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Full text of "Children with Mental Retardation: A Guide for Teachers, Parents, and Others Who Work with Mentally Retarded Preschoolers"

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Project Head Start 




Mainstreaming Preschoolers : 

Children with 


DHEW Publication No. (OHDS) 78-31110 

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 mainstreaming and 
mental retardation. Chapter 5 
describes specific ways in which 
parents can help their mentally 
retarded child. But parents will 
find the other chapters useful in 
learning more about development 
in mentally retarded youngsters, 
techniques and activities to 
promote learning, how Head Start 
functions in serving handicapped 
children, and what resources 
outside of Head Start are 
available to help fill their child's 
special needs. 

\T&Mainstreaming Preschoolers was developed by the staff of CRC Education and Human Deve- 
, a suljsidiary of Contract Research Corporation, 25 Flanders Road, Belmont, Massachusetts 
Contract No. HEW 105-76-1139 for the Administration for Children, Youth and Families. 

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

Stocli Number 017-092-00029-4 

Mainstreaming Preschoolers: 

Children with 


A Guide for Teachers, Parents, 
£ind Others Who Work with 
Mentally Retarded Preschoolers 


Eleanor Whiteside Lynch, Ph.D. 

Program Director for Special Education, Institute for the Study of Mental 
Retardation and Related Disabilities, and Assistant Professor of Special 
Education, School of Education, University of Michigan 

Betty Howald Simms, Ed.D. 

Professor of Education, Depairtment of Special Education, University of 

, 15 WST IStti STi^EET , 

^^*^ MEV/YaW^A.Y. iJPU ■ 

Caren Saaz von Hippel, Ph.D. 

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

Jo Shuchat, M.A. 

Research Associate, CRC Education and Human Development, hic, Contract 
Research Corporation 

The authors were fortunate in being able to draw on the advice 
and contributions of many knowledgeable and talented people 
during the preparation of this book. Chief among th^were the 
following expeHs on mental retardation and early childhood 
education, who reviewed the text in its successive versions and gave 
us many excellent suggestions for improving it. 


Thomas Hilliard, Ph.D., Clinical Psychologist, San Francisco, California 
Merle B. Karnes, Ed.D., Professor of Education, Institute for Child Behavior and 

Development, University of Illinois 

Lois Barclay Murphy, Ph.D., Washington, D.C 

Sister Mary Louise Reinke, M.S., Director, Head StaH, Yazoo City, Mississippi 
Howard Spicker, Ph.D., Professor of Education, Department of Special Education, 

Indiana University 

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, Texas 

Alice H Hayden, Ph.D., Director, Model Preschool Center for Handicapped 

Children, Child Development and Mental Retardation Center, Umversity o± 


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


Jacqueline Liebergott, Ph.D., Associate Professor, Department of Communication 

Disorders, Emerson College 

Sheldon Maron, Ph.D., Assistant Professor of Special Education, Departinent 

of Special Education, Florida State University 

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


Janet Zeller, M.S., Supervisor and Instiructor, Graduate Special Needs 

Program, Wheelock College. 

Much of the credit for the success of this book is due to the team responsWle 
for the visual and stylistic aspects. Their creative efforts were ^^sf^^X- , 
we are very grateful The skiU and enthusmsm of the production staff, on whwh 
we have relied so frequently in thepast, were demonstrated even more 
impressively in this difficult and complex effort. 

CRC Education and Human Development, Inc. 

Editor: Nancy Witting 

Graphic Design Unit: Kristina Engstiom, Sandra Baer, Linda Hailey 

Designer: Alison Wampler 

Photographer: Harriet Klebanoff 

Illustrator: Stephanie Fleischer 

Contract Research Corporation 

Production Staff Barbara Boris, Mary Tess Crotty, KeUy 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 Psychological Association; Association for Children with Learning 
Disabilities; Association for Children with Retarded Mental Development; 
Council for Exceptional Children; International Parents' Organization, Alexander 
Graham Bell Association for the Deaf; National Association for Mental Health; National 
Association for Retarded Citizens; Occupational Therapy Association of America; Spina 
Bifida Association of America We also wish to thank the following federal agencies who 
reviewed this book during its development: Bureau of Education for the HandicappedAJ.S. 
Office of Education; National Institute for Child Health and Human Development/ 
National Institutes of Health; National Institute of Mental Health; President's 
Committee on Mental Retardation. 

We are grateful to the Resource Access Projects and the Regional Office staff of the 
Administration for Children, Youth and Families 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 invaluable 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 during 
this project. Rossie Kelly's involvement throughout the project, in discussions, 
coordination of reviews of this book among Program Development and 
Innovation Staff, and continued receptiveness and helpfulness required to 
complete a project of this scope was essential. In addition, we thank the 
following persons in Program Development and Innovation for their interest, 
involvement, and review of this book diuing its various 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. PhilUps, Ed.D.; and Linda 
Randolph, M.D. 

Caren von Hippel 
Jo Shuchat 
Eleanor Lynch 
Betty Simms 


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, 
recording, and evduation 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 background 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 m 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, makmg it 
possible for teachers, working 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-handicaped chil- 
dren 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 Preschoolers, 
was prepar^ 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 assoaa- 
tions concerned with handicapped children were asked to critique the materials 
during their various stages of development. Their response was enthusiastic. Vari- 
ous federal 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 Penodic 
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 Head 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, EcLD. 

Administration for 
Children, Youth and Families 


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: Wfiat Is Mental Retardation? 9 

Mentally Retarded Preschoolers 10 

How Is Mental Retardation Defined? 11 

Recognizing Problems for Referral 18 

Chapter 3: How Mental Retardation Affects Learning in Three- 

to Five-Year-Olds 25 

Development in Retarded and Non-Handicapped Children 26 

How Do Children Learn? 28 

What Children with Mental Retardation Are Like 34 

Chapter 4: Mainstreaming Children with Mental Retardation 43 

Planning 46 

The Physical Setting and Classroom Facilities 56 

General Teaching Guidelines 59 

Specific Teaching Techniques 71 

Activities 80 

Chapter 5: Parents and Teachers as Partners 93 

What Parents Can Do 95 

What Teachers Can Do 99 

Chapter 6: Where to Find Help in Your Area 103 

Finding Out About Resources 104 

Who Are the Specialists? What Do They Do? 112 

Chapter 7: Other Sources of Help 117 

Professional and Parent Associations, and Other Organizations 118 

Bibliography 125 

Appendix 129 

Screening and Diagnosis 130 

Chart of Normal Development (Birth to Six) 132 



The Purpose of This Book 

This book was written for teachers, 
parents, and others, such as diagnos- 
ticians and therapists, who work 
directly with mentally retarded pre- 
schoolers. It provides some good ideas 
for helping retarded children learn and 
feel good about themselves, and 
answers many questions, including: 

What is mainstreaming? 

What is mental retardation? 

How does mental retarda- 
tion affect learning in three- 
to five-year-olds? 

How^ can you design an 
individualized program for 
a retarded child? 

What activities are especial- 
ly useful for children with 

How can parents help their 
retarded child? 

Where can you go to seek 
help— people, places, and 

The information in this book is 
also usefiil for working with all 
preschool children, non-handicapped 
as well as handicapped. 

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 concerned 
with one handicapping condition. The 
other seven books address: 

• emotional disturbance 

• health impairments 

• hearing imptdrment 

• learning disabilities 

• physical (orthopedic) handi- 

• speech and language 
impairments (communica- 
tion disorders) 

• visual handicaps. 

There are certain guidelines that 
are similar in working with all kinds 
of handicapped preschoolers. These 
guidelines should be 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 
Teachers as Partners," "Where to Find 
Help in Your Area," and the sections 
on planning, the physical setting, and 
general teaching guidelines in the 
chapter "Mainstreaming Children with 
Mental Retardation." While these 
chapters (or sections of chapters) are 
largely the same in most of the 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 handi- 
capped children and children 
with special needs mean the same 

Chapter 1: 





Help a handicapped 
child enter the main- 
stream of life during 
the preschool years. 

What Does 



"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 experiencing the strengths 
and weaknesses of their handicapped 

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 
(Public Law 92-424) required that 10 
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 10 
percent of the total number of enroll- 
ment opportimities in Head Start 
programs in each state be available to 
handicapped children. And most 
recently. Public Law 94-142, the Educa- 
tion for All Handicapped Children Act, 
has mgindated that the public schools 

provide "free, appropriate education" 
in the "least restrictive setting" for 
handicapped children from 3 to 21 
years of age. Thus, mainstreaming has 
become an important and well- 
accepted approach in the education of 
yoimg hginmcapped children. It is the 
function of Head Start programs to: 

serve handicapped children in 
an integrated setting or main- 
stream environment with other 
children; provide for the specied 
needs of the handicapped child; 
and work closely with other 
agencies and organizations 
serving handicapped children 
in order to identify handi- 
capped children, and provide 
the full range of services 
necessary to meet the child's 
developmental needs. 

(Head Start Transmittal Notice 75.11 

Research on children has shown 
over and over that the early years of 
life are critical for learning and 
growth. It is during this time that 
children's intellectual, social, and 
emotional development can be most 
influenced. If special needs are recog- 
nized and met during these years, 
handicapped children wiU have a 
much better chance of becoming com- 
petent and independent adults. Handi- 
capped youngsters who are given the 
opportunity to play with other children 
in the Head Start classroom learn 
more about themselves and how to 
cope with the give and take of 
everyday life. This is one of the first 
steps toward developing independence. 
By participating in regular preschool 
settings that are able to provide for 
specif 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 

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

Mainstreaming Helps 
Handicapped Children 

Participating in a mainstream 
classroom as a welcome member of the 
class teaches children with special 
needs self-reUance 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. 
Working and playing with other chil- 
dren encourages handicapped children 
to strive for greater achievements. 
Working toward greater achievements 
helps them develop a healthy and 
positive self-concept. 

Mainstreaming can be an especial- 
ly valuable method for discovering un- 
diagnosed handicaps. Some handicaps 
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 
handicap. Preschool may therefore be 
the first chance some children get to 
receive the services they need. 

Mainstreaming Helps 



Mainstreaming can help non- 
handicapped children, too. They learn 
to accept and be comfortable with 
individual differences among people. 
Many studies have shown that chil- 
dren's attitudes toward handicapped 

children become more positive when 
they have the opportunity to play 
together regularly. They learn that 
handicapped children, just like them- 
selves, can do some things better than 
others. In a mainstream classroom, 
they have the opportunity to make 
friends with many different indi- 

Helps Parents 

Mainstreaming is also good for the 
parents of children with special needs. 
With you, the other members of the 
staff, and specialists sharing the 
responsibility for teaching a child, the 
parents come to feel less isolated. They 
can learn new ways to help their own 
child. As they watch their child 
progress and interact with non-handi- 
capped children, parents are helped to 
think about the child more realis- 
tically. They wiU see that some of the 
behavior they are concerned about is 
probably typical of all young children, 
not just children with handicaps. In 
these ways, parents come to feel better 
about their children and themselves. 

Helps Teachers 

Mainstreaming also has advan- 
tages for you. You have the chance to 
make a significant impact on a 
handicapped child. The techniques you 
develop for working with a child with 
special needs are just as useful with 
non-handicapped children who have 
minor weaknesses in the same areas. 
In fact, many of the most effective 
teaching techniques known were first 
developed for handicapped children. 
Finally, working with handicapped 
children is a chance to broaden both 
your teaching and personal experience. 


How Is 


Mainstreaming can be carried out 
in a variety of ways. How you decide 
to mainstream a particular handi- 
capped child will depend upon the 
child's strengths, weaknesses, and 
needs, and will also depend upon the 
parents, the staff and resources within 
your program, 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 abilities. 

Some handicapped children may 
thrive in a full-day program with non- 
handicapped children. Others wiD 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, main- 
streaming may not be the most helpful 
approach. The principle to follow is 
that handicapped children should be 
placed in the "least restrictive en- 
vironment." This means that the 
preschool experiences of handicapped 
children should be as close as possible 
to those of non-handicapped children, 
while still meeting the special needs 
created by their handicaps. 

Mainstreaming involves the efforts 
of many people working as a team — 
teachers, the child's parents. Head 
Start staff (in health, education, handi- 
cap, parent involvement, and social 
services), other specialists providing 
consultant services on a full- or part- 
time basis, agencies serving handi- 
capped children, and the public 
schools in the community. The identi- 
fication, development, and coordina- 

tion of this team effort is both a 
challenge and a critical requirement in 
meeting the needs of a handicapped 

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 
public 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 pro- 
vide the best program for both handi- 
capped and non-handicapped children. 

This book also discusses different 
degrees of the handicapping condition 
known as mental retardation, and 
describes some of the things children 
with mental retardation can do well 
and things they may have some 
trouble doing. Specific activities and 
teaching techniques are given pri- 
marily for use with mildly or moder- 
ately retarded children. However, there 
are numerous suggestions for working 
with severely and profoimdly retarded 
children as well. If you have a severely 
or profoimdly retarded child in your 
classroom, it is essential to seek 
outside assistance. It takes consulta- 
tion with trained specialists and addi- 
tional classroom staff to give such a 
child the help he or she needs. 

What Is 
Your Role in 

This book approaches mainstream- 
ing from the standpoint of child 
development. It emphasizes the im- 
portance of seeing handicapped chil- 
dren first and foremost as children, 
with the same needs all children have 
for love, acceptance, exploration, and a 
sense of competence. By understand- 
ing how all children develop and 
learn you can better understand the 
effects of a particular handicapping 
condition. For example, knowing the 
importance of visual information will 
help you understand the effects of 
blindiiess on a child's development. 
You can then use this knowledge to 
plan appropriate activities for bmlding 
on the child's strengths and working 
on his or her weaknesses. 

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

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

• developing and putting into 
effect an educational pro- 
gram that meets the indivi- 
dual needs of each child in 
the classroom, including 
the special needs of a child 
with a handicapping condi- 

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

• finding out, through your 
handicap coordinator or 
social services coordinator, 
w^hat special services a 
handicapped child is receiv- 
ing and how^ you can get a 
specialist to help you in 
your classroom teaching 

• arranging referrals 
through your handicap co- 
ordinator or social services 
coordinator for diagnostic 
testing, 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 manual they 
will be described in more detail, but 
they are summarized on the following 


Where to Go 
for Help 

There are many resources you can 
tap for help with a handicapped child. 
Take advantage of these resources by 
actively seeking them out. For detailed 
information on Head Start and other 
resources in your area, see Chapter 6. 
For detailed information on national, 
professional and parent associations 
and agencies, and a list of helpful 
materials, see Chapter 7. 



Public schools 
Community agencies 
Hospitals and clinics 
State Department 
of Education 


Head Start staff 

Child's parents 


Public school teachers 

of handicapped children 

Resource Access Projects 




Avith mental 



State and federal agencies 
for the handicapped 
Professional associations 
Parent organizations 

Chapter 2: 

What Is 



Children with mental 
retardation have a 
slower overall rate of 
learning and develop- 
ment than other 

10 Children with mental retarda- 
tion aren't so very different from 
non-handicapped children. Like 
other preschoolers, they can do 
some things better than other 
things, have happy moods and sad 
moods, and need your support to 
learn and grow. 

This chapter looks at how 
mental retardation is defined, and 
at what mental retardation means 
for those who teach and work 
with mentally retarded pre- 
schoolers. Some of the terms in 
this book are commonly used to 
describe mentally retarded people. 
These terms have been agreed 
upon by specialists who work in 
the field of mental retardation. 
However, it is important to recog- 
nize that the terms sometimes 
become labels. Labels usually limit 
rather than extend our under- 
standing, and labeling a child 
often produces negative and in- 
accurate expectations for that 
child. Describing children in terms 
of strengths and weaknesses is 
much more valuable to you than 
being able to fit them into a label 
or category. Learning about 
mental retardation can help you 
to realize the special needs of 
retarded children. However, only 
by working with a retarded child 
will you recognize his or her 
unique skills and problems. 




The "Head Start'' 

In defining handicapping condi- 
tions, Project Head Start distinguishes 
between categoricEil definitions, 
which are used for reporting purposes, 
and functional definitions, which 
describe a child's areas of strength 
and weakness. The categorical 
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 
categorical diagnosis of a child. This 
diagnosis is used only for reporting 
piuT)Oses. A functional definition or 
diagnosis, 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 defini- 
tion of mental retardation is to 
be used for reporting purposes in 
Head Start programs: 

A child shall be considered 
mentally retarded who, during 
the early developmental period, 
exhibits significant sub- 
average intellectual functioning 
accompanied by impairment in 
adaptive behavior. In any de- 
termination of intellectual 
functioning using standardized 
tests that lack adequate norms 
for all racial/ ethnic groups at 
the preschool age, adequate 
consideration should be given 
to cultural influences as ivell as 
age and developmental level 
(i.e., finding of a low I.Q. is 
never by itself sufficient to 
make the diagnosis of mental 

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

How^ Is 

An overall slowness in develop- 
ment is characteristic of children with 
mental retardation. This slowness 
makes them seem younger than they 
are. During the preschool years, retard- 
ed children fall consistently behind 
other preschoolers in their ability to 
learn, to remember what they have 
learned, and to solve problems. In the 
preschool years, "adaptive behavior" 
refers to a child's increasing ability to 
use language, to play with others, and 
to do things independently. In retarded 
preschoolers, this ability is Limited. For 
example, they may not be able to 
respond to their names or to catch on 
to simple games. They may not be 
able to jump, hop, feed themselves, or 
signal that they need to go to the 

The part of the definition in italics 
is important. Formal tests of intel- 
lectual functioning (called I.Q. or 
intelligence quotient tests) are not 
always good predictors of a pre- 
schooler's later development. Young 
children are hard to test, especially 
since they are changing so quickly. 
Furthermore, many of the tests aren't 
accurate for youngsters from different 
cultural, language, and ethnic back- 
grounds. For preschoolers (as well as 
for older chilcken and adults), a low 
score on an I.Q. test is not enough to 
diagnose them as retarded. 






Specialists in mental retardation 
generally agree on a set of terms for 
the levels of the handicap. These terms 
are: mild, moderate, severe, and pro- 
found. They refer to different levels of 
I.Q. and adaptive behavior, and to 
different abilities to learn. 

Many mild impairments other than 
mild mental retardation are not con- 
sidered handicaps by Project Head 
Start if the conditions do not require 
special services. For example, a child 
whose vision can be corrected with 
eyeglasses is not considered visually 
handicapped. Children are considered 
handicapped if they fall \yithin the 
legislative definition and if, by reason 
of this handicap, they require special 
education and related services. 
Mildly mentally retarded children are 
considered handicapped according to 
the legislative definition if they exhibit 
"significant sub-average intellectual 
functioning accompanied by impair- 
ment in adaptive behavior..." and if 
they require special education and 
related services. 

The levels of retardation are 
perhaps best described in terms of how 
the children in your classroom func- 
tion, what and how they learn, and 
how much time they need to learn. 

Mild Retardation 

We might think of mildly retarded 
children as those who learn consider- 
ably more slowly than other children 
of the same age. As preschoolers, 
mildly retarded children may be good 
at large motor activities but have some 
trouble speaking, remembering things, 
following directions, and coordinating 
the use of their eyes and hands. They 
may be slow to learn routines and 
simple games, and may not be able to 
put all their thoughts into words. 
Mildly retarded children are sometimes 
called "educable mentally retarded." 
They should be able to learn most of 
the activities in your classroom, but 
will probably need more help and 
more practice than the other children. 

Moderate Retardation 

Moderately retarded preschoolers 
tend to be further behind in all areas 
of development. They are often climisy, 
are very late in talkmg, have trouble 
remembering things, and tend to 
behave like children about half then- 
age. In yoiu- classroom you may need 
to show them many times how to do 
things. You will probably find that it 
helps to use simpler language to 
explain things, and to break activities 
down into small parts that can be 
taught and practiced one at a time. 
These children can benefit from 
attending preschool and from being 
with non-handicapped children. They 
are sometimes called "trainable men- 
tally retarded." 

Severe and Profound 

Severely and profoundly retarded 
preschoolers, like infants, require help 
with all of their daily needs. Many 
have special problems with movement 
and feeding that call for help from an 
occupational therapist. Because they 
need so much care, it is unlikely that 
many such children will be enrolled in 
Head Start classrooms. However, in 
some communities, Head Start may be 
the best program available to provide 
stimulation to the child and support 
the child's parents. If you have a 
severely or profoundly retarded child 
in your classroom, you will want to 
talk with specialists about the child's 
special needs. 

Rate of 

Perhaps the single most important 
concept in the diagnosis of children 
with mental retardation is the concept 
of rate of learning. AH children 
learn at different rates, but children 
with mental retardation have a slower 
overall rate of learning and develop- 
ment than other children. Even 
though the rate of learning in mental- 
ly retarded children is slower, these 
children are capable of learning a 
great deal at their own pace. If you 
see that a child is developing very 
slowly, you may want to refer him or 
her to specialists for further evalua- 
tion. The specialists should be qual- 
ified to examine the child in order to 
assess language development, cog- 
nitive development, medical history, 
and physical health. Working as a 
tearn, the child's parents, teachers, and 
specialists should determine how to 
improve the child's learning at home 
and at preschool. 



Some mentally retarded children 
have other handicaps. These other 
handicaps result from damage to the 
central nervous system, which is the 
control center for all of the body's 
functions. The other handicaps wOl 
vary, depending upon the type of men- 
tal retardation and its cause. If a 
retarded child in your classroom has 
another handicap, you may find it 
helpful to read aoout it in the 
appropriate book in this series. 

Severe or Profound 

Some severely and profoundly 
retarded yoimgsters never develop 
speech. However, more and more of 
them are being taught to commimicate 
orally or by signs, using special 
intensive training procedures. Some of 
these children may have severe physi- 
cal handicaps like those found in 
cerebral palsy; others may be blind 
and/or deaf. Some children with 
severe or profound mental retardation 
have epOepsy. Usually their seizures 
are controlled by medication, but their 
doctor may ask you to help by 
recording the effects of the medica- 
tion. Mainstreaming may not be best 
for some of these children. 

14 Moderate Retardation 

Motor, speech, and language devel- 
opment are often so delayed in 
moderately retarded children as to be 
considered associated handicaps. 
There may be other handicaps, such 
as deafiiess or blindness, but these 
occur less frequently with moderate 
retardation than with severe and 
profoxind retardation. 

Mild Retardation 

Mild mental retardation is not 
usually associated with severe handi- 
capping conditions. However, a nuldly 
retarded child is more likely to have 
other handicaps than a non-handicap- 
ped child. 

There is no medicine used to treat 
mental retardation. If a retarded child 
in your class is taking medication, it is 
for another problem. 




Accurate diagnosis will enable you 
and others to give the kind of help 
that a child needs. This means, first of 
aU, 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. 
Further, the tests' results have to be 
properly interpreted. Accurate diag- 
nosis, therefore, can sometimes be 
tricky, as the following examples 

Bumping into the chair made 
Mark even angrier. 

Mistaking One 
for Another 

Inaccurate diagnosis can mean 
that a child's special needs are over- 



Margarita, a three-year-old in a 
preschool program, was thought to be 
retarded. She did not respond when 
her name was called. She communi- 
cated by making gestures and a few 
sounds that did not seem to be words. 
In the classroom she couldn't keep up 
or follow directions. Sometimes she 
played alone in the corner. The older 
children in the neighborhood called 
her "dummy." The teacher talked with 
Margarita's parents and got their 
permission to refer her to specialists 
for a complete evaluation. 

The evaluation determined that 
Margarita had a serious hearing loss. 
As a result, she didn't understand 
what was going on around her, and 
could not respond to her name. She 
had enormous difficulty learning to 
talk because she couldn't hear dif- 
ferences in sounds. She was con- 
fused by the normal activities in the 
classroom because she could not 
understand the directions. 

Fitted with a hearing aid, 
Margarita began to receive special 
training from a teacher of seriously 
hearing impaired children. Correctly 
diagnosed as hearing impaired, rather 
than incorrectly as mentally retarded, 
Margarita can now begin to receive 
appropriate services. 

Children like Margarita with 
perceptual problems in hearing, speaking, 
and seeing may be misdiagnosed as 
mentally retarded because some percep- 
tual skills are involved in testing any 




Mark was a five-year-old whose 
behavior problems kept him from 
learning what other children were 
learning, so he seemed to be retarded. 
Mark ran around the classroom, hit 
and kicked other children, used only 
one or two words, and was not toilet- 
trained. He was so far behind the 
other children in the classroom that 
his parents and teacher thought he 
must be mentally retarded. 

Mark was referred to a large clinic, 
where he was evaluated by an inter- 
disciplinary team of specialists. After 
reviewing his history, talking with his 
teachers and his parents, and observ- 
ing him in a classroom and at play, 
the diagnosticians said the problem 
was emotional disturbance. Mark had 
average intelligence but had serious 
difficulty adjusting in his home and at 
school. His way of coping with a world 
that he could not understand was to 
act like a much younger child-. 

