needs  in  terms  of  further  learning.  The 
results  of  the  diagnostic  process  often 
do  not  tell  the  teacher  or  parents  what 
they  should  do  to  help  the  child  in  the 
identified  problem  areas.  Diagnosticians 
themselves,  depending  on  their  knowl- 
edge of  classrooms  and  of  specific 
teaching  techniques,  may  be  able  to  dis- 
cuss with  the  teacher  and  parents  spe- 
cific ways  in  which  they  can  help  the 
child  in  the  classroom  and  at  home. 
Often  the  teacher  or  parent  needs  to 
take  the  initiative  in  order  to  obtain 
this  kind  of  information  from  a  diagnos- 
tician. 


139 


140 


Testing 


The  selection  of  appropriate  tests, 
their  administration,  and  their  interpre- 
tation is  often  a  difficult  process, 
requiring  a  great  deal  of  expertise. 
Sometimes  the  precise  test  needed  has 
simply  not  yet  been  developed,  and  a 
diagnostician  must  use  the  best  of 
what  is  available  and  then  interpret  the 
results  with  great  caution.  Many  fac- 
tors can  lead  to  inappropriate  testing  or 
inaccurate  test  results: 

•  mistaking  one  handicap  for  another 

•  mistaking  cultural  differences  for 
handicaps 

•  mistaking  normal  physical  or  men- 
tal immatvirity  for  handicaps 

•  testing  a  child  who  is  not  used  to 
test-like  situations 

•  testing  a  child  when  he  or  she  is 
not  feeling  well 

•  testing  a  child  in  a  language  that 
is  not  his  or  her  home  language 

•  testing  a  particular  developmental 
area  in  a  child  by  requiring  a 
response  that  involves  behaviors  in 
which  the  child  has  special  needs 
(for  example,  testing  cognitive 
functioning  by  requiring  a  verbal 
response  from  a  withdrawn,  non- 
verbfd  child,  or  peer  interaction  or 
reality  testing  from  a  severely 
handicapped  psychotic  or  autistic 
child). 


Even  if  children  are  given  tests  that  are 
appropriate  to  their  age,  cultural  back- 
ground, and  suspected  handicaps  — 
and  that  are  methodologically  valid  and 
reliable  —  test  results  can  be  inaccu- 
rately interpreted. 

Tb  ensure  that  tests  are  appropriate 
to  a  specific  purpose,  and  that  they  are 
administered  and  interpreted  correctly, 
any  screening  test  that  a  teacher  wants 
to  use  should  be  discussed  ahead  of 
time  with  a  trained  professional  who  is 
knowledgeable  about  the  test.  Tfests 
used  for  diagnostic  purposes  should  be 
administered  and  interpreted  by  special- 
ists trained  in  the  use  of  the  test. 

In  addition  to  interviews  and  histo- 
ries, your  own  continuing  observation 
of  a  child  in  a  variety  of  situations  in 
your  preschool  program  is  an  invalu- 
able tool  in  understanding  and  helping 
a  child  learn.  During  the  preschool 
years,  children  experience  a  great 
amount  of  development  emd  change  in 
all  areas.  This  means  that  ongoing 
assessment,  balanced  against  over- 
testing,  is  needed  to  provide  a  more 
accurate  picture  of  a  child's  developing 
skills  and  functioning.  Ongoing  assess- 
ment can  help  prevent  mislabeling  of 
children. 

For  additional  information  on  the 
diagnostic  process  —  including  proce- 
dures and  persons  —  contact  the 
Resource  Access  Project  in  your  area. 

For  additional  information  on  tests, 
write  to: 

Head  Start  Tfest  Collection 
Educational  Tfesting  Service 
Princeton,  New  Jersey  08540 


Chart  of 
Normal 
Development: 
Infancy  to 
Six  Years 
of  Age 


The  chart  of  normal  development  on 
the  next  few  pages  presents  children's 
achievements  from  infancy  to  six  years 
of  age  in  five  areas: 

•  motor  skills  (gross  and  fine  motor) 

•  cognitive  skills 

•  self-help  skills 

•  social  skills 

•  communication  skills  (understand- 
ing language  and  speaking). 

In  each  skill  area,  the  age  at  which 
each  milestone  is  reached  on  the  aver- 
age is  also  presented.  This  information 
is  useful  if  you  have  a  child  in  your 
class  who  you  suspect  is  seriously 
delayed  in  one  or  more  skiU  areas. 

