School Health

Looking at Mental and Physical Health for our Exceptional Individuals

by Raymond T. Heipp. Ph.D.


As we look ahead toward the re-opening of school buildings and a return to face-to-face education, we will begin to see additional activities like forehead scans for fever, hand sanitizer or washing hands requirements, and the wearing of masks. While those will be important as we seek to regain healthy physical environments, we cannot forget what lies behind those masks; the individual and their mental health!

I can only share what I have experienced, heard from professionals in the field, or read in respectable articles. Anxiety rates, depression, and escalations have increased drastically. As neuro-typical adults, we have probably felt this anxiety during this time. A dear friend of mine who is a doctor on the front line with a teen who has some physical issues shared with me that the anxiety levels in her house are through the roof. Ironically, the major source of the anxiety there is from her husband who is worried for her well-being, his daughter’s well-being, and what this will mean for their family in the future. Their daughter has picked up on the worrying and has found her anxiety levels increased simply on account of that. However, she can actually process those feelings and express her concern to both her parents. What about those individuals who, after picking up anxiety from those around them, cannot process those feelings, express them, or even have someone with whom they can share them?

As we move into our next phase of life after this pandemic, we must keep the mental health of our exceptional individuals in mind. It will not be as simple as saying that “they will be back in school, so it will be normal.” It will not return to any sense of normalcy immediately. We need to understand that while we broke routines in shifting from face-to-face learning to virtual learning, we will also be breaking a newer routine of the virtual as we return to face-to-face learning. Add to that the fact that face-to-face learning may be adjusted to meet safety and health recommendations and may not be easily understood for some individuals. What happens when we cannot have lunch with our friends? What happens when courses like adapted physical education are changed or postponed to another semester? What happens when therapy time becomes a unique hybrid of face-to-face and virtual to protect against issues like this happening in the future? These are all events that can begin to heighten anxiety levels even after the return to a school building.

So what can we do? First, we must not live in denial. This pandemic, no matter what the news agencies state, caused a major disruption in learning. The shattering of the educational routine is something that is real and must be addressed and supported upon our return to the classroom. How can we do this? Look at ways of making learning a holistic process. Learning must become an area where we are not simply learning our numbers or letters. We need to take a look at how we can create lessons based on the individual needs and levels of our exceptional individuals that can be easily applied in multiple environments. What does that mean? Let’s break out just couple of areas here. Communication skills need to be presented in a way that can move the lessons to wherever the individual is located. SLPs can augment their face-to-face time with virtual sessions in school to make that transition to the home environment easier during a time of illness or day away from the building. Washing hands is something that should have a set routine which is followed everywhere. Even bus rides should have routines built in that demonstrate learning can take place in alternate locations. Thus, we must redefine routine to make it something which focuses around the individual, not the location.

Next, we must be aware of the need for some of our exceptional individuals, as well as some neuro-typical students, to have time and space to get away. Sensory rooms or spaces, and sensory items like socially and educationally-appropriate fidgets need to become acceptable and a new norm within schools and even workplaces. We need to work with all individuals and teach a level of understanding and tolerance for those who do not process anxiety easily. How do we make our learning environments more sensory-friendly? How do we as educators, especially in inclusive classrooms, move beyond the idea of “back in my day we….” and into an era where sensory breaks are part of the curriculum? Those are issues that are not pedagogical in nature. Those are issues that are directly related to mental well-being. If we are truly educating our students to become the best they can be, then we must give them the tools to deal with further anxiety in society. We need to be aware that the statement “I am getting them ready for the real world” in not allowing for sensory release is not factual. Instead, the truth of it lies in the fact that it is simply modeling what society is seeing in the “real world” and not doing anything to prepare for it. True preparation for dealing with that “real world anxiety” would include techniques for dealing with it; like sensory breaks, yoga, and meditation.

Finally, we need to understand that for some of our exceptional individuals, this is an event which will never fade from their memories. The actual trauma they may have experienced in this utter disruption of their lives will be similar to individuals who suffer from any level of PTSD. Please remember that PTSD is not strictly related to the military. In actuality, any major trauma can bring about its onset. We need to be conscious of this as our exceptional individuals return. We also must be supporting ourselves in this as we, too, have experienced the trauma of this pandemic at different levels. Thus, the best way for us to get ready to help our exceptional individuals is to make sure that we are supporting ourselves. Take time to center yourself each day. Find some time for you to relax and process all of this internally. Find some activity to bring you to a point of peace from which you can continue to make a difference in the lives of these individuals.

I thank you for all that you have done, are currently doing, and will continue to do. You, like our doctors and nurses, are on the front lines of life! We at School Health will be doing what we can to support you too. I am excited to announce two upcoming ways of us assisting you. First, we will be releasing a new video series at the end of this month. At the time of this blog, 15,000 of you had viewed our first series which focused on Working with Our Exceptional Individuals during the COVID-19 Pandemic. Our upcoming series is going to focus on Creating a Holistic Transitioning Model. We will be looking at changing our perceptions of transitioning from a linear to a holistic format; what that means and how we can do it effectively. I am also pleased to share with you that we will be hosting a webinar in August as we are returning to school buildings. This webinar is going to focus on the topic of anxiety and what our students will be facing as they re-enter school. Our guest speaker will be Dr. Maria Frankland from the University of Maine. Please stay tuned for specific information about that.

As always, please feel free to reach out to me with any questions at rheipp@schoolhealth.com. We are all in this together and will come out of this time stronger than ever!

Product Review: Giraffe Bottle Handsfree Drinking System

by Gabriel Ryan


GabeGiraffeMany people struggle to drink enough water each day. What if I told you I’ve recently increased my water intake by 60% just by trying out a different water bottle? Getting the right amount of water can be especially challenging for those who cannot reach or hold a water bottle easily.

Whether you are generally healthy or have any health conditions, without water, we run the risk of dehydration.  In a Harvard Health Publishing article, by Heidi Godman, titled “How much water should you drink” published 2016, updated 2018. The question is posed, “How much water a day should you drink?” the answer, according to Dr. Julian Seifter, Senior Advisor at Harvard Medical School, “There's no one-size-fits-all answer…water intake must be individualized, and you should check with your doctor to be sure you're getting the right amount.”

Like many people, I carry a water bottle every day. My favorite water bottle for many years has been the CamelBak 0.75L and the smaller version 0.4L. I like the silicone bite valve, multiple clear colors, durable design, and cap with the loop to cli it to my bag. I have found that the larger bottle is a bit too heavy for me to lift when full. The smaller bottle, I can easily hold but I drink it so quickly I am having to refill it often. Together with my family we ingeniously came up with a small bungee cord that could attach to the cap loop in case the bottle slid off my wheelchair tray or out of grip. Those of you who have had this happen while traveling in the car know all too well how frustrating it is to have your drink roll around the floor of the vehicle out of your reach until you get to your destination.

Giraffe BottleWhile attending the ATIA Conference in Florida earlier this year with the School Health Team, I learned about the Giraffe Bottle Handsfree Drinking System.  As mentioned in their resource material, “The Giraffe Bottle Hands Free Drinking System allows users with various abilities to stay hydrated. The system is designed to be flexible and easy to use. The solution is great for desks, wheelchairs, beds, tables, and more. Helps people with disabilities, injuries, or other conditions including CP (cerebral palsy) or MS (multiple sclerosis). Hydration is important to your body, heart, brain, and muscles. And depending on your mobility, getting a drink isn’t always an easy task. That’s where the Giraffe Bottle Hands Free Drinking solution comes in. The Giraffe Bottle provides the user with another level of independence and it also frees up the parent or caregiver.”

I’ve used a similar product with a flexible neck in the past, and although I liked the flexibility, the bottle was not clear and drinking tube not soft, so I discontinued use.  The Giraffe Bottle caught my eye right away with its flexible neck, clear bottle and soft drinking tube!  I decided to purchase one and give it a try.

Some of the key features and options when purchasing are:

  • The ModularHose neck is available in six lengths ranging from 9 inches to 36 inches, with an included drinking tube, valve and cleaning brush.

  • The 750ml bottle is clear with volume marking on the side and comes with a lid, cap and seal.

  • Replacement parts are individually sold. As you need to replace parts you can purchase just the pieces you need.


When my purchase arrived, I was able to use this product right out of the box, there was minimal assembly.  I purchased a modular bottle holder as well but so far; I have preferred keeping the bottle in the mesh side pocket of my backpack which is attached to the back of my wheelchair. (I’ll have to spend more time with the holders and attachments and review those in a future blog.)

My favorite features of this bottle are:

  • I have increased my water intake by 60% because I can independently give myself a drink whenever I want to. No more water bottles sliding away out of reach.

  • The modular neck is easy to reach and adjusts exactly where I want to position it and I can swing it away when not in use.

  • The bottle is 750ml which means I can go a longer time without needing assistance with a refill. The clear bottle lets me easily see the contents without removing the lid to peer inside.

  • The tubing is flexible, small, and soft. It is comfortable to drink from.

  • The special valve attached to the drinking tube- after your first drink following a bottle refill, you don’t have to sip on the drinking tube with enough suction to get the liquid from the bottle all the way through the tube to your mouth each time, the liquid stays in the tube near the opening, ready for you to drink.


One of my favorite features, the special valve, does have a minor drawback. I found that it is important to keep the end of the tube you drink from upright so that the water doesn’t spill out on its own. I also found that I have gotten splashed in the face by small amounts of water if the tube is bumped. I have a good sense of humor and it doesn’t bother me too much, but those sensitive to water splashed on them would want to make sure they keep that in mind.

This is a great product for those looking to increase hydration more independently. I have enjoyed using it and have received many compliments and questions about it in my travels. Stick your neck out and purchase a Giraffe Bottle today!

Choosing the Appropriate Fidget

by Terri Griffin


The change in learning environment can cause anxiety and distraction. Fidgets are an easy way to help learners and first-time teachers at home stay focused and on track, even (especially) when tasks seem dull, tedious, or boring.

Research shows that physical activity — even a little foot-tapping or gum chewing — increases levels of the neurotransmitters in the brain that control focus and attention. A subtle fidget tool may help block out distractions, fight boredom, and increase productivity.

People on the autism spectrum may find using fidget tools soothing and calming as the tools help them meet their sensory needs. For people with ADHD, the tools can provide a movement outlet that allows them to focus and concentrate better. Some people with anxiety may also benefit from using fidget tools.

The purpose of a fidget is to act as a sensory filter. It is a tool that can help with self-regulation, attention, and calming.  It is not a toy.  The wrong fidget, or a fidget used the wrong way, can end up being distracting or disruptive, the opposite of the desired effect.

Fidgeting must be deliberate to be effective. Intentional fidgets allow you to self-regulate in a controlled, constructive fashion. An effective fidget doesn’t distract from the primary task because it is something that the user doesn’t have to think about. It provides an activity that uses a sense other than the one required for the primary task. For example, a quiet manipulative using the hands while looking at or listening to the teacher can help promote increased focus.

Fidget tools should be used intermittently. People can become desensitized to the sensory benefits of an object, so use it for short periods at times when concentration is most needed or swap between fidgets over the course of the day.  When not in use, fidget tools should be kept out of sight.

Fidget tools come in a wide array of shapes, sizes, colors, and materials. Not every fidget will work for every person. Different types of fidgets can meet different sensory needs. There is no one size fits all sensory fidget.

Many different items can be used as a fidget tool. They do not need to be expensive or even something purchased. Sometimes people find something as simple as a small piece of soft material.  What matters is to find a tool that works for the individual person.

Along with being quiet and safe, what makes a good fidget tool?

  • Can be used without causing distraction to the user or others around them

  • Can be used without looking, so the user can focus on the task or lesson

  • Meets the user’s sensory needs (e.g., texture, shape, sensation)

  • Fits the user’s physical abilities (in particular, motor skills and hand strength)


Some things to consider for choosing an appropriate fidget for your needs.

Who – Consider who will be using the fidget.  Do they crave or dislike certain textures? Do they like to pull or pinch or squeeze? Do they crave pressure or proprioceptive input? How much strength do they have to manipulate a fidget? Is the person an oral seeker – are they likely to chew and bite it?

Material – Fidgets are made in in a variety of material. Plastic, metal, rubber, stone, and latex components can create items that feel soft, squishy, hard, wiry, or malleable.

Motion – Some people are drawn to a fidget because of the motion used to manipulate it. Consider what form of movement is most soothing — stretching, twisting, flexing, building, spinning, shaping, clicking, etc.

Size – Many fidgeters like to keep something in a pocket, so that it is easily transported, discreet, and can be used without anyone seeing. Small fidgets can also be ideal for one-handed use and finger-tip manipulation. However, items that are a bit larger and chunkier can feel more substantial and engage more muscles and more parts of the brain.

Appearance – Even though fidgeting is primarily a tactile experience, what it looks like can matter. Some fidgeters are drawn to playful colors, looks, and shapes. Because memory and recall have been shown to improve when more areas of the brain are activated, additional stimulus created by the visual, auditory, and emotional experience of using a fidget tool is likely to have a positive impact.

Durability – Many fidget tools are fairly inexpensive and vary in durability and washability. Hard plastic and metal are likely to stand the test of time. Rubbery or gel-filled items tend to pick up more dirt and can be more difficult to clean.

Weight – Some fidget users prefer items that have a little heft or weight. Of course, they should not be too heavy or cumbersome.

Understanding the variety of sensory needs can help find the tools or resources that would be best for each individual. You may want to try a few to figure out which tools best help with calm and focus.

Stimming

Stimming, short for Self-Stimulation, refers to self-soothing behaviors. For those who find repetitive motions to be calming, these fidget tools might be good choices: TanglesLoopezGyrobiSwingOssensory stonesmarble BoinksDimplpencil topper fidgetsthinking putty

Tactile

Some with SPD find certain textures particularly soothing. Several fidget tools offer interesting tactile experiences. Here are some examples: Tangle Therapyspaghetti ballstextured sensory rulerVelcro stripssensory stonesfidget ballspencil gripsAku ring

Fine Motor

Fidget tools can also help build fine motor skills, strengthen finger muscles, and help develop eye-hand coordination.  These are some fidgets that provide dual benefits: LoopezGyrobiCaterpinchTwisterssqueeze fidgetsthinking puttypencil grips

Sources:

Claflin, Carol, PhD. “The Benefits of Fidget Tools: What Research Says About ADHD AND SPD.” Retrieved from https://therapyshoppe.com/therapists-corner/117-the-benefits-of-fidget-tools

Grogan, Alisha MOT, OTR/L. “The Quintessential Guide to Fidgets for Kids.” Retrieved from

https://yourkidstable.com/fidgets-for-kids/

Griffin, Kim, OT. “Top Five Tips for Choosing Fidget Toys at Home and School.” Retrieved from

https://www.griffinot.com/top-five-tips-fidget-toys/

Isbister, Katherine. “Fidget toys aren’t just hype.” Scientific American: The conversation. Retrieved from https://www.scientificamerican.com/article/fidget-toys-arent-just-hype

WorkSMART Blog. ”Finding the Best Fidget Toy.” Retrieved from http://blog.trainerswarehouse.com/finding-best-fidget-toy

WorkSMART Blog. “Finding the Right Fidget for Any Sensory Diet.” Retrieved from

http://blog.trainerswarehouse.com/finding-the-right-fidget-for-any-sensory-diet-adhd-and-more

Rotz, Ronald, PhD & Wright, Sarah. “The body-brain connection: How fidgeting sharpens focus.” Retrieved from https://www.additudemag.com/focus-factors

The Efficacy of Fidget Toys in School Settings for Children with Attention Difficulties and Hyperactivity

https://digitalcommons.ithaca.edu/cgi/viewcontent.cgi?article=1329&context=ic_theses

Mennillo, Michelle. “Stop touching things! The role of fidget toys” http://occupationaltherapychildren.com.au/stop-touching-things-the-role-of-fidget-toys

Stalvey Sheryl and Brasell, Heather. “Using Stress Balls to Focus the Attention of Sixth-Grade Learners.” The Journal of At-Risk Issues. Retrieved from https://files.eric.ed.gov/fulltext/EJ853381.pdf

Rohrberger, Amanda. “The Efficacy of Fidget Toys in a School Setting for Children with Attention Difficulties and Hyperactivity.” Ithaca College Theses.

https://digitalcommons.ithaca.edu/cgi/viewcontent.cgi?article=1329&context=ic_theses

American Occupational Therapy Association. Fact sheet: Occupational therapy using a sensory integration-based approach with adult populations. Retrieved from https://www.aota.org/About-Occupational-Therapy/Professionals/HW/Using-Sensory-Integration-Based-Approach-With-Adult-Populations.aspx

Working with Our Exceptional Students during the COVID-19 Pandemic

by Raymond T. Heipp. Ph.D.


In 1951, a short story appeared in a children’s magazine, Boys and Girls Page, called, “The Fun They Had.” It was written by an author named Isaac Asimov who would later become one of the most distinguished science fiction writers of the 20th century. The premise of the story was that by the year 2157, all schooling would be done in the homes by computerized teachers. The young protagonists of the story find a real book in their attic and begin to wonder about what it must have been like to attend school with other students. Almost seventy years later, the idea of schooling done at home through a computer has come to the forefront due to the COVID-19 pandemic.

I write this to you during the first day of “lockdown” in Ohio. We have already seen our schools move to an online format. Many districts and almost all universities have already begun to announce that the semester will continue without further face-to-face classes. Other states, like Kansas, are moving towards this same online-teaching format for all schools. In speaking with educational leaders throughout the country, the conservative expectation is that over 80% of schooling during the 2019-2020 school year will be completed as such.

What does this mean for our exceptional students? It means that there is going to be a change in routine which may create some issues for them. The first thing to remember is that scheduling is very important in a student’s routine. It’s a good idea to take a look at the structure of their day and try to keep it as similar to their regular school day as possible. The second thing is to realize that services must continue for them in a differentiated format. The Office of Civil Rights put out a letter describing this mandate here: https://www2.ed.gov/about/offices/list/ocr/newsroom.html. On that page, they also have a link to the US Department of Education’s Information page regarding coronavirus here: https://www.ed.gov/coronavirus?src=feature. Please stay abreast of the fact that we must continue the education of our students and that this situation is dictating changes in our sharing of information with all students.

As many of you teachers are moving into online teaching, I understand you are not sure where to start.  Right now, I have seen everything from teachers sending notes and quizzes via email, to those who have taken advantage of products like Zoom, Skype, Google Classroom, and Blackboard to keep learning going in as close to a typical situation as possible.  For those of you who do not know where to start, Dr. Kelly Grillo from the Council for Exceptional Children conducted a fantastic webinar last Thursday. You can check it out here: https://www.cec.sped.org/Tools-and-Resources/Resources-for-Teaching-Remotely.  Please also check out their resource listing as they have the most up-to-date listings of resources, especially those which are at no cost now to you or the schools.

I have also done several things in order to best assist us through this transition.  First, if you are on Twitter, please feel free to follow me @DrSmartEd as I am reviewing and retweeting ideas and other resources as I find and review them. I am also creating a video series on “Working with Our Exceptional Individuals During the COVID-19 Pandemic” on the School Health YouTube Channel: https://www.youtube.com/playlist?list=PL1hxoeTdARrPewCfsKbJ2IpDU_OZYqd73. This video series discusses what we can be doing at home and during preparation. It highlights activities that can be done with household items as well as items which may either be lying around the school and accessible to parents or guardians in the home environment. I am discussing what others have shared with me and trying to give an overall view of how we can make this as effective as possible for all of our students. I am also going to be adding to my blog output which you have linked to here at: https://www.schoolhealth.com/blog/addressing-the-coronavirus-with-our-exceptional-individuals/.

Two things are of the utmost importance to remember when you are designing online lessons. First, communication is critical! You must be overly explicit in directions to the students and to the parents/guardians who are working with the students. This is important for two reasons. The first reason is what one might expect, clear communication will lead to the lesson or activity being done correctly the first time. It will be able to be completed without the need for continued questioning during any of the parts of the activity. The second reason is to create a structure around the lesson or activity, thereby creating a sense of security in the minds of both the student and the guide. We are all highly anxious and stressed right now. Explicit communication helps! If it is permitted by your district, phone calls or even video connections add another layer of psychological comfort to this situation.

Second, you want to be as understanding and caring as possible. Many of our exceptional students will be overly needy and seeking attention during this time. Many people are exuding feelings of stress and those feelings are not easily understood by those with exceptionalities. As we work with our exceptional individuals, it is important to be patient during this unique and difficult situation. The first person to be patient with is yourself! We are in uncharted territory here and there is no absolute right or wrong way of doing things. Have faith in your own teaching abilities and interact with your students how you believe it is best to interact with them, following the health guidelines designed by your state and educational guidelines set up by your district.

Use any and all resources at your disposal.  If you have questions, please reach out to me at rheipp@schoolhealth.com and I will respond. Don’t forget to check out the video series too.

We will get through this together and be even stronger in our educational ways!

Addressing the Coronavirus with our Exceptional Individuals

by Raymond T. Heipp. Ph.D.


The Coronavirus epidemic has flooded our airwaves and rightly so. We must be prepared for any type of virus which could create any type of sickness, let alone one potentially leading to death. I have had a number of individuals reach out to me and ask what is the best way to work with our exceptional individuals to warn them of this and get them to take positive action, without creating undue stress and fear. This really requires us to know the individuals with whom we are dealing and use it as a learning tool that can carry into other aspects of life.

The first thing we need to do is discuss how to stay healthy. Daily activities like washing hands thoroughly, sneezing or coughing into a facial tissue or elbow if a facial tissue is not easily available are two things to begin to review. Explain how diseases can be carried through the air and on surfaces. But, by properly washing hands, we reduce the number of germs on them. By sneezing or coughing into a facial tissue or elbow, we are making sure not to spread germs toward others.  After the sneeze, we need to wash our hands too. Discuss how hospital masks can be something which helps to reduce the germs coming in or out, but we still need to make sure our hands are clean. Also consider an alcohol-free foaming hand-sanitizer when hand washing is not possible.

Bring up how to properly clean our areas too. This is an excellent opportunity to establish a purpose behind why we put away our things, wipe down tables and trays, and throw away our trash. For those wondering, I highly recommend moving away from bleach-based wipes. Bleach leaves a residue which can be problematic for those who like to touch and put their hands or other objects into their mouths. It also has a distinct odor which can cause issues for some with sensory processing issues. So what is good to use? I am a big proponent of Clorox Hydrogen-Peroxide Disinfectants. They work as well as the bleach wipes, but address the two issues above with high success. Some use peroxide to clean and whiten teeth, so that concern is eliminated.  The scent issue is almost non-existent. Ironically, if you use Lysol Disinfectant Spray or products, you will see that one of the germs it works on is human coronavirus. The current outbreak is related to that and more severe, but we know that the folks at Lysol were doing their due diligence!

Several groups have been concerned about the anxiety associated with talking about death and viruses. First, you know the cognitive level of the individuals with whom you are working. If they are of moderate to higher cognitive levels, then share the news exactly as it is with them. There have been deaths associated with this and it is right for them to know. For those individuals of lower cognitive functioning, explain that one needs to be careful and take care of his/herself or bad things can happen. We know that some individuals may not understand the differences between various illnesses and we do not want them to get over-anxious anytime he/she has a cold. Explain that not all sicknesses lead to death. By taking proper care of oneself, one can stay as healthy as possible.

The next thing we want to discuss with them is healthy eating. Not all of our exceptional individuals will be taking vitamins as a supplement to their food. Thus, we need to emphasize eating as healthy as possible. Again, you know the individuals with whom you work the best. There are going to be situations where highly processed foods are the only choices available to these individuals. So discuss things like having a bowl of cereal or a slice of bread/toast in the morning. As the basis for this discussion, use the idea that eating in a healthy way helps to fend off colds. Make the adjustments you need to make to your discussions taking into account the individuals in front of you. If you think it’s appropriate, share what you eat and why.

Dressing appropriately is also another topic to bring up here. Again, relate it directly to your individuals. There may be some who do not have coats, gloves, or hats. If that is the case, maybe see what is in the school or institutions lost and found and share with these individuals if possible. Some of our individuals may not be able to dress themselves, but that does not mean that they should not hear this discussion. They need to be included so that they might have the ability for self-advocacy later in life.

The next item to consider bringing into these lessons is Emergency Preparedness. Start with what do you do if someone gets sick in the class? Discuss and create in a visual chart how to move and where to go. Keep it simple in the way the individual flow will go if someone does get sick. Let everyone in the class know that it does happen. You can also expand that to other emergency situations. Let them know what to do if you have external issues like a fire or tornado. It is again essential to have visual cues as to where to go if these situations occur. If you have an individual who would need to use something like an evacuation chair, like the EvacuaSafe Excel, teach the individuals to stay out of its way and let them know that it is for a specific individual. It is not a toy and is only used for safety purposes.

