Instructional History for Treatment Plan

Instructional history pertains to what has worked, what has not, what should be carried over, and what should be left behind. Understanding where a student has been and what approaches have been tried will help guide our treatment plan.

Instructional Design “ADDIE”

The ADDIE model of instructional design is a five-step process to developing iterative learning and training activities.

All five phases:

Analysis

Design

Development

Implementation

Evaluation

All five phases are equally important, but in practice, most effort is often put into the Design and Development stages, while the Analysis, Implementation, and Evaluation phases are often less well done.

Originally it was developed in 1975 by Florida State University for the U.S. Army. ADDIE remains the default instructional design process for many organizations.

https://www.watershedlrs.com/blog/learning-evaluation/addie-instructional-design-model/

https://getsynapse.com/instructional-design-everything-you-need-to-know/

Theory of Multiple Intelligences​ - Dr. Howard Gardner

Picture from https://www.theedadvocate.org/why-is-the-theory-of-multiple-intelligences-so-valuable/

“Intelligence is the capacity to do something useful in the society in which we live.

Intelligence is the ability to respond successfully to new situations and

the capacity to learn from one’s past experiences.”

- Dr. Howard Gardner,

Author of “Frames of Mind and Multiple Intelligences: The Theory in Practice,” 1983

Introduction https://www.literacynet.org/mi/intro/index.html

Theory of Multiple Intelligences, developed by Howard Gardner, suggests that the traditional notion of intelligence, based on I.Q. testing is far too limited. It proposes teachers to be trained to present their lessons in a wide variety of ways using music, cooperative learning, art activities, role play, multimedia, field trips, and inner reflection. Gardner maintains that his theory of multiple intelligences should "empower learners," not restrict them to one modality of learning.

There are 9 intelligences, and we each rank highly on some and lower on others.

The theory outlines nine types of “smart”:

1. = Linguistic intelligence (“word smart”)
2. = Logical-mathematical intelligence (“number/reasoning smart”)
3. = Spatial intelligence (“picture smart”)
4. = Bodily-Kinesthetic intelligence (“body smart”)
5. = Musical intelligence (“music smart”)
6. = Interpersonal intelligence (“people smart”)
7. = Intrapersonal intelligence (“self-smart”)
8. = Existential intelligence (“life smart”), and
9. = Naturalist intelligence (“nature smart”) 

Find out which ones are best matched for your future career!

Assessment: Find Your Strength

https://www.literacynet.org/mi/assessment/findyourstrengths.html

Table 1 Multiple Intelligences development adapted by Nuña del Salvador

http://www.scielo.org.mx/img/revistas/ijcopi/v6n1//2007-1558-ijcopi-6-01-00020-gt1.jpg

Assessments and Interventions for Youth With Brain Injury

Assessment and Treatment of Children with Traumatic Brain Injury 

by Karen McCord, PT

Powerpoint Presentation

https://www.scripps.org/assets/documents/26a_assessment_and_tx_of_children_mccord.pdf

Traumatic Brain Injury Evaluation Guidance PDF

https://www.tn.gov/content/dam/tn/education/special-education/eligibility/se_traumatic_brain_injury_evaluation_guidance.pdf

See Appendix E with Assessment Instruments

This list includes a lot but not all acceptable available measures. The determination of which measure is used in an evaluation is at the discretion of the assessment specialist.

Cognitive

• Wechsler Preschool and Primary Scale of Intelligence- IV
• Wechsler Intelligence Scale for Children-V
• Wechsler Adult Intelligence Scale-IV
• Wechsler Nonverbal Scale of Ability
• Woodcock Johnson Tests of Cognitive Ability – IV
• Kaufman Assessment Battery for Children-2
• Differential Ability Scales-2
• Stanford Binet Intelligence Scales-V
• Wide-Range Assessment of Memory and Learning-2
• NEPSY-II
• Delis-Kaplan Executive Functioning System
• Behavior Rating Inventory of Executive Function: Second Edition

Communication/Language

• Preschool Language Scale-5[JS7]
• Clinical Evaluation of Language Fundamentals-Preschool: 2
• Clinical Evaluation of Language Fundamentals-5
• Oral and Written Language Scales-II

Articulation/Phonology

• Arizona Articulation Proficiency Scale-3
• Clinical Assessment of Articulation and Phonology-2
• Diagnostic Evaluation of Articulation and Phonology
• Fisher Logemann Test of Articulation Competence
• Goldman-Fristoe Test of Articulation-3
• Hodson Assessment of Phonological Patterns-3
• Kaufman Speech Praxis Test for Children

