Planning For Independence

 Health and Personal Care

Overview

Personal-care programs involve all facets of the curriculum. Such programs can include developing students' ability to communicate a need, developing the fine- or gross-motor skills needed for dressing and undressing, and developing the organizational skills needed for choosing, maintaining, and managing clothing. For some students who require a high degree of support, the development of personal-care skills can become one of the major emphases of their overall program.

Proficiency in such areas as eating, dressing, grooming, personal hygiene, and toileting is crucial to the student's sense of self-worth and ability to control the environment in which he or she lives. Not all students will achieve total independence in personal care. Nevertheless, opportunities to establish appropriate health and hygiene habits need to be provided in the home, school, and community.

Within the school environment, lunch time and recesses provide students with opportunities to learn and apply independence in eating as well as to enjoy communication and social interaction.

The Planning Cycle

Assessment and Development

In the first two phases of the planning cycle, educators need to:

  • involve parents in establishing realistic personal-care expectations based on individual needs;
  • observe and assess what students can do for themselves;
  • become aware of students' motor and cognitive abilities;
  • involve qualified healthsupport professionals if needed;
  • become aware of the methods by which students communicate their likes, dislikes, choices, and problems;
  • assess students' gross- and fine-motor control, balance, range of motion, and perceptual abilities;
  • consider modifications to clothing, equipment, and eating utensils to accommodate students' needs.

Implementation and Evaluation

In the last two phases of the planning cycle, educators need to:

  • teach personal-care programs in the most natural environment possible, ensuring that the setting is age-appropriate;
  • frequently review specific modifications and adaptations of equipment;
  • evaluate specific programs continually;
  • consult with health professionals when the need arises;
  • share program strategies with parents;
  • communicate progress to parents regularly.

Resources

Metropolitan Toronto School Board. The Developmentally Handicapped Student: Curriculum Guidelines. Toronto: Metropolitan Toronto School Board, 1986.

Orelove, Fred, and Sobsey, Dick. Educating Children With Multiple Disabilities: A Transdisciplinary Approach. Baltimore: Paul H. Brookes, 1987.

Case Study - Elementary Level

Student Profile Ten-year-old Nick had anoxia during childbirth. His physical problems include microcephaly, cerebral palsy (spastic quadriplegia), mild scoliosis, and a dislocated hip. He has no form of independent mobility and depends on others for all aspects of his daily care. He has poor head control, limited use of his hands, and no use of his legs. He has excellent eye contact and communicates by eye pointing at a picture board. Nick cooperates only for favourite staff members. He is very difficult to feed and often clamps down on his spoon so that it is difficult to remove it from his mouth. He lives in a small (fifty bed) residential facility for persons with developmental disabilities.

Learning Environment Nick has been placed in a junior class for students with developmental disabilities in a regular school.

Expected Learning Outcomes Nick is expected to:

  • develop finemotor skills;
  • demonstrate personal-care skills to the extent that he is physically capable;
  • improve his ability to relax, socialize, and communicate with staff and students;
  • communicate his needs and desires.

Student Program Nick is being provided with opportunities to:

  • relax, inhibit his bite reflex while eating, and take food off the spoon with his tongue;
  • make choices about what he would like to eat or drink by eye pointing;
  • eye-point to his lunch, cup, toothbrush, coat, and other personal belongings;
  • eye-point to yes and no cards to indicate whether or not his face is clean after he has viewed it in a mirror;
  • improve his reach in order to operate environmentalcontrol switches;
  • learn to exert sufficient pressure to turn switches on and off.

Case Study - Secondary Level

Student Profile David is an eighteen-year-old student with severe disabilities, including poor fine- and gross-motor skills. He is learning to print his name, to count to 5, and to recognize colours. David seems unaware of his appearance: his hair is often messy and his clothes are uncoordinated. He often comes to school dressed inappropriately for the weather. He is friendly, but in conversation he often repeats the same few phrases over and over.

Learning Environment David has been placed in a special class in a secondary school. He is integrated into regular classes for physical education, and he has his lunch in the cafeteria with the other students.

Expected Learning Outcomes David is expected to:

  • develop appropriate conversational skills;
  • accept responsibility for his personal hygiene and grooming;
  • develop skills required for independent living;
  • demonstrate age-appropriate behaviour in his peer relationships.

Student Program David is being provided with opportunities to:

  • maintain a well-groomed appearance and dress appropriately and seasonally;
  • shower and wash his hair after physical education classes and swimming;
  • complete grooming routines after lunch each day;
  • socialize and converse with other students in the school cafeteria in order to improve his expressive language and to become more aware of personal grooming through peer influences;
  • shop for clothes in the community, matching colours and choosing the clothing items he needs to make a complete outfit.

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