Basically, we are reminding our individuals of how to live a healthy lifestyle and complete certain hygienic daily activities. We are using the current events in an open and honest way to reinforce the importance of these daily health activities. Yet, we are not going immediately to the “do this or die” mentality that I have heard some in the public forum suggest. We are also using this as an opportunity to review emergency procedures. Having plans like this reviewed is important for all individuals. We are not avoiding the issue; rather, we are using it as a learning tool. Our exceptional students may be getting a lot of their “worldly” information from online sources. We need to recognize that fear and anxiety can form quickly when these sources are the basis for interpretation of global issues. Being cognizant of this and working to explain things in an applicable way can move to decrease irrational escalations. This event also gives us the opportunity to create those visual maps and plans that are good for all in the time of any emergency.

Finally, invite the school nurse in as a guest speaker. Have her speak about how to stay healthy. Let our exceptional students see that school nurse as a leader in health and wellness, not just someone you see when you are sick. When we approach this epidemic in a balanced manner, addressing the specific needs of our population at a level they can understand, we create the ability for them to live the best life they can!

Reviewing ATIA 2020

by Raymond T. Heipp. Ph.D.


We have just returned from ATIA 2020 in Orlando! I have been attending and speaking at this Conference for the better part of a decade now, and I firmly believe that this was one of the best we have seen in many years. There were some consistent themes that ran through the conference and I wanted to share a few highlights with you.

First, thanks to social media and digital methods of communication, we saw a number of sessions occur during lunch breaks and immediately after the final presentations where individuals could gather based on topic, region, or group. ATIA’s sessions book up quickly with excellent presentations and presenters. That means our days get packed with information. What about those topics that were not addressed?  These informal sessions add another depth to what we can gain from gathering for ATIA. I also appreciate the fact that groups like the AT Makers and others can find times when they can gather and share ideas. This is a way to have our weekly or monthly chats be taken to another level. It also provides an opportunity to better understand the needs of each of our schools or centers in an effort to relate how various activities might or might not work for us.

I was thrilled by the number of people with whom I spoke regarding adults; both transitioning out of the school and into the workplace and at home. Adults with differing abilities are so often overlooked by the general public; yet they have so much to offer. There are a number of ways to make current workplaces accessible for our adults. We are already seeing a concentrated movement on the part of colleges and universities to better meet the needs of college ready students. Let’s step up that movement into adults.  There are a number of both software and hardware products that can easily adapt a workplace or collegiate environment.  Software like Read&Write and ClaroRead Pro do a great job of granting better access. Devices like the C-Pen, LiveScribe Pen, and Glassouse create a deeper layer of access and information gathering, while not appearing child-like. Even the specialized placement of TalkingBrix2 can give feedback necessary for doing and completing a job. We MUST NOT forget our adults and widen the understanding of businesses to the talents which they can bring to any company when given a chance.

Closed captioning for those with auditory issues and greater access to reading for those with visual impairments were other hot topics with many at the show. Part of creating access is to remember to have all the bases covered in what access actually means. Those of you designing websites need to remember to add closed captioning to videos you post. I saw some great new embossers which created smooth and complete braille documents; especially the ViewPlus ones.

As for newer products here in the US which impressed me, there were a couple which were of note. Abilia has a neat device called the MEMO Timer which is a personalized timer that can be carried or worn. It uses the idea of vertical timing with colors to provide the user with quick feedback. I also like that it can be used for anyone completing activities, and not just students. It is not yet available in the US, but that is being worked on now! Ablenet also demonstrated some of their newer versions of devices like the SuperTalker FT and the iTalk4. I love the fact that Ablenet is already creating their switches from earth-friendly materials so that they can be recycled. They are definitely ahead of the game there!

The biggest impression on me came from my friends at BJLive! Their sensory experience is amazing. They are redefining the idea of sensory room or sensory space and making it come alive for ALL age levels and locations. They are just beginning to introduce their concepts here into the US, and I will keep everyone posted on that. The applications of this are mind-boggling! They also have a new visual timer called the Resettea - it is pragmatic, researched, and has the high level of quality I have come to expect from them.

In all, this was an exciting conference and a great way to start the new year! I will be sharing other thoughts and insights with you along the way. Now I am off to CEC. If you have any questions, please feel free to contact me at rheipp@schoolhealth.com.

 

A 2020 Re-Vision for Special Education

by Raymond T. Heipp. Ph.D.


Back in the 1990s, I recall speaking at a seminar with a number of school leaders. I was asked to speak on how my school was dealing with the rise of students with ADD (we were just beginning to see ADHD in medical reviews) and how we dealt with them in “standard” classrooms as “inclusion” was not a term being used. One of the other speakers was speaking about working with students as a whole and posed this question, “What if we taught every student as though they had an IEP?”

That question created mass panic to the attendees at that time. They were picturing the fact that each student would have a paper IEP and that they would have either a class of 30 students with IEPs at the elementary level or 5 classes of 30 students with IEPs at the middle and high school levels. That was not what the speaker was intoning. Rather, he was speaking about the approach to teaching by taking into account each student’s abilities along with the class material.

A few years later, I would have the opportunity to discuss the work of the late Dr. Gregory Knittel with him where he focused on the decision-making process of master teachers in classes. Dr. Knittel found that a Master Teacher makes a formal decision about once every 30 seconds in a class. Those decisions focused on the students and how they are interacting with the material. A Master Teacher was keeping in mind the ways that the students processed information and working to ensure that the opportunity for learning was there for all students.  He also found that those who were not master teachers only made formal decisions once every 90-120 seconds and those decisions focused on the material or behavior of the students, not on the actual learning.

So, what does all of that mean for our Special Education classrooms? What if 2020 became the year we began re-visioning special education? Yes, we are still going to have IEPs (digital and paper now) for our students. And yes, we will still have some students who need to be in specialized classes. But, let’s really get our school communities in line with an individual’s potential. Let’s create scenarios where our students come to appreciate ALL of their peers and not just those who excel on the athletic field or in the classroom. We read stories on a regular basis of how an individual with differing abilities is making a positive impact in the lives of other students, so let’s create that on a daily basis in our classrooms.

On my Twitter feed (@DrSmartEd) last week, I picked up an amazing story from my alma mater, Saint Ignatius High School. Every December, they have a Student-Faculty basketball game to wrap up a Community Day focused on service. This year had an amazing event occur. One of the seniors asked if his younger brother with differing abilities could get in the game. His brother was sent to the foul line (adjusted slightly) and asked to shoot a free throw. The young man made the free throw and it was like he had won the NBA Championship. The seniors all mobbed this young man and celebrated his shot. What a gift this young man gave to the entire school community watching. We need to capture the emotion of this and make it real each day.

We read about schools who are implementing coffee or snack carts. Let’s get more of those out there with our students who have differing abilities manning them. The life and social skills gained from this are tremendous, along with the desensitization of our neuro-typical students in interacting with these students on a regular basis. Let me know at rheipp@schoolhealth.com if you would like ideas as to how to make something like this happen.

But it cannot stop there! What about having students with differing abilities read daily announcements. I have seen some schools who use video announcements use students with Down Syndrome or CP as co-anchors. What about having some of those students work together with the Speech and Debate team or Model UN group? Individuals with differing abilities make sensational actors and stagehands and can be part of school productions or videos. What about having some of the older students with differing abilities go down to the elementary and pre-k classrooms and read to those students?

In our transition programs, let’s get our hands “dirty.” So many schools have to put together their own kits for teaching skills to students. Let’s look at some of the alternatives and never put a job out of a student’s reach until the students have come to realize it is out of their reach. I know of a school in Texas where several of their students with differing abilities, including a young man with Down Syndrome, learned to weld! Let’s not forget the Dr. Stephen Hawking’s, Dr. Temple Grandin’s, Alexis Wineman’s (Miss Montana 2012 and first Miss America Pageant Contestant with autism), and Brad Cohen’s (teacher and administrator with Tourette Syndrome) of the world and use them as role models for ALL of our students. Again, feel free to reach out to me for suggestions on approaches.

To some of you, this may sound like pie in the sky. I completely understand and you are right, to a degree! The question for us becomes if you don’t start it in your school or community, who will? Education should always be about hope – hope for the future. We are bringing skills and abilities to our students which could positively drive their future lives. Ableism is an issue today and we are the ones who can begin to diminish its effects in our communities. Let’s look at what we are doing and focus on the approach. As we approach things with a “Yes, we can!” mentality, we inspire others to do so. There is no magic wand for this and it will not occur overnight. But it is teachers, administrators, therapists, and people like you who are making a difference and moving the world in the right direction.

You are a gift to this world as are our individuals with differing abilities! Let’s work together to make sure that everyone has the opportunity to succeed. Let’s create that re-vision here in 2020 and keep it moving through this decade.

Lights and Sounds and Holiday Time, Oh My!

by Raymond T. Heipp. Ph.D.


November winds have brought in a change in weather along with an anticipation of the upcoming holiday season.  The sights, scents, and sounds of this time bring back wonderful memories of the past for some. Unfortunately, those same sights, scents, and sounds may also trigger high levels of anxiety and a sense of overwhelm in others. When preparing for your holidays, whether in a classroom, therapy room, or home; keep in mind your students, clients, guests, and self. Please be aware that this is not a post focused on taking away holiday traditions. Instead, we can take those traditions and make them more accessible to everyone.

Let’s start in the classroom or therapy room. We exist in a day and age where holidays are celebrated in different ways. Some classrooms are permitted to decorate for the various holidays, while others are not. No matter what the guidelines of your school or center are in the decorating or celebrating of holidays, there are specific ideas to keep in mind. First, remember that there is an energy which flows through the very air at this time of the year. It is a sense of anticipation and excitement for many of our students. So, the first thing to create is a place that maintains calm. If decorations are permitted, put them out in a tasteful and purposeful manner. Have a set area of the room which recognizes those holidays but maintain one area that is holiday-free. If you already have a sensory space in your room, use that as the holiday-free area.

Watch the use of any scents in classrooms and therapy rooms which are not normally being used. For example, I have been in some therapy rooms which used infusers with scents like peppermint, lemon, or orange to increase focus and awareness. I have also seen the use of essential oils in both classrooms and therapy rooms. Essential oils which promote focus or wellness are in some rooms and create an engaging environment. However, be careful adding something new to environments. Although scents like pine, cinnamon, and apple might be appropriate in the home environment, they might be triggers and confusing in the classroom or therapy room. Be consistent with what you have been doing and do not cause confusion by changing the routine.

Be aware of lighting. Some individuals do not like lighting, especially the LED lighting of today. I have been in several sensory rooms which do use tree lights on the ceiling. But they use it as a matter of setting a mood. Therefore, using similar lighting in classrooms can cause confusion in some. Watch for the overall brightness due to the number of the lights too as it can be painful to some.

In the home environment, decorate as you normally would. Be sure to introduce each decoration and explain why you are putting it out. If it is something of a tradition for you already, share that information with others so that they understand the tradition. Invite the individual to help, but understand if they don’t wish too. Be sure to ask if they don’t like some traditions. For example, my son did not like watching the original version of the Grinch. Ironically, he did not like the scene near the end where the Grinch’s heart grows and the colors that flash out when this happens. So be aware that parts of television and movies can be something that causes some triggering. He still does not like that scene today.

Prepare all individuals for special meals and family gatherings.  Have practice dinners with simple ingredients. Perhaps, introduce foods and flavors earlier so that there are no surprises at the meal itself. Realize too that any cooking going on automatically changes some of the scents of the house. Again, have a place where individuals can go to “escape” the holidays. Whether it is a bedroom or area of the house or apartment not being used, introduce that as a safe space. Discuss prior to the gathering the location and what can be done there like reading or just sitting quietly. Have some noise-cancelling or noise-reducing headphones available in case the level of sound is what is creating the overload. Home should always have a safe place.

If you are travelling, think about the place to which you are going. How might you handle any escalations there? Keep in mind rooms where an individual can go to calm down. It is absolutely appropriate, if an escalation is taking place, to move the individual to a different location and let him or her watch a tablet or listen to music through headphones. I realize that it is not easy trying to explain behaviors like this to anyone, even family. I just spoke with a mother who dreads the holidays because her family does not understand escalations or how to work with them, believing the child to simply be ill-behaved. In situations like that, plan for briefer stays. Maybe even do some prep work with the family as a whole, although that is a daunting task in itself.

The final focus for the holiday season must be for yourself! Take time each day for your own special time. Find that activity which best fits your needs. For some, it might be hitting the gym, taking a run, riding a bike, or engaging in yoga. For others, it might be a cup of hot herbal tea and some time for reflection. The important thing to remember is that this type of time is essential. Please be sure to find that time, even if it is only 5 minutes, as you are critical in this whole process. What you have to do is to make sure that you are actually relaxing and re-energizing your body and mind. Some make the mistake of thinking that by simply reading a fictional book or vegging in front of a screen is the same. The reality is that those latter actions are simply avoidance tendencies which do not aid the body in overall relaxation. Find that activity which replenishes yourself as the holiday season can be even more stressful for you as you are dealing with so many issues, including hosting gatherings and getting gifts!

Be present to yourself and your needs. Then, you can be present to each individual and his or her needs. Remember, we can continue with holiday traditions and activities. We just need to create additional ways of access for everyone, even those with significant sensory issues.

May this be a wonderful season for you, your family, and all with whom you work! We here at School Health wish you the best!  If you have any questions for me, please contact me at rheipp@schoolhealth.com.

Social Media and Our Exceptional Individuals

by Raymond T. Heipp. Ph.D.


The school year is in full swing. Over the last several weeks, I have had the opportunity to attend this year’s Closing the Gap Conference and meet with districts and universities throughout the eastern half of the United States. There were the standard topics upon which I was asked to speak like sensory spaces, adaptive seating, transitional curriculum, and questions about specific individuals. However, there was one topic which caught me off guard. That topic was social media and how it is used by our exceptional individuals.

The most significant issue which teachers, administrators, aides, and therapists described was the fear of cyber-bullying. That is definitely a significant problem in today’s society as a whole.  We see reports every day about how our neuro-typical students have to face cyber-bullying.  Our concern is magnified when we think of how some of our exceptional individuals might have a harder time understanding and dealing with this. What I heard from some groups is that they try to keep their individuals off social media altogether. I am not a fan of that approach and here is why.

Back in the late aughts, I conducted a number of administrator trainings with the focus on being able to guide and assess teachers using digital information through educational technology. The biggest issue in many of their minds was how their teachers were using interactive whiteboards – most were using them as a screen on which images were projected. When it came to interaction, many classrooms only saw the teachers using them as a substitute dry-erase board (chalkboards for those of us from a different era.) As I took the various administrators through these sessions, I always ended with social media. Twitter had just begun and the opportunity for designing and growing one’s Personal Learning Network (PLN) was so revolutionary. Facebook had already begun its descent upwards. MySpace was already on its downward trend. There was one training where I had a superintendent interrupt me and say that social media was something his district would “never adopt as long as I am alive.” I had never had that vocal a response before so I asked him why. “I don’t care about what somebody had to eat last night. I only care about my kids passing their tests.” As you can see, his words still echo in my mind a decade later.

I thanked him for his candor and asked him if he thought his students were still going to use social media. He answered affirmatively and went on to add that they were kids and would do what kids do outside of school. I then asked him if role models were important to kids. He said yes. I kept going and asked if he believed his teachers were role models, to which he again said yes. So I asked him why he would not want his teachers to be the models for how to use something like Twitter or Facebook. I added that if his teachers were not going to be the role models, the most influential people on those platforms would be people like Brittany Spears (who had one of the largest number of followers at that point). So I asked him who would be the better role model for his students. As you might imagine, that line of reasoning caused a shift in his thinking.

I compare his thinking to the reasoning we are using today with social media and our exceptional individuals. I too am concerned with cyber-bullying. However, we often fail to recognize that cyber-bullying is now something we discuss in the news every day. When it is done covertly, it is bullying. But when it is done overtly, some hide behind their “right to free speech.” So how do we address this balance?

First, I firmly believe that to restrict anyone, especially our exceptional individuals, creates more of a desire to use these platforms. It also creates a gap between those individuals and their peers. My son recently began his collegiate career. Even though I have been on Twitter for over a decade and stay in contact with family, friends, and former students on Facebook, he was never big on using social media. He recognized that some of his friends were putting things on Facebook that were “silly” as he put it. He only joined the Facebook realm because some of his activities began posting schedules and other information online and he appreciated (as did I as a parent) the ability to have this information readily available. Texting became blasé for his peers and they became the SnapChat generation. It is amazing how deep their conversations can be via this platform. I have seen my son support others and be supported in ways not possible before. These students are also big into Instagram and I have been told that Facebook is for us “old” people! But the reality is that they are creating relationships which can span greater distances than ever before.

I bring these points up because social media is the way our young folks connect today. This is their world and not ours. They live in a global community which is much smaller than ever. It is as though the world is shrinking for them. Boundaries can be less strict. We have to understand that the days of having “pen-pals” and using rotary phones to talk to each other have been replaced by live video chats and cell phones with unlimited minutes. So who will be the ones to guide them and be their role models? We must be willing to take that role (even when SnapChatting is completely confusing!)

I follow a number of exceptional individuals on Twitter and never cease to be amazed with how much I learn from them. I am not at liberty to share their information in this blog but if you follow me at @DrSmartEd, you have probably seen me retweet or comment on their posts.  They let themselves be connected to the world beyond their homes. They also have the proper support that lets them pick and choose who to allow to directly connect with and who to block when necessary.

I had one group ask me why I thought it was good for even those with severe conditions to be on a social media platform. I explained that all too often, individuals only receive compliments or have contact with a small number of people. By expanding that group size, we can actually generate more positivity for these individuals. If they are of age, have them take selfies or have someone snap a picture of them doing various activities and create the posts. Find good folks to connect with (I follow the Dalai Lama!) Let our exceptional individuals interact on a positive level globally. These individuals feel constrained enough without letting them engage in activities that their peers do.

Will this eliminate cyber-bullying? NO! But by giving proper guidance and support, they can begin to see this negativity for what it is. We also can be there to translate the “bullying” going on overtly into distinguishing between facts and opinions. For those with more severe issues, we can guide them to the positive side of this world! We want them to be proud of who they are and what they bring to this world. We also want them to begin to understand that there will be adversity in this world and sometimes it will be directed towards them. By modeling for them how to deal with this negative feedback and how to block while reporting bullies, we are able to be there for them, even when we might not be around.

Please feel comfortable in having our exceptional individuals on various social media platforms.  Be there for them and don’t fear being on these platforms yourself. Model for them how to use these platforms correctly and how to be strong in the face of adversity. We will not find an answer to or get rid of cyber-bullying. However, we can equip individuals to better handle it when it arises. We can also have them comfortable with connecting with the outside world and being happy with who they are.

And if you have insights as to how this SnapChatting can be easier for us “old” people, please let me know!

Track My Route: Providing Special Education Transportation with Safety at Every Stop

Guest Blog by TMR Technologies


Technology in schools has continued to evolve in the past decade to improve the student experience in the classroom. Tablets, laptops, and smart devices have been crowding classrooms across the country, but school transportation has largely remained the same. TMR Technology is trying to bring school transportation up to speed with the rapidly improving technology available today.

TMR Technology provides schools K-12 with innovative software solutions to improve efficiency, convenience, and safety. Founded by a group of Indiana University students in 2017, we set out to solve a problem that each of us faced growing up; the trials and tribulations of taking the school bus. Our first solution, Track My Route, is a mobile application that tracks school buses for parents and students grades K-12. It uses real-time GPS tracking and provides a user-friendly mobile interface. The solution was created to help reduce both the morning rush atmosphere and the time that students are stuck waiting outside at the bus stop. Parents with busy schedules that rush to meet their child at the bus stop don’t have to guess when the bus will arrive, and school administrators can spend less time responding to calls from parents asking where the bus is.

School transportation for parents of special needs students can be an immense challenge. We take pride in helping special education programs overcome this challenge because that is where we got our start. Our Track My Route solution was first piloted in a special education cooperative in the Chicagoland area, and they are now our longest tenured customers. While working with the cooperative we were able to determine what our users needed from our solution for it to effectively improve their transportation experience. Most special education buses pull up directly to the students house instead of a stop nearby. TMR was able to take this into account to ensure our Track My Route solution can provide special education riders safety at every stop.

Cindy Lambrakis is the operations manager of special needs transportation at American School bus, and believes Track My Route can alleviate pain points that come with student transportation. "From an administrative perspective, Track My Route will help to alleviate the volume of calls that our dispatchers are inundated with on a daily basis. The drivers will be able to concentrate on driving and not radio chatter." She went on to discuss special needs transportation. "Structure is very important to a special needs child. Once a parent has put on that child's coat or safety vest, that child knows he or she is ready for the bus. When the bus is late, their routine was just stopped. This can negatively affect their behavior both on the bus and in the classroom. Track My Route will accurately let the parents know where that bus is, allowing the parent control on the timing of the coat/vest, ensuring everyone is ready for a great day. Planning for medication, bathroom breaks, doctors appointments, etc., is important to our parents. Tracking the bus times would be very valuable for the parents' management of these issues."

The cooperative fully implemented our solution to make it available to all of their student riders for the 2018-2019 school year. We are looking forward to providing them with their second year of Track My Route starting this fall and releasing several new updates for their users here soon. We are continuing to expand the user base of TMR within the Chicagoland area by adding Libertyville District 70, who will also be using Track My Route starting this fall semester. If you are interested in learning more about TMR Technology you can visit www.trackmyrouteapp.com or email info@tmrtechnology.com

The Mindful Classroom

by Connie Morris


From my days as a student, to a long-time educator, I will never outgrow the first day of school excitement. Our back-to-school is a week out, and I have restless nights, to-do lists, shopping lists (which comes with a price tag) and felt the summer days slip away. I spend time setting up the class environment to be welcoming, warm and stress-free. I am not alone; I am surrounded by teachers doing the same thing. And even before one student walks through our doors, we need to remind ourselves of the words we hear prior to take-off when flying:

In the event of a decompression, an oxygen mask will automatically appear in front of you. To start the flow of oxygen, pull the mask towards you. Place it firmly over your nose and mouth, secure the elastic band behind your head, and breathe normally. Although the bag does not inflate, oxygen is flowing to the mask. If you are travelling with a child or someone who requires assistance, secure your mask first, and then assist the other person. Keep your mask on until a uniformed crew member advises you to remove it.”

Secure your mask first. We do travel with children every day. If you want to create a mindful classroom, encompassing social emotional learning, you need to take time for self-care. Studies have supported adult stress can affect children’s stress levels. It is important we model the behaviors we are hoping to develop. We are managing students, the learning process, health, behavior and emotions. That is stressful! Don’t forget to use these hints for school in your own life.

Take a few breaths. Deep breathing can quiet our minds. It will release stress, anger, and frustration. Neuroscience explains focusing on and changing your breath also changes the chemicals in your brain. It is an exciting lesson for older students teaching how we, as humans, have this ability. Deep breathing is a great tool when addressing the Social Emotional Learning component of managing emotions.Join your students in starting each day with mindful minutes. Start small and add time as you all grow in this skill. Take a slow breath in while counting to four, then slowly breath out to the count of four as you exhale. Give verbal reminders throughout the day to students when they can transfer this skill as they need it.

Take breaks. Stress happens! Teaching children to take a break, walk or go get a sip of water is a coping skill that can last a lifetime. Go on a mindful walk when the class seems to need a bit of quiet time. Look for season changes, four-leaf clovers or search for nature items. You and your students will return learning-ready!

Move! Mindful movement binds the body and mind. You can create space and time for this in your schedule or for individual needs. Yoga mats are helpful boundaries, but any space will do. Using visuals will help everyone stretch, twist and balance. Studies support mindful movement increases focus, academics, self-management and social skills.

Practice mindfulness. Allow the students to sit comfortably. Play quiet music and dim the lights. Take a thorough body scan, from head to toe, releasing any stress or tension they are aware of. This is a great time to offer lotion for their hands. Instruct them to rub their hands together quickly and then cup their hands on either side of their face and take a deep breath. Try this for three breaths, not only is it relaxing, but your room will smell great!

Be grateful. In even the most challenging situations, gratitude changes our outlook on things. By practicing gratitude, we rewire our brains to see the positive. What better skill could we hope for in our students. Our attitude is contagious! Help students recognize and verbalize each other’s strengths. Your room will become a warm and nurturing environment naturally.

