NOTES FOR TEACHERS, AIDES and STAFF WHERE A STUDENT WITH MD ATTENDS THE SCHOOL


About the Student:

Q. How do I get information about what the student will need?

A.  There are many sources of information that you are able to utilize. Parents of a student with Muscular Dystrophy know and understand the daily requirements of their student and are therefore often a great resource for you. Also, the student will generally know the daily tasks they require assistance with and how to deal with these challenges. If after speaking to the student and their parents, you need further clarification, you can speak to the student’s Physiotherapist or Occupational Therapist who can advise you of some of the unique items of equipment or services that may be required to assist with integration of the student. If you require information regarding funding you can contact the Education Department who can assist you in gathering all of that information.

Some useful website include:

Department of Education (Victoria)

Australian Independent Schools Victoria

Catholic Education

The MDA can also provide you with information relating to support your student may require. The website is:  old.mda.org.au or call 03 9320 9555

Q. Is it appropriate to ask the student or their parent what assistance they require?

A. Yes! A parent and their student understand what assistance they may or may not require. The family is likely to be very obliging, especially if they see you taking an interest in their student.

Q. Is there a system where information about the student can be consolidated on a regular basis?

A. The system which is commonly used is called a Student Support Group (SSG). Meetings are held on a regular basis and are usually conducted at the school and chaired by the Principal or allocated person.

The aims of the Student Support Group are to:
• ensure that those with the most knowledge of, and responsibility for the student, work
together to establish shared goals for the student’s educational future
• plan reasonable adjustments for the student to access the curriculum
• provide educational planning that is ongoing throughout the student’s school life
• monitor the progress of the student.

Responsibilities of the SSG
In order to achieve these aims it is the responsibility of the Student Support Group to:
• identify the student’s needs
• determine any adjustments to be made to the curriculum
• plan an appropriate educational program
• develop an Individual Learning Plan
• discuss the plan with teachers and provide support to implement the learning plan
• provide advice to the principal concerning the additional educational needs of the student
and the types of resources required to meet these needs
• review and evaluate the student’s program on a regular basis as determined by the group,
and at other times if requested by any member of the group.
Refer to the Curriculum Planning

For further information refer to the Student Support Group Handbook 2009

Q. Who will be involved with the student’s educational needs?

A.  The student’s educational needs are usually addressed by the SSG. The SSG consists of-
• the parent/guardian/carer(s) of the student;
• a parent/guardian/carer(s) advocate (where chosen by the parent/guardian/carer(s));
• a class teacher (primary) or teacher(s) nominated as having responsibility for the student
(secondary);
• the principal or nominee (to act as chairperson); and
• the student (where appropriate).

This will depend on the level of schooling, the student’s abilities and how disabled the student is. Commonly, a student will require the help of an Integration Aide in and outside the classroom to help with both classroom work and normal daily activities. The student’s parents can inform the school if their student is struggling at home with tasks and if their student has appointments both during school hours and of an evening that may disrupt their education.

Q. Should I ask the student’s previous teacher for information about the student?

A. Yes, a student’s previous teacher will be able to pass on important information about any learning difficulties the student may have, how the student behaves in the classroom, the physical needs of the student and how they affect the classroom. The teacher may also be able to pass on information relating to the capabilities of their student and aspects of the curriculum they may try to avoid and strategies used to overcome this.

Q. Am I able to discuss personal issues with the student?

A. Always first check with the family about how much the student is aware of and what they want their student to know. If the student wishes to discuss a personal issue, it is appropriate for you to listen to their concerns and address them appropriately. They may need professional counselling and therefore need to be referred to the student welfare coordinator or the equivalent. They may also only want to vent their frustrations and therefore not require you to take any further action. However please remember that if the student reveals anything to you that you feel is either inappropriate or may endanger themselves or others, you must report this to the appropriate person. Any discussions you may have with your student must be kept strictly confidential.

Q. Am I able to discuss any issues relating to the student with other teachers/integration aides?

A. It is best to only discuss issues about your student with any other teachers or integration aides who work directly with your student. It may be more appropriate to discuss issues about your student at the SSG’s, unless it is an issue which cannot wait until this time and needs immediate attention.