Knowing that Mark could learn 
normally if he were not so troubled 
made a difference in the program and 
services provided for him. He entered a 
mainstream classroom where he 
received special help from a psycholo- 
gist and the teacher. Now Mark is 
learning better, has stopped running 
around the classroom, and is toilet- 
trained. Mark still has a long way to 
go, but he has taken the first step. 

16 Mistaking 

Cultural Differences 
for Handicaps 

Cultural or ethnic differences have 
sometimes been confused with mental 
retardation. This confusion is very 



Maria was five when her family 
moved to the United States from 
Puerto Rico. She entered a Head Start 
classroom soon after her arrival. 

After about three weeks, her 
parents got a call asking tfiem to come 
to the center for a conference. Maria 
was not doing well. She didn't seem to 
know anything that the other children 
knew. Tiie teacher thought Maria was 
mentally retarded, and wanted a 
specialist to test her. Dismayed, 
Maria's parents agreed to tfie test. 
Maria tested in the moderate range of 
mental retardation. 

Her parents were horrified. In her 
preschool class in PueHo Rico she had 
already learned to name objects pic- 
tured in storybooks, jump rope, and 
retell her favorite stories. How could 
they be calling her mentally retarded? 

Fortunately, Maria's parents asked 
the right questions. They learned that 
the diagnostician had tested Maria in 
English, her second language. Al- 
though all of the family spoke English 
somewhat, their first language was 
Spanish. Maria was still not fluent 
enough to understand the rapid-fire 
English in the classroom or the formal 
English used in a standardized psy- 
chological test. If Maria's parents had 
not understood what was happening, 
their bright daughter might have been 
labeled mentally retarded, which 
would have had countless damaging 
effects. Parents and teachers need to 
make sure that children are tested in 
their first language. 

Cultural Differences 

Many cultural differences can lead 
to a child's being misdiagnosed as 
mentally retarded, because many tests 
are standardized to fit children from a 
middle-class, white American back- 
ground. Children from low-income or 
minority families may not have had 
the same chance to work on school- 
related skills (such as naming pictures 
in books) as children from middle-class 
families. They may not have seen the 
same kinds of social behavior that 
children from middle-class families 
have learned as "normal." And if they 
speak, for example, Spanish, Chinese, 
or a non-standard English dialect at 
home, they may not understand what 
is being said to them, which means 
they can't answer the test questions 

Because of circumstances like these, 
children from minority and low-income 
families can appear retarded when 
their test scores are compared with the 
test scores of children from middle- 
class families. The problem is often 
not with the children but with the 

We don't mean to say that there 
are no mentally retarded children from 
low-income or minority families: 
mental retardation occurs at all 
income levels and in all ethnic groups. 
But you should be especially wary of 
diagnoses of mental retardation based 
on tests given to children. K you're 
told that a particular child has been 
tested and found to be retarded, and if 
your experience with the child makes 
you think the child is not retarded, tell 
your handicap coordinator that the 
child should be looked at more care- 

Differences in Maturity 

Another mistake that is sometimes 
made is to confuse behavior problems 
and physical or mental immaturity 
with retardation. This confusion hurts 
boys more than it does girls, because 
boys generally mature more slowly 
than girls. This may mean that some 
skills aren't as advanced as those of 
girls the same age. But it doesn't mean 
they're retarded — they will catch up 
when their bodies are ready. Boys may 
demonstrate more behavior problems 
than girls, and tend to be more 
boisterous and rowdy. Again, this 
doesn't mean they're retarded. 

Maintain Your Awareness 

Head Start programs have a well- 
deserved reputation for promoting the 
rich cultural and ethnic differences 
that exist among the families they 
serve. You are perhaps least likely of 
all professionals to confuse cultural 
and ethnic differences with mental 
retardation. Likewise, you are familiar 
with the lands of behavior associated 
with physical and emotional immatur- 
ity. But it is important for you as a 
Head Start teacher to watch carefully 
for special problems, so that all 
youngsters who are truly developing 
slowly have the advantage of an 
assessment by specialists. 

Young Children Can 
Be Difficult to Test 

Young children are not always 
easy to assess or diagnose. They may 
not sit still. They aren't always 
interested in what you want them to 
do. They may cry if they don't want to 
do something, throw the materials, or 
wet their pants. But any child with a 
problem deserves the attention of a 
team made up of specialists, the child's 
parents, and you. Any chOd you have 
a question about deserves a referral, as 
long as the parents agree. 




Some retarded children will be 
diagnosed before they are enrolled in 
Head Start, but others may not be. 
Children who are only mildly retarded, 
for example, may be enrolled in your 
program without ever having been 
recognized as handicapped. The 
teacher may be the first person in the 
life of the child who can alert other 
professionals to a problem, so that 
services for the 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. 


Learn to Observe 

Your own classroom observation, 
plus conversations with parents about 
their children, can be the best foimda- 
tion for deciding whether to refer a 
particul£ir child to a professional 
diagnostician. As a classroom teacher, 
you observe children and draw con- 
clusions every day. 

Do you have a child in your class 
who seems difficult to handle, hard to 
get along with, or slow? 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 that 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 underestimate your ability to 
spot serious problem areas that may 
signal a handicapping condition in a 

Ask Questions 

Ask yourself some good, basic 
questions to determine whether a child 
should be referred for professional 

Does the child learn so slowly 
that it keeps him or her from 
participating fully with the other 

Is the child's adaptive behavior 
(ability to use language, to play 
with other children, and to be 
reasonably independent) so poor 
that it keeps him or her from 
participating fully with the other 

If your answer to either or both of 
these questions is yes, and if the 
parents agree, referral is in order. If it 
turns out that the child is not 
handicapped, you and the parents will 
be reassiured and will gain a better 
understanding of the child. If a 

groblem does exist, the child will then 
e able to obtain the needed help. 

Different children — different surroundings 
different influences — different expectations. 

Cultural Differences 

It is important to distinguish be- 
tween children who are different and 
children who may be handicapped. 
Since the children in your classroom 
come from a variety of backgrounds 
and child-rearing experiences, it is only 
logical that they will react to your 
classroom in a variety of ways. 

For example, Juan's teacher 
noticed that he was having a lot of 
trouble asking questions, describing 
things, and generally explaining 
himself. The teacher knew that in 
Juan's home everyone spoke 
Spanish. She suspected that he was 
having the kinds of problems any- 
one has in learning another lan- 
guage, and that he was probably 
not speech impaired. She decided to 
take a good look at his speech 
problems over the next six months, 
and as she predicted, they lessened 
as his English improved. 

In another example, Sara came 
from a home where hitting and 
kicking were tolerated as normal 
behavior among the children. This 
sort of behavior in the Head Start 
classroom made her teacher suspect 
emotional disturbance. For Sara, 
however, this behavior was not only 
normal but necessary, since she 
needed to protect herself from her 
brothers and sisters. With her 
teacher's help, Sara came to learn 
that this sort of behavior was not 
allowed in class, and in fact wasn't 
needed there for self-protection. 
Sara no longer acted as if she had 
severe emotional problems. 


20 Juan and Sara were not handi- 

capped. They were simply behaving 
in ways that made sense from the 
point of view of their life exper- 
iences. Finding out about a child's 
family and home will help you to 
identify when diagnosis is called 

Individual Differences 

Distinguish between those children 
whose temperaments and individual 
learning styles you find difficult and 
those children who may be handi- 
capped. Children, like adults, can be 
slow or fast to catch on to things, can 
be quiet and thoughtful or very 
energetic and into everything. Some 
get frustrated 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 difficult because of personality 
differences between the two of us? Or 
is the behavior of the child genuinely 
different from the range of behavior 
shown by other children the same 

Gret Professional Help 

From the child's point of view, 
referral is better than non-referral. 
This means that if you think a 
handicap might account for the be- 
havior you have observed, it is best to 
have the child professionally evalu- 
ated. 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 wiU not be 
met. Referral is also preferred over 
non-referral for children who have 
already been diagnosed: as we have 
seen, children can be incorrectly diag- 
nosed. If a child enters your class 
already diagnosed as mentally retard- 
ed, take an especially close look. 
Have the child re-evgJuated if you 
have any doubts about the diagnosis. 

Using a checklist to observe a child can alert 
you to the possibility of undiagnosed mental 




The checklist of behaviors that 
follows can alert you to undiagnosed 
mental retardation, and help you know 
when to refer a child for professional 

The checklist is divided into three 
major sections. "Information Coming 
from the Environment" examines the 
ways in which children take in 
information about the world through 
their senses (seeing, hearing, moving, 
smelling, tasting, and touching). The 
second section is called "Processing 
the Information," and refers to the 
ways in which children organize the 
information (such as remembering, 
making associations, understanding 
causes and results, and so forth). The 
third section, "Using the Information" 
concerns the two major ways in which 
children can express what they have 
learned: by what they say and by 
what they do. The titles of these 
sections refer to parts of the learning 
process. (At the beginning of Chapter 
3, a section called "How Do Children 
Learn?" describes the learning process 
£ind the kinds of problems that can 
occur.) In addition, there is one short 
section in the checklist on the child's 
behavior in the classroom, which has 
to do with the child's relationships 
with other people. 

Basically, the checklist reflects two 
primary signals of mental retardation: 
being slower than others to catch on to 
new things, and slower to finish a 
task. The items on the checklist are 
specific, representing behavior that 
may indicate a problem. We must 
emphasize that these items are an 
approximate description. Probably 
every child in your classroom will 
show one or more of these character- 
istics from time to time. Only when 
such behavior happens often or aU the 
time may there be a problem. 

How To Use the 
Observational Checklist 

For each item on the checklist, 
check whether a child "often or 
always" behaves that way, or "rarely 
or never" does. Three or more checks 
in the "often or always" column mean 
that a child may have a serious 
problem. And the possibility of a 
serious problem means that you 
should talk to someone in your 
program (such as the handicap, 
health, or social services coordinator) 
about referring the child for profes- 
sional evaluation. 


Observational Checklist 


Coming from 
the Environment 

The child doesn't understand direc- 
tions, reacts slowly to them, or 
waits to see what the other chil- 
dren are doing first. 

The child seems confiised and 
doesn't do what other children are 
doing along with them. 

The child doesn't know what to do 
with materials and toys, or uses 
them for the wrong purposes. 

Loud sounds disturb the child. 

A lot of unorganized moving 
around in the classroom confuses 
the child. 

The child has trouble noticing fine 

The child doesn't answer to his or 
her name. 

The child can't carry out a one-step 

The child can't concentrate on one 
thing for very long, and is easily 

The child doesn't show interest in 
classroom siurroundings. 









the Information 

The child has trouble remembering 
what he or she has seen or heard, 
or what has happened. 

The child can't match colors and 

The child can't sort colors and 

The child can't answer simple 
questions (such as "What's your 
name?") or gives answers that 
make no sense. 

The child doesn't know things that 
other children in the class know. 

The child does things in the wrong 
order (such as drying the pan 
before it has been washed). 

The child can't predict dangerous 
consequences of actions before he 
or she does them. 

The child can't hear small differ- 
ences in words (such as boy /toy, 

The child can't retell a simple 

The child has trouble following two 
or more directions in the right 

The child doesn't understand com- 
mon environmental sounds (for 
example, can't tell you "a car" 
upon hearing the beep of a car 

The child doesn't remember the 
classroom routine. 

The child forgets what he or she is 
doing in the middle of it. 

The child has trouble inventing 
stories and actions in pretend play. 

The child doesn't understand basic 
concepts such as relationships, 
time, space, and quantity as well 
as other children do. 

d^ ^^ 









Using the 

Verbal Responses: Talking 

The child doesn't talk at all. 

You can't understand the child's 

The child can't communicate using 
words and gestures, either alone or 

The child can't name or describe 
familiar objects. 

Motor Responses: Moving the 

The child trembles or shakes. 

The child falls down or bumps into 
things a lot. 

The child walks unevenly, or limps. 

The child has poor eye-hand coor- 
dination (for example, knocks things 
over a lot). 

The child can't puU simple clothing 
on or off. 

The child has trouble using toys 
such as blocks and puzzles. 

The child can't copy simple forms, 
such as a line, circle, square. 







The Chad's 


in the Classroom 

The child resists change and vari- 
ety in activities by crying, throw- 
ing tantrums, or refusing to par- 

The child cannot make choices 
about what to do or select activities 

The child imitates the games of 
other children rather than invent- 
ing his or her own games. 

The child withdraws from partici- 
pating in most or all of the 

The child is constantly disrupting 
the class. 





24 Steps 

If you suspect that a child in 
your class has undiagnosed 
mental retardation, take the 
following steps. 

1 , Find out if the standard 
screening tests have been given. Talk 
to the handicap coordinator, the person 
responsible for coordination of health 
services, or someone else in your pro- 
gram who you think could be helpful. 

2 • If the child has been 
screened, no problems have been found, 
and you are stiU concerned about the 
child, speak to the handicap coordinator, 
health coordinator, or social services co- 
ordinator. The parents will have to give 
their permission for further testing. Ex- 
plain the professional diagnosis process 
and the reasons for it to the parents. 

3. While waiting for a profes- 
sional diagnosis: 

• Talk with the parents about what 
they notice to help you work more 
effectively with the child. 

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

• Chapter 4 discusses guidelines and 
ways of conducting activities for 
children. Use them if they seem 
appropriate and if you find they 

4. Find out the results of addi- 
tional 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 suggested changes in the ser- 
vices the child is receiving. 

Chapter 3: 





Learning in 


It is necessary to know 
what children with 
mental retardation can 
do in order to develop 
an effective program. 


in Retarded 
and Non- 

Although much is known about the 
milestones in child development, we 
still can't predict exactly when young 
children will say their first words or 
take their first steps. We do know, 
however, that most non-handicapped 
children reach a given milestone of 
childhood within a few months of each 
other. For example, Luz Maria learned 
to walk when she was 11 months old. 
Her younger brother, Jose , did not 
walk until he was 15 months old. But 
both of these children are developing 

The chart on page 133 shows the 
sequence of normal development from 
birth to six years of age. In general, 
retarded children follow the normal 
sequence of developmental skills 
shown on the chart. They simply 
achieve these skiUs at a slower rate 
than non-handicapped children. This 
means, for example, that a mildly 
mentally retarded three-year-old is 
Likely to be developing skills that are 
appropriate for non-handicapped two- 

To a great extent, development is 
ordered, meaning that some things 
have to be learned before others, such 
as walking before running. But de- 
velopment does not occur in a lockstep 
fashion. Retarded and non-handi- 
capped children are individuals, each of 
whom will demonstrate a unique 
pattern of development. This means 
that occasionally a child may skip 
some skills. Another child may be slow 
to pick up some skills. And still 
another may demonstrate some skills 
earlier than expected. It is only when a 
child is behind in all areas, or when a 
child is at age level in some areas but 
far behind in others, that he or she 
needs some special help. 

Having fun motivates 
children to learn. 

the Effect of 

By observing children in the class- 
room and talking with their parents, 
you can learn what effect the retar- 
dation has on them. Using this 
information, you can then plan activ- 
ities that build on their strengths and 
help them with their weaknesses. 

Understanding what a child 
currently can and cannot do can also 
help you to understand why the child 
behaves in a particular way. For 
example, it is extremely helpful to 
know that Joseph, a mentally retarded 
four-year-old in your classroom, acts 
more like a two-year-old. Since you 
know that almost all two-year-olds 
alternate between trying to do every- 
thing on their own and wanting lots of 
help, it's not surprising that Joseph is 
so changeable. He's not trying to get 
attention or make you angry. He is 
simply testing his control over the 
world, as two-year-olds do. 

Looking at children with mental 
retardation from this developmental 
perspective can provide you with 
many insights into why they behave 
as they do, and when they might be 
ready to learn new skills. It can also 
enable you to help parents understand 
their child's retarded development. Of 
course, not all children's behavior can 
be explained as easily as Joseph's, but 
many of the puzzling things that a 
child does can sometimes be figured 
out by looking at the difference 
between a child's age and his or her 
developmental level. 

If there is a retarded child in your 
classroom, use the chart of normal 
development to decide where the child 
is developmentally. Look at the learn- 
ing model presented on page 28-29 
to discover whether the child has 
problems receiving information from 
the environment, processing informa- 

tion, or using information. You can 
then develop a set of activities for the 
child that suits the child's functioning 
level and that takes advantage of the 
child's learning strengths. 






Young children are naturally 
curious and eager to learn. Success 
makes them continue to feel this way. 
Failures can cause them to take fewer 
chances and to turn away from 

Like all of us, children with mental 
retardation work best when they are 
rewarded for the efforts that they 
make. Adult attention and approval 
can be a strong source of motivation, if 
the praise is honest. Classroom and 
home activities can also be designed to 
allow children to feel successful and 
independent in as many ways as 

For example, Rolando had trouble 
with fine motor skills. He couldn't 
draw as well as the other children, and 
when he painted his brush went 
beyond the edges of the paper. His 
teacher solved the problem by giving 
Rolando extra large sheets of paper (to 
catch the paint that went beyond the 
edges). Rolando was able to draw and 
paint more easily, and felt good about 

Encouragement is important, but it 
is also necessary to provide expecta- 
tions based on what each child can 
currently do (not on the child's age in 
years). If you begin early to set 
expectations that will help each child 
stretch and grow, you will be helping 
him or her to grow up to be as 
independent and self-fulfilled as pos- 


^* How Do 

Learning can be thought of as a 
process that enables children to know 
and do things they didn't know and 
couldn't do before. For this to happen, 
children take in information from their 
environment — or, more exactly, from 
people, things, and events in their 
environment. Next, children organize 
this information in their minds, which 
makes it usable. Last, they behave in 
a way that indicates that learning has 
taken place. 

Understanding the learning process 
can be extremely useful. If a child is 
having trouble learning, you can try to 
determine which part of the process is 
causing difficulty, and work out a 
specific remedy. 

The following chart may help you 
to understand tlus learning process. 

Taking in 

Information comes 
from people, events, 
and things in the 


The child thinks 
about the information 
and attaches 
meaning to it. 


The child uses the 
information: you 
see new behavior. 

Children take in information with 
their senses: sounds, sights, 
smells, tastes, textures, moving. 

This means that the child under- 
stands that some things cause 
others, that some things follow 
others, that some things are dif- 
ferent from others. It also means 
that the child can remember 
what is learned. 

The child now understands some- 
thing new or can do something 
new. You know this because the 
child tells you (verbal response) 
or shows you (motor response). 

from the 

Children normally use all of their 
senses to take in information from 
their environment. AU children — includ- 
ing retarded children — learn through 
a combination of seeing, hearing, and 
moving, which are the most important 
senses, and smelling, tasting, and 
touching. (Although "moving," strictly 
speaking, is not a sense, children also 
learn by moving things and their 
bodies in space.) However, there are 
children at all ability levels who have 
problems using some of their senses. 

As you observe children with retar- 
dation, think about the possibility that 
some of their problems may be due to 
poor vision, or poor hearing. If they 
can't see or hear well, the things or 
events they experience will be limited. 
In other words, they will receive less 
information from their environment. 

Sometimes, vision and hearing are 
fine, but there is so much to see, hear, 
and do that some children get con- 
fused. It's as if their senses let in too 
much information at one time for their 
brains to handle. Brain damage may 
not allow some children to filter the 
information coming in, so that they 
have a hard time concentrating. 


30 Limiting 

Sensory Information 

If a child has trouble limiting 
information from the senses (sensory 
information) and seems confused and 
distracted, working in quiet comers 
can help him or her concentrate on 
one thing at a time. Annie's teacher 
noticed that during free play Annie 
wandered around the room, touching 
the toys and looking at the children, 
but was unable to settle on one 
activity. Recognizing her problem, the 
teacher took Annie to a quiet comer 
away from the distracting, motion- 
filled part of the classroom. He gave 
her some pennies and nickels, and 
showed her how to sort them into 
piles. Annie was able to do this, after a 
couple of mistakes, because she was 
able to concentrate. 

Focusing Attention 

Focused activity can be helpful to 
children who have trouble with one or 
more of their senses, or who are easily 
confused, like Annie. Your role could 
be to direct these children to a favorite 
activity. Playing with a truck, for 
example, focuses a child's attention on 
the toy and gives the child practice in 
handling and moving things. You can 
also emphasize particular sensory in- 
formation to make sure it is clear. For 
example, if a child has trouble coloring 
on a sheet of paper, you could draw a 
thick black boundary around the edge 
of the paper. 

Sensory Information 

Information from one sense can be 
reinforced by pairing it with informa- 
tion from another sense. This is easily 
done with words: "That tastes sweet, 
doesn't it? This feels hard." Putting 
sensory information into words for a 
child can also be the best way to 
indicate which information is most 
important at a given moment. If, for 
example, you are walking to the comer 
store with the children, there is much 
information coming in from several 
senses at the same time. The sun feels 
warm, the cars sound loud, the traffic 
light has just changed to red, the 
children are talking, and the sidewalk 
feels hard. Simply remind the child, 
"There is the red light. A red light 
means stop." 

"If I pour the water in the 
top, it comes out the bottom. 
The hose holds it in!" 

the Information 

As their senses explore the people, 
events, and things in their environ- 
ment, children remember, organize the 
information, attach meaning to it, see 
relationships, and figure out uses for 
each new learning experience. All 
young children need a great deal of 
direct contact with concrete exper- 
iences in order to process the informa- 
tion well. This is why showing a child 
how to do something works better 
than describing how to do it: showing 
is concrete and direct, while describing 
is abstract and indirect. 

Retarded children learn to process 
information in the same way that non- 
handicapped children do, but it takes 
retarded children longer. Retarded 
children also need more concrete 
experiences, and can't yet handle most 
abstract ones. 

For example, counting is abstract 
in the sense that it requires a child to 
use mental symbols to represent real 
objects. The number 3, for instance, is 
an abstract symbol that stands for 
three objects or events — three cookies 
on the table, three trips to Grandma's. 
Some children who are retarded have 
a hard time making the mental leap 
from the real cookies or trips to 
Grandma's to the numerical symbol 
for them. Most mildly and moderately 
retarded children can learn to do this, 
but it will take them longer and will 
probably require especially careful 

Making the Abstract 

Depending on how serious the 
retardation is, a child may continue to 
have difficulty with abstract learning, 
such as understanding the relationship 
between size and weight — that just 
because something is bigger, it isn't 
necessarily heavier. For example, 
although an inflated beach ball is 
larger than a baseball, that doesn't 
mean it is heavier than a baseball. Of 
course, some relationships are more 
concrete or observable than others, 
which makes them easier to teach to 
retarded children. You can show a 
child the relationship between a mitten 
and a hand, for example, by putting a 
mitten on the child's hand. But it's 
very difficult to show a preschooler 
that lightning causes thunder. 

For some children, however, even 
showing is not concrete enough. They 
may have to be physically moved 
through an activity. 

For example, Laura was in a circle 
game. The children were clapping as 
they sang a song. Laura was not 
clapping, and didn't seem to under- 
stand. Her teacher stepped behind her, 
took both of Laura's hands in hers, 
and clapped them together. Laura then 
was able to clap her hands awkwardly 
by herself, and after a while she could 
clap them in rhythm with the other 


32 Practice with 

Processing Information 

You can help children who have 
trouble processing information, by 
giving them practice. For associating 
things with ideas and words, the child 
should spend a lot of time talking. 
Talk with the child about things 
around you: the ball the child is 
throwing, the picture the child is 
seeing, the water the child is touching, 
and so on. 

For learning relationships between 
things and classifying them, you can 
give the child several toy animals of 
two sorts — large and small, brown and 
blue, or lions and tigers. Ask the child 
to sort them into piles. When the child 
can do this, do the same activity with 
pictures of the animals. 

Or you can play the same/different 
game. Show the child several objects, 
such as a sock, a mitten, a shirt, and a 
fork. Ask which go together, which 
don't, and why. A younger child will 
be able to tell you how things are 
alike. (For example, a chair and a sofa 
are both for sitting on.) 

There are many things you can do 
to improve a child's ability to re- 
member. Rhyming jingles and songs 
are especially good, such as the song, 
"Head, Shoulders, Knees, and Toes." If 
a television commercial seems to 
interest the child, use it for this 

To help the child put ideas in the 
right order, try repetitive songs such 
as "Old MacDonald" or "Froggy, 
Froggy, Who's Your Neighbor?" in 
which some lines must occur in the 
right order. Or try the bear hunt game. 

Children are able to use what they 
have learned when they can general- 
ize, or can apply what they have 
learned from the original situation to 
another one. If a child has learned to 
recognize a dog as a kind of four- 
legged animal, generalizing involves 
recognizing that a beagle and a collie 
are both dogs. You can help the child 
generalize by saying such things as, 
"The circle in this book is like the one 
you painted yesterday" or "You have a 
red sweater like Harriet's." 

Real and concrete experiences help 
children to remember, organize, under- 
stand, and make use of what they 
have learned. This is true for all young 
children. It's just that retarded chil- 
dren need concrete learning experi- 
ences for a longer period of time than 
other children do. 