At the end of your day, when your head hits the pillow, allow yourself to relax and reflect. Be thankful for your career, for your students and for the difference you make. Take a few breaths, scan your body and let go of any stress, and most of all, be positive. You are special!

Clarifying Color-Vision Deficiency Screening

by P. Kay Nottingham Chaplin, EdD


Good-Lite ColorCheck CompleteVision screeners frequently have questions regarding when to follow the recommended manufacturer instructions for color vision deficiency screening tools. This blog is designed to address that question, and also provides a solution for color vision deficiency screening in preschool- and school-aged children beginning at age 3 years.

Many state vision screening guidelines recommend that color vision deficiency screening follows manufacturer instructions when conducting the screening. Confusion may occur when the manufacturer instructions are written specifically for optometrists and ophthalmologists to use during eye examinations. Color vision deficiency testing in a doctor’s office differs from screening for color vision deficiencies in schools, Head Start programs, or similar settings.

Instructions for color vision deficiency testing may call for monocular testing - or testing one eye at a time with the other eye covered (occluded). When screening for color vision deficiencies in schools, Head Start, or similar programs, the screening should be conducted binocularly (both eyes open and uncovered).

This difference in monocular testing during an eye examination and binocular screening in school, Head Start, or similar settings is supported by James E. Bailey, OD, PhD, Distinguished Professor Emeritus, 2018, Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, CA (personal communication, June 5, 2019).

If all vision screening for the child is successful except the color vision deficiency screening, the child should be referred to an eye doctor for an eye examination (Nottingham Chaplin, Baldonado, Cotter, Moore, & Bradford, 2018).

The eye care professional will confirm whether a color vision deficiency exists. If a child has a color vision deficiency, the eye care professional will also identify the type and severity (mild, moderate, or severe) … The eye care professional will also consult with the parents/caregivers regarding how the type and severity of the color vision deficit may affect the child’s learning, life, and career choices.

Ask the parents/caregivers to obtain a copy of the results from the eye care professional and to share those results with [school or Head Start staff, for example] because classroom and/or learning activities may require accommodations when color deficiencies are present.” (Nottingham Chaplin, et al., 2015, p. 211).

When state vision screening guidelines call for color vision deficiency screening for preschool- and/or school-aged screening, the Good-Lite ColorCheck Complete Vision Screener includes LEA SYMBOLS® for preschool-aged children and LEA NUMBERS® for school-aged children. The LEA SYMBOLS® section includes one demonstration plate and seven plates for red/green screening. The LEA NUMBERS® section includes one demonstration plate, 14 plates for red/green screening, and three plates for blue/yellow screening. Instructions are included in the Good-Lite ColorCheck Complete Vision Screener.

Screeners in a school, Head Start program, or similar setting using this book would conduct color vision deficiency screening binocularly (both eyes open and uncovered).

 

References:

Nottingham Chaplin, P. K., Baldonado, K., Cotter, S., Moore, B., & Bradford, G. E. (2018). An eye on vision: Five questions about vision screening and eye health-Part 2. NASN School Nurse, 33 (4), 210-213.

How the Term 'Sensory Room' Became the Kleenex of This Generation

by Raymond T. Heipp. Ph.D.


“We are looking to put together a sensory room, what products do you suggest?” That is one of the most dangerous statements I hear these days from educators looking to better support their students. What so many educators do not understand is that the term “sensory room” means different things to different people. So much so, the “sensory room” today has taken on an all-encompassing meaning in much the same way as “Kleenex” did for facial tissues back in the 1920s when they were first introduced.

We have the research that demonstrates higher levels of anxiety within our students today. We have also seen evidence that sensory breaks, even as simple as chair push-ups or standing up, adds to a student’s ability to focus. Finally, we know that having a room where students can go when they are escalating can decrease the amount of time for the escalation and lessen the impact of that escalation on other students or adults. But how do we go about creating the right atmosphere at a reasonable cost?

When I work with groups, I begin by asking them what they hope to accomplish with this room or space. I get a lot of strange looks as these well-educated teachers just assume all sensory rooms are exactly the same. That is when we begin to speak about several purposes that these rooms or spaces may actually have. The first type of room we discuss is the actual sensory room where students have the opportunity to touch, walk on, see, hear, and smell different textures, colors and scents. These rooms or spaces are excellent for younger students. They begin to experience the world in a protected environment. These areas are good for all students too, not just those with differing abilities. What we tend to see is that the older the students get, the less they need of this type of space or room.

Which brings us to the second type of room we discuss, the movement room. The movement room is exactly as it sounds. It includes a multitude of ways for students move and experience the world in a different way. These rooms often have items on the floor for balance or movement. They usually have some type of swing for vestibular feedback. We also often see jump ropes, bungee jumpers, flags, bean bags for physical activity; although the kids look at it as play. These rooms tend to be good for all students at all ages. The difference lies within the ages of the students as to what items might be found in the setting.

A third type of room is actually a calming room. We see more of a need for this for students as they begin to get older, although individuals of any age are prone to escalation. This needs to be set up in a specific room with a focus on items that calm rather than stimulate. Bean bag chairs, fiber optic lighting, sands or putties are all items which work well in this type of a room.  Ironically, the more care put into this type of room the better for the staff too! Within any educational setting, the pressure of the day needs to be released and a room like this helps everyone.

The next question I ask focuses on the students or adults who will be using the room or space. Understanding who will be using the room will assist in deciding what items should go in the room. That is important as there is no “one-size-fits-all” in products that help everyone. You want to know if there are items which need to be avoided due to some individuals perseverating on them (usually ones that make noise or having some repetitive action) or items which are a must-have for certain groups. We must be cognizant of those using the room so that we do not bring in items which defeat the purpose of the room or cause anxiety.

Does this mean that ready made kits or packages are not good? No, not at all. Some of these packages have the large items that fit a purpose and a population. We can then contextualize smaller things for the specific population of that location. Some of these packages also make sense from a fiscal view as they cost less than the items sold separately. My caution to you is to be careful of the groups who simply ask you the size of the room or try to push a “deluxe package” on you. There are some excellent packages which cost $20,000 and more. Again, those might be the right choice, once we have decided on our purpose and have looked at who will be using the room.

Please be careful too of items from the local dollar store. There is a reason that these items are there. Their lack of durability might be a problem and you might end up spending more than you would have in replacements. Our students can break anything and will often find a way to break things that we thought were unbreakable. However, buying something because it is cheap is not a wise investment. The other caveat for some of these dollar store items is that they may contain latex or lead-based paints. We have to be cautious for the health of our students.

I do firmly believe in having these rooms or spaces in all of our schools. However, the proper preparation needs to occur before simply going out and getting things. Do your homework and don’t be afraid to call in the support of those you might trust. Every student and adult needs sensory feedback in some way throughout the day. Let’s provide that support for everyone!

I am there for your support too, so feel free to reach out to me at rheipp@schoolhealth.com.

We Are a Crocus in this World

by Raymond T. Heipp. Ph.D.


CrocusWorking with individuals with differing abilities stands out as one of those occupations that is considered more of a vocation than a job. The role one plays does not matter in this consideration. There is no such thing as a hierarchy outside of any structures created so that “personnel evaluations” can be conducted and managed, along with rewarding those who have helped shape the lives of so many. Thus, the title one has; teacher, therapist, administrator, aide, nurse, parent, guardian, etc.; does not diminish the energy one puts into this role.

This role can be one of the most draining roles of any in the world. It is most draining on one’s emotions! Every day, we go out and work with individuals knowing that they bring a strong message to this world. Yet, to the rest of the world, these individuals are seen as either someone to simply be pitied or someone who is “a burden to society.” In both of those cases, the rest of the world has no clue about that individual. This external push back can also be a drain on those of us working with these individuals daily. We also become emotionally drained when our expectations for progress need to be tempered with the challenges that each individual faces.  We do see regression and struggle. We work extremely hard at finding solutions or techniques that might help only to sometimes find that the individual does not react well to them. We look at them almost like our own children (even if they are adults!) and seek to protect them and give them the greatest chance to succeed. Between the struggles, the outside perceptions, the stress and emotional duress, and the demands on our lives, the question must be asked; “Why do we do this?”

The answer is simple. We do this out of hope. Hope, that characteristic which remained in Pandora’s box, forms the reason we do what we do. Hope is that voice inside of us pushing us to go one step further with that individual. Hope is that feeling we get that says we will make a difference; and we do every day! Hope presents us with the ability to look in an individual’s eyes and see what they bring to this world. Hope is a life-giving force for us, even on those days where we feel spent.

We feel the true essence of hope. Many look at hope as something akin to wishes. “I hope I win the lottery” or "I hope to find true love” are statements that detract from the depth that hope should bring to any individual. “I hope spring arrives soon” is what I am hearing as I write this at the end of an 18 day trip working with individuals in multiple states. That is a concrete example of equating hope to a wish. We know that spring will arrive at some point and it is more of a wish that we stop having snow, colder temperatures, or inconsistent weather. That is not the real meaning of hope.

Hope is learning that the beautiful young lady with severe CP and verbal apraxia is able to complete a significant amount of high school classwork independently and carry a 3.0 average. Hope is seeing the smile come from a non-verbal child because you are talking to them and then having them guide your hand as they try to communicate to you. Hope is watching the young woman with Spina Bifida and other physical issues compete in the Para-Olympics. Hope is watching a young man who was non-verbal as a child and is on the autism spectrum be accepted into the honors program at a major university. In all these cases, hope is not some wish. Hope is the driving force that keeps us focused on why we do what we do. It is the belief that the outside world is incorrect in their suppositions about individuals with differing abilities and that we can assist those individuals in overcoming their obstacles and live a vibrant life. Hope places within us the understanding that our actions do make a difference and the faith to know that we might not be there to see what difference we made, but know that we made it.

In nature, hope exists in the essence of the crocus. The crocus is a beautiful little flower that blossoms each spring. It does not wish that spring will come soon. It knows what its role is and will push through to bloom no matter what the weather might be. Those of us in the Midwest have seen (too many times, unfortunately) snows in March and April. Yet, the crocus comes out knowing that spring is coming. It is filled with the hope that says “Take Action” and it has no doubt about what it is doing. Those of us who work with those with differing abilities have that same hope. It is a hope which says “Take Action” to us and pushes us to understand that the snows and bad weather of life cannot hold us back. The other neat thing about the crocus is that it has the ability to naturalize even in grass. That means it can grow and increase its numbers even in areas where growth might not be expected. We are that crocus; naturalizing by working with each other and recruiting others to understand that “Ableism” is another of the “isms” which must be removed from our existence. We all have something amazing and beautiful to bring to this world. Thank you for what you are doing and know that you are not alone in this venture!

CEC 2019 – Braving the Polar Vortex for Our Friends

CEC Recap ImageCEC 2019 saw some unusual weather in the Indianapolis area. The arrival of the polar vortex was not what most attendees were expecting when they were planning their trip this year! I happened to be speaking to a group recruiting teachers to Alaska and they were using the tagline “Alaska is the Hawaii of the North!” as on the first full day of CEC, Anchorage, Alaska was 25 degrees warmer than we were in Indianapolis and that doesn’t even count the wind chill!

Yet, inside the building, there were excellent ideas and presentations going on. As I prepared for the conference by reviewing the sessions, I was not surprised by the number of research-focused sessions. However, I was pleasantly surprised that the next three most prolific topics there were: Autism Spectrum Disorder/Intellectual Disability; Collaboration and Inclusive Practices; and Personnel Preparation. We are at a point in time where the ideas of inclusivity and awareness of how to support students with differing abilities are at the forefront of Special Education.

Within the context of inclusivity, there were a myriad of sessions describing how the simplest adjustments can bring about high levels of success for all students. The critical piece though in any movement toward true inclusivity is to ensure that the teachers and paraprofessionals are properly supported and trained in approaches which work for all students. Even when I was heading up a Special Needs Program in the 1990s, I remember the concern of teachers being “how can I help these students when I know nothing about their issues?” Back in the 1990s, we were mainly dealing with issues of ADD and physical issues like CP. Today, we see that there are more differing abilities which are not restricting our students from succeeding in classrooms. It is the lack of funding for holistic preparation for our teachers which is slowing us down. The irony is that the techniques which best support our students with differing abilities also are supportive of our neuro-typical students too.

How do we continue to move toward more inclusivity and a transparency in technology for students in the classroom. Teacher preparation is the first step. I am seeing many universities already moving toward courses which focus on inclusive pedagogies within their general education classes. This is not to say that there should not be Special Education classes. However, the awareness of how to work with a student on the autism spectrum is also good for working with the neuro-typical population. Simple things like pacing, verbiage, sensory awareness, and approaches to assignments are supportive of all students. We also need to recognize that there are students with differing abilities who may not be diagnosed. Understanding a variety of teaching techniques is important for those students too.

Another important take-away from the conference was the message that there is not a one-size-fits-all approach for working with students with differing abilities. The more we share approaches which work, the more we are able to adapt to the specific needs of our students. Using approaches which incorporate multi-modal learning along with including opportunities for sensory feedback better meet the needs of our students, but require proper training and support to be used effectively.

Due to the timing of this year’s conference, vendors found themselves with a decision as to whether to attend CEC or ATIA. Only about 5 vendors sent groups to both conferences. On account of that, I was not able to see the “Sidekick” from Ablenet in action. Thanks to my colleagues, Terri Griffin and Gabe Ryan, I was able to get some firsthand feedback. It seems like an amazing device which permits any user to use devices like a trackball or a standard mouse with an iPad. Thanks to the good folks at Ablenet, I will have one when it officially comes out later in the year and will be able to feature it in some of my AT Seminars. So look for a review of that in the coming months. While at CEC, I was impressed with the Talking Pen. I am doing a little more research with this device, but see many potential applications for our classrooms, including adding to making reading a more inclusive process.

If you were not able to attend either CEC or ATIA and would like to have me stop out and talk more to you and your staff, please let me know. I am back out on the road bringing AT Seminars and other sessions to districts throughout the country. By sharing what is working for us in the classroom, we are able to come closer to creating highly inclusive environments for our students.

Student Athlete Risk for SCA

PLUS_EV_sch_soccer_2_HRIs your team prepared?

Coaches spend countless hours preparing student athletes for competition, but how about training them to save a life? Studies show between 6,000 - 8,000 teens experience sudden cardiac arrest (SCA) annually;of those affected, only 1 in 10 will survive.2

Student athletes are at heightened risk for SCA due to the additional strain placed on the heart during athletic conditioning and competition. Contributing factors include the influx of adrenaline, dehydration, fever, and changes in electrolytes.3

An SCA victim’s best chance of survival depends on having an automated external defibrillator (AED) close at hand. Nine out of ten victims who receive a shock from an AED within the first minute’s survive.Ensuring that your students and coaches are trained to respond to an SCA emergency could help save a life.

SCA can strike without warning, but sometimes symptoms are presented.

Train your student athletes to know the warning signs:5

  • Fainting

  • Chest pain

  • Shortness of breath

  • Irregular heartbeat – racing or fluttering

  • Dizziness or lightheadedness

  • Extreme fatigue


Watch this video to learn the story of a high school volleyball player whose life was saved when volunteers took action.

Having AEDs readily accessible throughout your school’s campus will help ensure that you are prepared to respond to an SCA emergency, whether it happens on the field, in the gym, or in the cafeteria.

 To learn more about how the ZOLL AED Plus can help prepare your school for an SCA emergency click here.

Sources:

1“Sudden Cardiac Arrest and Teenage Athletes: What’s the Risk?”. Promise powered by Nemours Children’s Health System. https://blog.nemours.org/2017/02/sudden-cardiac-arrest-teenage-athletes-risk/

2“AHA Release 2015 Heart and Stroke Statistics”. Sudden Cardiac Arrest Foundation. http://www.sca-aware.org/sca-news/aha-releases-2015-heart-and-stroke-statistics

“Sports and Sudden Cardiac Arrest(SCA)”. Cardiosmart – American College of Cardiologyhttps://www.cardiosmart.org/Heart-Conditions/Sports-and-Sudden-Cardiac-Arrest

4Source: 2017, AHA Mediagenic Survey Results; 2017, AHA with Edelman Intelligence; 2017, AHA with BLR Media; Postgrad Medical Journal, October 2007.

5”Sudden Cardiac Arrest (SCA) in Student-Athletes”. California Interscholastic Federation. http://www.cifstate.org/sports-medicine/sca/index

Addressing the Multi-Ton Gorilla in our Midst Throughout 2019

by Raymond T. Heipp. Ph.D.


StressI wish you and your families a happy and healthy 2019! For many, transitioning into a New Year is a time of hope and resolutions. Many see this transition as a time for positive change and a better tomorrow. While they should keep their focus on that positive change, we must not forget that there are those who are struggling now more than ever. During this time of transitioning, those who suffer from high levels of anxiety may not see any level of hope at all.

Throughout 2018, I was asked by many groups to speak on and assist them with understanding how the sensory item side of assistive technology could help those with differing abilities. We began to see a better recognition by the outside world of the value of sensory input and how it could calm and balance some individuals. The wonderful thing for me to experience was the amount of teachers, therapists, and people in general who found some sensory item they liked and began discussing how it could help them. There was a subtle transition to understanding what I and others meant when we said that everyone has some degree of sensory processing issues and that the use of appropriate sensory items could be good for all.

As I worked with various groups like school districts, hospitals, and support organizations, I began to get a better sense of an issue which is rampant throughout our greater community; anxiety. Anxiety has been around since the dawn of time; but in recent years, its effects have begun to reach more people at even younger ages. It is a belief among some that this spike in anxiety is simply due to millennials coming of age. However, as bizarre as it is to blame millennials for everything, the rise in anxiety is not their fault. We can trace early writings in Western Civilization regarding anxiety to Greek and Roman authors who addressed “distress” and the dealing with emotional outbursts. Yet, some in our culture look at anxiety as a weakness, rather than as a common issue.

2018 saw a rise in public admissions of issues surrounding anxiety. Even professional athletes, like Kevin Love of the Cleveland Cavaliers, began to admit to dealing with anxiety and its comorbid colleague, depression. A recognition of the role of anxiety in daily life was presented with some understanding, while others hearing these stories continued to live in denial and make excuses. There are no excuses with anxiety. We all will feel it at some time and all have to deal with varying levels of it in our lives.

There are some positive movements in addressing anxiety in daily life. Post-Traumatic Stress Disorder (PTSD) is an affliction for many individuals within our country. It is most associated with those who have served in our military. Its recognition can be the defining factor in helping those who suffer. There are programs being developed, like the one for VA Hospitals by Dawn Robinson, which seek to identify those with PTSD and assist in the development of a plan to help those individuals cope and live a better life, as anxiety-free as possible. As Ms. Robinson has stated though, the biggest reason for the lack of a PTSD diagnosis in our veterans is their belief that it demonstrates a sign of weakness and is therefore unbecoming anyone in the service. That idea is so far from being factual, yet is perceived as a truth. The valor of these men and women should be the focal point from the outside world, not the potential for a “weakness.”

I have spoken with many veterans over the years and have heard the horrors that they went through. I remember speaking with a veteran of Vietnam who shared with me human atrocities beyond imagination, yet spoke about how upon returning to the US had to deal with being shunned by many. For them, PTSD occurred on multiple fronts. As Ms. Robinson and the VA continue to develop this program, other groups should take note of how to incorporate it into their areas. PTSD is not simply a disorder afflicting our people in the service. It also affects first responders. Poilce, Firefighters, and Emergency Medical Technicians, along with doctors and nurses, have to deal with tragedy on a daily basis. For some, they deal with the stress and anxiety through alcohol and other pain killers. Anyone who has gone through a traumatic experience in their lives can also suffer from PTSD. Those who have had to deal with unexpected death or tragedy can feel increased anxiety. We cannot forget women who have endured rape situations and individuals who have endured significant levels of abuse too in this category. Trauma is something that comes in various shapes to individuals and we should never judge what trauma should be for anyone but ourselves.

Thus far, we have looked at adults with anxiety. We cannot forget that our children may have high levels of anxiety too. As an administrator, I saw anxiety in my students at the high school level. Anxiety for these students has continued to grow over the years. The stress of trying to fit in to groups has always been a part of the development of students. Yet, it does not mean that some students do not feel more pressure than others. In working with our students with differing abilities, acceptance is a critical issue. Some of these students have achieved a level of acceptance with peers and have healthy self-images. Other students struggle and seek to fit in through actions which may not be in their best interest. While part of this is a natural developmental process, if anxiety levels rise to a degree where self-injurious behaviors become part of the norm, then the student needs assistance. We cannot be content to say that “it is a phase” or “they will work through it.” These are the statements which may precede student suicides or other serious issues.

We cannot minimize what today’s students are struggling with in their lives. I grow annoyed with those who continually cite that they had it so much more difficult as children. “I had to walk to school 10 miles each way in six feet of snow uphill both ways daily! We didn’t have fancy calculators or cell phones either, so we had to count on our fingers and toes and do research in books.” I get that idea. I also know that you are incorrect to say that you had it “worse.” It was simply different. In many ways, our students are being forced to grow up sooner, compete on a global scale earlier, and market themselves positively by the time they are in middle school.  That stress can create unbelievable levels of anxiety; levels which may be do deep, they are not easily seen at the surface. Thus, we need to be conscious of actions and words of the students to understand where they are at better. Otherwise, we may not learn of these depths of anxiety until there is a school tragedy or a suicide.

Suicide is a large issue today. We have experienced the suicides of popular figures in culture. I have also had a number of friends admit to suicidal ideas based on where they were in life. Research suggests that there are more adults dealing with suicidal thoughts now than in previous generations. Why is this? There appear to be many suggested explanations for this.  Greater feelings of inadequacy and higher levels of stress creating greater anxiety are definitely major reasons for this. Let us not act as ostriches though and bury our heads claiming that the reasons are more superficial. High levels of anxiety today are influenced by what is happening to each of us.These may involve influences such as socio-economic issues, political issues, gender or racial issues, or religious issues. However, anxiety does not discriminate as it affects all people in varying degrees. So those of you trying to blame either political party or the era in which one was born are incorrect.

So what can we do to help in 2019? First, we need to assess ourselves. Ask yourself how are you doing today? I recently read an article by Candida Moss who suggested that journaling was one of the most recommended resolutions being suggested to individuals for 2019. A journal does allow for the processing of ideas and lets the writer go down into the depths of their mind for a better understanding of how they are doing. Along with that assessment, commit to a healthier lifestyle. You have always heard “eat well and exercise.” For some, baby steps are all that is necessary. Start walking each day and drink more water. Limit your fast food trips and make a few more meals at home. You do not need to suddenly become a fitness guru, but take the time to improve your health.

Next, learn how to listen. Many of us are able to hear things, but that does not mean we are really listening. Actual listening requires one to not make any judgments or to find a “solution” to another’s problem while hearing the words. Let the other person get their issue out. Be open to meeting someone for coffee or lunch to listen to them. Part of active listening also requires one to be aware when the best advice is to suggest that the speaker go get additional advice from a minister at their church or a counselor. We are not all walking around with degrees in psychology or psychiatry, so it would be better to suggest bringing up deep issues with a professional.

Third, learn how to respond. “You think you got problems” and “That ain’t nothing” are not only grammatically shaky, but also are non-supportive to the speaker. Listen, think, and then respond.  Always let them finish before even starting to put together a response. Life coaches will attest to the fact that may of their clients are first seeking an empathetic or sympathetic ear.  Watch cable shows and listen to radio shows where individuals with opposing points are involved. Most of the time is spent speaking over each other and not listening. When truly listening to another, realize that you have no point to prove.

Fourth, recognize that some individuals may need sensory items to keep them calm. I am not speaking of fidget spinners as those of you who have heard me speak, know my feelings about them! Other sensory fidgets, weighted items, and tight or wrapped clothing should not be pointed out and referred to in any negative manner. Fidgets are not toys and specialized clothing is helpful for some. Be aware that even actions like pencil tapping or leg crossing and uncrossing may be ways of releasing kinetic energy to help a person stay calm. Just be aware of the needs of others as well as your own needs.

Finally, be nice! We can always say be nice to others and that is important. But, be nice to yourself first! No one is perfect! Recognize that you may have some anxiety that is coming out in covert ways. Invite yourself to really look at the good things you bring to the table. Know that you are an amazing person who has so much to offer to this world! If you have concerns, share them with someone and don’t hold them in. If someone wants to share concerns with you, do the best you can for them, but do not take on their concerns too!

We all matter in this world! May 2019 be a wonderful year for you as you are a wonderful person!

Stop the Bleed and AEDs at the University of Connecticut

We received the following testimonial from Justin Pedneault, the University of Connecticut Rescue President & Training Coordinator. Justin contacted School Health for assistance in getting the university to their goal of being a Heart Safe Campus. 