Q. Is there written material about MD that I can read?

A. Yes! Like with all information, there is accurate and inaccurate information available. As you are probably aware, the internet is a terrific resource. When looking on the internet, try to find sites that are reputable and government backed (such as MDA). Most websites that end in .org, .net or .gov generally fit this criteria (but not all!). Be sure to get information from more than one source (if possible) and cross check that the information is the same. This way you know the information you are reading is accurate and up-to-date. Beware of information that is old as this may now be outdated and not accurate. The MDA website has information on many forms of muscular dystrophy on the website. The web address is: old.mda.org.au. You can also contact organizations, such as MDA directly for hard copy documents that can be sent to you.

Q. Do I need to set out some long and short term goals for the student?

A. Like with any student, Short term goals give both the student and teacher something to strive for. This can aid in keeping the student motivated in school work, especially if the student is beginning to loose their abilities.

Long term goals can be a little more difficult, as many muscular dystrophies are progressive and the student may decline very fast. Not achieving these goals due to their disability may cause the student to loose motivation and become depressed. Younger students especially find it difficult to comprehend their condition as it deteriorates as they may not always understand their muscle weakness and loss of function.

Q. What is my role and responsibility as the teacher of a student with MD?

A.  Your obvious role is as an educator. However, you may be required to be an advocate for the student both among his/her peers and school policies. Depending on the circumstances of your school, you may also be required to be an aide for the student, helping them with their daily activities when there are no alternative options available. If you are at any stage uncomfortable with your role, speak to the school principal or add it to the agenda of the next SSG for discussion.

Q. What is my role and responsibility as the integration aide of a student with MD?

A. The role of an integration aide is to provide support to students and schools. Primarily to work with the student and assist them with daily tasks that they are not able to complete independently. The aim of having an integration aide is to enhance school capacity to improve student outcomes and provide continuity of care to all students, and assist in the development of Individual Learning Plans and the defining of appropriate curriculum support.

Q. Will the student work with more than one integration aide?

A. It is possible that the student may work with more than one integration aide in the one year. It depends on your school’s situation and how they have structured the integration in your school.  Often it is a good idea to have more than one integration aide who is familiar with the student in case of absence of the usual integration aide.

Q. Will the student be able to attend excursions or camps?

A. Yes. The student should be able to attend most school camps and excursions. If you are planning a camp or excursion, try to make them as wheelchair accessible as possible. Most educational excursions cater for wheelchairs and many camps have disabled facilities. When planning activities for your camp make sure you have taken your student’s needs and abilities into consideration. If access to particular activities is not possible, make sure you have an alternative. A support person may be required to attend the camp to support the student. Often this is the integration aide.

Q. What strategies can be used to encourage the student to be more independent?

A. Care needs to be taken to ensure that a student is allowed to develop independence of thought and allowed to make choices. You should encourage a student to make a decision by saying “Let me know if you need your jumper on and if you need any help.” Instead of “It’s cold so I’m going to put your jumper on”. As a student matures we need to respect their right to make choices and, like others, to make mistakes.

Health and Well-being

Q. Should I treat or speak to the student differently to other students?

A. Apart from their physical challenges, a student with MD usually goes through the same life stages and development as their peers. The student makes up just one part of the whole class and should be treated as such. Only when the student’s needs inhibit the student’s participation in class should the student be given modified work or different treatment. Remember that often because of lack of function and the inability to keep up with their peers, a student may become frustrated and display aggressive or antisocial behavior.

Q. Is it appropriate for an integration aide to move away from the student when they are engaged in personal conversation with their peers?

A. Yes! Students with  muscular dystrophy still need to act their age. This includes socialising with other students. A student with MD should be encouraged to maintain relationships with his/her peers and should be allowed to act in such a way. The safety of the student must always be taken into consideration when the integration aide moves away from the student.

Q. If the student gets tired what should I do?

A. When a student experiences fatigue, often behavior issues will follow. If this occurs, setting up a “quiet area” where the student can go and have a break away from everything else which is going on can help them settle and re focus on the task. Sometimes it may also be appropriate to assist the student by scribing for them. Remember that students are most tired towards the end of the day and may need more assistance then.

Q. If the student is unwell, is there anything specific I need to do?

A. Be more vigilant if you know your student is unwell. Many muscular dystrophies affect the lungs and a simple cold can turn into something more serious if not dealt with early. Keeping a student indoors is an option in cold weather and if the student has a cold. Monitor the student closely as symptoms can develop very quickly. Discuss the student’s well being and school attendance with the family.