"I am a puppet. I like carrots 
for snack. Do you?" Puppets 
can be used to teach 




If children have received informa- 
tion from their environment through 
their senses, and if they have attached 
meaning to the information they have 
received and remembered it, they 
should be able to respond in a way 
that lets others know what they have 

Children have two ways of ex- 
pressing what they have learned: what 
they say (verbal responses) and what 
they do (motor responses). Children 
who are retarded may have trouble 
expressing themselves with words (a 
verbal response), or may be awkward 
and clumsy with their bodies (a motor 
response). This makes it hard for them 
to use the learning that has taken 

Verbal Responses 

The most important thing you can 
do to improve children's verbal respon- 
ses is to help children understand and 
communicate meaning. This is much 
more important than teaching them 
the correct way to pronoimce a word. 
To help children understand language, 
talk to them about things and events 
in their day-to-day world. Use simple 
words, make your sentences short, 
speak clearly, and use as many 
"props" as you can. Put Randy's hand 
on the ball when you say, "This is a 
ball." Put your hands on his hips and 
guide him into the chair as you say, 
"You are sitting down." 

It often helps children start to talk 
if they are encouraged to say words 
that are very familiar to them. Es- 
pecially good are movement or action 
words, such as go, come, show, sit, 
and walk, and words for things used 
every day in the classroom, such as 
ball, box, toy, and juice. Choose 
words that are short and easy to say 

(book, not reading comer), and 

focus on things that mean a lot to the 
child. If Sylvia loves to plav with toy 
ceirs but isn't interested in olocks, you 
would concentrate on getting her to 
say car, not block. Sing songs and 
read stories that use the words you 
have chosen. When the songs and 
stories are familiar to Sylvia, pause 
when you get to the word you want 
her to say, and ask her to supply it. 

When children are used to saying 
some words, you wUl want to help 
them use those words to express 
meaning. If Jessie knows what milk is, 
and if he can supply the word "milk" 
in a story about cows you have read to 
him many times, let him watch you as 
you pour the milk. Point to it and ask, 
"What is this, Jessie?" (Many more 
suggestions for helping a child develop 
language can be found in Chapter 4.) 

You might have in your class a 
child who can't talk at all, and who 
doesn't signal what he or she wants. 
Your main task is to help this child 
communicate using gestures, such as 
pointing. If a child has a severe 
physical handicap, work on eye ges- 
tures for communication. The speech- 
language pathologist and other spe- 
cialists can give you many other ideas 
for helping a non-verbal child develop 

Motor Responses 

Children who have motor problems 
are generally clumsy and awkward. 
Such children need extra gross motor 
experiences — lots of opportunities to 
run, jump, slide, kick, and so forth. 

Playground activities are excellent 
for children with motor problems, but 
also try to set up classroom motor 
activities so that these children aren't 
isolated. If a child has a severe motor 
problem, you may want to ask for help 
and advice from a physical therapist 
and an occupational therapist. In 
Chapter 4 you can find more sug- 
gestions for helping children improve 
their motor responses. 


'' What Children 
with Mental 
Are Like 

Later in this section, the skills that 
mildly, moderately, severely, and pro- 
foundly retarded youngsters generally 
have are described. These descriptions 
should serve as guidelines, not rigid 
rules. Some children can do more than 
is suggested, while others can do less. 
Some children are behind others tKeir 
age in one or two skiU areas, not in all 
areas. As you get to know the 
children, you will also get to 
know what each child is like. It 
is your expertise as a teacher that will 
help children do as much as they 
possibly can. 

The Importance of 
Teacher's Expectations 

Studies have shown that the ex- 
pectations a teacher has of children's 
abilities and performance influence 
what they do. In one experiment, 
several teachers were told that several 
of their pupils were unusually intel- 
ligent. In fact, the children's intel- 
ligence was really normal, not su- 
perior. But since the teachers thought 
the children were very bright, they 
treated them that way and expected 
more from them. After a year, these 
children were tested again. It was 
found that they made large gains in 
their intelligence scores. TTiis result 
was not obtained when teachers were 
told that several of their pupils were of 
average intelligence. 

The experiment confirms what 
good teachers already know: Expect 
more from a child and you'U get 
more. Expect less and you'll get 

Each description that follows refers 
to an "average child. Since all 
children are different, these descrip- 
tions won't necessarily apply to chil- 
dren in your class. Study each child in 
your class carefully, so that the 
description of an "average" retarded 
child won't make you expect less — or 
more — of him or her than the child is 
really capable of. 

Age and Self-Concept 

To help you understand skill de- 
velopment in retarded children, they 
will be compared with non-retarded 
children. For example, what a moder- 
ately retarded four-year-old can do is 
compared with what you might see an 
average (non-retarded) two-year-old do. 
While this is helpful, it is not the 
whole story. Retarded or not, a four- 
year-old has lived twice as long as a 
two-year-old, and has seen, heard, and 
felt more than a two-year-old. Another 
difference is that a non-handicapped 
two-year-old has probably had a lot of 
successful experiences in that time, 
while a retarded four-year-old may 
have had a lot of failures and 

For these reasons, it is necessary to 
consider a child's self-concept — how a 
child feels about him- or herself^along 
with what a child currently can and 
can't do. If Tina's motor skills are very 
much like a non-retarded three-year- 
old's, that doesn't mean that she is 
totally Uke a three-year-old or that you 
should treat her just like a three-year- 
old. In many ways, she feels like a 
four-year-old, and this makes a big 

The next few pages discuss what 
children with mild, moderate, severe, 
or profoimd retardation are generally 
like in five skill areas: motor, language 
and speech, self-help, social, and cog- 
nitive skills. 

However, it must be re^mphasized 
that no two children are alike. Handi- 
capped children often vary even more 
than non-handicapped children within 
an age range. The sldll descriptions 
that foUow are general. They need to 
be interpreted for the particular child 
you are working with, taking into 
account the child's age, degree of 
handicap, past experience, self-concept, 
and motivation. It is also important to 
remember that handicapped children, 
like other children, are always learn- 
ing and developing, and that a 
description that may fit a child one 
month may no longer be true the next. 
Finally, while three- to five-year-olds 
are discussed as a group, everyone 
knows that three-, four-, and five-year- 
olds, handicapped or not, behave quite 
differently from each other. 


Children learn better when 
they are proud of what they 
can do. 

36 Children 
Who Are 
Mentally Retarded 

Children who are mildly 
mentally retarded are generally 
developing at about two-thirds to 
three-fourths of the normal rate 
of development. Therefore, you 
are likely to find three- to five- 
yecw-olas working on developing 
skills that are generally found in 
children who are 2 to 3V2 years 

Motor Skills 

In terms of fine motor skills, 
children at this developmental level 
are beginning to use their fingers, not 
just their whole hands and fists, to get 
what they want. They can generally 
turn pages in a book one at a time, 
turn doorknobs, and build a tower of 
six to seven cubes. They c£in pick up 
small objects like buttons and stones, 
hold a crayon with their fingers, and 
scribble across a page. Many of them 
can draw a circle or a cross if you 
show them how. 

Some children with mild mental 
retardation are not delayed at all in 
their gross motor skills, and can use 
their bodies as well as other children 
their age. Other children with mild 
retardation are delayed in their gross 
motor skills, and are just beginning to 
use their bodies effectively. They fall 
less often than they did a few months 
before, and are learning to run, stop 
suddenly, and change directions. 
Going up and down stairs may still 
present problems. Within the next year 
and a half or two years, however, the 
child will probably learn to go up and 
down stairs one step at a time without 
holding onto the railing (as long as 
there are no other physical handicaps). 

Language and Speech 

The development of speech and 
understanding of language depend on 
intellectual functioning. Therefore, it is 
an area that is often quite delayed. 
Like all young children, children with 
mental retardation are able to under- 
stand more than they can say. 
Language may be limited to simple, 
single words that are meaningful to 
them, like "cookie," "dog," "daddy." 
Or, they may combine two or three 
words to express a more complete 
thought, like "cookie gone" or "more 
juice," and may be able to use the 
pronouns " — ' ' 




Palmer grasp— whole hand. 

Pincer grasp— fingers. 

Self-Help SkiUs 

The degree of development in self- 
help skills among children with mild 
mental retardation depends more on 
what has been learned and expected at 
home than on their retardation. Most 
of them will probably be a lot like their 
non-handicapped classmates. The 
yoimger children will be much better 
at taking their clothes off than putting 
them on. When they do dress them- 
selves, some things may get put on a 
little twisted, backwards, or wrong-side 

If a child has difficulty with fine 
motor skills, buttons, snaps, zippers, 
and laces will be hard. You may need 
to teach the child how to do and undo 
them, or help until the child makes 

All of the children should be 
feeding themselves, but they may not 
win any prizes for their table manners. 
They may still ignore their forks, and 
may find a full glass of milk very 

Becoming independent in toileting 
depends on the child's family and their 
values. Whether mildly mentally retar- 
ded preschoolers are toilet-trained or 
not has less to do with their retar- 
dation than with their families' values 
and life styles. If they have been 
taught that it is important to be dry 
and unsoiled, they should be able to 
communicate when they need to go to 
the toilet. They may, however, need 
some assistance in removing their 
clothes, wiping themselves after a 
bowel movement, putting on their 
clothes, and wasmng their hands. As 
their dressing and washing skills 
improve, they wiU learn, like aU 
children, to toilet privately and inde- 

Social SkiUs 

Socially too, three- to five-year-old 
children who are mildly mentally 
retarded are likelv to behave more like 
two-year-olds ana three-year-olds. Don't 
be surprised if one moment they are 
very clingy and dependent and the 
next minute refuse all help. As with 
two-year-olds, "no" is a common word 
in their vocabulary. They are still 
testing their impact on the world. 
Even though the children may look 
brave and bold one minute, they may 
be very frightened when they are 
separated from their parents, and cry. 

They notice the other children in 
the classroom and often play alongside 
them, but their play is usually solitary 
and without the give-and-take that we 
see in non-handicapped three- to five- 
year-olds. As the youngsters mature in 
your classroom, they wiU often become 
more outgoing, less negative, and more 
eager to please. Instead of being afraid 
of oeing left by their parents, children 
tend to be more afraid of monsters, 
bugs, scary animals, and the dark. 
The children may begin to play with 
others and, like all children, will have 
their ups and downs in the daily give- 
and-take of a preschool classroom. 

A few of the youngsters may begin 
to be able to imagine and make 
beUeve. Often some of the first pretend 
play that they do centers aroimd real- 
life experiences that they have had, 
such as going to preschool, going to 
the doctor, or going marketing. In fact, 
you may be surprised at how accurate 
their "pretend" play can be. Some of 
the best teaching feedback that one 
teacher ever got was from a mildly 
mentally retarded little girl who played 
school at home every day after she left 
the classroom! 


38 Cognitive Skills 

Children with rrdld retardation 
show a wide range of ability in their 
cognitive skills, lliey should, how- 
ever, be matching familiar objects by 
color, form, or size, and responding to 
simple requests such as "Give me the 
pencil" or "Put the ball in the closet." 
They should be able to point out body 
parts, sing phrases of some simple 
songs, and enjoy looking at pictures 
and learning favorite stories. Early 
ideas of what things are for are 
beginning to be formed, and the child 
may be able to answer a few questions 
such as "What do we hear with?" 
"What do we ride in?" and "What is a 
cup used for?" 

Who Are 

Moderately mentally retarded 
children develop at about half the 
rate of non-handicapped children 
the same age Therefore, moder- 
ately mentally retarded three- to 
five-year-olds are more develop- 
mentally similar to non-handi- 
capped children who are 1-1/2 to 
2-1/2 years old. 

Motor Skills 

Their fine motor sldlls are generally 
well enough developed that they can 
tiun the pages of a book, but several 
pages get turned at once. They can 
usually hold two small objects in one 
hand, and no longer drop the first one 
when the second one is offered. 
Crayons and pencils are made for 
scribbling, and scribbling just any- 
where is as common as scribbling on 
paper. They hold the crayon with their 
whole fist and do not yet use the 
fingers separately. Though the tower 
may lean a little, a moderately mental- 
ly retarded three- to five-year-old with- 
out other physical handicaps should be 
beginning to stack three or four cubes. 
As they develop and have more 
classroom experience, they will be able 
to hold crayons with their fingers 
rather than their fists, scribble within 
boundaries, stack more cubes, and 
begin to turn knobs, lids, and dials. 

The patterns of a 1-1/2- to 2-1/2- 
year-old are common to moderately 
mentally retarded three- to five-year- 
olds in the gross motor area as well. 
By this time, as long as there are no 
compHcating physical handicaps, they 
shoiild be able to walk well, with few 
falls. Children should be able to climb 
into large chairs, onto the couch, and 
onto the bed. They should be able to 
walk up stairs with help and creep 

down steps. Pushing and pulling other 
objects is not only fun, but also good 
for their physical development. They 
can throw a ball overhand, but it often 
lands on the floor nearby instead of 
hitting the intended target. Their 
running is still stiff and awkward, but 
they are able to move fast. 

Language and Speech 

Language and speech development 
is one of the most difficult areas for 
moderately mentally retarded children. 
Between three and five years of age, 
most are using a series of nonsense 
sounds that sound like talking. They 
are able to understand more words 
(receptive language) than they are able 
to say (expressive language), and they 
should be able to understand com- 
mands such as "no," "stop," "come 
here," and "give me." 

Some of the youngsters may be 
able to carry out two commands given 
simultaneously, such as "Pick up the 
ball and give it to me." They also may 
be able to point to farrdliar objects in 
the room when they are named by the 
teacher, or to use as many as eight to 
ten words appropriately. With 
teaching, practice, and development, 
moderately retarded children will 
begin to combine two words to express 
an idea such as "all gone," "want 
more," or "me thirsty." The words that 
have the most meaning for them are 
the ones they tend to use first. 

Self-Help SkiUs 

Most two-year-olds don't do a lot 
for themselves, but they are very good 
at taking off socks, hats, and mittens. 
This is true as well for moderately 
retarded three- to five-year-olds. These 
children will probably be ready to try 
eating with a spoon, though there may 
be as many misses as hits. It still 
takes two hands to hold a glass and 
even at that there are many tips and 
spills. By this time, their bowel and 
bladder schedule should be well estab- 
lished and predictable. Though a child 
may not let you know that it's time to 
go to the toilet, it is often possible to 
avoid accidents and begin toilet train- 
ing by placing the chUd on the toilet at 
regular intervals. 



What's a little spilling, if he can pour his 
own juice? 

40 Social Skills 

Socially, children at this develop- 
mental level are quite self-centered. 
They insist on having things exactly 
their way. They may react violently to 
sudden changes or upsets in their 
routine, and get easily frustrated. They 
want what they want when they want 
it! Fortunately for everyone aroimd 
them, this doesn't last too long. The 
child wOl soon move into wanting to 
be admired, praised, and encouraged. 
Although the child may continue with 
some of the "terrible twos" behavior 
for a while, it won't always be this 

Cognitive Skills 

Cognitively, children at the low 
end of the moderately retarded range 
should be able to name one or two 
familiar things in their environment. 
They can follow a one-step direction, 
can point to two or three body parts, 
identify familiar pictvires in story- 
books, choose the named object from 
three alternative choices, recognize 
their own name when called, and 
match familiar objects. 

Who Are 
Severely and 

Children with severe and pro- 
found mental retardation develop 
at a much slower rate than non- 
handicapped children. Their de- 
velopment may he one-tenth to 
one-third of what we would ex- 
pect of non-handicapped children 
of the same age. Severely and 
profoundly retarded children al- 
most always have other handi- 
caps. This makes learning even 
more difficult. Often the other 
handicaps are physical or neuro- 
logical (involving the central 
nervous system). Many of them 
have epilepsy or other seizure 
disorders that require continual 
medical monitoring. For these 
reasons, it is difficult to describe 
what these children are like. 
Generally, however, a severely 
and profoundly mentally handi- 
capped retarded child functions 
very much like an infant. 

Friends are important for everyone. 

Motor Skills 

Their fine motor development is 
progressing from focusing on objects 
with their eyes to following objects 
moved in front of their eyes. They are 
also balancing their heads, grasping 
things placed in their hands, reaching 
for interesting objects, putting objects 
in their mouths, releasing objects, 
pulling a toy by a string, holding 
objects for prolonged periods, and 
picking up objects using a palmer 
grasp (the palm of the hand). Soon 
they will be able to use a pincer grasp 
(the thumb £md finger). 

The early gross motor sldEs that 
these youngsters display initially in- 
volve learning to coordinate primitive 
reflexes. As they develop, they gain 
control of their head, neck, and torso, 
begin to bear weight on their feet and 
legs when held in a standing position, 
and sit when propped up. Eventually, 
the youngster will be able to sit 
without support, creep around on the 
floor, crawl, puU to a standing posi- 
tion, take supported steps, and walk. 
All of these motor milestones do, 
however, tend to be seriously delayed. 
It would not be uncommon to have a 
three- to five-year-old severely or pro- 
foundly retarded youngster who is not 
yet able to walk independently. 

Language and Speech 

Language and speech is another 
area of extreme delay in youngsters 
with severe and profound retardation. 
All of the sounds that they make are 
important to the development of 
language, though much of the child's 
vocal play does not seem to be 
anything like real language. If a 
severely or profoundly retarded child is 
following the normal sequence of 
speech development, throaty noises 
should be replaced with single vowel 
sounds like ah and eee. 

Non-handicapped three-month-old 
infants begin to use sounds in a 
communicative way. When an adult 
nods or talks to them, they respond 
with a smile and sounds. The child 
will coo, gurgle, laugh, and respond 
differently to voices than to other 
noises in the room. High-pitched 
squeals, grunts, and vowel soimds in a 
series come next, followed shortly by 
single consonant sounds such as d, b, 
and m. Combining sounds, imitating 
sounds, using tongue play to make 
new sounds, and saying "ma ma" or 
"da da" with meaning foUow. 

The whole progression is accom- 
plished by the non-handicapped infant 
during the first year. This is often the 
developmental level at which three- to 
five-year-old severely retarded children 
are still functioning. 


42 Self-Help SkiUs 

Like infants, severely and pro- 
foundly mentally retarded children 
who are three to five years old often 
do very little for themselves. Serious 
motor handicaps, particularly those 
related to chewing and swallowing, 
may require special attention from a 
specialist in occupational therapy, 
physical therapy, and/or speech and 
language therapy. 

If the child has no physical 
handicaps that limit movement, you 
may begin a simple training program 
to help the child learn to take off and 
put on clothes. Almost all severely and 
profoundly retarded youngsters can be 
toilet-trained. You may want to work 
cooperatively with the family to estab- 
lish a toileting schedule so that 
training can begin. 

Social Skills 

Socially, these children may smile, 
pat a mirror image of themselves, and 
show fear when left with strangers. 
They relate much more to adults 
than they do to other children. With 
adults, they like to play peek-a-boo and 
to drop toys on the floor for you to 
fetch. Since their language is very 
limited, they express enjoyment with 
smiles and laughs, and discomfort or 
unhappiness with crying. They can 
sense how someone feels about them 
by the person's touch, the tone of 
voice, and the facial expression. 

Even though these children can't 
participate in many activities in your 
class, they still enjoy and learn from 
being included in the group— if only by 
being able to watch. The sound, 
movement, and energy in the class- 
room stimulate their interest in the 
world around them, and this helps 
them learn. 

Cognitive Skills 

Much of the play that severely and 
profoimdly retarded children enjoy has 
to do with learning about the world. 
For example they are learning that 
things that are hidden still exist; that 
if they drop a block, it falls down; that | 
if they shake a bell, it rings. At this I 
level of functioning, children are learn- 
ing to recognize the people they know J 
and to respond to them differently 1 

than to strangers. They are beginning 
to look for dropped objects, to respond 
to their names, to play simple games 
like pat-a-cake and peek-a-boo, and to 
look at pictures in books. 

Many of the needs of children with 
retardation are exactly like the needs 
of other children. As they take risks 
and try new things, they need to be 
loved, to have limits, and to be 
supported as they learn. 

This chapter has described how 
children with different degrees of 
mentad retardation generally function. 
However, it must be emphasized that 
these descriptions refer only to the 
"average" crdld. Each child is different 
from every other child, even though 
they may have the same level of 
retardation. It is the teacher's respon- 
sibility—and challenge— to get to know 
children well enough to be able to 
stretch each child's capabilities as 
much as possible. Your expectations of 
what a child can achieve have a 
strong influence on what the child 
actually does achieve. So be sme that . 
yoiu: expectations are guided by what ' 
you have learned about each indi- 
vidual in your classroom, not by 
descriptions of an "average" child. 

Chapter 4: 






Mainstreaming in- 
volves planning and 
organizing the class- 
room environment and 
activities to meet the 
needs of mentally 
retarded children. 

44 This chapter can help you 
understand the importance of 
early mainstreaming eocperiences 
for children with retardation. In- 
cluded are techniques for plan- 
ning, ideas for classroom arrange- 
ments, and general teaching 
guidelines that are useful for all 
children; and specific techniques 
and activities for use with re- 
tarded children. 







Project Head Start stresses that all 
handicapped children, regardless of 
the severity of their handicap, should 
be considered for enrollment in Head 
Start if the particular program can 
meet their needs adequately. On the 
other hand, not all handicapped chil- 
dren are best served in Head Start 
programs. Both the resources within 
your program, including available 
staff, and the resources in your 
commimity determine what you are 
able to offer children. This means that 
you, the total Head Start staff, and a 
physician or other appropriate pro- 
fessional should decide whether that 
child should participate in the pro- 
gram. If another setting would be - 
better suited for meeting the child's 
needs, Head Start may be able to 
assist in the alternative placement. 

Although very few children are 
severely or profoundly retarded, occa- 
sionally such a child may be enrolled 
in a Head Start program. Children 
who are this limited often need the 
kind of care an infant needs. They 
have to be carried, washed, changed, 
and fed. Their participation may be 
minimal, but they may be drawn into 
the world by hearing voices and music 
and by getting attention from the 
teacher and others. Even if these 
children do not participate, they 
shovdd be positioned so that they can 
see the other children, and should be 
given objects to touch, move, and play 
with (such as bells, rattles, textured 
toys). Talking to and holding these 
children also contribute to their learn- 
ing and growing. 

Children with severe and profound 
mental retardation usually have other 
handicaps. Their speech, feeding, and 
movement should be checked by 
specialists in speech and language, 
occupational therapy, and physical 
therapy. These specialists can help you 
and the parents develop the best 
program for a severely or profoundly 
retarded child. Of course, such children 
should also be checked by a pediatri- 
cian on a regular basis. 

Mildly and 

Children with a mild or moderate 
degree of retardation generally do not 
put a heavy strain on your class. 
Introduce the child as you would any 
other child. You may need an addi- 
tional aide and probably some extra 
planning time to enable you to treat a 
retarded child as much as possible as 
you treat other children. 

Be ready to provide special support, 
but only when the child needs it. As 
you observe the child, you will learn 
when to offer assistance and when not 
to. Sometimes the need for help will be 
relatively minor, such as making sure 
that an extra pair of hands is 
available for helping with outerwear at 
arrival and departure times. You may 
need an aide to help with a retarded 
child especially at transition times, 
during outdoor play, at meals, and 
with snacks. 

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

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

^« 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. 

0« Learn all you can about retarda- 
tion. Read enough about it so that you 
feel comfortable, prepared, and 
confident. Talk to teachers, parents, 
and friends who have worked or lived 
with retarded 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 yet capable of, 
they wiU fail. As we have said before, 
the best encouragement for learning, 
improvement, and growing is a good, 
solid success. You can create the 
circumstances that make this not only 
possible, but likely. And the grin on 
the child's face is a very fine reward 
for you. 



H^i' ■ "^ """" ~"^ 

1 \ ■^^'^IL^i^ 




The planning process for a child 
with mental retardation 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 
people: the teacher, the parent or 
parents, Head Start staff representing 
the various service components, and 
service providers from outside agen- 

The goal of the planning process is 
to produce an Individualizea Educa- 
tion Pl-ogram (I.E.P.) for the child, 
which is now required by PubUc Law 
94-142, Education for All Handicapped 
Children Act, and required by Head 
Start Performance Standards. Based 
on a professional diagnosis of the 
child's handicapping condition, the 
Individualized Education Program 
spells out classroom activities, parental 
involvement in the development of the 
program, and special services to be 
provided for the child. 

For each handicapped child Project 
Head Start requires the following 
elements in the planning process: 

1. An interdisciplinary team is re- 
quired to make two kinds of diagnoses: 
a categorical diagnosis and a 
functional diagnosis. A categorical 
diagnosis 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. The team also 
should develop a functional diagnosis, 
or assessment, which is useful to you 
in your classroom planning and 
teaching. It is a developmental profile 
that describes how the child is 
functioning, and that identifies the 
services the child requires to meet his 
or her special needs. 