At the beginning of the 2017-2018 school year, I was working with the University of Connecticut School of Nursing on the Storrs campus to add a second AED to the nursing building. In addition to this, I wanted to add signs throughout the building directing people to the nearest AED, a first response kit and bleeding control kits to both AEDs, and then seek HeartSafe Workplace designation from the Connecticut Department of Public Health.  As part of this process, School of Nursing Dean Deborah Chyun asked me to give a 3-5-minute presentation at a campus-wide forum, with all academic department heads represented, in April 2018.  I gave a quick talk about the need for these improvements and how I was working with the School of Nursing to get them done. Following my presentation, the provost’s office, which put the event together, was flooded with emails asking how to do the same thing in all of the other academic departments and schools on the Storrs campus.

In response, the provost’s office created a committee that included the UConn Fire Department, Michael Zacchera from Hartford Hospital, Dr. Richard Kamin from UConn Health, the Facilities and Maintenance unit, the Office of Planning and Design, the Office of Emergency Management and myself. Our goal was to spend $150,000 towards accomplishing this task in academic buildings by the end of the fiscal year, giving us about 30 days to select equipment and place the first order.  We quickly met and ordered 100 Stryker (Physio Control) CR-Plus AEDs, alarmed cabinets, and 200 stop-the-bleed kits (2 kits with each AED cabinet) from School Health. This included signage and first response kits (mask, gloves, trauma shears, razor, etc.) with each AED. These were destined for all academic buildings on every UConn campus.

We were extremely fortunate that School Health worked with the manufacturer to donate all the cabinets, enabling us to purchase an additional 35 AEDs/cabinets/bleeding control supplies. We have since been given permission to plan for an additional 200 AEDs (with cabinets, first response kits and bleeding control kits) to cover every single building including residential and staff buildings on every single UConn campus (Storrs, Stamford, Hartford, Avery Point, Depot Campus). Our goal is to deliver an AED and bleeding control supplies to any victim in a round- trip walk of less than 3 minutes. This is a requirement to get the Connecticut Department of Public Health HeartSafe Campus designation, which we as a university are working to attain.  We have been working very closely with the DPH and they have been touring buildings with us while selecting the locations for these emergency supplies. Every inch of every building is being evaluated to determine the most beneficial and appropriate locations.

School Health has been a helpful and valuable partner in our effort to meet the needs of a large, complex enterprise like the University of Connecticut that has dozens of academic buildings spread across five campuses. Our goal is to make our campuses safe and responsive places for our students, faculty, staff, and visitors, and School Health has been key in helping us reach that goal.

Outside of my efforts with this committee, I also serve as the President and Training Coordinator for UConn Rescue, a student organization at the University of Connecticut which allows students to gain experience in the medical field with EMS training. This organization meets monthly with EMS continuing education classes and training scenarios for members. A key component of UConn Rescue is our training program. UConn Rescue regularly hosts American Heart Association Basic Life Support for Healthcare Provider CPR/AED classes, AHA Heartsaver CPR/AED classes, AHA Heartsaver First Aid classes, and Stop the Bleed classes each semester. We began offering our first classes in April 2016 after I became an American Heart Association Basic Life Support CPR Instructor. I continue to be responsible for every aspect of coordinating, teaching, ordering, managing instructors for our ever-growing and expanding training classes each semester. UConn Rescue has offered over 1,500 seats for various trainings and trained almost 1,000 students, staff and faculty. These student-run programs meet the training requirement for the Connecticut DPH HeartSafe Campus designation.

While working on the HeartSafe Workplace efforts with the School of Nursing during the spring 2018 semester, I worked on integrating the Stop the Bleed class into the nursing simulation curriculum. The plan was to replace an existing assignment in the nursing students’ junior class schedule during a simulation in their fundamentals nursing class. As such, all undergraduate nursing students will be trained in the Stop the Bleed class before graduation in their junior year fall semester.

I have greatly enjoyed my efforts at the University of Connecticut and I look forward to seeing all my projects through and always seeking to improve existing processes.

Creating a Sensory Room

by Ochanya McRoberts


Do-it-Yourself Sensory Fun!

As special educators, we’ve all been faced with the task of creating an effective and efficient sensory room or space for our students. We know that sensory rooms can have extensive effects on our kiddos and can make a big difference in a child’s development, and because of this, we want to make these spaces awesome. But realistically, we are often stumped by the thought that it might become too expensive or could possibly take up too much classroom space.

I am happy to share with you that this is not the case! Creating an effective sensory space does not have to be expensive, nor does it require a large section of your classroom space. To help out with this, I’ve compiled a few tips to help you get started. Happy creating!

What First?

First, let’s start with considering your students and their needs, as every child is unique, and the sensory spaces/activities you create for them should be unique, too. Start with thinking about the room or space in the classroom that is accessible and how you might be able to incorporate sensory items. This is also the point at which you will want to start brainstorming themes and the kind of input (or output) the area will provide.

Make a list of toys or sensory activities your students like, while making sure to incorporate their interests and passions as much as possible. Also, try to remember that all spaces are usable; a corner, a closet, or a simple wall could be the perfect starting point for your work if you do not have an entire room to spare.

Once you have developed your ideas for the space and an enjoyable theme, it’s time to start thinking about how to pull it all together.

The Right Stuff 

With your desired space in mind, it’s time to do an inventory of your kiddos’ needs. Not all students need the same kinds of sensory stimuli, and it is essential that you have an understanding of what your students’ bodies are seeking. Usually, our kiddos are seeking three basic kinds of stimuli: tactile, vestibular, and proprioceptive.

Students who need tactile input may display difficulty with perceiving or interpreting their environment, and may benefit from sensory activities that provide stimuli such as touch, pressure, and temperature.

Students in need of vestibular sensory supports may appear to be clumsy, or they may seek out intense sensory input such as spinning, bouncing, and jumping on a trampoline.

Similar to vestibular needs, students who have proprioceptive sensory needs may appear as clumsy, may fall a lot, or may display a general lack of awareness of their bodies in space.

While you are taking inventory, take note of your students’ behaviors, likes and dislikes, as this information will help you decide the best kind of activities for your sensory area. Also, please be sure to talk with your students’ Occupational Therapist to help pick the right activities.

High-Quality on a Budget

Now that you’ve knocked out the logistics of your project, it’s time to tackle the hard part: how does this fit your budget?! Before you turn your bank upside down, take a few moments to look over your needs list and identify some alternative choices. For example, instead of buying a new swing or trampoline for the corner, a cheaper solution could be a rocking chair or perhaps a yoga ball.

Another example is the all-time favorite ball pit- they’re fun and engaging but can be pricey. Instead, try ordering a kiddie pool and multicolored balls online. And Christmas lights and bulk fabric make fantastic forts or hide-away spots.

Now, I know what you’re thinking. You are probably thinking that all of your ideas can’t be ordered online, or, maybe your ideas are so creative that they don’t even exist yet (this happens more often than you think). If this is the case, bringing this area to life might require the use of tools and a little elbow grease, and it’s easy to get discouraged if some of these designs need to be built from scratch. When creating sensory boards, tables or walls, try to remember that materials such as water beads, waterproofing, PVC pipes, vacuum-sealed bags, empty plastic bottles, sand, vegetable oil, and glue are your best friends. You might even strike gold in your own kitchen, basement, or garage. You will be surprised by how many details in your sensory area can be made from re-purposed items/materials!

Now that you’re prepared (and encouraged), go make some awesome, sensory fun!

New AED Legislation in California

Sudden cardiac arrest affects nearly 10,000 youth nationally per year according to the American Heart Association, while the National Center for Catastrophic Sport Injury Research reports that more student athletes die annually from sudden cardiac arrest than from sport-related trauma. As a result, more and more states are enacting AED legislation.

California Assembly Bill 2009 Requires AEDs at Interscholastic Athletic Programs by July 1, 2019

Joining several other states that have enacted some form of AED legislation pertaining to schools, California has established new requirements for public and charter schools that offer interscholastic athletic programs.

  • Mandates at least one automated external defibrillator (AED) be present on campus and accessible to authorized personnel during interscholastic athletic events or activities by July 1, 2019.

  • Requires a written emergency action plan that directs the use of the AED, and to have policies that protect school district employees from liability for providing emergency care.

  • Ensures AEDs are available to athletic trainers and coaches and other authorized individuals at athletic programs, on-campus activities, and events.

  • Ensures AEDs are registered and inspected and maintained according to the manufacturer’s specifications, including, at a minimum, biannual testing and after each use.


Seconds Count with Cardiac Arrest

Sudden cardiac arrest causes more than 350,000 deaths every year, and while it is largely an issue for older adults, the syndrome is also among the leading causes of death among young athletes.

Rapid treatment of SCA with an AED can be lifesaving. An AED analyzes the heart rhythm and then sends an electric shock to the heart to try to restore its normal rhythm.

Every minute that defibrillation is delayed, the likelihood of survival from SCA drops about 10 percent. If bystanders act quickly and use an AED (in conjunction with CPR), the survival rate is 89 percent among student-athletes suffering SCA on a school campus.

According to the bill’s author, Assemblyman Brian Maienschein -San Diego, 42 young athletes in California died while engaged in physical activity between 2009 and 2011, and among those cases where a cause of death was released, 68 percent were attributed to sudden cardiac arrest.

“Although SCA can occur at any time, vigorous exercise appears to act as a trigger, making SCA more common during athletic practices and games,” Maienschein said in a statement. “SCA is the leading cause of death in athletes during exercise and usually results from intrinsic cardiac conditions that are triggered by vigorous exercise.”

“If automated external defibrillators are more readily available for authorized personnel to use, the lives of more student athletes and spectators will be saved,” he said.

He adds that while almost every coach in California has been trained to use the AED, only about 75 percent of high schools have the machines. The chances of survival are close to 90 percent if a deliberator is used within the first minute of collapse. After that, chances of surviving rapidly decline.

American Heart Association Recommended Protocol

The American Heart Association already has a recommended protocol for schools to create a cardiac emergency response plan:

  • Identification of one or more cardiac emergency response teams trained to respond quickly in case of medical emergencies;

  • Strategic placement and routine maintenance of AEDs, ideally to ensure that an AED is readily accessible so that a rescuer can retrieve it and deliver a shock within three minutes of collapse;

  • Dissemination of the plan throughout the school campus;

  • Ongoing staff training in CPR and AED use;

  • Regular drills throughout the school year to ensure school staff are prepared to respond to medical emergencies;

  • Working with local emergency responders to ensure the plan is integrated into community emergency response protocols; and

  • Annual review and evaluation of the plan.


Full text of the Bill can be found here.

School Health can help you decide what supplies you need to prepare your school for emergency situations. Visit our California AED Legislation Page for more information.

Adaptive Seating: Things to Consider

by Raymond T. Heipp. Ph.D.


SE Today-blog badgeThroughout my travels here in the US, I am constantly being asked questions about adaptive seating. There are so many questions and almost as many assumptions being made about these various types of seating. In the blog written by Andrea Simpson, she speaks of how an SLP can use a “Bitty Bottom” to assist in language activities. She adeptly discusses that as one of the manners in which to include the sensory and movement pieces into speech therapy.

In that idea, she hits upon the key point for any type of sensory feedback or, in this case, adaptive seating, there is no one-size-fits-all! That is the foundation from which I suggest we all operate. I recently was called by a principal who was absolutely frustrated. He had ordered chairs with moving seats for all of his third through fifth grade classrooms. He explained to me that he had read the stories and heard from colleagues as well as the manufacturer how wonderful these seats were for students with attention issues. Yet, after the implementation at the beginning of the school year, he found those classes were the least focused on studies and the hardest to control. We had a great talk and he came to better understand that while those seats may have been working well for some of the students with attention issues, they are not going to work for all students in the same way. Plus, for those students who were not demonstrating any attention issues, those seats became an excellent distraction. I simply gave him this analogy; imagine the seats being fidget spinners. Students who need the spinner and have been properly trained how to use it for their own benefit will use it well. However, it becomes a toy and distraction for all of the students who do not need it.  He understood that immediately.

So, what do recommend to schools? First, I suggest that they analyze specific student needs. You will have some students who need specific types of seating. There is plenty of research out there which supports how some students can actually increase their activity engagement when they are properly supported and comfortable; thereby deceasing environmental factors which limit engagement. If you are looking for specific research, you may want to involve your OT or PT as much of the research comes out of their realm. I remember the first article I used was Rigby et al in 1995 looking for ways to help those with CP and other physical health issues. The one point which is fairly consistent is that adaptive seating can be effective, but it must be geared toward the individual and cannot simply be assigned to everyone.

Special Tomato Extended Small MPSBy knowing the needs of the students, schools can then begin to look at what they have and what they might wish to have available. We will see products like Tumbleforms and Special Tomato seating which have their roots in assisting those with CP as well as being able to be applied to many more individuals. We also see Rifton chairs and other types of chairs which are meant to be a support as well as allow individuals to interact with classroom materials and others. Those are the types of adaptive seating which are recommended for specific individuals through the work of therapists. These are some of the easier decisions to make when it comes to seating.

The more difficult decisions come when the seating enhances focus and attention and does not carry with it ways to analyze exactly what a student might need. For these cases, I recommend a variety of tools for classrooms and therapy rooms to offer choice. Let’s face it, in our inclusive classrooms, students with differing abilities do not want to stand out from their neuro-typical peers. So, we need to think about these classrooms as an ability-friendly way of approaching education.

Those who have heard me speak know that I am a big proponent of using inflatable cushions as a support for a variety of students. It is ironic that Ms. Simpson referred to “Bitty Bottoms” as many realize I love this product and see it as a benefit for students who need it at the middle school and high school levels. These cushions are small, easily customizable, and can be carried in a backpack from location to location. I am always amazed too at the number of classrooms which use CoreDisk cushions with the teacher having one for herself, providing a wonderful model for the students, while sitting more comfortably at the desk.

Exercise balls are another common manner of adaptive seating. Please remember the following guidelines though if they are being used in a classroom. First, have a stand in which the exercise ball can be placed. It helps to limit the rolling that may not be easily controlled by some students. Second, make sure the exercise ball is the appropriate size for the students. If the students cannot place their feet flat on the floor while using the exercise ball, it is too large. Balance plays an essential role in using the exercise ball. Thus, being able to place one’s feet on the floor while sitting on the ball is important to the effects of the ball on learning. Third, make sure that the students have enough of a sense of balance and core strength to maintain a position on the ball. I have heard stories of students sitting down and going right over on to their heads because they did not have enough core strength to use the ball properly.

Specialty types of seating for sensory feedback like Beanbag Chairs and Scallop Seats may be quite appropriate for students too. Those of us who lived through the 1970s have had experience with Beanbag Chairs. The irony is the flexibility within those chairs is perfect for some of our students who need feedback at multiple points throughout the body. Although associated with being a calming and relaxing method of seating, these chairs have also proven themselves to give enough proprioceptive feedback to the body allowing the students to read or review information with limited distractibility. Scallop Seats are great for positioning students, whether on a floor or on a chair. Although some might look at them as a modified booster seat, they are actually an excellent way to add some texture, upper body parameters, and posture support for students.

There are many more types of adaptive seating out there, so the process of determining what is best can be overwhelming. By starting with a review of the school’s students and a cataloguing of what is already at the school, one can begin to piece together a plan for seating support in all classrooms. Remember that there is no such thing as one-size-fits-all. Speak to your vendors and see who is willing to let you try products before you buy. That way, you get a better sense of what will work along with having a great return on your investment.

As always, if you have any further questions, please feel free to reach out to me at rheipp@schoolhealth.com. We are all in this to help individuals with differing abilities, so I am here for you. We know that everyone has a voice and sometimes that voice is stronger when we do not have the distraction of an uncomfortable seating arrangement!

Of Electrical Blackouts and Sensory Overload

by Raymond T. Heipp. Ph.D.


SE Today-blog badgeThis past August, I was reminded that this was the 15thanniversary of the electrical blackout that affected the East Coast and parts of the Midwest. I can vividly remember what I was doing during those days.  The power went out just as I was beginning a multi-day training for new faculty members coming into my high school. Of course, the first comment someone made was “did you guys forget to pay the bill?” I was tempted to get rid of that rookie for making such a lame joke and showing no real creativity there.

Needless to say, the next few days were interesting. We still had the training but altered where and how it was done. I completely understood that we would have to delay any training on technology or academic online systems but didn’t understand the presenters who could not present without their PowerPoint slides. I think the new faculty came to understand that adjustments can be made no matter what the situation when we did things like having a peripatetic discussion on teaching methodologies one morning around the neighborhood and having our “fancy dinner” change into grilled burgers and salad. There is definitely a lesson to be learned from this as some adjusted easily and others experienced difficulties.

I hope that you do not experience any electrical blackouts throughout this year! My greater concern though focuses on classrooms and buildings which create sensory overload for our students. We must be aware that every human being has sensory needs and triggers as we put together our classrooms and the activities within them. We also are reaching a time where I am seeing more schools adding a “sensory room” for student use.

Sensory rooms are good for all students and not just those with differing abilities.  We need to understand that a good sensory room varies from school-to-school. I have seen schools and institutions which have put in $50,000 Snoezelen Rooms which work very well. But as a former administrator, I recognize that very few of our schools have that type of a budget for sensory. So how does one go about creating a good sensory room? Talk to others who have them and then talk to those who can help you make them a reality. A good sensory room can be designed inexpensively and effectively as long as you know what you are looking to accomplish and are not seeking the quick and cheap way out.

Sensory RoomThere are sensory room kits that have many of the items you might need to create a sensory room. First you need to determine what kind of a room you want. Do you want it simply to be calming or be calming and interactive? When I say interactive, I refer to the fact that the user can actually dictate color schemes and devices to be used as they calm down. A sensory room that gives this control to the user is available for less than $18,500. The items in those kits include things like Bubble Tubes, Fiber Optic Showers, LED Sensory Projectors, and Fiber Optic Star Carpets. All of these can be purchased individually too which makes it easier to manage. Calming Sensory Room kits can be purchased for less than $8000.  The difference with these kits is that the users cannot dictate color schemes or how things will flow within the room. Either way, these items can bring students on the verge of a meltdown to a more calmed demeanor quickly.

I visited the STEPS Academy this summer and watched how they designed their sensory rooms. Each room was a different theme (space and under the sea). There were high tech and low-tech items in the rooms. They did have one of the Fiber Optic Star Carpets and it was fantastic to watch the children come in and just sit right down and decompress. For me, the critical piece to the design of a sensory room is knowing your students and what they like.  STEPS is definitely aware of their students with their themes and assortment of items that stay within the theme while giving sensory input.

We need to carry this awareness into our classrooms too. Classrooms do not need to have Fiber Optics or Bubble Tubes, but they do need to be aware of sensory overload. Too many pictures and items on the walls can be distracting for any student and downright overwhelming for others. Be creative, just not Jackson Pollock as you put your room together. Have meaning and purpose to what is displayed. One can go into just about any Chemistry classroom and see the Periodic Table on the wall. That makes an impact on students and is not overwhelming (unless you don’t like Chemistry!) Also, watch the colors you are using. Keep the colors bright without being too distracting. Large areas of red or orange can become distracting for some students.

Light FiltersThe lighting can also be overwhelming. Many of our classrooms still use florescent bulbs in the ceiling. Consider getting Light Filters to place over them. The best light filter colors tend to be blue, green, and purple. Please be careful though. Just running to the store and getting cheap sheet sets or cloth is not the same as Light Filters. My favorite anecdote comes from a presentation I was giving on making classrooms sensory friendly and discussing Light Filters. I had a teacher stand up and say I was correct (always nice to hear!) She went on to describe how she had bought some material at her local Walmart and covered her lights. During the afternoon of the first day of school, she thought she smelled something burning. She looked up to see one of the pieces of material smoldering from the direct exposure to the lights.

Twisty TwidgetsFinally, as you prepare for your own classes, build in sensory breaks. OTs will share with you that a simple one-minute break can reinvigorate students and allow better attention to take place in ALL students. Consistent sensory breaks can also create a positive learning environment with limited issues from students. For the kinesthetic student, these breaks can actually increase the learning of material.

Sensory overload can occur in anyone, not just students with sensory processing issues or differing abilities. By taking some time to make a classroom sensory friendly, you can add depth to the learning process. A sensory-friendly classroom can also make you feel more relaxed in front of your students.  Sensory rooms and sensory-friendly classrooms are important in today’s academic environments. With anxiety levels being reported as the highest they have ever been in our students, we need to do our part to let them be students and take in the information we share with them.

May this be a year without any electrical blackouts or sensory overloads for you and your students!

Three Must-Have Resources that Explain the Effective Communication Rights of Students with Disabilities

by Robin Ryan and Gabe Ryan


SE Today-blog badgeIt is good to know that the Federal Special Education budget has not been cut.  At this time, it is good to review the joint guidance that has been prepared by the Federal Government in regards to the Rights of Students in regard to effective communication.



Joint Guidance on the Federal Laws


The U.S. Department of Education’s Office for Civil Rights, Office of Special Education and Rehabilitative Services, and the U.S. Department of Justice’s Civil Rights Division have released some joint guidance materials related to students with disabilities and meeting their communication needs

Sifting through varied legal requirements designed to support the learning needs of students with disabilities sometimes leaves educators and parents/guardians puzzled. Having guidance on the intent and explanation of different aspects of the law related to providing services is invaluable to educators and families. This encourages less time spent interpreting what a law ‘might mean’ and more time creating a supportive plan and accomplishing goals, moving toward successful outcomes for students.

The following guidance materials relate to the public schools’ responsibility to ensure students with hearing, vision, or speech disabilities have access to effective communication through appropriate aids and services.


  1. Colleague Letter


    The DOE and DOJ Colleague Letter (in Spanish) is intended for educators. This two-page letter briefly introduces the aspect of effective communication for all students and highlights a Frequently Asked Questions Document. This letter touches on the responsibilities schools have for meeting the communication needs of students and the differing ways the three Federal laws relate – The Individuals with Disabilities Education Act (IDEA), Title II of the Americans with Disabilities Act of 1990 (Title II), and Section 504 of the Rehabilitation Act of 1973 (Section 504).


  2. FAQ


    Frequently Asked Questions on Effective Communication for Students with Hearing, Vision, or Speech Disabilities in Public Elementary and Secondary Schools. This 30-page FAQ document is intended for educators and parents/guardians. The first few pages of the document provide an introduction and detailed description of the three Federal laws. Starting on page six, the Q and A portion consists of twenty questions and their answers with related regulation and/or case references. Question #20 includes a list of additional resources for continued guidance and explanation of the provision of services. The appendices of the document are a supportive extension with a few case studies as well as a section specifically on IDEA- Part B: Communication Needs.


  3. Fact Sheet


    Meeting the Communication Needs of Students with Hearing, Vision, or Speech Disabilities (in Spanish) This two-page fact sheet is intended for parents/guardians, however is really an essential overview for anyone. This document includes six questions with bulleted answers to each one. It is a quick look at what the law requires of a school, who is eligible, what aids and services could be required and where to find more information.


Please share these must-have resources with your colleagues and families today!


As the individual communication needs of your students are determined through the appropriate process, we invite you to explore and find the assistive technology tools within the School Health Special Education website.

Ensure the Best Placement of AEDs in Your School

AED in wall cabinetThe increasing square footage of schools can make determining how many automated external defibrillators (AEDs) and where to strategically place them seem like an overwhelming task. But it is a necessary task to ensure the best response in the event of sudden cardiac arrest (SCA). If you need help determining the best number and placement of AEDs in your school, connect with one of our experts.

The American Heart Association recommends AEDs be accessible within three minutes of an SCA emergency. Every minute of delayed defibrillation equates to a 10% decrease in the chance of survival of the victim.When an AED is applied prior to the arrival of an ambulance, the victim’s chance of survival increases nearly fivefold.2

It’s important to consider the following when equipping your school with AEDs.

  • Placement – AEDs should be placed within 3 minutes of anywhere within the facility. That means a responder has 1.5 minutes to get to the device and 1.5 minutes to get back to the victim when walking at a brisk pace. On average an individual walking at a pace of 4 miles per hour will walk 152 steps in 1 minute.That’s 228 steps to the device and 228 steps back. Determine your 1-minute radius and center an AED around that.

    TIP: Consider obstacles in the pathways to AEDs. For instance; hallways with security doorways, multiple floors, furniture.



  • Visibility – Make sure AEDs are easily located within your school by placing wall signs above the AED to direct responders to the location. Wall signs are sold separately from AEDs and budgets should allow for proper AED signage. A well-marked path to an AED can make the difference in the survival of a victim when minutes count.