Q. How do I support the student to socialise with their peers?

A. Understanding is the first step. Often peers have misconceptions about conditions such as MD which need to be cleared up. Once the student’s peers understand more about the condition and that there is a person behind the disability, they are more likely to accept them.

Q. Is it appropriate for me to hold onto or lean on their wheelchair?

A. The wheelchair is an extension of the individual as it is integral to their independence and movement. Ask the student if it is ok to hold or lean on their wheelchair before doing so. Take care not to break or damage any part of the wheelchair as they are very expensive pieces of equipment.

Q. Will I need to put an electric wheelchair into manual mode?

A. Generally no. Electric wheelchairs are very easy to maneuver by the person using it when they are in the electric mode; however, they become very heavy to move when in manual. The only time this may not be the case is if the battery on the wheelchair runs out. Putting an electric wheelchair into manual mode for any time other than when the battery runs out, warrants an incident report by Department of Human Services (DHS) as this is deemed a form of restraint.

Q. How should I position myself when I am talking to the student?

A. When talking one-on-one with a student, try to sit at their eye level. It can be very difficult when you have a MD to lift your head to look you in the eyes and can cause fatigue.  The best way is to either pull up a chair or kneel down on the ground.

Transfers/Positioning

Q. Does the student stay in their wheelchair for the entire school day?

A. It really depends on the student and how far their condition has progressed. In the later days of schooling, the student is likely to stay in the wheelchair as they have limited ability to move, however, in the initial stages of using a wheelchair, the student is likely to use the wheelchair for only part of the time.

Q. Is there any reasons why the student will need to get out of their chair?

A. Students may need to get out of their chairs to go to the bathroom or for some classroom activities. They may also need to get out of the chair if the electric wheelchair is not suitable for a specific location.  Whilst the student is able to easily transfer in and out of their wheelchair it may be appropriate to move the student to a different chair to enable them to sit at a table. For the older student who is more reliant on his wheelchair it will be more difficult to move them out of their wheelchair and so this would only occur when it is absolutely necessary.

Q. If the student needs to get out of their chair who can help them?

A. The teacher, teacher’s aide or the integration aide can assist the student to get out of their wheelchair. Sometimes the use of a lifting machine may be required. In some circumstance, a transfer out of the wheelchair may require more than one person.

Q. How do I assist the student to get out of their chair?

A. Seek advice from a trained therapist who knows the student on how to assist the student to get out of their wheelchair. Do not attempt to do this unless you have been shown how to. Once you have been shown how to do this, follow their instructions carefully. Cutting corners can often lead to accidents and you or your student may get hurt.

Q. Will I need to lift the student?

A. There may be times when the student will need to be lifted or transferred so that they can continue to access the classroom environment, the toilet or to follow the exercise regime set by their physiotherapist. In these situations the integration aid or staff member who has been trained to complete transfers or lifts,  will be required to lift the student. However taking into consideration that most public institutions including schools have a no lift policy. Become familiar with the Occupational Health and Safety Policy of your school. It is common that if a student weighs over 25kg a lifting machine must be used for all transfers. When lifting a student under 25kg, make sure to follow all Occupational Health and Safety procedures and instructions from the physiotherapist.

Q. If the student falls, how should I help them?

A. Firstly make sure the student is not hurt. If possible assist the student to get up off the ground. Try not to make a fuss about the student falling and encourage their peers to do the same. Bringing attention to your student falling will only alienate them further and may affect their confidence levels and the way which they are perceived by their peers.  If the student is hurt you must apply first aid protocols and seek help.

Q. How do I know if the student is comfortable when sitting in their chair?

A. Ask! They will be able to tell you if they are comfortable sitting in their chair. Small things, such as the way their clothing is positioned can cause discomfort as the creases rub the student’s body. Their body may also not be positioned in a comfortable way and may need slight adjusting to ensure they are comfortable.

Q. If the student is not comfortable when sitting in their chair how do I assist them to do this?

A. You may need to assist the student with re positioning in their wheelchair if they are not able to do this for themselves. Always ask the student what part of their body needs moving and how to do this. Each person is different and the way they sit or move may be different for each student. If you are still unsure after you have discussed this with your student, consult with the family and/or the therapist who is familiar with him.