^ • Based on the functional assess- 
ment, an individualized education 

plan is to be developed for the cMld. 
This plan describes the child's 
participation in the fuU range of Head 
Start services, and the additional 
outside services that will be provided 
to respond to the child's handicap. 

3. Periodically, ongoing assess- 
ments 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 education plan or the 
services he or she is getting are no 
longer appropriate or needed, they 
should be changed or adjusted. 

4. When the child leaves the program, 
Head Start should make arrangements 
for the continuity of needed 
services in elementary school. This 
can be done in a variety of ways, but 
usually involves holding a conference 
with parents, the school, and service 
providers. The elementary school 
should be given a description of the 
services the child has been receiving, 
recommendations for futiire services, 
and the child's records from Head 

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 and other 
handicapped children as they are with 
retarded children. 

Step 1: Observe each child in 
a variety of activities, and record your 

Step 2: Set objectives based on 
what you have observed as reasonable 
for the child to achieve. 

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

Step 4: Develop the plans with 
the cnild'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 services with the public school. 

Each of these steps in the planning 
process for handicapped children is 
discussed in greater detail below. For 
help in individualizing your activity 
planning for retarded children, see the 
section entitled, "Specific Teaching 
Techniques," p.71. 


48 Step 1: 


The process and purpose of ob- 
serving is the same for all children. 
The purpose of observing a child is to 
identify the child's developmental 
level — the level at which a child is 
actually functioning. This can tell 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 
evaluation. Evaluation is particularly 
necessary and useful to the planning 
process because it makes you aware of 
the basis for what you do in the 
classroom. The following example de- 
scribes a situation that caUs for 


At the beginning of the year, you 
meet four-year-old Alan. The first 
thing you notice is that he seems 
confused — he doesn't seem to under- 
stand what is going on. When you ask 
the children to sit down to hear a 
story, Alan gets up and goes to the 
sand table. When you put paper and 
crayons in front of him, he just stares 
at them. You realize that Alan is a 
child you need to observe closely, so 
you can figure out what the trouble 
could be. 

You think that there are several 
possible explanations for Alan's be- 
havior. It is possible that he has a 
hearing problem, which would explain 
his difficulties in following directions. 
But when you call his name when his 
back is turned, he looks at you — so 
that isn't it. 

Maybe he has never been away 
from his parents before, and the 
emotional stress of the separation is 
troubling him. But you notice that he 
says goodbye to his mother fairly 
easily in the morning, and doesn't 
seem very upset after she has left — so 
that isn't it. 

So then you think that whatever it 
is, he'll get over it in time. After all, 
some children do take longer than 
others to adjust to new situations. A 
month passes. You are beginning to 
think that there might be something 
wrong with Alan, since the unusual 
behavior is continuing. 

You start to keep notes. You write 
down all the behavior that seems 
unusual: what the circumstances are 
and what Alan does. After another 
month, you suspect that he might 
have a problem that calls for outside 
help. 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 a detective in this way. If you 
notice a problem in a child, try to 
figure out possible explanations for it. 
Test each 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 do and say. Using observation 
as a tool for learning about children^ 
involves being systematic, watching 
for patterns, and using the informa- 

Be Systematic 

Your first step is to decide what you 
want to observe. Thinking about Alan 
again, for example, you remember that 
he can't complete a simple puzzle. 
Since you know that doing puzzles 
requires fine motor skills, you want to 
observe how he handles other activ- 
ities that require such sldlls. 

You next think of other activities 
that require fine motor sldlls. They 
might be coloring, working with clay, 
turning the pages of a book, picking 
up a spoon and a cup, and zipping a 
zipper. You will want to observe AJan 
when he is doing these things. 

Yoiu* observation notes should in- 
clude several kinds of information: 

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

• What is happening aroimd the 
child. ("The room was noisy, and 
Alan was getting little attention 
from the teachers at that 
moment." "It was a hot day, and 
that comer of the playground was 
crowded." "I asked Alan to cut out 
a picture of a jack-o'-lantern with- 
out my help.") 

• The details of what Alan does 
and how he does it. ("Alan held 
the cup with two hands, and 
dropped it when he tried to hold it 
with one hand." "Alan's move- 
ments were very slow and listless, 
and he put his head down on the 
table twice.") 

• How the child is feeling. ("Alan 
felt good because he had just been 
able to throw the ball to me for the 
first time." "Alan was annoyed by 


50 Hisako, who kept reaching for his 

cookies." "Alan s favorite cousin is 
visiting from Alabama this week.") 

You continue to observe Alan's 
sldlls regularly enough and long 
enough to get a sense of how he is 

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, "Alan 
spilled his rmlk," this might mean that 
he was angry, wasn't paying attention 
to what he was doing, was awkward, 
had a problem with his arm or hand 
muscles, or a number of other possibil- 
ities. However, consider this version: 
"Alan reachea for his milk cup with 
both hands. The closer he got to the 
cup, the more his arms trembled. 
Finally, the trembling made him 
knock over the cup." These notes 
would be immensely helpful both to 
you and to a trained diagnostician, 
who would recognize that they could 
indicate a serious physical problem. 

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

2. Write down the details as soon 
as possible 

Note down what you see as soon as 
possible, since it's easy to forget 
quickly the details of a child's be- 
havior in a particular circumstance. 
Details are important. They describe a 
child's individuality. They are also "the 
best indicators of a child's strengths 
and weaknesses. 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. 
Observe and make notes as often as 
necessary to get a fuU picture of what 
the child does easily and has problems 
with in the sldll area you are focusing 

4. Vary the settings in which you 

Children can behave differently in 
different activities and moods, so it's 
important to observe a child in a 
variety of situations. Observe the child 
on the playground and in the class- 
room. 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 is feeling happy, 
sad, tired, rested, friendly, and angry, 
because these feelings affect the child's 

"February 1 7, For the first time today, 
Peter tried to figure out how the pedal 
on the tractor works." 

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 of the room 
while another adult manages the 
classroom activities. Or you can be a 
participant-observer, talang part in the 
activity of 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, imtO 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 forgets 
words, stumbles, or knocks things 
over. All preschool children do these 
things firom 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 
aroimd with you and keep track for a 
few days. Be sure you are objective 
(factual) about yoiur observations — try 
to keep your own feelings and reac- 
tions separate. In this way, you will be 
able to see the patterns that point to 
the particular skills with which the 
chila needs help. 

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

Use the Information 

Once you have observed a child 
systematically, written down your ob- 
servations, and reviewed your notes, 
you should be able to identify areas of 
strength and weakness in the child's 
skills. This information can be used to 
develop objectives for the chQd, and to 
select activities and teaching tech- 
niques 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 Alan, it 
becomes clear that he does have a 
problem with his fine motor skills. In 
particular, you notice that he has a lot 
of trouble with hand-eye coordina- 
tion — making his hand move to the 
place where his eyes tell him his hand 
needs to go. Since your objective is to 
improve Alan's hand-eye coordination, 
you select activities that involve this 
skill so that he can get the practice he 
needs. These activities might include 
puzzles, sand table, making collages, 
and pointing to pictures. You can also 
decide to work alone with Alan more, 
both because he needs your help with 
the sldll and because he works Ibetter 
on it in a quiet place away from the 
other children. 


52 Step 2: 

Set Objectives 

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

Here are some guidelines for setting 

1. Be Specific 

When you have gotten together 
your observations, you will find some 
areas of strength and some weak- 
nesses. This information is not par- 
ticularly useful until it is translated 
into what the child needs. State 
objectives in terms of skills and 
behaviors that need to be learned and 
that you can observe. Set a target date 
for the achievement of each objective. 
For example, if Tanya has difficiilty 
sorting out related items, your objec- 
tive for her is to learn to group items 
according to likenesses. To make this 
objective more specific and easier to 
observe, state it as follows: "In two 
months, Tanya wiU be able to group 
toy animals oy size, and marbles by 

2. Develop Both Long- and Short- 
Term Objectives 

If Robert has difficulty with self- 
help skills such as eating and 
dressing, a long-term objective for him 
might be: "Robert will learn to fasten 
and unfasten his clothes with a 
zipper." Short-term objectives that will 
help Robert meet the long-term one 
are: "In one month, Robert wiU be able 
to finish unzipping a zipper that has 
already been started. In two months, 
Robert will be able to imzip a zipper 
without assistance. In eight months 
Robert wiU be able to zip up a zipper 
without any help." 

3. Develop New^ Objectives as 

Objectives wiU have to be changed 
if yoiu" observations show that there is 
a need for it. If Robert surprises you 
and learns to zip up his zipper in only 
six months instead of eight, or if it 
takes him more than t\yo months to 
unzip the zipper, you wiU want to 
develop new objectives to fit Robert's 

"Objective: Derek will 
snap the bottom snap on 
his jacket by April 15. " 

step 3: 

Step 4: 


Select the 
Acivities, and 

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 retarded children, a full-day, 
center-based program is best. For 
others a part-day program combined 
with a home-basea 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 participate in all standard 
Head Start activities along with the 
other children. The child's program 
can then be revised, if and when it 
becomes necessary. 

To make it possible for retarded 
children to participate in aU your usual 
classroom activities, think about ways 
to adapt them, and prepare them 
differentiy. You can use a variety of 
teaching techniques to make sure the 
child gets what ne or she needs. For 
examples, look at the "Activities" in 
this chapter. 

Develop Plans 
with Parents and 


Sometimes it is hard for parents to 
recognize changes in their child from 
day to day. In the classroom you have 
the opportunity 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, 
parents 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, 
in their different roles, toward the 
same end. Develop your plans with 
parents. Share with parents the pro- 
gress their child is making in your 
classroom and ask them to share with 
you the child's accomplishments at 
home. As you work together with 
parents, you might invite them to 
observe the program and to assist in 
class activities. 


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 spe- 
cialists can provide them with valu- 
able information on the child's activity 
in a more normal setting. In turn, the 
specialists can help you imderstand 
what limits 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 abili- 

54 Step 5: 

Continue to 
Observe, Reassess, 
and Make 

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. (Remember how qioickly 
children change at this age, especially 
in a stimulating Head Start class- 
room!) As you observe regularly and 
record a retarded child's responses in 
major sldU areas, your understanding 
of that child and the effects of the 
retardation will 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. If, for example, there is a 
pattern of poor eye-hand coordination, 
consider 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: 



Head Start and the 

PubKc Schools 

As a result of the Education 
for All Handicapped Children Act, 
public schools will increasingly be 
providing the benefits of mainstream- 
ing classrooms and special services to 
handicapped chOdren. After being in a 
mainstream Head Start classroom and 
receiving special services, children 
with mental retardation will need to 
have these advantages continue. There 
are several things a handicap or social 
service coordinator and you can do to 
contribute to the continuity of the 
education that a child with mental 
retardation in your program has been 

• Some Head Start programs 
have developed formal re- 
lationships with the public 
schools in their areas, to 
assist in the transition be- 
tw^een preschool and ele- 
mentary school. If your 
program has no formal re- 
lationships with the public 
schools, you might explore 
the possibility of establish- 
ing them. Your program 
director or handicap co- 
ordinator will know^ where 
to go for suggestions on 
how^ to achieve this. 

Developmental continuity 
is made easier if com- 
munity providers of special 
services to Head Start chil- 
dren continue to provide 
them to children as needed 
when they go on to public 
school. Before a child 
leaves Head Start, vou can 
discuss the child's mture 
plans with the specialists 
who have been working 
with him or her. 

Parent participation in the 
services their child has 
been getting in Head Start 
is a valuable foundation to 
build on. Encourage par- 
ents to continue their in- 
volvement and to make 
sure that their child re- 
ceives needed services in 
elementary school. 

Finally, you can keep in 
touch with the child and his 
or her family after the child 
leaves your classroom. 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 \vould be vv^el- 




Setting and 

No two Head Start programs have 
the same classroom faolities, 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 reaDy make 
any preschool program. One of the 
best things you can do for retarded 
children is to talk to them, encourage 
them to talk, and listen to them. 

By and large, most handicapped 
children don't require special class- 
room arrangements or extra materials. 
You can adapt and reorganize the 
materials you already have to meet the 
needs of retarded children. Basically, 
the classroom should be arranged to 
suit the special needs of the retarded 
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 fi*eely. In general, arrange your 
room so that the child can explore the 
space and use the materials with as 
little assistance as possible. Here are 
some suggestions that are useful with 
all children. They are particularly 
helpful for children with handicaps, 
including mental retardation. 




K you have a child in your 
program who is just learning to walk 
and is still climisy, make sure that 
there is enough space between furni- 
ture groupings to avoid "collisions." 
The traffic patterns between activity 
areas should be easy to recognize. 
Making a map of your 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 


All the trucks together. 

Neatly arranged materials invite playing. 


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 in- 
crease the amount of materials and 
number of activity areas. The use of 
well-defined and consistent space pat- 
terns wdll avoid confusion and help the 
children become familiar with the 

classroom organization. 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 block area, the 
housekeeping comer, and other areas. 
Other space cues, such as cabinets and 
movable partitions, 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 materials are 
kept and where activities take place. 


Avoid placing noisy activities next 
to quiet activities. Noise and move- 
ment distract some children from 
quieter tasks. Noise interrupts the rest 
breaks that some handicapped chil- 
dren need. Most retarded children need 
help in improving their language 
skills, but it's hard to make out what a 
teacher is saying if it's very noisy. 
Listening and speaking are a lot easier 
for everyone when it's relatively quiet. 
Be sure there are quiet places in the 
room, perhaps sectioned off. 


Play areas should be clearly marked. 

One good way to label cubbies. 


Getting away from it all. 




Some children aren't used to 
sharing a room with a lot of other 
children, and they may use more than 
their share of the space. You can use 
physical signals to limit their move- 
ment. For example, when Sean sits in 
a circle, he might extend his legs and 
kick the child next to him. To 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, will also help limit 
children's movement. 

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

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

Personal Places 

There should be a quiet place 
available where children can go on 
their own. Some classrooms have 
cubbies where children keep their 
personal belongings. These are some- 
times 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. Tiy 
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 
aU every once in a while. 

You Have 

Just like for all young children, you 
don't need expensive or fancy mater- 
ials for a child with retardation. You 
can often adapt what you have by 
thinking about what the child needs to 
learn from the materials. Watch the 
child to see if they are too complicated. 
If they are, the way the child reacts 
will let you know how to simplify 

You might ask a retarded child's 
parents for help in adapting classroom 
materials. They may already have 
done this sort of thiiig at home. 

Try to use materials that will 
stimulate children's curiosity. Offer 
materials that need active fingers and 
hands, and that allow a variety of 
uses. Since learning takes place 
through all the senses, include mater- 
ials that a child sees, hears, feels, 
smells, tastes, and moves. 

The only extra materials you might 
consider obtaining for retarded pre- 
school children are those designed for 
younger children. If a retarded child is 
functioning at a two-year-old level, 
provide materials designed for two- 
year-olds. Have some two- or three- 
piece puzzles on hand, for example, 
some large picture books with untear- 
able pages, and some large pegboards 
with easy-to-grip pegs. If it is easy to 
locate such materials, fine. If not, you 
can usually think of ways to adapt 
what you already have. 




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

With retarded children, you wiU 
want to apply your teaching sldlls 
consciously, 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 per- 
formance, they require extra considera- 
tion. Following are some basic prin- 
ciples that you may already know and 
use with ail children. They are parti- 
cularly useful in working with children 
who have handicaps, including mental 


60 1. 

Your Feelings 
and Keep Trying 

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

"Me? I've never worked with a 
retarded child before. I won't know 
what to do with her. She'll just 
stare at me, or cry. Her parents will 
see I don't know what I'm doing. 
What should I do if I talk to her 
and she doesn't answer? Who will 
help me with her? How will I be 
able to have enough patience to 
show her something for the sixth 
time in a row? 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 embarrassed. If I try 
something and it doesn't work, 
what on earth will I do then?" 

If Ms. Lazon had been able to 
speak with other staff members in her 
program about these worries, instead 
of keeping them to herself, she might 
have felt better. Talking with the 
director of the program, she might 
have been able to find out why she 
had been chosen. The handicap or 
social services coordinator could have 
explained what kinds of help were 
available to her. 

Starting Out 

Some adults are nervous and 
worried about working with a handi- 
capped child for the first time. This is 
a typical reaction when they don't 
know the child very weU yet (if at all). 
As a result they sometimes start out 
thinking of the child as a "retarded 
child." As they spend time with the 
child, watch the child, play with the 
child, and hug the child, they usually 
find that they have begun to think of 
the child as a "child with retar- 
dation," 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 frustrated 
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 cure a child, or to make 
the cMld into the fastest puzzle-doer in 
the class, or into the best runner or 
climber. Sometimes, even with the very 
best help from you, the staff, and 
specialists, a child doesn't make as 
much progress as hoped. 

If he doesn't learn today, 
you can try again tomorrow. 



This was true of Pierre, a child 
with very serious problems. 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 
children with retardation. 

When Pierre 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. 

But every now and then, Pierre did 
seem to do better. He learned a few 
new words, and he kept still long 
erwugh 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 breakthrough was about to 

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

But in spite of all their efforts, 
nothing worked. Pierre's problems are 
as serious now as they were on his 
first day in Head Start. 

Some children, like Pierre, never 
seem to progress. All you can do is 
your best to try and help. There will 
also be many times when you will 
succeed in helping these children to 
make the best compensations they can 
for their handicap, and to take advan- 
tage of the talents and skills they do 



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


Your aide or assistant helps you 
teach activities and work with children 
individually. This help is especially 
valuable if you have a retarded child 
in your class who needs special 
attention and assistance. Aides should 
be included in developing educational 
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 
mainstreaming. Some children, how- 
ever, need the security of an attach- 
ment to only one adiilt in the 
classroom before they are able to work 
with several adults. For such a child, 
you may want to assign an aide to 
work with the 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 pres- 
ence of a few people they know and 
care about. 

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


62 Volunteers 

Volunteers can be helpful in work- 
ing with handicapped children even 
though their work hours are probably 
shorter and less predictable than those 
of aides. They, too, need explanations 
and directions from you about what 
they are requested to do. 

Parents make good volvmteers. 
High school and college students are 
also ideal volunteers. Young people 
who are learning about children in 
school are often interested in working 
with them. Another source of volun- 
teers could be senior citizen clubs or 
apartment complexes for the elderly. 
Many elderly people, especially those 
whose grandchildren don't live nearby, 
would be pleased to help with young 
children — and they certainly are exper- 
ienced! Another excellent source of 
volunteers is organizations and 
agencies in your community that work 
with handicapped children (such as 
Easter Seal, United Cerebral Palsy 
Associations, children's hospitals, re- 
habilitation centers). 

See to it that everyone who works 
with a handicapped child in your class 
gets along well with him or her. 
Everyone works better when they 
enjoy what they are doing. 



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 frequently, and 
demonstrate them when necessary. 
Enforce them consistently, so that 
children will learn that they must be 

Children also need limits to help 
them control their behavior. Unlike 
safety limits, behavioral limits require 
you to make some judgments about 
what is appropriate and what is not. 
Each of us has a range of child 
behavior 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 

Whatever behavioral limits you set, 
be consistent in enforcing them. K the 
limits keep changing, the children will 
never know what you expect, and will 
not learn what you are trying 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 
personally 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 
learning of the other children? If the 
behavior does not disturb the other 
children, then perhaps it should be 
something you may want to learn to 
live with. 

For example, if Tasha's loud voice 
seems much more annoying to you 
than to everyone else in the class, 
maybe it is not so important that she 
be quiet, after all. 

Can the Child Help It? 

Does the child have control over 
the behavior? For example, you may 
find it hard to take the slowness of a 
particular child in getting ready for 
the next activity. Although you can do 
some things to speed up the process, it 
may not be possible to speed it up as 
much as you would like. This means 
you must adapt to the child's behavior. 
Concentrating on the child's needs 
rather than on the behavior may help 
you change. 


This behavior is 
disturbing the boy, 
and should be 
J stopped. 

64 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 
child, not just more convenient. 

Derek is a child who has a hard 
time keeping still for long. Helping 
him learn to stay and work at the 
puzzle table is important, because he 
won't be able to learn the skills puzzles 
can teach him if he is running around 
the room. On the other hand, it's not 
important that Derek sit at the table. 
He may need to move around the table 
as he works on the puzzle, but he can 
stiU learn this way. There would be no 
educational reason for asking him to 
sit still. 

Can You Think of 
Substitute Behavior? 

What behavior do you want the 
child to substitute for the unacceptable 
behavior? One good way to help 
children change undesirable behavior 
is to teach them a good substitute. A 
child who hits other children can be 
taught to express anger with words, or 
to stalk away from the anger-pro- 
ducing situation, or to hit a punching 
bag. Make sure that the new behavior 
competes with the undesirable one. 
Laiu*a can't hit Rudy and stalk away 
from him at the same time, so stalkmg 
away would be a successful technique 
for her. 


Plan yoiu- 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 

A child with mental retardation is 
especially sensitive to the pace of the 
day. Some retarded children tire easily, 
and may need more quiet times than 
non-handicapped children. This 
doesn't necessarily mean a nap — often 
ten minutes alone in the book comer is 
enough. Also, the child's attention 
span may need training and strength- 
ening if he or she isn't used to 
preschool. If a child's attention span is 
short, make the activities 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 
imderstand or to do something. Provid- 
ing time for that extra turn or two can 
mean the difference between success 
and failure. 


At home children with special 
needs are sometimes isolated from 
other children. One of the benefits of 
mainstreaming is that it offers these 
children the opportunity to play with 
other children and to learn a new skill 
by seeing someone else do it correctly. 
You can plan and organize your 
learning situations so that this inter- 
action, called "peer modeling," can 
occur. In areas where a handicapped 
child is weak, another child (a peer) 
who has the sldll can act as a model, 
likewise, in areas where a handi- 
capped child excels, she or he might be 
paired with a less sldlled 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 
child with special needs from any 
activity, especially large-group activi- 
ties. Exclusion means isolation, and 
isolation means feeling different and 
bad. To include the child, give extra 
assistance or change the expectations 
for the child. For example, when 
several children are painting a mural 
together, stand near the child to make 
sure that he or she enjoys it without 
disturbing the other children's paint- 
ing, hi 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 sldlls. 

Individualized teaching does not 
mean isolating a child. Rather, it 
involves modifying the activity so that 
all children participate within the 
same learning situation. 


Modify the activity 
for several children. 




We have already mentioned the 
benefit of using children as models for 
each other. This principle applies 
directly to using non-handicapped 
children to assist you in mainstream- 
ing 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 chil- 
dren can help in mainstreaming a 
handicapped child include: 

• introducing a new child to the 
physical setting of the classroom 

• helping a confused child to organ- 
ize his or her materials for a 
cutting and pasting activity 

• providing a child with opportim- 
ities to practice a newly learned 

• assisting a poorly coordinated 
child during playground games 

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

• sitting close to an easily frightened 
child to provide support when the 
lights go out diuing a film-strip. 

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



Every skill is really composed of 
many sub-skills — there is no such 
thing as a one-step activity. Skills such 
as tying shoelaces, cutting a circle 
with scissors, doing a somersault, or 
learning to count consist of many sub- 

Some children can master a new 
skill very quickly with little help from 
you. These are children who already 
know the sub-skills and can use them 
in performing the new skill. Handi- 
capped 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 mental retardation have 
this problem in all skill areas. 

For these children, you can break 
down the activity into sub-skills that 
can be learned at their current skill 
level. For example, if you want to 
teach a child to hop, check to see if he 
or she can balance on one foot. 
Balancing on one foot is a sub-skill of 
hopping, and must be mastered first. 
Since breaking down skills into small 
parts is very important with retarded 
children, we cover it in detail in the 
"Activities" section of this chapter. 





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

For example, children can begin to 
learn about traffic lights by hearing a 
story about one and by coloring a 
picture of one with red, yellow, and 
green crayons. Then you could play a 
game of "Red Light, Green light" 
with them. The next step in the 
classroom might be to set up a maze, 
complete with teacher-made traffic 
signals, and have each child go 
through the maze as the light changes. 
(You can make the light change by 
inserting red, yellow, or green cards at 
different times.) Finally, you will want 
to go outside and practice the real 
thing. By sequencing these activities 
from simple to more complex, you 
have helped the child to generalize, 
and have reinforced the concepts you 
are teaching. 

Be sure to demonstrate to a child 
how the skills learned in one activity 
can be used in others. A retarded chold 
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. 





and Guidance 

Use physical contact to help a 
handicapped child, to ensure safety, to 
provide guidance, and to limit space. 
Feel free to express your affectionate 
feelings with a pat or a hug. Guard 
against using physical contact to 
punish a child. 

Physical contact is especially im- 
portant for a retarded child, who can 
often learn best by being "moved 
through" an activity one or rnore 
times, until independent participation 
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. 

Using physical guidance as you 
move Marilyn around a circle and as 
you help Peter with the stencil is a 
temporary technique that allows them 
to be 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 
willing 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. 

If he can reach the paint brushes, allow 
him the pride of getting them himself 



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 make up for all the extra 
problems 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, 
simply because this is what they are 
used to. 