However,  it  is  important  to  remem- 
ber that  these  milestones  are  only  aver- 
age. From  the  moment  of  birth,  each 
child  is  a  distinct  individual,  and 
develops  in  his  or  her  unique  manner. 
No  two  children  have  ever  reached  all 
the  same  developmental  milestones  at 
the  exact  same  ages.  The  examples  that 
foUow  show  what  we  mean. 

By  nine  months  of  age,  Gi  Lin  had 
spent  much  of  her  time  scooting  around 
on  her  hands  and  tummy,  making  no 
effort  to  crawl  After  about  a  week  of 
pulling  herself  up  on  chairs  and  table 
legs,  she  let  go  and  started  to  walk  on 
her  own,  Gi  Lin  skipped  the  crawling 
stage  entirely  and  scarcely  said  more 
than  a  few  sounds  until  she  was  15 
months  old  But  she  walked  with  ease 
and  skill  by  9'/2  months. 


Marcus  learned  to  crawl  on  all  fours 
very  early,  and  continued  crawling  until 
he  was  nearly  18  months  old,  when  he 
started  to  walk.  However,  he  said  single 
words  and  used  two-word  phrases 
meaningfully  before  his  first  birthday. 
A  talking,  crawling  baby  is  quite  a 
sight! 

Molly  worried  her  parents  by  saying 
scarcely  a  word,  although  she  managed 
to  make  her  needs  known  with  sounds 
and  gestures.  Shortly  after  her  second 
birthday,  Molly  suddenly  began  talking 
in  two-  to  four-word  phrases  and  sen- 
tences. She  was  never  again  a  quiet 
child 

All  three  children  were  healthy  and 
normal.  By  the  time  they  were  three 
years  old,  there  were  no  major  differ- 
ences among  them  in  walking  or  talk- 
ing. They  had  simply  developed  in  their 
own  ways  and  at  their  own  rates.  Some 
children  seem  to  concentrate  on  one 
thing  at  a  time  —  learning  to  crawl,  to 
walk,  or  to  talk.  Other  children  develop 
across  areas  at  a  more  even  rate. 

As  you  read  the  chart  of  normal 
development,  remember  that  children 
don't  read  baby  books.  They  don't 
know  they're  supposed  to  be  able  to 
point  out  Daddy  when  they  are  a  year 
old,  or  copy  a  circle  in  their  third  year. 
And  even  if  they  could  read  the  baby 
books,  they  probably  wouldn't  follow 
them!  Age-related  development  mile- 
stones are  obtained  by  averaging  out 
what  many  children  do  at  various  ages. 
No  child  is  "average"  in  aU  areas.  Each 
child  is  a  unique  person. 

One  final  word  of  caution.  As  chil- 
dren grow,  their  abilities  are  shaped  by 
the  opportunities  they  have  for  learn- 
ing. For  example,  although  many  five- 
year-olds  can  repeat  songs  and  rhymes, 
the  child  who  has  not  heard  songs  and 
rhymes  many  times  cannot  be  expected 
to  repeat  them.  All  areas  of  develop- 
ment and  learning  are  influenced  by  the 
child's  experiences  as  well  as  by  the 
abilities  tney  are  bom  with. 


141 


Chart  of  Normal  Development 


>5>* 


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0-12  Months 


Sits  without  support. 

Crawls. 

Pulls  self  to  standing 
and  stands  unaided. 

Walks  with  aid. 

Rolls  a  ball  in  imita- 
tion of  adult. 


Reaches,  grasps, 
puts  object  in  mouth. 

Picks  things  up  with 
thumb  and  one  finger 
(pincer  grasp). 

Transfers  object 
from  one  hand  to 
other  hand. 

Drops  and  picks  up 
toy. 


Responds  to  speech 
by  looking  at 
speaker. 

Responds  differently 
to  aspects  of 
speaker's  voice  (for 
example,  friendly  or 
unfriendly,  male  or 
female). 

Turns  to  source  of 
sound. 

Responds  with  ges- 
ture to  hi,  bye-bye, 
and  up,  when  these 
words  are  accompa- 
nied by  appropriate 
gesture. 

Stops  ongoing  action 
when  told  no  (when 
negative  is  accompa- 
nied by  appropriate 
gesture  and  tone). 


Makes  crying  and 
non-crying  sounds. 