    TIP: Place a wall sign at the end of a hallway or at an entrance to direct responders to the location of an AED.



  • Accessibility – Make sure the AED(s) is easily accessible to responders. Wall cabinets designed to hold AEDs are often alarmed and improve accessibility while deterring theft. The Americans with Disability Act (ADA) guidelines state the height to reach the handle of an AED should be no more than 48 inches high.



  • Location – Consider locations throughout the school that are easily accessible. Consider places of congregation and high-traffic or high-risk areas. For example, at the end of hallways, near the cafeteria, auditorium, office and gymnasium. Schools with multiple levels should place AEDs on each level to ensure the quickest response time.

    TIP: Provide AEDs at school sponsored sporting events by placing the AED in an easy to transport carry case.  



  • Program Management – Implementing an AED program management solution will ensure your AED(s) are rescue ready and compliant. Program management solutions make it easy to track the expiration of pads and batteries as well as CPR certification for trained responders.


Sudden cardiac arrest (SCA) strikes anyone at anytime and anywhere. Making sure your school and staff are trained to respond makes all the difference for the survival of an SCA victim.

AED on student deskThe ZOLL AED Plus® with Real CPR Help®, provides rescuers the confidence to deliver high-quality CPR when it matters most. In addition, long-life consumables, 5-year pads and batteries, increases readiness and decreases frequency of maintenance.

 

 

 

 

 

1Link MS, Atkins DL, Passman RS, Halperin HR, Samson RA, White RD, Cudnik MT, Berg MD, Kudenchuk PJ, Kerber RE. Part 6: electrical therapies: automated external defibrillators, defibrillation, cardioversion, and pacing: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122:S706–S719.

2Weisfeldt ML, et al. J Am Coll Cardiol. 2010;55(16):1713–20.

3”The Average Steps per Minute for Different Exercises”.Verywellfithttps://www.verywellfit.com/pedometer-step-equivalents-for-exercises-and-activities-3435742

Asthma Peaks in September

By: Sally Schoessler, MSEd, BSN, RN -- Director of Education, Allergy & Asthma Network


September – the temperatures start to drop, there’s a crispness in the air and the hallways of our schools are once again filled with activity. Children have returned to school with boxes of tissues, new binders and freshly sharpened pencils.

Asthma Peaks in SeptemberOne in 10 children in our schools will also bring their asthma back to school. Asthma is a huge issue in America’s schools and is the number one reason for school absences – it is responsible for more than 13.8 million missed school days. And there is a proven phenomenon that occurs every year – the September Asthma Peak.

The third week of September has been identified as the peak time for asthma flares among children and youth. Hospitalizations and visits to the emergency room due to asthma tend to spike during this time.

So what’s so special about September and asthma?

In summer, most families are more relaxed about their Asthma Action Plans and asthma controller medications, but when school restarts, there is renewed stress around family schedules and expectations for the new school year - not to mention the pressure of academics, sports and social aspects of school that can include bullying. The student enters a new classroom (or classrooms) with different children in a relatively small space, increasing the risk for infections.

Our environment changes with the fall season. Outside, the weather gets chillier and ragweed and mold pollens return. Inside, we’re in closer quarters with others and we tend to keep the windows and doors closed as the weather gets cooler and cooler.

It’s important for the school’s healthcare team – led by the school nurse – to come together to promote asthma management all year long, but especially in September. With the student at the center of care, the parents and family, the medical home and the school team can be strategic in minimizing asthma flares. First and foremost, talk with your student to see how they are feeling and if they know how to access their asthma medications as needed during the school day and after-school activities.

Back to SchoolEvery student with asthma should have an Asthma Action Plan, which should be updated annually. This plan directs the care of a student with respiratory issues and provides guidance from the medical provider. Another vitally important point is to stress the importance of hand washing. Good hand hygiene is key to stopping the spread of germs and illnesses at school.

As students settle into a new school routine, encourage healthy habits to get the school year off to a great start!

Shop Allergy and Asthma products on SchoolHealth.com! You'll find essential products to help keep your students healthy this year.

Fighting Germs in Schools Helps Stop the Spread of Illness and Reduce Absenteeism

Good hand hygiene helps keep germs at bay and is a critical part of preventing colds, the flu, and infections from spreading. Most of the country has just come through one of the worst flu seasons in recent history. Schools were hit especially hard and many schools faced days-long closures as they tried to stop the flu from spreading or find enough healthy staff for classrooms.

While handwashing with soap and water remains the gold standard for hand hygiene, it’s not always realistic as students move between classrooms, buildings, busses, and navigate the demands of a busy school day. And, when a student is sent to the restroom to wash their hands, how do we know that they’re washing with soap and water for the prescribed length of time – or if they’re washing at all?

Sanitizers to the rescue! School Health recommends an all-inclusive approach to fighting the spread of germs in your school. A complete solution includes using alcohol-based hand sanitizers and surface disinfectants that are scientifically formulated for no trade-off protection, in addition to handwashing, as an important part of cleanliness and well-being.

PURELL® products are universally recognized and trusted to provide fast and effective protection from germs.1In one study, schools that combined hand-hygiene education with PURELL products reduced teacher absenteeism by 10 percent.2Student absenteeism was reduced by 51 percent when PURELL hand hygiene products were used in conjunction with a curriculum to teach kids about good hand hygiene.3

Placing the right products in key locations helps teachers and staff remind students to practice good hand hygiene during the day, which helps stop germs and illness from spreading. Hand hygiene is the single most important way to prevent the spread of infection, but it’s just half of the solution. You can significantly improve results when you also prevent recontamination by disinfecting the surfaces people touch.

School Health recommends using a combination of hand sanitizers, surface disinfectants, and wipes. Placing these products in easily accessible, high traffic areas will help to combat germy conditions and keep kids healthy. Some placement suggestions include:

  • The entrance to the school

  • The entrance to the gym and locker rooms

  • Outside of the restroom

  • Near the water fountain

  • Outside of classrooms, offices, and the teacher’s lounge

  • In food preparation areas and cafeterias


To learn more about solutions for a clean and healthy classroom, Request a Consultation with one of our experts. You can even learn how to get FREE dispensers with your purchase!

Increasing The Odds For Survival with Real CPR Help

Zoll AEDCPR Saves Lives.That’s why more than 30 states now require students to receive CPR training before they graduate from high school. Many of these states also require that students be trained to use an automated external defibrillator (AED).

CPR + AED = even more lives saved.

The evidence is indisputable: high-quality CPR is the primary component in influencing survival from cardiac arrest.1 Not every patient will need a defibrillating shock, but every patient will need CPR to increase the flow of oxygenated blood to the heart and brain.

Even for seasoned health care professionals, it’s hard to know if you are pushing hard enough and fast enough to meet current AHA Guidelines for compression rate and depth. With ZOLL’s proprietary Real CPR Help technology, you know. It provides audio and visual feedback that guides rescuers to deliver high-quality CPR. ZOLL introduced Real CPR Help® in 2002, and it is standard on every AED and professional defibrillator ZOLL sells.

Superior Support in a Rescue, 100% of the Time!

The ZOLL AED Plus®defibrillator with Real CPR Help provides integrated, real-time CPR feedback to help rescuers save a life. Only half of all sudden cardiac arrest victims will need a shock, while 100% will need high-quality CPR. Real CPR Help guides you every step of the way, telling you—and showing you—whether you need to “Push Harder” or whether you’re providing “Good Compressions.”

Not all heart rhythms are “shockable,” but high-quality CPR can potentially convert a non-shockable rhythm into one that is shockable. Even if this isn’t possible, CPR will keep blood circulating until emergency services arrives.

If a shock is required, CPR must begin immediately after the shock is delivered. The heart struggles as it tries to restore to a normal rhythm. Without CPR, a shock alone may be ineffective. Whether the victim requires a shock—or not—the AED Plus will support you 100% of the time.

Focused on CPR Quality

High-quality CPR improves survival from cardiac arrest, and rescuers need to “maximize the quality of CPR” to save more lives.1,2

High quality means providing compressions at the proper depth and rate, making sure not to lean on the chest, and keeping interruptions to an absolute minimum. In its 2015 Guidelines, the American Heart Associationidentifies five critical components required to provide high-quality CPR:

  • Compression rate of 100–120 per minute

  • Compression depth of 2–2.4 inches (5–6 centimeters)

  • Avoid leaning on the chest to allow for full recoil after each compression

  • Minimize pauses in compressions (chest compression fraction > 60%)

  • Avoid excessive ventilation (2 breaths/30 compressions without advanced airway; 10 breaths/minute with advanced airway)


Rescuers at every experience level need assistance when delivering CPR. The Real CPR Help technology on ZOLL’s AEDs and professional defibrillators assists lay rescuers and health care professionals alike in delivering high-quality CPR to meet the guideline recommended rate and depth.

How Real CPR Help Works

Using accelerometer technology, a sensor inside ZOLL’s CPR electrodes captures the rate and depth of each compression. Once the electrodes are placed on the patient, the person providing CPR presses on the clearly marked hand placement indicator that covers the sensor. The information captured is sent to the defibrillator, where it is immediately processed and provided in real time to the rescuer.

This real-time feedback is a critical component in reaching high-quality CPR. With audio and visual prompts to push harder, rescuers can immediately adjust their CPR as needed to reach the most effective rate and depth of compressions.

Chances of Survival More than Doubled

Studies in Arizona and California prove that high-quality CPR saves lives and that Real CPR Help can improve CPR quality.3,4 A large study of EMS providers in Arizona showed that the odds of survival increased 2.7 times with ZOLL’s industry-exclusive Real CPR Help and scenario-based training.3 And survival to discharge and good neurological outcomes doubled after the implementation of a “resuscitation bundle” at the University of California San Diego Medical Center that included Real CPR Help and specialized training.4

In a sudden cardiac arrest emergency, the victim’s best chance for survival is immediate CPR and a rescuer with an AED. Many people may not realize how critical effective CPR is in determining a victim’s outcome. ZOLL’s Real CPR Help guides rescuers at every experience level with real-time feedback to give them the confidence that they are providing potentially life-saving, high-quality CPR.

1Meaney PA, et al. Circulation. 2013 Jul 23;128(4):417–35.
2Neumar RW, et al. Circulation. 2015;132(suppl 2):S315–S367.
3Bobrow B, et al. Annals of Emergency Medicine. July 2013:62(1):47-56.31.
4Davis DP, et al. Resuscitation. 2015 Jul;92:63-9

Tips for Coordinating Spot Vision Screening Q & A

Spot Vision ScreenerWe received many questions during our Tips for Coordinating Spot Vision Screening webinar. As a resource for you, we have compiled the most frequently-asked questions and have provided them here with their answers.

If you have a question about the Spot Vision Screener and don't see an answer here, be sure to request a consultation with one of our vision screening experts!

Q: Do you still need to do a visual acuity test?
A: The Welch Allyn Spot Vision Screener uses a completely objective screening methodology to screen for 6 potential vision issues including amblyopic risk factors, common refractive errors, and strabismus. Visual Acuity testing is subjective but can identify visual problems unrelated to refractive error. Both screening methods have their benefits and limitations; therefore, the most thorough exam occurs when both instrument-based vision screening and visual acuity are used.

Q: Can I convert the results to a visual acuity score (20/20, 20/40)?
A: No. The Spot Vision Screener results will indicate “All Measurements in Range” or “Complete Eye Exam Recommended.” The device also lists the condition(s) found and the measurements of each eye. Welch Allyn does not recommend converting the results to a visual acuity score. If your state requires a visual acuity score we recommend using age appropriate tests and following state vision screening guidelines.

Q: How does it measure stereopticity?
A: It doesn’t. The Spot Vision screener is completely “objective” in that it requires no response. Whereas stereopsis is “subjective” (requiring a response from the subject).  That would be a different test. If your state requires a Stereopsis screening we recommend using age appropriate tests and following state vision screening guidelines.

Q: Does the result screen delineate between near and distance results?
A: Spot Vision Screener can detect measurements for Myopia (near-sighted) and Hyperopia (far-sighted) which are what a near or distance vision test looks for. In addition, Spot detects 3 amblyopic risk factors (Hyperopia, Strabisus (Gaze) and Anisometropia (unequal refractive power) as well as Astigmatism (blurred vision) and Anisocoria (unequal pupil size). 

Q: Can you screen children who are wearing glasses?
A: Yes, but it will take the glasses into consideration. Spot has criteria settings and if they are not referred then they met the criteria settings already established within the devices.

Q: Any suggestions on screening students who wear glasses?
A: Screening with glasses can be tricky, you can screen through single Rx Lens (no bifocals) with Spot. To screen students with glasses, push the glasses up the nose and drop the chin. This helps move the glare off the lens for a better capture. The thicker the lens, the more challenging it can be to screen through; this is also the case if the lenses have scratches on them. It is easiest to screen children wearing glasses in a dark room that minimizes reflections off the lenses.

Q: How accurate are the results? Sometimes if I screen the child two or three times I get both pass and refer.
A: It’s best to go with the first result while the eyes are in a natural relaxed state whereas continually screening the same patient can result in accommodation, thus skewing the results. 

Q: Why do I get different results for the same student if I have trouble screening and try again?
A: Accommodation is the ability for the human eye to improve vision when provided time to focus on an object.This is most widely discussed with amblyopic risk screening on children under age 6 but can still occur with subjects over 6 years of age. This also may occur when a child is just below or above the criteria threshold for their age, thus prompting multiple results. As with the previous question, the best practice is to go with the first result. 

Q: What is the recommended age for use?
A: Refer to the Welch Allyn statement regarding use of Spot Vision Screener in school-aged children.

Q: How reliable is this tool when screening children with developmental disabilities that have difficulty focusing on the machine?
A: Spot Vision Screener is an effective tool for screening children with developmental disabilities. Remember, Spot does not replace a comprehensive eye exam and children with disabilities may also need to see an eye doctor. Spot has an extremely high capture rate even with Autistic or developmentally delayed children. It’s vision optics system and design results in a high capture rate and the non-invasive screening distance of 3.3 feet helps allow the child to be comfortable without feeling like you’re invading their space. 

Q: How do you load student data for screening?
A: There are three options available for loading student data for screening into the device.  

  1. INSTANT SCREENING - Screen and then follow the prompts to enter the student’s information including name, ID, date of birth, gender, etc. 

  2. SELECT FROM THE QUEUE - Preload a list of students by utilizing the import/export function which allows you to create a spreadsheet and load the data into the device by using a USB.

  3. PRE-ENTER STUDENT DATA - Follow the prompts to enter the student’s information including name, ID, date of birth, gender, etc., then proceed to the screening portion.


Q: Is financial assistance available to purchase a Spot?
A: 
You might reach out to a local Lions Club or other local charitable organization, like Prevent Blindness, for assistance; they have helped with the purchase of equipment. Some schools have utilized their Medicaid reimbursement funds to purchase the Spot Vision Screener. Others have utilized the banner space at the bottom of the results page to raise funds by promoting local services and/or optometrists.

School Health Services Give Children a Bright Future

Shared with permission from the Healthy Schools Campaign.


Mary Ellen Barkman, the Medicaid Coordinator for Pinellas County Schools, the eighth largest school district in Florida, is passionate about their vision screening program. “We’re saving children’s lives,” she says.


Spot Vision ScreenerFor instance, last year, there was a new student in the district, a recent immigrant from Egypt who spoke only Arabic. Her teacher struggled to reach her and felt that beyond the language issue, the girl must have some cognitive problems. As part of her special education evaluation, she was tested with one of the district’s new Spot Vision Screeners. This quick screen showed that she had a serious muscle problem that caused triple vision. After she received the specialized prism glasses she needed and hearing aids for her hearing loss, she was at grade level within a year. “Without those screenings she may not have been able to reach her fullest potential,” Barkman says. “With help, children can have such a bright future.”


The district’s investment in spot screeners is the result of careful analysis of the district’s needs. Several years ago, school health services managers reported to Barkman that there was an issue with the district’s protocol for vision screenings. They were inefficient and time consuming, and they simply didn’t work for students who couldn’t talk or who had trouble sitting still or following instructions—often the very students who needed accurate screenings the most. The district researched many options and settled on Spot Vision Screeners, which work by taking a picture of the child’s eye and using it to screen for visual acuity, muscle imbalance and tumors. In fact, in the first year of using the screeners, the district identified a serious tumor in a student that had been missed by his primary care doctor. The machine creates a printout for parents that explains any follow-up services their child needs, and the district has formed partnerships with a vision van, local optometrists and the Lion’s Club to provide services for children who need follow-up services after screenings. And because the screeners are so easy to use, the district’s vision teams can make much more efficient use of their nurses to follow up with students who fail the screenings, rather than having to do the screenings themselves.


Barkman and the Pinellas County Schools team have woven together many different funding streams to build this unique program including Medicaid funding for the actual Spot Vision Screeners. Most of the funding comes from effective maximization of Medicaid billable services, such as Physical and Occupational Therapy, Speech Therapy, Nursing, Social Work, Psychology and Transportation and Administrative Claiming. Half of the reimbursement dollars are given to her program to spend on priorities they identify. The other half goes to operating to offset salary costs of billing providers. Because of this, Barkman works hard with her practitioners to make sure they are billing for all eligible services and maximizing Administrative Claiming reimbursement. They even developed their own electronic documentation system to make this easier. Over five years, the district has increased Medicaid revenue by $1.7 million to increase resources for students.


What’s next for Pinellas County? One priority is developing a micro-credentialing system for the one-on-one assistants who work with children with multiple challenges, to give them skills for physically transferring the children, feeding, seizure monitoring, CPR and social supports. Medicaid will support an increase in their salary after achieving the credential, which will allow them to be Medicaid-claimable health assistants. This invests Medicaid dollars directly into something that meets the needs of some of the district’s most vulnerable students.


“The key is out of the box thinking,” Barkman says, “and the box has gotten smaller.” She continues to look for ways to leverage whatever funding is available. “It’s such a blessing to be able to help a child reach their fullest potential. It’s important that people understand how important the Medicaid dollars are to that,” Barkman says.

Rochester News Station Interviews Gates Chili CSD & Mobilize Rescue Systems about Life-Saving Technology

Fox Rochester's Ashley Doerzbacher interviewed Superintendent Kim Ward and the Mobilize Rescue team about the #Mobilize1Million campaign and the use of the Mobilize Rescue System at the Gates Chili Central School District.

You can watch the interviews here (Be sure to scroll down to watch all five segments.)

Mob1mil_2Mobilize Rescue Systems offer the only interactive trauma and first aid system capable of helping untrained bystanders assess, manage, and monitor a spectrum of medical emergencies.

Each Mobilize product includes access to the Mobilize Rescue app, which provides users with just-in-time instructions to assess and manage life-threatening emergencies. Bystanders can follow simple steps in the Mobilize Rescue app, and have the knowledge and ability to provide care anywhere they go.

The interactive app is designed by experienced medical providers to place the highest accepted standards of emergency medical care in the hands of the everyday person. The app takes the guess work out of providing care - the untrained rescuer can determine the problem, locate the proper equipment and be taught to use it properly with interactive, just-in-time training.

Here are some notable quotes from the interview. These quotes highlight the benefits provided by Mobilize Rescue Systems during an emergency situation.

"I just feel like we're more equipped to handle any situation. It's a different world out there, and we need to be prepared. It's not something we like to think about, we hope we never have to use it, but helping our staff, even students, anyone who walks in the building knows what (the Mobilize Rescue Systems) are, knows where they're found next to our AEDs. They at least know they are equipped to respond and help save lives. We talk about innocent bystanders, these units allow you to be active in trying to save lives, in trying to stabilize victims until the emergency staff can arrive." - Superintendent Kim Ward, Gates Chili Central School District

"The technology for first aid has just changed so dramatically, with AEDs and everything else, and (the Mobilize Rescue System) is an addition to that." - Doug Emblidge, FOX Rochester

"It's so hard to predict how you will react in times of crisis, or during an emergency. That's why this is so important." - Jennifer Johnson, FOX Rochester

"It's also good to know, when we send our kids off to school, you trust that they're in good hands and you feel a little bit more confident that they've got (the Mobilize Rescue) technology there." - Alexis Arnold, FOX Rochester

"Safety comes first... I think it's important for people to feel a comfort, and to have hope that they can help until emergency responders can arrive on the scene." - Superintendent Kim Ward, Gates Chili Central School District

Learn more about the #Mobilize1Million campaign, and how you can sponsor and empower your school, workplace, community, or family to save lives.

Happy 100th Birthday Occupational Therapy!

by Dr. Raymond Heipp


Any birthday is a cause for celebration. blog2_1But a 100thbirthday, that is a cause for ceremonial jubilee! I was honored to attend the 100th birthday celebration for occupational therapy at the American Occupational Therapy Association (AOTA) Conference this past weekend in Philadelphia. It was an amazing time that highlighted the role occupational therapy has played in our lives during the past millennium.


Occupational Therapy is often misunderstood by the public at large because it is lumped into categories which contain other types of therapy. By its very definition, occupational therapy is a therapy which “helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations).” (AOTA Website)

It is a therapy that is good for everyone and can assist in daily life practices. As a former school administrator, I am a big proponent of OT/Sensory breaks in classrooms every day. It is amazing how a brief exercise can increase focus and attention for all of our students, let alone those with differing abilities.

I had the opportunity to speak at length to a highly-respected OT, Susan Wilkerson, or “Miss Sue” as her clients refer to her. We spoke about some of the changes that had occurred in OT over the years. These changes are partially due to a better understanding of the ways in which the human body processes sensory input, and partially due to a stronger level of respect being placed upon the field. OTs have a strong focus on making sure that individuals are able to handle the daily tasks which are encountered each day. During our discussion, I focused on the sensory side of things with her. This is an area which is often overlooked in our classrooms.

“Miss Sue” has recently developed a series of kits that really bring occupational therapy to a new level of engagement in the classroom. Although all of them are extremely well-designed and thought out for the classroom, I wanted to focus on three that made an impression on me. All three of these kits would be items I would encourage my teachers to use, no matter the grade level or the course.blog2_2

I was amazed at the School Health Bilateral Brain Breaks Kit. This kit includes items that one would normally see out on a playground. For example, the “Skip-a-Long” is a toy placed on the ankle that encourages jumping and coordination. I remember seeing similar items on playgrounds as far back as the 1960s. And, here they are again playing an important role in getting both sides of the brain to “talk” to each other. I watched in awe as a few of the younger OTs and a couple of children visiting the conference immediately began using it and had fun.

I did not try the Skip-a-Long for fear of a hospital visit, but I did try the “Bungee Jumper” from the same kit. It is basically a foam base and bungee version of a pogo stick. That concept, again, is something that has been around for a long time. Sue shared with me some of the research behind that particular item and one of the ways that this kit can be effective in the classroom. The research demonstrates that a student fighting with attention issues who uses the “Bungee Jumper” for five minutes will bring focus back to their minds for upwards of two hours! Those of us who have worked with students facing attention issues know that five minutes of focus is difficult, but two hours of focus is amazing!

 

blog2_3Another kit that fascinated me was the School Health Yucky Lunch Kit. The small plastic “Lunchbox” holds a piece of “Cheese” with “Mice” crawling through it, a “Banana” with “Banana slugs” in it, “Pasta,” and a few other “Creatures” that would make any adult cringe! But how it captures the attention of students! The activities include pushing the mice through the cheese and placing the slugs in various locations on the banana. While these activities may seem “gross,” they are actually “fine” when it comes to motor activities. (Okay, sorry to my OTs who got that lame joke!) Finger dexterity, motor planning, fine-motor skills, and varied sensory input are just some of the actions occurring while children play with this kit.

blog2_4

The last kit I want to speak of here is the School Health Sensi-Desert Kit. This kit was a hit with almost every OT who stopped by to visit Miss Sue. The specialized sand along with the lizards and snakes who “live” in the sand create a unique feel for those sticking their hands into it. The sand is not the kinetic sand or even real sand as some might expect. It is actually a specialized sand that feels more like soft earth or wet sand without as much coarseness. It was amazing to see so many of the therapists who did not want to stop playing in this sand as it gave positive sensory feedback. With all of these kits, School Health has included the EdTeam Action Guide™. This guide contains creative educational and therapy ideas in language, fine motor strength, coordination, gross motor movement, balance, early concepts, and more - all written by Miss Sue. The goal is to create an environment where anyone can use the kit to its greatest advantage with the students.

Raymond T. Heipp, Ph.D. is a 25+ year veteran of administrations and classrooms for students with differing abilities. He has designed many support programs for various schools and facilities. And, his expertise in assistive technology has enabled him to create updated approaches when working with students and educators. Dr. Heipp firmly believes that everyone, no matter what their ability, has a voice (or spirit) and deserves a chance to succeed. He suggests that we never doubt their abilities!