Overprotecting a child is a trap 
that you don't have to get caught in. 
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 slow 
child because you can do them faster 
and better. But if you're always the 
one who zips the zipper and sets out 
the paint brushes and turns the book 
right-side up, the child won't have a 
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 
exfra encouragement to children who 
try to do things on their own will pay 
off many times in the future. You can 
help children think of themselves as 
able, not imable. When they grow up, 
they will be in the habit of expecting 
as much from themselves as they are 
really capable of. 





Making sure that confidential in- 
formation stays confidential involves 
careful 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 
stigmatized 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 
confidentiality of records- 

• Records must be stored in a 
locked place where unauthor- 
ized 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 
consent forms to give anyone 
outside of Head Start permis- 
sion to see the records. 

These procedures are designed to 
make sure that aU records on a 
handicapped child and his or her 
family are seen only by people who 
need to see them for legitimate educa- 
tional or medical reasons. 

Avoid writing down confidential 
information such as that contained in 
the child's records. limit the confiden- 
tial information you do write down to 
what you need for working with the 

You should not repeat confidential 
information about handicapped chil- 
dren or their parents, either to other 
parents or to staff members who are 
not working with the children. This is 
an invasion of the privacy to which 
handicapped children and their 
parents have a right. 

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

Teachers have sometimes been 
embarrassed to find that their com- 
ments about a handicapped child's 
family 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. 




This section suggests specific teach- 
ing techniques that you can use to 
help mentally retarded children in 
your classroom learn better. It includes 
recommendations for improving self- 
concept, tips to keep in mind, the 
techniques of task analysis and beha- 
vior modification, how to handle 
transition times, and ways to help 
with language problems. 


Children's self -concept is affected 
by the expectations of the people who 
are important to them. For example, if 
Jackie's parents and teachers think it 
is important to eat neatly, she will 
enjoy their approval, and feel proud of 
herself when she keeps her milk in the 
cup and her food on the plate. 
Children who believe that they are 
capable of ful filli ng the expectations of 
the people who are important to them 
develop a positive self-concept, or a 
sense of worth in themselves. This 
sense of worth in turn encourages 
them to try new things and again be 
successful. They begin to feel capable 
when they are praised and valued for 
the good things they do. For this 
reason, social skills, gross motor skills, 
and all the other skills have to be 
thought about in connection with 
children's self-concept. 

"Do the other children like me?" 
"Am I big and sti-ong?" "Can I cHmb 
to the top of the jungle gym?" "Is my 
teacher proud of me?" Children ask 
themselves these kinds of questions 
often. Those who can answer "yes" are 
likely to have a positive self-concept — 
they find the world a fiiendly and 
delightful place, and they are eager to 
try out new things. Children who 
answer "no" are Ukely to have a 
negative self-concept — the world is an 
unpleasant place where new experi- 
ences mean new failures. Since failing 
is so painful, these children may tend 
to avoid the new experiences, because 
they foresee getting hurt by them. 

Children with a negative self- 
concept can react in a number of 
ways. They seem to need your atten- 
tion very often. They may be with- 
drawn and quiet, and may refuse to 
play with other children. They may be 
frightened, insecure, timid. They may 
be resentful and sullen. They may cry 
a lot. They may misbehave, disrupt 
activities, or annoy or try to hurt other 


72 Although poor self-concept is dam- 
aging to aS children, it is a special 
problem for children with mental 
retardation: their handicap means that 
they can't yet do some things that 
other children their age can do. Mildly 
and moderately retarded children, in 
particular, are very well aware that in 
some ways they don't "measure up" to 
the other children. This is why 
children who are retarded are very 
much in need of successes. With 
successful experiences, these children 
will feel better about themselves. 

"I made this all by myself!' 

Here are some steps you can take 
to help children develop a better self- 

• Structure activities so that 
the child feels successful. 
Break them down into as 
many small steps as needed 
for success. 

• Praise progress, no matter 
how^ small. 

• Try to be positive about 
failures. "You tried very 
hard. With such good prac- 
tice, I'm siu*e you'll learn 
how^ to do that soon." 

• Be patient Avhen it is neces- 
sary to show a child how^ to 
do something many times. 

• Be tender, accepting, and 

• Don't talk about a child's 
problems in front of him or 

• Concentrate on a child's 
strengths, not w^eaknesses. 
Use those strengths to the 
child's best advantage. 

• Fit the activity to the child, 
so that it is challenging but 
not overwhelming. 

• Be consistent about what 
you are expecting from a 

• Make the child responsible 
for a part of the classroom 
routine, and praise his or 
her reliability. 

• Never allow other children 
to make fun of a child. 

• Include each child as fully 
as possible in all activities. 
Isolation hurts. 

• Give each child the oppor- 
tunity to show^ off a little, 
such as displaying draw- 
ings. When a child is proud 
of something, show^ it to 

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 

Show the child how to do the 
particular 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 John how 
to jump, lift him off the ground with 
you as you jump, to show him how it 

Stand or sit close to the child 
during 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 crowd- 
ed pages. 

2. Make It Short 

Some of the retarded children you 
work with will be very active. Some 
may get easily distracted. It will be 
hard for them to sit and listen. When 
a child doesn't pay attention, 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 Organized 

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 bell 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 

4. Teach It 

Non-handicapped children often 
seem to learn without being taught. 
They pick up on lots of things that 
they see around them and soon 
recognize and know them: colors, cars, 
rhymes, and numbers. But children 
who are retarded often have to be 
taught things that other children learn 
on their own. With retarded children, it 
helps to use more demonstrations than 
words. Don't just tell them how to do 
something; show them how. 

Give the children lots of practice. 
Repeat the same activity in the 
classroom and on the playgroimd. 
Each time you do an activity, help the 
children remember when they did it 

Point things out and describe 
them. For example, "Look at the big, 
soft pillow." "Miyeko's coat is blue. 
Kevin's coat is brown." 

Teach 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. 



Task Analysis 

Task analysis is a teaching tech- 
nique you may already know about. It 
works particularly well with children 
who are mentally retarded. The tech- 
nique calls for breaking a task (activ- 
ity) down into small sequential steps 
and teaching each step until the child 
can do the whole thing. For example, 
if Mara is having trouble learning to 
put her T-shirt on, her teacher can 
break the task down into the following 
smaller steps: 

Lay the shirt flat on a table with 
the back up and the bottom 
toward the child. 

Put both arms inside the shirt. 

Move both arms along the sides Lift the shirt up so the neck 
of the shirt to the armholes. hole is on top of the head. 

Pull the neck hole down over 
the head. 

Pull the bottom of the shirt 
down from the armpits to the 

Pull the bottom of the shirt 
down from the chest to the 

When you consider how many 
motions it takes to put on a shirt, it's 
no wonder that some children find it a 
complicated task. Going through this 
type of analysis can help you be 
patient with a child, who knows 
perfectly well when a task is compli- 

Often the easiest way to teach most 
skills, including self-help skills, is to 
teach the last step first. The name of 
this technique is backw^ard chain- 
ing. The satisfaction in doing some- 
thing, either putting on a shirt or 
completing a puzzle, is greatest as the 
last step is finished. Backward chain- 
ing not only makes it more likely that 
children will succeed at doing some- 
thing, it also lets them see the result of 
their effort immediately, and be 
pleased at their accomplishment. On 
the other hand, if you teach children 
how to put on a shirt, for example, by 
starting with the first step, they will 
have a long wait before the final 
successful moment. And some of them 
might not have the patience to wait 
that long for success. 

Mara's teacher taught her how to 
put on her shirt using backward 
chaining. She first helped her get her 
shirt almost all the way on, but taught 
her to do the last step by herself— to 

Eull the shirt down from her chest to 
er waist. As soon as she could do 
that, she congratulated her and taught 
her the next-to-last step — to pull it 
down from her armpits to her chest. 
Each time she learned a step, she 
congratulated her and taught her the 
one just before. This way, Mara got 
lots of practice, was successful, felt 
proud of herself, and learned to do 
more each day. 


Behavior modification is a teaching 
technique that relies on an old prin- 
ciple: when we are rewarded for 
something we do, we are more likely to 
do it again. Psychologists call this 
positive reinforcement. 

For example, if you tell Sasha that 
his shirt is beautiful, he is more likely 
to wear it again. K your supervisor 
tells you that you work well with 
children who are slow, you are likely 
to try even harder and to be willing to 
work with others who are difficult to 
manage. If, however, you are criticized 
for the way you managed a parent 
meeting, you are less likely to want to 
manage it again. 

Rewarding children in your class- 
room for effort and accomplishment 
keeps them working and learning, 
according to principles of behavior 
modification. You probably reward 
children in your classroom often and 
without special effort. For example, 
when they have worked very hard, 
you probably praise their efforts, smile, 
or give them a friendly pat. But what 
is rewarding and motivating for one 
child may not be rewarding and 
motivating for another. For some 
children, you may need to make a 
special effort to figure out what is 
most motivating to them. To do this, 
you have to get to know the individual 
child, and consider what you do that 
makes that child work harder and 
behave in desirable ways. Sometimes 
rewarding children for effort or ac- 
complishment by allowing them to 
listen to a favorite record, giving them 
extra time to play with a favorite toy, 
or giving them the privilege of feeding 
the fish or watering the plants motiv- 
ates them. 


76 To motivate children, the reward 
must be something they want and 
must be given right after they make 
an effort or accomplish a task. While 
you want to give children time to 
practice what they have learned, you 
want to be sure that you encourage 
them to learn more. And to learn 
more, children need to do a little bit 
more or a little bit better. 

On the other hand, when we are 
punished for something we do, such as 
being criticized for managing a parent 
meeting, the impleasantness tends to 
make us want to stop doing it. 
Punishment, however, can have the 
opposite effect from what you intend. 
TTbe attention from being scolded, for 
example, is a kind of positive reinforce- 
ment for children who don't get 
enough attention. They are therefore 
encouraged to repeat the undesirable 
behavior, not to stop it. This is why 
simply ignoring vmdesirable behavior 
sometimes works better than punish- 
ing children for it. When they are no 
longer rewarded with the attention of 
a teacher who is scolding or criticizing 
them, they are less likely to continue 
the problem behavior. 

Although punishment is not useful 
for changing most kinds of undesir- 
able behavior, there are times when 
you have to stop a child, with a firm 
"no" or a gentle scolding, to protect the 
safety of the child or another child. 
You obviously have to stop a child 
right away from nmning out into a 
heavily traveled street or from hitting 
another child. 

You will find that one good way to 
prevent dangerous or undesirable be- 
havior is to teach children appropriate 
behavior instead. Of course, physical 
punishment in any form does not 
belong in a preschool classroom. 




The hardest times for many 
teachers and children are the transi- 
tion times — the times between activi- 
ties. For children with mental retar- 
dation, these unstructured times can 
be disastrous. Without careful manage- 
ment, the time can become confusing 
for a child, sometimes resulting in 

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 
aroimd and sets a smoother tone for 
the next activity. 

To 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. TTiis winding-down time is 
especially important for many mental- 
ly retarded children. Eric, a moderately 
retarded child, couldn't cope with 
sudden changes. If he was told to stop 
immediately, with no warning, he 
would throw himself onto the floor and 
bang his head. But when he was told 
a few minutes in advance that it was 
almost time to stop, he was able to 
shift gears and stop even his favorite 
activities without a tantrum. 



Children with retardation often 
have problems talking and under- 
standing speech. K there were twenty 
children in your class who were old 
enough to tie their shoes but didn't yet 
know how to, you would do more than 
give them twenty pairs of shoes to tie. 
You would teach them how to tie 
shoes. In the same way, children who 
have not yet learned the speech or 
language skills that other children 
have learned clearly need more help 
than just hearing people talk. If that 
were enough, they would have learned 
in the first place. The next few pages 
contain several suggestions for helping 
retarded children to communicate 


1. Be a Good Listener 

' It is difficult to practice talking if 
there is no one listening to you. 
Children with a language problem 
need to be listened to and rewarded for 
trying to talk. It reaUy helps them 

when they realize that adults will stop 
and Listen seriously to what they are 

Sometimes, children with speech 
problems are hard to understand. 
Usually, as you listen to them more 
and more, you begin to develop an ear 
for what they are saying. Parents can 
often help you understand their chil- 
dren. You might ask them for help. 

It is also important that you help 
the other children in the class under- 
stand what a retarded child is saying. 
It often happens, however, that the 
children understand the child better 
than you do at first! 

2. Talk About What You Are Doing 

Children's earliest speech is about 
the present— what is happening now. 
While you are doing things with the 
children, talk about them. For example, 
if you were helping the children make 
pretzels, you might make comments 
such as these: 

"We need to put the flour in the 
bowl. Hamilton is pouring it in. 
Mary, can you hold the bowl for 
him ? Okay, the flour is all in. Who 
can add the sugar? Good, ru)w the 
sugar's in. Jennifer is putting in 
the salt. " 


"Here goes the egg. 
What color do you 

78 3. Give Directions Simply 

Children with language problems 
sometimes don't do what you ask 
them to do because they don't under- 
stand what you want. Help them learn 
to follow directions by taking the 
following steps: 

• Get their attention. 

• Talk to them in language that is 
appropriate to their level of lan- 
guage development. For example, 
& the children speak in two- or 
three-word sentences, tell them 
what to do in three- or four-word 

• While you are talking, use motions 
to show them what to do. If they 
still don't understand, take them 
through the directions step by step, 
using your hands to move their 

4. Use What the Children 
Already Know 

It is easiest to leam something new 
if it is paired with something farrdliar 
when you teach it. For example, if a 
child uses single words and you want 
him or her to begin to use two words 
together, put together two single words 
the child already knows to make a 
two-word phrase. 

Sylvia has never used more than 
one word at a time. She knows the 
words "more" and "juice." Each day at 
snack time you might ask, "Sylvia, do 
you want more juice?" One day she 
may reply, "More juice." Then you can 
say, "Gk)od! You want more juice." 
Sylvia has spoken her first two-word 

5. Repeating Words Correctly 

Repeating what children say with a 
correction is called "modeling." It 
allows children to hear the right way 
of saying something without making a 
big deal about their mistakes. If 
Leon says, "I want more duce," you 
can reply, "Yes, you want more;ufce." 

6. Expand on What Children Say 

Expansion is like modeling, be- 
cause it also involves repeating what a 
child has said. But instead of just 
saying what the children have said, 
you add something more — you "ex- 
pand" the phrase. This not only shows 
them that you understand what they 
have said, it also suggests new 
information they might add. When 
Paul says, "Susie is hiding," you 
might say, "Yes, Susie is hidmg 
behind the blocks." 

7. Get the Children Talking 

Many retarded children with lang- 
uage and speech problems don't talk 
unless they are encouraged to do so. It 
is sometimes hard to t£ilk very much 
to children who don't answer very 
much. But in order to speed up their 
speech and language development, it is 
important to get these children talking, 
to keep them talking, and to listen to 
them. The following suggestions may 
help these children talk more. 

• Talk to the children while they are 
doing something. They are more 
likely to talk at these times, 
because they are less self-con- 

• Encourage the children to bring in 
special things from home, and give 
them time to share them with the 
rest of the class. 

• Encourage the children to talk 
about how they feel. Being able to 
tell a friend that you are angry 
may cut down on the need to hit 
your friend. Jn the same way, 
being able to say "I like you" has 
its special rewards. 

Let the children do as many 
different things in the classroom 
as possible. It gives them more to 
talk about. 

Teach the children how to give 
important information, such as 
their names and addresses. They 
will probably have to learn such 
information bit by bit. 

Teach the children a short rhyme 
or song they can perform for 
others. Being able to put on a 
show can really build children's 
confidence in their speaking abil- 

Include activities and words that 
are meaningful to the children. 
They have all heard the word 
"milk" but they may never have 
heard of "eggnog." 

Ask the children open-ended rather 
than yes/no questions. "What are 
you going to buy with that 
nickel?" is better than, "Are you 
going to buy sugarless gum with 
that nickel?" 

Listen when a child talks. Few 
people talk for very long if no one 
wants to listen to them. 


"What is on my 



Like all preschoolers, children who 
are mentally retarded need to learn 
skills in the following areas: 

• gross motor 

• fine motor 

• language and speech 

• self-help 

• social 

• intellectual. 

This section describes activities 
that can help children improve their 
performance in all areas of develop- 
ment. Each description involves ways 
of modifying the activity or tips to 
keep in mind so that mentally retarded 
children can participate. As you know, 
any activity can be used to teach 
many kinds of skills. Depending on 
how the activity is done, some skills 
win get more practice than others. For 
example, if you wish to use a puzzle 
activity to practice fine motor coordi- 
nation, any simple puzzle will do. But 
if you also want to practice the 
inteDectual skill of learning colors, you 
v^ need a puzzle with different 
colored pieces, so that you can teU the 
child, "Now, put the red piece in." You 
can use the activities in this section to 
provide practice in many other sldlls 
than the ones we have listed. 

" "Pick 
" "Stand beside 


Playground activities can help 
children improve their: 

• muscle coordination 

• body awareness 

• rhythm 

• balance 

• ability to follow directions 

• language development 
("Step on the circle." 
"Jump off the step " 

up the ball. " 
the tree.") 

• eye-hand coordination 

• socialization with other 


Playgrovmd or gym time should be 
a planned part of every day. The 
equipment that you need for the 
activity should be ready and in good 
shape (such as balls, hoops, beanbags, 
parachute, records). Time spent on the 
playground should aUow for free play 
as well as plaimed games and activi- 
ties. The activities should emphasize 
cooperative play whenever possible. 

Conducting the Activity 

1. Give verbal directions and show 
the children what to do. 

2. Stay close to children with retar- 
dation vmtil you are sure they 

3. Be sure you have planned the 
transition from one activity to 
the next. 


Some children can get too excited 
during free play. If this happens, 
invite the child to play with you 
(catch, kick ball, or animal walks). If a 
child consistently overreacts during 
free play, you might consider making 
up a plan for the child that leaves out 
free play for a while. 

Beanbags are easier to catch than 
balls. Provide them to ensure a child's 
success at catching. 

Rather than have the children 
choose sides in games, divide them by 
the colors of their shirts, or by 
separating them into two equal groups. 
It hurts not to be chosen for a team. 

End every activity in a way that 
makes starting the next one easier. For 
example, end a race by having aU 
children sit down when their turn is 

Be sure that the play area is safe: 
fenced, no glass, and small enough to 
be well supervised. 


Obstacle Course 

An obstacle course helps children 
improve their: 

• muscle coordination 

• body awareness 

• balance 

• socialization with other children 

• ability to follow directions 

• language development ("Go 
under the table," "Jump over 
the pillow," "Wiggle through 
the tire.") 


Set up a simple obstacle course 
inside the classroom or on the play- 
ground. Chairs, tables with blankets 
over them, rubber tires, and cloth 
tunnels can be put together to make 
an obstacle course. Make the first one 
easy so that everyone can do it alone 
or v^th little help. 

Conducting the Activity 

1. Show the children how to go 
through the course by doing it 
yourself, as much as you can, or 
by having a child demonstrate it 
for the others. 

2. As the children go through the 
course, describe what they are 
doing. ("Susan is going imder 
the chair, through the tunnel, 
and over the chair.") 

3. Let children take several turns 
for fun and practice. 


Check the course for safety to make 
sure that a tumble wouldn't hurt 

Make sure the children go through 
it one at a time, so they can take it at 
their own pace. 



Simon Says 

An activity like "Simon Says" 
helps children improve their: 

• ability to follow directions 

• ability to imitate 

• muscle coordination 

• body image 

• balance. 


You need only to tell the children 
the rules of the game. Stand or sit in a 
circle with the children, and demon- 
strate the directions as you give them. 

Conducting the Activity 

1. Begin the game. Use "Simon 

says " on most directions at 


2. Play only as long as the game is 
still fun. 


Start with easy directions, and go 

A retarded child may need help. 
You or an aide might physically move 
the child through the motions at first. 


Pvizzles can help children improve 

• eye-hand coordination 

• sense of position in space 

• depth perception (near/far). 


Choose simple three-piece puzzles of 
animals or objects that the child can 
recognize. Find a quiet spot for the 
child to work on the puzzles, with just 
you or an aide. 

Conducting the Activity 

1. Show the child the puzzle. 

2. Name the pieces, as you point to 
them ("the red one," "the long 
one," "the rovmd one"). 

3. Show the child how to fit a piece 

4. Give the child that piece and tell 
him or her to "put it in." 

5. If the child can't do it, put your 
hand over his or her hand and 
put the piece in. 

6. Keep helping the child, gradually 
letting hun or her do more 
without help. 


Introduce puzzles to a child with 
retardation one at a time. It is best not 
to start a new pvLzzle imtil the child 
has mastered the last one. 

Don't be surprised if the child 
would rather twist, mouth, or feel the 
puzzle's pieces and holes than fit the 
pieces in. 

Field Trips 

Field trips can help children im- 
prove their: 

• language development (in- 
creasing vocabulary) 

• fine motor skills (handling 

• gross motor skills (walking) 

• intellectual skills (receiving 
information, association, 

• social skills (meeting 
people, socializing with 
other children). 


Before any field trip, plan how you 
wall provide the extra supervision that 
is needed for a child with retardation. 
Cjet volunteers and notify the place 
that you are coming. Prepare all the 
children for the trip by teUing them 
about it several days ahead of time. 

Conducting the Activity 

1. Allow plenty of time to get 
everyone ready, so that no one 
feels rushed. 

2. Put a name tag on each child 
and assign adults to specific 
children. Be sure that each retar- 
ded child has one adult to hold 

I onto. 

3. Point things out to a retarded 
child. Re-explain things simply. 

1 Whenever possible, show him or 
I her how things work instead of 
just talking about it. 

4. Review the trip when you return: 
what the children did and what 

t they saw. 


Choose places or trips that have 
meaning for young children, such as 
the neighborhood store, the big kids' 
school, or a ride on a bus. It's 
important that the trip be short. 
Yoimg children tire easily and can 
become cranky without enough rest. 

Explain what happens at the 
places you visit: what the people there 
are doing, and why. 

Some typical field trips can be too 
exciting for very active children with 
retardation, such as going to a circus, 
a basketball game, or the zoo. Think 
twice about the value of the trip. 

If a child usually takes medicine at 
a time when you wiU aU be out of the 
building, be sure to bring the medicine 

Consider asking a retarded child's 
parent to come with you as a helper. 




Naming Objects 
and Pictures 

This type of activity helps children 
improve their ability to: 

• associate words with 

• progress from the concrete 
(objects) to the abstract 

• socialize vAth adult(s). 


This activity can be played like an 
organized game or done at any time 
during the day. All you need are 
pictures of some of the common objects 
in the classroom (chair, table, clock, 
doU, block). 

Conducting the Activity 

1. Ask a child to point to objects in 
the room that you name. "Show 
me the chair." "Show me the 

2. When the child can do that, have 
the child point to pictures of the 
same objects. 

3. When the child can point to 
pictures, ask him or her to name 
objects in the classroom. "What 
is this?" 

4. When the child can name the 
objects, have him or her name, 
pictures of the same objects. 


Try to keep this activity as much 
like a game as possible. It's most 
important not to turn the child off to 
language. If it looks like the fun is 
wearing thin, that's enough for this 

Help the child pronounce the 
words. Praise the child for every 
attempt to say words — effort deserves 


Dressing activities help children 
improve their: 

• independent dressing skills 

• concept development (up/ 
down, backwards/ front- 

• fine motor coordination. 


Some dresing and undressing activ- 
ities happen every day in Head Start 
classrooms: for example, taking off 
and putting on sweaters, boots, gloves, 
and smocks. Children may need more 
help and practice with some lands of 
clothes than with others. Start with 
outerwear, such as jackets and coats. 
Set aside a time each day to work on 
dressing and undressing skills. 

Conducting the Activity 

1. Break the task down into small 
parts, teaching one step at a 
time. (See the description of task 
analysis, earlier in this section, 
for a specific example of how to 
do this.) 

2. Praise each effort and each 


Don't try working on dressing 
skills imtil the child is ready and 

Start with simple, loose-fitting 

Don't rush. Take time to demon- 
strate each step to the children, and 
give them plenty of time to attempt it 
on their own. It helps to practice 
dressing skills with some children 
each day. 


As we all know, rest is also an 
important "activity." It is especially 
important for young children. Some 
children with retardation need more 
rest than non-handicapped children. 
Rest gives them and other children a 
chance to relax and be calm, even if 
they don't fall asleep. 


Make rest a regular part of the day 
that children can anticipate. Have a 
cot or pad available for each child, and 
figure out a routine for getting them 
out and putting them away. 

Conducting the Activity 

1. Have children get out the rugs, 
mats, or cots, following the 
established routine. 

2. Help the children to relax by 

Slaying soft music, dimming the 
ghts, tellng a quiet story. 