Repeats  some  vowel 
and  consonant 
sounds  (babbles) 
when  alone  or  when 
spoken  to. 

Interacts  with  others 
by  vocalizing  after 
adult. 

Communicates  mean- 
ing through  intona- 
tion. 

Attempts  to  imitate 
sounds. 


12-24  Months     Walks  alone. 

Walks  backward. 

Picks  up  toys  from 
floor  without  falhng. 

Pulls  toy,  pushes 
toy. 

Seats  self  in  child's 
chair. 

Walks  up  and  down 
stairs  (hand-held). 

Moves  to  music. 


Builds  tower  of  3 
small  blocks. 

Puts  4  rings  on  stick. 

Places  5  pegs  in  peg- 
board. 

Turns  pages  2  or  3  at 
a  time. 

Scribbles. 

Turns  knobs. 

Throws  small  ball. 

Paints  with  whole 
arm  movement, 
shifts  hands,  makes 
strokes. 


Responds  correctly 
when  asked  where 
(when  question  is 
accompanied  by  ges- 
ture). 

Understands  preposi- 
tions on,  in,  and 
under. 

Follows  request  to 
bring  familiar  object 
from  another  room. 

Understands  simple 
phrases  with  key 
words  (for  example. 
Open  the  door,  or 
Get  the  ball). 

Follows  a  series  of  2 
simple  but  related 
directions. 


Says  first  meaningful 
word. 

Uses  single  word 
plus  a  gesture  to  ask 
for  objects. 

Says  successive  sin- 
gle words  to  describe 
an  event. 

Refers  to  self  by 
name. 

Uses  my  or  mine  to 
indicate  possession. 

Has  vocabulary  of 
about  50  words  for 
important  people, 
common  objects,  and 
the  existence,  non- 
existence, and  recur- 
rence of  objects  and 
events  (for  example, 
more  "^nd  all  gone). 


JT 


# 


^cJt' 


*^' 


1^^ 


.^ 


^' 


Follows  moving 
object  with  eyes. 

Recognizes  differ- 
ences among  people. 
Responds  to 
strangers  by  crying 
or  staring. 

Responds  to  and 
imitates  facial 
expressions  of 
others. 

Responds  to  very 
simple  directions  (for 
example,  raises  arms 
when  someone  says, 
Come,  and  turns 
head  when  asked. 
Where  is  Daddy?). 


Imitates  gestures 
and  actions  (for 
example,  shakes  head 
no,  plays  peek-a-boo, 
waves  bye-bye). 

Puts  small  objects  in 
and  out  of  container 
with  intention. 


Feeds  self  cracker. 

Holds  cup  with  two 
hands.  Drinks  with 
assistance. 

Holds  out  arms  and 
legs  while  being 
dressed. 


Smiles  sponta- 
neously. 

Responds  differently 
to  strangers  than  to 
famihar  people. 

Pays  attention  to 
own  name. 

Responds  to  no. 

Copies  simple  actions 
of  others. 


Imitates  actions  and 
words  of  adults. 

Responds  to  words 
or  commands  with 
appropriate  action 
(for  example:  Stop 
that.  Get  down). 

Is  able  to  match  two 
similar  objects. 

Looks  at  storybook 
pictures  with  an 
adult,  naming  or 
pointing  to  familiar 
objects  on  request 
(for  example:  What  is 
that?  Point  to  the 
baby). 


Recognizes  difference 
between  you  and  me. 

Has  very  limited 
attention  span. 

Accomplishes  pri- 
mary learning 
through  own  explora- 
tion. 


Uses  spoon,  spilHng 
little. 

Drinks  from  cup,  one 
hand,  unassisted. 

Chews  food. 

Removes  shoes, 
socks,  pants, 
sweater. 

Unzips  large  zipper. 

Indicates  toilet 
needs. 


Recognizes  self  in 
mirror  or  picture. 

Refers  to  self  by 
name. 

Plays  by  self,  initi- 
ates own  play. 

Imitates  adult 
behaviors  in  play. 

Helps  put  things 
away. 


Chart  of  Normal  Development 


^ 


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.^° 


,vO^ 


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24-36  Months     Runs  forward  weU. 

Jumps  in  place,  two 
feet  together. 

Stands  on  one  foot, 
with  aid. 

Walks  on  tiptoe. 

Kicks  ball  forward. 


Strings  4  large 
beads. 