Behavior/Emotional/Social

• Behavior Assessment System for Children-3
• Conners-3
• Conners Comprehensive Behavior Rating Scales
• Social Skills Improvement Rating Scales
• Adaptive Behavior
• Adaptive Behavior Assessment System-3
• Vineland Adaptive Behavior Scales: Third Edition

Check a book 

Traumatic Brain Injury in Children and Adolescents, Assessment and Intervention by Margaret Semrud-Clikeman To buy it: https://www.guilford.com/view-cart

Webinar by ASHA 

Assessments and Interventions in the Schools for Youth With Brain Injury

Functional Independence Measure FIM (adults) and WEE FIM (children) Ratings

With my students

Since I’ve been working with kids on wheelchairs I was curious to learn how the Functional Independence Measure is used with those students. Below is the link I used to make self-notes in case I need the reference. What’s more, I love the clarity and explanation I found there.

Thank you Physiopedia!

https://www.physio-pedia.com/home/

 The FIM  https://www.physio-pedia.com/Functional_Independence_Measure_(FIM)

The FIM uses the level of assistance an individual needs to grade functional status

• from total independence
• to total assistance.

FIM™ is comprised of 18 items, grouped into 2 subscales - motor and cognition.

The MOTOR Subscale includes:

• Eating
• Grooming
• Bathing
• Dressing, upper body
• Dressing, lower body
• Toileting
• Bladder management
• Bowel management
• Transfers - bed/chair/wheelchair
• Transfers - toilet
• Transfers - bath/shower
• Walk/wheelchair
• Stairs

The COGNITION Subscale includes:

• Comprehension
• Expression
• Social interaction
• Problem-solving
• Memory

FIM scores range from 1 to 7.

• 1 = "total assistance with helper” to
• 7 = "complete independence with no helper".
• Scores falling below 6 require another person for supervision or assistance.

Tasks that are evaluated using the FIM include:

• bowel and bladder control,
• transfers,
• locomotion,
• communication,
• social cognition as well as the

following six self-care activities:

• Feeding
• Grooming
• Bathing
• Upper Body Dressing
• Lower Body Dressing
• Toileting

The FIM measures what an individual can perform and not what that person could do under certain circumstances.

FIM Levels:

No Helper

• 7. Complete Independence  (Timely, Safety)
• 6. Modified Independence (Device)

Helper - Modified Dependence

• 5. Supervision (Subject = 100%)
• 4. Minimal Assistance (Subject = 75% or more)
• 3. Moderate Assistance (Subject = 50% or more)

Helper - Complete Dependence

• 2. Maximal Assistance (Subject = 25% or more)
• Total Assistance or not Testable (Subject less than 25%)

The WeeFIM II® System, a pediatric version of the Functional Independence Measure™ (FIM) System; also provides a method to evaluate outcomes for pediatric rehabilitation programs.

The WeeFIM II System measures several metrics of functional ability including 

• Self-care refers to how well a child can feed, groom, bathe, dress, and complete toileting tasks including the management of bowel and bladder.
• Mobility refers to how well a child can transfer in/out of a chair or wheelchair, on/off a toilet, or in/out of a tub or shower. Mobility also includes a child's ability to walk, crawl, or use a wheelchair, and to go up/downstairs.
• Cognition refers to how well a child understands information, expresses themselves, interacts with peers, solves daily problems, and recalls information.

With my students

March - Brain Injury Awareness Month

Brain injuries are unseen and unpredictable in their consequences. Their effects might be very traumatic.

Brain injury affects who the person is and the way the injured person thinks acts and feels. It can change everything about him in a matter of seconds.

Damage to the brain following a traumatic brain injury is permanent because damaged brain cells cannot regenerate or repair themselves however there is hope for functional recovery. This is because functions affected by TBI may be rewired and improved by healthy brain cells.

Things to remember about a person with BI:

• A person with a brain injury is a person first.
• No two brain injuries are exactly the same.
• The effects of a brain injury are complex and vary significantly from person to person.
• The effects of a brain injury depend on different factors such as cause, location, and severity.

Four types of brain injuries:

• Concussions
• Contusions
• Penetrating injuries
• Anoxic brain injuries.

Physical symptoms of brain damage include:

• Persistent headaches.
• Extreme mental fatigue.
• Extreme physical fatigue.
• Paralysis.
• Weakness.
• Tremors.
• Seizures.
• Sensitivity to light.

The Brain Injury Association of America https://www.biausa.org/