3. Find a gentle way to end the rest 
period and put away the rugs, 
cots, or mats. 


Don't expect all children to nap. 
Allow for quiet movement and quiet 

Don't expect children to rest right 
after a noisy activity. Help to quiet 
and relax them before rest time. 
Everyone needs some calming down 




Story Reading 

Reading stories to children can 
help them improve their: 

• ability to pay attention 

• listening skills 

• vocabulary development 
(naming pictures) 

• language development (im- 
derstanding spoken words) 

• sequencing (retelling the 

• socialization wdth class- 

• ability to connect written 
words with spoken words. 


Plan ahead of time which book to 
read. Try to find one that ties in with 
something else the children have been 
doing or are going to do that day. For 
example, if someone is bringing a pet 
turtle to school, you may want to read 
Dr. Seuss's Yertle the Turtle. Big, 
bright, colorful pictures, pop-up illus- 
trations, and touchable books help 
mentally retarded children stay inter- 
ested and timed in. 

Prepare the children for a quiet 
activity by talking softly, playing 
restful music, suggesting they think 
about quiet things (such as a leaf or a 
snowflake falling to the ground), or 
perhaps giving them back rubs. 

Conducting the Activity 

1. Let the children get comfortable 
on mats, piQows, or rugs, in a 
place where each can see the 
book and pictures. Make sure, 
though, that they aren't so 
crowded together that they 
bother each other without mean- 
ing to. 

2. Before you begin to read, teU the 
children a little about the story 
and what to watch and listen for. 

3. Read the story using different 
voices for different characters. 
Vary the loudness and softness 
of your voice. Change the speed 
a little, but don't read so fast 
that children can't foUow. 

4. Show the pictures as you go 
along, giving children time to 
look, touch, and feel the illustra- 

5. Encourage the children to com- 
ment on the story and to reteU 
parts of it. 

6. Tie the story back to the class- 
room activities. "We have a 
turtle, too." 

7. If some children find the stories 
too hard to understand, choose 
simpler ones to read to them, in 
a small group or individually. 


People listen in all kinds of posi- 
tions. It's okay if the chQd wants to 
lean on you, lie down, or listen from 
vmder the table. 

If the child wanders away, don't 
make a big deal about it. You may 
want to draw the child back by asking 
him or her to point to something. Or 
you can have the child help you turn 
pages. Or you can wait until the next 

Use short stories. Children especial- 
ly like rhyming words and nonsense 
sounds in rhythm. 

Sometimes children with retar- 
dation win tear a book out of excite- 
ment or because they don't know what 
books are for. Show them how to 
handle books, stay with them as they 
learn, and provide books with cloth or 
plastic pages to practice with. 


Snack time can be an opportunity 
for children to improve their ability to: 

• eat independently 

• socialize with classmates 

• speak (ask for what they 
w^ant, name foods) 

• grasp and coordinate eye- 
hand movement 

• understand concepts (nmn- 
ber of crackers, size of cup). 


Have the snack, plates, cups, nap- 
kins, and anything else you need clean 
and ready. 

Conducting the Activity 

1. Let the children take turns set- 
ting the table, passing the snack, 
and cleaning up. Show a retar- 
ded child how to do each task 
and give help when needed. 

2. Establish a routine for getting to 
1 the table and being served. 

3. Use snack time as a social time 
to share, talk, and take turns. 

4. Use snack time as a self-feeding 
teaching time for ret£trded chil- 
dren who are just learning to eat 

5. Use a routine for clean-up. 


Have snack at the same time every 
day, so that the children can antici- 
pate it. 

To help a retarded child learn to set 
the table, put down placemats that are 
marked with the table setting: 

Set the rules about "seconds" ahead 
of time. 

To avoid spills and crashes, show 
each child how to pour into cups and 
pick up plates. 

Be prepared for some mistakes 
while the children learn. Have a 
sponge or paper towels handy to clean 
up spills. 





Stencil activities can help children 
improve their: 

• eye-hand coordination 

• sense of direction (left/right, 

• understanding of concepts 
(shapes, angles, curves). 


If the children can't imitate lines, 
circles, and other shapes on their own, 
stencils can help them learn to 
recognize such shapes and the motions 
involved in making them. 

Use plastic stencUs or make sten- 
cils out of heavy cardboard. You may 
want a stencil for a vertical line, 
horizontal Une, circle, square, and 
triangle. Have ready paper, a crayon 
or felt-tip pen, and tape. 

Conducting the Activity 

1. Tape the stencil to the paper at 
one edge, so it won't sUp. 

2. Show the child how to mark 
inside the stencil. 

3. Guide the child's hand initially, 
until he or she can manage 

4. Be sure to pick up the stencil to 
show the child what he or she 
has made. 


Check to make sure that the child 
is ready for this kind of activity: are 
the child's hands steady enough? 


An activity such as the old sheU- 
and-pea game lets children work on: 

• concept formation (object 
permanence: things con- 
tinue to exist even though 
you can't see them) 

• receptive language (under- 
standing directions) 

• eye-hEind coordination 

• socialization with an adult. 


Find a small object that the child is 
especially fond of Have two or three 
cloth diapers, towels, or similar cover- 
ings ready. 

Conducting the Activity 

1. In a quiet comer, show the object 
to the child. Let the child handle 

2. Lay the pieces of cloth in front of 
the child in a row. 

3. Slip the object under each of the 
pieces of cloth briefly, then leave 
it under one of them. 

4. Ask the child to find the object. 

5. Repeat. 


Be sure the child likes the toy well 
enough to search for it. 

Use cloth that you can't see 

You might start with a fairly 
large toy and gradually shift to 
smaller ones. 

"Can you find the car?' 

'Good for you! You found it!" 


Music activities can help children 
improve their: 

listening skills 

ability to pay attention 

sequence and sense of rhythm 

fine motor skills (manipulat- 
ing musical instruments) 

speech development 

ability to socialize 

body movement. 


Plan activities in music so that 
they relate to other classroom activi- 
ties. If you are doing a unit on 
animals, community helpers, or body 
parts, find songs to play and sing that 
relate to these topics. Have all the 
equipment that you need (record 
player, rhythm instruments, records) 
ready and working. Plan ways for a 
child with retardation to be successful 
in the activity. For example, the child 
may clap along, beat a drum, or 
march to the music. 

Conducting the Activity 

1. Tell the children what the activ- 
ity is. Show them how to do it. 

2. Allow some time for the children 
to do what they would Like to do 
with the music: march, clap, sing. 

3. Relate the music to the other 
classroom activities. 


Show a child with retardation how 
to use a rhythm instrument. Help the 
child make the instrument work. 

Use different lands of music to 
calm down or pep up the children, or 
as a gentle way to signal a change in 





Sorting activities help children 
work on: 

• concept formation (classifi- 

• receptive language (under- 
standing descriptions of 
objects: "Put the red cars 
here and the blue cars 

• eye-hand coordination 

• socialization. 


Have the materials to be sorted 

Conducting the Activity 

1. Explain and demonstrate the 

2. Once the child imderstands, let 
him or her take several turns. 

3. Give help as needed. 

4. When the child finishes, check 
the work. Ask the child to teU 
you what he or she did. Praise 
efforts and successes. 


Start with objects that differ fi:om 
each other in only one way. For 
example, you might have ten small 
trucks— five blue and five red. When 
you are sure that the child knows how 
to sort these, you can make the game 

Using pictures rather than objects 
is one way to make the activity 
harder. Another way is to the 
number of things and the ways in 
which they are different. For example, 
put all of the small, blue circles 
together and all of the large, green 
circles together. 

Having the children sort by func- 
tional categories makes the activity 
still harder. For example, put all of the 
things we could ride in together; put 
all of things we codd eat together. 

Be sure the objects for sorting are 
interesting. Make sure the materials 
are safe; you may want to laminate 
many of them. And finally, choose 
objects that are easy to handle and 
that won't bounce or roU away from 
the child. 

Small-Group Activities: 
Art, Cooking, Science 

Small-group activities such as 
painting murals, baking cookies, or 
caring for classroom pets can help 
children improve their: 

• ability to cooperate 

• ability to pay attention 

• ability to follow directions 

• language £ind speech devel- 

• socialization with other 

• concept development 

• eye-hand coordination. 


Have materials and equipment 
ready. Be prepared to give extra help 
to retarded children or to modify the 
activity to help them be successful 
with it. 

Conducting the Activity 

1 . Demonstrate the activity. 

2. Assist any child who is having 

3. Have a routine for cleaning up 
and putting away. 


Retarded children tend to learn best 
when they are taught one at a time or 
in small groups. Plan as many 
activities as you can for small groups. 

Be prepared to stop children before 
they do too much and ruin what is 
being made. 

Make siu-e all materials are non- 
toxic. After all, paint and paste look 
good enough to eat. 

Stand nearby to prevent grabbing, 
ripping, and so forth. 


92 Summary 

Below is a chart of the activities 
discussed in this chapter. It is de- 
signed to help you identify at a glance 
which activities are especially useful 
for the different skill areas that 
children with retardation need practice 
in. As you see, every activity provides 
practice in at least two skill areas, 
which means that the child will be 
helped in several ways at once. ("Rest" 
is not included on the chart— it's good 
for giving children energy for all the 
other activities!) 

You can determine which skill 
areas to work on from your owri 
observations of a particiolar child, and 
from your discussions with handicap 
specialists. Remember that these activ- 
ities are only examples — you know 
and do many more than these. No^y 
that you have seen how these activi- 
ties work on different skiU areas, think 
about the skills involved in other 
activities you do in school. Water play, 
blocks, dress-up comer, puppet play, 
and coloring all involve many sldll 

/ / 






Obstacle Course 




Simon Says 







Field Trips 





Naming Objects 
and Pictures 







Story Reading 





• • 






Hidden Object 













Art, Cooking, 




• Skill areas the activity is especially good for. 

Chapter 5: 



Teachers as 


Working with 
parents as partners 
will help you, the 
child, and the parents. 

94 One of Head Start's unique 
achievements has been the in- 
voh)etnent of parents in the educa- 
tion of their children. Parents are 
the primary educators of their 
children, and their involvement is 
the cornerstone of a successful 
Head Start program. This partner- 
ship is even more important in the 
education of a child who is handi- 
capped, 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 
preschool experience the child 
and parents will participate in. 
Making it a successful ex- 
perience will have positive ef- 
fects 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 need to reinforce what you are 
teaching in preschool if maxinnun 
progress is to be made. Changes in a 
child that come about through your 
efforts, the efforts of specialists who 
provide services, and the experience of 
mainstreaming affect parents. For all 
these reasons, it is important that the 
parents participate directly in \yhat 
you are trying to accomplish with the 
child in the program. 

Direct parent involvement in de- 
cisions affecting their child is es- 
sential. They should decide with you 
what and how you teach their child, 
and what efforts they wiQ make at 
home. They should participate in 
decisions involving formal assessment 
and diagnosis of their child, and 
selection and arrangements for any 
special services that are needed. They 
should be a part of any decisions that 
are made as a result of assessments of 
their child's progress. 

One of the major areas in which 
parents are needed as decision-makers 
is in the development of an individual- 
ized education plan for their child. 
This plan is a written statement 
developed in meetings of the diagnos- 
tic team, the parents, and the teacher. 
It spells out the educational goals for 
the child, the activities that wiU take 
place in the classroom, the involve- 
ment of parents, the special services 
that will be provided by other 
agencies, and details of the evaluation 
procedure. Parental consent is required 
by law at two points: to give permis- 
sion 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 
guarantee that parents have their 
rightful say in the education of their 

The rest of this chapter discusses 
specific ways in which parents can 
help in the education of their child, 
and provides guidelines for teachers in 
worlong with the parents of handi- 
capped children. 

A teddy-hear from home 
helps her feel secure at school. 

Can Do 

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 
might begin by taking the following 


Get to know your child's teacher. 
Give him or her a realistic idea 
of how much you can do. Take 
into consideration the amount of 
extra time you can afford to 
spend working with your child, 
as well as how much time you 
would like to spend. Even if you 
have a fair amount of free time 
avaOable, you may find it diffi- 
cult to work closely with your 
chOd for long periods of time. 

2. Recognize that you have a 
tremendous influence on the 
growth and development of your 
child. What you do does make an 
enormous difference. Try to partici- 
pate in your child's learning as 
much as possible. 

3. Seek guidance from your child's 
teacher if you are not certain 
how to use everyday events at 
home as learning 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 

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

The next section discusses how to 
prepare your child for the Head Start 
program, some things you may find 
helpful to discuss with the child's 
teacher, and how to use everyday 
events in the home to foster your 
child's development. 


96 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, bring your 
child to the Head Start center. Intro- 
duce yourself and your child to the 
teacher and other staff members. 
Encourage your cMld to explore the 
classroom and to play with some of 
the materials. Try to make sure that 
your child has a good time diuing this 

Because some retarded children 
function like much younger children, 
they may be fidghtened at first about 
leaving home. You and the teacher 
may 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 
have to feel comfortable in the class- 
room 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 seciuity. 

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 
visitor, or a trip), or unhappy times 
(such as death, illness, or disruption in 
the family routine). 

Skill Areas 

You may feel that you need help 
from the teacher in understanding the 
skill areas— such as language skills, 
motor sldlls, social sldlls, self-help 
skills— that your child has serious 
weaknesses in. Don't hesitate to ap- 
jroach the teacher for this help, or for 
lelp in figuring out ways to use daily 
lome activities to help bmld on the 
child's strengths and work on the 
child's problems. 

Try to talk frequently with the 
teacher in terms of specific skills. 
Exchange suggestions. If yoiu- child is 
living witii both parents, both of you 
should try to get involved in confer- 
ences and conversations. Each parent 
may have a different perspective. 

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 yoiir 
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 
opportunity to exchange ideas with the 

Describe to the teacher an average 
day at home, in order to learn how 
you can use these everyday events to 
work on the skills your child is having 
problems with. 

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 
possible in daily activities at home, 
just like other children. If it's good for 
a non-handicapped child to help feed 
the dog, then it's good for a retarded 
child. Any activity the child can be 
involved in can go a long way toward 
helping him or her build self-confi- 
dence and competence. 

You win probably have to make 
some additional effort to help your 
child become actively involved in daily 
events. Work out with the teacher 
what you can realistically do, but 
recognize that extra effort is necessary. 

Talking about the pictures helps a retarded 
child to learn. 

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 very 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 extra suggestions 
for things you can do. Talk with the 
teacher about what you like to do with 
your child and about what the child 
likes to do at home. Those activities 
can all be learning opportunities. 

If you would like some specific 
activities to do at home with your 
child, look over the activities in 
Chapter 4. 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 daily routine as a way 
to teach the child. All of the things 
that you do at home can be used to 
help the child with special needs learn 
more about the world. 

1. Using the Daily Routine 

For example, you can describe 
what you're doing when you turn on 
the lights, set the table, or make the 
bed. You can point out and name 
colors in the house and outside. You 
can name your child's pieces of 
clothing. You can give the child simple 
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 
your child improve. 

Be consistent in what you ask your 
child to do. If it is reasonable to expect 
a child to hang pajamas on a hook in 
the morning, then you should expect 
the child to do this every morning. 


98 Expensive toys or materials aren't 
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 teach- 
ing 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, coimted, and folded 
together. Pictures can be named, or 
used to tell stories. 

Most handicapped children need 
more, not less, stunulation from people 
aroimd them. A good and simple way 
to achieve this is for you and other 
members of the family 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 a retarded child. 

Confusion and failure can result if 
you shower the child with too many 
activities. As you work with yoiu" 
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 theu* own, since we 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 has clumsy or unco- 
ordinated body movements, you may 
worry that he or she could get hurt by 
aU that tripping and falling. You may 
even feel that you should put the child 
in a playpen or crib to protect him or 
her from bumps and bruises. Doing so, 
however, is a disservice to your child, 
who learns best about the world by 
exploring it firsthand. You might ask 
the teacher to suggest how to "child- 
proof your home so that exploration 
is less dangerous for a child who isn't 
too steady on his or her feet. 

3. Praise and Encouragement 

We aU benefit from honest praise — 
children as well as adults. Praise 
program staff honestly for their efforts 
with your child, and ask them for 
feedback 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 sit still to managing to eat 
independently — represents real prog- 
ress and deserves real praise. 

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

It is important, however, that your 
praise be honest, and that your child 
has done something to earn it. Chil- 
dren with retardation, just like other 
children, are very good at recognizing 
insincerity. If you praise your child at 
times when he or she has not been 
trying or has not mastered something, 
the youngster will be confused and will 
not understand what your expectations 

Ask the teacher to share asses- 
ment results with you . Everyone invol- 
ved should understand how the child 
is functioning and share pleasure in 
the child's progress. 

Can Do 

Guidelines for 
a Partnership 
with Parents 

Parents of children with special 
needs are as concerned about their 
children as any other parents, if not 
more so. One difference for parents of 
a retarded 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 work with parents. 

1. Establish and Maintain Contact 

Describe the Head Start program 
in detail, and invite the parents to 
observe and participate in the class- 
room. Work out the child's educational 
goals in conference with them. Review 
the child's short- and long-term objec- 
tives with them at least every three 
months, or whenever needed. 

I Although at least two home visits a 
year are required in Head Start 
programs for aU children, you may 
need to make more visits if a child is 
handicapped. Maintain contact with 
the parents as often as you can. Visits, 
phone calls, notes, and sending chil- 
dren's projects 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 parent, along with every- 
thing else I have to do?" 

Some teachers and parents send a 
notebook back and fortn each day or 
so. Teachers write a short note and 
send it home. Parents write one back 
for the child to take to preschool the 
next day. 

2. Know the Family's Limits 

Everyone has a personal limit on 
how much he or she can do for a chQd 
at home or in the classroom. Get to 
know families well enough to under- 
stand these limits. Make sure that the 
suggestions you give them for working 
with their cMld can easily be included 
into their daOy routine. For example, 
ask parents to talk to their child as 
they help him or her dress, to name 
the foods the child is eating, and to 
give the child simple things to do (like 
putting a spoon by each plate). 
Encourage parents to visit and partici- 
pate in your classroom as much as 
they can. 


100 3. Focus on the CMld'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 aU problems and 
frustrations, and they may expect 
much less from the child than he or 
she is reaUy capable of. They may 
need the help of a psychologist, a 
social worker, or a counselor in 
learning to accept and deal with these 

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 
feelings, if you feel they need it. Your 
main role is to be the teacher of the 
child. You should concentrate on the 
child's education and development. 

4. Recognize and Deal with Your 

Be aware and honest with yoiu*self 
about yoiu' own feelings toward a 
handicapped child and his or her 
family. Negative feelings, such as 
blame, anger, sorrow, nervousness, 
and fear, are imderstandable. Getting 
to know the child and the family helps 
to reduce some of these negative 

Think positively about children 
with special needs. Focus on what 
they can do, not on what they can't 
do. Help the parents see their child .as 
someone who can grow, learn, and 
improve, no matter how severely 
handicapped. Most of us feel better 
about ourselves when people look at 
our strengths rather than our weak- 

5. Be Reassuring, but Be Honest 

Parents may be worried and upset 
when their child is about to be 
evaluated for the first time, or re- 
evaluated. At such a time, it might be 
tempting for you to tell them not to 
worry, and to teU them that everything 
wUl 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 
reassuring, be calm, be imderstand- 
ing — 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 talk or 
move or act like other children by the 
end of the year?" Don't be afraid to 
say that you don't know the answers, 
but help parents find someone with 
whom they can discuss their concerns. 
Your social services personnel should 
be able to help you find people who 
can answer some questions. The 
answers to other questions, such as 
"What will my child be able to do 
when he grows up?" are often vmcer- 
tain and complicated. Beware of people 
who have easy answers. 

Some parents need reassurance and 
evidence that they can help their child. 
Help tiiem see the many things that 
they already do that help their chil- 
dren, and tell them about all the 
things they are doing well. 

of Parents 

Parents of Children 
with Special Needs 

Parents of handicapped youngsters 
often have special concerns. In gen- 
eral, 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 con- 
cerns that parents of children with 
handicaps often have should help you 
understand what some parents mean 
when they hint at a concern without 
actually saying it. 

Enrollment in a Mainstream 

Parents may worry that their chOd 
will not fit into the Head Start 
program. 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 Hsten to what is going on — 
let them see for themselves how their 
child plays with and works with the 
other children and with you. Seeing is 

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 tease their child. You can 
reassure them that preschool-aged chil- 
dren are usually too young to notice 
handicapped children as different 
unless the handicap is very obvious. 
They usually can't pick out a retarded 
child to tease. You can also tell them 
that you do not allow teasing or 
bullying of any child in your class- 
room, 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 
children with special needs. It is not a 
reason for a child to avoid the 
classroom, any more than it is a 
reason for a child to avoid the rest of 
the world. You can teU parents that 
managing these situations, when and 
if they arise, is a normal part of your 

"Seeing is believing" fits here, too, 
so invite the parents to visit the 
classroom so that they can get a 
feeling for the atmosphere themselves. 

Throughout the year, keep the 
parents 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 these situa- 
tions at home. What do the parents do 
to help their child play with brothers 
and sisters or with neighborhood 

You have developed a number of 
techniques for helping children co- 
operate and get along in yovir class- 
room. You will probably find that 
these techniques are just as useful for 
a child with special needs. 


102 Teacher's Time 

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

The Future 

Parents may worry that their child 
will not make progress in your pro- 
gram. You can assiu-e them that there 
are many things that you can teach 
their child, and that their child will 
also learn a lot from the other children 
in the class. 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 progress in the future, but that 
you wiU help the child learn as much 
as he or she can in Head Start. Be 
honest when you describe the sldU 
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 the child is 
progressing at home. 

As with non-handicapped children, 
if you genuinely like a child, and if 
you and other staff members in yoiu: 
program have worked out a sensible 
plan to meet the child's needs and 
stimulate his or her development, you 
have a solid basis for developing a real 
partnership with the parents. While 
jarents of handicapped yoimgsters 
lave some concerns that are different 
rom the concerns of other parents, - 
you can use the same skills and ways 
of working with them that you have 
already developed in yoiu: conversa- 
tions and personal contacts with other 

Parents of 



Many Head Start programs have 
children with handicaps in their 
classes. Generally, parents of non- 
handicapped children in a mainstream 
classroom have no strong concerns 
about the presence of a child with 
special needs in the class. If the 
parents of a non-handicapped child are 
concerned, invite them to come to your 
classroom to see for themselves. This 
will show them that a handicapped 
child is first and foremost a child and 
an individual, Uke their own child. 
Visiting your mainstream classroom 
wiU help dispel incorrect ideas parents 
may have about a handicapped child 
whom they have never met. 

If some parents express a concern 
that their child wiU pick up undesir- 
able behavior from handicapped chil- 
dren, you can explain to them that it 
is normal for children to copy the 
behavior of other children— this is one 
of the ways they learn. However, 
undesirable behavior tends to be 
outgrown quickly, once it has been 
tested and met with disapproval. 

If parents would like to talk to their 
child about handicaps, you might 
suggest that they do this in a factual, 
non-emotional way. If the parents are 
concerned that you won't have enough 
time for their non-handicapped child, 
you can describe to them the staffing 
arrangements your program has made 
to enable all children to have enough 
teacher time. If they are worried that 
their child might be hurt by a child 
with retardation, you can point out 
that there is no more danger of injury 
from a retarded child than from any 
other child. 

In general, be calm, reassiuing, 
and objective, and describe the very 
real benefits to their child of main- 
streaming a child with retardation in 
the classroom. 

Chapter 6: 

Where to 


Help in 

"four Area 

A team of people is 
needed to help you 
mainstream. There 
are many kinds of 
professionals who can 
provide help. 

104 Head Start is a comprehensive 
child development program for all 
eligible children— handicapped 
and non-handicapped. It includes 
jnainstreaming experiences in the 
classroom; medical, dental, mental 
health, and nutrition services; 
parent involvement; and social 
services. To strengthen services to 
handicapped children, Head Start 
programs are required to make 
every effort to work with other 
programs and agencies who serve 
these children. This cooperation is 

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 different kinds 
of skills and knowledge. You are 
the primary planner of the child's 
daily educational program and the 
person who is central in carrying 
it out. But it will help you and the 
child if you can work with these 
specialists in your Head Start 
program and with other 
specialists in your community. 
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 provMe, how you can make 
the most of what's available, and 
the kinds of specialists you may 
meet as you work with handi- 
capped children. 


To find out about resoiirces, start 
by asking questions. Ask other teach- 
ers, your center director, other program 
staff, and then ask people they 
suggest. You need some basic informa- 
tion about the kinds of support 
personnel available in your program. 
For example: 

• Is there a handicap coordinator, 
a mental health professional, 
or a health coordinator who is 
familiar with retardation and with 
retarded children, and who can 
suggest materials, methods, and 
additional resources? 

• Is there an educational co- 

ordinator, a director of educa- 
tional services,or another 
classroom teacherwho can help 
you to make any changes in your 
program as needed by a retarded 

• Does the program have a social 

Avorker, a social services direc- 
tor ,or a parent-involvement 
staff memberwho can help 
arrange contacts with the child's 
family and with resources outside 
the program? 