Turns  pages  singly. 

Snips  with  scissors. 

Holds  crayon  with 
thumb  and  fingers, 
not  fist. 

Uses  one  hand  con- 
sistently in  most 
activities. 

Imitates  circular, 
vertical,  horizontal 
strokes. 

Paints  with  some 
wrist  action.  Makes 
dots,  lines,  circular 
strokes. 

Rolls,  pounds, 
squeezes,  and  pulls 
clay. 


Points  to  pictures  of 
common  objects 
when  they  are 
named. 

Can  identify  objects 
when  told  their  use. 

Understands  ques- 
tion forms  what  and 
where. 

Understands  nega- 
tives no,  not,  can't, 
and  don't. 

Enjoys  listening  to 
simple  storybooks 
and  requests  them 
again. 


Joins  vocabulary 
words  together  in 
two-word  phrases. 

Gives  first  and  last 
name. 

Asks  what  and 
where  questions. 

Makes  negative 
statements  (for 
example.  Can't  open 
it). 

Shows  frustration  at 
not  being  under- 
stood. 


36-48  Months     Runs  around  obsta-      Builds  tower  of  9 

cles.  small  blocks. 


Walks  on  a  Hne. 

Balances  on  one  foot 
for  5  to  10  seconds. 

Hops  on  one  foot. 

Pushes,  pulls,  steers 
wheeled  toys. 

Rides  (that  is,  steers 
and  pedals)  tricycle. 

Uses  slide  without 
assistance. 

Jumps  over  15  cm. 
(6")  nigh  object,  land- 
ing on  both  feet 
together. 

Throws  ball  over- 
head. 

Catches  ball  bounced 
to  him  or  her. 


Drives  nails  and 
pegs. 

Copies  circle. 

Imitates  cross. 

Manipulates  clay 
materials  (for  exam- 
ple, rolls  balls, 
snakes,  cookies). 


Begins  to  understand 
sentences  involving 
time  concepts  (for 
example.  We  are 
going  to  the  zoo 
tomorrow). 

Understands  size 
comparatives  such  as 
big  and  bigger. 

Understands  rela- 
tionships expressed 
by  if  . . .  then  or 
because  sentences. 

Carries  out  a  series 
of  2  to  4  related 
directions. 

Understands  when 
told.  Let's  pretend. 


Talks  in  sentences  of 
3  or  more  words, 
which  take  the  form 
agent-action-object  (I 
see  the  ball)  or  agent- 
action-location 
(Daddy  sit  on  chair). 

Tfells  about  past 
experiences. 

Uses  "s"  on  nouns  to 
indicate  plurals. 

Uses  "ed"  on  verbs 
to  indicate  past 
tense. 

Refers  to  self  using 
pronouns  I  or  me. 

Repeats  at  least  one 
nursery  rhyme  and 
can  sing  a  song. 

Speech  is  under- 
standable to 
strangers,  but  there 
are  still  some  sound 
errors. 


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Responds  to  simple 
directions  (for  exam- 
ple: Give  me  the  ball 
and  the  block.  Get 
your  shoes  and 
socks). 

Selects  and  looks  at 
picture  books,  names 
pictured  objects,  and 
identifies  several 
objects  within  one 
picture. 

Matches  and  uses 
associated  objects 
meaningfully  (for 
example,  given  cup, 
saucer,  and  bead, 
puts  cup  and  saucer 
together). 

Stacks  rings  on  peg 
in  order  of  size. 

Recognizes  self  in 
mirror,  saying,  baby, 
or  own  name. 


Can  talk  briefly 
about  what  he  or  she 
is  doing. 

Imitates  adult 
actions  (for  example, 
housekeeping  play). 

Has  limited  attention 
span.  Learning  is 
through  exploration 
and  adult  direction 
(as  in  reading  of  pic- 
ture stories). 

Is  beginning  to 
understand  func- 
tional concepts  of 
familiar  objects  (for 
example,  that  a 
spoon  is  used  for  eat- 
ing) and  part/whole 
concepts  (for  exam- 

Ele,  parts  of  the 
ody). 


Uses  spoon,  spilling 
little. 

Gets  drink  from 
fountain  or  faucet 
unassisted. 

Opens  door  by  turn- 
ing handle. 

Takes  off  coat. 

Puts  on  coat  with 
assistance. 

Washes  and  dries 
hands  with  assis- 
tance. 