Q. If I have any questions in regard to manual handling of the student who can I ask?

A. Usually the student will have access to a physiotherapist or an Occupational Therapist who understands the needs of the student. This therapist will usually sees the student at the school. Arrangements can be made for the therapist to do some training on manual handling which specifically relates to your student. If this is not available, consult the principal of the school to make arrangements for you to complete an external manual handling training session.

Toileting

Q. How do I assist the student to access the toilet?

A. The amount and type of assistance you provide your student depends on what stage the student is up to in their development. In the early stages they will almost always just need assistance to get in and out of their wheelchair, however as their MD progresses and they are less mobile and  not able to use their hands very well you may be required to fully assist with this.

Q. Does the student need any equipment to go to the toilet?

A. Often a student will require the use of an aid to go to the toilet such as a urine bottle or a commode. A urine bottle can be used by men who are unable to stand to urinate. A commode is a chair on wheels that allows for easy transfer from a wheelchair to the toilet. Once the student is on the commode, it can be wheeled over the toilet. The commode can also be used in the shower.

Q. Will I need to move the student from their wheelchair onto the toilet?

A. Your student may require assistance to access the toilet as their condition progresses. In the early stages they may only need to be supervised and with time may regress to requiring much more assistance.

Q. How do I transfer the student onto the toilet?

A. Once the student is no longer able to move themselves over to the toilet; they may require the assistance of an integration aide to help them. If the student is able to stand and weight bear they will usually only require help to guide them with their transfer. If the student is no longer able to weight bear then the use of a lifting machine is required.

Q. Does the toilet area need to have a specific set up to allow for access?

A. Yes. Schools need to be equipped to accommodate wheelchairs. There are disability standards for the set up of toilets which must be adhered to. Schools are able to put in a grant application for Major Works to the Department of Education in your region for the cost of modification to bathrooms etc.

Q. How many times a day will the student need to go to the toilet?

A. This varies from one student to another. It can range from a student not going to the toilet at all during the day and only going before and after school right up to a student needing to go to the toilet several times a day. The student’s toilet needs should be discussed with the student or the family.

Q. How long should I allow for a toilet stop?

A. This depends on how much support the student needs to access the toilet. If the student is still mobile and needs little assistance generally it can be rather quick. However as the student’s condition progresses they will require more time. This is partly because the transfer using a lifting machine can take some time and partly due to the weakened muscle, including bowel and bladder.

Q. When is the best time to have toilet stops?

A. The best time to access the toilet will depend on the curriculum, the student’s needs and the position of the bathroom. This should be discussed  at the SSG, keeping in mind the student’s needs as a priority. Students with MD often have problems with toileting which can often impact on their health; therefore it is important to allow the student the time to use the toilet without rushing them or making them feel like they are missing out on something. If the student is required to leave the class early, make sure the teacher provides the student with any information they may have missed out on.

Q. Can one person assist the student for toilet stops or do we need two?

A. This depends entirely on the needs of the student and the school’s policy. Where possible it is preferable when using lifting equipment to have two persons assist, however it is reasonable to expect that one person who has been trained and is able to contact someone in an emergency assist the student to access the toilet.

Meal Times

Q. What type of assistance will the student need during meal times?

A. The student may be able to feed themselves in some circumstances, but may also require assistance other times. Often students in the later stages of MD will require your full support to eat and drink. Students require assistance because muscles that are used in swallowing and chewing can become gradually weaker. This can increase the risk of dehydration, malnutrition, choking or respiratory infections caused by inhaling food or liquid into the lungs (aspiration).

Q. How can I best help my student during meal times?

A. Cut meals if necessary, using a knife and fork. Big portions of food are usually not handled well and food needs to be downsized. Straws should be used when drinking if the student is not able to hold a cup. Also, drinks may need to be propped up and a straw with a bendy top is usually preferable. Don’t assume you know what the student wants to eat next, ask them what they want next, how much, and if the size of the food is small enough.

Q. Who else can support me with further information?

A. Parents, carers and teacher’s aides may also be able to support you with further information. Often consultation with an Occupational Therapist who knows the student’s abilities is able to offer further advice.