Happy 100th Birthday Occupational Therapy!

by Dr. Raymond Heipp

Hero-AOTA2017Any birthday is a cause for celebration. But a 100th birthday, that is a cause for ceremonial jubilee! I was honored to attend the 100th birthday celebration for occupational therapy at the American Occupational Therapy Association (AOTA) Conference this past weekend in Philadelphia. It was an amazing time that highlighted the role occupational therapy has played in our lives during the past millennium.

Occupational Therapy is often misunderstood by the public at large because it is lumped into categories which contain other types of therapy. By its very definition, occupational therapy is a therapy which “helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations).” (AOTA Website)

It is a therapy that is good for everyone and can assist in daily life practices. As a former school administrator, I am a big proponent of OT/Sensory breaks in classrooms every day. It is amazing how a brief exercise can increase focus and attention for all of our students, let alone those with differing abilities.

I had the opportunity to speak at length to a highly-respected OT, Susan Wilkerson, or “Miss Sue” as her clients refer to her. We spoke about some of the changes that had occurred in OT over the years. These changes are partially due to a better understanding of the ways in which the human body processes sensory input, and partially due to a stronger level of respect being placed upon the field. OTs have a strong focus on making sure that individuals are able to handle the daily tasks which are encountered each day. During our discussion, I focused on the sensory side of things with her. This is an area which is often overlooked in our classrooms.

“Miss Sue” has recently developed a series of kits that really bring occupational therapy to a new level of engagement in the classroom. Although all of them are extremely well-designed and thought out for the classroom, I wanted to focus on three that made an impression on me. All three of these kits would be items I would encourage my teachers to use, no matter the grade level or the course.

 

BBBreaksI was amazed at the School Health Bilateral Brain Breaks Kit. This kit includes items that one would normally see out on a playground. For example, the “Skip-a-Long” is a toy placed on the ankle that encourages jumping and coordination. I remember seeing similar items on playgrounds as far back as the 1960s. And, here they are again playing an important role in getting both sides of the brain to “talk” to each other. I watched in awe as a few of the younger OTs and a couple of children visiting the conference immediately began using it and had fun.

I did not try the Skip-a-Long for fear of a hospital visit, but I did try the “Bungee Jumper” from the same kit. It is basically a foam base and bungee version of a pogo stick. That concept, again, is something that has been around for a long time. Sue shared with me some of the research behind that particular item and one of the ways that this kit can be effective in the classroom. The research demonstrates that a student fighting with attention issues who uses the “Bungee Jumper” for five minutes will bring focus back to their minds for upwards of two hours! Those of us who have worked with students facing attention issues know that five minutes of focus is difficult, but two hours of focus is amazing!

 

Yucky LunchAnother kit that fascinated me was the School Health Yucky Lunch Kit. The small plastic “Lunchbox” holds a piece of “Cheese” with “Mice” crawling through it, a “Banana” with “Banana slugs” in it, “Pasta,” and a few other “Creatures” that would make any adult cringe! But how it captures the attention of students! The activities include pushing the mice through the cheese and placing the slugs in various locations on the banana. While these activities may seem “gross,” they are actually “fine” when it comes to motor activities. (Okay, sorry to my OTs who got that lame joke!) Finger dexterity, motor planning, fine-motor skills, and varied sensory input are just some of the actions occurring while children play with this kit.

 

 

Sensi-DesertThe last kit I want to speak of here is the School Health Sensi-Desert Kit. This kit was a hit with almost every OT who stopped by to visit Miss Sue. The specialized sand along with the lizards and snakes who “live” in the sand create a unique feel for those sticking their hands into it. The sand is not the kinetic sand or even real sand as some might expect. It is actually a specialized sand that feels more like soft earth or wet sand without as much coarseness. It was amazing to see so many of the therapists who did not want to stop playing in this sand as it gave positive sensory feedback. With all of these kits, School Health has included the EdTeam Action Guide™. This guide contains creative educational and therapy ideas in language, fine motor strength, coordination, gross motor movement, balance, early concepts, and more - all written by Miss Sue. The goal is to create an environment where anyone can use the kit to its greatest advantage with the students.

 

Snug VestsThere were many more amazing insights taken away from this conference. However, those are for another blog! I do have to say that the prototype version of the new Snug Vest and some of the other items coming down the road from them are very impressive. Those of you who have attended my seminars know how much I appreciate what Lisa Fraser has done in the creation of the Snug Vest and how it is used in a multitude of ways.

As I left the AOTA Conference and Philadelphia, I was definitely on sensory overload! It is good that so many of the tools there though allowed me to get my focus back quickly and drive safely. Happy Birthday, Occupational Therapy! May you continue to grow and expand your reach over the next 100 years!

And thank you too to all of you OTs out there! You make a significant difference in our world and your work is appreciated!

Raymond T. Heipp, Ph.D. is a 25+ year veteran of administrations and classrooms for students with differing abilities. He has designed many support programs for various schools and facilities. And, his expertise in assistive technology has enabled him to create updated approaches when working with students and educators. Dr. Heipp firmly believes that everyone, no matter what their ability, has a voice (or spirit) and deserves a chance to succeed. He suggests that we never doubt their abilities! 

EnableMart Product Review - TheraBand Hand Exerciser

Crush, Pinch, and Grip Your Way To Better Hand Health
by Gabriel Ryan

blog3_1

TheraBand Hand Exercisers are small resistance balls that fit in the palm of your hand. These exercisers can be used to strengthen your grip, increase hand mobility, and improve dexterity. The Hand Exerciser comes in two different sizes standard and extra-large.

I use this type of resistance ball with my physical therapist, Laura, for the following exercises:

  • Reaching

  • Stretching my arms

  • To practice hand grip and release (by transferring the ball from one hand to the other)


"The hand exercisers are good for dexterity exercises and can be helpful to use when recovering from an injury or to build endurance.” Laura Perry, DPT

TheraBand Hand Exercisers are:

  • Made of non-latex polymer

  • Washable with soap and water

  • Useful for cold therapy – just refrigerate for 1.5 to 2 hours

  • Useful for hot therapy – just microwave 5 second increments

  • Helpful for toes and foot strengthening


Here is a quick reference chart that gives you some ideas of exercises you can do with the TheraBand balls.

blog3_2

 

 

 

 

 

 

Which level of resistance is right for you? Check out the following chart:

















Color Red/Red XL Green/Green XL Blue/Blue XL Black/Black XL
Lbs. of Force at50% Compression 3 lbs. 5 lbs. 8 lbs. 17 lbs.

 

You can learn more about and purchase the TheraBand Hand Exercisers and other resistance exercise related products by visiting the EnableMart website.

ATIA 2017 Recap: Accessibility and ATIA

by Dr. Raymond Heipp

The annual Assistive Technology Industry Association (ATIA) conference is an event that always reinvigorates my support for those with differing abilities. Each year I try to focus on areas in which I have the most questions. This year, my focus was accessibility. It was so wonderful to see old accessibility products that have been updated, and new products which cover areas that may not have been previously addressed. Although any blog post cannot do full justice to the impact of devices, let me do my best to give you a view of accessibility at ATIA this year!


Accessibility and Established Products

blog4_1
This year, I found several products that had been updated to bring accessibility to even more people. The first of those items was the TAPit Interactive Platform. Already known for its ability to adjust and adapt, the manufacturers have taken it a step further. The device has always been able to differentiate between intended and that unintended touch.

Now, it is a native multi-touch device that can still have that differentiated ability in two ways:

  1. It relies on conductive properties of the hand or conductive material to interact. Hence, anyone who leans on the screen using sleeves or gloves is not going to affect the touch at all.

  2. The firmware allows the device to recognize that stationary conductive touch as unintended touch – in just one second. This eliminates some of the delays that might have been encountered with the older version of the TAPit.


In all, the changes to the TAPit permit much greater access for all studentsblog4_2 and adults!

I also spent time looking at access for those who need to use a switch, but may not have the capability to effectively use a standard type of switch. Those who know me know that I highly recommend proximity switches to create greater accessibility.

There are really only two proximity switches which I feel comfortable recommending to individuals and those were both present at the show. First, the Candy Corn offers accessibility by proximity with the added benefit of visual and auditory cuing when the switch is activated.
blog4_3
The second switch is another great one and it is the Movement Sensor Switch. This switch has an amazing amount of flexibility and is able to activate upon detecting the slightest movement. I think that this device offers so much flexibility for personal accessibility!

Accessibility and Differentiated Approaches
blog4_4
It was wonderful to meet and speak with the team from Enabling Devices. Seth, Vincent, and Bill have such a strong knowledge of devices and how to make them work for each individual. My favorite device of theirs is listed above and is the Movement Sensor Switch. My next favorite device from them is the Ultimate Switch. This device can be mounted anywhere and needs limited force to be activated. I could have played with it all day.

Ironically, as I was speaking with them, a woman stopped by to ask about it. She had one of the original versions of it, which was still working, and wanted to see some of the updates to it. In listening to her, she described how the ease of interaction created heightened levels of access for her child. A switch should create access, not additional problems to be overcome. The Ultimate Switch offers a universal approach to creating accessibility with any device.

Accessibility is Critical in 2017

You are going to see that I am on an accessibility bandwagon in 2017! I will be travelling the country looking for how we are creating accessible environments for everyone. If you have an accessible environment you want to highlight or have questions as to how to make your location accessible, please contact me at rheipp@schoolhealth.com so that we can schedule a visit. Let’s make 2017 the Year of Accessibility for All!

ATIA 2017 Recap: Accessibility and ATIA

by Dr. Raymond Heipp

The annual Assistive Technology Industry Association (ATIA) conference is an event that always reinvigorates my support for those with differing abilities. Each year I try to focus on areas in which I have the most questions. This year, my focus was accessibility. It was so wonderful to see old accessibility products that have been updated, and new products which cover areas that may not have been previously addressed.

Although any blog post cannot do full justice to the impact of devices, let me do my best to give you a view of accessibility at ATIA this year!

TAPitAccessibility and Established Products

This year, I found several products that had been updated to bring accessibility to even more people.  The first of those items was the TAPit Interactive Platform. Already known for its ability to adjust and adapt, the manufacturers have taken it a step further. The device has always been able to differentiate between intended and that unintended touch.

Now, it is a native multi-touch device that can still have that differentiated ability in two ways:

  1. It relies on conductive properties of the hand or conductive material to interact. Hence, anyone who leans on the screen using sleeves or gloves is not going to affect the touch at all.

  2. The firmware allows the device to recognize that stationary conductive touch as unintended touch – in just one second. This eliminates some of the delays that might have been encountered with the older version of the TAPit.


In all, the changes to the TAPit permit much greater access for all students and adults!

Candy CornI also spent time looking at access for those who need to use a switch, but may not have the capability to effectively use a standard type of switch. Those who know me know that I highly recommend proximity switches to create greater accessibility.

There are really only two proximity switches which I feel comfortable recommending to individuals and those were both present at the show. First, the Candy Corn offers accessibility by proximity with the added benefit of visual and auditory cuing when the switch is activated.

 

Movement Sensor SwitchThe second switch is another great one and it is the Movement Sensor Switch.  This switch has an amazing amount of flexibility and is able to activate upon detecting the slightest movement. I think that this device offers so much flexibility for personal accessibility!

 

 

 

ultimateswitchAccessibility and Differentiated Approaches

It was wonderful to meet and speak with the team from Enabling Devices.  Seth, Vincent, and Bill have such a strong knowledge of devices and how to make them work for each individual. My favorite device of theirs is listed above and is the Movement Sensor Switch. My next favorite device from them is the Ultimate Switch. This device can be mounted anywhere and needs limited force to be activated. I could have played with it all day.

Ironically, as I was speaking with them, a woman stopped by to ask about it.  She had one of the original versions of it, which was still working, and wanted to see some of the updates to it. In listening to her, she described how the ease of interaction created heightened levels of access for her child. A switch should create access, not additional problems to be overcome. The Ultimate Switch offers a universal approach to creating accessibility with any device.

Accessibility is Critical in 2017

You are going to see that I am on an accessibility bandwagon in 2017! I will be travelling the country looking for how we are creating accessible environments for everyone. If you have an accessible environment you want to highlight or have questions as to how to make your location accessible, please contact me at rheipp@schoolhealth.com so that we can schedule a visit. Let’s make 2017 the Year of Accessibility for All!

What You Need to Know About Cardiac Emergency Response

Badge_SH_CardiacEmergencyResponseIn 2015, the American Heart Association (AHA) reported over 326,000 out-of-hospital cardiac arrest events. When cardiac arrest events occur outside of the hospital, the average survival rate is just 10.3 percent.But did you know that survival rates are three times higher if the event is witnessed by a bystander? And when a victim receives assistance, even by a lay bystander, the chances of survival can double, and in some cases triple! [1]

Take Action and Saves Lives

The first minutes of a cardiac emergency are the most critical, and even the best emergency medical services (EMS) personnel can’t reach victims right away. A study in the Canadian Medical Association Journal showed that people who suffer cardiac arrest on the upper floors of high-rise buildings are less likely to survive than those on the lowest floors. The higher floors are associated with longer response times for EMS personnel to reach victims, and they directly correlate to lower survival rates.[2]

But with a Cardiac Emergency Response Plan (CERP), we can help bridge the gap between a cardiac emergency and the arrival of EMS personnel. A CERP is a written document that outlines specific steps to take when a cardiac emergency occurs. According to the AHA, “A carefully orchestrated response to cardiac emergencies will reduce deaths in school settings and help ensure that chaos does not lead to an improper or inadequate response.” [3]

Is Your Cardiac Emergency Response Plan Complete?

Essential parts of a CERP include making sure that you have adequate staff on hand who are trained in CPR. When CPR is performed, even by a lay bystander, a victim’s chance of survival is greatly improved. Products like the AHA’s CPR in Schools Training Kit is an essential tool for training staff and students the proper way to perform CPR.

A CERP will also include making sure your school has enough AEDs, and that your AEDs are properly located. Remember that timing immediately after a cardiac emergency is critical. The number of AEDs at your school should be sufficient to enable your response team to retrieve an AED and respond to a victim within two minutes, both inside the school and on the school grounds. AEDs should have clear signage and should always be in locations that are always accessible. School Health offers a full line of AEDs and accessories to make sure that your school has the equipment you need.

Proper maintenance of AEDs is also critical. Imagine the nightmare scenario of investing in an AED program but not maintaining it. Suddenly a cardiac emergency occurs and your AED is retrieved only to find that the pads or batteries have expired. We hear from people who try to maintain their AED program using an Excel spreadsheet, but that is simply not enough – especially when your campus contains many AEDs or AEDs distributed across campus locations.

School Health Brand AED Program Management helps you manage all the AEDs at your location and even across your campus.  What’s more, this system tracks all your responder certifications so you know that each person on your cardiac emergency response team has proper and continuous training. And, it keeps you compliant with local and state regulations by automatically registering your AEDs with local EMS services. You will even receive direct updates about changes to the regulations in your area.

When you have a complete CERP and include these essential elements, you can save lives when a cardiac emergency occurs. School Health works directly with the AHA to make sure that we can provide the products and information you need to be prepared. If you would like a consultation or on-site visit to discuss your CERP or lifesaving products for your school, please contact us.

[1] http://www.sca-aware.org/sca-news/aha-releases-2015-heart-and-stroke-statistics

[2] http://www.cmaj.ca/content/188/6/413

[3] http://cpr.heart.org/idc/groups/heart-public/@wcm/@ecc/documents/downloadable/ucm_477110.pdf

Get a "GRIP" and Keep On Moving

blog5_1Have you ever been frustrated that items slip out of reach or move around when you need them to stay put? The easy-to-clean, light-weight and flexible GRIP Activity Pad may be the solution you need!


Having used many non-skid pads in the past, I decided to try out the 10” x 15” GRIP Activity Pad for 1 year to see how it would compare. I use a custom tray that connects to the armrests of my wheelchair for eating and participating in various activities regularly. For as long as I can remember, I have always carried a rectangle of non-skid material in my bag to place on my tray to keep items from sliding or rolling away.

blog5_2
My Overall Conclusion:
After using the GRIP Activity Pad for 1 year, the GRIP Activity Pad is an item I will continue to use. Here are some of my favorite features of this product:

  • Non-Slip Pad. The GRIP Activity Pad kept items in place on my tray whether the tray was flat or at a slight angle. I’ve had all types of dishes placed on the pad, as well as grocery items and electronic items. Things stayed where I needed them to on the pad. If your item isn’t too heavy, the pad offers a good grip. I enjoy going to the movies and this pad fit perfectly under the cardboard popcorn container and kept it from sliding away.



  • Easy-To-Clean Material. Using soap, water, and a light scrub the GRIP Activity Pad cleans up like new. I used a small soft bristle brush and simply let the pad air-dry. Within about half an hour the pad was ready for use again and seemed to also gain back some of its grip.



  • Multi-Colored. One characteristic that was useful to me was the pad having a different color on each side; one side black and the other side yellow. Depending on the activity I was doing on my tray, I liked having the option to flip the pad over to visually increase or decrease the contrast. I also like the option to choose the color showing on my tray when going about my daily routine. Sometimes the bright yellow was helpful in situations where I wanted my tray surface to stand out. Other times I preferred the black side since it blended in with the tone of my chair.



  • Portable and Travel Friendly- Traveling with this pad was easy and convenient. I found I was able to roll the pad and place it in my bag and unroll whenever I needed a non-skid surface at my fingertips. As an added benefit, this pad did not loose shape or wrinkle.


Learn more about and purchase the GRIP Activity Pad and other non-skid related products by visiting the SchoolHealth.com website!

This blog was written by EnableMart Blog Writer Gabe Ryan from Sacramento, California. Gabe has used a wheelchair since he was three years old and is an experienced user of assistive technology tools. Some of these tools have been life-changing for him and he looks forward to sharing his experiences and perspectives with our blog readers. Gabe enjoys abstract paintings, is an avid music lover, and enjoys using his iPad and iPhone to connect with family, friends and the community.

Get a "GRIP" and Keep On Moving

badge_sh_gripsolutionsHave you ever been frustrated that items slip out of reach or move around when you need them to stay put? The easy-to-clean, light-weight and flexible GRIP Activity Pad may be the solution you need!


 

Having used many non-skid pads in the past, I decided to try out the 10” x 15” GRIP Activity Pad for one year to see how it would compare.

I use a custom tray that connects to the armrests of my wheelchair for eating and participating in various activities regularly. For as long as I can remember, I have always carried a rectangle of non-skid material in my bag to place on my tray to keep items from sliding or rolling away.

My Overall Conclusion:

After using the GRIP Activity Padgabe for one year, the GRIP Activity Pad is an item I will continue to use. Here are some of my favorite features of this product:

  • Non-Slip Pad. The GRIP Activity Pad kept items in place on my tray whether the tray was flat or at a slight angle. I’ve had all types of dishes placed on the pad, as well as grocery items and electronic items. Things stayed where I needed them to on the pad. If your item isn’t too heavy, the pad offers a good grip. I enjoy going to the movies and this pad fit perfectly under the cardboard popcorn container and kept it from sliding away.



  • Easy-To-Clean Material. Using soap, water, and a light scrub the GRIP Activity Pad cleans up like new. I used a small soft bristle brush and simply let the pad air-dry. Within about half an hour the pad was ready for use again and seemed to also gain back some of its grip.



  • Multi-Colored. One characteristic that was useful to me was the pad having a different color on each side; one side black and the other side yellow. Depending on the activity I was doing on my tray, I liked having the option to flip the pad over to visually increase or decrease the contrast. I also like the option to choose the color showing on my tray when going about my daily routine. Sometimes the bright yellow was helpful in situations where I wanted my tray surface to stand out. Other times I preferred the black side since it blended in with the tone of my chair.



  • Portable and Travel Friendly. Traveling with this pad was easy and convenient. I found I was able to roll the pad and place it in my bag and unroll whenever I needed a non-skid surface at my fingertips. As an added benefit, this pad did not loose shape or wrinkle.


Learn more about and purchase the GRIP Activity Pad and other non-skid related products by visiting the SchoolHealth.com website!

gabeThis blog was written by EnableMart Blog Writer Gabe Ryan from Sacramento, California. Gabe has used a wheelchair since he was 3 years old and is an experienced user of assistive technology tools. Some of these tools have been life-changing for him and he looks forward to sharing his experiences and perspectives with our blog readers. Gabe enjoys abstract paintings, is an avid music lover, and enjoys using his iPad and iPhone to connect with family, friends and the community.

Let’s Talk About Sudden Cardiac Arrest in Schools

october-cardiac-200x300Each year, approximately 7,000 children age 18 or younger experience sudden cardiac arrest outside a hospital with survival rates of less than 10 percent. Immediate CPR can double or triple someone’s chance of survival, which is important for schools since children spend at least one-third of their days in this environment.

Yet only 34 states require CPR training and hands-on practice as a high school graduation requirement and just four mandate school planning for sudden cardiac arrest. That leaves 15 states and the District of Columbia without laws related to CPR, AEDs or cardiac emergency response plans (CERPs) in schools.

Last month, School Nurse published a policy statement from the American Heart Association advocating for state laws requiring the implementation of CERPs in K-12 schools. Cardiac Emergency Response Planning for Schools: A Policy Statement provides a national model for K-12 schools to develop, implement, practice and evaluate a CERP, while addressing the legal aspects and critical nature of training and drills in bringing a CERP to fruition.

The statement recommends that all schools have a CERP in place that contains the following minimum, evidence-based core elements:

  • Establishing a cardiac emergency response team

  • Activating the team in response to a sudden cardiac arrest

  • Implementing automated external defibrillator (AED) placement and routine maintenance within the school (similar to fire extinguisher protocols)

  • Disseminating the plan throughout the school campus

  • Maintaining ongoing staff training in CPR/AED use

  • Practicing using drills (akin to fire and lockdown drills)

  • Integrating local EMS with the plan

  • Ongoing and annual review and evaluation of the plan.


Monica Martin Goble, MD, AHA volunteer and pediatric cardiologist at the University of Michigan Congenital Heart Center, was co-chair of the working group that authored the paper. She says, “Every minute counts in sudden cardiac arrest. The safety of students, school staff and visitors will only be enhanced by school teams that feel empowered to administer lifesaving care until EMS arrives.” 

A key component to high-quality CPR training is a psychomotor component, or hands-on training. Programs like the AHA’s CPR in Schools Training Kit™ enable students to learn the lifesaving skills of CPR in just one class period. Plus, the kit teaches AED use and choking relief. For school administrators interested in developing a plan, a CERP toolkit, including the policy statement and an accompanying “Policy-in-Brief” can be accessed at heart.org/cerp.

This October, we invite you to join the AHA and School Health as we work together to increase survival from sudden cardiac arrest, especially in school settings. #CPRSavesLives

CPR Week: Learn Two Simple Steps to Save a Life

DS-11042 SH CPRWeek Banner-1024x427_jpg (2)

CPR and AED Awareness Week is Every June 1-7


Statistically speaking, did you know that if you are called on to give CPR in an emergency, you will most likely be trying to save the life of someone you love? This could be a parent, child, friend, or a student.

June 1-7 is National CPR and AED Awareness Week. In 2007, the American Heart Association worked collaboratively with the American Red Cross and the National Safety Council to federally designate a National CPR and AED Awareness Week. On December 13, 2007, Congress unanimously passed a resolution to set aside this week each year to spotlight how lives can be saved if more Americans know CPR and how to use an AED. In the declaration, Congress asked states and municipalities to make AEDs more publicly accessible. Schools around the country emphasize the importance of CPR and AED use during this week each year with CPR/AED classes and live events/demonstrations that are conducted.

The AHA invites you to celebrate National CPR and AED Awareness Week in your school. To help get you started, we have created FREE materials that you can print on your school’s printer. Simply visit heart.org/cprweek to access these materials which can be used by themselves or in conjunction with an existing CPR course, like the CPR in Schools Training Kit.

Join the AHA and its Mission to Increase Survival from Cardiac Arrest


We are asking all educators to please take a few minutes out of your day to learn a potentially lifesaving skill. In just 90 seconds, you can learn the two simple steps to Hands-Only CPR by watching this video and sharing the link with your students and co-workers.

Thank you for learning how to save a life!

Free CPR Training Resource Helps Students and Community to Save Lives


Is Your Campus Prepared for a Cardiac Emergency?


Each year, more than 350,000 out-of-hospital cardiac arrests occur in the United States. Cardiac arrest is an electrical malfunction in the heart that causes an irregular heartbeat (arrhythmia) and disrupts the flow of blood to the brain, lungs and other organs.