Plays  near  other  chil- 
dren. 

Watches  other  chil- 
dren, joins  briefly  in 
their  play. 

Defends  own  posses- 
sions. 

Begins  to  play  house. 

Symbolically  uses 
objects,  self  in  play. 

Participates  in  sim- 
ple group  activity 
(for  example,  sings, 
claps,  dances). 

Knows  gender  iden- 
tity. 


Recognizes  and 
matches  6  colors. 

Intentionally  stacks 
blocks  or  rings  in 
order  of  size. 

Draws  somewhat  rec- 
ognizable picture 
that  is  meaningful  to 
child,  if  not  to  adult. 
Names  and  briefly 
explains  picture. 

Asks  questions  for 
information  (why  and 
how  questions 
requiring  simple 
answers). 

Knows  own  age. 

Knows  own  last 
name. 


Has  short  attention 
span. 

Learns  through 
observing  and  imitat- 
ing adults,  and  by 
adult  instruction  and 
explanation.  Is  very 
easily  distracted. 

Has  increased  under- 
standing of  concepts 
of  the  functions  and 
groupings  of  objects 
(for  example,  can  put 
doll  house  furniture 
in  correct  rooms), 
and  part/whole  (for 
example,  can  identify 
pictures  of  hand  and 
foot  as  parts  of 
body). 

Begins  to  be  aware 
of  past  and  present 
(for  example:  Yester- 
day we  went  to  the 
park.  Today  we  go  to 
the  library). 


Pours  well  from 
small  pitcher. 

Spreads  soft  butter 
with  knife. 

Buttons  and  unbut- 
tons large  buttons. 

Washes  hands  unas- 
sisted. 

Blows  nose  when 
reminded. 

Uses  toilet  independ- 
ently. 


Joins  in  play  with 
other  children. 
Begins  to  interact. 

Shares  toys.  Takes 
turns  with  assis- 
tance. 

Begins  dramatic 
play,  acting  out 
whole  scenes  (for 
example,  traveling, 
playing  house,  pre- 
tending to  be  ani- 
mals). 


Chart  of  Normal  Development 


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48-60  Months     Walks  backward  toe- 
heel. 

Jumps  forward  10 
times,  without  fall- 
ing. 


Walks  up  and  down      , 
stairs  alone,  alternat-    betters, 
ing  feet. 

Turns  somersault. 


Cuts  on  line  contin- 
uously. 

Copies  cross. 

Copies  square. 

Prints  a  few  capital 


Follows  3  unrelated 
commands  in  proper 
order. 

Understands  com- 
paratives like  pretty, 
prettier,  and  pret- 
tiest. 

Listens  to  long  sto- 
ries but  often  misin- 
terprets the  facts. 

Incorporates  verbal 
directions  into  play 
activities. 

Understands 
sequencing  of  events 
when  told  them  (for 
example.  First  we 
have  to  go  to  the 
store,  then  we  can 
make  the  cake,  and 
tomorrow  we  will  eat 
it). 


Asks  when,  how,  and 
why  questions. 

Uses  modals  like  can, 
will,  shall,  should, 
and  might. 

Joins  sentences 
together  (for  exam- 
ple, I  like  chocolate 
chip  cookies  and 
milk). 

Talks  about  causality 
by  using  because  and 
so. 

Ttells  the  content  of  a 
story  but  may  con- 
fuse facts. 


60-72  Months    Runs  lightly  on  toes.    Cuts  out  simple 

shapes. 


Walks  on  balance 
beam. 

Can  cover  2  meters 
(6 '6")  hopping. 

Skips  on  alternate 
feet. 

Jumps  rope. 

Skates. 


Copies  triangle. 
Traces  diamond. 
Copies  first  name. 

Prints  numerals  1  to 

5. 

Colors  within  lines. 

Has  adult  grasp  of 
pencil. 

Has  handedness  well 
established  (that  is, 
child  is  left-  or  right- 
handed). 

Pastes  and  glues 
appropriately. 


Demonstrates  pre- 
academic  skills. 


There  are  few  obvi- 
ous differences 
between  child's 
grammar  and  adult's 
grammar. 

Still  needs  to  learn 
such  things  as 
subject-verb  agree- 
ment, and  some 
irregular  past  tense 
verbs. 

Can  take  appropriate 
turns  in  a  conversa- 
tion. 