• Does your program have 

consultantSjWhether from the 
Head Start regional office, public 
schools, nearby colleges or univer- 
sities, community health or social 
service agencies, a state depart- 
ment of education, the State De- 
velopmental Disabilities CoimcH, 
or local chapters of national associ- 
ations serving mentally retarded 
children? (For more information on 
national associations, see the 
section in Chapter 7 on profes- 
sional and parent associations.) 

Head Start 



Certain components — social ser- 
vices, health services, educational ser- 
vices, handicap services, and parent 
involvement — are found in Head Start 
programs. Programs vary greatly, 
however, 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 program 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 people 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 
person (or people) can help you put 
together a team of specialists to work 
with you and a retarded child in your 
class. When needed, the teacher and 
the social services person work to- 
gether to arrange referrals for children 
and families who need diagnosis and 
treatment or family counseling. Social 
services oversee the follow-up, too, 
making sure appointments are made 
and coordinating services 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 receiving. 

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. 

He£dth 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 program for diagnosis 
and treatment. This means they can 
help you get health information or the 
services of specialists for a child. For 
example, an ophthalmologist or 
optometrist (eye specialists) may be 
called upon to examine a child with 
vision problems, or an audiologist 
(hearing specialist) may be recruited to 
assess a child's hearing. A mental 
health professional such as a psychol- 
ogist can diagnose mental retardation. 
Other specialists such as a neiu-ologist 
(nervous system specialist), an occupa- 
tional therapist (activities specialist), a 


106 physical therapist (movement special- 
ist), or an otologist (ear specialist) may 
be consulted when necessary. 

You will want to know who in 
your program is responsible for con- 
tacting and coordinating health 
service agencies, and what your 
relationship is with the agencies. 
What kinds of assistance can you 
expect from them? What conference 
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) have or 
will have access to these resources, 
either within the program or 
through outside referrals. 

Be sure that the parents are 
completely informed of any plan for 
services for their child, and that they 
give their consent. 

Education£d Services 

This component comprises all 
aspects of the educational program. 
All Head Start programs 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 
can provide guidance and advice to 
teachers in the classroom. This advice 
would include helping you to observe 
a child systematicaDy, to assess a 
child's skills, and to develop and carry 
out an individualized education plan 
for a retarded child. Your center's 
educational director should be able to 
help you tailor classroom activities to 
meet each child's needs. 

Parent Involvement 

Parent involvement, a cornerstone 
of Head Start, encourages family 
participation in all 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 com- 
mimity. To achieve parent involve- 
ment in a child's Head Start experi- 
ences, each program works toward 
increasing parents' understanding of 
their child's needs and how to satisfy 
them. Project Head Start is based on 
the premise that successful parent 
involvement requires parents to par- 
ticipate in making decisions about the 
program and about what kinds of 
activities are most helpful and impor- 
tant 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 in the organization of 
your program, the people in this 
component are responsible for the 
coordination 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 with 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 to- 
gether, the better the child wiU do in 
your class. 

Handicap Services 

A handicap coordinator is respon- 
sible for supervising the mainstream- 
ing of all handicapped children in the 
program. This person is usually 
farmliar 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 relationshin 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 
provide a free public education to all 
handicapped 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 as well. 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 
director of special education is a good 
resource for such information. 

One aspect of the Education for All 
Handicapped Children Act that 
concerns Head Start teachers and 
parents is its outreach component. 
Under the law, public school systems 
are required to demonstrate a practical 
method for identifying 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 also varies 
from state to state. In some, it consists 
of an advertising campaign to let 
parents, teachers, and others know 
whom they 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 in addition to 
a public awareness campaign. To take 
advantage of this service, which is 
your right under the law, call the 
director of special education in your 

local school system, the superintendent 
of schools in your town, or the special 
education section of your state's de- 
partment of education. 

Since the Head Start program in 
many states enrolls children for whom 
the pubUc school system is also 
responsible, this means that there are 
many services that the school district 
will be able to provide for these 
children in your classroom, such as 
free diagnoses and specialists' services. 
The handicap coordinator or someone 
else in your program should be in close 
contact with the public schools in your 
community, and should know aU of 
the resources available and how to 
link up with them. 


108 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 commimity, however, 
there are other people who know what 
agencies or people provide the services 
you need for a child with special 

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 contact this person to alert 
the school system to the special 
needs of a child. After all, the child 
wiU 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 
development problems in children. 
Sometimes the hospitals have special- 
ty clinics for children with particular 
health and developmental problems, 
such as mental retardation. The 
services the hospital can offer wiU 
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 
Affiliated Facility, which provides 
direct services to handicapped children 
and their families. The address for this 
resovirce is given in Chapter 7, page 

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 
possible sources of training and tech- 
nical assistance and enlist their sup- 
port in helping Head Start programs 
find and serve handicapped children. 
The addresses of the RAPs are given 
in Chapter 7, pages 123-124. 

Often, parents of school-age retar- 
ded children are very knowledgeable 
about the resources that can be tapped. 
Find out if your community has an 
organization for parents of retarded 
children. You coiJd also write to the 
National Association for Retarded 
Citizens (address given on page 121), 
because local parent groups are often 
affiliated with this organization. 

How to Make the Most 
of Available Resources 

You can make the most of avail- 
able resources by taking the following 

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 prob- 
lem first with other Head Start 
teachers 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're aiming for so you 
can plan activities to meet that aim, 
and so you wiU know when you have 
reached it. 

3. Agree on Responsibilities 

Work out together with the special- 
ists what you expect from them and 
what they expect from you. People 
sometimes start out with different 
expectations— such as who is respon- 
sible for working with the child (the 
specialist or the teacher), or who is 
responsible for checking on whether 
the plan has worked. Responsibilities 
need to be spelled out so tiiat an 
agreement can be reached. 

4. Make Sure You Understand 

Advice and explanations that don't 
tell you specifically what you can do 
for a child in your classroom leave you 
as stranded as you were before. If you 
don't understand, ask. Some specialists 
are used to saying things in com- 
plicated ways, and they need to be 
reminded to say them in plain 
English. Advice won't do any 
good if you can't use it. And if 
you don't understand it, you can't use 

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 
specialists need to know 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 every- 
one else is doing, so that the services 
can be coordinated. Otherwise, two 
specialists could be providing the same 
services for a child — or even worse, 
no one coidd be providing them. 

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

6. Consider Parents Specialists 

Work with parents in the same 
way that you work with specialists. 
Parents are specialists on their own 
child's needs, strengths, problems, 
likes, and dislikes. Fiirthermore, like 
working with specialists, working with 
parents involves agreed-upon objec- 
tives, knowing what each of you is 
doing, knowing how the child is 
progressing, and regular contact. 

7. Expect a Lot 

You will be working with a child 
who has problems that may be 
unfamiliar 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 resoiirce persons both inside and 
outside your program, you need to be 
doing a great deal yourself. You need 
to identify what the child can cur- 
rently do and what he or she is 
developmentaUy prepared to learn. At 
the same time, you will 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 child, and 
the child's family. 




Using Local 
Resources for 


• observes child 

• records information 

• develops questions 

• identifies where help 
is needed. 

Head Start 
for Referral 


• receives results 

• coordinates program 

• coordinates foUow- 


Team Within 

Educational Services 
Handicap Services 
Health Services 
Parent Involvement 
Social Services 

determines additional 
information needed 
plans strategy for 
gathering information 
provides, seeks, and 
coordinates services 
makes referral to outside 




• observes child 

• notes information 

• develops questions 

• identifies where help is 


Resources } 

Head Start 


Outside 1 






for Referral 

• translates information 
into educational 



Occupational therapist ^^ ^k 

• processes referral ^^ ^^ 

• carries out educational 

Ophthalmologist ^^^ ^M 

previews questions ^^^m ^h 


Pediatrician ^^P ^B 

W draws together inforrnf^T^ ^M 

^ assesses progress. 

Physical therapist ^w ^r 

tion and resources from^^ "▼" 


within program. 

Speech-language patholo- i 

gist 3 


Neurologist i 


Optician ^ 




Otologist 1 


Social worker 

■ ^ 


Colleges and universities 

• translates information 

into home activities 

Professional associations 

• discusses educational 

Public school personnel 

plan with Head 

Resource Access Projects 

Start staff 

Social service agencies 

• assesses progress. 

State departments of 


University Affiliated 


• provide additional 


• recommend steps to 


"' Who Are 

the Specialists? 

What Do 
They Do? 

This section describes the special- 
ists mentally retarded children are 
most likely to need help from, and the 
kinds of help they can provide. Other 
specialists who work with handi- 
capped children are described in the 
section beginning on page 116. 


A psychologist conducts 
screening, diagnosis, and 
treatment of people with 
social, emotional, psycholog- 
ical, behavioral, or develop- 
mental problems. There are 
many different kinds of 

What Is Done 

Psychologists may ask chil- 
dren questions, observe them at 
play, ask the parents questions, 
and observe the children inter- 
acting with the parents. They 
may choose to administer stan- 
dardized tests to assess chil- 
dren's intellectual abilities and 
adaptive behavior (ability to use 
language, to play with others, 
and to do things independently). 
Psychologists sometimes use 
play activities to understand 
and treat children. At times 
they may want to talk with the 
whole faimly to help with prob- 
lems they might have concern- 
ing a particular child. Psychol- 
ogists can also help to decide 
what lands of educational pro- 
grams and activities would be 
best to improve children's intel- 
lectual abOities and adaptive 


A speech-language pa- 
thologist conducts screening, 
diagnosis, and treatment of 
children and adults with 
communication disorders. 
This person may also be 
called a speech clinician or 
speech therapist. 

What Is Done 

The speech-language pa- 
thologist talks with the child's 
parents and teachers to obtain a 
full case history of the child and 
an idea about the child's speech 
and language at home and in 
school. The pathologist then 
spends time talking to the child. 
Usually this is done in the 
context of a play situation. After 
this type of informal observa- 
tion, the speech-language pa- 
thologist gives the child a bat- 
tery of tests to assess the child's 
ability to understand and pro- 
duce speech. As part of a 
screening or evaluation, the 
child may be asked to draw 
pictures, say words, manipulate 
and name objects, describe pic- 
tures, repeat sentences, answer 
questions, or tell a story. 

Depending upon what is 
foxmd out from tests, observa- 
tion, and parent and teacher 
interviews, the speech-language 
pathologist may design and 
carry out a therapy program for 
the child. When the speech- 
language pathologist feels that 
there may be other problems 
contributing to the speech or 
language disorder, he or she 
may recommend that the child 
see an audiologist, psychologist, 
otolaryngologist, or other pro- 
fessional for further examina- 
tion and recommendations. 

The speech-language path- 
ologist can provide a teacher 
with specific instructional sug- 
gestions for a particular chila. 
The pathologist can also give 
the teacher ideas for develop- 
mentally appropriate objectives 
for the child. Finally, the 
speech-language pathologist 
may work with the parents of a 
child with a speech or language 


A pediatrician is a medi- 
cal doctor who specializes in 
childhood diseases and prob- 
lems, 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 
classroom, and what activities 
are within the child's capabili- 
ties. Nutritional problems may 
be identified. If there are specific 
health problems, such as epi- 
lepsy, the pediatrician may pre- 
scribe medication, or may sug- 
gest another specialist. 


114 Physical 

A physical therapist 
evabiates and plans physical 
therapy pro-ams. He or she 
directs activities for pro- 
moting self-sufficiency pri- 
marily related to gross 
motor skills such as walk- 
ing, sitting, and shifting 
position. He or she also 
helps people with special 
equipment used for moving, 
such as wheelchairs, braces, 
and crutches. 

What Is Done 

A physical therapist evalu- 
ates each child with whom he or 
she works before, during, and 
after each treatment program. 
The physical therapist may give 
muscle tests to see how strong 
each muscle is, and how much 
the child can move it. Such tests 
help a therapist to choose the 
right kind of treatment. The 
therapist may help a child 
practice walking, crawling, hop- 
ping, skipping, and going up 
and down stairs. A physical 
therapist also teaches children 
how to maintain their balance 
when standing, walking, and 

As part of a program of 
physical therapy for a particular 
child, the therapist can tell you 
if there are any exercises or 
activities that you can do to 
help the child, and can show 
you how to do them. 


An occupational therapist 
evaluates and treats chil- 
dren who may have dif- 
ficulty performing self-help, 
play, or school-related ac- 
tivities. The aim is to pro- 
mote self-sufficiency and in- 
deperulence in these areas. 

What Is Done 

After evaluating children to 
see how they use their muscles 
to eat, dress, and carry out 
preschool activities (such as 
drawing, cutting, and pasting), 
the therapist chooses exercises 
and activities designed to im- 
prove the child's motor skills in 
three areas. The self-help area 
includes feeding, dressing, toilet- 
ing, and washing. The play 
area includes moving the body 
(sitting, walking, handling ob- 
jects) and psychosocial aspects 
(getting along with others, toler- 
ance for frustration). The pre- 
school area includes perceptual- 
motor skills (paper and pencil 
activities, hand-eye and body- 
eye coordination) and the ability 
to move the body smoothly. 
This therapist will tell you what 
you can do to help the child, as 
part of the therapy program. 


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

What Is Done 

The ophthalmologist ex- 
amines the child's eyes using 
lights, simple pictures and toys, 
and a variety of instruments to 
discover how well the child sees. 
Ophthalmologists use different 
procedures in treating children, 
depending on what they find 
the eye condition to be. Ophthal- 
mologists may, for example, 
prescribe glasses and/or medica- 
tion, or perform siu-gery. If asked, 
they may suggest special 
modifications in teaching (such 
as in materials and seating 



An audiologist conducts 
screening and diagnosis of 
hearing problems, and may 
recommend a hearing aid or 
suggest training approaches 
for people with hearing 

What Is Done 

The audiologist performs the 
above services and can also be 
called upon to answer questions 
in the following areas: the 
nature of a child's hearing loss, 
what the child can and cannot 
hear, the usefulness of a hearing 
aid, the care of a hearing aid, 
and the availability of special 
programs for children with hear- 
ing impairments. 


Other Specialists 

Below is a list of other specialists 
who may work with handicapped and 
non-handicapped preschoolers. 

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

A Neurologist is a medical 
doctor who conducts screening, 
diagnosis, and treatment of 
brain and nervous system dis- 

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

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

An Optometrist examines the 
eyes and related structures to 
determine the presence of visual 
problems, eye diseases, or other 

An Orthopedist is a med- 
ical doctor who conducts screen- 
ing, diagnosis, and treatment of 
diseases and injuries to muscles, 
joints, and bones. 

An Otologist is a medical 
doctor who conducts screening, 
diagnosis, and treatment of ear 

A Psychiatrist is a medical 
doctor who conducts screening, 
diagnosis, and treatment of 
psychological, 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 Social Worker provides 
services for individuals and 
families experiencing a variety 
of emotional or social problems. 
This may include direct coimsel- 
ing of an individual, family, or 
group; advocacy, and consulta- 
tion with preschool programs, 
schools, clinics, or social 

Chapter 7: 



There are many 
associations and 
books that can pro- 
vide more detailed 
information on main- 
streaming children 
ivith mental retardation. 

118 In addition to specialists in your 
program, community, or region, 
there are other sources of help you 
can draiv on to assist you with 
children who are mentally retarded. 
Around the country are a number of 
organizations concerned with 
mental retardation. They can send 
you helpful information about 
retardation and about how you can 
work with the children in the class- 
room. There are also many good 
books and articles that you may 
find useful. These are listed in the 
bibliography at the end of this 





and Other 


For the associations and organiza- 
tions in this section, we have listed 
their national addresses, whether they 
have local branches, what they do, 
and how they can help you. 

American Association 
for the Education of the 

This is a new organization in the 
field of retardation. Its membership is 
committed to developing and sharing 
new knowledge about effective ways 
for working with severely and pro- 
foundly handicapped people. 

This organization has only a na- 
tional office. For more information 
write to: 

American Association for the Educa- 
tion of the Severely /Profoundly 

1600 W. Armory Way 
Seattle, Washington 98119 

American Association 
on Mental Deficiency 

This association is the oldest pro- 
fessional society devoted to research, 
training, and program development for 
persons with mental retardation. Its 
nearly 12,000 members are profession- 
als representing a variety of interests 
and disciplines dealing with many 
types of aevelopmental disabilities. 
The objectives of the AAMD are to 
effect the highest standards of pro- 
gramming for mentally retarded per- 
sons, to promote cooperation among 
those working with them, and to 
educate the public to imderstand, 
accept, and respect people with mental 

These aims are achieved in the 
following ways: The association serves 
on panels to develop and evaluate 
standards for services and facilities for 
retarded citizens. It plans national 
educational and informational semi- 
nars, and attends meetings at local, 
regional, national, and international 
levels. It supports legislation concerning 
the rights and services available to 
retarded citizens, as well as the 
prevention of mental retardation and 
related developmental disabilities. And 
it furthers the professional identity of 
all individuals and disciplines in the 
field of mental retardation. 

The association publishes many 
low-cost materials of interest to profes- 
sionals. AAMD has regional, state, 
and college/university branches. For 
more information write to: 

American Association 
on Mental Deficiency 
5101 Wisconsin Avenue, N.W. 
Washington, D.C. 20014 

American Association of 
University Affiliated Programs 

This organization is most interested 
in providing diagnostic services to 
individuals with developmental disabil- 
ities (which include mental retarda- 
tion) and in providing training for 
people who work with handicapped 
persons. University Affiliated Facilities 
provide services in areas such as early 
and special education, pediatrics, child 
development, child psychology, social 
work, child neurology, speech pathol- 
ogy, physical and occupational thera- 
py, nutrition, and nursing. Nearly 50 
UAFs have been established through- 
out the country. The association 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 
consultation services. For more infor- 
mation write to: 

American Association of University 
Affiliated Programs 
2033 M Street, Suite 406 
Washington, D.C. 20036 

Closer Look 

Funded through the Bureau of 
Education 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 comprehensive services 
for their own handicapped child as 
well as for others. Closer Look publish- 
es a newsletter about handicaps and 
new programs, as well as information 
of special interest to parents. The staff 
win also respond to questions that you 
may have. The newsletters and infor- 
mation are free. By writing to them 
you can be added to their mailing Ust. 

This organization has regional 
branches. For more information write 

Closer Look 

Box 1492 

Washington, D.C. 20013 


120 Council for Exceptional Children: 
Division on Mental Retardation 

This division is concerned with 
teaching children who are mentally 
retarded, and with training special 
education teachers to be more effective. 
CEC and this division publish low-cost 
informational materials of interest to 
professionals and parents. 

CEC has local chapters. For more 
information write to: 

Council for Exceptional Children 
1920 Association Drive 
Reston, Virginia 22091 

Council for Exceptional Children 
Information Center 

This information center provides 
abstracts of current research and 
bibliographies of information currently 
available in publications and nonprint 
media. It also provides annotated 
listings of agencies that serve excep- 
tional children and their families. 

Covmcil for Exceptional Children 
Information Center 
1920 Association Drive 
Reston, Virginia 22091 

Epilepsy Foundation of America 

The Epilepsy Foundation of 
America is a national voluntary health 
organization. It acts as a national 
spokesman and advocate for people 
with epilepsy, and supports medical, 
social, and informational programs. 
Because many people with epUepsy are 
also retarded, the Foimdation offers 
many low-cost and free publications 
that teachers and parents of mentally 
retarded children have found helpful. 
A monthly newspaper. National 
Spokesman, is available by subscrip- 

The EpUepsy Foundation has local 
chapters. For more information write 

Epilepsy Foundation of America 
1828 L Street, N.W. 
Washington, D.C. 20036 

Instructional Materials Centers 

These centers have media and 
materials suitable for use with retard- 
ed children. Often the director or staff 
of the center can demonstrate mate- 
rials, suggest especially good mate- 
rials, and consult with you about your 

To 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 universities' special edu- 
cation departments. 

National Association 
for Retarded Citizens 

This association, founded and oper- 
ated by parents of children with 
retardation, has been responsible for 
lobbying for the rights of retarded 
citizens and their families. The associ- 
ation's purpose is to encourage study, 
research, and therapy in the field of 
mental retardation; to develop a better 
understanding of the problems of 
mental retardation by the public; to 
improve the training and education of 
personnel for work in the field; and in 
general to promote the welfare 
of the mentally retarded of ail ages. 
They publish many fi'ee or low-cost 
materials of interest to parents and 

NARC has many local chapters. 
For more information write to: 

National Association for 
Retarded Citizens 
2709 Avenue E. East 
P.O. Box 6109 
Arlington, Texas 76011 

National Center for Law 
and the Handicapped, Inc. 

This organization was established 
to ensure equal protection iinder the 
law for handicapped people. It partici- 
pates in selected court cases by 
consulting with the lawyers of handi- 
capped people whose rights may have 
been violated. Sometimes NCLH pro- 
vides a lawyer for a handicapped 
person. The staff can answer questions 
and provide information about legal 
issues affecting children who are 

For more information write to: 

National Center for Law and 
the Handicapped, Inc. 
1235 North Eddy Stieet 
South Bend, Indiana 46617 

National Easter Seal Society 
for Crippled Children and Adults 

The National Easter Seal Society 
for Crippled Children and Adults 
provides information about handicaps. 
It assists disabled persons and their 
families in finding and making effec- 
tive use of resources that will be 
helpful to them in developing their 
abilities and in living piirposeful Uves. 
It assists communities in developing 
necessary and appropriate resources 
for disabled persons. It attempts to 
establish and maintain programs and 
services that are appropriate and 
realistic. And it tries to create a 
climate of acceptance of disabled 
persons, which will enable them to 
contribute, to the full extent of their 
competence, to the well-betng of the 

The Society conducts a three-point 
program in service, education, and 
research at the national, state, and 
local levels. In some areas the staff 
operates programs for handicapped 
infants and young children. In some 
areas they can help parents find 
financial support for their handi- 
capped child's special needs, e.g., 
wheelchairs, braces. 

The society puts out several free 
publications, and a monthly journal 
called Rehabilitative Literature. 
Easter Seal as local chapters. For more 
information write to: 

National Easter Seal Society for 
Crippled Children and Adults 
2023 W. Ogden Ave. 
Chicago, Dlinios 60612 


122 The National Foundation/ 
March of Dimes 

The National Foundation/March of 
Dimes has as its goal the prevention 
of birth defects. Its principal programs 
and activities include funding basic 
and cUnical research, funding medical 
service programs, offering professional 
education, and providing health in- 
formation. The foimdation publishes 
pamphlets, booklets, and audio-visual 
materials for the general public on the 
prevention and treatment of birth 

March of Dimes has local chapters. 
For more information write to: 

The National Foundation/ 
March of Dimes 
1275 Mamaroneck Avenue 
White Plains, New York 10605 

President's Committee 
on Mental Retardation 

This is a committee of 21 citizens 
appointed by the President, and three 
cabinet members ex-officio. The citizen 
members include professional and lay 
persons and parents of retarded chil- 
dren. The Secretary of Health, Educa- 
tion and Welfare is chairperson. The 
committee's objectives are to advise 
and assist the President on all matters 
pertaining to mental retardation; 
evaluate national, state, and local 
efforts; help coordinate federal activi- 
ties; facilitate commvmication between 
federal, state, and local agencies; 
inform the public about mental retar- 
dation; and mobilize support for re- 
lated activities. 

The committee's principal pro- 
grams and activities include conduct- 
ing conferences on such key issues as 
screening of yo\mg children, early 
intervention, and legal rights of the 

The committee publishes free and 
low-cost materials on mental retarda- 
tion for the general public, parents, 
teachers, and other professionals. For 
more information write to: 

President's Committee on 
Mental Retardation 
Department of Health, Education 
and Welfare 
Washington, D.C. 20201 

Resom^ce 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. They function as brokers, 
facilitating 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 will assist local 
grantees in determining and meeting 
their needs in the area of handicapped 
services, the cost of any required 
training or technical assistance must 
be borne by the grantee and/or the 
resource provider. 

RAPs have been established to 
identify 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 men- 
tal health centers, speech and hearing 
clinics, developmental disabilities coun- 
cils, universities and colleges, pro- 
fessional associations, and private pro- 
viders of training, technical assistance, 
materials and equipment. 

DHEW States 
Region Served 


Access Project (RAP) 



New Hampshire 




Rhode Island 

Education Development Center, Inc. 

55 Chapel Street 

Newton, Massachusetts 02160 

New York 
New Jersey 
Puerto Rico 
Virgin Islands 


West Virginia 




District of Columbia 

New Mexico 

New York University 

School of Continuing Education 

3 Washington Square Village, Apt. IM 

New York, New York 10012 


Mineral Street Annex 
Keyser, West Virginia 26726 


North CaroUna 
South Carolina 

Chapel Hill Training Outreach Project 

Lincoln School 

Merritt Mill Road 

Chapel HiU, North Carolina 27514 




The Urban Observatory 
1101 17th Avenue, South 
Nashville, Tennessee 37212 



University of Illinois 
Colonel Wolfe Preschool 


403 East Healev 
Champaign, Illinois 61820 


Portage Project 
Resource Access Project 
412 East Slifer Street 
P.O. Box 564 
Portage, Wisconsin 53901 

Contract not awarded 
at time of printing. 