Survival stats are grim. Over 70 percent of cardiac arrests happen outside of the hospital, which means this can happen anywhere - at home, at work, or even in an educational setting. About 90 percent of people who suffer out-of-hospital cardiac arrests die. And while CPR, especially if performed in the first few minutes of cardiac arrest, can double or triple a person’s chance of survival, only about 46% of people who experience an out-of-hospital cardiac arrest get the immediate help that they need before professional help arrives.

Students play in integral part in increasing survival from cardiac arrest. Currently, 31 states require CPR training, including hands on practice on a manikin, as a high school graduation requirement. As of result of this legislation, approximately 1.8 million students (nearly 60 percent of the U.S. student population) are trained each year in the lifesaving skill of CPR.

Being prepared and confident to respond requires keeping skills as fresh as possible. That’s why the American Heart Association recommends receiving CPR training every two years and why it is currently exploring ways to bridge the gap between mandatory high school training and university-level courses.

Since the needs of university level students differ greatly from the needs of middle or high school students, the American Heart Association has introduced the brand new CPR in Schools University Toolkit. The toolkit consists of free resources for event activation, promotion, and social media resources for student athletes, members of a Greek organizations, resident assistants, student government officers, club members, among others. These resources provide everything needed to plan, organize and execute a CPR training event for students on campus.

Bring CPR Training to Your Campus with AHA's CPR in Schools Training Kit


55583fl_w_3_1The AHA’s CPR in Schools Training Kit is an all-in-one educational program that provides an opportunity for college students to bring Hands-Only CPR training to their campuses. Hands-Only CPR is CPR without mouth-to-mouth breaths. It is the recommended approach for anyone who has not been trained by a credentialed instructor who sees a teen or adult suddenly collapse in an out-of-hospital setting.

This kit allows college students to facilitate Hands-Only CPR trainings with their fellow students and spread the message of Hands-Only CPR. In this leadership role, students teach other students how to save lives.

The training kit comes complete with support from the American Heart Association, the trusted leader in heart health. These kits are easy to use, durable, and are designed to train 10 -20 people at once. The kit is also reusable, so one kit can train hundreds of people. Plus, you do not need to be an AHA instructor which is why thousands of high schools and middle schools throughout the country are currently using these kits. The kit can also be used to train campus faculty, staff and community members to extend the lifesaving skills into the community.

Students learn so much in college, but it’s also important to continue the skills they learned in high school. Please share this with friends and family to make students aware that they can become a part of the generation of lifesavers and help save a life with CPR.

Ask the Expert: Vision Screening with Dr. P. Kay Nottingham Chaplin, (EdD)

Ask The Expert

School Health is pleased to bring you this “Ask the Expert” blog with Dr. P. Kay Nottingham Chaplin, (EdD), director of Vision and Eye Health Initiatives for School Health and Good-Lite, member of the Advisory Committee to the National Center for Children’s Vision and Eye Health (NCCVEH) at Prevent Blindness, and co-chair of the NCCVEH Education/Data Subcommittee.

In this blog, Dr. Nottingham Chaplin will address a few commonly asked questions about vision screening, guidelines, and best practices.  


 

Q: What is the difference between optotype- and instrument-based vision screening?

A:  Optotype-based screening is the name for screening with tests of visual acuity, commonly known as eye charts. Software tests of visual acuity, such as EyeSpy 20/20™, are also available for optotype-based screening. “Optotype” is the name for pictures, letters, or numbers on tests of visual acuity.

Recognition visual acuity is the quantifiable, subjective measurement of the clarity, or clearness, of vision at the brain level when identifying black optotypes on a white background using specific sizes at a prescribed and standardized distance.

Instrument-based screeners neither measures visual acuity nor provide reports with visual acuity values (i.e., 20/XX). Instead, these devices analyze light reflecting from the retina at the back of the eye. This analysis provides information about the presence of risk factors in the eyes that may lead to decreased vision or amblyopia.

Instrument-based screening devices, such as the Welch Allyn® Spot™ Vision Screener, measure both eyes simultaneously and provide objective information about:

  • Significant refractive errors (i.e., hyperopia, myopia, and astigmatism);

  • Asymmetry of the refractive error from one eye to the other, known as anisometropia (for example, one eye may be myopic and the other hyperopic);

  • Misalignment of the eyes;

  • Presence of media opacities (i.e., cataract); and

  • Anisocoria (unequal pupil size).


Q: Do national guidelines or recommendations exist for instrument-based screening?

A: Two national guidelines or recommendations currently exist.

In 2015, the National Expert Panel (NEP) to the National Center for Children’s Vision and Eye Health at Prevent Blindness published recommendations for lay screeners, nurses, and others who screen children in educational, public health, or primary health care settings.

The NEP paper states that when screening children ages 3, 4, and 5 years, instrument-based screening is useful for shy, non-communicative, or preverbal children who cannot participate in optotype-based screening.

A guidance document from the American Academy of Pediatrics (AAP), American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, and the American Academy of Ophthalmology was published in 2016 for screening the vision of infants, children, and young adults. The AAP guidelines are for pediatricians and primary care physicians.

The AAP guidance document states:

  • Instrument-based screening can begin with children as young as age 12 months, although screeners will likely be more successful engaging a child at age 18 months.

  • At age 3 years, distance optotype-based screening may be attempted or the child can be screened with an instrument.

  • At ages 4 and 5 years, either distance optotype-based or instrument-based screening may be used.

  • At ages 6 years and older, optotype-based screening remains the preferred method, but instrument-based screening may be used when children and young adults cannot participate in optotype-based screening.

  • Instrument-based screening may be a helpful alternative when screening children of any age who have development delays.


Q: If I use an instrument, such as the Welch Allyn® Spot™ Vision Screener, do I need eye charts?


A: Screeners cannot successfully screen 100% of children with tests of visual acuity. Similarly, screeners cannot successfully screen all children with an instrument. Reasons may be related to pupil size, environmental lighting, and a child’s ability to fixate on the device’s target.

If you primarily conduct instrument-based screening, you want a test of visual acuity, such as an eye chart or Eye Spy 20/20, as a back-up jto be used if you cannot capture an reading with an instrument. For example, if an instrument has a 90 percent capture rate, a test of visual acuity will enable you to screen the other 10 percent of children the same day.

Whether you prefer optotype- or instrument-based screening, or a combination of the two approaches, a key to successful vision screening is using evidence-based tools and procedures as one of 12 components of a strong vision and eye health system of care. You can also use this checklist to evaluate your annual vision health program.

The right screening tools give us an important leg-up for identifying potential visual impairments. Screening with evidence-based tools helps ensure that we find and treat children with vision challenges so that all can learn and perform to the best of their abilities.
School Health offers a wide variety of optotype- and instrument-based screening tools to meet your needs. Click here to see our full line of vision screening products.

If you have a question that was not answered above, please let us know in the comment section below and we will research the answer.






Keep in touch with Dr. Kay!



For more information and references:
Vision and Eye Health at NASN: https://www.nasn.org/ToolsResources/VisionandEyeHealth

Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology (2016). Visual system assessment in infants, children, and young adults by pediatricians. Pediatrics, 137(1), 1-3. Retrieved from http://pediatrics.aappublications.org/content/pediatrics/137/1/1.51.full.pdf

Cotter, S. A., Cyert, L. A., Miller, J. M., & Quinn, G. E. for the National Expert Panel to the National Center for Children’s Vision and Eye Health. (2015). Vision screening for children 36 to <72 months: Recommended Practices. Optometry and Vision Science, 92(1), 6-16. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274336/pdf/opx-92-06.pdf

Donahue, S. P., Baker, C. N., Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology (2016). Procedures for the evaluation of the visual system by pediatricians. Pediatrics, 137(1), 1-9. Retrieved from http://pediatrics.aappublications.org/content/pediatrics/137/1/1.52.full.pdf

National Center for Children’s Vision and Eye Health, Vision Systems, at http://nationalcenter.preventblindness.org/vision-health-systems-preschool-age-children-0

Nottingham Chaplin, P. K., Baldonado, K., Hutchinson, A., & Moore, B. (2015). Vision and eye health: Moving into the digital age with instrument-based vision screening. NASN School Nurse, 30(3), 154-60. Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/?term=Vision+and+eye+health%3A+Moving+into+the+digital+age+with+instrument-based+vision+screening

Nottingham Chaplin, P. K., & Bradford, G. E. (2011). A historical review of distance vision screening eye charts: What to toss, what to keep, and what to replace. NASN School Nurse, 26(4), 221-227. Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/21877630

Nottingham Chaplin, P. K., Marsh-Tootle, W, & Bradford, G. E. (2015). Navigating the path of children’s vision screening: Visual acuity, instruments, & occluders. Retrieved from https://www.schoolhealth.com/media/pdf/NavigatingVisionScreening.pdf

Year of Children’s Vision at http://nationalcenter.preventblindness.org/year-childrens-vision

Much of the information for this document came from:

Nottingham Chaplin, P. K., Baldonado, K., Hutchinson, A., & Moore, B. (2015). Vision and eye health: Moving into the digital age with instrument-based vision screening. NASN School Nurse, 30(3), 154-60. Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/?term=Vision+and+eye+health%3A+Moving+into+the+digital+age+with+instrument-based+vision+screening

 

 

Develop a Lifesaving Cardiac Emergency Response Plan for Your School

 

Sudden Cardiac Arrest (SCA) affects roughly 326,000 people each year, including over 6,000 youth. During cardiac events, time becomes a critical factor. With each passing minute, an SCA victim’s chance for survival decreases by 7 to 10 percent.

Recently, a study that appeared in the AED Rescue ImageCanadian Medical Association Journal showed that people who suffer cardiac arrest on the upper floors of high-rise buildings are less likely to survive than those on the lowest floors. The study found that less than 1 percent of people above the 16th floor survived a cardiac arrest, while over 4 percent of people on the first or second floor survived. The higher floors are associated with longer response times for EMS personnel to reach victims, and they directly correlate to lower survival rates.

But these first minutes are critical whether a victim of SCA is in a tall building or a small community school. That’s why it’s important for both rural and urban communities to develop a planned response to a cardiac emergency, before the emergency occurs. Having a planned response that is known and rehearsed can help save precious minutes between an SCA event and when a victim begins to receive care.

To help prepare your school for a cardiac emergency, the Sudden Cardiac Arrest Foundation recommends having a Cardiac Emergency Response Plan in place. A Cardiac Emergency Response Plan is a written plan that establishes what steps to take if an SCA event happens in your school.

According to the SCA Foundation, the Cardiac Emergency Response Plan will help make sure that you can respond efficiently and effectively when a cardiac emergency occurs. Quick action in the first few minutes of a cardiac emergency, even by lay bystanders, can double or even triple a victim’s chance of survival.

With a Cardiac Emergency Response Plan, you can:

  • Identify a Cardiac Emergency Response Team – The Cardiac Emergency Response Team should include staff members with CPR/AED training, the school nurse, school administrators, health and physical education teachers, athletic directors, athletic trainers, coaches, and event advisors. Each member of the team should be familiar with the plan, and provide evaluations and updates as necessary.

  • Properly Place AEDs – The number of AEDs placed at a school should be sufficient to enable the response team to retrieve an AED and respond to a victim within two minutes of notification, both inside the school and on the school grounds. AEDs should have clear signage and should always be in locations that are accessible at all times. School Health offers a full line of AEDs and accessories to make sure that your school has the equipment you need.

  • Ensure AED Readiness & Maintenance – AEDs should be regularly checked and maintained according to manufacturer’s recommendations. Schools should designate a specific contact to verify AED readiness and maintenance. In addition, resuscitation kits - including latex free gloves, a razor, a pair of scissors, antiseptic wipes, and a CPR barrier mask – should accompany all AED devices

  • Establish Emergency Response Protocol – The Cardiac Emergency Response Team should establish a protocol to follow in case of a cardiac event. The protocol should include properly recognizing the signs of cardiac arrest, calling 911 and assigning someone to meet the emergency responders, starting CPR, and using an AED.

  • Train Staff for Cardiac Events - The sooner an SCA victim receives care, including bystander CPR, the more likely they are to survive. An effective Cardiac Emergency Response Plan calls for at least 10 percent of school staff – including the school nurse – to be trained in CPR and AED use. This training should include both cognitive and hands-on practice, with continuous training that helps to ensure readiness in the event of a cardiac emergency. Products like the AHA’s CPR in School Training Kit can help ensure that your staff has the training that they need.

  • Notify Parents – The Cardiac Emergency Response Team should notify parents that the school has adopted a Cardiac Emergency Response Plan, and encourage parents to be trained in CPR/AED use.


These carefully orchestrated responses to cardiac emergencies will help reduce deaths in school settings and can help ensure that chaos does not lead to an improper or inadequate response.


For more information about Cardiac Emergency Response Plans and insightful SCA information, please visit the Sudden Cardiac Arrest Foundation.

Worried about lice outbreaks? Don’t lose your head.

As students with their winter hats and caps return to school from break, we’ll see another visitor come with them: head lice.


badge_lice_outbreak2

Winter is a more active time for lice outbreaks as children have more close contact and often share coats, scarves, and hats with one another. And as lice outbreaks increase, so does the news around them. Lately parents and health professionals have been bombarded by over-hyped information campaigns about “super lice.” When we hear “super lice” we immediately conjure mental images disgusting bugs that are bigger and stronger than any kind of lice or nit that we’ve seen before. We picture them crawling around the scalps of children and jumping menacingly as they spread among the children of the school.

We naturally become concerned for the welfare of children when they hear these fear-inducing names. We look for ways to respond quickly, and with brutal force – hoping to prevent the spread of infestation.  However, this response can sometimes create problems where none existed before.

Know the facts - “Super lice” are actually treatment-resistant lice with a media-hyped name. As an example, think of infections that are resistant to antibiotics. Treatment resistant lice are created in much the same way – through improper use of chemical applications or prescription treatments.

Interestingly, treatment resistant lice are not a new phenomenon. These kinds of lice have been present in schools for over 40 years.


Campaigns and media stories about super lice contain pieces of information that, while factual, are dangerous when taken without context. This can breed fear and cause further problems. For example, improper treatment with harsh chemicals and pesticides is one of the ways that treatment-resistant lice have become stronger. And sometimes parents resort to home remedies such as mayonnaise or olive oil that are not scientifically proven to be effective in treating lice. That's why manual removal through combing is a critical part of treating any lice infestation.

Combing is the only safe and effective method to end infestations especially for lice that are resistant to chemical treatments. School Health is pleased to offer the LiceMeister® Comb, which has the US Food and Drug Administration clearance as a medical device for the purpose of screening, detecting, and removing lice and their eggs (nits). Lice combs are also useful for removing dead nits from the hair in order to reduce diagnostic confusion and the chance of unnecessary re-treatments in the future.

How you can be prepared - Parents should become proactive in the examination and treatment (when necessary) of their children when they are exposed to lice. With proactive examinations, parents are able to identify lice concerns early which makes treatment easier, and helps prevent the spread of lice among students.

Sometimes, identifying head lice can be quite difficult. Using the LiceMeister Comb along with a magnifying lens is recommended to accurately identify lice. It can be easy to confuse nits with dandruff, hair spray droplets, and dirt particles.

  • The best diagnosis is made by finding a live nymph or adult louse on the scalp or hair of a person.

  • Nits attached firmly within 1/4" of the base of hair shafts may indicate an infestation if no moving nits are found. This is not accurate 100% of the time.


Watch for signs of lice - that "Tickly" Feeling Can Be a Sign of Head Lice

Head lice symptoms include:

  • A tickling feeling or a sensation of something moving in the hair

  • Frequent itching

  • Sores from scratching


Oh no, head lice! The National Pediculosis Association (NPA) has identified tips to help parents and schools control head lice without the danger of exposing children and their environment to pesticides and other harsh chemicals.

NPA’s Tips for Parents:

  1. Know how to identify lice and nits in advance of outbreaks. (See NPA’s Critter Card)

  2. Know how to check heads at home so kids can arrive to the group setting lice and nit free. (See NPA’s LiceMeister comb teaching video)

  3. Know your child's school policy on head lice. Policies vary greatly from school to school.


Of course, the best way to treat lice is not to get them in the first place.

What You Need to Know About the Latest AHA Guidelines

New information from the American Heart Association about providing lifesaving care during a cardiac emergency.


 

Resuscitating unconscious boyOn October 15th 2015, the American Heart Association (AHA) released the newly revised guidelines for cardiopulmonary resuscitation (CPR), and emergency cardiovascular care. The AHA continues to emphasize the importance of HIGH QUALITY CPR in an emergency cardiac situation. Effective CPR provided immediately after a cardiac event can double or even triple a victim’s chances for survival.


Studies have shown that people who feel comfortable performing CPR are significantly more likely to attempt life-saving resuscitation. Routine practice is needed in order to get the rhythm down for to perform the proper depth and rate of CPR.



Here are the AHA’s newest guidelines for providing high quality CPR:

 




Single rescuer:





  • The recommended sequence for a single rescuer has been confirmed: the single rescuer is to initiate chest compressions before giving rescue breaths to reduce delay to first compression. The single rescuer should begin CPR with 30 chest compressions followed by 2 breaths.





Single or multiple rescuer:




  • There is continued emphasis on the characteristics of high-quality CPR: compressing the chest at an adequate rate and depth, allowing complete chest recoil after each compression, minimizing interruptions in compressions, and avoiding excessive ventilation.

  • The recommended chest compression rate is 100 to 120 compressions per minute (updated from at least 100/min).

  • The clarified recommendation for chest compression depth for adults is at least 2 inches but not greater than 2.4 inches.





How do you know if you are performing high quality CPR during a rescue? With CPR, practice makes perfect. From manikins to AEDs to CPR masks, School Health offers the products that you need in order to practice proper CPR. We can help you make sure that everyone is properly trained to respond in an emergency cardiac situation.



Watch a video to see how Pasadena ISD is training the next generation of lifesavers!





 




 




Consider the following products for quality CPR and CPR practice:





 






























CiSTrainingKitAHAFullProduct_LS_med The American Heart Association CPR in Schools Training Kit gives you the tools you need to teach the core skills of CPR and AED use in under 30 minutes.
59105_w The CPR RsQ Assist helps the lay responder perform high quality CPR by combining voice commands with a metronome that indicates proper compression frequency.
loopscreengrabgamify-2 When training students or community groups to perform life-saving CPR, School Health recommends the LOOP CPR Training Game. The LOOP uses game-related concepts to create a compelling training experience by showing what’s right and what needs to improve.
prestan_three-adult_v21_1 The Prestan Adult Manikin with CPR Monitor is a way to practice on a life-size manikin, offering a realistic experience to provide better CPR outcomes in emergency situations.
55410 The Prestan CPR/AED Training Kit is available exclusively through School Heath and is the complete CPR/AED training solution. By combining Prestan Manikins, the Prestan AED Trainer, and the LOOP CPR training game, training groups can practice the skills they need to achieve proper rhythm and depth, as well as best practices for proper AED use.
g5_expirationupdate Todays advanced AEDs also provide real-time feedback that offer helpful instructions to guide responders in emergency situations. School Health recommends the Cardiac Science Powerheart G5, the ZOLL AED Plus, and the Heartsine 650P. These advanced AEDs combine ease of use and reliability to help everyone when responding in an emergency situation.




For incredible save stories and insightful SCA information please visit the Sudden Cardiac Arrest Foundation.

4 Tools to Help Children Exercise Their "Speech Muscles"

Enhance speech therapy exercises with these four activities that can accelerate learning and increase performance.


 




















Mirrors


Use a mirror to heighten the child's awareness of how muscles of the mouth are used to produce speech. The mirror provides the child with a visual image of the sounds they are being taught. By using a mirror, the child sees how the lips and tongue work to produce sounds. Children can build speech muscles by looking at a mirror and making funny faces!
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Straws


Give your child a straw and ask her to blow through it. This activity strengthens the lips and cheeks. Some children allow air to escape through the sides of the mouth, and the result is "slushy speech." By blowing through a straw, the child stabilizes the jaw and practices appropriate lip closure.
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Toobaloo


This simple, break-resistant device magnifies voices so students hear themselves clearly while speaking softly. The auditory feedback helps students to focus and hear the sounds that make up words (phonemes) more clearly as they learn to read, spell, or process language aloud. Speech students can use the Toobaloo to help improve their articulation and phonology.
toobaloo

WhisperPhone


Hands-free, acoustical voice-feedback headsets help learners hear phonemes and their own voices more clearly. Whisper Phones strengthen the learning process by intensifying the sound of one's voice and minimizing auditory distractions. Users are able to focus much better on what they are learning and classrooms are actually quieter because children only need to use a soft voice to hear themselves clearly.
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Grant for Teaching CPR in Schools

 

John Meiners Photo 2015_editedThis blog has been written by John Meiners. John Meiners is Executive Vice President of Emergency Cardiovascular Care (ECC) Programs and International Strategies for the American Heart Association (AHA). In this key role, John leads AHA’s global effort to increase survival from cardiac arrest by working toward AHA’s global goal of reducing mortality from cardiovascular diseases and stroke by 25% by 2025.



Creating the Next Generation of Lifesavers


In the United States, 38 people every hour will have a cardiac arrest outside of the hospital. However, only 10 percent of these victims will survive. Seventy percent of the time, cardiac arrests will occur in the home. Lifesaving CPR performed by a bystander can double or even triple a person’s chance of surviving a cardiac arrest. The life you save by performing CPR is most likely to be your own family or friend!


Students play an integral part of increasing survival from cardiac arrest. Twenty-four states now require all students to be trained in CPR, with hands-on practice on a manikin, before graduating from high school. That means approximately 1.2 million students (nearly 40 percent of the U.S. student population) will be trained in CPR each year! The American Heart Association (AHA) is actively involved in helping to create the next generations of lifesavers who will help increase the chance that a cardiac arrest victim has the help he or she needs until paramedics arrive.

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Apply for a Grant to Train Your Students


renditionDownloadIn the first year of the AHA-Ross Dress for Less Stores CPR in Schools Program, we have trained more than 330,000 middle school students in life-saving CPR. Over three years, more than 1,000,000 students in 33 states will learn CPR. For more information about this successful CPR in Schools Program, please visit here.

We are excited to announce our newest grant program for high schools! Because of the generous donation from the Ross Stores Foundation, 250 high schools across the country will receive 2 FREE CPR in Schools Training Kits™ in the 2015-2016 school year. This all-in-one kit contains 10 manikins and materials for school teachers or administrators to train hundreds of students, as well as online resources to make implementation easy. Students learn the core skills of CPR in under 30 minutes, and it contains everything needed to learn CPR, AED skills and choking relief in school classroom settings. The easy-to-use kit utilizes the AHA’s latest science guidelines and it is portable, allowing for easy storage. It was developed for educators, school nurses or even student leaders to train groups of 10-20 students at once in a school setting.

If you’d like to learn more about getting your school involved, visit www.heart.org/rosscprschoolgrant.


Hurry! The deadline for grant applications is September 30th, 2015.

Remember, cardiac arrests can happen to anyone, anywhere, and when you least expect it.


Abby Snodgrass is one of those students that was able to learn CPR in high school and become a lifesaver. This is her story:

Abby was out shopping when she heard commotion on the next aisle. She ran to see what was going on and saw an 11-month-old baby who suddenly stopped breathing. Abby had recently learned CPR at her Hillsboro High school in Missouri and immediately starting performing the lifesaving technique. The baby eventually started breathing again, and emergency responders said if Abby had not acted so fast, the baby might have died.

This is just one of the many great stories of students saving lives through CPR they learned in school, thanks in part to partners like Ross Stores who donate funds to provide grants for hundreds of high schools across the country. While we’ve made some great progress over the years, we also need your help to expand this program across the country! If CPR training is not currently required in your state, join us in supporting legislation at http://becprsmart.org.

We thank you for being such an integral part of creating safer communities. Together, we can increase survival from cardiac arrest.

For incredible save stories and insightful SCA information please visit the Sudden Cardiac Arrest Foundation.

School Nurse from New Orleans Wins $10,000 to Upgrade Her Health Room

Angela_Damico_social_revised2Nurse Angie from Dwight D. Eisenhower Academy is Selected as the 2015 Ultimate Upgrade: Health Room Edition Contest Winner


Her students know Angela Damico fondly as “Nurse Angie.” Every day Nurse Angie cheerfully shows up to her New Orleans office to face another day of bumps, bruises, coughs, splinters, stomachaches, and bee stings. And that’s on a quiet day. Nurse Angie regularly administers prescription medications, and handles the more serious medical issues that come up in her population of nearly 800 young students.