Gives  and  receives 
information. 

Communicates  well 
with  family,  friends, 
or  strangers. 


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Plays  with  words 
(creates  own  rhyming 
words;  says  or  makes 
up  words  having 
similar  sounds). 

Points  to  and  names 
4  to  6  colors. 

Matches  pictures  of 
familiar  objects  (for 
example,  shoe,  sock, 
foot;  apple,  orange, 
banana). 

Draws  a  person  with 
2  to  6  recognizable 
parts,  such  as  head, 
arms,  legs.  Can  name 
and  match  drawn 
parts  to  own  body. 

Draws,  names,  and 
describes  recogniz- 
able picture. 

Rote  counts  to  5, 
imitating  adults. 


Knows  own  street 
and  town. 

Has  more  extended 
attention  span. 
Learns  through 
observing  and  listen- 
ing to  adults  as  well 
as  through  explora- 
tion. Is  easily  dis- 
tracted. 

Has  increased  under- 
standing of  concepts 
of  function,  time, 
part/whole  relation- 
ships. Function  or 
use  of  objects  may 
be  stated  in  addition 
to  names  of  objects. 

Time  concepts  are 
expanding.  The  child 
can  talk  about  yes- 
terday or  last  week 
(a  long  time  ago), 
about  today,  and 
about  what  will  hap- 
pen tomorrow. 


Cuts  easy  foods  with 
a  knife  (for  example, 
hamburger  patty, 
tomato  slice). 

Laces  shoes. 


Plays  and  interacts 
with  other  children. 

Dramatic  play  is  clos- 
er to  reality,  with 
attention  paid  to 
detail,  time,  and 
space. 

Plays  dress-up. 

Shows  interest  in 
exploring  sex  differ- 
ences. 


Retells  story  from 
picture  book  with 
reasonable  accuracy. 

Names  some  letters 
and  numerals. 

Rote  counts  to  10. 

Sorts  objects  by  sin- 
gle characteristics 
(for  example,  by 
color,  shape,  or  size 
if  the  difference  is 
obvious). 

Is  beginning  to  use 
accurately  time  con- 
cepts of  tomorrow 
and  yesterday. 

Uses  classroom  tools 
(such  as  scissors  and 
paints)  meaningfully 
and  purposefully. 


Begins  to  relate 
clock  time  to  daily 
schedule. 

Attention  span 
increases  noticeably. 
Learns  through  adult 
instruction.  When 
interested,  can  ignore 
distractions. 

Concepts  of  function 
increase  as  well  as 
understanding  of 
why  things  happen. 
Time  concepts  are 
expanding  into  an 
understanding  of  the 
future  in  terms  of 
major  events  (for 
example,  Christmas 
will  come  after  two 
weekends). 


Dresses  self  com- 
pletely. 

Ties  bow. 

Brushes  teeth  unas- 
sisted. 

Crosses  street  safely. 


Chooses  own 
friend(s). 

Plays  simple  table 
games. 

Plays  competitive 
games. 

Engages  with  other 
children  in  coopera- 
tive play  involving 
group  decisions,  role 
assignments,  fair 
play. 


•ir  us.  GOVERNMENT  PRINTING  OFFICE  :  1978     O— 272-363 


Hyi631  Lasher,  Miriam  G. 

L335   Mains trearaing 

M435   preschoolers:  Children 

with  emotional 

disturbance: 


A  guide  for 


I 


DATE  DUE 


HV1631  Lasher,  Miriam  G. 

L335   Mainstreaming 

M435   preschoolers:  Children 
with  emotional 
disturbance:  A  guide 


TITU« 


OATI    out 


BORROWER'S    NAME 


AMER.CAN  FOUNDATION  F0«  THE  BLIND,  INC. 

15  WESTlSth  STREET 

NEW  YOflK,-N.  Y.  IfiOll 


DEPARTMENT   OF 
HEALTH,    EDUCATION.    AND    WELFARE 
WASHINGTON.    D  C     20201 


OFFICIAL    BUSINESS 


POSTAGE    AND    FEES    PAID 
U.S.    DEPARTMENT   OF    HEW 

HEW-391 


U.S.  Department  of  Health,  Education,  and  Welfare 

Office  of  Human  Development  Services 
Administration  for  Children,  Youth  and  FamiUes 
Head  Start  Bureau 

DHEW  Publication  No.  (OHDS)  78-31115