Q. Does the student use any specialised equipment to feed themselves?

A. Sometimes a student may need cutlery that has been adapted. If this is the case, they will have this themselves. Mostly, they will only need a straw to help them drink.
In the later stages a student may have a (PEG) feed system.  Specific Training is required.

Q. Does the student need a separate area to have their meals?

A. Only if it is required for a specific reason. The OT will be able to design a program specific to the needs of the individual. Usually the child will only require either a tray on their wheelchair or a table which is at the right height that they can get under.

Q. Is there anything specific that I should not do during meal times?

A. Don’t force feed the student. Also, to avoid choking, don’t feed the student big chunks of food, wait for them to be ready for the next mouth full and avoid leaving them for too long whilst they have food in their mouths. Also don’t assume the food that the student wants next, ask which food they would prefer next!

Classroom Assistance

Q. How much help does a student need in class?

A. This will depend on the student’s condition. In the case of DMD for example, in the early primary school years, the student may not require much help (if any) from school staff. However as that student gets older, they may require more help as the condition progresses.

Q. Should I encourage the student to do as much as they can themselves?

A. Yes! Promote the student’s independence and allow the student to do as much as they can on their own. Muscular Dystrophies are all progressive and by allowing the student to do as much as they can on their own, you are giving them the chance to experience things that they are likely to not be able to do in the future.

Q. How often will I need to help the student?

A. Once again, it will depend on the condition. You may need to help the student when they perform daily activities such as going to the bathroom, eating and drinking. You may also need to help the student take notes in class. A lot depends on the student and their abilities. Take your lead from the student, their parents and former teachers about when and how much you should help your student. Try to promote independence in the classroom and allow the student to do as much as they can on their own.

Q. Will the student need to use alternate methods of learning and taking information?

A. Like their peers, all students with a muscular dystrophy have unique methods of learning. If one method of learning does not appear to work for that student, try another method. Try to think outside the square and test all different methods of learning as often those that are a little bit away from the norm, work wonders!

Note taking is something that is very likely to be different with a student with  muscular dystrophy. A student may fatigue easily and find it difficult to write for long periods of time. They may therefore require the use of a scribe or a computer to take down the notes that they require.

Q. What are the student’s choices for alternate methods of learning?

A. There are many different learning methods. It is the SSG’s responsibility to create and follow an educational plan which has been created for each individual student.

Q. Who else can support me with further information?

A. A Visiting/specialist teachers may be able to help you in gaining more information about alternate methods of learning. Alternatively you can discuss this at the SSG or contact the Department of Education.

Q. Can the student use a computer?

A.  Yes. The use of a computer can be especially helpful if the student is unable or struggling to write. The use of a computer may allow the student to keep up with the class as they become less tired than they would by writing. Students with more advanced MD can also benefit from the use of a computer, especially if there is disability friendly software available. The use of a computer also promotes independence in the classroom.  

Q. Will I need to write (scribe/note take) for the student?

A. As is the case with many muscular dystrophies, the students abilities may depreciate as they go through schooling. Often a student is capable of taking their own notes at an early age and should be promoted for as long as possible. However, in the later stages of MD, students may find it difficult to write and may need a scribe. Depending on the circumstances of the school, this may be the responsibility of the teacher, the teacher’s aide, a parent or even another student.

Q. Will the student need to check the work that I have scribed before handing it in?

A. Definitely, you want to encourage your student to take ownership of their work, which includes them proof reading their work. You want to make sure you have noted what the student intended to say

Q. Will I need to help the student with setting up of their work station?

A. Depending on the capabilities of your student, you may need to help the student set up their workplace. However, keep in mind you want to promote the student’s independence for as long as possible.

Q. Do I need to stay with the student the entire time or can I move away?

A.  You can move away from the student, so long as they are not position, situation or area that could be uncomfortable or dangerous.

Q. Where is the best place to position the student within the classroom?

A.  Somewhere where the student’s body position is square to the main presentation/board/teacher. Try to minimise the amount that the student looks up and turns their head. This is because this alone can be very tiring for the student.

Q. Should the student be first/last getting in and out of the classroom?

A. Depending on the student’s capabilities, the student may need to leave the classroom early or wait until everyone has left. If a student is in a wheelchair, they may need to leave last so all bags and chairs are pushed in allowing the student to leave the classroom easily. However, if the child is still walking, you may want them to leave the classroom early so they have more time to make it to their next class.