But Nurse Angie works in a small room that also serves as the office for 3 other teachers. The furniture in her office is old and worn, and some of it broken. During examinations, a wiggly fabric screen provides privacy as students come and go from the crowded room.

Yet Nurse Angie works tirelessly without complaining about her equipment or conditions. It is because of this that School Health is pleased to be able to award the Ultimate Health Room Upgrade grand prize to Angela Damico at Dwight D. Eisenhower Academy in New Orleans!

We will work closely with Nurse Angie to provide her a more functional health room that serves her and her students. And, we will keep you updated on the progress along the way.

Here is an excerpt from the entry for Nurse Angie, submitted on her behalf by a colleague:


"Each morning Nurse Angie walks with her cooler to the cafeteria to carry ice back to her office, where she hands out ice packs for bumped heads and “magic” peppermints to settle upset stomachs. She has a continuous stream of customers with complaints ranging from coughs to splinters to bee stings. She administers ADHD, asthma, allergy and other every day prescription medications, and often can be heard calling parents and doctors to remind them to keep things up to date. She handles the many serious medical issues that crop up with our student population of nearly 800…juvenile diabetes, Sickle Cell Anemia, HIV, seizure disorders, psychiatric disorders. She races out of here when necessary to treat fight victims, evaluate sprains and falls and stabilize broken bones on the playground. In between all of these medical emergencies Nurse Angie calls parents to give them a “heads up” on what accident or illness has occurred at school today, or to tell them what to look out for if there has been a head injury.

She conducts hearing, vision and height/weight screenings, scoliosis screenings, brings in doctors and dentists to provide physicals or examinations for our high poverty student population. She prepares first aid kits for field trips and sporting events. She keeps track of immunizations and sports physicals, and each year must organize and file the most enormous mound of paperwork I have ever seen. She educates parents about the children’s medical conditions. She feeds hungry students and counsels those with eating disorders. She hosts children at lunchtime who are allergic to fish and sends out reminder emails to the staff about those allergies.

Nurse Angie does all of this cheerfully, never complaining about the shortage of outlets as she unplugs and re-plugs all of her necessary equipment into the overloaded extension cords. She has no privacy to give injections or examinations. She soothes the children with a pleasant “Oh, my Angel” so that they never complain about the large dents in the collapsing leather beds. Sometimes as I glance into her side of the room I am reminded of that scene in “Gone With the Wind” where all the soldiers are lined up laying on the ground…sometimes there are so many kids in the beds, chairs and in line to see her that I wonder how she keeps her patience.

Dwight D. Eisenhower Academy is located in the Algiers neighborhood of New Orleans, LA. It was originally built in 1970 and operated as a public elementary school run by the Orleans Parish School Board. In August 2005 Hurricane Katrina devastated the city of New Orleans, damaging or destroying nearly all the 128 school buildings. The Eisenhower school building was wind-damaged, but not flooded, and closed for a time following Hurricane Katrina. It reopened as an open enrollment public charter school, and since that time the enrollment has doubled, tripled, and quadrupled. Conditions here at the school are extremely overcrowded and there is no money for building maintenance. The building has never been remodeled.

Nurse Angie needs privacy screens, lockable storage cabinets, file cabinets and a desk that lock, a hot water heater, an ice machine, more outlets, and new exam beds at the very least. Nurse Angie needs to know that someone cares about her as she is so busy caring for others."

Stay tuned for the “after” picture and update from Nurse Angie’s Ultimate Upgrade!

Just Ask Questions: One Strategy Toward Meaningful Outcomes

Our featured blog writer Gabe Ryan was invited to speak about his experiences throughout his educational and professional career. Gabe has used a wheelchair since he was three years old and is an experienced user of assistive technology tools. Some of these tools have been life-changing for him and he looks forward to sharing his experiences and perspectives with our blog readers. 

blog6_1I was recently invited to speak as the Keynote for the Sacramento County Office of Education’s Infant Development Program. This is the ‘early start’ program for our area. Because I was a graduate of this program, the staff was particularly interested in how my life had been and what I had been doing since I transitioned out of their care as a little guy.

As a person who has moved through general education receiving support and services from educational programs, it is exciting to me that the professionals in this field were interested in hearing my perspective. I shared my experience from preschool to high school, my employment, and my activities outside of education. I reflected on different milestones and what I thought were points of interest to those working with our youngest children and their families.

A few months after this presentation another exciting opportunity was offered to me, this time at a state level! I was asked to present to the California Department of Education’s Advisory Commission on Special Education (ACSE) as the student voice of the month. The commission was interested in hearing a student’s perspective on their experience.

Being asked to share at these two events was encouraging. I appreciated the opportunity to share my knowledge, and being a part of their professional development was meaningful to me.

In my presentations I used an analogy that went something like this: each person, be they teacher, parent, service provider, or student is like a cog in a giant machine. I feel this is an important key point to continue to share. Some have small parts, some have larger and more complex parts. Some people only know their piece of work, while others know everything about the giant machine. But regardless of their position everybody involved is crucial to the outcome.

Service providers may not always see an outcome immediately or directly. But their work in combination with other providers, systems, and parents can be a huge part of advancing to a positive outcome for a student. These outcomes could be months or years down the road, sometimes figuring things out or reaching goals takes time.

I am fortunate to have continued opportunities to share my perspective and ideas. I challenge you to reach out to those you serve and ask how your services have impacted their outcomes, ask for ideas and input on the services you provide. You may find a wealth of resources and knowledge right at your fingertips.

No matter what agency you are from you make a difference and impact those you serve. Working together we create a system that is supportive and encourages learning, independence, and a better quality of life.

Are Your Eye Charts Up to Date? The Evolution of Eye Charts Over the Past 150 Years

StandardizeEyeChartsEye charts are an important part of vision screening, but how did these vision screening tools look in 1915? What about 1862? The answer may surprise you.


 

When you think of the word “Snellen,” you probably think of Snellen’s legacy – the Snellen Eye Chart with the big "E" at the top. This chart continues to hold a place of prominence on many walls in school nurse's offices and in the hallways of medical practices today.

Snellen, a Dutch ophthalmologist, introduced the first version of his eye chart in 1862, as a way to determine visual acuity (Bennett, 1965). Recently featured on CBS Sunday Morning, Snellen's work set a new standard for vision screening. His Snellen Eye Chart and the  Snellen Ratio are still in wide use today.

Before 1862, oculists used varied and sometimes interesting methods to assess visual acuity.

When the first school setting vision screening program began in 1899, a Snellen chart was used. (Appleboom, 1985) Many versions of eye charts have come and gone over the years, and even today's version of Snellen's chart differs from the 1862 version.

But did you know that the time-honored Snellen chart is not the preferred letter chart for testing visual acuity in 2015?

Why is a Snellen chart not the preferred chart of 2015?


 

While Snellen charts revolutionized vision screening programs they do not adhere to national and international guidelines for standardized eye chart design (Nottingham Chaplin & Bradford, 2011). Six guidelines for standardized eye chart design are (Nottingham Chaplin & Bradford, 2011):

  1. Optotypes should be of approximate equal legibility.

  2. Each line on an eye chart should have the same number of optotypes (typically 5).

  3. Horizontal spacing between optotypes should be equal to the width of the optotypes on a line.

  4. Vertical spacing between lines should be the height of the optotypes in the next line down.

  5. The size of optotypes should progress geometrically up or down the chart by 0.1 log units (i.e., 20/32 vs. 20/30).

  6. Optotypes should be black on a white background under good lighting conditions (luminance between 80 cd/m2 and 160 cd/m2).


If you were to draw a line around the outside of the ototypes on an eye chart adhering to the national and international guidelines, you would see a chart with an inverted triangle. Conversely, if you outlined the optotypes on a chart that does not adhere to national and international guidelines, you would see a chart with a rectangle.

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So, look at the eye chart yesyou use. Do you see the inverted pyramid or a rectangle?

What should we use instead of Snellen charts for Vision Screening?


 

Despite many state, public health, & district vision screening guidelines listing Snellen as the preferred chart for school aged children it has been recommended to use Sloan charts for vision screening.

Developed by Louise Littig Sloan, phD, and Dr. Palmer Good, of The Good-Lite Company, the preferred tests of visual acuity for school-aged children and adults use Sloan Letters as optotypes.

Sloan published information about those letters in 1959 (Sloan, 1959). which was later used by vision professionals to design a new, standardized chart in the inverted pyramid format.

It is recommended to switch from Snellen to Sloan charts to ensure an evidence-based test of visual acuity for school-aged children that meets national and international design guidelines for standardized eye charts.

School Health offers a variety of Sloan charts and cards that meet the national and international guidelines. Call us today for a consultation on the Sloan-related screening products that are available to you.

Shop Sloan & Snellen Charts & Cards>>

Request a FREE Vision Screening Consultation>>

Resources:

Appelboom, T. M. (1985). A history of vision screening. The Journal of School Health, 55(4), 138-141.

Bennett, A. G. (1965). Ophthalmic test types. A review of previous work and discussions on some controversial questions. The British Journal of Physiological Optics, 22(4), 238-271.

Nottingham Chaplin, P. K., & Bradford, G. E. (2011). A historical review of distance vision screening eye charts: What to toss, what to keep, and what to replace. NASN School Nurse, 26(4), 221-227.

 

Product Review: Candy Corn and Smoothie Switches

The switches with names that excite the taste buds and entice users with their marvelous features.


There are many switches on the market for people who need alternate ways to access their computers, tablets, toys or games, and other daily living activities. Figuring out which switches are right for your needs can be difficult. Comparison charts such as the AbleNet Access Switch Comparison Chart can be helpful way to know about a variety of switches and their features.

I recently had the opportunity to explore two types of sensitive switches, the AbleNet Candy Corn Proximity Sensor and the Smoothie 125/Smoothie 75 by Pretorian Technologies Ltd.

Candy Corn Proximity Sensor  blog4_2


  • Fits in the palm of your hand

  • Activates without pressing or touching

  • Orange lights activate for visual cues

  • Beeping sound for auditory cues

  • 3.5 millimeter switch jack

  • Can be mounted magnetically


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  • Low profile

  • Entire area of switch operates with a light touch

  • Auditory click when pressed

  • Varied colors

  • Large 125 mm diameter and small 75 mm diameter

  • Three recessed holes for mounting


blog7_2I started by connecting the switches to an AbleNet PowerLink 4 Control Unit to control everyday use items. The switches were ready to use out of the box, and I found them easy to operate.

Independently turning on and off lamps, an oscillating fan and even a handheld mixer (helping mix muffins) was possible using either switch. They were both easy to operate with either light touch or motion. Positioning is always an important consideration when deciding on placement and switch access. Mounting or angling the switch might take a few trials to get it right. The motion access on the Candy Corn is exciting, however you have to be 10 millimeters or closer for this to activate.

While reviewing these two products, I learned that a longtime friend, Justin, is learning to use two-switch scanning. Justin is using switches that are mounted to his wheelchair near the sides of his headrest.  His mom explained, “For Justin, turning his head to the right and left is his most reliable and purposeful movement.” I decided to visit Justin so he could try the Candy Corn Sensor and the Smoothie  switches.

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Here is what Justin’s mom had to say about each:

“Justin can easily turn to the right to click a button type switch, however, his positioning isn’t always exact. I like that the Smoothie switch can be activated with a light touch anywhere on its surface. Justin has a harder time turning far enough to the left to activate a button switch, by positioning the Candy Corn proximity switch within his range of movement, he was able to access his computer games and switch toys without repeated tries.” - Judy Lee

Judy also said that she liked the audio cue of the Candy Corn, which prompted Justin to move his head back to midline. It was wonderful to check these switches out with Justin. With so many ways switches can be used, it was a great opportunity to explore with these lighter touch and proximity tools.

If you are looking for a lighter touch or sensitive switch the AbleNet Candy Corn Proximity Sensor and the Smoothie 125/Smoothie 75 switches might be an excellent option for you.

Learn More about Ablenet Switches at Enablemart>>

This blog was written by EnableMart Blog Writer Gabe Ryan from Sacramento, California. Gabe has used a wheelchair since he was three years old and is an experienced user of assistive technology tools. Some of these tools have been life-changing for him and he looks forward to sharing his experiences and perspectives with our blog readers. Gabe enjoys abstract paintings, is an avid music lover, and enjoys using his iPad and iPhone to connect with family, friends and the community.

How Emergency Oxygen Significantly Changes the Outcome of Medical Emergencies

Badge_OxygenWhen a serious or life threatening emergency arises, there are sometimes additional risks that can prove to be even more harmful than the primary issue. During a physical trauma oxygen can be depleted from the bloodstream, which leaves the victim at an increased risk for shock. Shock occurs when cells and organs are not receiving enough oxygen and nutrients to function properly.

Shock can be caused by any condition that reduces blood flow, or that reduces the amount of available oxygen in the blood. Common causes for shock include:

  • Sudden cardiac arrest

  • Heart attack or heart failure

  • Heavy bleeding

  • Dehydration

  • Severe allergic reactions

  • Spinal injuries

  • Serious injuries


Shock can often be a life-threatening condition affecting multiple organs in the body. Shock requires immediate medical treatment and can quickly escalate the severity of emergencies that may otherwise have not been life-threatening. As many 20% of people who suffer from shock will die from it.

Emergency oxygen helps to treat shock by bridging the gap between the onset of a medical emergency and the arrival of the first responders on the scene. Just like a fire extinguisher, oxygen products can be safely pre-positioned to provide immediate access to medical oxygen during a medical emergency between the onset of the emergency and the arrival of fire & rescue personnel.

According to the National Fire Protection Association (NFPA) response times in the United States for fire & rescue ranges from 6 to 15 minutes from the time of dispatch. The response time can be higher, depending on traffic conditions or rural situations. Emergency oxygen provides immediate application of oxygen to a patient by a by-stander during the first critical minutes between the onset of the medical emergency and the arrival of the fire & rescue personnel.

Emergency oxygen systems are portable and easy to use solutions that focus on providing oxygen to both breathing and non-breathing people who have suffered serious injuries.

The American Red Cross says that emergency oxygen can help to improve the condition of hypoxia (insufficient oxygen reaching the cells) and can also help reduce pain and breathing discomfort.

Did you know?



  • Cardiac arrest in children and adolescents is usually attributed to respiratory causes rather than heart factors.

  • The primary goal of CPR during treatment of sudden cardiac arrest is to provide oxygen to the vital organ, especially the brain.

  • The National Association of School Nurses (NASN) points out that the majority of sudden death in children occurs from respiratory arrest.

  • Emergency oxygen is often overlooked during Sudden Cardiac Arrest incidents where CPR is administered and an AED is present.  While shocking the heart is vital to restart the heart, a lack of oxygen to the brain can prove just as fatal as heart fibrillation.


Emergency oxygen isn't just for use in a Sudden Cardiac Arrest.  Emergency oxygen can also be used for:



  • Asthma attacks

  • Diabetic emergencies

  • Cardiac arrest (post-resuscitation)

  • Chest pain

  • Heat exhaustion

  • Migraine headaches

  • Breathing difficulties

  • Allergy emergencies

  • Seizures

  • Dehydration

  • And many more medical emergencies


90896fl_lg_2School Health offers the OxySure Emergency Oxygen System  as a complete solution to administer emergency oxygen in the event of an emergency. OxySure is a lightweight, portable, and above all SAFE way to have emergency oxygen available, on-demand. This system gives a parent, a bystander, or even the victim themselves the ability to administer lifesaving oxygen when it is needed.

OxySure can help to significantly improve the outcome of a medical emergency. And, it complements the efforts of first responders. We recommend prominent placement of emergency oxygen devices. The most effective placement is alongside an AED device as emergency oxygen is recommended as part of the post-resuscitation process during a cardiac incident.

For more information on OxySure and available accessories for emergency oxygen, contact School Health at 888-323-5465.

Shop All Emergency Oxygen Systems>>







Ryan Eborn Ryan Eborn is from Salt Lake City, Utah, and has worked with School Health and Enablemart since 2010. Ryan graduated from the University of Utah with a degree in Strategic Communication. Since joining the School Health team he has had much experience in the special needs and early childhood fields. Ryan enjoys the rewarding challenge of bringing new tools together with teachers and students so that everyone can perform to the best of their ability. In his off time, Ryan enjoys living in the Rocky Mountains and everything that Utah has to offer, including skiing, hiking, camping and biking.

Scissoring Skills Part 2- The 4 Stages of Scissoring Skills Development

Badge_ScissorsPart2Learning to use scissors in a correct and controlled way takes patience and a lot of practice. For grownups, this is sometimes a skill that we take for granted. Because this is now a simple skill for us, we might expect it to be a simple skill for children too. And, we can sometimes become frustrated when this skill doesn’t progress as quickly as we think it should.

This frustration can introduce angst in to the learning process, which is actually counterproductive for children. Sometimes we feel like we need to “show” children how it’s done for them to understand. But, using scissors effectively is the culmination of a coordination of fine motor skills that we have developed over time.

Understanding the first steps to take and the path by which these skills progress helps us to be patient with children as they work toward their goals.

Stage  1 – Learning to hold the scissors. Children typically can learn to hold scissors between 18 months to 2 years of age. During this stage they will begin by opening and closing scissors with two hands and move to a more mature grasp as time goes by. They may be able to snip paper or a string during this time, and it is often beneficial to practice using a “helping hand” to stabilize the paper while holding the scissors. Cutting at this stage will typically not be directional, and there may not be forward movement of the scissors. Children may also open and close the scissors in an exaggerated manner while they are learning to work with scissors.

Stage 2 – Cutting with lines and curves. Children can progress to cutting straight lines and making curves between the ages of 2 and 4 years. During this stage they will typically start by using the scissors to push a cut across a sheet of paper. It is sometimes beneficial to have children practice cutting small strips of paper during this stage. Using a paper with a heavier weight will provide more stability, which lets the child focus more on operating the scissors, rather than holding the paper. These cuts are not likely to be highly accurate but children will typically be able to have some success with a straight line, and may even begin to turn a paper and make curved cuts as they progress.

Stage 3 – Accurately cutting curves and shapes. Between 4 and 5 years of age children will typically progress to a stage where they are able to cut accurately along curved lines and around shapes. They are able to turn and manipulate the paper as well as the scissors when they follow lines. They will often exercise better control as they open and close the scissors. This enhanced control typically produces smoother and less jagged cuts. At this point most children can work with various weights of paper and may even begin to be comfortable with non-paper materials.

Stage 4 – Mature manipulation and grasp. By ages 5 to 7 years children can generally progress to cutting complex shapes and figures. At this stage, their grasp of scissors and coordination between the cutting hand and the helping hand has become consistent. Most cuts will be made smoothly, without jagged edges or paper tears.

Appropriate expectations and practice are key factors in the progression of scissor skills. Many children progress differently based on their experiences at home or at preschool. EnableMart offers some great products that can give struggling students a leg up, and that help more advanced students perfect their skill.

The Developing Basic Scissor Skills Work Cards detail different steps in scissor skill development. These cards offer exercises appropriate for each level of development and can be photocopied, so that children can re-do exercises or work with the same exercise on different weights of paper.

The Developing Scissor Skills Guide is another great resource to guide scissor skill development from the basic level to the more advanced level.

It is always important to start with the right scissors. EnableMart offers the Child-Safe Scissor Set by Melissa & Doug. These scissors won’t cut clothing or hair, and have safety blades to help prevent injury.

Through patience and understanding, we can support children as they develop this essential skill. If you need help, be sure to contact us for additional resources or products to aid in development

Read Part 1: Five Things Your Children Should Be Able To Do Before They Work With Scissors

Scissoring Skills Part 1: Five Things Your Children Should Be Able to Do Before They Work with Scissors

Badge_ScissorsPart1Using scissors requires the combined use of many skills. Children must incorporate fine motor skills and bilateral coordination with hand-eye coordination. Because coordination of these skills is required, scissor skills tend to develop slowly, and in stages. Sometimes, we have a tendency to become frustrated and try to help by showing how it’s done. But, this “watch-me” approach isn’t as effective in helping children learn effective scissor skills.

Before children learn to use scissors, they should have effectively mastered some basic coordination and motor skills. When kids can perform these basic tasks we can feel more confident in starting to work with scissors.

1. Opening and closing each hand. One of the most basic movements for a child is to grasp something. Newborn infants exhibit the grasp reflex, but that is different than cognitively holding an item. Being able to open and close each hand helps bridge the gap between holding something by reflex and holding something because you want to hold it.

2. Isolating the thumb, index, and middle fingers. Being able to isolate movement between the thumb and fingers is key to being able to hold and manipulate items. (If children aren’t able to isolate their thumb and fingers, having full control over scissors probably isn’t realistic.)

3. Using a fork or a spoon. At feeding time, being able to hold a fork or spoon, and coordinate the movements required to get food from bowl to mouth is important. Using a fork or spoon requires the ability to hold or grasp an object, target a larger area (the bowl), and use muscle memory to make sure that food gets in their mouth instead of on their nose or chin.

4. Control wrists, forearms, and shoulders. Coordinated bi-lateral movement is needed to manage paper and scissors. Children should be able to use and move their wrists, forearms, and shoulders with good control.

5. Using hands in cooperation with each other. Children should be able to use their hands in a coordinated fashion to perform such tasks as taking the lid off of a jar or brushing a doll’s hair. Being able to use one hand to assist the other is a necessary step toward good scissor skills.

Development of these skills may vary depending on individual children, as well as exposure and experience both at home and in a pre-school or daycare setting. It is important to remember patience as these skills develop.

If you feel that development is taking longer than expected, you can sometimes find better results by modifying the tasks or activities that children are doing on a daily basis. Be mindful of incorporating activities that will help to hone motor skills and coordination. Sometimes, it is also necessary to alter our own expectations.

When children continue to have difficulty mastering these skills, screening by an occupational therapist can often be helpful.

Once these skills have been mastered, you are ready to begin to work with children in the development of scissoring skills. Enablemart offers a range of materials to guide you in this development process, including printed guides and development cards, and even scissors that are designed to help children develop scissor skills correctly and safely.

Here are links to a few key products:

Easi-Grip, Mounted Table-Top, Push-Down, & Self-Opening Scissors
Developing Scissor Skills- A Guide For Parents & Teachers
Developing Basic Scissor Skills Work Cards

Read Part 2:  The 4 Stages of Scissoring Skills Development

Multi-Positioning Seat Company Born Out of Need and a Father's Love

Special Tomato, offering special needs products taking the "Dis" from "Disability".                           blog8_1 Read below to find out how the company got its start, and its unique name. 

Carrie Bergeron was born in 1976 to Tim and Peggy Berrgeron. Carrie was their youngest of four children and was born with Down syndrome, a disorder which is typically associated with physical growth delays and mild to moderate intellectual disability, along with characteristic facial features.

In 1976, the information available to parents about Down syndrome was limited. There was less support from the medical community, and social support through understanding and advocacy groups was only just beginning.

Tim and Peggy quickly began to see that many of the things that could help Carrie learn and grow simply did not exist. The lack of available special needs products pushed Tim, an industrial designer, to begin a company that designed products to meet these needs.

Tim began to focus on developing seats that used softer material than had been traditionally available, and that were more durable and aesthetically pleasing. These seats were critical because they offered a way to position a special needs child in ways that facilitated day to day life – making everyday life easier for parents and care givers and more comfortable for the kids in the seats.

But over time, Tim noticed that the traditional materials used in even his seats weren’t as comfortable as they might be. Because special needs children can be seated for sometimes several hours at a time, Tim realized that they should be using a soft material that would breathe, be cleanable, and durable. Through recognition of this need (and through trial and error) the new Soft-Touch material used on today’s Special Tomato chairs was born.

But why the Special Tomato name?


blog8_2One summer evening found Tim in the garden, picking tomatoes in preparation for supper with the family. Carrie went outside to join her dad. She was frustrated and wondering why learning and schoolwork was more difficult for her. And, she wondered why the kids at school would tease her.

Tim recalled the year that Carrie was born, and a “special” tomato that had caught his attention at harvest time. The tomato had a large, smooth bright red side that was enlarged. The large bump on the side was so unique and looked so appetizing, and at supper, they found that tomato to be just as juicy as all the others.

Tim tells Carrie that she is his “special tomato.” Even though she has some differences, the strength of her character and outgoing personality make her just as special as each of her brothers and sisters.

Carrie is well known for her story and for using her gifts to help others as an advocate and a motivational speaker. Learn more by watching her story below:

Learn More about Special Tomato Products


Special Tomato features the Multi-Positioning Seat which offers a soft and lightweight seating solution that is both comfortable and durable.

Other popular seating solutions by Special Tomato include the Hi-Low Multi Position Seating (MPS) System which adds the conveniences of adjustable height and seat pitch.