124 DREW States 
Region Served 

7 Missoviri 




North Dakota 
South Dakota 





Pacific Trust Territories 







Access Project (RAP) 

University of Kansas City 
Medical Center 
Children's Rehabilitation Unit 
39th & Rainbow Blvd. 
Kansas City, Kansas 66103 

MQe High Consortium 
Hampden East I-Room 215 
8000 East Girard Avenue 
Denver, Colorado 80231 

Los Angeles Unified School District 
Special Education Division 
450 North Grand Avenue 
Los Angeles, California 90012 

University of Washington 
Model Preschool Center for 
Handicapped Children 
Experimental Education Unit WJ-10 
Seattle, Washington 98195 

Easter Seal Society for Alaska 
Crippled Children and Adults 
726 E. Street 
Anchorage, Alaska 99501 


Many books have been published 
on children with retardation. It is not 
possible to list all of them here. The 
ones mentioned are especially good for 
iinderstanding what mental retarda- 
tion is and for helping you work with 
retarded children in your classroom. 

Books About 
Mental Retardation 

Barnard, Kathryn E., and Erickson, 
Marcene L. Teaching Children 
with Developmental Problems - A 
Family Care Approach. St. Louis: 
The C.V. Mosby Co., 1976. 

This book is difficult reading in some 
sections, but presents information on 
normal and abnormal development, 
causes of retardation, and guidelines 
for assisting parents of retarded chil- 
dren. It includes an excellent develop- 
mental schedule with suggested activi- 
ties for promoting development. This 
schedule might be especially helpftil to 

Ehlers, Walter H.; Krishef, Curtis H.; 
Prothero, Jon C. An Introduction 
to Mental Retardation - A 
Programmed Text. Columbus, Ohio: 
Charles E. Merrill Publishing Co., 

This text takes the reader through 15 
"lessons" on mental retardation, in- 
cluding topics such as special 
problems faced by families, community 
services, and causes of retardation. 
Because the text is programmed, 
readers have a chance to check their 
learning as they go. 

Grossman, Herb J., ed. Manual on 
Terminology and Classification in 
Mental Retardation. 2nd rev. ed 
(1973). Available from: American 
Association on Mental Deficiency, 
5201 Connecticut Avenue, N.W., 
Washington, D.C. 20015. 

This comprehensive handbook defines 
and explains mental retardation terms. 

Smith, Robert M. An Introduction 
to Mental Retardation. New York- 
McGraw-Hill Book Co., 1971 

This book describes the causes of 
mental retardation and the needs of 
people with mental retardation from 
birth to old age. It has a very good 
chapter on programming for preschool- 
aged children with retardation. 

Guides to Teaching 
and Classroom 

Anderson, Zola. Getting a Head 
Start on Social and Emotional 
Growth (1976). Available from: 
Meyer Children's Rehabilitation Insti- 
tute, University of Nebraska Medical 
Center, Omaha, Nebraska, 68105. 

This is a practical and easy-to-read 
guide for preschool teachers on devel- 
oping the social skills and emotional 
growth of young children. Chapter 11 
describes emotional problems and sug- 
gest methods for teachers to use in 
dealing with them. This is helpful in 
dealing with a child's frusfration, and 
with the emotional problems that may 
accompany mental retardation. 

Blake, Katliryn. Teaching the 
Retarded. Englewood Cliffs, N.J.: 
Prentice Hall, 1974. 

This book discusses the child with 
mild mental retardation, and makes 
practical suggestions about curriculum 
content and teaching techniques. 


126 Brown, Sara L., and Donovan, Carol 
M. Developmental Programming 
for Infants and Young Children: 
Volmne 3, Stimulation Activities. 

Ann Arbor, Mich.: University of Michi- 
gan Press, 1977. 

This clearly written book of activities 
suggests what parents and teachers 
can do to foster development in chil- 
dren who are functioning at a level 
below three years of age. Each activity 
includes necessary modifications for 
children with additional handicaps. 

Connor, Frances P., and Talbor, Mabel 
E. An Experimental Curriculum 
for Yoimg Mentally Retarded 
Children. New York: Teachers 
CoUege Press, 1970. 

This curriculum was written primarily 
for mildly mentally retarded pre- 
schoolers, but it has also become a 
mainstay in a number of programs for 
the moderately retarded. It presents a 
comprehensive r£inge of objectives 
appropriate for all preschoolers. 

D'Audney, Weslee, and Dollis, 
Dorotiiy. Calendar of 
Developmental Activities for 
Preschoolers (1975). Available from: 
Meyer Children's Rehabilitation Insti- 
tute, University of Nebraska Medical 
Center, Omaha, Nebraska, 68105. 

This is a resource book on preschool 
activities arranged in calendar format. 
The simpler activities are presented in 
the fall 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 sldll 
areas involved in each activity. 

D'Audney, Weslee, ed. Giving a 
Head Start to Parents of the 
Handicapped (1976). Available from: 
Meyer Children's Rehabilitation Institute 
University of Nebraska Medical Center, 
Omaha, Nebraska, 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 
dangers of labeling. It also provides 
specific suggestions for working with 
parents of special needs children, in- 
cluding those with retardation. 

The Exceptiongd Parent Magazine, 

Box 964, Manchester, New Hampshire 

Addressed to the parents and teachers 
of handicapped youngsters and adults, 
this maga2dne has many articles of in- 
terest, including "what to do," "how to 
do it," and "where to get help." 

Findlay^ane, et al. A Planning 
Guide: The Preschool Curriculiun - 
The Child, The Process, The Day. 

Chapel HiU, N.C.: Chapel HiU Train- 
ing Outreach Project, n.d. 

This book elaborates on curriculvun in- 
formation foimd in the Learning 
Accomplishment Profile developed 
by Anne Sanford, and presents 44 
preschool curriculum units intended for 
developmentaUy delayed or impaired 
children. It has a section on curricu- 
liun (who determines it, what it is, and 
what goes into it), a section on 
methods and principles (preparing 
instructional objectives, task analysis, 
error-free learning, and positive rein- 
forcement), the 44 cvuriculimi units, 
with objectives and skOl sequences, 
and bibliographies. It is helpful, al- 
though not necessary, to use the 
Planning guide together with the 

Foxx, Richard M., and Azrin, Nathan 
H. Toilet Training the Retarded. 

Champaign, El.: Research Press, 1973. 

This book describes a rapid program 
for achieving independent toileting. 
The procedures are best done in the 
home, but teachers, parents, and coor- 
dinators or psychologists should find 
this a useful reference as they work 
together to develop a toilet-training 
program. This book is hard reading in 
places, but worth the trouble. 

Groldstein, H. Social Learning 
Curriculum. Columbus, Ohio: Charles 
E. Merrill Publishing Co., 1974. 

This is a package of materials, consist- 
ing of a teacher's guide and ten "phase 
books," which cover various social 
learning concepts for school-aged re- 
tarded children. Some sections can be 
used with preschool children. Supple- 
ments cover mathematics, science, and 
physical education suggestions for 
these children. There are "stimulus" 
pictures representing familiar situa- 
tions, which can be used to give chil- 
dren practice in talking about every- 
day social situations. The package also 
contains duplicating materials and 
charts. The emphasis of the ciuriculum 
is on helping children to think criti- 
cally and act independently. 

GroUmen, Sharon Hya, and Perske, 
Robert. More Time to Grow^: 
Explaining Mental Retardation to 
Children: A Story. Boston: Beacon 
Press, 1977. 

This book is in two parts. The first is a 
story for yovmg children about a girl 
whose little brother is diagnosed as re- 
tarded. It sensitively describes her feel- 
ings about what it's like Kving with a 
retarded child. The second part is a guide 
for parents and teachers, written in 
imderstandable language, on helping 
children with retardation learn and 
grow. It also lists and describes organi- 
zations concerned with mental retarda- 
tion, and books and films on retarda- 
tion for children, parents, and 

Hansen, S. Getting a Head Start 
on Speech and Language 
Problems (1974). Available fi-om: 
Meyer Children's Rehabili- 
tation Institute, University of 
Nebraska Medical Center, Omaha, 
Nebraska, 69105. 

This good, simple guide to working 
with preschool children who have 
speech and language problems gives 
language milestones, screening proce- 
dures, and teaching techniques. 

Hogden, Laurel^t al. School 
Before Six: A Diagnostic 
Approach (1974). AvaDable from: 
Cemrel, Inc., 3120 59th Sti-eet, St. 
Louis, Mo. 63139. 

School Before Six is printed in 
two volumes. Volume I includes proce- 
dures for assessing young children's 
learning needs and strengths through 
testing procedures in four developmen- 
tal areas: large, small, and perceptual 
motor skills; language; social-emotional 
skills; and conceptual skills. General 
teaching strategies and activities are 
suggested to help children develop in 
each of these areas. Volimie II includes 
a wealth of activities in areas such as 
science, art, table games, food prepara- 
tion, language, social science, and 
music. Volume I is extensively cross- 
referenced to Volume II to simpUfy the 
selection of appropriate activities for 
specifically diagnosed situations. 


128 Johnson, Vicki M., and Werner, 
Roberta A. A Step-by-Step 
Learning Guide for Retarded 
Infants and Children. Syracuse, 
N.Y.: Syracuse University Press, 1975. 

As the name suggests, the book lists 
over 200 tasks appropriate for the pre- 
school curriculum. For each task the 
authors have stated the objective and 
suggested ways to teach it. 

Jordan, June, ed. Not All Little 
Wagons Are Red: The Exceptional 
Child's Early Years (1973). Avail- 
able 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 
stability, and physical well-being. Two 
sections are particularly helpful: the 
development of children who need 
special help, and program models and 
resource materials, llie book includes 
many fine illustrations, and describes 
a variety of alternative ways to meet 
children's needs. 

LavateUi, CeUa S. Piaget's Theory 
Applied to an Early Childhood 
Curriculum. Boston: A Center for 
Media Development Book, American 
Science and Engineering Inc., 1970. 

This book describes how teachers can 
help four- to six-year-old children with 
retardation to acquire logical ways of 
thinking. It teUs teachers how to pro- 
vide children with concrete materials 
to learn from, and supplies teachers 
with questions to ask of children to 
stimulate their mental activity. 

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 sldUs, and motor skills. 

Guides to 
Other Resources 

Goldstein, H. Bibliography: Educa- 
tion of Moderately Retarded 
Children. New York: Yeshiva Univer- 
sity, 1974. 

This contains a list of books dealing 
with all aspects of working with mod- 
erately retarded children. 


Tests are only one 
source of information 
in evaluating a child 





This section describes the nature 
and purpose of screening and diagno- 
sis, 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 
problem areas, if any exist. 


Screening is a process that 
identifies children who need 
specific treatment (for example, eye- 
glasses or immunization shots) or 
who need to be referred for a 
diagnostic evaluation. Screening is 
therefore an important tool in the 
early identification of handicapped 

Screening procedures such as 
checklists and tests are inexpensive, 
quick, and easily administered. They 
give the screener an overview of a 
child's performance. Teachers, aides, 
and others need to be trained to use a 
particular screening procedure correct- 
ly. For the screening services that 
must be provided for every child, see 
Project Head Start Performance 

Not all children who fail a screen- 
ing test are found to have a problem 
when they are given a full diagnostic 
evaluation. 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 
performing at his or her best at that 
particidar time. For these reasons, a 
child who is not handicapped may fail 
a screening and be referred for further 

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 stan- 
dard screening tests and you stiU feel 
there may be something wrong, do not 
hesitate to ask an appropriate profes- 
sional to look at the child more closely. 


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 prob- 
lem areas. The diagnostic process 
assesses both physical and psycho- 
logical 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), psycho- 
logical tests, medical and other 
reports/tests of physical functioning, 
and other sources of information about 
the child. These 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 interdisciplinary team of specialists 
(or a professional who is qualified to 
diagnose the specific handicap). The 
diagnostic process should involve: 

i • a categorical diagnosis of a child, 
using Project Head Start diagnostic 
criteria, to be used solely for reporting 

^ • a functional assessment of a child. 
This functional assessment is a 
developmental profile that describes 
what the child can and cannot 
currentlj' do and that identifies areas 
requiring special education and related 

O • an individualized program plan 
based upon the functional assessment 
and developed jointly by the diag- 
nostic team, the parents, and the 
child's teacher 

4 • ongoing assessment of the child's 
progress by the teacher, the child's 
parents, and (as needed) the diagnostic 

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. Diagnosti- 
cians themselves, depending on their 
knowledge of classrooms and of speci- 
fic teaching techniques, may be able 
to discuss with the teacher and parent 
specific 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 




The selection of appropriate tests, 
their administration, and their inter- 
pretation 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 
factors can lead to inappropriate 
testing or inaccurate test results: 

• mistaking one handicap for 

• mistaking cultural differ- 
ences for handicaps 

• mistaking norm£il physical 
or mental immaturity for 

• testing a child who is not 
used to test-like situations 

• testing a child when he or 
she is not feeling w^ell 

• testing a child in a lan- 
guage that is not his or her 
home language 

• testing a particular devel- 
opmental area in a child by 
requiring a response that 
involves skills in which the 
child is handicapped (for 
example, testing cognitive 
functioning by requiring a 
verbal response from a 
speech-impaired child, or a 
motor response from £in 
orthopedically handicapped 

Even if children are given tests 
that are appropriate to their age, 
cultural background, and suspected 
handicaps — and that are methodolog- 
ically vaHd and reliable — test results 
can be inaccurately interpreted. 

To 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 profes- 
sional who is knowledgeable about the 
test. Tests used for diagnostic purposes 
should be administered and interpreted 
by specialists trained in the use of the 

In addition to interviews and 
histories, your own continuing obser- 
vation of a child in a variety of 
situations in yoiu- preschool program 
is an invaluable tool in vmderstanding 
and helping a child learn. During the 
preschool years, children experience 
a great amount of development and 
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 assessment can help prevent 
mislabeling of children. 

For additional information on the 
diagnostic process — including proce- 
dures and persons — contact the 
Resource Access Project in yoiu- area. 

For additional information on tests, 

Head Start Test Collection 
Educational Testing Service 
Princeton, New Jersey 08540 

Chart of 




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) 

cognitive skills 

self-help skills 

social skills 

communication skills (under- 
standing language and speaking 

In each sldll area, the age at which each 
milestone is reached on the average is 
also presented. This information is use- 
ful if you have a child in your class 
who you suspect is seriously delayed in 
one or more skill areas. 

However, it is important to remem- 
ber that these milestones are only 
average. 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 aU 
the same developmental milestones at 
the exact same ages. The examples 
that follow 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 scarce- 
ly said more than a few sounds until 
she was 15 months old. But she 

walked with ease and skill by 9'/2 

Marcus learned to crawl on all 
fours very early, and continued crawl- 
ing 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 sud- 
denly began talking in two- to four- 
word phrases and sentences. 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 differen- 
ces among them in walking or talking. 
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 covild 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 all 
areas. Each child is a unique person. 

One final word of caution. As 
children grow, their abilities are 
shaped by the opportunities they have 
for learning. 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. AU 
areas of development and learning are 
influenced by children's experiences 
as well as by the abilities tiiey are bom 


Chart of Normal Development 







f. -^^ 

.-c^^ ^ 










0-12 Months 

Sits without support. 


Pulls self to stand- 
ing and stands 

Walks with aid. 

Rolls a ball in im- 
itation of adult. 

12-24 Months Walks alone. 

Walks backward. 

Picks up toys from 
floor without falling. 

Pulls toy, pushes toy. 

Seats self in child's 

Walks up and down 
stairs (hand-held). 

Moves to music. 

Reaches, grasps, 
puts object in mouth. 

Picks things up with 
thumb and one fin- 
ger (pincer grasp). 

Transfers object 
from one hand to 
other hand. 

Drops and picks up 

Responds to speech 
by looking at 

Responds different- 
ly to aspects of 
speaker's voice (for 
example, friendly or 
unfriendly, male or 

Turns to source of 

Responds with ges- 
ture to hi, bye-bye, 
and up, when these 
words are accom- 
panied by appropri- 
ate gesture. 

Stops ongoing action 
when told no (when 
negative is accom- 
panied by appropri- 
ate gesture and 

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 

meaning through 

Attempts to imitate 

Builds tower of 3 
small blocks. 

Puts 4 rings on stick. 

Places 5 pegs in peg- 

Turns pages 2 or 3 at 
a time. 


Turns knobs. 

Throws small ball. 

Paints with whole 
arm movement, 
shifts hands, makes 

Responds correctly 
when asked where, 
(when question is 
accompanied by 

Understands prepo- 
sitions on, in, and 

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 

Says first mean- 
ingful word. 

Uses single words 
plus a gesture to ask 
for objects. 

Says successive 
single words to de- 
scribe an event. 

Refers to self by 

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 and all 










Follows moving 
object with eyes. 

Recogrmes differen- 
ces among people. 
Responds to stran- 
gers by crying or 

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 

Holds out arms and 
legs while being 

Smiles spontaneous- 


ftesponds differently 
to strangers than to 
familiar 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 

Recognizes difference 
between you and 

Has very limited 
attention span. 

Accomplishes pri- 
mary learning 
through own explora- 

Uses spoon, spilling 

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 

Plays by self 
Initiates own play. 

Imitates adult 
behaviors in play. 

Helps put things 

Chart of Normal Development 






24-36 Months Runs forward well. 

Jumps in place, two 
feet together. 

Stands on one foot, 
with aid. 

Walks on tiptoe. 

Kicks ball forward. 





Strings 4 large 

Turns pages singly. 

Snips with scissors. 

Holds crayon with 
thumb and fingers, 
not fist. 

Uses one hand con- 
sistently in most 

Imitates circular, 
vertical, horizontal 

Paints with some 
wrist action. Makes 
dots, lines, circular 

Rolls, pounds, 
squeezes, and pulls 





Points to pictures of 
common objects 
when they are 

Can identify ob- 
jects when told their 

Understands ques- 
tions forms what 
and where. 

Understands nega- 
tives no, not, can't, 
and don't. 

Enjoys listening to 
simple storybooks 
and requests them 







Joins vocabulary 
words together in 
two-word phrases. 

Gives first and last 

Asks what and 
where questions. 

Makes negative 
statements (for ex- 
ample. Can't open 

Shows frustration at 
not being under- 

36-48 Months Runs around ob- 

Walks on a line. 

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 

Jumps over 15 cm. 
(6") high object, 
landing on both feet 

Throws ball over- 

Catches ball 
bounced to him or 

Builds tower of 9 
small blocks. 

Drives nails and 

Copies circle. 

Imitates cross. 

Manipulates clay 
materials (for exam- 
ple, rolls balls, 
snakes, cookies). 

Begins to under- 
stand sentences in- 
volving time con- 
cepts (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 

Understands when 
told. Let's pretend. 

Talks in sentences 
of three or more 
words, which take 
the form agent- 
action-object (I see 
the ball) or agent- 
(Daddy sit on 

Tells about past ex- 

Uses "s" on nouns 
to indicate plurals. 

Uses "ed" on verbs 
to indicate past 

Refers to self using 
pronouns I or me. 

Repeats at least one 
nursery rhyme and 
can sing a song. 

Speech is under- 
standable to stran- 
gers, but there are still 
some sound errors. 










Responds to simple 
directions (for 
example: 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 

Matches and uses 
associated objects 
meaningfully (for 
example, given cup, 
saucer, and bead, 
puts cup and saucer 

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, house- 
keeping play). 

Has limited attention 
span. Learning is 
through exploration 
and adult direction 
(as in reading of 
picture stories). 

Is beginning to 
understand function- 
al concepts of 
famiUar objects (for 
example, that a 
spoon is used for 
eating) and part/ 
whole concepts (for 
example, parts of the 

Uses spoon, spilling 

Gets drink from 
fountain or faucet 

Opens door by 
turning handle. 

Takes off coat. 

Puts on coat with 

Washes and dries 
hands with assis- 

Plays near other 

Watches other chil- 
dren, joins briefly in 
their play. 

Defends own posses- 

Begins to play house. 

Symbolically uses 
objects, self in play. 

Participates in simple 
group activity (for 
example, sings, claps, 

Knows gender identi- 

Recognizes and 
matches six colors. 

Intentionally stacks 
blocks or rings in 
order of size. 

Draws somewhat 
recognizable pictiu-e 
that is meaningful to 
child, if not to adult. 
Names and briefly 
explains picture. 

Asks questions for 
information (v^^hy 
and how questions 
requiring simple 

Knows own age. 

Knows own last 

Has short attention 

Learns through 
observing and imi- 
tating 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 
doU house furniture 
in correct rooms) 
part/whole (for 
example, can identify 
pictures of hand and 
foot as parts of body). 

Begins to be aware of 
pEist and present (for 
example: Yesterday 
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 un- 

Blows nose when 

Uses toilet independ- 

Joins in play with 
other children. Begins 
to interact. 

Shares toys. Takes 
turns with assistance. 

Begins dramatic 
play, acting out 
whole scenes (for 
example, traveling, 
playing house, 
pretending to be 

Chart of Normal Development 

48-60 Months 








Walks backward 

Jumps forward 10 
times, without 

Walks up and down 
stairs alone, alter- 
nating feet. 

Turns somersault. 

Cuts on line contin- 

Copies cross. 

Copies square. 

Prints a few capital 












Follows three un- 
related commands 
in proper order. 

Understands com- 
paratives like 
pretty, prettier, 
and prettiest. 

Listens to long 
stories but often 
misinterprets the 

Incorporates ver- 
bal directions into 
play activities. 

Understands se- 
quencing 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 w^hy ques- 

Uses models like 
can, will, shall, 
should, and might. 

Joins sentences to- 
gether (for exam- 
ple, I like choco- 
late chip cookies 
and milk). 

Talks about causali- 
ty by using because 
and so. 

Tells the content of a 
story but may con- 
fuse facts. 

60-72 Months 

Runs lightly on 

Walks on balance 

Can cover 2 meters 
(6'6") hopping. 

Skips on alternate 

Jumps rope. 


Cuts out simple 

Copies triangle. 

Traces diamond. 

Copies first name. 

Prints numerals 1 
to 5. 

Colors within lines. 

Has adult grasp of 

Has handedness well 
established (that is, 
child is left- or 

Pastes and glues 

Demonstrates pre- 
academic skills. 

There are few ob- 
vious differences 
between child's 
grammar and adult's 

Still needs to learn 
such things as sub- 
ject-verb agreement, 
and some irregular 
past tense verbs. 

Can take appropri- 
ate turns in a con- 

Gives and receives 

Communicates well 
with family, friends, 
or strangers. 












Plays with words 
(creates own rhyming 
words; says or makes 
up words having 
similar soimds). 

Points to and names 
4 to 6 colors. 

Matches pictiires of 
familiar objects (for 
example, shoe, sock, 
foot; apple, orange, 

Draws a person with 
2 to 6 recognizable 
parts, such as head, 
arms, legs. Can name 
or match drawn parts 
to own body. 

Draws, names, and 
describes recognizable 

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 

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 
yesterday or last 
week (a long time 
ago), about today, 
and about what will 
happen tomorrow. 

Cuts easy foods with 
a knife (for example, 
hamburger patty, 
tomato sUce). 

Laces shoes. 

Plays and interacts 
with other children. 

Dramatic play is 
closer to reality, with 
attention paid to 
detail, time, and 

Plays dress-up. 

Shows interest in 
exploring sex differ- 

Retells story from 
picture book with 
reasonable accuracy. 

Names some letters 
and numerals. 

Rote counts to 10. 

Sorts objects by 
single characteristics 
(for example, by 
color, shape, or size , 

Is beginning to use 
accurately time 
concepts of tomor- 
row and yester- 

Uses classroom tools 
(such as scissors and 
paints) meaningfully 
and purposefully. 

Begins to relate clock 
time to daily 

Attention span 
increases noticeably. 
Learns through adult 
instruction. When 
interested, can ignore 

Concepts of function 
increase as well as 
imderstanding 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 complete- 


Ties bow. 

Brushes teeth im- 

Crosses street safely. 

Chooses own 

Plays simple table 

Plays competitive 

Engages with other 
children in coopera- 
tive play involving 
group decisions, role 
assignments, fair 

■l!rU.S, GOVERNMENT PRINTING OmCE ; 1978 O— 270-712 

HV1662 Lynch, Eleanor Whiteside, 
L989 Mainstreaming 
S48 preschoolers: Children 
with mental retardation: 
a guide for teachers, 



HV1662 Lynch, Eleanor Whiteside 

L989 Mainstreaming 

S48 preschoolers: Children 
with mental retardation:" 
a guide for teachers. 

OITC out 



15 WEST letti STREET '^- 

NEW YORK, «.Y.i0011 

WASHINGTON. D C 20201 . 






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

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

DHEW Publication No. (OHDS) 78-31110