Q. Will the student need special furniture eg table, chair?

A. It is likely that the student will need some special furniture in the classroom. Once a student is in a wheelchair, it is likely that they will need a higher table so that the wheelchair is able to fit under it. Students who are not yet wheelchair dependent may also require the use of a chair specifically designed for them.

Q. How does the school obtain any specific furniture that may be needed?

A. A recommendation by the OT is made to the SSG/ Once it is agreed upon, the equipment is then purchased either using funding allocated to the student via  the  Department of Education’s Program for Students with Disabilities.

Q. How do we provide access to the student when tables in the class are too high eg science, art tables?

A. You may be required to provide a table in the classroom which is height appropriate. Otherwise, you may look at the feasibility of the wheelchair being height adjustable. If the student is able to sit in a high chair, they may need assistance to get on and off the chair and will need to be closely supervised.

Q. Should the teacher provide the student with written notes for the class activity?

A. If the child struggles with writing, then it may be a good idea to prepare written notes for that student. Otherwise someone else could scribe for them. Limiting the amount of writing can help with endurance and fatigue.

Q. Should the student be graded the same as other students?

A. Student’s with MD should be graded on their achievements the same as other students. If they have participated in any way, this needs to be acknowledged.

Q. Are there any exceptions?

A. The only time a student should not be graded is when they have not participated in the activity at all.

Q. Should I expect the student to attend all classes eg PE?

A. The student’s attendance to classes needs to be discussed and negotiated at the SSG meetings. It may be inappropriate or impossible for the student to participate in certain classes. Alternative methods may include, score taking, free study time etc.

Q. What should the student do if they do not attend a specific class?

A. If a student misses a class due to being absent, it is appropriate for the student to gather class work either from the teacher or integration aide.  Make sure the student understands the information that has been given to them.

Q. Will the student need extra time to complete their work or during tests/exams?

A. Yes, it is likely that many individuals with muscular dystrophy will require extra time to help them complete  tests and exams. An application needs to be submitted to VCAA for special consideration in VCE If approved, details will be sent to the school.

Q. Should the curriculum be modified for the student?

A. Yes if they are having difficulties, however as little as possible. Like any other student in the class who is having difficulties, the curriculum may need to be modified to an appropriate level for that student.  Any modifications to the curriculum must be passed through the SSG.

Q. How should the curriculum be modified?

A. It depends on the difficulties the student is having. If the student is having difficulties learning the set work, the teacher must modify the type of work given to the student. If, however, the student is able to complete the work but needs extra time or scribing to complete it, then this needs to be provided so that the student is able to achieve.

Q. Is there anyone who can provide us with advice on how to modify the curriculum and who’s role is it to do this?

A. Yes, OT’s and speech therapists can give you advice on modifying the curriculum. A recommendation is made to the SSG, and the teacher modifies the work to include recommendations from the OT’s and speech therapists.

Q. What happens when the student’s regular integration aide is away?

It is up to the school to have a plan of action if this is to occur. If no one else in the school is able to work with student with a disability and no one else is available, the principal needs to engage the services of an emergency integration aide. This can be done by contacting their regional Department of Education.
Q. Is the student expected to do the same amount of homework as their peers?

A. It depends on the student’s capabilities and medical commitments. In relation to progressive conditions (i.e. get worse over time), a younger student, may have more energy and fewer medical commitments meaning they are more capable to complete set homework tasks. As the student gets older and the condition progresses, the student may have reduced endurance and require more medical attention. This means completing homework tasks may be more challenging and smaller amounts of homework should be considered. Usually it is the quality of the work not the quantity. Also alternative methods to deliver the work must be investigated. For example, word prediction programs, voice recognition programs etc.

Q. Should the student be given extra time to complete their homework?

A. As mentioned above, it really depends on the student’s capabilities and medical commitments. Assess the student’s needs periodically and assess if you feel the student may need more time to complete their assigned homework. Also discuss with the student and their family how much assistance their student is able to have at home to complete tasks. Remember, students don’t always have access to as much assistance at home as they do at school.


INTEGRATION OF THE MUSCULAR DYSTROPHY STUDENT INTO A SCHOOL PHYSICAL PROGRAM


The Importance of Integration

All students, whether disabled or not, have a need to feel part of their peer group. Sport is a great way that students can get involved with each other in a fun and active way. Self esteem is also increased when they feel they are making a worthy contribution. It is easy for MD students to miss out on this opportunity. This is where you can help. In the PE Program, by modifying game rules or using different equipment, you can involve the MD student physically in part of your session. This is important as they are particularly at risk of becoming socially isolated. If play is not possible they should be encouraged to be part of the group by umpiring, scoring and coaching.

Schools are in a unique position, to introduce students to a variety of sports from which they can make decisions as to which community sports they wish to persue. This should be true for MD students too. There are sporting clubs for individuals with MD where games are designed for them and competition is between MD players only. However if MD students are not introduced to these sports at school they may never discover the enjoyment that can be experienced through playing them.

Modified Games

Below is a list of sporting games that form a part of the secondary school curriculum and suggested changes that can be made to include the MD student. Remember that the emphasis should be on enjoyment and play rather than competition for the MD student and the others involved.

1. Softball

Set up a tee (normally used in teeball) and have a lightweight bat and ball for the MD student when it is his turn to bat. (Use a plastic bat, a foam ball, a large rubber ball or plastic ball with holes). These can be purchased from service stations, toy shops or sports stores. This equipment should only substitute normal playing equipment for the MD student. Also give him an opportunity to gace a ball thrown to him (The ball should be bigger and the throw should be much softer).

To overcome weakness in shoulder movements, advise MD students to hold the bat with one hand and swing their wheelchair around. The force of the swing to hit the ball will come from the whelchair momentum, not the strength of their arm. To make it possible for him to reach first base rule that the ball must be thrown to 2 people before it reaches first base.

When fielding, attach a piece of foam to the wheelchair in front of the student’s legs so that they can move around the outside of the diamond and stop the ball. A bike basket could also be attached to the side of the wheelchair so he can move into positions under the ball for a catch. If the ball touches the bike basket on the full the batter is out.

2. Soccer

Include the student in the soccer drills with a big balloon soccer ball or physio ball. These can be purchased from Ansell. MD students can practice headbutting, and kicking using his wheelchair, to other students or the aide.

Half field ballonn soccer, can be played for about 20 minutes to involve the MD student for part of the session. It can also utilise skills the other students have learnt in an easy and fun way. Another option is to divide the class into those who want to play a fun game of balloon soccer with the MD student and those who want to play a full field game of soccer.

2. Hockey

To modify hockey to suit an MD student, quite a few changes need to be made and special equipment must be used. the game can be played in a similar way to soccer. It displayed on an indoor or outdoor netball or basketball court, with five players in each team. Each has a lightweight hockey stick. A plastic ball with holes is used and witches hats can mark the goal area at each end.

3. Golf

For a higher functioning MD student position him forward in a wheelchair to make access to hitting the ball possible. Support his arms to make shoulder movement easier or him, and if necessary allow him to use lightweight hockey stick.

For a lower functioning student limit golf to putting only. Use the practice green at the beginning of the golf course or put the ball at the edge of each putting green and score the amount of hits it takes him to get the ball into the hole (so he does not have to drive it down the range).

4. Orienteering

This is a great sport for MD students to be involved in because it does not require much modification. Because of this MD students are made to feel a part of the group and can compete against the other students on the same level

Prepare well. Organise the course so that a wheelchair can get around it. have simple codes at each checkpoint that can be copied by the MD student.

Have students go out in pairs. This is safer for all the students but particularly for the MD student. encourage the MD student’s partner to allow him to do as much as possible. A compass can be fixed to the arm of his wheelchair with a suction cap or some blue tac. The map can be laid flat and stuck to his table that fits into his wheelchair.

It is understood that modifying games may take away a sense of competition for the other students. Therefore games will need to be played without the MD student being physically involved. However when this occurs engage him in other ways. Encourage him to know the rules well and become a good umpire.

Teaching Umpire Skills

Take time to teach the MD student the rules of each sport. This can be done whilst explaining the rules to the other students. Give them a set of rules and go through these with the student to make sure he understands.

Video replays of the television coverage of sports is another way of teaching sporting skills to students and umpiring skills to the MD student. Student’s learn by example so while the MD student is learning what is required to be a good umpire, his classmates are learning specific skills such as footwork and racket swing.

Umpire with the MD student until he is confident. Give encouragement and praise.

An alarm (for example, a self defense alarm) may need to be used if the MD student cannot use a whistle confortably as he may find it difficult to continually bring it up to his mouth.

Warm U Activities

If it is not possible for the MD student to participate in the whole PE session, it is important for him to be involved for a short time in pre-game activities. Therefore a few activities that specifically involve the MD student and slo help teach skills to the other students has been suggested. However, these are only examples of how activities can be modified.

1. Beanbag Hockey

This game should be played indoors on a wooden court. Divide the group into 2 teams and give each student a number. Use rolled up newspaper for 3 hockey sticks, a beanbag, and 2 chairs for goals. Place the beanbag and 2 hockey sticks in the middle of the chairs and then call a number. The people from each team with that number run to the middle and aim to score a goal for their team by hitting the beanbag under their chair.

Allow the MD student to hold a hockey stick so that he doesn’t have to reach down and pick one up when his number is called.

2. Balloon Volleyball

This game should be played indoors on a wooden volleyball court. Divide the group into 2 teams and have each team stand down their side line except 1 player who stands in the centre of the court with a badminton racket. Play starts when 1 player hits a balloon over the net. After playing he runs to the end of the line and the person at the beginning of the line runs on to the court to play next. Meanwhile the player of the side must try to hit the balloon back over the net. If that player does not get if over the next person in line tries. The side has 3 chances to hit the balloon over. Play continues until one side scores 11 points

3. Obstacle Course

An obstacle course can be set up by using witches hats, chairs, gym mats, landmarks and anything else in the sports store room. Two similar courses can be set up and the class can be divided into two teams. The MD student can be one team and an able-bodied student in a manual wheelchair on the other team. using this method, the competition between the teams will be equal. All the players on each team must complete the obstacle course. the team that finishes first is the winner.

The obstacle course van be modified to teach a number of different skills. An example is to hit a ball with a hockey stick or kick a soccer ball around the course.

Safety Issues.

Some games could possibly be modified for the MD student, but because he is in a wheelchair it would be dangerous to have him on the field competing against other students for the ball. Therefore safety of the other children must be considered.
Safety of the MD student is also important. Remember that :

Balance is easily lost.

Fatigue is a serious hazard. Only moderate exercise should be done.

No strain should be exerted.

Strength exercises are contraindicated.

Consultation with the student’s doctor or parents is recommended to ensure that activities and planned modifications will have no adverse effects.

Although safety of the MD student is essential, it does not mean that he should be over protected. All MD students are likely to fall at some stage but like other individuals recover quickly.

Further Guidelines For Teachers

As integration into normal sport for the MD students is relatively new, you will need to discover their interest and work with them to make participation appealing and accepting. Praise and encouragement are essential in motivating them to be involved.

It is important to have an understanding of which muscle groups are more severely affected and which movements are possible. This allows you to concentrate on what they can do rather than on what they cannot. Through this, their abilities will be strengthened and realistic goals will be obtained.

Do not underestimate what they can do.

Motivate the MD student to participate as much as possible. When the other students go for a jog around the oval or run a cross country event, encourage the MD student to drive around in his wheelchair with them.

Put some thought into how you can modify further sporting activities to allow even some types of participation of the MD student with the group. This is important because as his peers are expanding their experiences and skills in sport, he is progressively becoming limited in his movement and therefore experiences and skills.

The whole class can also be involved in setting the rules so the MD student can participate. In this way competition can still be maintained and the MD student will be accepted by his peers.

Muscular dystrophy progresses at different rates in each MD student therefore each child will have a different degree of muscle weakness. Using the pamphlet will give you an understanding of how to integrate them into a normal sport program, however it is by no means comprehensive. Sport programs must be planned on an individual basis according to the child’s abilities and limitations.

Further Information

Further information on MD and how to integrate the MD student into a normal sport program is available from the Muscular Dystrophy Australia (MDA). It is suggested also that you contact MDA about your MD student and how to use this information effectively for them.

The MDA will also provide information on where to purchase specialised equipment.


Bookmark and Share